Recovery and Rainbows

“Careful or you’ll end up with a Borderline Personality Disorder diagnosis”

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“Be careful, because if you carry on acting like this, you’ll end up with a BPD diagnosis” my consultant at St Anns warned me after yet another “incident” caused me to wind up in A&E.

“You don’t want that, do you?” she asked patronizingly. I was somewhat unsure as to whether this was a rhetorical question or if she was genuinely expecting an answer.

Borderline Personality Disorder (BPD) is the outcast…the black sheep of the mental health ‘family’ (albeit a very dysfunctional family!). Frequently passed from pillar to post, flailing headlong into the revolving door to mental health services, many with BPD resort to drastic, self annihilating measures with 80% of BPD sufferers attempting suicide at least once, and 10% of sufferers completing suicide (which is more than 50 times greater than the rate of suicide within the general population).

I had heard the term BPD thrown around in the various mental health assessments I had endured over the years, but it was always followed by an ominous question mark or a vague “to be discussed at a later date” footnote. It seemed that to receive this diagnosis would deem me “untreatable” and subject to a life full of diazepam, crisis teams and professionals who wouldn’t touch me with a barge pole.

Those three letters of the alphabet clumsily clustered together held so much weight, and seemed to have a huge bearing on my future employment prospects and my chances of encountering a mental health service that were equipped to treat Personality Disorders.

Of the myriad of symptoms present in those with BPD, I fit in perfectly (its pretty worrying that this is the only time I’ve “fit in”!). Unstable self image, fear of abandonment, impulsive episodes, chronic feelings of emptiness- all hallmarks of BPD.

I recall an online game I played as a child, where the sheep has to make an arduous journey to cross the road, frantically dodging cars in order to survive. Life with BPD is not all that dissimilar to this game, except that the hazards are not motorized vehicles, they are emotions- and I have to dodge them to get through my day. Some will hit me and surrender me into a state of sheer terror, others will bypass me, slyly biding their time until they have another opportunity to catch me off guard and disable me.

It often feels like an exam that I am destined to fail. I must encounter these hazards and try to cope with them. Be it a seemingly small problem (i.e. missing the bus) or severe problem (i.e. death of a family member) my brain fails to differentiate between the two, and treats them both equally. Things are either right or wrong, I either despise someone or am infatuated with someone. Those with BPD are predisposed to this “black or white” mindset.

As you can probably imagine, this all or nothing approach to various areas of life, does stunt emotional development, and severely affects ones ability to sustain stable relationships. Although being in a relationship with BPD is by no means off the cards, it can be a challenge. Like many individuals with BPD, when I love, I love fully, idealizing partners and friends and obsessing over the intensity of the relationship (imagine the generic anxieties you feel at the start of a relationship, and multiply it by 100, with a delicious side dish of paranoia and self loathing thrown in for good measure- and then you’re edging closer to BPD territory).

Somewhat ironically, BPD embodies a poignant paradox, in that we yearn for closeness, longing for affection, but our endeavours to fill the emptiness inside (e.g. self harm, impulsivity etc.) often drive away those most dear. The constant toying between “go away” and “ no please come back!” can be grating for the partner. We fear abandonment, so we cling on tight, but we fear this person may hurt us, so we spring back like an incredibly volatile elastic band, and often need to be coaxed to trust others.

When I was younger these feelings of anger manifested into actions at an alarmingly quick rate. In fits of rage I would hurl objects across my room (which for a dyspraxic with no spacial awareness probably looked quite ridiculous!), my mind angrily ablaze, as rationality tried its best to extinguish the flames. My younger self was on the rampage, and it was terrifying.

Intrusive thoughts and an inability to regulate my emotions means I was terrified of what I may do in the heat of the moment. There was an irrepressible war inside my mind: rationality vs impulsivity – myself a prisoner as this all transpired within me.

It is difficult to reason with me during any kind of dispute. Seldom have I been composed enough during an argument to discuss things calmly and rationally. Instead the nuance of reasons that lead to an argument are brashly overlooked and replaced with sweeping, reductionist statements, often (accidentally) placing blame.

I am aware that so far, these descriptions I have clumsily pieced together sound like some kind of nightmare tinder bio! However, I cannot reiterate enough that those with borderline personality disorder feel things incredibly deeply, and devote every fibre of their beings to causes and people they believe in. Yes, due to my volatile and often self indulgent nature, I expect that sometimes being in my company is a little like treading on eggshells. But what many people fail to acknowledge is that all these personality traits are universal- rage, paranoia, fear of rejection. Those with BPD are not unusual in experiencing these feelings, we just experience them in a hyper-sensitive way.

“Borderline between what and what?” as Winona Ryders character ponders in the film Girl, Interrupted.

Initially, the term borderline personality disorder was born out of a flawed categorization system. Mental illnesses were categorized as “psychoses” or “neuroses”. Simply put, when BPD was first written about, it failed to fit into either category, and instead teetered precariously on an imaginary tightrope between these two groups of illnesses.

As with most mental illnesses, attached is a varying degree of stigma. Unfortunately, BPD is not quite as publicized as say, anxiety. This is probably not helped by the fact that fictional characters such as Hannibal Lecter have personality disorders*.

*although I am somewhat tempted to scare my friends by wandering round eerily muttering “Clarice!”

I suppose I should be grateful that the title ‘BPD’ is somewhat vague- unlike ‘EUPD’, another term used for this personality disorder, standing for ‘Emotionally unstable personality disorder’. What an excellent way to further perpetuate stereotypes and create stigma! If you tell someone you have an “emotionally unstable personality” you may as well go the whole hog and don a straightjacket.

Although I have only recently been diagnosed with BPD, the disorder was first mentioned in passing at a CPA (care program approach- a meeting to discuss your treatment) when I was an inpatient on an adolescent ward. “Reckless behaviour, impulsive…” the words spun through my head, as I silently expressed my despondency that yet another de-humanizing label was being flung my way. And so a long, arduous journey to this diagnosis ensued. Psychiatrists will not diagnose a minor with BPD, as teenage years are often a period of change, turmoil and generic “you don’t understand me MUM!” angst, and therefore the diagnostic criteria for BPD is considered to be not as reliable or valid in adolescence.

