October 9, 2008

I first came out 28 years ago. My coming out promotional message was that I was happy, sane and well. I was a happy, sane and well lesbian. The coming out process was remarkably simple and painless but it was the era of Greenham Common and second wave feminism. Three years ago I had to work out a new coming out strategy to accompany the onset of what was to become a severe mental illness.

Inevitably the first stage of this was coming out to myself - much harder than coming out as a lesbian to family, friends and colleagues. (And 'the public' through various media appearances.) I had to recognise that what was happening to me wasn't just an unfortunate plummet in confidence about my work skills. It was a fully-fledged depression.

There have been three dimensions to coming out - who to come out to, about what and how. That sounds nice and neat and considered but of course in practice it's just sort of happened. I'd be meeting a friend for coffee, with a fairly firm idea of not talking about my mental illness at all, and then between the chocolate muffin and the white chocolate caramel macchiato, the fact that I've been sectioned has somehow worked its way into the conversation.

I've tried to be careful about what I say to whom, both to protect myself and the other person. Depression, anti-depressants, therapy. All not too tricky to tell people about. The next stage of my decline was much harder. I discovered self-harming as a powerful and addictive coping mechanism. It's the self-harming that's been incredibly painful to tell friends about. I've had to continually check my motives for telling people. Was it simply in the spirit of always being very open with friends about my life? Or to dabble in a spot of awareness-raising? Or to try to come to terms myself with what is a bizarre and mystifying behaviour? Are any or all of these legitimate?

My main method of self-harming is cutting and like many people who cut, the victims are usually my arms. So this creates an unusual factor in relation to coming out as someone with mental health problems. Visibility. If I choose to wear short sleeves in the summer, my scars are highly noticeable. I remain selectively 'out' about revealing the fact or sight of my self-harming. If it's likely to really upset or disturb people, or to cause a diversion of attention (eg in a meeting), I cover-up. Or even, with kids, to lie about the cause of my scars or to explain via the helpfully ambiguous term of having 'scratched myself'.

That takes us up to coming out about having borderline personality disorder. There are a zillion different effective chat-up lines, introductory sentences in a CV, and social opening gambits. “I've got borderline personality disorder" isn't one of them.

That's pretty much the personal side of my story about coming out about the various elements of my mental illness. I've schlepped out the description of coming out to myself and those close to me because I feel unless one has gone through that, it's incredibly difficult if not impossible to tackle being out with strangers. I'm involved in 'public education', through being a Rethink media volunteer. My main mental health work is running Star Wards, a campaign I set up to improve acute inpatients' daily experiences and treatment outcomes. (www.starwards.org.uk). Most of the time I can feel that being a service user adds to the credibility of the campaign. But there's still the sticky business of my BPD. Other things that help me tell people about this are:

  • Writing articles about BPD. It's a bit like 'immersion therapy' for phobias - if you do something on a big scale, smaller incidences of it are less daunting. And I can feel that so many people already know about it, what's one or two more?
  • Having role models. I don't know anyone else with BPD, but there are lots and lots of deeply impressive service users and survivors (like Peter Campbell and Rachel Perkins) that I feel strengthened by their example.
  • Being able to talk to friends and colleagues if I'm feeling insecure.

Also, if you've had experience with coming out to people who care about you, you're likely to be relatively, or even very, confident about your situation. (I have a silent mantra of “It's not my fault" for times when I feel vulnerable to being negatively judged about my illness, especially my self-harming and/or BPD.) That confidence is invaluable when talking with people who don't know you, eg when running a training session for health staff or school kids.

Being out about mental illness can be a bumpy process, but perhaps the most valuable part of it isn't the message that it gives other people. It's that it reinforces in ourselves that being mentally ill is a completely morally neutral condition. And one that has personality strengthening aspects, not least the ability to challenge and remove the imposed stigma that mental illness has acquired.

Finally, I'm lucky that having been out for many years about one socially awkward characteristic, coming out a second time round hasn't been too bad. I hope that you find that being open about your mental health experiences is not only unproblematic but actively empowering and liberating.

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