Sunday and Monday were a mess. But on Monday afternoon I was already feeling slightly better.
Before I go on with this post I want to make it very clear that I am not apologizing for my previous post, my behavior, or my thoughts. Nor am I addressing anyone in particular, you’re all very kind and thoughtful. The pain is all part of living with depression and BPD (or borderline traits), and if we want to help reduce stigma we must be as honest as possible so others can fully understand mental illness. Now, with that in mind…
There was no obvious trigger for Sunday’s meltdown. However, I had been feeling things going on a downward spiral depression-wise since last Thursday. I was in a lot of pain. And when I say pain, the best way I can think of explaining it to people who don’t have depression or experience with mental illness, is comparing it to a myocardial infarct (a heart attack). Except in this case, it’s a constant emotional infarct, and you don’t just feel it in your chest but in every corner of your body, even in the air you breath. Unfortunately, it’s something you don’t understand until you’re in the thick of it (much like med school).
Also, and this is a cruel part of depression, is the fact that a lot of people (myself included) find that when they are in the deep throes of depression they simply cannot cry. Trust me, I’ve wanted to cry so many times, and I wanted to cry so much on Sunday, but it was simply impossible. It’s like your body refuses to produce tears, just to mess around with you, making the pain even more unbearable because the most instinctive and natural way of demonstrating/feeling pain is by crying.
On Monday, I was supposed to have an appointment with R. However, she had to change the appointment to Thursday. This hit me really hard, because after Sunday’s debacle I was still feeling really bad on Monday and I had put all my hope into having the interaction with R help elevate my mood. So, I went into a panic when her secretary called me to reschedule. And I did something I never do…. I texted R the following message:
Hey again, I’m so sorry to bother you so much today. I don’t usually do this but I’m quite desperate because I feel exceptionally terrible since yesterday and I have zero hope. I am NOT saying I am going to do something. I am simply reaching out precisely to avoid that from happening because I’m desperate, tired, LONELY, and I need someone who’ll understand my point-of-view as a medical student. Actually, I don’t know what the point of this message was anymore, so sorry! I just need a few words from a wise person so I can keep going and I would appreciate if you could say something through here that isn’t go call 911…Like I said, I don’t tend to do this because I don’t like to invade privacy, but it was a last resort , so I apologize for bothering so much!
She answered: I’ll call you in a few minutes I’m with patients now.
She eventually called. And we talked for about 15 minutes. I just broke down crying at one point and told her the pain was unbearable and I couldn’t take it anymore, that I was tired of living like this. I told her that probably other patients have told her this before, but that I’m tired of waking up every morning angry because I wasn’t dead. She listened and told me a few simple words, in addition to the usual “Do you feel you need to be in hospital? Are you sure you aren’t going to do anything?”. Mainly, I was just thankful for her taking the time to validate me and try to help me.
Among the things she said, was that I have to remember I’m going through a difficult period in my life (my recently accepting being abused) and that it is only now that I’m allowing myself to feel everything related to my past. She told me to look for a distraction, to get out of bed, to do anything that would take my mind off the topic, and to try to talk to my sister even if it was just meaningless conversation. She then said something that seemed a bit off at the moment, but it made all the difference the next day when I went back to the pediatrics rotation: she told me to remember my goals, that it’s evident medicine is something I want to do.
It all gave me so much strength, I am so thankful for that. When I finished talking with her I felt she had transferred some additional energy into me and I was able to force myself to get out of bed and take the day head-on. I was still feeling like shit, but I was able to manage.
And then yesterday I went back to the pediatrics rotation and I actually enjoyed my first day back. Things made sense again yesterday. I woke up and one of my first thoughts were R’s words: Remember your goals, remember you want this. As the day progressed I felt rejuvenated and I felt joy in having chosen medicine as a career. Then I had my appointment with G, who added more to he positive energy R had already given me. I felt I had purpose again, and my suicidal thoughts are hibernating for now.
So, that’s the aftermath.
Now, what I want to address is this: Just because I suddenly feel uplifted does not invalidate my feeling absolutely miserable on Sunday and Monday.
Why do I want to address this? I don’t think I’ve ever explained this before in the blog, but it really pisses me off when people invalidate your feeling horrible just because later on you feel slightly better. This rings especially true for people with BPD, and my evident change in mood after Sunday makes me want to explain this to those of you who might not understand and might fall prey to brushing it all off under the conclusion that it was just for show.
My thoughts and behavior were attention-seeking, yes, but not the “attention-seeking” people often discuss unfavorably where they make the sufferer into some kind of manipulator. They were attention-seeking in the sense that I WAS IN HORRIBLE PAIN AND I NEEDED HELP….so I reached out and searched for help. There’s absolutely nothing wrong with that. I want to make it a point that if you’re ever feeling pain, there’s no need to trudge on with it. Seek attention = Seek HELP. And whoever criticizes you for that isn’t worthy of being part of your life.
So, this all gets a bit tricky when you have BPD or borderline traits. Why? Because having emotional lability means your emotions will go up and down and all around in a matter of seconds, and people usually don’t feel comfortable with that. It results in others saying mean things like: “Well, you weren’t that miserable to begin with, since you’re looking great now.”
And that really pisses me off, because guess what? I was miserable. I was really miserable. I wanted to die, people. I was making plans in my head, taking into consideration every suicide-related detail. I’m not making this up just for shits and giggles. I don’t think it gets any worse than waking up in the morning and trying to decide between a belt or bedsheets to wrap around your neck. The degree of misery a person is feeling to have those kinds of thoughts is…unbearable…but unfortunately all too real.
Anyone can have these kinds of thoughts, I just happen to have them many times in a week because I have depression. And I have to live with that, I have to deal with it and address it. But having BPD or borderline traits doesn’t help one bit, because when you’re feeling this miserable you can’t see a future. You literally cannot see a future. You try and try and nothing comes to mind. All that is happening is the now, this moment. And the problem is that it feels like the now/this moment is going to be forever. In other words, “I feel miserable now so I will always feel miserable”. Imagine having to live with that in your head, being 100% confident and certain that you will be miserable forever.
So please, don’t invalidate a borderline’s emotions, behaviors, thoughts, feelings, just because one moment they’re miserable and the next they’re cracking jokes. It doesn’t take away the fact that a moment before they were feeling miserable. It reminds me of a fourth year med student who was doing a rotation in psychiatry when I was doing my third-year clerkship. She was angry at a patient who possibly had BPD because when we picked her up at the unit’s recreational room she was cracking jokes, but then when we sat down to talk to her in private she broke down crying and kept mum. I understood what she felt, the fourth year med student however, was accusing her of being manipulative and rolling her eyes.
But since BPD and depression aren’t the only mental illnesses in existence, the general message of this post is the following:
Never invalidate what another person is feeling. You don’t know their story, you don’t know their background, and you have absolutely no idea what it’s like in their head. The human being can be quite an arrogant and egocentric creature, we like to think we know everything about everyone. But just because others don’t experience the world the same way you do doesn’t mean their version is not real. One of the worst things you can do to someone is to invalidate their experiences. You might as well invalidate them entirely as a person.
Be kind, be compassionate, be gentle.
I have a splinter on my foot now from standing so long on the soapbox.