But it is so much more than being a “difficult” teenager, or a brief period of “going off the rails” in your 20’s.

Those fleeting moments that most experience at times- when you say “fuck it”, throwing caution to the wind- be it frivolously spending all your money on something futile (that pair of rollerblades that sit in the garage collecting dust), booking a one way plane ticket, or telling your boss that you think they have no moral compass and embody everything that is wrong with our society (oops)– we all experience these rare moments of impulsivity.

The difference is that in BPD these moments are as regular as Big Ben chiming on the hour, every hour. Fancy getting a tattoo? Sure, lets do it NOW! Feeling low? Why not self medicate with a lethal concoction of anti-depressants and cheap booze?! An unquenchable thirst for adrenaline you say? How about a late night drive at 100mph, windows down and music blaring so loudly you probably deserve an ASBO? You didn’t intend to even leave the flat, but now you’re practically inhaling tequila slammers and flirting with some sleazy, misogynistic guy? Because objectification and attention is still a form of love… right?

Like many who have a map of the mental health system etched into my brain and have seen the inside of ambulances more times than I care to remember- fortunately, I find myself in a very different place today.

If you suffer from BPD you will have undoubtedly heard from those around you (professionals included) how dreadful the disorder is, and how damaging it is to interpersonal relationships. But what about what these people don’t tell you?

BPD is not a life sentence. You will not end up institutionalized and unable to function in the community. You can experience a life where you are pleased to wake every morning and face the challenges each day brings, instead of being hit with waves of dread the minute you open your eyes.

My passion for music, my education, my supportive family, my love for animals, my ability to run, dance (badly), jump, skip. My body that has arms to embrace and eyes to see all that this world has to offer us. I am more than my disorder, and so are you.

But you don’t seem Autistic?

FB_IMG_1554414848450 Last week a good friend of mine asked me what it was that made me, a sociable, chatty individual… autistic.

You may picture a socially-awkward child who has memorized the entire train timetable across the south of England, or the child who tugs down on their sleeves, avoiding eye contact at any cost, retreating into their own hazy world.

But what about the high functioning autistic individuals – the ones who aren’t autistic enough for the autistic crowd, but similarly are too far removed from the neurotypical crowd? The people who still flinch at the shrillness of sirens and are often bombarded with sensory overload, but because of their “normal” motor skills are disregarded by others?

“You don’t look autistic”- a phrase that has been flippantly hurled my way countless times over the years, particularly as I precariously find my footing in the world of adulthood.

Like many ASD people (I am reluctant to use the word “sufferer” as do not want to label myself as the victim), as a child, my ASD was far easier to recognize. The ritualistic, obsessive behaviours I *had* to do. I am not talking about things such as needing to plump your pillows or things done for comfort.

I am talking about regimented sequences of actions that I had to complete- because if I didn’t something terrible could happen- my sister could die, my parents killed in a car crash. To many neurotypicals and rationalists this will seem truly absurd, but I cannot emphasize enough how truly harrowing it is to be a slave to routines that in reality have no bearing on what happens in the world.

The thing is, like many people on the ASD spectrum, I often feel overwhelmed by the outside world. Social situations are complex and confusing- someone says “its nice to see you” and it could fester in my brain for days. Is it actually nice to see me? Or are they just saying that because social etiquette dictates that they should? What was their tone like? Did they look down their nose at me? And so the post-mortem of a friends blasé comment continues for days on end, until the next one comes along. The routines I rely on create some stability in an otherwise chaotic plane of existence.

It is tiring. It is isolating. And most of all it is hugely misunderstood. There were numerous times as a young child that my parents were called in to discuss my behaviour. Often misinterpreted as me being “difficult” or “disruptive” it was often just a side effect of my Autism. (Ps) I am not referring to my teenage years- I will admit that I was often a gobby cow to teachers and the like!) Interests that snowballed into all-encompassing obsessions- my parents annoyance as I yet again launched into a monologue regarding the tallest rollercoasters in the world! (pretty ironic considering as an adult I am scared of heights!). And the deep sadness that ensued upon realizing that none of my peers became so ‘hooked’ on things as I did. None of them felt so deeply, they brushed things off and carried on.

“Sticks and stones may break my bones…” the words of my year 4 teacher Mrs Burton still echo in my head- after a girl named Hortensia* or Allegra (or something equally as ostentatious) teased me for being “weird”. But for children with ASD the words DO matter. These words will plant themselves in your head and be analysed meticulously until every pathway of meaning has been explored.

*Side note: I’m fairly sure Hortensia is now dating a wannabe Tory MP and climbing the greasy corporate ladder so I don’t think I came off too badly from our year 4 spats.

But as an adult, my ASD manifests in different ways- sleeping surrounded by pillows to feel “safe”, relying heavily on routine to feel okay (to many, days off are a welcome guest, however they often fill me with dread as to how I will micromanage the time). On my first date with my boyfriend, apparently I avoided almost all eye contact with him, causing him to think I wasn’t interested! Then there are the social cues, the fragmented inter-personal relationships as a result. I’ve sort of accidentally established a reputation for having “no filter” – people often remark on this with humour, as if I am blunt in a witty, funny way. Admittedly, sometimes this is the case, however, majority of the time it is because I find reading other peoples body language/reactions to conversation very challenging as a result of my ASD.

Even writing this now I am wary of the idea that this could come across as “woe is me”. It’s easier to hide behind a computer screen, cradling a mug of green tea, but communication will always be a fear of mine. It used to be so much of a fear that the school “Sister” (or nurse, in normal speak) gave me these cards, titled “Today I am feeling” where you select the emotion accompanied by an emoji, to flash at people (because nothing abolishes the stigma around Autistic kids like getting them to furiously wave flashcards in other pupils faces!) All jokes aside, it was a kind, but slightly futile gesture. For those with high-functioning autism, who are fully verbal, it is hard to be taken seriously- particularly as a female.

