Flavors of Depression

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There are many, many things that make coping with depression difficult, and I’ve talked about many of them over the course of this blog. But one that I’m not sure if I’ve touched on yet is what I can only call the different flavors of depression. A friend of mine recently brought it to my attention by pointing out that different difficult times come from different needs: sometimes you may need to unwind and feel distracted, other times you may need connection, still other times you may need to feel accomplished and useful.

For me, it can be incredibly difficult to feel out what I need when I’m in a depressive episode, especially because what I need can change drastically from day to day (and sometimes hour to hour). So the best I can do is try to suss out what kind of depression I’m feeling. I don’t have a clear sense of what I want most of the time, so I try to pay attention to what I’m feeling. Of course I’m feeling depressed, but what KIND of depressed.

For people who don’t experience depression, it might not be clear that depression refers to a wide variety of different feelings and states. Sometimes depression is an incredibly strong and passionate kind of a feeling. It can feel as if everything is going wrong and everything hurts. That flavor of depression is often the self-hating variety for me. It’s an incredibly immediate feeling that often comes with crying fits. But sometimes it’s not an emotional experience at all to be depressed.

Sometimes depression is feelings of complete and utter numbness and emptiness. Sometimes my mind will pull out and out and out in perspective until my entire life feels tiny and pointless. Those are the days that I’m not sure I can even get out of bed because I don’t know why. Everything feels far away and my body does not feel like my own. It comes with dissociation and suicidal thoughts. This is the flavor of depression that scares me more than anything because I feel dead inside.

Of course the overwhelming feeling in almost every depressive episode is something like “bad no good can’t do not like” which is incredibly unhelpful. Instead of getting overwhelmed at that point, a good strategy for me is often to try to listen to what I want.

Now to be clear, what I want is definitely not always what I need when I’m depressed. But I can typically get a better feel for what needs I am not fulfilling when I think about what sounds appealing in a given moment. That can help me suss out if I’m the kind of depressed where I should hang out with people or the kind of depressed where I need to take a break from life for a little bit or the kind of depressed where I need to go work out.

For example if all I want is to lie in bed and do nothing (as has been the case recently), I know that anhedonia is one of the problems, and that what I’m really craving is something that makes me feel accomplished. It also tells me that I need to spend as much energy as possible finding something that will feel enjoyable in this moment, because anhedonia saps my ability to feel pleasure in anything.

At other times all I want is to talk. Sometimes it doesn’t even matter who, I just feel as if I’m drowning in my own mind. This one is pretty easy to figure out: it means I’m missing connection and community. I feel lost and I’m starting to lose the ability to differentiate between rational, reasonable thought and the thoughts that my depression and anxiety mix in.

When I first became depressed, I didn’t quite get the ways that depression has moods. No person’s emotions remain completely static for days and months at a time. Even when you’re depressed, the subjective experience, the focus, and the strength of that depression shifts and changes just as it would for anyone else.

This is one of the things that makes it difficult not only to determine what coping skills are best for you at a given moment, but also how to ask for help. Many times a friend or partner will ask me what I want to do or what sounds helpful and I cannot answer. That’s because depression changes regularly, and in order to figure out what would be helpful I have to do the emotional work of sifting through all the feelings to determine which flavor I have today. In the midst of an episode, that can seem overwhelming and impossible.

If I could ask anything of support people, it’s helping me through this sorting process. Asking me easy questions like “what is your first impulse of what to do right now?” or “tell me what it feels like.” Those questions can help guide me to understanding what I need.

If I could ask anything of myself it would be patience. I always want to fix things. With depression, I need to understand them first.

Cooking and Grocery Shopping In Recovery

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I recently saw an article of tips and tricks about grocery shopping when you have an eating disorder. Of course I clicked on the link, but I was surprised to find that almost everything on the list was exactly the opposite of how I prefer to approach food.

People’s strategies for recovery are as widely varied as they themselves are, and different people find different approaches to meal planning, shopping, and cooking helpful. So I thought I might throw out some of what’s helped me become more comfortable with the process of getting food from the store to inside my belly in the hope that others might find something useful in it.

I’d also love to hear other people’s tactics. The more we can share with each other what’s helped us, the less alone and confused anyone has to feel. So here are my strategies for the actual shopping and cooking processes while in recovery.

