When Someone With Borderline Personality Disorder ‘Cries Wolf’ – Rehab Center

I’ve tried to reach out blindly to so many people for help these past few months, and all that’s done is given me the label “attention-seeker,” written off as manipulative, a liar and a waste of time.

Attention-seekers like myself are written off as lost causes instead of treated like people who are seriously and constantly hurting, who are only “wasting your time” because they know their own is running out. I want your attention the same way a person drowning wants the attention of a lifeguard, but I can’t scream for help and raise my hand because instead of drowning in water I am drowning in my own heightened emotions.

One of the most severe symptoms of borderline personality disorder (BPD) is recurring self-harm and suicidal behavior/attempts.

When it comes to feeling suicidal, I’ve noticed people stop taking you seriously after a while. If I was going to kill myself, surely I would have done it by now. In the minds of those who aren’t consumed by this disorder, I’m simply crying wolf in order to feast on some nice juicy attention again. The thing about “crying wolf” is that the wolf is invisible, but it’s still there. The reason I’m crying wolf is because the wolf is going to kill me.

I don’t know how anyone can feel like this for even one second of their entire existence and not explode fragments of their bleeding heart everywhere, because every second of being alive is exhausting. BPD has been described as the emotional equivalent of having third degree burns over 90 percent of your body. This disorder I wasn’t even aware I have has impacted every single part of my life.

The sleepless nights that turn into empty days.

The drugs and alcohol that numb for a minute and pain for an hour.

The constant, always present feelings of worthlessness and shame and of guilt. Guilt for who I am and what I’ve done to the people who used to be around me or are still tied to me because of relation or university class or a lease.

Cooking enough food to feed four even though I’m not hungry because it’s been days since I’ve remembered to swallow anything solid and that’s how many attempts it’s going to take to stay down. Pretending there’s something wrong with my scales because there’s no way I could be that weight, is there? It hasn’t been that long since I last ate…has it?

Holding knives against my throat at 3 a.m. because I can’t stand another second alone with my thoughts, tying scarves and chords into nooses that break, routinely overdosing on drugs not just on weekends with “friends” but in the middle of the afternoon alone in my bedroom, praying this is it. This will be the time my heart finally gives up and shuts down.

Crying, then laughing, then needing to cut, then laughing, then crying again, then arguing with myself about jumping off a building, then needing a hug. All in the space of an hour. Every hour. No breaks, no time outs, not even when I’m asleep because apparently with BPD even your subconscious is as unstable and spasmodic as you are. Nightmares and pleasant dreams lurch back and forth at sickening speeds until you awake confused and frightened, your reality questionable.

Always letting down the people in my life because no matter how hard I try I can never be more than what I am. Knowing that everyone I love who hasn’t already done so will leave me and never look back because they think there’s nothing left to look back on.

The look of disgust but not surprise on my beautiful housemate’s face when after everything I have put him through, from suicide attempts to uncontrollable emotional outbursts that required him to physically restrain me and call the police, he comes home to find me in my room drunk or high.

He thinks I don’t care, but all I do is care and that is why I can’t stop doing the things that are ruining my life. There is no neutral or in-between emotions for me, and until I learned what borderline personality disorder was I thought everyone felt the way I did and just handled it better.

Every emotion is like getting in the shower and either being hit with a stream of freezing ice cold water that makes your skin turn blue with cold and your teeth chatter, or getting assaulted with boiling hot water that stings your flesh and burns you deeply. I understand what lukewarm showers are, but I am unable to experience them.

The shower analogy also explains the way I see people around me. Black and white. All good or all bad. I will meet someone at a bar, share a laugh with them, accept their friend request on Facebook and then all but propose to them. Strangers will become family almost immediately and things like them not replying to my messages within a quick manner or rejecting an invite to hang out have the same impact on me as if they had punched me in the face or told me they wished I was dead. They have just confirmed everything I had always known about myself to be true. I’m disgusting. I’m unlovable. I’m nothing. Everyone hates me. I’m alone.

One of my best friends who now refuses to speak to me, once spoke to me on the phone for four hours when I was distressed. Not for the first time that week he did everything humanly possible to put me in a better headspace and reassure me I was loved, and it worked. Until he said goodbye and hung up the phone. Then it was as if those four hours had never happened. I remembered everything he had said and I still believed it all to be true, but I couldn’t retain the positive emotions I felt when he was speaking to me. I couldn’t hold on to the sense of relief and love I had felt only seconds ago, the shower was turned back on full blast and I was burning. So I called someone else. And when they hung up I messaged another person. My phone became full of screenshots of words of support and love from all those I communicated with, and for a while it helped me, but if I wasn’t continually receiving messages that proved people cared about me I would assume they had come to their senses and realized they would be better off without me in their lives. This fear of abandonment consumes me and causes my emotions to manifest into situations in which I will impulsively act out in dangerous ways in an attempt to communicate my pain to those around me or to try and sooth the storm inside me. These impulsive behaviors may seem like they are for attention, but more than half the time they take place when I am alone and no one is aware of them.

