Borderline Personality Disorder

Effecting 1.6% of the population or 4 million people in America, Borderline Personality Disorder, or BPD, is more common than schizophrenia and bipolar disorder combined. Most of these diagnoses are women however it is hypothesized that the stigma of mental illness contributes to men not seeking a diagnosis and treatment. It is being renamed to Emotional Dysregulation Disorder, Emotional Intensity Disorder or Emotionally Unstable Personality Disorder around the world to help spread more awareness and to better explain the disorder.

With nine symptoms, the disorder is complex and difficult to treat due to the severity of the symptoms. There are 256 possible combinations of symptoms making it unique for every person. 

Black and white thinking, or splitting, is when a person with BPD immensely loves something to extremes but one day, loathes the person or thing for no real reason. They flip back and forth between love and hate and many struggle to have moderate feelings as their love is all or nothing. They can split on a job and walk out, split on a hobby and throw it all away or split on a person and leave them.

The intense emotions and push/pull reaction of those with BPD stem from their deep fear of abandonment and rejection. Their ability to suddenly hate a person allows them to walk away before their subconscious perceived abandonment. Most of those with BPD are childhood  abuse victims and this coping mechanism often develops to deal with abandonment as they learned how to cope in their abusive unsupportive environment. 

Suicidal thoughts are present in most cases and 80% of those with BPD will attempt suicide in their life time at least once. Self harm is also a hallmark symptom as most borderlines self harm and most self harmers have borderline. This can be anything from cutting, burning, head banging or intentionally starving themselves. 

Impulsive behavior is also a problem and can be illustrated as road rage, reckless spending, sex, drug use or an eating disorder.

Their underdeveloped emotional regulation often leads to dramatic emotional episodes of extreme anger, extreme sadness, extreme happiness and so on. While an average person has an emotion scale of 0-10, with 10 being intense, a person with BPD has a scale of 0-20 as their emotions are extremely intense and usually unwarranted. One comment from a friend can result in a suicidal episode or an argument can result in broken dishes, slammed doors off hinges or self harming behavior. 

Paranoia is also common as those with BPD are often the victim of emotional abuse and manipulation. However, they also self perceive themselves as a victim when they may not be in that specific situation. They may believe a friend is plotting against them or their spouse is cheating. This can often lead to destructive behavior or splitting to cope.

A deep haunting feeling of being “empty” and purposeless is another symptom. Those with BPD often sift through various jobs and hobbies as they are always on a hunt for fitting in, happiness, stability and a purpose in life. The empty void is often filled with impulsive behavior and/or self harming behaviors.

While the mood swings of BPD mimic those of bipolar disorder, they are not the same as unlike bipolar disorder, BPD mood swings are usually based off of environmental factors, such as rejection or abandonment and the mood swings of bipolar disorder are a chemical imbalance. The mood swings of BPD can last hours or days. A long standing constant episode (multiple days or weeks) may indicate bipolar disorder rather than BPD.

Disassociation is also common and seen as a left over coping mechanism from their years of abuse. They learned how to emotionally remove themselves from the world in order to cope with their pain from trauma. Emotionally tuning out of life can destroy stability in everyday life and some may find themselves in lengthy episodes which cause them to feel only partially present. This act of stepping back is seen as a sort of “out of it” state that plagues many. Some report episodes last for hours or days while others report weeks or longer. 

The emotional immaturity of those with BPD makes every day life difficult. Many struggle to maintain basic relationships, jobs and a social life. Many do not work and their life history is usually speckled with job loss, school failure and general lacking the ability to interact with the world in the way their peers do.

The diagnosis of BPD can be difficult as it mimics bipolar disorder and post traumatic stress disorder. The diagnosis is often only given after reaching adulthood as some symptoms can be the result of teenage angst which are outgrown in maturity and not the result of having BPD.

While it has been seen as one of the most complex and difficult to treat mental illnesses, some new therapies are offering hope. However, the poor access to regionally close medical care, lack of insurance, the high cost and other factors present a road block for many. 

