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My mental illness has been my longest relationship.
I was diagnosed with my first mental disorder at 12. Fifteen years and two more diagnoses later, I have a much different handle on mental health (stigmas and overall management) and disorders than many of my adult friends dealing with diagnoses for the first time in their lives. Even members of our generation—one that is much more open to the realness and prevalence of mental illness—can experience this unfortunate, trickle-down influence from their parents’ generation.
When a doctor tells you you’re mentally ill, you may feel like it’s basically the end of the world, or that you’re a different person now.
A pattern I see often is that, at least for a short time, some people will take a diagnosis as a new identity to commit to—as in, “Hi, I’m Jacqui and I’m mentally ill.” Watching this happen, it almost looks like when people become engaged and start adjusting to the word “fiancé.”
Suddenly you’ve got this new commitment forming in front of you, and you’re planning to share your future with another entity.
We could draw some parallels if we wanted to get creative. But it’s important to note that you’re not committed to your mental illness, nor it to you. In fact, nothing has changed about you whatsoever. Who you are, how you function, and what you’re made of are exactly the same as they were before your official diagnosis. Yes, perception is everything, and you’re moving into a new perception of yourself, which can take some time—but if you’ve been living with a mental illness (or several) undiagnosed and without help for any period of time, you’ve actually been given a gift.
Things a diagnosis is not:
What a diagnosis is:
Two of my diagnoses came as a huge shock to me until I had time to digest them, so I do understand why so many struggle with their diagnosis. If just yesterday you felt like one of the normies who just happened to be going through a rough patch, a diagnosis for a mental illness can seem like someone just flipped the table on your own identity. Everyone reacts differently to it, and a ton of that stems from how your family will handle or perceive it. Sometimes there’s shame, sometimes there’s fear of rejection. Will this disappoint my parents? How will everyone react?
Something well established by medical professionals in a great tome called the DSM. You have been given a name through which you can access studies, treatments, allies, specialists, medications, and communities to gain a better understanding of how your brain works and what methods have proven effective to make your life feel more manageable.
I’d apparently had anxiety my entire life and never knew it. I never thought of myself as a nervous person, because I could function in situations other people couldn’t. I spoke up in classes, I could perform in front of strangers, I could present, and I could lead. I was outgoing and loud-mouthed from the very beginning. For most of my life, I equated anxiety with shyness. It took five whole years after being diagnosed with clinical depression for my panic disorder to evince in a way that halted my outgoing capabilities, and when the diagnosis came, I thought it had manifested suddenly within myself, as if out of nowhere.
I thought, surely there was a trigger. Surely the subway—where I had my first full-fledged panic attack that I was cognizant of—had triggered this panic disorder into existing and now I was stuck trying to live my life around it. And this really did rule me for years and years. Going on public transit or being in a car I wasn’t driving required several benzos and a routine of anti-psychotics. It required the correct amount of planning: enough time that I could adjust my schedule around when I’d need to use the Xanax, and enough spontaneity that I wasn’t lying fetal somewhere dreading going out for hours on end, becoming more and more agoraphobic until I’d simply bail. Going to class was hit or miss, to the point where all my teachers had to be told that my anxiety was so crippling that if I got up unannounced and had to leave class, they were to let me with no questions asked.
It was only after several years of living like this that I realized the strangling fear I felt as a child when the lights when out in movie theatres was the same panic disorder I’d officially been diagnosed with. Hell, the amount I made myself physically sick in my single-digit years because I was inexplicably afraid I was trapped or going to die should have warranted a diagnosis at ages eight or nine. Yes, being on a subway for the first time did trigger me considerably, but that disorder has always been a part of me whether I knew it or not. The difference now was that I could get effective help for it and begin to better manage that which controlled me.
My (current) last disorder is by far the most complicated in the bunch, and it’s the one I’ve spent the most time considering and navigating since the diagnosis was first given at 18. You may have seen the show Crazy Ex-Girlfriend, and while spoilers have never bothered me, I want to give you fair warning that there are minor spoilers directly ahead.
In season three, episode six, the lead character Rebecca is given a diagnosis for borderline personality disorder. Until that episode, this show was simply something relatively enjoyable that I could waste time with as a means of escapism. But when Rebecca was told that her new doctor had a new diagnosis for her that was different than anything she’d been given previously—that, in fact, she may have been misdiagnosed her entire life—the hope that she exuded overwhelmed me and it was in that moment that I felt the strongest oneness with that character, despite sharing that same disorder myself. That same sense of hope at the chance of reprieve is exactly the way I feel about receiving an educated diagnosis.
When the doctor reveals the disorder to Rebecca, he urges her not to look it up online. Of course she does, and she’s met with every terrible thing said about borderlines within seconds of hitting “search.” Borderlines are manipulative, many doctors refuse to work with borderline patients, the disorder is often lifelong, no medications are approved for the treatment of borderline… you name it. I was very raw by this point, but that was so incredibly relatable too. What’s always bothered me about the “borderlines are manipulative” thing is that “manipulation” is nearly always thought of as malicious and calculated. For myself, it’s desperate and self-deprecating. As in, “I’ll do and say and be anything if you’ll stay with me. If I think you’re leaving, I’ll work incredibly fast to turn the tables—even if it means being mistreated.”
I’m on year nine with this diagnosis, so I have faith Rebecca’s going to figure out through DBT, CBT, TFP, or even MBT that there are treatments that can work with her. But most importantly, her sense of hope from a new diagnosis was immediately gone and she felt dread and hatred toward BPD. Even a character with extensive therapeutic experiences, stints in psychiatric hospitals, and a nonchalant attitude about mental illness instantly felt ruled by this newly named part of herself.
From the outside looking in, I have no idea what mental illness must look like, because I empathize too severely over the entire topic. Between spending most of my life in my own treatments and losing loved ones to suicide, I can only see diagnosis as a semi-straighter path forward instead of an insurmountable hurdle to drag around behind you.
Here’s the truth: I let my illnesses rule me for much of my life. Most, even. I am far from having a clear sense of self (just one little piece of my BPD). But I am thankful every day for my diagnosis of borderline, because even in periods without therapy due to insurance or lack of available doctors, I can take a step back when I am being destructive and dangerously impulsive and ask very important questions.
Am I dissociating?
Am I devaluing this person I care about?
Am I idealizing someone who’s abusing me?
Am I being mistreated or do I deserve this?
Will doing this fix the situation in any way?
But I’m also a successful editor, a college graduate, a loyal friend, and a (struggling) writer. I’m in a successful, symbiotic, and fulfilling relationship. I owe all of this—all of the will I’ve ever had to be productive and worthwhile—to the clarity my diagnoses have given me. To the reprieve that can follow.
As that was probably the most mindful I’ve ever been (because I have an unquiet mind and can’t leave myself alone with my thoughts safely ever), I have to finish season three of Crazy Ex-Girlfriend if anyone wants to join me.