I woke this morning heavy hearted, and I’ve already idled away some unknown mindless length of time pondering why it is I feel so crap today. I think I’ve finally now worked it out.

I’m not sure if I’m ill or well (mentally/psychologically) and I’m trying to work out which of the two things I am-cause I have to be one or the other don’t I?….surely?

I have BPD. I’m black and white and cognitively inflexible bows

I see the world as either/or. I see myself as either/or. I see you as either/or.

Am I ill? Or am I well? That is my question. This is the issue I personally wrestle with huge amounts and can’t stop wrestling with.  If my therapist were here she’d say “summer- it doesn’t have to be that you’re either well or unwell. You can be shades and variants of both at different times.”

Visualise my inflexible mind exploding at this flexible suggestion. I’m cognitively inflexible, remember!

I’m black OR I’m white. I’m all OR I’m nothing. I’m ill OR I’m well, and there is n.o.t.h.i.n.g  inbetween.

The ‘am I ill or poorly issue’ is a recurring theme in my therapy. I’m sure my mental inflexibility must really annoy her (among other things), because no matter how many times she tells me life isn’t a discrete category of one thing or the other, my mind will just NOT compute this bonkers notion.

When she tells me that there doesn’t have to be a choice made, and that you can be both ill and well at the same time – all you need to do is visualise smoke and steam emanating from the vicinity of my NHS patient chair and that’s a fairly accurate image of how much this blows my tiny mind.

What the actual FUCK?! (is what I silently think). grimace

I will often physically shake my head when she says this flexible-ness, in an attempt to shake my cognitive inflexibility away, just as a wet dog would do shaking muddy water off it’s fur; but try as I might I just CAN’T be cognitively flexible. (Even me saying categorically that I CAN’T be cognitively flexible, is evidence of my categorical inflexibility 😛)

My identity is as black-and-white categorical and discrete as is everything else about me and how I perceive the world.

When I wake each morning I need to work out if I am ill today or well today. There is a logical and understandable reason for this…I have unstable mood, so tracking where I am on that mood continuum is a natural mechanism for keeping my otherwise emotionally chaotic life reasonably ordered and monitored, whether that is illusory control, or real discernible control. It makes sense I guess that I would become hyper vigilant in assessing my mood state regularly, given that I’ve already had such a long battle with my mental health. But my whole personality and self identity changes with every variation in my functioning and mood, and that is the BPD bit of it.

I am ill me, till I am well me, but I can never ever be ‘indifferent me.’ I just can’t do indifference, or vague watered down approximations of X shades of greyness. I am either ill or poorly. Job done. Truth. Yes?……no? Choose one of the other. You MUST choose.

‘Both is just not an option’ commands my brain.

The difficult to handle cognitive dissonance aspect (internal stress at incompatible ideas), rears it’s head when people react to me as if I am ill at times when I perceive myself as well, OR when people respond me me as a “normal person”, assuming I’m well, when inside I feel shite.

If people suppose I’m ill when I feel well I feel……….pissed off.

If people treat me as a well person when I actually truthfully feel ill, I feel……….. like a freakish fraud who is pretending to be what I’m not and not benefiting from any assistance at dealing with this BPD mood monster that lives inside me.

Why don’t they see how unwell I feel? I ask myself. Nine times out of ten though it’s my own responsibility, because I don’t like to tell them how I really feel because that feels too exposing and difficult for me to do. I seem to spend most of my life either concealing my illness and silently resenting that people are treating me as a normal person when I feel not normal (in other words not treating me differently because of my illness, which is on the face of it, good) OR getting frustrated that people can’t seemingly view me as a capable happy shiny person when I’m well, but instead seem to perceive me as a loose cannon who needs patronising mental health warnings and concerns over keeping myself well and looking after myself (kindness on their part granted, but fucking irritating from my perspective).

Do you follow? I’m as confused as you are believe me.

I’m rarely satisfied. But that may just be down to me and how I manage my illness and communicate it to people…… People can’t win with me I suppose, because I’m a continually fluctuating beast. My psychiatrist said to me on our last sesh that mental health services didn’t know how to respond to me in a way that I find consistently helpful because when I feel good I impatiently want them to forget that I’ve ever been ill and want them to trust that I’m now well and will be forever well (which is unrealistic) OR I want them to be there for me nurturing and caring and supporting the very moment I feel unwell to avoid me feeling vulnerable and emotionally uncontained (which is unrealistic because I’ve just been trying to convince them I’m well now and don’t need wrapping in cotton wool, so the professionals have backed off by this point). When she said this, it stung, because Dr Cautious actually had a point there, and it’s deeply threatening whenever people point out the truth.

