Oceans of Emotions

I've always loved water. Being in it, on it and under it. I've enjoyed swimming in all kinds of swimming pools, beautiful Victorian bath houses with cold little cubicles, my modesty sheltered by Circus tent-striped curtains, modern circular 'fun' pools, aimed at frustrating the serious swimmer, rivers, lakes, and most exhilarating of all, the sea. Again and again I have returned to water imagery to try to explain the complexities of my own mental health struggles.

As I have widened my experience of explaining, discussing and challenging assumptions about mental health in general and my own diagnosis in particular, I have realised that, because I cannot show you operation scars, or other visible symptoms, it becomes difficult to help you understand my experiences.

When your primary symptoms are centred around emotional volatility and their impact on your behaviour, most people think that you are describing being 'moody'. That or words and phrases like: over-dramatic, highly strung, over-sensitive melodramatic, emotionally manipulative, serve to dismiss my experience and need for additional support. This has come sharply into focus throughout my recent experience of going through the Work Capability and Personal Independence Payment assessments. So, once again, I will try to explain how come time and resources have been spent on treating my 'moodiness' since my diagnosis in 2011.

Mablethorpe V Maui

I grew up with visits to the seaside on the North Antrim coast, which means that I became used to waves crashing in from the Atlantic. As a strong swimmer I enjoy riding on the top of waves as they hurl me towards the shore. Once when visiting Ghana, I experienced huge Atlantic waves with swirling undertows which were far too strong even for me to cope with. I certainly learned the limits of my ability in the huge Rollers off Sir Charles Beach on the Gold Coast.

Imagine then, my first visit to the North Lincolnshire coast, when after nearly a year in South Yorkshire a group of us went for a day out at the beach. As the flat beach gave way to water, I was deflated, as the 'waves' (or rather ripples) lapped at my ankles providing none of the excitement or exhilaration I normally associated with sea swimming.

My point is? Imagine that you live your life with emotions which never reach the ripples of Mablethorpe. Imagine that every day you awake with an emotional arousal akin to the waves crashing in off the Atlantic onto the Antrim coast. You never manage to start or return to 'neutral'. Then imagine that the everyday events and trials begin. Someone cuts me up in traffic - I am not able to be annoyed, because my emotional temperature is already raised, one small event can provoke an outpouring of rage.

So what? A lot of people experience road rage. Problem being that the waves of emotion are at Gold Coast levels and continue that way for a sustained period of time. Now imagine that before I can return to smaller waves of emotion, I receive an important phone call at work, which puts additional pressure on my deadlines for the day. The emotion switches, but returns to huge crashing wave levels, this time of anxiety. As a result of this heightened emotion I find I have physical symptoms, nausea, triggering migraine symptoms. Sometimes I may throw up. Sometimes I may find I succumb to a debilitating migraine attack lasting 48 to 72 hours. I am only half way through a normal day.

In the past sometimes the only way I had of reducing the high levels of emotion was to self harm - thus somehow releasing the building pressure. Imagine cycling through a full range of emotions from anger, anxiety, to relief and feeling excessively giddy several times in one day, like this. Is it any wonder contact with other people and life in general is exhausting?

Oceans V Brooks

One of the observations commonly made by others about the behaviour of people with Emotionally Sensitive Personality Disorder (formerly Borderline PD) is that my reaction is out of proportion to the triggering event. There are a number of reasons for this, some biological, some due to my experiences in life. Research has shown that the emotion centre of the brain (Amygdala) is more highly attuned and sensitive than average. For those who have experienced childhood trauma this emotional disfunction means that memories, particularly the emotions evoked are overly vivid and are experienced with the immediacy of immediate experiences - as if I am reliving the original trauma related to the given emotion.

Sometimes the encouragement to 'just let go of the past' adds to the pain, as I feel judged for feeling the fear, rejection, sense of shame with the same power as if it had happened in the immediate present. When I fear that I am going to lose a friendship, I am not only filled with the fear in this moment, it connects with every time I have experienced rejection throughout my life. So, I am not only dealing with one wave of emotion at a time, I am trying to manage oceans of the same emotion, an accumulation of every time I have felt, particularly, painful emotions. Again, is it any wonder that my emotional reactions are out of proportion to the triggering event in the here and now?

Self Defeating V Effective

There are effective ways of managing life but there are also self defeating behaviours which over the years I have developed to help me get through the crashing emotional waves, but which do nothing to take the power from them. Symptoms related to the emotional turmoil of ESPD (BPD) include, self harming behaviour, substance misuse, overspending, excessive speeding, or reckless driving, problems with eating, an unstable sense of self, major problems in relationships. When I am struggling to maintain day to day life in the face of my turbulent internal struggles, it becomes impossible to think of more effective ways of coping. However, those self defeating behaviours, which, however, flawed, have kept me going over the years, need time, patience and space to be replaced by more effective coping skills.

