I’ve been managing multiple mental health illnesses ever since I was a teenager.
My borderline personality disorder has been there ever since I can remember, lurking in the shadows and silently poisoning every aspect of my life. My depression was the first to be diagnosed though, obtrusive waves of sadness that turned into debilitating, suicidal despair. The anxiety came later, disguised as introversion until I tried to cure it with recreational drugs.
Every single day, depression, anxiety and BPD try their best to inconvenience me into a mental breakdown.
Managing multiple mental illnesses is hard. Like, really hard. For the first 10+ years of my mental health journey, I was a walking unhealthy coping mechanism with no concrete diagnosis or self-awareness to speak of. I indulged in every self-destructive behaviour possible in a desperate attempt to control the chaos in my mind – of course, making everything 10x worse.
Even now that I know the intricacies of each disorder and have plenty of coping skills up my sleeve, there are still days where my mind feels completely alien to me – and that’s because when you have multiple mental health illnesses, new symptoms, surprises and setbacks pop up all the time.
Luckily though, most days I kick every single one of their asses. Yep, I even power through BPD’s toxic, shit-stirring shenanigans!
Comorbidity in Mental Health Illnesses
Comorbidity, the presence of more than one disorder in the same person, is extremely common when it comes to mental health.
Mixed anxiety and depression is the most common mental disorder in Britain. Bipolar disorder is also closely associated with other mental illnesses. In the National Comorbidity Survey, 95% of people with bipolar disorder qualified for three or more psychiatric disorders.
It is extremely common for one mental illness to cause, trigger or worsen another. Co-existing mental illnesses often have very intense cyclical relationships which is why management and recovery is so focused on self-awareness. For example, it was only after I was diagnosed with BPD that I realised my social anxiety was rooted in severe self-identity issues.
So, here’s everything I’ve learnt about managing multiple mental illnesses at once – and staying pretty damn sane as I do it!
Disclaimer: I am not a mental health professional. What works for me may not work for you – this is all written from my own experiences. You can read my full disclaimer and find out more about managing multiple mental illnesses from a medical perspective here.
1 – Find The Right Medication For You
My medication journey has been pretty chaotic. I’ve been on and off different medications since I was thirteen years old, from antidepressants and antipsychotics to sleeping tablets and anxiety medications. A lot of them either didn’t work or just made my symptoms worse, but once I got my final diagnosis and was confident in my ability to speak up, I managed to find a treatment plan that kickstarted my recovery.
Right now I am med-free (can I get a high-five?), but knowing what works and what doesn’t is vital when managing multiple mental illnesses. Work openly with your GP or mental health professional to find the right combination of medication for you – remember, everyone’s mental health needs are different!
If you need some more info, the mental health charity Mind have some amazing resources on their website, from what to do before considering medication to some tips on coping with side-effects. You can access this information here.
2- Understand The Unique Relationship Between Your Mental Health Illnesses
As I’ve already mentioned, comorbid disorders often have a cyclical/cause-and-effect relationship. Understanding how each of your mental illnesses interact with each other is an essential step to managing them because it allows you to break self-destructive cycles.
For example, my BPD causes me to have severe self-identity issues. These identity issues cause anxiety in social situations. The anxiety will then make me spiral into depression because of my perceived inadequacy and unlikability. Being aware of this has helped me so much because it allows me to treat the root issue rather than blindly attempt to fix its consequences.
I highly recommend CBT for managing multiple mental illnesses. To learn more about CBT, including how to access it, visit Mind’s guide to CBT.
3 – Have A Safety Plan
A safety plan can be used in times of crisis or on bad mental health days. It’s important to have one when you’re managing multiple mental illnesses because when one of your illnesses starts playing up, the others tends to follow suit. This can be incredibly overwhelming and extremely destructive to your mental health.
Devise a clear, simple plan that you or your loved ones can refer to in times of crisis. For example, it might consist of three steps like this:
1 – If I’m feeling extremely low, I’m going to try some of these self-care activities to make myself feel better.
2 – If that doesn’t work, I’m going to talk to a loved one / call Samaritans for support and advice.
3 – If I feel I am in crisis, I am going to contact my local mental health charity, crisis team or GP.
Remember, make it simple and uncomplicated!
4 – Keep A Mental Health Journal
Journaling for mental health and self-discovery is great for managing multiple mental illnesses because it encourages you to be reflective and introspective.
Rather than simply experience or ruminate negative thoughts and emotions, journaling provides you with a healthy way to analyse and reflect on them. It opens your eyes to any recurring or cyclical thought-patterns you may have, as well as your triggers and behaviour-patterns. This can really help you to understand the negative thoughts and behaviours that are linked to each of your mental illnesses, as well as how they overlap and interlink.
Journaling is a wonderful outlet for my crazy emotions! To learn more about how journaling can improve your mental health, read this article with 60 free mental health journal prompts for inspiration.
5 – Practise Mindfulness
For me, having BPD, depression and anxiety means having to constantly internalise negative thoughts. A lot of them. All. The. Time. My negative thoughts can swing from paranoid and angry to depressed and suicidal in a matter of minutes.
If I let them, they can completely consume me. It’s not only exhausting – it can be pretty terrifying!
Luckily, mindfulness has been a life-changer for my mental health. Being more mindful allows me to acknowledge and accept my thoughts without letting them overwhelm me. They become just thoughts, which stops me from being so scared of their presence. It also makes it easier for me to refocus my attention away from them.
If you are managing multiple mental illnesses, mindfulness can also help you to categorise or ‘name’ your thoughts. I am able to say “oh, that’s an anxious thought” or “that’s BPD again”. This kind of self-awareness encourages me to think more objectively about my thoughts and where they come from.
Learn more about using mindfulness to benefit mental health.
6 – Have A Variety of Coping Skills and Strategies
Self-destructive bad habits are so easy to fall into when you suffer from multiple mental health illnesses.
My entire life revolves around resisting unhealthy coping mechanisms and applying healthy ones instead. It has taken years of trial and error – there was a time I thought mindfulness was a load of shit and couldn’t practise it to save my life. There was a time I’d give up on journaling after a mere five minutes, succumbing to the bottle or jumping back into a toxic relationship.
However, with perseverance and by trying a bunch of different activities in my will to get better, I now have a variety of healthy coping mechanisms under my belt! Having a variety of coping skills and strategies is great for managing multiple mental illnesses because what relieves one disorder’s symptoms might not relieve the other’s.
Managing multiple mental illnesses is exhausting and scary – but it also shows an incredible amount of resilience. Don’t feel guilty or ashamed if you’re struggling and never be afraid to ask for help. You are brave, beautiful and kicking ass!
If you have any other tips and tricks on managing multiple mental illnesses, please leave them in the comments below – I’d really like some more ideas!