This is a reader submission from Hana Graham, who suffers from borderline personality disorder. She's working with her team of medical professionals to plan a baby and we asked her to write about the process.
I have a long, sordid mental health history. The current diagnosis includes borderline personality disorder, some form of depression (major? psychotic? dysthymia? cyclothymia? the jury is out!), severe anxiety/panic disorder, EDNOS (anorexia/binge eating disorder), and 14 years of self-harm (cutting, burning, dermatillomania). I did develop PTSD after being sexually assaulted in 2012, but I'm pretty sure I've kicked its butt (yay)!
(Image: Author's own "collage I made while I was hospitalized")
Nobody likes to talk about borderline. When I say "I'm borderline", you say "bunny boiler!" I'm here to show you why that's wrong, and why I have just as much a right to love and a family as a neurotypical woman does. Why I am going to be a good mom. Why it's not "wrong" or "immoral" for me to want biological children. How women like me can plan for baby, and to share the resources I'm using. For the record, I was born and raised in America, and I now live in Northern Ireland, which is part of the U.K., with my husband, and all current resources are a part of the National Health Service, which is free.
The funny thing about borderline is how much work it takes, and how oddly accurate the "outdated" name is, in that respect. I could give up, and give in, and either end my life, or resign myself to living in hospital care for the duration of my time on earth. But I am stubborn, and I want to live my life as fully as I can. I walk a tightrope. I have a very delicate balancing act going on every single day. It requires a couple days a week of absolute rest, so I don't overload and have a breakdown. The anxiety ties into this in a big way. For most people. "stress" means something inherently stressful. I'm always functioning just below my max capacity for stress, because of my anxiety, and it when it comes to stress, well, I'm like my cats. If you so much as rearrange my furniture, THE WORLD IS ENDING AND I AM GOING TO DIE.
If I don't manage my stress levels, I will wind up dissociating, which is scary. I am not real, my fingers aren't my own, things happen that don't actually happen, I'm liable to injure myself in attempts to verify my existence. These are the days when I absolutely need my husband, because I need him to essentially babysit me and keep me as grounded as he can. I am not safe to be alone on these days. These days are my primary worry when we have children. We've been together long enough that he can tell when I have dissociated without me needing to say or do anything. It shows in my voice, my mannerisms, my eyes, my movements. I'm still wondering how to plan for these days, because they are random, and I know motherhood is stressful, and I'm frightened. Thankfully, these days are rare, but that could change with the stress of parenthood.
I have this idea in my head that when neurotypical couples plan a baby, there isn't really the same sort of planning involved. They can say, "Let's have a baby", and just start trying for a baby. I let all of my doctors, from my psychiatrist to my gynecologist and back again, know that we are planning to start trying in June or July 2014. All of my doctors are already in touch about our timeline. They will all be communicating throughout my future pregnancy. My psychiatrist has told me I will also be given a "pre-natal mental health team". This sounds like a team of superheroes to me. I'm not sure what one of these teams encompasses, but I'm so happy to know it will be there.
(Image: Author's own, "back when I was coping poorly"
I have relaxed a bit since an incident a few months ago. I was discussing my self-harm, and my doctor blew my mind by asking if I intended to continue this behavior throughout pregnancy and motherhood. Self-harm has been my failsafe coping mechanism for 14 years, nearly 15. It has been my security blanket. It works when nothing else does. It also complicates everything, but I always dismiss that annoying truth at the time. It had honestly never crossed my mind that having kids would have to be a final goodbye to my self-harm, which has been around for over half of my life. I took something the doctor said next as a veiled threat: "If you were to relapse after becoming a mother, I wouldn't report you to child services, but others might."