I’ve woken up more than once on my bedroom floor after purposely overdosing on a cocktail of drugs, surrounded by suicide notes I have no recollection of writing and a bleeding wrist. I have then continued on with my day because the world doesn’t stop just because I have. On my mother’s birthday I nearly took my own life after an argument with first my housemate and then her. I sat sobbing for nearly 10 hours trying to simultaneously convince myself to “just do it!” and also “Don’t be stupid!” I had convinced myself the best present I could give my mom was to not be in her life any longer. I convinced myself the only way I could make things right with my housemate was to permanently end my existence so he never had to look at me again.

I can’t remember the last day I’ve had where I haven’t seriously considered killing myself as the most viable option at least once. I am plagued by hopelessness. I can’t hold down a job because my emotional breakdowns happen out of the blue and I am unable to turn up to my shifts. I can’t do or say anything to get the friends that mean absolutely everything to me back in my life and in my corner again because no matter how badly I want to change and get better, I am a prisoner of my own pain and there is no key. I can’t find permanent accommodation because I can’t afford to live by myself and no one can stand to live with me. I can’t walk past a store without spending whatever small amount of money I have saved for bills or food on something to numb the pain.

It never stops and I don’t know where this disorder ends and I begin. Realizing what was causing my life to be so hard also made me realize I don’t know who I am, but I know who I’m not.

I’m not J. Jarvis anymore. Maybe I never really was.

I lost her somewhere between the sixth drink and the second pill. After the nightmares started happening while she was awake and the sun went down permanently.

I’m not the stand-up comedian or the soccer player or the writer I once prided myself on being.

I’m not anyone’s friend or anyone’s housemate or someone you met at a party once.

All I am is pain and loneliness and defeat swirling around in an underweight, scarred and tired shell. I’m only 20-years-old and already my life feels over. I want it to be over.

If you know someone with BPD please, just give them a hug because for that three to five seconds, you’ll make the unbearable agony inside of them endurable, and that’s all we are trying to do. We have no other choice. Every poor decision, every attention-seeking action is us trying to endure.



Borderline Personality Disorder Makes Me a Social ‘Chameleon’

For me, living with borderline personality disorder (BPD) is like living the life of a chameleon. I feel like I have no identity of my own. In any given situation, I am both consciously and unconsciously trying to be someone I think others will accept. Trying to “fit in.”

For example, I would say I like a diverse genre of music. Mainly because if I am around you and you like country music, I will then listen to country music. If you like alternative rock, then I listen to alternative rock. And so on and so on.

Sure this makes me flexible and adaptive in many environments, but it also means I don’t know what I like. There is a sense of panic and a wrenching in my stomach when you ask me what I like. The honest answer is really I don’t know. The fear of abandonment with BPD is so strong, it feels like I am constantly drowning and I have to use whatever means necessary to stay afloat. Even if it means putting your needs before my own.

In time, it becomes automatic without forethought. The pain of abandonment is excruciating. It feels like in the blink of an eye, everything I love and hold dear to my heart is ripped away. In that moment, I cannot think rationally and I think the way I feel right then is going to last forever. I spiral into the “nobody loves me and I am all alone” trap. Depression kicks in. I panic. I feel worthless. I feel I am a burden and the world is better off without me. I am sure from the outside, it looks like I am being overly dramatic. I assure you, I am not. I am merely responding based on the sheer intensity of my thoughts and emotions.

If you care about someone with BPD, I hope you can understand why we would do anything to prevent this from happening. It truly does feel like our world is crashing down on us.

And if you ask “What do you want to eat?” and the person with BPD says, “I don’t know” or “I don’t care,” they might be a chameleon like me and they are doing their best to adapt to the current environment they are in. Please have patience. We are doing the best we can.


Bipolar Disorder Facts Vs. Myths: What People Living With Manic Depression Want You To Know

Vincent van Gogh, Virginia Woolf, and Carrie Fisher were notable artists in their respective fields who all had bipolar disorder, though it manifested in their lives in different ways. The disorder, characterized by mood swings, from high (manic) to low (depressed), affects 5.7 million adult Americans every year, yet misinformation abounds.

In Ted-ED’s latest video, “What is bipolar disorder?” Helen M. Farrell describes what being bipolar means, its root causes, and the treatments for the disorder.

Read More: Signs Of Bipolar Depression Explained

So, can you separate fact from myth when it comes to bipolar disorder?


False: There are many variations of bipolar disorder. For example, type 1 has extreme highs alongside the lows, while type 2 involves briefer, less extreme periods of elation interspersed with long periods of depression, according to Farrell. Unlike bipolar disorder, depression has no mania, meaning there is no state of seeming very happy, confident, energetic and productive. In bipolar disorder, people go through both low moods or depression and high moods where they experience increased energy, feelings of euphoria, insomnia, and impulsive behaviors like promiscuous sex.


False : There’s a popular misconception that if someone with bipolar disorder is depressed, taking antidepressants could flip them into a mania. If people fall into a deep depression with bipolar disorder, they need the drugs. In a study in The New England Journal of Medicine, researchers randomly assigned 366 patients with bipolar disorder to a treatment of mood stabilizer drugs and a placebo or mood stabilizer drugs and an antidepressant for up to 26 weeks. The findings revealed there are no differences in adverse effects, like a shift from depression to mania between the groups.