Some improve with age and treatment while others live with the disorder their whole life. Some are receptive to therapy while others reject it. Society sees those with BPD as manipulative, abusive, dramatic and attention seeking. There is an ongoing debate in the actual legitimacy of the disorder as some believe the behaviors of those with BPD are simply to garner attention or sympathy. 

BPD is a misunderstood disorder. The people with BPD are typically very sensitive and emotionally intense. They love fiercely and passionately with little holding them back. As they struggle in day to day life, many are secluded from society as a result of self isolation or explosive behavior that makes them an outcast.

With more awareness, those with BPD will gain more access to information, diagnosis and treatment. The jaw dropping suicide rate is nearly 500 times that of an average person, making it the deadliest mental illness. With more accurate information, the stigma of BPD will be fought and these passionate souls will gain more acceptance and support.

I Am Suicidal And This Is What I Need You To Do

I know what you’ve just heard me say is a shock. Something that should make my skin crawl is on my mind and I can’t stop thinking about it. It’s like that itch in the arch of your foot as you scramble to pull your shoe off and scratch it. But that itch is ending my life and as each moment passes, it grows with intensity.

What I want to tell you is that I’ve actually been trying to tell you for some time now. I’ve written out a message to your several times, but deleted it. I’ve picked up the phone to call you, but hung up before I dialed. I don’t want to bother you. My brain is telling me that you are too busy and you don’t care. My brain is telling me that I’m being selfish to ask for your help. My brain is telling me to not send that message; delete it.

So what I’ve just told you has been rehearsed in my head a hundred times and typed out a thousand. I am gritting my teeth to scream for your help after being silent for so long. Please listen. Please listen to my scream as I whisper to you my deep dark secret. I have told you my truth that I have been holding in for so long. I have told you I have an itch. What I can’t explain to you is that this itch isn’t just recent.

It’s actually something much bigger than that. You see, since I was a child, I have been putting together a puzzle. I have been planning my own death and with each new found realization surrounding my death, I place another piece in place. As I settle on the location, the method, the time of day, my last letter and my will, I build my puzzle.

Unfortunately, as time has gone on, my puzzle has become stronger. Piece by piece, the details of my death become solid and I grow more and more content and comfortable with the idea. As my comfort and satisfaction grows, the danger increases and my dangerous puzzle threatens my life every waking moment. But you hold a piece; the most important piece.

You are ultimately what is going to halt the completion of my puzzle. Your refusal to allow me to put that piece in place is refusing to allow me to complete the puzzle and refusing to allow me to see my puzzle come to life. This is the last piece and you hold it in your hands.

I know that it’s a lot to ask. I am asking for your emotional labor and your time. It is a lot of me to ask of you to be so involved with my thought process and to swim in my emotions with me. I know it will be exhausting and sometimes you just simply won’t be able to do it. I know that you have your own emotions and thoughts to tend to and it is truly selfish of me to ask you to dip into mine but I need you to.

When you can, I need you to hold this puzzle piece tight. And I need you to battle with me. You have always told me that you support me in my battle with suicide so I am here to tell you what I need you to do. I am here to tell you that there is a battle to fight and that battle is me.

I need you to fight with me. I need you to tell me reasons to stay. I need you to remind me of my daughter’s face when she learns mommy has died. I need you to remind me of the years I would miss, the love I would miss. I need you to tell me that I’m not harming anyone and I am not a burden. I need you to tell me that it’s been a bad day and tomorrow will be better. I need you to tell me that the pain will pass, it always does. I need you to argue with me because I don’t believe it.

I may seem like a child, but my delusional thoughts are telling me that I am literally physically causing you harm by existing and the only cure to end your pain is to end my life. I literally believe that an imaginary woman would replace me and fill all the voids I would leave behind. This person is smarter, funnier, calmer, happier and acceptable, as I am a cancer of the earth only to be disposed of as soon as possible so I can allow my replacement to step in.

But I need you to remind me that you love me. I need you to tell me that I am valuable. I need you to tell me that no one will replace me. I am important, I have purpose. I know it’s ridiculous and I am asking a lot, but I need you to help me fight this battle with me. I need you to argue. I need you to find reasons for me to stay, even if it’s just one. Maybe my cat would go hungry without me or I would miss our son’s graduation.