Whoah, what?! I thought I was being super responsible by being open and honest with my doctor. My husband and I have already agreed if I were to ever decline or have a breakdown again, it will be best to immediately sign myself into a hospital rather than let our kids ever, EVER see me in that state. It's not pretty, and I imagine it would damage them. We feel that's responsible of us. Apparently, we could be punished for it. Am I meant to lie about my stability to my doctors to avoid losing my kids? It just doesn't make any sense to me. I'm waiting now to be enrolled for group sessions with the "self-harm team", in a really big effort to finally quit. To reconcile the fact that I don't really WANT to quit, but I NEED to quit. For myself, and for my family. It's also the closest thing in the entire island of Ireland I can get to DBT, and I really, really wanna try that. Now, my doctor and I are weighing the pros and cons of medication. With conditions like mine, it really is a tough call. What's riskier - the side effects of a medication that keeps me relatively stable and functional, or the effects of a panic attack on a fetus? As it stands right now, I'm going to try coming down off medication before my husband and I start trying for a baby. The plan is to go back on medication IMMEDIATELY after giving birth - which rules out breastfeeding for me. If things get bad, I might go back on them in the third trimester. My chances of developing post-partum depression or even post-partum psychosis are so high we're not even going to risk it. Hell, my odds for pre-natal depression are high.
My husband is excited. I'm excited. But I am also really, really scared. I wrestle with my fears. Am I going to be a good mother? Are my kids going to resent me? Can I actually handle being a mom? Is this going to be a big mistake or the best decision ever? My husband is amazing, super supportive, and reassuring. Sometimes, though, it falls on deaf ears, and I melt into a big pile of worry. The guilt is enormous as well. My entire life, until I met my husband, I had decided it was irresponsible of me to pass on my "faulty genes". Society often reinforces this idea. I very recently got into an internet argument (I know, I know) with a man who told me how selfish and irresponsible I was to be planning a family. How "no child wants a sick mommy".
I hope and pray my kids don't inherit any of my mental health issues. My family history looms ominously over their not-yet-conceived little heads, but there's a chance they'll make it out okay. I always explain to people that anyone having kids is selfish, when there are so many out there who need a home, and that even if you adopt, as my adoptive parents found out the hard way, there is no guarantee your child is neurotypical.My birthmother told the adoption agency everything about our family's medical history, including the mental health aspect. They chose not to include it in the paperwork. My adoptive parents had no idea what to expect. I hit puberty and shit hit the fan. They spent years being interrogated and accused of abuse by mental health professionals. They spent years blaming themselves and questioning themselves. We are all still furious about it. They did the absolute best they could do with me, and I am so grateful to them. I would not be here today if they had not gotten me the best help they could. I am here because they helped me. But they weren't prepared for it and had very little idea of what to do at first.Who will be better prepared for a mentally ill child than me? I will know what signs to look for. I will know if my child is trying to hide self-inflicted wounds, I know all the tricks firsthand. I will have compassion that others might be lacking. I will have an understanding that neurotypical people do not and cannot possibly have, because they have never lived with a brain that is actively trying to kill them. I will be able to help them learn how to function and cope with the world that is so unkind to people like us, and so hard sometimes, so hard. (Image: Allie Brosh: Hyperbole And A Half)
People always say things like, "but diabetes can be managed", "I'm autistic, I'm not mentally ill, my brain is just wired differently." Well, mental illness can usually also be managed, unless it is so severe you need 24-hour care in an institution. Often times, mental illness is also just a matter of brains being wired differently. The fact it is still treated as some kind of magical voodoo illness and not a matter of chemicals and neural pathways makes me sigh a lot. Deep down, I do not feel me creating a child is anymore selfish than someone with diabetes or cancer in their family having a child.
(Image: Author's own, "from when I was released from hospital")
I'm excited. I'm terrified. I'm frustrated by the lack of resources out there for women like me. I'm still months away from trying to conceive. We're quitting smoking for the New Year, because of our timeline, and I am terrified to lose a coping mechanism. I am scared and excited for groups with the self-harm team. I'm terrified of becoming a very real grown up who has to learn something about how to cope with life in a way that isn't severely harmful to myself and those who love me. I'm scared I can't handle all this, no matter how much I want a baby, that I'm going to totally lose my mind. Research shows that people with borderline have synapses controlling emotion that fire longer and harder than others, so it's no surprise we have absolutely no control over our emotional range, and I have no idea how to start dealing with feelings like everyone else seems to do so easily.But I am ready. I am. I am being responsible, I think, with all this extensive planning. I am excited to journey down this road with my husband and my loved ones, and their amazing support. I am grateful to be where I am today, no matter how hard it gets sometimes. I'm excited to start this journey, and to share it with all of you, to hopefully create more resources out there for women like me. I'm borderline, and I'm planning a baby.
(Image: getty Images)