True: Bipolar disorder gets worse if left untreated. A delay in diagnosis and treatment can lead to personal, social, and financial problems that can make the patient and those around them more difficult to deal with. Untreated bipolar disorder is associated with substance use, abuse, and dependence, and can lead to a 10 to 15 percent lifetime risk of suicide.


True: Doctors work with patients on a case-by-case basis to administer a combination of treatments and therapies that allows them to live to their fullest potential. People with bipolar disorder can benefit from even simpler changes, including regular exercise, good sleeping habits, and sobriety from drugs and alcohol. The acceptance and empathy of family and friends is crucial.


Why We Need to Stop Casually Throwing Around Words Like ‘Bipolar’ or ‘OCD’

If you say kangaroo enough times, it stops being a furry animal with a pouch and becomes a sound. The ang disconnects from the gar, and the shapes your mouth makes are foreign territory. It starts to feel impossible that you’ve ever said kangaroo in your life before this point. Semantic satiation is the study of repetition—the psychological phenomenon in which the echoing of a word causes it to lose all meaning. There are plenty of curious studies that prove the power of the word or the loss of that power. Language is weird and slippery, but its capability never to be underestimated.

I can’t remember the first time someone said it in front of me. But it happens a lot and always in the same tone: “I’m having a total panic attack about it” or “X and Y happened and I went mental, I had an actual panic attack.” To take that at face value, it’s quite an odd thing to claim a medical episode when you’re describing a mild to moderately stressful everyday incident. Why would you say you’re experiencing overwhelming and disabling anxiety, feeling like you’re being choked to death or having a heart attack, wanting to collapse under the desk, when you’re not? If I overhear this in public, I scowl and want to say, “Really? Did you really find yourself paralyzed in a cubicle wondering whether this will be the time you’re going to die, puke, or shit yourself—maybe all three?”

If I see it online, where it often manifests, I want to quote the tweet and show the mutation of language for what it is. This is just one example relevant to me and my own mental health, but it’s undeniably part of a wider discourse we’ve carried over into 2016. You’ll be familiar with it. It’s “I’m so OCD,” “he’s completely bipolar,” and “so depressed right now.”

Why has this slipped into speech in the first place? It’s part of our growing language of catastrophe. Whether it’s the media, ads, or public service announcements, everyone is demanding our attention, and in order to grasp it, the sell becomes exaggerated. In Britain, we’ve absorbed America’s insistence on hyperbole. We totally love or hate something and nothing in between. In case someone doesn’t know you’re being sincere, repeat “genuinely,” “seriously,” or “literally,” and that’ll work. The stakes rise on social media between average young person to person: We’ll go kill ourselves, we hate our lives, and we say fuck “everything.” Of course, brands and businesses regurgitate our drama and Mondays are a cause for faux-depression memes that insist we’re all in this together, so we stay in and watch their shows and deserve to eat our dark feelings with their junk. We’re a generation of oversharers, and why else are emotions there but to be shared?

There’s nothing inherently wrong in it. But when people say they’re having a panic attack when they’re just stressed, or “OCD” because they like cleaning, it points to either a total disconnect between language and meaning or a troubling symptom of self-diagnosis culture. Or, more worryingly, both. Naturally, anyone should be able to describe his or her own feelings and moods on his or her own terms. But at what cost and to whom?

Dr. Zsofia Demjen is a linguist who studies the intersections of language, mind, and health. She explained why this trend matters. “Using bipolar or schizo or essentially technical words to describe mundane or everyday experiences means the original technical meaning of the term becomes diluted and it becomes more strongly associated with these simpler or more fleeting experiences. It normalizes illness. The potential problem is that ‘I’m depressed’ now means ‘I’m sad.’ Then how does someone who actually has depression describe his or her illness or how he or she feels? How can people differentiate the much more complex, much more intense thing they have from this thing everyone always claims ownership of?”

David Hartery, 25, has bipolar disorder, and it pisses him off when bipolar is wrongly used. “It’s always to do with changeability or indecision, or even if they are talking about mood swings, it’s always making light of it. Bipolar’s quite a hard thing to live with so I think it’s annoying and spreads a false idea of what bipolar is, which is harmful.” Doug Thompson, who has OCD, finds this adoption of language similarly reductive. “Saying something or someone has OCD is on a level with ‘you’re being silly’ for me. I guess I associate it with being childish. And I’m sat silently thinking, You don’t know, whenever anyone uses it to effectively say he or she is just a neat freak.”

Ableist language like this matters because when people apply an illness to themselves, they don’t have to deal with it daily.

There’s something to be said for how it makes sufferers feel; they’re going through something stigmatized and often debilitating, while people are essentially being collectively flippant about it. Emily Reynolds is working on a book about mental health. Even she struggles when people misuse the term. “I know people don’t mean to do it and it’s thoughtlessness rather than spite, but it just wounds me a little bit every time and makes me feel I can’t trust that person,” she explained. “I’m happy to call out family or friends, but sometimes, at work, for example, you just can’t. [When] people throw around ‘I feel so manic’ or ‘he’s so bipolar,’ I just feel awkward about my diagnosis. Even with my level of willingness to talk about it, I feel small and awkward.”

