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Five things nobody told me about living with a mental illness

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Since turning 18 I've actively sought and managed my own treatment, this includes seeing a raft of counsellors, psychologists, psychiatrists and health professionals.

I've had my share of hospital visits, undertaken a year of Dialectical Behaviour Therapy (DBT), completed a 20 day inpatient Schema program and recently started an Eye Movement Desensitisation and Reprocessing program.

I also take medication and have found a lot of purpose through my work in the arts.

I've been through all this and I'm proud of my progress. But my journey would have been easier if someone mentioned, all those years ago, five simple facts about living with a mental illness.

1 - People don't understand how much work goes into managing it

Living with BPD has been challenging because I present as 'high functioning'. In the past when people told me I was fine, I would try to be fine… until I couldn't.

For years I was in a cycle of everything's fine, crisis, seek help, everything's fine. Eventually I found a counsellor who I felt safe with. He explained that I was taking a band aid approach to mental health and suggested I try to improve my management plan.

I now see managing my mental health as the emotional equivalent to being a professional athlete. Even on days when I don't need help, I know I have to train. I've got to hit the mindfulness gym to build up my resilience. Instead of personal trainers I have psychologists. Instead of dietitians I have group therapy sessions. Instead of weight training I learn distress tolerance and coping skills.

It's different work, but it's still work – mental instead of physical. Just because it doesn't have a trendy hashtag doesn't mean it's something I can start and stop. It has to be incorporated into my daily life. 

2 - When I say 'BPD' you hear 'manipulative'

I can understand how from the outside looking in someone who has undiagnosed mental illness or compounded trauma can seem manipulative. Personally, I have a lot of abandonment issues and low feelings of self-worth, which can activate dissociation, self-harm and lack of impulse control.

When it happens it's confusing for me, so I can only imagine how it is for the people I'm closest to. But, these behaviours are past forms of self-protection and coping that I am trying to address.

In my last relationship, when I disclosed that I had BPD, I was met with, 'oh so you're a manipulator, like so and so'. It felt like I'd been hit in the chest. It hurt because I thought they understood how much effort I put into managing my mental health.

I explained that manipulation requires a certain level outcome awareness that I don't have. I reminded them that I'm aware I have a mental illness and I'm actively taking steps to manage it. They nodded and then said, 'yes, but I know how this works. You don't mean to be, but you're manipulative'.

I've always been open about my mental illness, but responses like this make me reluctant to tell people. It feels like no matter how much work I do, they refuse to see me beyond their assumptions of who 'someone with BPD' is. 

3 - Group therapy can be comforting and supportive

I'd been in treatment for depression and anxiety for years, but despite how hard I worked I had a lot of problems. In 2014 I was referred to a psychiatrist who went through the criteria for BPD. I remember just looking up at her with shock, 'how did you know everything? That's exactly how I feel'. 

For me it was a huge relief to finally have a diagnosis that fit. Because I could take direct actions to manage my mental health. My psychiatrist referred me to a DBT program. When I walked into the first session I was nervous. In films, group therapy sessions are commonly portrayed as a lot of crying about the past, and I was scared. 

I remember in one of my earliest sessions I talked about how I had trouble interpreting people's facial expressions and how confused people got about this, thinking I was being difficult. The facilitator asked the room, 'has anyone else experienced this?' Immediately four hands shot up and several heads started nodding. I let out a deep breath.

Don't get me wrong, there were tissues from time to time, but the group space was not about baring our souls. The focus was always on skills: emotion regulation, distress tolerance, interpersonal effectiveness and mindfulness.

Through group therapy I got a better understanding of how BPD works and what tools I could use.

4 - Stigma is real

My work in the arts has helped me stay engaged with my community. It's helped me stay connected with my body and it's helped me work as an advocate for others. However, even within the arts industry there is a stigma around mental illness.

The industry encourages artists to engage in self exploitation, which is counterproductive to mental health management. Despite the fact that mental health issues are prevalent within the arts industry, taking time off for mental health related issues is still not viewed in the same way as taking time off for a physical injury.

There are new initiatives being developed like the Wellbeing Collective with Arts Centre Melbourne, but there's still a long way to go. 

5 - Appropriate medication can help

I was like a lot of people who are dealing with the symptoms of a mental illness or compounded trauma. I didn't recognise how I was self-medicating with food, drugs, alcohol and even physical activity.

Working with my psychologist I was able to recognise my patterns. We talked about the pros and cons of medication early on and addressed my expectations. Medication is not a cure for BPD, it's a tool that may or may not work for each individual person.

In my case, we decided that it would be good for me to go on anti-depressants after I'd been actively engaged in my mental health management for a consistent period. Because I didn't have a strong support network of friends and family at the time, I was able to use anti-depressants as an additional tool in my support system.

Over the years my medications have changed slightly based on my needs. But, the important thing has always been talking with my GP, psychologist and psychiatrist to figure out what's best for me. That's an important rule for everyone.

Natasha is a SANE Peer Ambassador who lives with borderline personality disorder.

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