So next time someone opens up to you about their ASD, remember it is a spectrum- and not everyone with ASD fulfils the “loner nerdy boy” stereotype the media has fed us. We, too, are interesting, competent individuals – it may take us a little longer to process certain things, but we appreciate your patience more than you can imagine.

Katie xx

The NHS is forcing the sick to become sicker.

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“But you don’t look like you have an eating disorder?”

When most people think of the term “eating disorders”- one might imagine the stereotype of a skeletal, white, teenage girl, surviving off a staple diet of black coffee and roll ups. There is a dangerous misconception that in order to struggle with an ED, you must be underweight. This view prevents people from seeking help for their illness, but it is not only society’s idea of eating disorders that is at fault. The NHS treatment of ED’s perpetuates the illness itself: diminishing individuals to a mere number. A number that will determine whether you can embark upon the long, arduous road to recovery, or whether you find yourself being routinely rejected from ED services, your weight never quite dropping low enough to get their attention.

There were the times I was still a healthy weight, but would obsessively hoard food, the kitchen cupboard arranged methodically, as I crouched on my knees, carefully slotting the last “Alpen Light” bar into its rightful place. The years I have spent going to ridiculous lengths to hide food packets, for fear of judgement. If my parents found a chocolate bar wrapper in my bin, surely, they’d think me a glutton. Fortunately, as an adolescent I was able to access support through CAMHS but navigating Adult Mental Health Services is something of a conundrum. It almost feels like trying to eat soup with a fork- sometimes you’ll get lucky and the soup will stay put, but majority of the time it slides through the gaps- leaving you unfulfilled and frustrated by the absurd difficulty of such a task.

Arguably, it is more dangerous to have a restrictive ED at a “healthy weight” (according to BMI calculator) as the malnutrition and physical deterioration can go unnoticed for years. When I have been visibly underweight in the past, people told me to eat. They knew I was very unwell, because my gaunt, ghostlike appearance communicated this. If a person at a healthy weight, or in a larger body has a restrictive ED, they are often met with praise regarding weight loss, and various comments about how “I wish I had your willpower!” thrown in for good measure.

We need to somehow change our cultural health paradigm from “weight loss” to “health”. Widespread endorsement of diets to enhance our lives has fostered acceptance of the idea that it is completely acceptable to restrict in an effort to achieve a “healthier” physique.

Those struggling at a higher weight are often patronized and disbelieved, even by so-called professionals. “You’re slim, and on the light side, but you’re ok” my old consultant muttered flippantly, as I stepped off the scale in disgust. This general attitude regarding my weight continued, and as the numbers dropped, along with my sense of worth, I prayed that the system would listen to me.

“Ask for help!” is the rallying cry to those struggling with an eating disorder. But is it not futile to ask for help, when often your request is met with the empty promise of being dumped at the bottom of a lengthy waiting list? – and then six months later a stern looking nurse reeking of cigarettes telling you you’re “not sick enough to qualify for treatment”.

Earlier this year, the NHS published figures to highlight the rise in inpatient admissions in Eating Disorder Services, with numbers more than doubling from 7,260 to 13,885 in the last six years. Beds on a ward are already stretched thin (no weight related pun intended), but it is the outpatients care system that results in patients withering away, finding themselves nosediving the downward spiral, desperate to be deemed valid enough for help.

Although a mental disorder, many ED thoughts result in an unhealthy focus on physical weight- that all important number that flashes up on your scales each morning (yes, scaleS, because your head has somehow convinced you that in order to get an accurate reading you must weigh yourself on three different sets of scales). That same number that pushes you into a frenzy- gulping, sobbing inhalations piercing the silence that the early morning brings for most. That same number that will mean you aren’t sick enough, in a system that perpetuates the illness itself. The doctors treat the sickest, all the while the sick get sicker.

For those who have no experience of an eating disorder- telling someone with an ED that they are not “sick enough for help” is like waving a red flag to a bull. It reaffirms all the poisonous thoughts they battle with on a daily basis, and can spiral someone into a “I’ll show them just how sick I can be” mindset. I, myself am guilty of this. Although I have now been discharged from ED services, I feel if I were struggling, I could only bring myself to seek a re-referral if I were to be medically underweight again (<BMI 18.5), for fear of judgement, but ultimately, rejection.

To summarise, there has been no real purpose of this cluster of words carelessly spilled across this page, however I wish to reiterate that there is no one “look” to having an eating disorder. Please do not let the flaws in the system deter you from pursuing your own recovery in other ways. Please do not feel you have to prove your illness to medical professionals in order to get treatment- it is tempting to, but long term it will inevitably cause more complications. Eating disorders are deadly MENTAL illnesses, and should be treated as such, irrespective of weight.

Dear University, shame on you.

img_20190118_174653_396 Shame on my university for promoting diet culture.

Yes, one cannot dispute the fact that obesity is a prominent issue in the UK- but food shaming and scare tactics is not the way to tackle it. Furthermore, these kind of messages perpetuate disordered eating patterns & obsessive calorie counting. For those that will retort “but overweight people wanting to lose weight need to count calories” – no. No they do not. “Health” can be measured in so many more ways than meaningless numerical digits.

Besides, a calorie is nothing more than a unit of energy, so why is diet culture portraying them to be devious parasites that infect us & “creep up on us”. Just as a car cannot run without fuel, a body cannot function without adequate nutrition, both in terms of food groups, and our basal metabolic rate (the amount of cals we require as a BASE- ie the amount we need for our bodies to perform its everyday functions if we were to lie in bed 24/7 with NO movement).

According to the NHS, the average inactive woman needs MINIMUM 2000 calories per day in order to maintain her weight. This poster, placed strategically in the school cafe, is suggesting a diet of 1600 cals with perhaps a couple of snacks thrown in. The jargon “aim to follow the 400-600-600 rule of thumb” is deeply worrying. For those pre-disposed to eating disorders & compulsive thought patterns- rituals and rules are so easy to latch onto, yet so difficult to dispose of.

Let us take our minds back to the frustratingly catchy, yet inherently detrimental PHE ad for 100 calorie snacks. “100 calorie snacks, two a day max” the rhyming slogan chimes, whilst a cartoon child shops with her Mum. This public health campaign to address obesity, could have a devastating impact on a child relationship with food. A healthy balanced diet is not dictated by calories.