I know it sounds childish but this is what I need. You hold this important piece of my puzzle in your hand and you can easily set it down and walk away. Many people have done this to me and I have had to fight to the urge to pick up the piece and complete my puzzle. One day, I will not be able to fight that urge and I will put that piece in place, the puzzle will be complete and I will be gone.

Giving you this piece is asking a lot of you, I know. I don’t mean to be so demanding and to ask for so much emotional labor. But the reality is that this is how it is and this is what I need you to do. You say that you love me and support me in my battle with mental illness so I need you to act on that. I need you to fight alongside me.

So now that I’ve come to you to whisper my deep secret to you; the itch that I must scratch; my fantasy of my own death, I need you to not allow me to scratch it. Hold my hands to help me breathe. Tell me why I must not scratch it. Remind me that it will pass. I know it always does, but I’m just caught up in the moment and I’ve forgotten. I believe the pain will never end. I believe I am already dying from the inside out.

But your refusal to give me that puzzle piece halts the completion of my puzzle and forces me to continue to exist even though I have spent nearly every day of my life wishing otherwise. This incomplete puzzle, this scratch I must itch, haunts me every day. It is always there, though some days it is louder, but it is always whispering to me to do it. Complete the puzzle.

The message I’ve sent to you just now has been typed out a hundred times but I didn’t want to bother you, I know you’re busy. I know I’m not worth your time. But I’m begging you to please help me. I am drowning in the ocean and I have this one second to hit “send” or whisper to you my wish to end it all. You have this one opportunity to not give me the puzzle piece. You can refuse to allow me to complete the puzzle. You are what will save me from myself.

Maybe this isn’t a good time for you and you can’t fight right now, I get it. I know that you may have your own puzzle going on, and it’s a lot to ask of you to keep my piece. So I ask that if you can’t fight with me today, please hand it to someone else. Someone else may be able to fight with me today in your place and it’s okay, I’m not mad. I understand. But please don’t set the piece down and walk away. Because one day I won’t be able to fight the urge to put that piece in place and complete my puzzle. One day, my puzzle may be complete and then it’s game over. I will really believe that I am better off dead. The world would be free of me grip. I would truly be saving you from me.

So now that you know what to do, please know that I love you. And that’s why I’ve told you my secret today. That’s why I have reached out. That’s why I have finally dialed your number and told you about the missing puzzle piece. I know that it’s a lot, but your acceptance or rejection of this piece is life saving. So I need you to take this seriously and I need you to battle with me.

I know that it’s a lot, so if you can’t battle today, I understand. But please give the piece to someone that can battle because I can’t battle alone. I might not be able to resist the urge and I will have to complete the puzzle. I will have to scratch the itch and then it’s my last day. My puzzle will be complete.

I need you to not allow me to complete the puzzle. I need you to not hand me the piece titled “No one really cares (they shouldn’t, I’m a loser) and the world is better off without me (because I am causing everyone pain). So I should just end it all; end all of the pain and suffering I have and caused as my life is trash to be thrown away and holds no value.” Your refusal to give me this puzzle piece is saving my life. So please help me today. Help me fight this battle. I need you the most today. You will be saving my life. You will be saving me from myself.

Thank you so much for taking the time to read this. I know that you are busy with your own battles to fight and your own worries to have. I know that I’m asking a lot of you to listen to me today and in the coming weeks, months and years. I’m asking for your service. But I love you and you said that you want to support me, so here is what I need you to do. I need you to fight with me and argue with my brain.


Signed,
Your suicidal wife

Favorite Person

With nine different symptoms, Borderline Personality Disorder has 256 different variations. Some are introverted while others may be the life of the party. Some experience dissociation or paranoia while others do not. Meeting one person with BPD is just that, meeting one person, one version of over two hundred flavors. Everyone is different.

However, one fascinating topic that comes up frequently in unofficial discussion of BPD is the “Favorite Person” phenomenon, or simply “FP”. While not an official symptom, the occurrence of this unofficial experience is common and it is a topic that has been written about in books and publications. So what is an FP?

