I wake up to beta blockers and I go to sleep with two different antidepressants and an antipsychotic medication. Each day I struggle to navigate a world that is by turns frightening, confusing and bleak. This is because I live with multiple mental health diagnoses; depression, generalised anxiety disorder (GAD) and borderline personality disorder (BPD).
Anxiety has been my constant companion since I was a small child. Depression entered in my teens, after years of homophobic bullying, and I was diagnosed with BPD at age 20, while battling a severe eating disorder at university.
Each illness comes with its own set of symptoms and characteristics, which affect my day-to-day life to greater or lesser degrees.
Sometimes it’s difficult to separate between the diagnoses as they all act as a barrier to me living a ‘normal’ life. There will be moments where I won’t be able to tell whether anxiety, depression or BPD is most informing my response to what’s happening around me, or whether one diagnosis is most prevalent in a particular situation.
For example, a lack of text or WhatsApp message from a friend can send me into a tailspin of self-doubt, panic and hopelessness. The emotions feel overwhelming, like huge, cold waves crashing over me; a sensation that’s a facet of BPD, but is also related to anxiety and depression.
“There will be moments where I won’t be able to tell whether anxiety, depression or BPD is most informing my response to what's happening around me”
The illnesses can also feed into one another, making each other more severe and harder to cope with. For example, when struggling in a workplace environment, my BPD brain would be seeing threats everywhere and making me second guess every interaction with others, further triggering my anxiety and eventually tipping me into a depression where my mood would drop and it would take a monumental effort to complete basic tasks like getting up and having a shower.
The very fact that I am diagnosed with BPD, a personality disorder that affects the way I relate to other people, often makes me feel more anxious and depressed, particularly due to the stigma and misinformation that still surrounds the illness.
Anxiety and depression are perhaps the best recognised and least stigmatised mental health conditions, but BPD continues to exist in a space where people are very suspicious and ill-informed about what personality disorders really mean.
Having more than one mental health problem can be incredibly exhausting. Some days I just don’t want to get out of bed because I’m afraid of how my brain will react to the world around me, and I can never be sure about whether I can cope with situations that just aren’t a problem for other people.
Unfortunately, I have to worry about ableism and discrimination, particularly when meeting new faces and navigating the workplace. I need reasonable adjustments to be made for me at work, but that’s something many employers still have difficulty embracing.
In my friendships, I struggle with very high levels of anxiety and I find it tricky to know whether my BPD is affecting my assessments of and responses to various situations. I’m lucky to have a group of supportive friends, many of whom have done their own research into what my mental health problems mean so they can better stand behind me and ensure that our relationship is robust and long-lasting.
Multiple mental health diagnoses also affect how the medical profession sees me and the kind of support I’m offered. Over the years, I’ve found that GPs are often daunted by the three different issues, and prefer to focus on the illness they feel most confident with. This means that I’m often left without support for the other diagnoses, and GPs fail to take into account the way that the illnesses intersect with one another. They are also hesitant to change any medication I’m on because all my medicines interact with each other in a delicate balance.
“I need reasonable adjustments to be made for me at work, something that many employers still have difficulty embracing”
Psychiatrists and mental health specialists are unsurprisingly more competent in this area, but referrals and appointments are sadly slow to materialise, due to the underfunding and understaffing of mental health services on the NHS.
The intersection of multiple mental health conditions doesn’t tend to be discussed enough, in part because it is such a complex issue. It’s also because we find it easier to pigeonhole people into single boxes, even though this is often too narrow a way to view and really understand those around us.
I hope for more acceptance around BPD and more compassion for people with more than one diagnosis, because we are navigating a world that can still be so hostile towards those with mental illnesses, particularly when they don’t fit neatly into one category.
It always helps to have friends who are willing to read about my conditions and understand the diagnoses, and employers who are happy to make the reasonable adjustments I need in working environments. It’s important to have people in my life who treat me as a whole, complex human being, rather than a set of illnesses or a problem to be solved.
My diagnoses inform who I am but they don’t define me.
Harriet Williamson is a freelance journalist. You can follow her on Twitter at @harriepw
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