Rage Rage Against the Dying of the Light

By Heidi Kathryn

I was 10 when the first fleeting thoughts of suicide flashed like white lights through my mind. I knew at a young age that my brain worked differently than others. Freshman year of high school was the beginning of a series of traumatic events that impacted my ability to regulate my emotions and sustain healthy relationships. I found myself in an extremely unhealthy relationship with a much older man that resulted in a terminated pregnancy and my first suicide attempt. I was hospitalized for a week, then was forced to move out of the city and into my father's house in a rural Colorado town.

Life in the small town wasn't much better. I went to class, made some friends, played sports, and endured three years of physical abuse from my father. The dog and I got the worst of it. Home was never safe for me. I lived in a constant state of fear and apprehension, wondering if he'd be in a bad mood when he came home. It wasn't until years later that I could put a term to that feeling. That feeling was anxiety, and I would learn to live with it, always.

Things never really seemed to get better. I went through the motions, survived high school and got the hell out of that tiny town. College would only exacerbate the anxiety and depression. I turned to self-harm, starvation, and drug use to feel in control or nothing at all. Suicide was always on my mind. I would go weeks on benders, without sleeping or eating. I would frequently show up to class agitated, sometimes even in tears. My professors would send me home and tell me to sleep. I got to the point where I didn't even care to cover my scars, new or old. I woke up wanting to die, and if I was able to sleep, I would dream of dying. My social scene was a series of abusive, drug-addled, violent relationships; I gravitated towards men who would hurt me. I circled the drain until graduation and then moved on again.

Photo by Aleksandar Radovanovic

As I've learned the hard way, multiple times now, changing my address never actually solved any problems. My anger and self-hatred festered the longer it went untreated. I became fearful of myself. I became fearful of others. Generalized anxiety turned into anorexia which turned into full-blown obsessive-compulsive disorder. I was so scared of bugs that I couldn't sleep through the night. My perseveration around germs was out of control such that touching a doorknob with my bare hands would send me into panic. Crying at my desk became a common occurrence. I struggled to find a therapist who could really help. Or even one who could understand. And in October 2014, I attempted suicide again. This time, it almost worked.

My colleagues and I agreed that treatment was the best option for me. The people I work with and our connections outside our organization worked tirelessly to get me into a program. These are friends and colleagues who know this field, and it still took a week. When we finally found a place for me, I had convinced myself that I didn't need anything intensive. I had planned on doing a program that was three days a week. After my intake, the provider suggested that I would need something more intensive, with more structure, to get me through this crisis. I remember my friend telling me "if you broke your arm and you needed surgery, you'd have the surgery. This is no different."

I entered the partial hospitalization program, which was followed by their intensive 12 week Intensive Outpatient Program that is rooted in Dialectical Behavior Therapy. The first day of partial hospitalization was the hardest. I remember sitting across from my psychiatrist while he did my intake. We talked about symptoms, sadness, numbness, and anger. We talked about physical and emotional abuse. I admired his socks, and he read me off the criteria for my current diagnosis.

"Tell me if any of these things sound like you," he said. "Extreme reactions--including panic, depression, rage, or frantic actions--to abandonment, whether real or perceived...A pattern of intense and stormy relationships with family, friends, and loved ones, often veering from extreme closeness and love (idealization) to extreme dislike or anger (devaluation)...Distorted and unstable self-image or sense of self, which can result in sudden changed in feelings, opinions, values, or plans and goals for the future (such as school or career choice)..."

My stomach turned as he read off the diagnostic criteria.

Photo by Max Greenwood

"Impulsive and often dangerous behaviors, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating...Recurring suicidal behaviors...Highly changeable moods, feelings of emptiness or boredom...Inappropriate, intense anger or problems controlling anger?"

The rage he kept referring to seared through me. I knew exactly what he was referencing. I planted my foot on the ground and slammed myself into the wall behind me so hard that my head bounced off the concrete.

"I'm not fucking borderline! That's not what's wrong with me! You're wrong!" I cried to him. Everything in me had wished that I would have just died.

Borderline Personality Disorder is a highly lethal, highly stigmatized mental health condition. The most recent data I've read say that 10% of people diagnosed with BPD die by suicide. The Diagnostic and Statistical Manual (DSM) lists BPD under the umbrella of personality disorders. It is the result of years of trauma. And it makes clinicians' skin crawl. From what I've noticed, the general public doesn't really seem to know much about it. But the things I've heard from mental health professionals about people, specifically women, with BPD are scathing and hateful. We are a clinician's worst nightmare. We are not the "right" kind of mentally ill.

This frustrating reality is what has prompted me to share my story with the world. I am a suicide preventionist who lives with chronic suicidal intensity and a diagnosis of Borderline Personality Disorder. I am deserving of hope and help. I am difficult, but that doesn't warrant being brushed off. Thank goodness my workplace and career choices have allowed my the opportunity to really learn how to advocate for my own mental health treatment. I am angry for anyone else with a history like mine, who have been brushed off as manipulative or difficult, who have been told their chances of success and recovery are nil, that they'd never be able to hold down a job, or that they'll never make good parents and should take their birth control and medication and shut the hell up. I hurt for folks who are so sick that leaving the house is more miserable than staying home inside their head, trapped in their thoughts, and folks who show up to an emergency room or clinic scared that they'll hurt themselves, and get dismissed because of a condition the world gave to them.

Heidi's dogs, Ivan & Violet

It is an injustice that the very people we are supposed to turn to for help are consistently blaming us for our condition and either flat out refusing to help us with our treatment, or giving us little attention when we show up for our appointments. It is an injustice that mental health professionals can victim-blame their clients. It is an injustice that anyone can list "trauma-informed" on their resume or website while still insisting that people with BPD are untreatable.

I have spent the last two years of my life reading, searching, and educating myself on my mental health condition. I see a therapist every week, take my meds every day, and visit the psychiatrist every two months. Instead of self-harm, I use tattoos to cope. When I feel an identity crisis coming on, I change the color of my hair. I use a combination of traditional and non-traditional methods to help me stay alive, like comedy and the company of my dogs. I have stayed relatively quiet about my experience with this diagnosis.

Not anymore. I will not remain silent while others are suffering. I will be loud enough so that others with similar experiences and diagnoses don't have to feel ashamed. The thing about activism is that it's so invigorating that is has given me a reason to keep living when my brain is telling me not to.

This is my suicide prevention.

*****

Heidi Kathryn is the Community Outreach Coordinator for the Carson J Spencer Foundation. Her passion for violence prevention has moved her into the field of upstream, innovative suicide prevention work. She provides outreach and support to the community as well as delivering mental health and violence prevention programming in workplaces, schools, and local public agencies. She is currently pursuing her MPH from Capella Unversity and looks forward to continuing her career in violence prevention and community engagement and collaboration.