When a person has BPD, their emotions are extremely intense. Included in this intensity can be an intense bond with another person. This bond is unlike a typical friendship or relationship. It is not having a best friend or being deeply in love with your boyfriend. Having an FP is intense and can be dangerous at times.

When the FP phenomenon happens, it is often fast. Nearly overnight, the person with BPD becomes absolutely obsessed with this new person in their life. It could be a coworker, a relative or a new friend. The often  one-sided intense connection is far beyond a typical relationship.

The person with BPD forms such an intense bond with their FP that they become emotionally dependent on them for purpose, self esteem, acceptance and approval. They seek their FP’s approval like an eager child tries to please their teacher. At their FP’s request, the person with BPD may change their appearance or personality for acceptance and approval. They live to please their FP.

This can lead to major problems in the relationship and may even fuel an abusive relationship. Like Harley Quinn to The Joker, the person with BPD is nearly willing to do anything to please their FP, even if that means breaking laws or enduring abuse. They live and breathe for the love of their FP.

As with the seasons of life, relationships change and people that may be good friends one day may move away the next. The nearly inevitable abandonment of all relationships leads the person with BPD to a panicked frenzy for day their FP abandons them. If there is a threat, real or imagined, the person with BPD will make frantic efforts to prevent abandonment, even threatening self harm or suicide at times.

The dramatic relationship is often one sided so while the FP may be a benign coworker, the person with BPD may secretly believe they are desperately in love and hang on every word. However, any kind of rejection from their FP results in an extreme response of self hate, self harm, suicidal thoughts, panic attacks and more. A simple unanswered text message could lead to an emotional breakdown and a look of disapproval may result in suicidal behaviors. The person with BPD seeks to please their FP at almost any cost.

This unhealthy relationship is a codependent nightmare. The person with BPD depends on their FP for love and approval. They may shut down and barely function when their FP is not around or unavailable. Their inability to function on their own can feed an abusive relationship and make it even more dangerous. The person with BPD may have more than one FP at the same time or several over a lifetime. This uncontrollable bond can develop overnight and can lead to unhealthy and abusive behavior both as a victim but also as an abuser.

Having an FP is nothing to desire. This emotional roller coaster relationship dictates a person’s emotions and day to day life. It puts a tremendous and unfair amount of pressure on the FP and the obsession can lead to stalking in some extreme cases. While some learn to maintain a healthy relationship with their FP, others may go down a bad path of being abusive or abused.

We all want to have strong relationships however an FP relationship takes it to the extreme. This relationship can lead to pain and suffering of both parties while laying the groundwork for an abusive relationship. Of course, as with most with BPD they may one day lose all emotions for their FP for no explainable reason and suddenly develop a new FP relationship with a different person. An FP can be a neighbor, a friend or they may not even love or even notice the person with BPD. This unhealthy relationship is a situation to be worked through and corrected as no person should be so emotionally dependent on another that they are literally willing to risk their life for a small ounce of acceptance and approval. A healthy bond should be the goal of every relationship and those dealing with the FP phenomenon can experience extreme obsession and even abuse.

What I Have Learned From My Nuerodivergent Son

My dream of becoming a mom started with baby dolls. I had names picked out and throughout school I took every child development class I could get my hands on. I read parenting books, babysat neighborhood kids and even began working on a degree in child development. I was an expert.

In my 20’s I began to have my children. A few things didn’t go exactly how I planned but it was a smooth road. I breastfed, cloth diapered and made sure they had the recommended tummy time exercise. My oldest daughter was toilet trained at 18 months, we learned our ABC’s and I applauded as they met every goal and milestone on time or earlier. School began and of course they were “A” students with spectacular behavior. I was perfect.

After my divorce, my perfect parenting continued just how I planned until a monkey wrench was thrown into my well oiled machine. I was unexpectedly pregnant. It was a dark time of unemployment, depression and poverty. It was an emotionally draining pregnancy and my planned out life became a mess. We hung on despite it all and a little 5 pound baby boy was born in August. I was scared, but I was a master by this point. I could do this with my eyes closed.