I feel most of my life I’m either pandered to for my illness when I actually feel well, OR not pandered to when I actually feel unwell. My response was that I wanted them to be more flexible, and listen to me when I say I am well or unwell and respond accordingly. But really, maybe the onus should be more on me to be more flexible and communicate more effectively. Who is right? Who is wrong? Can the professionals and me both be right and wrong in different aspects?

BOOOOOM smoke billows from my cognitively inflexible brain

Is the difficulty actually not about them, and  instead in how I communicate about myself about my relative illness or wellness? squints in full concentration

Who the hell am I? Am I ill or poorly? And how can other humans know how best to treat me and perceive me when my swings from illness to wellness are so unpredictable and so continual and so bloody intense?

My psychiatrist used to see me a few months apart and the differences in how I [psych speak] “present” to her, are so vastly different that imagining I am the same patient must be a stretch for her. It’s the same with my therapist who I see weekly. How the fuck can she prepare for an appointment with me in advance?! She has no bloody idea what she’s in for! I could be rock bottom, I could be bouncy and vibrant with a flight of ideas, or I could be quiet and reflective. Sometimes I’m friendly. Sometimes I’m reserved. Sometimes I barely speak and mainly listen. Sometimes she can never shut me up. Sometimes I feel I don’t need her. Sometimes I want to cling on for dear life. I can also be both well and ill in one therapy session, just as I can be be both very ill and perfectly well within one sodding day. Sometimes only minutes apart. I can be capable and confident and smiley then weeping and crumbling and drowning half an hour later, but I don’t communicate those extremes to people as quite frankly, I’m ashamed of it.

I allow people to visibly see a small fraction of my mood swings. I conceal the rest until I’m alone. It is perfectly possible for me to attend a meeting all smiles and then cry the whole drive home at the sheer effort of hiding for that hour or two of the day that I’m honestly feeling really bloody awful. If I authentically was myself in all situations in all moments, I predict I would not socially survive. I would have no friends and would barely achieve anything (so I imagine anyway, so the fear of that possibility leads me to protect myself via altering my behaviours).

Mood swing concealment is an art I have become a seasoned expert at.

Minimisation is my super power. Even if I say to someone “I’m not feeling great today”, what I actually mean invariably is far worse than that. What I tend to actually feel on days I admit I’m ‘not great’ is closer to this…….

“Today I badly want to self harm to soothe the internal agony I’m feeling. Today I am pretty much questioning my entire existence on this planet, believing myself to be an inept useless piece of crap who I should destroy for the benefit of humanity. Today all I can foresee is my future as a stretch of everlasting endless psychological pain. I’ve wanted to die more or less since I was born, and today just trying and succeeding in not hurting myself is about as good as it gets. If I can get through the day not giving into those self-destructive urges then that’s about the best I can hope for. Fingers crossed I keep myself safe.”  

But I don’t say that! Because the mentally ill truth isn’t socially palatable, is it?

 If I actually said in response to the “how are you” question, “well, I’m actually battling suicidal urges today- how are you!” or “I’m very keen to self-harm today and using any technique I can to distract myself but hopefully I’ll manage to keep myself self-harm free and add another link to my no self-harm paper-chain,” I doubt anyone would ever speak to me again!

So sometimes I have to hide my illness and play down my symptoms, only to end up feeling horrible when I’m alone again feeling all the ill and crap stuff juxtaposed with the mental confusion of having been treated as a well person just a short time earlier, because I presented to them as a well person! My fault though isn’t it. Or society’s I suppose.

Note to self- It’s easier to blame society. Good plan summerSHINES ;)

It’s tough. I’m low. This sucks. I’m trying not to be down though because I’m too busy right now to be depressed. The timing is inconvenient. sigh If I could wave a magic wand I’d want to be allowed to be ill when I’m ill, and well when I’m well, and people take me as I am in real time. It’s hard for them though, and for me. I need to figure out how to manage my differing shades of illness and wellness.

If anyone had some wisdom to share on the ill/well continuum do please throw it at me in the comments section as I’m a bit bamboozled and confused as to what I do. If you have a mental health condition which fluctuates in severity, how do you manage this issue? Do you have seperate ill and poorly identities as I do? Do you communicate fully to people the extent of your downs as well as your ups? How do you react when people treat you as ‘well’ when you’re ill, or ‘ill’ when you actually feel well? Am I the only one wo struggles with this?

Wisdom appreciated, please!!

summerSHINES ©