The issue goes deeper than individual feelings. “If we come to understand mental illness as something everybody has on a weekly basis, it facilitates the attitude of ‘just snap out of it,'” says Dr. Demjen. “That in turn actually facilitates stigma because then if someone does have OCD, say, in the clinical sense—see, even I’m having to specify clinical here because already we have this dilution in language—his or her symptoms end up not being taken as seriously as they should be.”

Dr. Demjen talks about something else called negative evaluation, which happens when we refer to other people being bipolar or OCD. “When people say that, they don’t mean the person is clinically ill. They mean their behavior isn’t seen as positive. And again, if you take the idea that words acquire and change meaning, then bipolar or OCD acquires this negative association. Then people who are diagnosed with one of these illnesses perceive it as a negative evaluation and judgement of themselves rather than a neutral diagnosis. This facilitates the stigma that they feel and also the potential stigma that others might impose on them because they also have the same associations. If someone goes to their employer and tells them, ‘I’m depressed,’ the employer has those associations as well.” It’s a vicious cycle.

You’d never use a physical illness like cancer as a negative throwaway term to mean lazy or weak. But because mental illness is invisible to most, it enables this slip of language to happen.

If you exaggerate this concept, it begins to look ridiculous. You’d never use a physical illness like cancer as a negative throwaway term to mean lazy or weak. However, because mental illness is invisible to most, it enables this slip of language to happen. It’s so easy to conflate anything with mental health—with feelings and emotions—because those are also “in your head.” Of all these terms, depression has been casually used the longest. To say “depressed” is to quite literally mean sad, gloomy, or dejected, and as a result, we’re used to naturally hearing that in its own context. That’s where language fails with its multiple meanings.

Why have these other terms started to get used, though? Dr. Demjen suggests it’s in part to do with disorders being more in the public domain now. “It’s positive we’re talking about mental health in the true sense, the illness itself, as it reduces stigma.” That’s definitely something you can notice online—increasingly, younger people are casually tweeting about a day they took off of work for mental health, making jokes at the expense of their illness. These are positive developments. However, as Dr. Demjen points out, that leads to the terms being more in people’s awareness and contributes to the casual use.

Thankfully, language use can change within weeks, even days. “Similar trends in the past have been ‘gay’ being used as a derogatory term, which is frowned upon and there’s an awareness that that’s no longer OK to do.” It wasn’t that long ago that the media used “psycho” in headlines to interchangeably refer to anyone criminal or mentally ill. You’d be pushed to find a publication daring to do that now.

Kate Nightingale from Time to Change, the mental health anti-stigma campaign run by Mind and Rethink Mental Illness, says it’s down to both individuals and larger communities to consider their words. “Having a mental health problem is hard enough—hearing it trivialized makes it unnecessarily harder. You probably don’t mean to stigmatize or hurt someone with a mental health problem—so we’d encourage everyone to think twice about the possible impact of using mental health language in such a casual way.” When you speak, say what you mean.

It’s not about taking over language and deciding who can say what. It’s about having a word to express to people who don’t understand what is affecting us. Many find being diagnosed and given a term for their illness empowering; they can go online and research their illness, the science, and the facts. They can hang onto that word when they’re having a bad patch. Within the mental health community, the word has immense power. Satiating these words will eventually make them meaningless to everyone.


How the Deaf Community ‘Gave Me My Voice’ as a Person With Auditory Processing Disorder

Thank you, Deaf community, for giving me my voice back.

For all of my 41 years, I have been challenged by oral communication. For most of my life, I could only achieve verbal fluency in short bursts that were intermittent and unpredictable. I now know that my struggle with spoken language was in part because I live with severe auditory processing disorder. I suspect I also have autism, but getting a diagnosis as an adult takes either thousands of dollars or what seems to be an Act of Congress, and I don’t have the means to obtain either at the moment.

My auditory processing disorder went unnoticed and undiagnosed for my first four decades of life. After a brain injury, its effects on my speech became so pronounced that it was finally recognized. When I learned in middle age of the reasons for my intensified difficulty with spoken language, I was urged to seek therapy with audiologists and speech language pathologists to correct my perceived shortcomings. But I like who I am, so I sought another avenue. I went instead to you, the people of Deaf community, and I asked you to teach me your language.

When sensory overload takes away my ability to use my oral communication, the neural pathways to my hands still function. I can still use American Sign Language (ASL) to communicate when my brain refuses to allow me to speak English. But I do not want this process to be abstract when it is in fact very human.

ASL is different from many languages because the story behind it is a story of perseverance in the face of oppression. It is the story of Deaf people’s precarious triumphs over the oralists who would have taken their natural language and forced them to assimilate and use speech for which Deaf people are not as naturally suited.

I thank you for sharing ASL. I thank you for sharing stories of your historical and contemporary successes of building and maintaining a fine and functional culture that has no need for a typical relationship with sound. I thank you for helping me to understand how you have always embraced those who are different from the mainstream, how you have room for Deaf and deaf people, hard of hearing people, and deaf-blind people.