Having painted part of the picture I hope this explains why Dialectical Behaviour Therapy (DBT) is such an intensive course of therapy. Once I was discharged, it was only the beginning of managing my emotions daily using the skills taught to me during the DBT programme. When talking of mental health conditions, I think people become confused particularly once direct care ends. If I am discharged from hospital following an operation, then the problem has been dealt with and my condition, hopefully improves. For some mental health and physical diagnoses there is no end point. Just as the diabetic needs to undertake both medication and lifestyle changes to manage their condition effectively, so I need some medication, alongside the DBT skills to be able to keep the waves of emotions manageable. 'Manageable' is not 'dealt with'.

Self Care - Do I really 'Get it'?

I can talk about recovery till the cows come home. I understand the DBT skills that help me manage my emotions and thoughts. I find them relatively easy to practise and use when necessary. However, when it comes to 'self care', especially of my physical well being I am in need of 'remedial' help or a 'refresher' course. I know the obvious question in DBT terms is, 'so what's the obstacle to using self care?' My honest answer is that at the core of my feelings towards myself is a fair amount of self loathing.

It's a knotty old problem that rears its head in all sorts of situations and causes my responses sometimes to be out of proportion to the stimulus. Whether I am succeeding or failing (in my own eyes) I will always have a 'director's commentary' running in my head telling me either that my current failure is confirmation of all that I believe about myself, or that my success can only be a fluke, or people flannelling me. Basically, I have never learned to trust my own instincts about how I am doing in work, relationships or any sphere. I think that is why people on the outside consider me to be an overachiever. I have always needed the confirmation of cups, medals and prizes as totems of my value. Strangely enough, no amount of outward success has ever made up for my own doubts about my intrinsic value or worth to the world.

Credit: Tweeted by @jessisheron

This lack of self validation has affected me in a number of ways, but perhaps most obviously in my inability to care for my health. My GP in the past has described me as 'stoic', 'strong minded' and 'a bit of a martyr'. She had earned the right to speak to me in that way, having taken an interest in my mental health and recognised the link between this and my lack of self care over a long period of time.

Given that I have been an athlete and been at the peak of fitness into my 30s before my mental and physical health broke down, I know how good it feels to feel 'good' - physically. My biggest problem for my health has been the overwhelming ennui that sucked all energy and motivation to exercise out of me. The Black clouds of depression which hung around my life in long, black days, were accompanied by the desire to cram junk food and large portions of 'bad for you' snacks into my body, in a failed attempt to fill the emotional void inside. No need to undergo major analysis or large numbers of tests to discover the cause of my burgeoning weight and loss of fitness. Easy to ignore until earlier this week, when I ended up in A&E because I had been vomiting up blood.

I know the cause of the waves of retching which caused the bleeding; years of chronic anxiety and panic attacks which included emptying the contents of my stomach as my abdominal muscles went into spasm. Most recently the continued lack of care about the contents of my diet,has been the main cause of my feeling sick. So, the easiest thing is to take care of it. In other words, take care of myself. Except, there it is, that nagging little voice from all the way back in my childhood - 'I am not worth looking after'.

It wouldn't be so bad if I hadn't started on the road to recovery from those emotional scars, so instead of ignoring these thoughts as just a part of who I am, I am starting to feel uncomfortable with this negative view of myself. Slowly, I am aware that the messages from my faith, friends and other sources is getting through to me that I might be worth caring about. And, on a simply practical level, I know that if I want to maintain my emotional equilibrium I need to live as if I believe I am a whole person who needs to be cared for physically as well as emotionally.

On Monday afternoon for the first time in my life, I picked up the phone and asked a friend to go with me to A&E. I told the Dr how badly I felt and what was worrying me about my symptoms. I then followed the instructions to contact my GP, the next day - was given an emergency appointment and received top class care, advice and reassurance. I will commit to attending the follow up appointments which will continue to monitor my condition and provide me with ongoing treatment. That is all simply because I want to feel better about myself, because when I am fit physically I am better able to make the most of every day of my life.

In a sense up to this point I have been deluding myself that I have left my self destructive tendencies behind with overt suicidal feelings and self harm. Instead, I have continued to punish myself by neglecting my physical well being, perhaps on a different level from all the self destructive behaviour before, but nonetheless still not prepared to let myself 'off the hook' as regards punishment. Essentially, I need to stop and acknowledge that punishment is only effective if there has been a crime which requires justice. Being myself, having the life I've lived is not a crime. The following words have been difficult for me to articulate but they are an essential step towards my healing: I have done nothing that deserves me punishing myself over and over. No one else is holding me to this account but me and it is time for me to truly be released from the prison of self loathing. Taking care of myself is a good start.

Self Care is important and is something which will help me to sustain the progress I have made in managing my BPD. It has taken me a long time, but I am beginning to get it and to get the importance of feeling good physically to feeling good mentally.