100 calories of skittles seldom reduces feelings of hunger, whereas many healthier snacks eg nuts, are over 100 calories but are more nutritionally beneficial.

As someone who in the past has opted for a diet coke as opposed to a 7up free due to a difference of about 6 calories (?!) I know how easily calorie counting can take you captive and encase you in its prison. I recall hidden journal pages littered with my “distraction techniques” – how to numb my bodies hunger cues when I’d foolishly miscalculated my week of arbitrary calorie restrictions, and wouldnt alllow myself a morsel of food until the next day greeted me.

Calories do not give us worth. They are neither good nor bad. They do not define how healthy someone is, they do not tell us how delectable it is to eat pizza in Italy, drinking in the freedom you have sought after for too long. Counting calories does not equate to happiness- in fact, quite the opposite. It absorbs joy like a sponge, your life becoming a series of arithmetic chores.

Counting relies fully on external validation. Relying on this number doesnt allow you to gage when you full hungry or full, or what foods you desire? Calorie counting is yet another way that diet culture has slyly manipulated us and it’s time to tell society (inc my university!) that we have better things to do than micromanage our food and appearance.

In the spirit of honesty, I must disclose that I do still struggle not to count calories- it is a behaviour so engrained in our society that to escape it seems an impossible feat. Plastered on restaurant menus, school canteens etc, it feels as if there is no way someone with a restrictive eating disorder can choose their food freely, without being influenced by damaging diet culture propoganda such as this. I live in hope that someday soon our tabloids & media will not longer be awash with fatphobic scare mongering, but for now, I know that calories, however one may perceive them, are essential needs for a body that yearns to be loved.

Ode to 2018

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2018 has been a bizarre hybrid of turmoil and growth.

The problem is that my mental illness has become something of a comfort. It wreaks havoc with my life, pulsing neurones through my weakening mind, but somehow luring me in. It’s a strange sensation, and one I have not been able to articulate coherently yet. How can something so damaging and destructive be something you yearn for? Something you mourn the loss of, as if losing an old friend.

Despite the trauma and turmoil it brings, my mental illnesses ensure that I am caged by the illusion of security. Somewhat ironically, I have been so fearful of failure, that in worrying so much I have caused failure. An endless spiral of self-sabotage. Self-acceptance is a concept my hazy little brain is yet to fully comprehend.

Yet next year I shall continue to navigate a life with less restrictions. Ice cream, university, friends, boyfriend, family, music, writing, travel. At times depression can make one a slave to lethargy, but instead I will forage for the fruits of freedom that lie off the beaten path. By no means am I suggesting I will be successful, but I will read between the lines, befriend curiosity as my ally, and have faith in the fact that whatever chaos occurs on this strange plane of existence, my body and mind are deserving of compassion.

My body works tirelessly to keep me alive, and how do I repay it? With scarring and starving and self-loathing syllables splintering into me. Where does this burning hatred stem from? By no means am I a pillar of society, but similarly I am not intrinsically, wholeheartedly BAD. I am merely a human, and although I wish to part ways with the past 12 months, I shall have the remnants of this year carved into my skin, absorbed as a memory for safe keeping.

When I feel lost, I will hold my hand over my heart and listen to its tender bray and know that I need not be afraid for I am already home, home in a body that has fought to keep me safe, even though I have made it tricky at times.

Never again will I be confined to the four walls of any hospital, mindlessly shovelling lukewarm beans on toast into my body, eating being both the cause and the cure to my illness simultaneously. Never again will I neglect my studies as a result of my eating disorder. I have learnt that just as a car needs fuel to move, a body needs food to study. The skipped projects, a missed chorus trip to Paris, my end of year exams that I failed to take, instead wandering around in a drunken daze of depersonalisation.

I recently completed an application for an Opera Course, and the alarming gap in my CV from the past year upset me. I was not upset, however, because of having a sparse 2018 CV, I was upset because it further highlighted to me how the past year had been largely wasted, lost in a blur as I surrendered to my mind. However, I have learnt an astronomical amount in the past year. Perhaps not your standard educational curriculum, but learning, nonetheless. How to allow the rising number on a scale to reboot my identity, how to show myself and others more compassion, how to grasp the idea that life goes beyond one’s perfectionistic traits and expectations. How to live.

2018 may have been littered with distress, but it also brought about a prolonged period of recovery, which I intend to continue long into the future. Slowly but surely, the relentless calories, ensure drinks & appointments have begun to reignite my identity as a person- a friend, daughter, girlfriend, sister. My self-inflicted chaos of mind and body has slowly undulated back into place, and the “me-shaped” hole inside myself is once more being filled by life’s wonderfully whimsical throbs of progression.

If schooldays are the “best days of our lives” why are children facing a mental health epidemic?

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“I just came here to say that I haven’t managed to attend many lessons this term as I’m really struggling with my mental health and even leaving home in the morning is a struggle”

“But you managed to get to this meeting ok?”

This is an actual conversation I had with the student welfare advisor at my secondary school.

How to put a condom on a cucumber, how to use Pythagoras theorem, how to construct a haiku… When I reflect on all the somewhat bizarre things I was taught in school, it dawns upon me that not once was I taught how to look after my mental health. How to know when to ask for help, how to flee from the aching voices of self destruction.

All these things now pail into insignificance.

4 years. I spent 4 years out of mainstream education, desperately clawing my way to victory – attending an LEA (Local Education Agency) education provision for the most part, but also sitting some GCSE exams in hospital- all the while my mind being sucked under by some venomous creature.

Perhaps it was because as an angsty teen (who so desperately longed to be “cool” – I am yet to understand what being “cool” entails!) I had no interest in Mathematics, but I distinctly remember one maths lesson at the Girls Grammar School I briefly attended. The teacher had the arduous task of attempting to make Pythagoras theorem seem compelling to a group of pre-teen schoolgirls, who quite frankly, couldn’t care less.

I recall my mind wandering, pensively roaming through various hypothetical scenarios, conjuring up a fantasy life I would rather be living. This daydream posed the question:

Would I have become mentally ill had I been taught how to prevent it?

