The Conversations We Don't Have Around BPD and Depression

Depression.

It is a topic I discuss quite frequently in a number of different settings and situations.  At some points, the discussion is deeply personal behind the closed doors of a therapist’s office or in a more intensive residential setting. Other times, the conversation is more generally focused on the epidemic of depression and how devastating it can be. I talk about it with coworkers and friends. I acknowledge its impact in stories I read online or hear about thirdhand. Though the discussions seem fairly extensive and I could likely talk for hours about how difficult it is to live, breathe and function when deep in the throes of a depressive episode, I want to talk instead about the conversations we don’t have.

Even within the taboo topic of depression, there are some areas that remain undiscussed… either too personal, too uncomfortable, or maybe too misunderstood to address with anyone who can’t directly relate.

I spent this morning in a women’s studies conference listening to bright young scholars and experienced field experts discuss marginalization, oppression, rhetoric, action, and honest conversations. I can’t help but have that context bouncing around in my mind as I write today. I’ve been incredibly lucky in so many ways and have privilege on a number of different levels. I am white, middle class, cisgender, well-educated, intelligent, well-spoken, well-read, and American (also, Texan, which is a privilege in and of itself). I have a  wonderful job, a roof over my head, sufficient finances to buy both the things I need and the majority of things I want. I run in circles with other similarly educated and economically independent individuals. In so many ways, my world is a very small bubble. However, at the same time, I am an opinionated, overweight, liberal, pro-choice (pro-voice, really), bleeding heart, social justice and activism oriented female in west Texas. I value inclusion, love, respect, and equal opportunities. I am a big fan of equity.

I don’t begin to assert that any of these qualify me to speak to the difficulties faced by minority/indigent populations or the LGBTQIA+ community, but my life has not been completely free of struggle and marginalization.

I had an experience a few days ago that would’ve been mildly annoying for someone who doesn’t have a mental illness, but for me, it was almost crushing. I was chatting with someone whom I know loves and respects me (and also accepts me for who and what I am) when he made an offhanded comment that he probably didn’t even think about. For me, however, the comment implied a level of neediness and desperation, a desire for attention and affirmation, and a general manipulative persona that I work very, very hard to avoid as completely as is possible. It has been a couple of days, and I am still hurt, saddened, and afraid I somehow let the darker side of my illness slip out.

In this situation, there are actually two hidden conversations. The first is internal. Even though he didn’t say, “I think you are trying to manipulate me into giving you specific attention and affirmation, and I am not going to do it,” that is exactly what I heard. When you have depression and borderline personality disorder, the inner dialogue often does not match the literal dialogue. I can hear someone say they love and value me, and all I can hear is that I will be a disappointment to that person.

I know it is distorted thinking. I know it is negative self-talk that I should not cater to or let dominate my life.

On good weeks when my depression is at a moderately low level, I can do that. On weeks that aren’t so good, I wish people could understand I am struggling just to keep my head above water.

This is the second unspoken conversation.

No matter how much love and trust is in a relationship, I cannot tell the other person something they thought was trivial was enough to send me into a tailspin. It is a matter of pride to some extent, but more so it is a matter of necessity. In the aforementioned situation where someone said something lightly or in jest and I heard something completely different, I know in my head the person who made the comment would accept my comments with love and grace and would try to assure me he meant nothing of the sort.

The problem for me, as a depressive in the midst of an intense episode, is I would hear this conversation as further condemnation of the fact that I mentioned it.  Hearing someone reaffirm what I know cognitively (that nothing was meant by the comment) serves only to demonstrate the huge gap between my reason and emotion. There are some days when the toll of self-hatred is so strong that functioning like a “normal” human (i.e. showering, putting on pants, letting the dog out, making food, etc) is truly more than I can handle. On these days, no matter the truth of the statement or the love behind it, I can’t handle having my own distortions pointed out to me.

I think of Maslow’s hierarchy of needs. On those days, my priority and goal is staying alive — not reshaping my distorted thoughts. Once I accomplish the first with some success, I can move on to the less primal needs.

Unfortunately, there are rarely acknowledgments for getting out of bed in the morning. There is no reward for going through the motions when my mind is screaming that it is all worthless and meaningless. Being an adult and just pushing through isn’t an essential job function.

This is a conversation that doesn’t happen. There are days when I only get out of bed because I have a meeting to attend. There are other days when I cry uncontrollably for hours, and only after I’ve managed to pull myself together can I actually focus on my work and accomplish anything. I can’t explain this to anyone.

And finally, for the conversation that no one ever wants to have, but is so necessary —the “S” word. Suicide. The event that can lurk in the back of a depressed and borderline person’s mind the majority of the time but only comes out from time to time. We don’t talk about it. Even when the thoughts are pervasive and overwhelming, it is not an “acceptable” topic to discuss. This is the one thing that is even iffy in the safety of a therapist’s office. Those of us with frequent suicidal ideation understand the very fine line that must be walked when sharing emotions and thoughts honestly without triggering the “imminent danger” mandatory reporting requirement.

This conversation goes hand-in-hand with my depression. There are episodes where the thoughts are gentler and more fleeting, but there are also episodes where the desire to take my own life is so overwhelming that it is almost more than I can bear. I don’t want these thoughts and feelings. I don’t enjoy keeping it all to myself.

But these are the way the conversations go.

No matter what situation I am in or what conversation is taking place on the surface, there is almost always a hidden conversation, that will never happen out loud, going on in my mind or heart. While I strive to live my life with honesty and integrity, there will always be an element of non-disclosure in my life. There will always be things I can’t say. There will always be days that aren’t good but can’t be discussed. There will often be thoughts I can’t share, both for my own safety and sense of well-being and yours. It is part of who I am.

Thankfully I am surrounded by those who love me and know me well enough to see the things I can’t say. They remind me in the darkest moments that there is light and hope and love, even when I can’t see it. I encourage you to reach out if you feel hopeless. Hear the words that aren’t being spoken and give them voice. Even if it is just to one person. Stand up and speak out. You are not alone.