I knew something was wrong at home when his urine was orange, so we immediately went back to the hospital we had just came from. It was discovered that he wasn’t able to suck correctly. We spent a week dealing with a poor performing pancreas and insulin checks after every feed but we were able to work around it with special bottles and a state of the art breast pump. It was just a little bump but I could make it work. Pumping did not work however and I was devastated when my son began formula feeding. The changes continued from there and it was just the beginning.

He slowly approached milestones and seemed to have his own set of rules. As he grew from baby to toddler to preschooler, his differences grew. He was the most energetic person I had ever met. He was so energetic that he physically hurt himself from his behavior. He jumped off furniture, knocked books off of shelves and broke countless household items from rough play or pure destruction. As my older children continued to be awarded with Honor Roll and dazzle the crowd, my son failed to reflect my expertise. I didn’t understand. I fell off my parenting high horse and the fall was long, hard and painful. I had gotten it all wrong.

I learned that everything that I had thought to be important was actually irrelevant. My organic breastfeeding days were gone and I had a child that had sensory sensitivities. My concern over vegetables and sugar went out the window as my son resisted eating and would vomit if he didn’t like the flavor. I fed him anything he could tolerate. He was so active that he was physically incapable of sitting down long enough to eat so I resorted to strapping him into his high chair and putting him in front of the tv to eat.

He didn’t play with toys like other children. He smashed through the house like a raging tornado and I was certain would never toilet train. His speech was so distorted that I (his perfect mother) struggled to understand his few words and he was unpredictable around other children and animals. He required constant supervision far more than my other children. Inconsolable meltdowns became normal in our household, both his and mine, and my perfect parenting practices fell apart one after the other.

I was assured by other parents that he was “just a boy” and he would “grow out of it”. But as time grew on, more red flags popped up and he continued to struggle to interact well with the world around him. Other children refused to play with him because of his impulsivity and he left a path of exhausted child care providers. He started preschool at 4 and I will never forget the look on his teachers face when I picked him up from school on the first day. I decided to take him to a psychiatrist.

The process of testing began as well as therapy and intervention. He began speech at school and his teacher gave him small goals such as sitting on the circle time carpet for 30 seconds. I had always been the parent with the “A” students so I had barely talked to my children’s teachers beyond a conference once a year. Now suddenly, I was talking to a teacher every day.

I had decided years ago that I would never drug my children with those dangerous stimulants however after a full school year in preschool with zero progress and a constant 1:1 behavior aide, I knew that we had to do something. We began to explore medication and other treatment options. Our household catered to his needs. We bought a sturdy living room set that could withstand his jumps and he began taking melatonin to help him sleep regularly. I learned to stop taking the lead and instead follow in his. I learned to play by his rules.

I learned to stop trying to make him conform and instead, I conformed. The school granted an IEP and he continued working with an aide. I built a strong relationship with his teacher, therapists and psychiatrist. I reached out to local parent support groups and I joined online support groups. I let go and I finally started to learn how to parent the right way.

He is now six and I am learning more each day. He stems when he is concentrating and clothing tags are like a cactus. We give transition warnings before any changes to his environment are made and he has a full book shelf for his collection of household items. His weighted blanket helps put him to sleep and I am certain that we have watched The Sandlot as a family at least 3,000 times. We are all learning.

Today was an awful morning so I cried on the way to school while his favorite song played on the radio so he couldn’t hear me. His hair hasn’t been brushed in two days and his shirt wasn’t buttoned but today was the first day he buckled his own seat belt. He had ice cream on his face but at least he ate. I’ve grown tired of his favorite song but he smiled when I looked in the rearview mirror. I'm growing.

I never thought I would be the mom to give her child cold hot dogs for breakfast, but here I am. I never thought I would be the mom to not care about academic success, but here I am. I’ve learned what is truly important. I have learned to follow instead of lead. I have learned that it’s not a competition. None of it is. I have learned that my children’s success is not the result of my parenting but rather their hard work. I have learned that “success” is different for everyone. I have learned that I really have no idea what I’m doing but I’m just guessing and hoping I made the right choice. I have learned to let go of the reins and to allow my children to grow in their own way, in their own time.