Yes, Grammar schools are notorious hothouses for a gruelling curriculum and churning out A*s with optimal efficiency, but these “best days of my life” were actually the ones that failed to equip me with the tools needed to navigate REAL life. I am not talking how to mindlessly regurgitate information onto a piece of paper in an A Level Exam, I am talking how to cope with peer pressure, self-destruction, social anxiety, interpersonal relationships. Real issues that occur in real life.

By no means am I undermining the importance of a rigorous academic education, however I feel that in addition to this, education on mental health & wellbeing desperately needs to be implemented in educational establishments throughout the UK to quell the growing epidemic of mental health problems in young people.

I recall one of my relatives once stammered in his usual drunken stupor: “ahh be grateful, these are the best days of your life!”, in response to a complaint I made about school.

My heart began to pound as a nervous laugh rose in my throat. “THESE are the best days of my life?!” I thought. If that’s the case I may as well check out now.

I have no idea where the idea of school and university being “the time of your life” stems from, but perhaps I would’ve enjoyed education more, had people previously disclosed to me that in reality it can often be a difficult, and somewhat mundane experience.

By the time I was 18 I had been to 10 schools, usually moving due to ill mental health or “social difficulties” (the teacher’s diplomatic way of avoiding telling my mum that I had no interest in making friends). Although I loved learning, I despised classrooms, large groups and loud noises, all of which are present in most schools. A late diagnosis of ASD (Autism Spectrum Disorder) should have been helpful, but instead it led me to feel more confused. Isolated, depressed and overwhelmed by the pressure- I began to falter.

I began to dread the thought of attending school, resorting to skipping lessons and hiding in the girl’s toilets, unable to articulate the anxiety and fear I felt. I recall once petting my friend’s hamster and wishing so desperately that I too could run around in a bubble-type ball, protected from the outside world. Classmates just presumed I was some oddball recluse who had gone a little mad (perhaps I had!), and so instead of being offered support, I was often greeted with stigmatisation.

Before this gets too “sob story on the X Factor” I would like to emphasize that this is not a “woe is me” statement. I simply wish to highlight that 10 years ago, mental health was taboo. Chinese whispers in the playground and vague ideas drawn from the media as to what mental illness was. “You have a personality disorder? Jeez are you like Hannibal Lecter?!” was a particular favourite of mine. I internalised the stigmatisation I received, and with undiagnosed conditions (due to CAMHS waiting lists being 6 months on average), it fuelled an unhealthy pattern of self-stigmatisation. If others thought I was an outcast, I must be.

My first inpatient admission came at the ripe old age of 13. School became deeply overwhelming, and sporadic CAMHS (Child and Adolescent Mental Health Services) appointments, although helpful, did not suffice. It sunk its keen claws into my pasty white skin, furrowing deeper, its refusal to retract becoming more insistent. I tried to free myself, ripping away, running away- but snatched back in its clutches. Unspoken words manifested in self destructive patterns. As something of a control freak myself, I cannot begin to recount how harrowing it was to know so little about mental health, and how to control it. At the time, I was unable to coherently articulate what “it” was, but in time I would discover that “it” was sprung upon me in the bloom of youth, yet perched on my shoulder, dragging me headfirst into adulthood with a mind I knew so little about.

One may argue that the lack of support for mental health in schools is a sectorial issue, however as someone who has attended both state and independent schools, I fear it is not. Yes, the reason why some independent schools have been able to move more hastily will lie in the greater resources they have at their disposal. Yes, financial support for programmes and practitioners is required, but an abundance of money is futile if there is no sharing and co-operation between teachers and parents who know the children concerned.

I often fear that during my time at Grammar School, many teachers wanted to help students with mental health problems, however they were under an untenable amount of pressure, and completely untrained to support pupils with complex mental health needs. All they were equipped to do was to hand someone a tissue and send them to the school counsellor. Just as all teachers are required to receive first aid training for physical health, with rising prominence of mental illness in children, surely it is just as important for teachers to be trained to deal with issues regarding mental health?

By no means am I suggesting that mental illness is completely avoidable. There are traumatic situations that occur beyond our control, however with regards to adolescent mental health, more preventative measures need to be taken to ensure the safety and wellbeing of future generations.

“It’s me or ED”

A relationship requires vulnerability, integrity and intimacy from both partners in order to flourish, and the very nature of eating disorders brutally erodes these crucial elements.

As the saying goes “twos company, threes a crowd”. Coping with an ED in the context of a romantic relationship can be problematic.

So please, reader, brace yourself, for I am about to disclose how much an (my) eating disorder caused me to act like a malicious, vindictive bitch towards my other half. Sometimes the guilt eats away at me (no pun intended), sometimes I recall the shocking things I did, the hurtful words that shot out from my mouth. But I suppose berating oneself for the past isn’t helpful to anyone.

There is a growing body of research to suggest that the human mind is capable of erasing bad memories as a way to cope with trauma. There have been various incidents that I have forgotten, and have only become aware of them recently as my friends and family tell me. Apparently I screamed uncontrollably at my boyfriend in public, swearing profusely, angrily kicking the bus stop and crying hysterically. Had he cheated on me? Had he stolen my belongings? What horrendous act could possibly justify this outburst of rage? Ah, of course! He had disrupted my ritualistic exercise habits.

Or there was the time I lashed out (verbally, thankfully) at my flatmate after a run. On more than one occasion I accused her of being self righteous and controlling and jealous of my “control” (the irony here being that anyone with an ED/hypergymnasia/addiction of any sort is so incredibly out of control!).

Within a matter of months I had become a living volcano, bound to erupt any second. As you can imagine, this began to take its toll on those around me. My boyfriend began to exhibit signs of “burnout”, with so much of his time and energy invested in my care. When in a relationship whilst suffering with mental illness, it is so easy to implicitly develop a patient/carer arrangement, whereby you become so reliant on your other half, to the point of a worryingly dependent relationship. The partners mental health may also deteriorate, interrupted sleep patterns and mood. Several times my partner missed a uni commitment or social event to see me in hospital, or console me. I then felt guilt for this, which caused me to sink further into a depression, and therefore rely on him even more (and so the self fulfilling prophecy goes).