  1. Plan ahead. I never ever go into a store without a list of everything that I need, and I try very hard not to buy anything that isn’t on the list (unless I look at it and realize I meant to put it on the list). This helps me to feel less out of control while I’m in the store, it ensures that my grocery trips take less time, and it means I can focus on crossing things off of the list instead of on all the food around me.
  2. Buy in bulk. Some people really don’t like this one, and I understand. There are times that it’s overwhelming to me to have too much food in my house. But I really prefer to have fewer trips to the store, and so I buy lots of frozen veggies, grains that don’t go bad, and other things that can last me up to a month so I don’t have to venture back to the store for as long as possible. Again, your mileage may vary on this one, and if you feel really overwhelmed with having too much at once then it can be really helpful to start with a smaller store rather than a Cub or a Rainbow.
  3. Produce and other things that go bad: approach with care. For a long time I wouldn’t buy anything that would go bad because it felt like too much pressure to eat it right this instant. If you have worries about things going bad then it’s actually possible to buy mostly long term things (frozen is your friend). My strategy has been to slowly introduce more perishables. I started with milk (because I need it for my mac and cheese) and have now worked up to such amazing buys as spinach. You don’t have to get a lot of any of these, or even a wide variety of perishables. You can make your basic diet one that doesn’t spoil and add on fresh things for more nutrients as you feel comfortable.
  4. Recipes aren’t necessary but they can be helpful to come up with fast and easy things. You in no way need to follow recipes exactly, especially if there are more ingredients than you want to deal with. I recommend doing some brainstorming before going to the store for things that will be as easy and fast as possible. I find the longer I have to commit to cooking, the less likely I am to get my meals in.
  5. Cooking in bulk can be great! I love to make extra pasta or rice so that I have a couple additional meals and don’t have to worry about cooking for a few days. Decreases stress, increases ease.
  6. Eat things that taste good to you. I don’t buy frozen meals even though in many ways they would seem ideal for me. I don’t like how they taste. Instead I try to get things that I want to eat because that will increase my motivation to cook them and put them in my stomach.
  7. With that said, also be aware of things that feel too anxiety provoking. I try not to have chips around too much because I eat them mindlessly and it causes me a lot of stress. That doesn’t mean cutting those foods out entirely, but rather being careful around them so that you can eat them with minimal stress (I only buy one bag of chips at my monthly grocery run so that I don’t feel overwhelmed).
  8. If you’re going to go grocery shopping with someone else, communicate how you shop and what they can do to support you. There are lots of people out there who like to wander and browse in the grocery store, so don’t assume that everyone wants a list or can be in and out quickly.
  9. I prefer to buy things that are not pre-portioned so that I can decide how much I am hungry for.
  10. Eat before you go! Shopping when hungry means everything will look good and it can get overwhelming really fast. I also try to build in some downtime post shopping trips so that I can calm any stress that might have built up.
  11. I prefer to have a few standbys for cooking that are as easy as possible and feel completely possible no matter how bad of a day I’m having. I always keep those around. For me it’s ramen noodles, mac and cheese, and chic’n nuggets.
  12. I also try to make my cooking in general simple. I like to do variations on the same theme. Most of my food comes in the form of grain+veg+sauce all mixed together. That means I only have to figure out three choices for any given meal, but also allows me all kinds of different flavors.
  13. When adding new things, don’t try to do too much at once. I never have enough protein in my diet, so I’ve been working on that, but I don’t try to do many things at once. This week I added protein smoothies to my diet. A few months ago I started adding fake meats to my basic meal template. One at a time is easier to keep track of, less stressful, easier to adjust if it starts stressing you out, and easier to grow accustomed to.
  14. There is no need to be a perfectionist. For a long time I didn’t want to cook because I didn’t feel confident about it and I hate not being perfect. But my food doesn’t have to turn out like the food on Iron Chef. It just has to turn out like something I want to eat. It can be ugly, I can make mistakes, and I can experiment without being some kind of failure.
  15. Spend money on food. I know that sounds privileged and stupid, but it’s an important shift of mindset for many people with eating disorders. For a long time I refused to budget any money for food because I didn’t see it as a necessity. But eating becomes much easier if you like the way your food tastes and if you can buy things that you enjoy, which means putting food as high on your budget priorities can go a long way. This is also part of why I allow myself to eat out more often than I probably should. My health is worth the money.

That’s what works for me at least. I hope some of it is helpful, and remember: if these things don’t sound useful for you then you don’t need to do them. Do what works for you.

 

Empathy vs. Sympathy

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Let’s play a game. If you were told that you can sympathize with someone or empathize with them, which one would you think is better?