My son is growing more each day. He has a bumpy road ahead of him with different treatment options, accommodations and medical advice. I’m not sure what the future holds for us but I do know that I will be right there with him, on the sidelines, cheering him on as he succeeds in his own race in his own way. I am so proud of his hard work and determination and I will always be there every step of the way.
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I'm Lying About My Diagnosis

There is a secret about mental illness that no one talks about. It is something that not all, but many people with a mental illness believe. It is buried deep in our souls and we barely whisper it to professionals, support groups or therapists out of fear and embarrassment. It is a question that some of us have that we may never believe we have an answer to.

If you go into any internet mental health support group and search for "Am I lying about my diagnosis?", you will get possibly pages of people asking the group to see if it's possible to subconsciously fake being mentally ill. Over and over, people question their diagnosis even if it's been reaffirmed by multiple doctors or has been long standing. Despite years of medication, therapy and doctors, some people still question if their experience is all a big lie for attention or pity. 

People that live with a mental illness begin to have symptoms in childhood or early adulthood, long before a diagnosis or treatment. Those who have lived a life with Bipolar Disorder may question if they genuinely have the disorder or if they are fabricating a dramatic tale. A person that deals with Depression may ultimately believe they are inventing their symptoms. And while you may attempt to assure this person that they aren't making up being mentally ill for attention, they will likely still hold the belief that it is all really a big sham.

The effects of believing their mental illness is not genuine may lead some people to halting medication, skipping appointments, ignoring advice and guidance and it may possibly lead to self isolation and depression which further complicates their condition.

While we know that many people with a mental illness question their diagnosis, the question of this phenomenon is why? It is not a true DSM symptom of being mentally ill although it is noted in some books and publications which indicates that it is a common occurrence to some degree. But what is it that causes all of these people to question their diagnosis even after the tests, doctors and support? What causes them to question it all and stop taking their medication?

Also, common within the mental illness community is the experience of being told that the symptoms are calls for attention or special treatment. People with a mental illness are told over and over that they are faking it for attention or their symptoms are just theatrics. Friends, family and even medical professionals doubt people's symptoms and diagnosis. So it is no wonder that after years of being told it's all just a game, people begin to believe it.

Symptoms beginning as a young child may be met with rolling eyes and sighs as the belief that the child is just acting out grows. As the child ages, they will internalize the comments and eye brow raising and over time, a seed will grow which will tell them that they are truly making it all up for attention or they are just being immature. The younger the symptoms start, the more difficult it is to compare life before a mental illness developed so while those who develop depression in their 20's may feel confident in their diagnosis, a person who developed Borderline Personality Disorder in childhood may question the validity of their diagnosis as they do not know what it feels like to not have symptoms of a mental illness.

A person that lives with depression may question if they genuinely have the symptoms or if they are simply just "lazy". But when people are depressed, they become so depressed that they skip meals because they are too unmotivated to simply get food. In extreme cases, severely depressed people may urinate on themselves because they are too unmotivated to go to the bathroom. A severely depressed person may isolate themselves in their bedroom and cut off contact with friends and family. Imitating these symptoms would be near impossible for someone that doesn't experience them in just the same sense as it is impossible to imagine life without depression if you've always experienced it. 

Our natural human instinct is to eat, have fun, be social and survive. Thinking of your own death should make you flinch while a suicidal person can't stop thinking about it. A mentally ill person may lay in bed for 16 hours and stare at the wall while a person who is mentally well would rather get up and participate in enjoying their life. A person that is mentally ill may eat so much that they vomit while a person that is mentally well would reject food if they were full. The behaviors and emotions of those that are mentally ill are inherently abnormal and believing that people carry on a years long "lie" of maintaining abnormal behavior and emotions simply for other's pity is simply disgusting and damaging to the mental health community.