It is sometimes hard for me to decipher why my partner stayed with me, when I had become a shadow of my former self, the old me desperately trying to claw its way out of this mess. The numbers on the scale, along with my zeal and zest for life dropped at my demand as I was lulled into a numb version of security. How do you stay with someone when they aren’t the same chirpy, upbeat individual you formerly fell for? When the life has been sucked out of them, their edges once pristine, now found threadbare and worn?

I could write an entire essay on the compatibility of mental illness and moral responsibility (don’t worry, I won’t!), but it can become difficult for the partner of someone with mental illness to differentiate between deliberately malicious actions and unconscious actions caused by a neurological disorder. I often struggle with the guilt regarding how I have treated those around me whilst struggling with my Mental Health. “You didn’t act like that because you’re unwell- you’re just a stupid bitch” I flit back and forth in my mind.

Saying my illness doesn’t come into the equation would be lying, however I never want to become the type who presents the “mental health card” in the hopes that those around me will not hold me accountable for my actions on the grounds of a faulty mind. Where does my illness end, and where do I begin?

The one idea I would like to highlight for anyone in recovery is how I found it incredibly helpful to think of myself and my illness(es) as two separate entities. This way I still take responsibility for my actions but I know when “ED” is causing me to act like a manipulative bitch.

Creating a detached identity for my illness has helped me more than I can coherently articulate at this moment in time. Rediscovering that I am NOT my diagnosis has been empowering as hell.

It has also allowed me to further understand that when ED feels challenged, that is when I become defensive and snappy to those around me, like a little, snarly Jack Russell (as a friend of mine once so eloquently put it!) Being in a relationship whilst having an ED is hard, because no matter how much you care for the person, your ED will hate them for trying to help you/for making you eat/for stealing focus away from it. This issue was prevalent in my relationship for some time- until my partner essentially said “it’s me or ED”. I remember him saying “I can deal with you struggling and I can support you, but it has to be us vs ED, not you and ED vs me.” These words often still resound in my ears today when ED begins to lure me back into her tangled web of lies, persuading me to deceive those I hold dearest, in case they try to take ED away from me.

I attended family therapy on the ED ward for several months, both with my parents and my boyfriend. Our family therapist often referred to “The New Maudsley Method” (a care approach devised by the Maudsley Hospital to emphasize the role relationships play in ED recovery).

This method uses the somewhat humorous metaphor of animals as caregivers. The Kangaroo sees how fragile the sufferer is and wants to put them in the Joey pouch and protect them. The Rhino practices tough love, desperately trying to apply logic, often becoming angry and stressed. The Ostrich buries its head in the sand in denial, and avoids talking about the illness. The Jellyfish flails around desperately, unable to help but instead, incessantly panicking. My parents were advised to “be dolphins”, gently nudging their loved one towards recovery, swimming alongside for guidance and encouragement. They were also encouraged to be like a St Bernard Dog. Not hairy and drooling, but reliable, calm and consistent, providing warmth and companionship. When my parents visited me, they actually brought me a toy St Bernard, who I so imaginatively named “Bernie”.

So, as I begin to conclude my slightly incoherent rambling- I will say one thing- the carer/partners feelings and wellbeing is equally as important as those of the sufferer. Although the partners natural inclination may be to dive head first into supporting their significant other, to quell the growing anxiety in their chest, you cannot pour from an empty cup.

On board an airplane, in case of emergency we are instructed to put on our own oxygen masks before assisting a child do the same. Although initially some may think that sounds selfish, you are of little use to others if you’re passed out on the floor due to lack of oxygen because you insisted on helping everyone first. You can probably see that what I’m hinting at with these poorly constructed metaphors is that you cannot help someone else if your own wellbeing is compromised.

The family/friends/partner of a sufferer will often be heavily impacted by the illness- and I strongly believe more needs to be done to support others in supporting those with EDs.

On the off chance that anyone requires further reading, the book “Skills based caring for a loved one with an ED” – New Maudsley Method” is an incredibly useful guide both for the patient and family. It addresses various kinds of ED’s and has really helped my family and I.

If you’ve successfully read another of my rambling blogs, then I sincerely thank you- for listening to the cold reality of EDs and the impact they have on families and friends. As always, I am open to feedback/questions!

Love, Katie x

“We’ll see you in 3 days, and in the meantime, if you feel suicidal just pop into A&E.”

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“We’ll see you in 3 days, and in the meantime, if you feel suicidal just pop into A&E.”

The words rang in my ears, my mind perplexed by the woman’s words. A&E? That was my designated point of safety? But why? How could they possibly aid someone in a mental health crisis, aside from treating any immediate physical harm?

A&E is not a suitable place for a mentally ill person to wait for psychiatric assessment or a bed on an appropriate mental health ward. But sadly, it is the lesser of two evils; the alternative being a police cell, which is commonly used as a place of safety for vulnerable persons under the Mental Health Act.

Following an accumulation of arguably self-destructive acts, I found myself in hospital.

A liaison worker came to my bedside, rubbed her hands together and said “so, can you tell me why you did this poppet?” in an unnervingly chirpy tone. I shot a sarcastic glare at her (damned teenage angst) and blurted “It’s a lot of things”, desperately clawing my brain for a way to condense my mental health history into one, concise sentence. “We have referred you to the crisis team” she replied.

Little did I know what a crisis getting hold of the crisis team was!

Earlier that morning I had sat in a curtained off cubicle in A&E with a police officer (who are often involved due to the Mental Health Act), already distraught and disorientated, rushing bodies flailing headlong through corridors- to their next patient- to treat them with the cold, clinical precision that matters of physical health demand. However, matters of mental health worsen under such conditions.

I fought off glares from other patients in A&E, probably wondering whether I was some juvenile delinquent who was going to somehow fashion a weapon out of hospital equipment.

This all felt so…degrading. So humiliating. I couldn’t help but silently acknowledge the irony of the situation. In one cubicle is a patient fighting for their life, and in the next is another wanting to give theirs up.