If I looked at most dialogue around emotions I would say the vast majority of people would answer empathy. There are articles and videos about how awesome empathy is.  But lately sympathy seems to be getting the short end of the stick. People often talk about how empathy is better than sympathy, or suggest that sympathy doesn’t have a place in social justice discussions because it’s condescending.

Let’s recap the basic differences between empathy and sympathy, since they’re often conflated and confused. Empathy is when you feel with someone. If your friend tells you that they’re sad because their cat died and you feel sadness as well, you’re empathizing with them. Sympathy on the other hand is having compassion for someone, or feeling something for/towards someone without taking on their feelings as your own. If my friend and I get in an argument and I can eventually understand her position I might be able to sympathize with her, but my own feelings may not change.

For a long time, sympathy was king of the hill, and in recent years empathy has grown to be the prized ability. Especially in social justice circles, I see minority and oppressed individuals pushing allies to try empathizing. The empathy is what allows others to understand the harm of their behaviors, to get motivated to make changes, or to see how sometimes good intentioned behaviors feel awful.

Especially in these contexts, sympathy is considered pitying and useless.

But there are some instances where sympathy is actually incredibly useful, or where empathy isn’t called for at all. I want to take the time to remember what the benefits of sympathy are, and to hopefully tease apart some instances in which sympathy is called for or when empathy is called for.

Now before I get into this conversation I want to make something very clear. No one gets to tell you if your feelings are appropriate to a situation or not. No other person has the right to police your opinions or tell you that you’re feeling the wrong way about something. However it may be true that your own emotions are not helping you act effectively or be safe, and in those cases an outside opinion can be helpful.

First and foremost, sympathy can be a helpful way to build into empathy. If you look at something like police brutality and you don’t yourself feel afraid and angry but you do feel sad for the people involved, that can be a first impetus to start learning more and putting yourself in the shoes of the people directly involved. This is especially one of those circumstances where it could be helpful to not quash sympathy (because it’s not good enough) but to push people to really listen to that sympathy and let it build into empathy.

Now empathy on the other hand is often more helpful when it comes to listening to other people, to building connections with other people, to being supportive. Especially with friends and family, it may seem easy to try to offer solutions when they open up, but sometimes all they want is a little empathy and an open ear. And when it comes to movements that feeling of being listened to is often incredibly important. It gives allies the knowledge to speak up when necessary, but to also understand when they need to be quiet.

While sympathy might push you to listen for a while, it doesn’t get you to internalize the feelings in the way empathy does, which means your feelings will always be taking priority over the feelings of the other.

So when is sympathy actually a better option?

Let me tell you a little story. Once upon a time I was very sick. I had an eating disorder and I was in the process of slowly trying to kill myself. However I didn’t really care. I felt little to no attachment to the world and didn’t have any desire to get better.

If someone at the time had truly empathized with me they would have felt awful, but they wouldn’t have had any motivation to push me into treatment. They would have understood how terrifying the possibility of recovery was, how much I just wanted to be left alone, how much I hated it when anyone mentioned that I should change my behaviors.

So instead of empathizing, my mother sympathized with me. She saw and understood that I was in pain, but instead of feeling that along with me she felt anger towards the eating disorder on my behalf. She felt fear of losing me and a strong desire to protect me. Because she sympathized with me instead of empathized with me, she chose to push me to get treatment and I am still alive and kicking today. Thanks Mom!

There are instances in which a person’s emotions aren’t keeping them safe. Abusive relationships are often (though not always) an example of this. People who are addicted to drugs or alcohol often have this kind of problem. And sometimes these instances are much smaller, like when one friend warns another not to go out with that guy, he’s actually a jerk. If your emotions are telling you that what you’re doing is totally the best course of action and someone you love and trust sympathizes instead of empathizing to tell you “hey, it looks like you’re hurting yourself,” that sympathy is way more effective than empathy.

Now again, it’s probably important to have facility with both skills. If you just sympathize and don’t understand what is really pushing the other person to behave the way they do, you are highly likely to make the situation worse. If my mom had empathized a bit more she might have found some more effective and less scary ways to get me help (or maybe not because I still have no idea what an effective method of pushing someone to get treatment is).

The important part is knowing that empathy and sympathy have different roles. Empathy is often the piece that gets you to listen and understand. Sympathy can be great for integrating your own feelings and perspective with someone else’s. So let’s get a little more love for sympathy.