People with a mental illness need to be met with understanding. When a person says they hear voices, they should not be questioned or doubted. When a child shows symptoms of anxiety, they should not be pushed into situations with the belief that it's all made up for attention. When a new mom expresses dark feelings and emotions, she should not be questioned or have the duty of having to prove herself. People who have a mental illness need the support of those around them, not for those to question their experience and the validity of their diagnosis. Carrying on with the lie that mental illness is really "all in your head" directly contributes to stopped or discontinued treatment which may lead to injury or death. It is a major part of the stigmatization of mental illness and questioning a diagnosis further spreads the message that mental illness isn't real.

How to Support Your Partner Battling Mental Illness

Part of being in a partnership with someone is dealing with the difficult times along with the easy times. It is easy to love someone when times are good. It takes minimal effort to show affection and happiness is all around. But it is the difficult moments that makes a partnership challenging. It is when their world falls to their feet and they need someone to catch them as they fall, that they need you the most. The times when all is hopeless and they are in the depths of rock bottom, it is then that your partnership matters the most.

When your partner lives with a mental illness, it can be incredibly intimidating. Supporting them through their symptoms may leave you feeling confused and not helpful. This will be a challenge in your relationship but if navigated correctly by both parties, the partnership can blossom from the bond that has grown as a result of the challenges you have faced together.

When a person has a mental illness, their emotions, behavior and thoughts are impacted. It can be confusing as a simple event or situation can cause a dramatic breakdown or they may push you away when they actually need you the most. The misinterpretations leads to poor communication and arguments may ensue as well as hurt feelings. This can leave you wondering what to do when you partner has a mental illness and how to best support them. Here are some tips:

1) Clean the house. Often times, a mental illness or condition such as depression can put adult responsibilities on hold. Dishes may stack up and something as simple as cleaning out the cat box can be overwhelming and simply not possible at times. A cluttered house can increase anxiety and may lead to more depression due to being overwhelmed. A load of dishes and quick vacuum may at least make your partner feel less anxious and more comfortable.

2) If your partner is anxious about something, talk to them about their fears. When a person is anxious, they tend to focus on the worst case scenario. It can be helpful if you become the voice of reason and attempt to dismantle their anxiety by breaking down their fears. Talk to them about their anxiety and help them see the reality of the situation instead of a potential catastrophe.

3) Your partner may struggle to follow their treatment plan. Juggling multiple appointments and medications can be overwhelming and a person with a mental illness may even reject treatment at times. If they need help, you can remind them to take their medication or encourage them if they are resisting. You can also attend appointments with them if they need an advocate. Picking up their medication at the pharmacy may be helpful as well as knowing which side effects to look for. It is important that you both come to an agreement of doing your own part in their path of wellness as your effort is just as important as theirs. They may need encouragement to stick to their treatment plan and having positive support can make a huge difference.

4) Come up with nonverbal cues that your partner can use to communicate with you. An example of this is if you are attending a social event and your partner wants to go home immediately but is unable to communicate this with you, they can discreetly pat your hand or arm quickly three times to communicate with you. Making eye contact and giving "the look" can also help communicate this immediate need to depart a social event. Another example of this would be them squeezing your hand if they feel a panic attack coming on but are unable to verbally communicate.

5) Find out what helps ease their panic attacks. Some people enjoy being bear hugged during a panic attack while others may lock themselves in their room. As you support them during and after panic attacks, take note of what triggered it and what helped ease it, if anything. Explore possibilities such as a weighted blanket or a phone app for meditation.

6) Write your partner a love letter for them to read when they are feeling down. It is common to be unable to recall what happiness feels like when a person is depressed. They may even forget the good qualities of themselves. Writing them a love letter can help refresh their emotions and remind them of your support and love towards them. Having a physical copy means that they can pull it out when they need it on difficult days.

7) Be open with communication and find what works for them. Maybe just a quick phone call can help them or talking through text throughout the day. However, some people with a mental illness have a difficult time respecting boundaries so it may be necessary to agree on boundaries such as not calling during work hours.

8) Offer to take over tasks that they are having a difficult time with. They may shy away from the public and hate grocery shopping or they may fear the crowded post office. It can be helpful to help with errands during difficult times. It can also be helpful when a certain chore is taken out of their hands which can dramatically reduce their daily stress which may include cooking dinner in the evenings or paying the bills.