I am in a grey area between deaf and hearing, so I know my experience is not identical to yours. I do not wish to take more than you freely offer. I do not wish to speak for you. But I do wish to offer my gratitude for what you have shared, and acknowledge that I understand the challenges your community has gone through to simply establish that you are OK just as you are. That Deafness is not bad, but simply another condition with which some human beings live.

Your gift of signed language has given me my voice back. Your amazing visual vernacular is poetry to my optically-oriented brain. With this gift of ASL, I know I will be able to make myself understood in ways I could not before. Please accept my offer of deep gratitude.

Thank you.


What I Want My Loved Ones to Understand About Bipolar Depression

Before I tell you these things, I want you to know that at the end of the day I love you very dearly. You’ve contributed to much of my growth, and that is irreplaceable.

I want you to know some things about the mental illness I struggle with.

1. Bipolar depression is a little bit different than major depressive disorder. My depression is typically followed semi-closely after a hypomanic episode. There doesn’t necessarily need to be a trigger.

2. When I say I’m tired, I truly mean it. When the battlefront is your own mind, it is exhausting. I spend an inordinate amount of time shoving down the thoughts of hurting myself or the constant fear that I’m not good enough and that everyone would be better off without me. So when I say I’m tired, please meet me in the middle so we can accomplish what needs to be done.

3. Telling me to “just be happy” and “just get out of bed, you’ll feel better” is useless and invalidating. It hurts, honestly. When I hear those words, I hear a lack of support and a lack of encouragement. It’s similar to telling someone with the flu, “just get out of bed and get better! Your fever isn’t that big of a deal.”

4. My coping skills might not be like yours. I like small spaces. My closet. In between the wall and the bed. Curled up under every blanket in the house. Please don’t try to change my non-destructive coping skills. Some days they are all I have to hold onto.

5. You can’t fix me… because I’m not broken. I understand it must be confusing and painful to watch my highs and lows, but I promise you what means the most to me is when you’re still there when the clouds of depression dissipate.



What It’s Like to Feel Like You Are ‘Not Sick Enough’ – Eating Disorder

I am here to tell you one thing and one thing only: When it comes to having an eating disorder, the twisted concept of feeling like you are “not sick enough” is one of the most dangerous parts of the disorder. Eating disorders are not a contest. You do not have to be “thin” to be struggling. (I used quotes because the word “thin” is so loaded with societal judgments that it has almost ceased to have meaning.)

You do not have to “look sick” to be so stuck in an illness that you cannot imagine living another day. You do not have to be hospitalized to be worthy of seeking treatment. You do not have to check off all of the diagnostic criteria listed in the DSM-V to “count.” There is no such thing as being “not sick enough.”

In the interest of full disclosure, I am writing this as much for you as I am for myself. For almost half my life, I have struggled with feeling like I am “not sick enough” to actually have an eating disorder. Concerns voiced by mental health professionals, coaches, friends, mentors and teachers over the years paled in comparison to the voice inside my head telling me that unless and until I lost [x] amount of pounds; unless and until I actually fainted upon standing instead of the world going fuzzy around the edges for a few seconds; unless and until I ate under [x] amount of calories a day instead of subsisting primarily on self-loathing, caffeine and nut butter, I wouldn’t be sick or “sick enough” to have a real problem.

Let me tell you a little bit about what it is like to feel not sick enough. It is having people praise your dedication and commitment to health and fitness, when it feels like anything but. It is receiving attention and approval based on your shrinking physical appearance, when attention is the absolute last thing you want. It is constantly being barraged with comments of “I wish I had your willpower,” “You look so good!” or the perennial favorite: “What is your secret?” It is rationalizing, manipulating, lying and ignoring. Perhaps most terrifying of all, it is actually wishing you were more sick so that your disorder could be “real.”

Nobody would knowingly ask someone with an eating disorder what their “secret” is.  Yet, when you are outwardly healthy, you get asked that a lot. I never came up with a good way to respond, so usually demurred or laughed awkwardly. Not because I didn’t have a response, but because it would have been a little intense to respond as follows:

My secret? Do you want to know my f*cking secret is? My secret is all I think about is food. My secret is unless I exercise twice a day, my stomach would be so knotted in anxiety I would be literally incapable of functioning. My secret is I could not show up or be present in social situations involving food (Hint: all of them) without losing my sh*t. My secret is I was so intensely distrustful of and hateful toward my body I could not and would not allow it to tell me what it wanted. Hunger is something I understand, knew or listened to. My secret is the food you saw me eating had been meticulously prepared, logged, weighed, measured and planned days in advance. My secret is my life is spinning out of control, but it is fine. I was at a healthy weight; therefore (and despite all evidence to the contrary), I wasn’t sick enough to have an eating disorder.

There is a massive and dangerous dichotomy between the general public’s understanding of eating disorders and their harsh reality. Let me tell you, and tell you again in case you weren’t listening or ready to hear it the first time: eating disorders do not discriminate. They do not solely present as severe malnourishment in young, white females. They are not always (if anything, they are rarely) identifiable upon first glance.

They have little to nothing to do with a person’s weight. The number on the scale serves only to torment the person with the illness, and not as a gauge of their health or sickness. Because of this, countless people become more and more entrenched in behaviors that are killing them.