Why I’m Afraid of the Future

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I’ve been teetering on the edge of a depressive episode for a few weeks now. I’m fighting it every way I know how: increasing my social time, being gentle with myself, getting out of the house, asking my boyfriend to make me meals, rubbing my cat on my face whenever possible…and yet I still find myself frustratingly out of control when it comes to my emotions. I downloaded a meditation app to try to feel less anxious and to combat the inexplicable crying jags that show up out of nowhere. I talked to my therapist, and looked for new coping skills.

But the whole time, no matter how hard I tried to remain positive and rely on skills, there was an undercurrent of fear that cut away at my progress. And the more I tried to work on remaining mindful and paying attention to the here and now instead of the possibility of bad things in the future, the more frustrated I got. Every time I tried a skill and didn’t get a result, my emotions flared up in fear, in disappointment, in resignation.

And it wasn’t until I had a bad therapy appointment that focused too heavily on mindfulness that I started to realize why.

Some background: From what I can tell I have only ever had one depressive episode in my life. That may sound surprising to you as I’ve been writing about my depression for the past three years or so. The reason I say that is because I cannot recall a time between the ages of 18 and 23 that I was not actively, overwhelmingly depressed. Sure, there were some times where it wasn’t as bad. But when I look back at those years (which is most of my adult life) and rate my mood on a scale of 1-10 (10 being bad), I can’t think of a single month where the average was better than an 8. And there were huge swathes of time, a full year at least, during which I could barely go two hours without crying.

During that time I was grappling with a very active eating disorder that took I would estimate 50% of my thoughts at any given time. I spent the last three years fighting self-harm (and failing to fight it most days). When I think of most of my life, I remember things that feel impossible. I have this

The last year has felt like a miracle to me. There was a time when it felt as if I would never simply be able to wake up in the morning and get out of bed without it leaving me exhausted, unhappy, or on the verge of tears. But in the last year I was able to simply feel hungry and eat food, to live out my days without overthinking anything, to live in a state of mostly contentedness.

It’s cliche to say it feels like breathing again, because it’s better than that. It feels like breathing when you’ve been inhaling water for years. It feels like coming back from the dead.

So with all of that out of the way, imagine seeing again the beginnings of a depressive episode. The only experience I have ever had with depression is one that I know with 100% certainty I would not be able to survive again. So despite how melodramatic this sounds, it feels like staring down what might be a terminal illness and people are telling me to just focus on the now. But it feels very important to me whether or not this is actually the terminal illness I think it is.

 

It is also very important to me that my support people validate how large and influential that past experience with depression, anxiety, and my eating disorder is. I will not do it again. I refuse. I am not being irrational when I focus on that fear because I have a very real and very strong experience from a large chunk of my past that is informing me this could be dangerous. Perhaps it would be easier to be mindful and only pay attention to now, but that also seems to me to be hiding from reality and not allowing myself to consider and weigh the possibilities against my ability to change my behavior. I need to be able to understand how much of my time and energy I should be putting into fighting this off, how much help I should ask for, how strongly I should be reacting to stay away from the depression.

I also want someone to actually engage with me about how likely it is that a future depressive episode would be the same as my previous one instead of just telling me not to worry about it. I would like to be able to examine how likely it is that it will be as bad with the help of someone more knowledgeable than I am.

For people with serious mental illness in their past, I’m not sure it always makes sense to tell them not to pay attention to their fear of the future. Sometimes that fear is grounded in reality. Being afraid of the effort it takes to survive a mental illness, and of the pain and shittiness of living through an active mental illness needs to be ok.

Every Relationships Has Rules

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There’s a fairly common trope running around in open relationship/poly circles that rubs me all the wrong ways. This trope says that the first conceptions of polyamory were rule based, but that’s bad and it only happened because monogamy is rule based. The trope is all about how awful monogamy is because it’s predicated on a rule that controls your partner, their body, and their actions.

I don’t at this moment want to get into the “is poly better or is mono better” debate (spoiler alert: I don’t think either one is better), but I do want to address the idea that having rules in a relationship is a bad thing and that there are relationships that exist without rules.

First and foremost, all of us have rules in our relationships. They might not be articulated, but there are things that if your partner does them you will end the relationship or at the very least have to have a very serious sit down to discuss what the fuck happened. A good example of this for most people is physical abuse. Most people have an unspoken rule against their partner punching them. This is a good thing.