In the next room, a patient who is in no way fit to return to the community is discharged to an underfunded crisis team, who can provide a phone call and annoyingly catchy hold music. One cannot deny that these decisions are predominantly influenced by resources (or lack, thereof). Sadly, that very patient may return to the sight of the bleak, sterile atmosphere of A&E shortly afterwards- and thus goes the revolving door approach to treatment.

When I was young, someone said “money makes the world go round!” I scoffed & vowed never to adopt that mind-set, however the more I encounter healthcare services, the more I am convinced of this statement. Pressure to meet targets & overstretched resources results in those in a mental health crisis receiving inadequate care, and access to proper support & safety becomes something of a lottery.

Furthermore, for those from marginalized groups (e.g. racial, economic, LGBT etc) accessing support only highlights the fact that inequality is a prevalent issue regarding mental health care. In light of Tory austerity, those from deprived backgrounds are often hit the hardest when it comes to overstretched services and cuts to the NHS. Studies show that those who are in the most deprived 10 per cent of society are more than TWICE as likely to kill themselves than the most affluent 10 per cent of society.

So, you may be thinking, “Well its all very well sitting and ranting endlessly about mental health crisis care, but isn’t it a bit futile? How is this helping anyone?” Firstly, hopefully it will encourage people to speak out about their experience with mental health crisis, but secondly, to pressure those at the helm of this fast sinking ship to make amends. Be this through protests, letters to your MP, volunteering for a helpline- I truly believe (perhaps naively) that the crisis within crisis care (gosh, how ironic!) can be averted in many cases.

Lastly, I thought I would compile a list of some available resources, aside from A&E for those in a Mental Health Crisis.

Helplines

Samaritans- 116123 available 24 hours a day, 365 days a year.

Mind- 03001233393 9am-6pm Mon- Fri

Sane- 0845 767 8000 6pm-11pm every day

NHS 111- although not specifically a mental health support line, they are available 24 hours a day, 7 days a week, and can arrange consultations, emergency GP appointments etc

GP appointments

Most GP practices will offer emergency appointments. You do not have to be a registered patient in the case of an emergency.

Crisis Houses

Crisis houses provide a short term stay in a safe, residential setting. Self referrals are accepted, and they are staffed 24 hours a day. There are two in London; Drayton Park Crisis House, and Maytree Crisis House.

Crisis teams

Crisis teams are a service that can support you outside of hospital, through home visits, or meeting in the community. They are available 24 hours a day. Some can be accessed through self referral, others require a GP referral.

Please look out for yourselves, and others.

Katie x

“What have you got to be depressed about?”

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In 2017 I stepped into a psychiatric ward in Homerton. I sat in the waiting area, cradling my black coffee in a ceramic mug with “Property of the NHS” plastered all over. There are some slightly patronizing posters dotted around the walls, and I find myself chuckling at the poster that has “Are you ok?” staring at me, with a thumbs up sign mockingly placed in the corner. I cynically think how odd it is to have such a poster on a mental health ward, because by definition, if you are on the ward, chances are you’re in some kind of crisis.

A lady comes into the waiting area and leads me up the stairs to the assessment room, wheezing dramatically as she walks. I sit in the chair whilst she assembles the necessary paperwork. The room is a faded blue colour- I had almost forgotten how profoundly uninteresting hospitals are. The lady begins to ask me some intrusive questions, and being something of a hospital veteran, I know that she is legally obliged to ask these. “Were you sexually abused as a child?” No. “Are your parents divorced?” No. “Have you ever been overweight?” No. “Has there been a recent traumatic death in your family?” No. The questions continue, until a bemused expression falls upon her face. “So… what has triggered all this then?”

The following conversation that ensued consisted of this woman, a so-called mental health professional essentially asking me: “What have you got to be depressed about?” Like many individuals with mental illness, I often experience an odd category of imposter syndrome- it sneaks up on me and convinces me that I am a burden, a waste on the NHS and it’s resources, that I’m just a drama queen, and that sitting in your room and weighing out your food in order to curb your crippling anxiety is totally normal! (hint: it is NOT)

I panicked, desperately trying to think of a reason she would deem valid. Maybe I am stressed trying to conform to todays’ oppressive society? No, too angsty. Maybe I don’t know who my real Father is? No, too Jeremy Kyle. Maybe I have offset the balance between cups of tea and cups of coffee lately, causing my mind to spiral downwards into an existential crisis? No, she wouldn’t buy that. Silence. This appointment felt as if this woman had singlehandedly corralled all my doubts and thrown them back at me.

Fast forward to this year, last week in fact. Anorexia reared her ugly head and saw me obsessively counting yet again: steps, calories, grams, miles etc. I chose to have some ice cream to counteract these thoughts. Feelings of gluttony surged through my body, as I try to fend off the impending waves of anxiety crashing towards me. My mind wanders back to that appointment in Homerton, and as I sat there scoffing down my somewhat overpriced vegan ice cream (yes I am the epitome of a millennial) it occurred to me once more: what have I got to be depressed about?

I come from your stereotypical white middle class family and have two loving parents. I have access to amazing education, a roof over my head and food on my plate (whether I eat said food is a different matter!). Pangs of guilt began to lash against me- how could I be so ungrateful? There are people in the world who have real things to be depressed about- I’m just a whiney, spoilt brat. A fraud. A fake.

The problem is, one is often expected to give a reason as to why they are feeling a certain way eg “I feel insert emotion because insert action happened”. It is logical, and acts as a neat equation for the individual on the receiving end of the convo.

This can be somewhat problematic for those with mental illness. Often when people ask me “what’s wrong?” I will give a half-hearted smile and mutter something about how tired I am or how busy the tube is (damn you northern line), but I will very rarely tell someone the truth. Lets’ be honest, saying “I don’t know. I just feel sad” would likely be met with puzzled looks or an awkward silence.

By no means am I encouraging people to blurt out their entire life story to the next unassuming person to ask you what’s wrong, but wouldn’t it be comforting if it were more socially acceptable to say “I’m just feeling a bit blue today” and you weren’t then pressured into thinking of some “real” reason that exists in the physical world?