9) Encourage self care. Self care is anything from eating healthy to taking time to read a book. Help them find what works for them and encourage them to have a self care day on difficult days. Bubble baths can be a great stress relief and accompanying them on a walk may get them out of the house on a routine basis. 

10) Listen to them. Sometimes they will only be able to answer "yes" or "no" questions while other times their mind is racing. Either way, listen to them. When a person is severely depressed, every word takes effort to think about and speak. Listen to their carefully chosen words. If they express fear or embarrassment, listen to them. Sometimes all they need is for someone to listen to them.

11) Take every crisis seriously. All suicidal threats should be taken seriously. If your partner is in crisis, help them find immediate help which may be a crisis line, a hospital or a doctor. Find out what the local crisis numbers are and write them down. 

12) Give them their space or reassurance. They may push and pull during your relationship and it's important to allow them to have their space when the need it but also calm their fears if they need reassurance of your support or feelings. 

13) Take care of yourself. Having a partner with a mental illness can be incredibly taxing at times and it's important that you take care of your own mental health. If you need additional help, find out who can also help you care for your partner in a crisis situation. Take time for yourself to clear your mind and find ways to relax. Set boundaries and limits if necessary in some situations.

Supporting a partner living with a mental illness can be exhausting but also an opportunity to strengthen your bond and build your relationship. Keeping open communication and giving them encouragement can be the difference of a successful and unsuccessful treatment plan. While the medications and therapies help a lot, it is the support of those around them that help them along their path of wellness. By being a supportive partner, you can give them the encouragement and love that they need and you can battle the mental illness together as a team.

Depression Is Letting The Dishes Stack Up

Depression is letting the dishes stack up for a week. Depression is eating a chunk of cheddar cheese and a spoonful of peanut butter for breakfast because you are too unmotivated to prepare food. Depression smells because you haven't showered in five days. Unanswered emails, unfinished projects, dropped plans, incomplete attempts; depression is abandoning. It is sleepy and cold.

Depression is calling in sick to work with "a headache" even though you want to explain that you have been crying on the bathroom floor all morning, but you don't. It is ignoring homework, bills, obligations and standards. It is all consuming and suffocating. Depression is feeling like a failure, a burden, an embarrassment. It is being ashamed, apologetic and hating yourself. Depression is being so deep in the pit of despair that the only way out seems to be ending it all.

Depression is laying in bed for 13 hours and staring at the ceiling fan. It is sleeping too much or not at all. Eating too much or not at all. Depression is losing the will to breathe. It is matted hair, overflowing trash cans, lost jobs and lost friendships. Depression is gained weight, lost weight, low self esteem and millions of tear drops. It is wanting to sleep for 1,000 years. Depression is lonely.

Depression does not ask for much, nor does it draw attention to itself. It lurks in the shadows of the room, hiding behind the curtains and false smiles. Depression fools those around it into thinking that everything is fine. It is a liar. Depression hides behind closed doors. It hides behind excuses and explanations. It is skipping dates, not returning phone calls, pushing people away and losing the will to go on.

Depression is feeling hopeless, unlovable, undesirable and not good enough. It is feeling desperate, inadequate, worthless and a waste of space. It is losing hope. It is being alone, scared and so very tired. Depression is losing the desire to see the future and hating the present. Depression is dirty floors, failed tests, overflowing laundry and a nap that lasts all day. It is painful, bleak, heartbreaking and soul crushing. It is one word answers and an indifferent shrug.

Depression is ignored, hidden and lied about. It is punished, shamed, frowned upon and ridiculed. Depression is misunderstood as laziness, selfishness and pity seeking. It is shoved to the side, pushed away and turned away.

Depression is all around. It screams from the painting and shouts from the songs. Depression lurks in diaries and journals, novels and photographs. It runs down cheeks, is whispered on lips but often left to the wind. Depression is in a friend, a coworker, a daughter or an uncle. Depression is a young child. Depression is in the mirror.