Different relationships are more explicit or less explicit about their rules. Some couples negotiate rules together about what they feel comfortable with their partner doing (having other partners, kissing outside the relationship, having sex with other folks, going away on long business trips, splitting up household and childcare duties etc.) while others just assume their partner has the same rules they do and get mad when the rules aren’t followed.

And some relationships focus less on rules and more on boundaries, wants, and needs. There should probably be a few hard and fast rules at the base of your relationship, just like there are in almost any interaction you have with other human beings. Each of us has some “dealbreaker” style things that make us feel disrespected and actively harmed and no one should have to put up with those sorts of things. Some of my rules include that I do not let my partner swear at me, physically hurt me, and that when we have problems we need to discuss them. It makes sense to have a few very basic, self-respect kind of rules about what other people may or may not do to you.

But beyond those very basic rules I try to focus instead on being clear about how my partner’s actions affect me instead of telling him what he can or can’t do. In general, in all relationships, mono or poly, romantic or platonic, this is probably a more useful tactic. I have some pretty nasty misophonia about chewing. When people chew around me I get irrationally angry and usually have to leave the room to restrain myself from punching someone or something. I told my partner this and let him know that it’s much easier for me if I also am eating or if there’s another noise happening, like TV or music. Now he typically doesn’t eat around me unless there’s something else going on.

Some people might say this is a rule, but it just doesn’t make sense to me to think of it that way. I was being responsible for my emotions by letting my partner know what was up, giving them a way they could make it easier, and then letting them know I’d go somewhere else if they did a certain behavior because it upsets me. This is the exact same way that I approach monogamy in my relationship.

EVERY relationship that I have ever witnessed has a mix of these very strong rules and the softer, more conversational boundaries. I tend to think that healthier relationships center around setting boundaries or expressing wants, but that doesn’t mean that any rules are a bad thing. Every person has some things that they 100% cannot tolerate. If my partner were to comment regularly on my weight, tell me to lose weight, criticize my food, or in some other way actively trigger my eating disorder, I would leave them because I cannot be around someone who does that and if someone wants to date me then that is a strong, hard, and fast rule.

There’s nothing wrong with having hard lines. There’s nothing wrong with recognizing that your partner’s behavior affects you. Being responsible means telling them that you cannot be around certain behaviors. But ideally you won’t have to do that because you’ll be with someone who cares about you and doesn’t want to hurt you. That’s true no matter what kind of a relationship you have, and I personally don’t care if it makes me controlling to have needs and boundaries. I get to take care of myself.

Telling My Stories: When Does It End?

Memoirs have to end. There’s always a last page, some kind of bow to wrap up the story. I’ve been writing about my mental health for nearly five years now. That’s a long time to be focused on one story, one kind of narrative, even though the elements have changed drastically over that time.

I’m not tired of writing about my mental health. I’m not tired of writing about myself, narcissistic person that I am. There’s enough content in any life to keep a writer going indefinitely. I could write about how this morning I woke up anxious with no inkling of why, how I got out of bed and checked my email to find a slew of nasty comments to my friends, how the only thing that kept me ok was hilarious GIFs. I could talk about my intense paranoias about money and being incapable of providing for myself, and the way that I wish I could be as generous as I want to be. I could talk about how I weighed myself this morning and chose to have a smaller lunch.

I could talk about all kinds of things because the tiny moments of difference and difficulty never end.

I don’t like stories with no end, no resolution. It’s not even that I want something to tell people, it’s that I want a point. I want some reason that I continue writing, something that I can pull from the flood of details and stories that is more than simply “this happened.” I’ve been wondering whether I have gained anything from all this wondering and reflection.

Last summer I started to feel healthy. I started to identify with the label “in recovery.” It started to feel like an end, like I could start to organize my story into a coherent narrative that would allow me to start making sense and meaning out of the pile of butt that is eating disorders and anxiety and depression. I felt as if I could begin to have a life again.

Of course the problem with that is that depression is chronic, and eating disorders have extremely high rates of relapse, and anxiety is more of a disorder that you manage rather than cure. And so I find myself this summer in another slump, feeling the kinds of feelings that I thought I had kicked through socializing more and using self soothing skills and creating routines and values in my life. I’ve been feeling the kind of depression that’s inexplicable. It’s the kind that appears out of nowhere and leaves me curled up in bed until 4:00 in the afternoon, alternatively crying and rocking in the fetal position. It makes no sense and sometimes it just happens, even if life is going really well (which, incidentally it isn’t. There has been a great deal of internet stress in my Skepchick life recently that’s certainly not making this any better).