When I was suffering from depression at the already angst-ridden age of 13, I became so sick of people asking me “What have you got to be sad about?” “Think about the people in Africa- they’d do anything to have your life” that I resorted to telling people I was having a difficult time at home. Implying that I was living between my warring parents got people off my back: they began to accept my grief. Because I had a “real” reason, my sadness was valid.

Many people I know (myself included) feel an overwhelming sense of guilt for having mental illnesses- often feeling they have no right to suffer- especially when well meaning family members exclaim “but you have so much to live for!” Not only does that statement assume that someone isn’t already conscious of their privilege, it misunderstands the causes of depression and perpetuates stigma. Yes, depression can be as a result of difficult life experiences, however it can also affect anyone irrespective of wealth, success, race, age, sex etc.

But it becomes a self fulfilling prophecy for the sufferer: you feel depressed, you feel guilty for feeling depressed, the guilt causes you to be more depressed: and thus goes the never-ending cycle.

A few months ago, the famous singer Demi Lovato had a relapse with her bipolar disorder, which resulted in a near fatal overdose. Although the vast majority of the comments were supportive, I was appalled to see so many tasteless memes and many clueless remarks such as “Wow it must be such a hard existence being rich and famous!” as if money makes you immune to mental illness. There were also comments describing mental illness as a “first world problem”, or a “middle class woe”. So many studies show that mental illness affects those from numerous different cultures, and has its roots in a mix of neurological, social and environmental factors.

So I will end this caffeine induced, somewhat narcissistic rant by saying: please do not berate yourself for how you feel. Depression is a chemical imbalance in the brain, affects people from all walks of life and does not mean you are ungrateful. Telling someone with depression to be grateful they haven’t got (insert illness, disease, horrible life circumstance) is not dissimilar to telling someone with a broken leg “Oh well, at least it’s not cancer!” Peoples’ problems are non-comparable. One can suffer from depression, and yet concurrently be aware of all the blessings in their life. The word “depressed” is not synonymous for “ungrateful”.

Have a lovely day.

Exercise: the double edged sword

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As I woke in hospital one afternoon in January, due to having collapsed in my flat that morning, you’d expect the first thing I’d do would be to contact my family, or gather my thoughts for a moment? Wrong. The first thing I did was check Strava, my running app, to enviously eye up other people’s workouts, and lament the fact I had missed my morning run.

In today’s society, so many people are loud-and-proud gym bunnies, constantly posting on social media about PB’s, juice cleanses and gruelling, military style workouts. Due to this, it became increasingly easy for me, an anorexic with a crippling exercise addiction to blend in and go unnoticed.

The reality is that few people recognize exercise as an addiction in the same way they do alcohol, gambling or drugs. This made it exponentially harder for me to seek treatment initially. It was only when my exercise addiction threw me into a horrendous relapse with anorexia that both myself and professionals saw my problems as valid.

How could I genuinely believe I had a problem when exercise addiction is greeted with praise? I once disclosed to a friend that I am addicted to exercise, to which she laughed and said “I wish I were addicted to exercise! I’m addicted to cake!”

What she failed to realize is that for me, exercise is often used to cover up psychological distress and acts as a benefactor to my eating disorder. The warning signs are not always visible, especially to a health professional who fails to consider the social implications of a disordered relationship with exercise: the fragmented interpersonal relationships, the loneliness.

The lectures skipped at university to “earn my lunch” in the gym. The coffee dates with friends that would often be cancelled in favour of a run. The shaking, purple hands from walking for miles in the cold, constantly glaring at my sports watch, praying for the step count to go up. I even forced myself to run after Christmas Day lunch last year, as opposed to sitting by the fire with my cats and a glass of prosecco (which I most certainly will be doing this year!). I wish I had understood that we are all worthy of food, regardless of our activity levels, and that food is not a “reward”, but a necessity for our bodies to function!

The problem is that many mental health professionals (and in my experience, even eating disorder professionals!) extol the virtues of exercise, and often prescribe it for mental health problems in general, as a natural alternative to medication or therapy. Although there is no denying that exercise boosts serotonin levels, and can often give people a much-needed purpose in their day, sadly many individuals with depression/anxiety, suffer simultaneously with eating disorders. For anyone with a compulsive way of thinking about food, weight and behaviours, exercise can quickly escalate into an unhealthy coping mechanism.

I was in the throes of an eating disorder, but all the while keeping up the façade of being a healthy, young woman who liked to keep fit! It was only when I had to take time off exercise, having just run a half marathon in the Autumn, that things really began to spiral. How could I justify eating if I wasn’t able to exercise? And so, my intake became even more restricted. I stopped attending university, I barely left the house, and began exercising in secret- doing numerous burpees and sit ups in a desperate attempt to claw back some control over my exercise regime. I would tell my flatmates I was walking to the shop to buy some food, and instead would sprint there, light headed and faint, but high on adrenaline.

After my weight dropped significantly, my flatmate and boyfriend persuaded me to seek help for both my eating disorder and my exercise addiction. They selflessly took me to numerous appointments and I began to realize that perhaps more people had noticed my ridiculous exercise regime than I initially realized.

And so began a year of ECG’s, blood tests, DEXA scans, isolation, hospital admissions, dieticians and the many tears that came with gaining weight and letting go of the behaviours that led me to this very dark place.

But I began to question: why was it that I only felt my problems were valid when they revolved more around food, and less around exercise? I strongly believe that exercise can be hugely beneficial in regards to someone’s mental health and wellbeing, however in my opinion doctors need to realize that mental health is not “one size fits all”, and although for some exercise can be an ideal solution, for those with a turbulent relationship with food, it can become yet another means of self-destruction.

Without wanting to have regrets, I must say that I wish I would’ve taken my exercise addiction seriously and sought help before my anorexia took hold. I cannot stress enough that disordered eating and an unhealthy relationship with food can come in so many forms: exercise, laxatives, binging etc.

I used to justify my exercise addiction with “Everything’s fine because I’m still eating…” but if the only way you can allow yourself to eat is after partaking in strenuous exercise- please know that this is a real problem, you are not alone, and you are worthy of help.

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