How Not to Fall Apart: Lessons Learned on the Road from Self-Harm to Self-Care - Softcover

Chapter 1

Before We Begin

Is this a good idea?"

"Is this a good idea?"

"Are we sure this is a good idea?"

This is the conversation I have with myself the most, sometimes out loud in the futile hope someone out there will reply. I said it when I told my doctor about my anxiety, I said it when I swallowed my first dose of Citalopram, I said it when I took myself to the ER, and I said it when I was thinking about writing this book.

Is it a good idea to write about something I'm still very much in the middle of? It feels like writing about war when I'm still on the battlefield or reporting on an earthquake when shockwaves are tearing down houses around me.

Deep down I know that writing this book is a good idea because it's what's helping me continue on. I have a Quality Street tin of mental health conditions that sometimes decide to get together and make a joint appearance. One condition at a time is relatively manageable but when they all flare up at once it feels like I'm walking around with my head on fire. Only no one can see the blaze. Apart from the scars that run up and down my arms like a train track, everything looks calm. Business as usual.

I hope that by writing my story, by turning my brain inside out and making the invisible visible, I can help someone in a similar position, someone who feels they're stuck in the trenches and there's no way out. What I've learned so far is that no matter how shitty your situation is, there is an escape route, and every time you climb out you'll be more equipped to deal with the next falling down. This book aims to remind people of that, and myself too.

No matter how shitty your situation is, there is an escape route.

Ultimately, your mental illness lies to you. It'll tell you that everything is wrong and that you have no future. It'll tell you that you should be ashamed and you're a nuisance and you don't deserve to get help. The world in which depression and anxiety reign supreme is extremely lonely, and I wanted to write this book to reach out and say: "Hey there, you're not alone, I'm right there with you."

Having said that, everyone's mind is unique, and while our background and diagnoses might sound similar, my story can't encompass your entire experience. In fact, diagnoses can be a strange thing. I was told I had unipolar depression at age seventeen, then a doctor came along and added bipolar to the mix in my early twenties, another one went back to the original conclusion, and finally, aged twenty-seven I was told I have borderline personality disorder. Each time I received a new diagnosis, I assumed I'd step out of my doctor's office and my entire life would change, but it never did. Instead, my mental health remained the same tough slog of a thing I have to push through to move forward.

This book isn't specifically about my borderline personality disorder, but it might touch on symptoms of that condition. I'll also touch on depression, anxiety, self-harm, and self-esteem while moving through my body-the head, the skin, the heart-and the world around me. I'll talk about the moments we all have when you're stressed, angry, sad,or all three. When you're plummeting into a sinkhole. When you feel so lost you could do with a map that tells you where you are and where you're most likely going to be tomorrow.

Depression is in no way equal to "sadness," but I am sad an awful lot. So I've also filled this book with little everyday reminders to pull myself out of my brain ditch. There are notes and anecdotes plastered all over my walls, my phone, my notebook, my mirror, and the back of my hand, and I've put them all together on paper in a way I hope you'll find useful. Some of these reminders are set up as lists. I love lists. They impose a sense of organization onto a lot of the chaos that whizzes around in my head. I make daily to-do lists. I make them for work. I make them for when I get home. I make bigger picture lists: week goals, month goals, year goals. I also have lists for things to reward myself with: tattoos, books, films, playlists.

The most important aspect of lists for me is the fact that they are a direct link to the future, even if it's as immediate as what I'm going to be doing in the next half hour. Lists tell me I need to hang on. They tell me not to give up just yet, which is why I'm using them so often in this book. Hopefully they'll have the same effect on you too.

While I hope to offer you the best advice I can, it's important to remember that there is no blueprint for experiencing a mental health problem. There's no one-size-

fits-all solution either. Personally, I've found reading about others' experiences to be enlightening and comforting, so I hope this book can achieve that for you. If anything you read makes you feel stressed out or uncomfortable, make sure you speak out and ask for help.

Now letÕs begin.

Chapter 2

Remember This When the World Won't Stop Spinning

PANIC AT THE DISCO

I'm twenty years old standing at the top of Row Mead and I'm about to die. Amy Winehouse has appeared on Glastonbury's Pyramid Stage. She weaves a halo over Worthy Farm with her booming voice and erratic yet hypnotizing movements. She's singing "Back to Black" and I'm trying to drink in the words that I've come to know so well, but there's a problem-something awful is happening to me. I'm pretty sure I'm dying.

Between "Cupid" and "Back to Black," my legs had turned to jelly, my stomach somersaulted, acidic dread had climbed up my throat, and as I fell toward the muddy grass I hoped someone would tell my family I loved them, because this was it. At the very least I was losing my mind; at the worst my life was about to end.

I opened my eyes and realized I was somehow not quite dead yet. My boyfriend, P., lifted me up and carried me to the medical tent, assuring me along the way that yes I was still breathing. The nurse handed me a plastic cup of water and suggested I go lie down in my tent and lay off the Ecstasy. I wanted to tell her I'd never done drugs in my whole life, but something told me she wouldn't believe me. I was ushered back outside, where Amy was still playing somewhere in the distance.

I hoped my weird dizzy spell was a fluke, but we had to cut our Glastonbury trip short: whether I was standing in a crowd of Kings of Leon fans or waiting for falafel in front of a food truck, I kept experiencing that surge of feeling, like my-life-is-ending-right-this-second. I was constantly sprinting back to our tent to cry and hyperventilate into my sleeping bag.

