I have just watched Dido, our Golden Retriever - the matriarch of our dog pack and eleven - push our study door open with a large shoe box in her mouth bringing it to us in the hope of a reward. She couldn't see where she was going and her whole body was wagging in the shear delight of the action. She deserved her chicken light strip! She is terrific at retrieving - but as she's got older she doesn't always wait until you ask her for something - she spots a displaced item and brings it anyway. I love her sense of purpose and joy in serving. She has now carried the box down to the utility room with my partner so it can be put there for recycling. She will almost certainly wait until his back is turned and then pick up another piece of cardboard and bring it back down the hall to me. I watch and wait.
Shrove Tuesday - and we are working up to pancakes. As this is my favourite food - I think I might even make some!!
As I prepare for a reflective Lent discerning my future vocation, I also want to share the most up to date information that I can about my mental illness with those who accompany me via these blogs. What I am about to write may not be comfortable to read but I will not be able to fully reflect and discern possible futures unless I am honest about my present and past. Below are some extracts that I have cut and pasted from a more personal letter to those I have been discerning the thought of setting up a Christian community with. I have chosen the sections that explain the diagnosis I have now received and it's implications. I hope this helps clarify and join up the dots as it were. I am hardly used to the idea myself - but I feel the next steps of managing a life long condition are to share what I am learning about myself.
Over the years, especially living with children who have been very badly hurt by others, my partner and I have learnt how 'secrets' can end up unhealthy and painful - we have always tried to live with authenticity and transparency even if at times that have been personally and professionally incredibly costly. So, when illness is about, what's the point in not saying more - just the fear of not being understood. Well, blow that - fear is courage waiting to happen.
So to my extracts:
I am in awe with gratitude at the support and encouragement I have received in recent months. Thank you for the part you have played in that. I have been very humbled.
Getting Better
Fortunately for now there are significantly more ups than downs and my general mood is consistently improved on my new drug cocktail. I have been diagnosed with Borderline Personality Disorder. This is a condition which is most commonly caused by early emotional abuse in childhood or, much less frequently, a period of sustained trauma in adulthood – things like domestic abuse.
This latest acute illness that I have suffered resonates significantly with an understanding of myself as ‘disappearing’ under the pressure of meeting other people’s needs as a priority.
Bordeline Personality Disorder is a condition which affects 1% of the population and of that around 75% of those diagnosed are women. It is diagnosed by a consultant psychiatrist who commonly uses a set of nine pathologies to identify the condition. If a patient exhibits five or more of the behaviours listed, she is diagnosed with BPD. In my case the match was eight out of nine – so I haven’t left a lot of room for doubt!
The main symptoms, which would be obvious to those of you who know and love me to varying degrees, are:
i) Poorly regulated emotions.
ii) Impulsivity.
iii) Impaired perception and reasoning.
iv) Markedly disturbed relationships.
I am not going to go into lots of detail, but will attempt to put some of the above into the context of the me-ness of me as I guess that’s the important part. Remember I am still the Jane I have always been. I am not suddenly different – just more aware of why I react in certain ways in some situations. Frankly, it’s a relief to know why there is a difference – but I am not immune to the stigma that surrounds mental illness particularly this one! On TV just now an advert for a series describes Personality Disorder sufferers as “present day lepers”. (Well, there are at least some encouraging biblical precedents in that one).
First thing I have had to recognise is that some of my earliest life experiences seriously damaged my perception of myself. Many of these issues became very unimportant as I began to experience success in my life choices but they were underlying and showed themselves to me even if not always to others as acute anxiety, poor sleeping, paranoia, over-eating and avoiding emotionally challenging situations which I could not control.
These early fractures in my personality and experience became less ‘acute’ as I got older and wiser – and gained a sense of my value.
I fell into a serious depression in 2002. We decided that a choice had to be made, I gave up my full-time academic career.
My BPD symptoms work out in the following ways. My impulsivity shows at its most acute in over-eating and spending money unnecessarily; also through insomnia and then over-working – hyperactivity; acute feelings of emptiness; anxiety – constantly blaming myself for everything and reckoning that I have done very poorly – even when others are open in their praise; feelings of depression – or imploded anger.
Most of my life there has been a correlation or trigger in physical illness which often depresses me and leads to a period of depression. My present bout of mental illness was in part triggered by a bad fall in June. I was suddenly physically trapped with the reality of my inner most feelings. I am usually suicidal when I become seriously depressed, although I have never attempted to take my own life in reality. This illness brought with it a new way of harming which was to cut myself. This was, at the time, a way of feeling powerful. An effect of the illness is that I feel very disassociated from my physical body – so this reminds me I am here – as it were.
The way my impaired perception and reasoning shows itself is in emotional self-flagulation. Very few things are not my fault and I can rarely genuinely please myself. This used to be easier when I was younger. I seem to have lost the ability to play in recent years and just be spontaneous. I am not only often paranoid in my thinking, but I also do what is often described as ‘magical thinking’ which is characterised as having unrealistic thoughts and beliefs. Most powerfully, my image of mysef is often unstable when I am ill. It takes a lot for me to see myself as gifted – ironic when I have had notable success in enabling others to claim this part of themselves. I see everyone else as very talented.
Lastly, there is the ‘symptom’ of ‘disturbed relationships’. I have had the reputation of being ‘aloof’ in the past and I am a master at avoidance. Interestingly I am very black and white about myself and highly judgemental – but mostly very forgiving, accepting and collaborative in relation to others – sometimes putting myself at serious risk.
That’s the illness and I am not exactly comfortable knowing I have it – but I am learning better strategies all the time regarding coping with it’s symptoms. I have a good drug regime now which works. I see a CPN weekly just now, but this will become less and less frequent in the weeks ahead. An occupational therapist is helping me with confidence issues – doing the things I want to do. I also attend Art Therapy.
I do hope this helps de-mystufy. I am on the mend and I am taking myself seriously for once – and part of that is realising what is important to me. Living and the companionship of friends even beats good health into touch.
The prognosis is that I will, inevitably, have relapses from time to time and the occasional bad day. At the moment I am doing one activity a day and bounce things that make me too anxious – but this is getting better. When I am functioning at a higher level again, I will need to keep an eye out for the early symptoms of a relapse and act quickly. The great advantage now is that this will most probably be pretty uneventful with a revision of medication with the local CPN and regular monitoring. I imagine I will continue to have depressive episodes from time to time – but they are unlikely to be as tortuous as this episode because I am now diagnosed and monitored. The best case is that I settle into periods of fruitful endeavour and manage a more evenly balanced lifestyle which pays full attention to my own needs as a priority. From this position I can not only stay balanced but be available to others.
I will always need to be challenged as to whether I am making healthy decisions in this area.
I will soon be working towards getting a new guide dog – and I was asked what I would like. I have asked for a dog who is as good as Teddy and Rainbow have been at stopping me dead in my tracks and warning me of what they have perceived as an obstacle or danger ahead. I need much the same in my forthcoming life dialogue – honesty, transparency of thought and that we continue to offer in prayer and meditation possibilities and hopes; dreams and realities.
Have a blessed Shrove Tuesday - and a fruitful journey through Lent.
Dear Jane,
Thank you for your honest explanation and reflection on your illness, it has been a great help in understanding a bit more about what you have been and are going through. I hope that it has also helped you to focus on what is important for you in regaining your health and strength. It takes a lot of courage to share your thoughts and reflections with others, because as you have said before, mental illness is so often not talked about openly. Keep believing in yourself, and in what the future holds for you.
Love, Moira
Posted by: Moira Jamieson | 02/06/2008 at 06:53 AM