There isn’t an end to stories about a life. At least not until the person they’re about is gone. Which means that trying to tell stories about myself feels pointless sometimes. A lot of the time. So how do I make meaning out of my mental illness, out of things that feel crappy, when I don’t get to see how they turn out? There’s always the possibility of a huge and awful relapse. If that happened, would everything I talk about be meaningless?

There is a lot of fear there. Many of my narratives do seem to move in a linear fashion: you start out sick and you get better. I hope I can challenge that narrative in myself because it is not the only meaningful one. Even if things get bad again, that does not negate that I had one amazing year. I don’t know if that’s meaningful or not. I don’t know if that’s a story. It’s important to me. It has been a long time since I had one really good year. That is a story.

I’m not sure if those stories do any good, the ones that are just a piece. But that’s what all stories have to be: a piece.

I suppose this is an attempt to reassure myself and the other writers out there that writing about your life and experiences is valid. Even if your life changes after you hit publish, the story still matters. It’s still a true piece.

Creating a Sensory Diet: Lessons from Autism

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After my recent post about similarities between ASD and BPD (so many acronyms), I’ve started to wonder about the usefulness of making these comparisons. Sure, it’s interesting to speculate and helpful to see the ways that people are similar, as well as understand where diagnoses can go wrong, but as a total layperson my contributions might have to be a little smaller than all that.

So here’s what I’m going to do for myself, as well as some suggestions for how other folks can learn from the parallels between borderline and autism.

I am a highly sensitive person. I don’t mean emotionally, although that’s also true, but I’m talking about physical senses. I love roller coasters, climbing, and other moving fast/adrenaline style adventures. I’m highly light sensitive and averse. I have lots of issues with textures (this is why I don’t eat tofu). Most perfumes and scents make me sneeze. I hardly have it as bad as some people, but I’m definitely on the “strong senses” end of the spectrum.

It’s extremely common for kids on the spectrum to have sensory difficulties, whether extreme sensitivity or under sensitivity or a mix of the two in various senses. And since it’s so common for those with autism, one of the more common elements of treatment is a sensory diet, or another way to help a kid or adult regulate and organize their sensory experience.

So what I’m going to try to do for myself is create a sensory diet. Once again, I’m finding that the curb cut effect is in full force. Sensory diets are probably great for just about anyone who finds that they’re not getting sensory needs met. I’m not diagnosable, but I definitely need more movement, tactile input, and help with my internal regulation (hunger, temp). After looking at some of the resources for folks with autism, I found a starting list that sounds like it will be helpful to me:

-emotion cards

-notebook and pen

-fidgets

-fuzzy socks

-candles

-be a burrito

-climbing/monkey bars/proprioception

-hammock or rocking chair

-be upside down

-piano

-go outside: water sounds

-exercise

-swimming!

That’s just for a start, but you get the idea. The bonus? I’m also using these sensory regulation tools for self soothing when my anxiety starts to go off the rails. I find it incredibly helpful to focus on very concrete, very basic things like the senses when I’m trying to combat anxiety. I can argue with just about anything else, but sensory input gets to the heart of the matter. So instead of making a self soothing box with affirmations or art work, which has never felt useful to me, I’m creating a sensory box with soft things and fidget and reminders of how to move my body effectively.

 As a side note, I would like to invite anyone with autism to let me know if this is appropriative at all, but my understanding of neurodiversity and its tenets is that stimming/sensory needs/other things autistics speak out about are often needed by lots of people, and the more we can integrate them into society at large the better.

On the flip side, I also think there are elements of the most common BPD therapy, DBT, that could be incredibly helpful to those who struggle to communicate or identify feelings, those who don’t find socializing super easy, or those who aren’t great at self soothing. DBT gives strategies like concrete and easy steps to set a boundary, and encourages patients to identify their values and needs. It suggests that people think about how physically different emotions feel to them so that they can use the physical reactions of their body to identify and communicate an emotion when it’s happening. It suggest methods to combat black and white thinking, like making pro and con lists, or writing out/reviewing facts about what is happening. While some of these things might require adaptation for people with autism, they could enrich that therapeutic experience.

Of course it makes sense for treatments to be individualized based on the diagnosis present, but I always wonder why there isn’t more cross pollination between diagnoses. Some of the techniques used for feeding therapies could be useful for eating disorders, DBT is useful for bipolar and eating disorders, autism treatments might be helpful for lots of people who feel quickly overwhelmed. I would love to see more communication between communities within the larger mental illness umbrella.