I hope this piece resonates with just one single person who may be on the fence between reaching out for a lifeline or continuing to struggle in silence. I said I was writing this piece for me, and I am. However, I am also writing it for you.

This piece is for the girls, the boys, the men, the women and the non-binary human freaking beings of the world. This piece is for anyone who has ever felt their struggles and their pain doesn’t “count,” because they don’t “look sick.” This piece is for the person who wants so desperately to believe they are worthy of help, love and wholeness, but still feels they need to get “sicker” before they have a “problem.”

This piece is for you. Because you matter. You are not alone. You do not have to show the world you are struggling with your food and exercise choices. You do not have to live the way you are living. While you may not realize it because the disorder is telling you otherwise, you are enough.


I Stopped Trying to Hide My Stutter & Here’s What Happened

I’ve been a stutterer for as long as I can remember. Well, I actually began stuttering when I was eight years old, but I honestly can’t remember what my speech was like the years before, in my fluent days. The National Stuttering Association defines stuttering as a “communication disorder involving disruptions, or ‘disfluencies,’ in a person’s speech,” and estimates that one percent of the world’s population stutters. Along with the inability to speak fluently, according to the Association, stutterers often experience physical tension in our faces, embarrassment, anxiety and a general fear of speaking.

As a veteran stutterer, I am well versed in the internal struggles that come along with the disorder. So, I spent a majority of my life trying to hide my speech impediment. My stutter is severe, meaning I have trouble speaking 70 percent of the time, so it hasn’t been easy to conceal. But I tried nonetheless.

In school and in social situations, I’d do all I could to avoid speaking. I’d pretend to text, I’d stuff food in my mouth, I’d leave a conversation and, worst of all, I’d isolate myself. I feared that if I stuttered openly around people, they would laugh at me. I feared that people would look at me as if I were some strange creature, that I would be an outcast.

This, in turn, left me with severe anxiety, low self-esteem and depression. I spent years avoiding opportunities that would require me to speak at length; I even avoided people.

This all changed in college, though. During my sophomore year, I decided that I wouldn’t hide anymore. Frankly, hiding such a huge part of myself was exhausting. I knew I couldn’t go on being afraid; I couldn’t continue hiding. I decided that I would stutter openly and not make silly excuses like “I’m sorry, I’m just nervous” or “I’m just really cold” to justify why I wasn’t speaking fluently at any given moment.

I decided to free myself. Here’s what happened when I stopped trying to hide my stutter:

1. People Asked More Questions

The more I stuttered openly — repeating words, saying ‘um’ repeatedly, prolonging my words and making funny faces — the more people asked about my speech. When I met someone new and I stuttered when saying my name (which happens often), the person would notice my impediment and ask me about it.

“What just happened there?” they’d inquire, or “Are you okay?”

I would explain that I stutter and what the impediment is. I’d be sure to add that my speech is “not a big deal.” Initially, this both annoyed and frightened me. Stuttering freely opened the door to this line of questioning, and forced me to be honest about it.

This was scary because I wasn’t sure how people would react when I explained that I stutter. Would they think I was “weird?” Would they think there was something wrong with me? Sometimes both those things happened — and still do. But other times, people were intrigued, and some simply didn’t care about my speech at all.

2. I Felt More Comfortable Talking About It

The more I opened up about my stutter, the easier it became to do. After a while of telling new friends that I stutter, I was used to the initial reactions and to explaining the disorder. It got easier and easier, and it felt like a huge weight was lifted off my shoulders.

I felt more free. The shame of not being able to control my speech slowly slipped away as I talked more about it and my experiences with the disorder.

When people asked questions about it, I didn’t panic and fret over what they would think of the things I said — and how I said them. I stuttered through my explanation and decided that I would be okay no matter how people reacted.

3. I Took Advantage of More Opportunities

I’ll admit that when applying for jobs, I dreaded seeing one small phrase: “must have excellent verbal skills.” My speaking ability is less than “excellent,” and I would often avoid applying for a job, participating in a school group, or even taking my professors up on cool opportunities to speak on panels or in front of local high school students.

Looking back now, I realize I missed out on so many great experiences simply because I didn’t want people to hear me stutter.

This changed — very, very slowly — as I stopped hiding my speech impediment. I began applying for challenging jobs (as challenging as a college job could be, anyway), speaking in front of groups and even leading class discussions. I’ll admit, I was scared as hell to do all of these things. But I did them, and I’m so happy that I did.

4. Social Situations Were Much Less Awkward

I’ll be honest, I know it has to be awkward to watch a person struggle to speak, make funny faces and even exaggerate hand gestures in conversation. I know it’s just as awkward for them as it is for me.

I’ve often heard people say, “it’s only awkward if you make it awkward.” I’ve always found that saying stupid because that implies that awkwardness (or lack thereof) is in our control. And when it comes to stutter, it totally isn’t. I’ve learned that if one thing can make any situation awkward, it’s stuttering.

I know. But as I stopped hiding my stutter and became more comfortable with it, these situations became much less awkward. People were more comfortable around me — and I was more comfortable around them — and this both boosted my self esteem and diminished my anxiety.