When I left Glastonbury and returned to my student life in Bristol, I convinced myself that whatever happened at the festival was the result of dehydration or perhaps a dodgy sandwich. But then a couple of days later it hit me again on the bus, then again in the student union bar, and again in lectures and one-on-one tutorials. In the moments between attacks I didn't feel right either. I felt disconnected from everything around me like my head was stuck in a snow globe. I barged into the doctor's convinced I had diabetes, a brain tumor, chronic fatigue, an iron deficiency, vertigo, meningitis, Ebola, Alice in Wonderland syndrome (yes, this is a thing), migraines, IBS, and meningitis again. I did test after test, but I was constantly told that I was in perfect health. During my fifty-sixth trip to the doctor, a new GP saw me. He asked how often I drank alcohol: "barely ever." And how often did I do drugs: "never." He put his pen down on his desk.

"I know I'm not supposed to say this, but you're a student, and that's sort of what students do."

"I don't like going out."

"Why?"

"I don't know. I don't like it."

"Do you have many friends?"

"Um, no."

He swiveled his chair around to face me. I felt that familiar dizziness again. My mind began to drift out of my body and the painted sailboat on the wall seemed to rock back and forth.

"Have you ever been diagnosed with depression or anxiety?"

"I saw a psychologist when I was a teenager, but that was because I used to self-harm."

"And now?"

"Not really."

"Not really?"

"I don't self-harm as much."

He gave me a stack of leaflets, some URLs that were scribbled on Post-its, and told me to have a read and get back to him. On my walk home I toyed with this new idea. Maybe I didn't have a terminal illness; maybe whatever I had was-mental?

While I had seen a psychologist as a teenager, those sessions were back in the Netherlands, where I'm from. The term "anxiety" had never been mentioned, even though I do remember discussing the feeling. The word in its English form seemed floaty. I kind of knew what it was, but not really. What actually is anxiety? What does it look like? How can you stop something you don't understand?

For me, anxiety is like having a crystal ball, but the ball is distorted and cloudy and everything in there is the most messed-up version of events. For example, "I can see that my future holds a work presentation and I bet I'll shit my pants and vomit on my boss and I'll never work in media ever again!"

The following week my doctor gave me the official diagnosis of generalized anxiety disorder. While coming to terms with anxiety as something I was dealing with, I realized how cruel a condition it is. Yes, it's in your mind, but it feels extremely physical. My symptoms include sweating, trembling, heart palpitations, and nausea. The nausea has always been my least favorite of the bunch; it's that horrible dragging feeling in the pit of my stomach that will stay long after the stressful event is over. It makes me feel like I'm constantly on the verge of puking, but nothing will ever come out of my throat. At university, the nausea developed into emetophobia (a fear of vomiting) and prevented me from showing up to classes, going to pubs, and even just leaving the house. I was in permanent fear that I'd puke wherever I went. Sometimes I'd get on the bus, only to have to get off again after one stop and walk home. I couldn't handle the rest of the twenty-minute journey.

I've also fainted and almost fainted a dozen times because of anxiety. I end up sending myself into such a whirlpool of worry and panic that my breathing spirals out of control, I feel dizzy, I start hyperventilating, and boom, I'm on the floor. While I was never in any actual immediate danger (apart from the time I fainted at the hairdresser and she almost stabbed me in the head with her scissors), I genuinely believe that in that moment I am going to die. It's the thing people really underestimate about panic attacks. It's not a matter of "just calm down." You can't, because it feels like you're trapped inside your own body, and the only escape is the relief you'll feel when the light finally goes out. You will die. There's no other option. It's terrifying.

But then when you do come out the other side, you live in constant fear that it's going to happen again. Any hint of nausea, mild dizziness, or a shaky hand and it's all systems go in my head. I imagine a bunch of army men running around preparing for battle: "She's about to blow, fellas! All hands on deck!" There's also that lingering feeling of shame after I survive an attack. When you were so certain you were about to die and yet you're still very much alive, it can feel like a slight anticlimax. Not that I wanted to die, but I'm embarrassed I genuinely thought I would and yet here I am-blood pumping, heart racing.

I've had anxiety in places that were so mundane and boring I'd never expected my body to unleash such an extreme reaction. In an Asda in Bristol during the height of my anxiety, I attempted to go food shopping with my boyfriend, P. It was one of those enormous Asdas where it seems like there's an endless stream of garish lights dotting aisle after aisle after aisle. I'm always afraid that in large supermarkets or shopping malls I'll get swallowed up; I'll be stuck in an aisle and never get out. Supermarkets feel like a mangled maze, and there's no place to stop for a rest. You have to keep going, right to the till, where if you're not fast enough you'll hold up all the people behind you.

P. walked ahead of me, ticking off the list of groceries I had meticulously made. Thanks to my fear of puking everywhere, I didn't really socialize at university, so I had a lot of time to do things like make a joint food plan to last us a week. I'd organize the list in food groups making it easier to find in the supermarket. I'd then calculate exactly how much the items would cost and split them down the middle so we'd each pay half. P. didn't really mind my food shopping dictatorship. It meant he saved money and didn't have to worry about what he was eating for dinner.

So we were in Asda and had only just made it to the fresh food section when I felt the panic settle in. I stopped in my tracks. The bright supermarket lights seemed to merge to form a wild tidal wave about to crash on top of me. I passed the shopping list to P. like we were soldiers in an epic war movie and I was handing over a picture of my wife and kids to my comrade before taking my last breath: "Go forth, be brave and please tell my wife I love her."

To the outside, I probably looked relatively normal. As P. went off into battle, I decided to find an aisle that was less busy. I found the entertainment section and picked up one of Britney Spears' unofficial biographies while my vision blurred and turned to blue. I slumped to the ground but managed to hoist myself into a sitting position. I felt like everyone was staring at me, so I grabbed the book and pretended to read. I sat there until P. collected me and we walked home. I felt defeated and silly and stupid and refused to talk about what happened. I spent the rest of the evening in bed.