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A few years ago I moved from the East Coast to Southern California. It was huge change. In the Boston area, I was part of numerous communities where identifying as a person with mental health issues barely caused a blink. Moving to a part of California where none of my previous groups, organizations or any peer support existed, I found myself in a land of strangers where “self-disclosure” was not an occasional choice, but a constant confrontation.
I remember being invited to a party early on where I knew almost no one. As I stood in the room, I felt the usual social anxiety percolating inside me. And the immense pressure of having to pretend I wasn’t fearful of people and new situations.
When I was introduced to a woman at the party, her first question (always an ice-breaker) was “What do you do?” I responded “I’m a writer.” This piqued her interest: “What do you write?” “Have you published?” “What is the title of your book?”
Generally I say that I write in all genres, but when it comes to naming my memoir, I’m immediately confronted with a dilemma. “The Buddha and the Borderline” is about my experience with the symptoms of Borderline Personality Disorder. And having published the book, I’ve outed myself even before the conversation can establish the trust and understanding that self-disclosure requires.
At first, I used to say “It’s a book about mental illness and recovery.” But that cannot help but put me in a box, often one harshly perceived. And if I name the title, I’ve immediately identified myself with a stigmatized and misunderstood diagnosis. By taking this approach in the initial moments of establishing a relationship, I’ve already framed myself as mentally ill and become vulnerable to other people’s assumptions and judgments.
“It’s a memoir?” She repeated. Well, I certainly can’t say it’s a novel. She can go online, type my name and the very first thing she’ll read in the Amazon preview is that as teenager I sent letters in blood to people who rejected me. In terms of dating, this has been a deal-breaker. Making friends runs the same risk.
So in the first phase of developing friendships outside of support communities, I walk a thin line. It’s a critical moment between establishing a human connection or positioning myself as an Other.
Despite all the gains made in shifting public awareness related to psychiatric disorders, the general population cannot help but internally or externally take a few mistrustful steps backwards when the terms “mental illness” or even worse, “disease” are uttered.
I’m basically a pinata filled with official diagnoses: Chronic PTSD, BPD, Depression, Anxiety and Panic Disorder, Bi-polar II and Alcoholism. For decades my life has involved treatments, recovery and support groups .I used to spend an inordinate amount of time trying to explain to others my diagnoses during initial exchanges, attempting to create a bridge that was destroyed before it could even be constructed.
With each diagnosis, I’ve worked tirelessly to educate myself and others, especially on a professional level. I have generally managed the symptoms to the point where I’ve risen above diagnostic thresholds. But I always use the term “recovery” to frame my labelled disorders, because I don’t consider myself cured; I do become “symptomatic” at times. Recovery is an ongoing process and not a linear one.
It actually never occurred to me that I had much choice in the matter when sharing mental health issues . Do I have to tell others (even if I’ve already outed myself) that I’m considered “mentally ill?” Because in reality, I have a choice. Psychiatry’s language and categories were imposed on me but it’s my own decision whether I identify with and use them.
So I’d like to share some guideposts for those of us who want to self-disclose to potential friends outside of peer groups.
1. You are Not Obligated to Self-disclose
For example, if I don’t drink at a party, I’m often asked why. People seem to feel they have the right to ask, and I’ve reacted by explaining “I’m an alcoholic in recovery.” Then struck me that “why don’t you drink?” is an invasive question. If I said I don’t eat seafood, no one asks why. But I’ve felt obligated to answer that question with my diagnosis.
But then I started playing with my language. If I’m willing to explain, I say “Every time I drink, I throw up, pass out and end up in a hospital.” There’s usually a pause at that point. Most people asking have gone through at least one of these things, though maybe not to the extent I have. If I’m not willing to engage, I simply say “Because I don’t want to.”
2) Refrain from Over-sharing
Despite all the stigma, the desire to be honest and garner understanding from others is natural. As an advocate, I tend to position myself as an educator with lived experience. But leading with mental health issues doesn’t follow the flow of building relationships. Outside of support groups, where identifying with a diagnosis is the first thing one does, the opposite is generally needed when making connections. Revealing oneself and the past is an incremental process. Now I let that information emerge gradually.
3) Test Out Whether a Person is Worthy
In time, you’ll discover if a potential friend or partner is understanding, trustworthy and supportive. Over time, you might learn that they too have had similar struggles. It’s like data gathering: the more information you have, the better you can decide whether it’s worth revealing the more personal aspects of yourself.
4) Share the Experience of Having Symptoms, Not the Diagnosis
Rather than presenting myself with a label, I describe what happens. This takes practice. We’re all used to relying on assigned language. The role of language in mental health cannot be overestimated because it shapes not only perceptions but often defines our experiences and identity for us. And yet we are in charge of how we want to define ourselves.
Just as I’ve often glibly shifted my “alcoholism” to a focus on what happens when I drink, the same can be done with other diagnoses. I most certainly qualify as having a “Social Anxiety Disorder”, but I’m also an introvert and hyper-sensitive to noisy environments. I can tell someone I’m uncomfortable with crowds or that I prefer hanging out one on one. If I’m anxious, I simply say I’m feeling anxious.
5) When Building a Relationship, Prepare In Advance For When Symptoms Arise
Rather than saying I have “Major Depressive Disorder”, I share that I have low points when I isolate too much. I explain that I often cancel outings and appointments, and might even go “off-grid.” In recently moving to yet another town and making new friends, I let them know I can be a “last minute canceller.” And I assure them that it’s not personal. Often the other person says “sounds like you feel depressed.” Yes! That’s exactly what I feel
6) Don’t Apologize for a Deficiency: Ask for Support
This can come in many forms:
- When I am too anxious to leave the house, I ask “Could you come to my place and have a cup of tea?”
- If I’m very depressed, I ask “Will you check in on me if I don’t respond? I might be cocooning but would love a little nudge.”
- I often share that “I’m sensitive to criticism.” It can be a perfect entry later on to remind the person that I’m having a reaction— and most often the criticism is well intentioned. I just need to give a little reminder that it’s one of my sensitivities.
When trust, understanding and support have been established, I then decide whether to delve into the complexity of diagnosis and what it means to me. By this time, the people I’m close with and trust have also revealed and shared their own struggles and, by and large, they are the same as mine.
We have become allies. We’re walking on the same path, regardless of what labels have been given. And that’s what I truly desire: fellow travelers who share this journey through an intense, challenging and beautiful life.