5. People Laughed More, But I Cared Less

Yes, a lot of great things happened when I stopped hiding my stutter, but some not-so-good things happened as well. Sometimes, my greatest fears regarding my stutter came true.

Sometimes when I spoke, people laughed at me, walked away from me mid-conversation (or hung up the phone on me), or called me names. I even lost a job because of it.

However, when I stopped hiding my stutter I began to accept it, and, in turn, I began accepting myself. And when I accepted myself, people’s opinions of me didn’t matter as much.

So yes, some people were jerks and sometimes it hurts my feelings. But I know it’s not the end of the world when someone does not accept me. I’m okay with that. And opening up about my stutter is what helped me to be okay with that.

6. I Met More People Who Stutter

I wasn’t the only stutterer to spend most of my life hiding my impediment. As I grew accustomed to talking about my speech and being open about it, I met a lot of other people with the disorder.

“Oh my God, you stutter too?!” I’d hear from strangers-turned-friends.

And it was/is so great to meet other people who speak the way that I do. I honestly believe that if I had not opened up about my stutter, I would have missed out on meeting some really great people.

Stutterers need other stutterers. Knowing people who share something so personal with me has been great for my personal growth, my self-esteem and my general happiness.

Emerging Treatments for Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) affects an estimated 1% of the US population, and approximately 50% of cases are considered severe. Individuals with OCD have been reported to have significant functional disability and worse quality of life compared with those without the condition.First-line treatments — cognitive behavioral therapy (CBT) that includes exposure and response prevention, and selective serotonin reuptake inhibitors (SSRIs) — have been found to be effective for a portion of patients. However, previous findings show that partial remission occurs in approximately 40% of patients, of whom 60% experience relapse within 5 years of treatment. In addition, residual symptoms often continue to affect patients who do improve with treatment.

“There are a number of reasons for the high nonresponse and relapse rates,” said clinical psychologist Jonathan S. Abramowitz, PhD, a professor and associate chair of the Psychology and Neuroscience Department at the University of North Carolina at Chapel Hill. The possibilities include “failure to engage in the treatment, presence of severe depression or psychotic symptoms, and very poor insight into the senselessness of the obsessions and rituals,” he told Psychiatry Advisor. Additionally, clinicians may not fully understand how to structure psychological or pharmacologic treatments to allow for optimal results.

There is a clear need for novel treatment options, and emerging evidence shows promise for several approaches. In the pharmacologic realm, a strong body of research indicates that SSRIs combined with clomipramine may improve short-term and long-term outcomes and reduce the risk of relapse.5Additionally, consistent findings suggest that augmenting SSRIs with low doses of dopamine-blocking antipsychotic agents may improve outcomes for patients with treatment-resistant OCD. Studies have shown efficacy for several second-generation antipsychotics, including olanzapine, quetiapine, risperidone, and aripiprazole, with some data showing superior efficacy for risperidone in particular.4 A 2012 study concluded that “risperidone and aripiprazole can be used cautiously at a low dose as an augmentation agent in nonresponders to SSRIs and CBT but should be monitored at 4 weeks to determine efficacy.”6

Growing evidence also supports the potential efficacy of glutamate agents in treating OCD. “Research has suggested that glutamate is an important neurotransmitter implicated in OCD,” said James M. Claiborn, PhD, ABPP, a psychologist in private practice in Maine and a member of the Scientific and Clinical Advisory Board of the International Obsessive-Compulsive Foundation. “Glutamate-blocking drugs may be of value in augmenting SSRI medications or perhaps as monotherapy,” he toldPsychiatry Advisor. While a 2012 open-label trial did not find support for the use of ketamine in improving OCD outcomes, a randomized trial reported in 2013 found that 50% of participants responded to treatment with a single dose of the drug.7,8 Results of several studies  suggest that augmenting SSRI treatment with lamotrigine, memantine, or n-acetyl-cysteine may be effective for some patients.9

Various psychotherapeutic approaches have demonstrated treatment potential for OCD, including the use of d-cycloserine (DCS) along with CBT. DCS,  “a partial agonist of the N-methyl-D-aspartate (NMDA) receptor, enhances the learning and memory processes underlying extinction of fear by indirectly stimulating the glycine recognition sites at NMDA receptors of the lateral and orbitofrontal cortex, dorsal anterior cingulate cortex, and insula,” wrote the authors of a review published in May 2016 in European Nueuropsychopharmacology.4 It is proposed that DCS might strengthen and expedite the extinction learning that exposure therapy appears to rely on.

According to other findings, multiple cognitive enhancement strategies may also warrant further exploration in OCD treatment, such as: cognitive remediation therapy, which emphasizes the development of cognitive flexibility; the inference-based approach, a new approach for OCD with poor insight in which patients are taught to rely on momentary sensory information vs obsessive reasoning in order to more accurately assess reality; and habit reversal therapy, which helps to increase patients’ awareness of premonitory urges preceding compulsive actions and to engage in competing responses instead.4 “I think that OCD is a consequence of habit formation in many patients,” said psychiatrist Danielle Cath, MD, PhD, a psychology professor at Utrecht University in the Netherlands and one of the authors of the 2016 review. “Habits are lower-energy repetitions that tend to easily generalize, and they must be replaced by more goal-directed behaviors that cost more energy and require constant effort and attention in daily life,” she told Psychiatry Advisor.

