October 12, 2011

Seaneen, Time to Change bloggerMark Brown recently wrote a post on the topic of stigma. Stigma surrounding mental health problems is rife in society. Challenging the stigma of mental health problems within society is one of the aims of Time to Change. However, how do we challenge the stigma of our own mental health problems in ourselves? 

I used to be a very prolific blogger on the subject of bipolar disorder. That was, until I was diagnosed with borderline personality disorder. Bipolar disorder, through the visibility of sufferers such as Stephen Fry, could be construed as one of the more acceptable mental health conditions to have. It is associated with great creativity. Borderline personality disorder, however, is a less acceptable condition to have, if anybody knows what it is at all. It is portrayed in the media via the prisms of films like Fatal Attraction, with the terminally attached Glenn Close cutting her wrists as she waits for the disinterested Michael Douglas to call. Within mental health services, its image fares little better. In this study, 84% of mental health professionals said that people with borderline personality disorder were the hardest client group to deal with.

I bought into it. It felt less damning having bipolar disorder attached to my name. Despite borderline personality disorder having a better prognosis than bipolar disorder, I did not want it. It felt like a wound to my very self in the way that bipolar disorder did not. Having gone through a period of over-identification with my initial diagnosis of bipolar disorder, I had begun to feel it was simply something I would live with but did not define me. The change of label challenged my own beliefs about what I had been experiencing. The somewhat negative perception of borderline personality disorder challenged my own perception of what kind of person I was. That it was not something I would simply live with, but something I actually was. I knew I had had traits of borderline personality disorder - particularly when I was younger - but I felt I had worked on them to the point where they were no longer a problem. By the time I learned of my diagnosis, I had not self harmed in over year and was in a stable relationship. And, as a diagnosis can do, it led me to questioning those things.

As I had been active in the mental health movement - and as someone with an interest in mental health which would eventually lead me to become a mental health nursing student - I was very aware of what the common perceptions of borderline personality disorder were. That people with borderline personality disorder were, “difficult”, “manipulative”, “demanding”, “needy”. I burst into tears at my appointment, and then shamefully left the room, as I had not cried more than once in the three years I had been treated. The tears were of shame and of fear. Shame of perhaps being seen as needy and demanding and fear that I actually was. 

I internalised the stigma of a personality disorder. Was I needy? Difficult? Was I damaged? Was my distress at the change of diagnosis an exercise in black and white thinking? I was vocal on the topic of bipolar disorder. When the diagnosis was changed, I wanted to hide. I felt as though I had been misleading people for years. I felt ashamed in a way I had never done so with bipolar disorder. My blogging dwindled, then became non-existent. I felt as though I couldn’t hang out with the bipolar kids anymore I had not identified with the diagnosis of borderline personality disorder in the way I had with bipolar, so I felt unable to talk to people with borderline personality disorder about my experiences, either.

The period of self questioning - and sometimes self criticism - that the rediagnosis bought proved to be valuable. Over time, I realised I had equally bought into the stigmatising views of personality disorders as society at large had. From one diagnosis to another, I hadn’t changed as a person. I was still me. Through recognising this, it helped me to shed the labels I had been given. Having bipolar disorder did not make me a better person than having borderline personality disorder would- nor was it the other way around. It was just a label attached to me in order to guide my treatment, a language with which to describe experience. Whatever I wrote about on my blog still stood, whatever the tag was. They were, after all, my experiences, whatever the diagnosis was. 

Either/or, I have been largely stable in my mental health for some time. This has made it easier to not reflect too much upon labels. I still don’t know what my real diagnosis is, or if I have one at all anymore. It could be one or the other, both, or neither. What I do know now is that it says nothing more about me than the fact that I’m Irish, or that I’m short. Bipolar, borderline, depressed or other, I know it says nothing more about a person than their shoe size. To own your diagnosis can be liberating, but I think one should be careful about letting it own you.     

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