When all other treatment options fail, more invasive techniques may prove to be appropriate. Findings show that ablative surgery could improve symptoms in 30% to 60% of patients with treatment-refractory OCD, and increasing evidence supports the relative safety and efficacy of deep brain stimulation, a less invasive approach that “functionally overrides and modulates pathological hyperactivity in disturbed networks, reducing the hyperconnectivity” of the cortico-striato-thalamo-cortical loops.4 Though deep brain stimulation has been associated with a 50% treatment response rate, researchers will need to elucidate “which characteristics of OCD patients determine which treatment option is the best,” said Dr Cath.

In some cases, the issues lie not with treatment efficacy but with clinician competency to appropriately deliver OCD-specific treatment. For example, though “medication is widely available, many professionals may not understand the most effective way to use these drugs, as it is different from how they are used for other disorders,” explained Dr Claiborne. The majority of patients require high doses over a period of 10 to 12 weeks in order to experience notable improvement, and some “experience exacerbation of symptoms early in a trial of SSRI medication, which may lead to discontinuation. This is unfortunate as this early increase in symptoms may predict a positive longer-term response,” he said.

As for CBT, patients are often unable to access a therapist adequately trained to treat OCD, which “requires very intensive treatments that we often do not offer, or they are suboptimally delivered,” according to Dr Cath. Providing effective treatment as early as possible may offer the best chance of recovery. Patients who remain partially symptomatic after treatment have an especially high risk of relapse in response to stressful life events, which becomes even more pronounced over time and with lower-impact events. “So there is a window of opportunity in first-onset OCD where we clinicians should do all we can to help patients become symptom-free,” she said.



A magic cure for stuttering ? Stop worrying about stuttering

Before he became a speech language pathologist, Jeffrey Glessing dreamed of becoming a golf course superintendent.

Then one day, while he was talking to his boss, Glessing’s plans took a rude knock. He was told by his boss he could never be a superintendent because he stuttered.

Jeffrey Glessing
Jeffrey Glessing

For Glessing, the episode became a turning point in his life. For the past 22 years, Glessing, of Mantorville, has devoted his career to debunking common misconceptions that society entertains about stuttering: That a person who stutters is not as intelligent or capable as others. And the view that stuttering is some kind of handicap that should be avoided and kept hidden, an attitude that can be more problematic than the stuttering itself.

Far from seeing it as handicap, Glessing today regards his stutter as a positive. But it wasn’t an attitude that Glessing adopted overnight. It became a journey. And the same is true for the main character in his new book, “The Mystery of the Mistakes in Mulligan’s Mouth.” The adventure story centers on a boy with a stuttering problem and his path toward acceptance with the help of a magic harmonica. The book is illustrated by one of Glessing’s students, Emmy Kidman, a Schaeffer Academy high school graduate who also stutters.

Glessing, who also works for Rochester Public Schools, said one reason for writing the book stemmed from a sense of dissatisfaction about how people who stuttered were portrayed in books and movies.

“If you had talked to me when I was 20, I would have said you were nuts,” Glessing said about his own attitudinal change. “I understand that what you see on the outside isn’t always what’s going on in the inside. Those are valuable lessons in life.”

Only about 1 percent to 2 percent of school-age children have a stutter. Some people who stutter outgrow it. Others don’t. For those who don’t, there may be no such thing as a cure, technically speaking (though the condition can be ameliorated), but one thing that can be overcome and cured are the negative side effects it can create in a person’s life, Glessing said.

Glessing said he once knew a person who viewed his stutter as such a problem that he avoided drive-thru windows and certain social situations. It can also lead to avoidance strategies such as changing words or speech patterns or pushing words out, all of which arises from and aggravates the tension and nervousness about the stutter.

“A lot of stuttering isn’t the stuttering. It’s the trying not to stutter, if that makes sense,” he said. “What the research is showing is that there’s a neurological difference in how your brain processes language and then you try to stop that or you feel socially punished. And then you tense up and that causes all the stuff that we think of as an adult stutterer.”

Glessing said one aspect of therapy is to manage and reduce that tension, and one place he often starts is to remind patients of the purpose of communication: It’s to get what you want, to get your needs fulfilled. If you go to a restaurant to order a cheeseburger but order a sandwich instead to avoid words you stutter over, then you have failed. But if you get the cheeseburger, even though you might have stuttered in asking for it, you have succeeded.

The book’s main character is Harry Mulligan, a boy who regards his stutter as a cross to bear because he has a mother who is unaccepting and frustrated by it. Then Harry finds a mysterious black box and with it an adventure that leads to a different understanding of his stuttering, with the help of an understanding grandfather.

“That’s the thing about stuttering, too,” Glessing said. “Everybody can find their voice in a different way. That’s why I wrote the book. I didn’t want to get too preachy. I didn’t want to steer people towards one kind of therapy, but rather one kind of belief. You communicate to get what you want and fulfill your needs.”

Source: postbulletin