If British girls’ mental health is at crisis point, why are we still refusing to change our schools?

Britain’s girls are at crisis point. In terms of their mental wellbeing and self-esteem, this is no exaggeration – and their parents are ill-equipped to realise the signs.

First published by The Independent, 24th August 2015

Britain’s girls are at crisis point. In terms of their mental wellbeing and self-esteem, this is no exaggeration – and their parents are ill-equipped to realise the signs. Research released today by Girlguiding UK has found that girls as young as seven are experiencing mental health problems, and these issues only grow more common throughout secondary school and into early adulthood.

The findings show that for girls aged 11 to 21, self-harming is one of the biggest health concerns, followed by cyber-bullying and mental illness. Out of the 1,574 girls surveyed, nearly half (46 per cent) reported having mental health issues, while even more (62 per cent) said they knew someone who’d suffered from a mental health problem. These figures should be shocking, but they aren’t, because the pressures facing young women are more pronounced and numerous than ever.

It’s not enough to get a string of perfect GCSEs or A Levels nowadays, you see. You need the Instagram-worthy group of friends, the attentive and good-looking boyfriend, the lips of Kylie Jenner, the curves of Jennifer Lawrence, the doe eyes of Zoella, and the reputation of being sexy and desirable without being a ‘slut’.

If your life isn’t perfectly cultivated online and offline, then woe betide you in a group of your peers. My sixteen year old fears about my MySpace profile not being customized adequately seem positively antique next to current worries about cyber-bullying and the phenomenon of ask.fm, where participants can be deluged in some of the most vile and disturbing anonymous abuse available online. Some of the abuse that teenage girls pile on each other in the virtual world make 4chan look like a unicorn’s rainbow playground.

And it doesn’t stop with aggressive ‘thinspiration’, either. There’s a strong sexual dimension to the online concerns of young women, particularly as many girls are pressured into sending explicit pictures and videos to boyfriends or would-be boyfriends, only to have them widely disseminated online or shared round school. Some girls are forced to disrupt their education and move schools after being publically shamed in this way. According to the same Girlguiding report, in the last week, 75 per cent of girls agree that anxiety about sexual harassment has a negative impact on their lives. It’s a perfect storm of aggression, isolation, harassment and misery.

So where do young girls turn when mired in this high-pressure environment? It seems that our medical services are ill-equipped to cope with the culture we’ve created. Deep cuts (8 per cent in real terms) have affected existing mental health services, despite a 20 per cent increase in demand. Meanwhile, only 13 per cent of NHS funding is allocated to mental health treatment, even though mental illness accounts for more than a fifth of the disease burden. Lack of information in schools, social stigma, long waiting lists, and GPs ill-equipped to spot early warning signs of mental illness are all barriers to young people getting the treatment they need.

We can help our young women. We can do so by opposing further butchering of mental health services by the current government. We can teach girls to mistrust images of perfection, in advertising, pop culture, and on social media, and let them know that from an academic perspective, their best is always good enough. Simple efforts like media lessons that point out how to spot Photoshopping, or expanding extracurricular activities alongside academia, can help to deconstruct poisonous beliefs about inadequacy.

Alongside this, we can campaign for comprehensive sex and relationship education that focuses on consent, respect, and healthy relationships between young men and women to tackle the culture of harassment and sexual abuse that often starts in schools. And above all, we can do what’s truly radical: listen to girls, and believe them when they tell us about their experiences.

How Borderline Personality Disorder Put an End to My Party Days

In the summer of 2010, just before I turned 19 and in my first year of university, I attempted suicide with a month’s supply of my antidepressants and ended up in intensive care, breathing on a machine.

First published by Vice, 10th August 2015

In the summer of 2010, just before I turned 19 and in my first year of university, I attempted suicide with a month’s supply of my antidepressants and ended up in intensive care, breathing on a machine. By my second year, my good-time friends had had enough of me. I was no longer invited out, and became very isolated and increasingly unhappy. I got into an abusive relationship and attempted suicide another two times. I was also bulimic – vomiting everything that touched my lips.

During the first year of my undergraduate degree I reduced my calorie intake to 250 a day – about two and a half slices of bread or five medium apples – and started to go slowly insane. I drank, took drugs and went to clubs with a religious fervour. My body started to cave in. I was starving and my hair started to fall out. My nails went blue. My skin turned to flaking scales. I once ate a burger after a night out and forced myself to run up and down the stairs until I actually passed out to “make up for it”. I went to my campus GP and told him I needed help. At five and a half stone, he said I wasn’t sick enough to warrant eating disorders treatment, and Borderline Personality Disorder was never even mentioned.

People couldn’t keep up with my impulsive behaviour, the manic phases and the fits of crying. The labels of “drama queen”, “attention seeker” and “total fucking mess” followed me around like a bad smell. I tried to conceal it, but being called those things hurt. I didn’t know how to explain that all the stuff I was doing was an attempt to manage my out-of-control emotions, because when I’m going through a bad patch it feels like being on a sickening rollercoaster – only, I can’t get off.

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Stephen Buckley, Head of Information at the mental health charity Mind, describes BPD as “a very broad diagnosis that can include lots of different people with very different experiences”. He told me that BPD can involve experiencing a number of symptoms for extended periods of time, including “feeling worried that people might abandon you; feeling very intense emotions that are also very changeable; feeling like you don’t have a strong sense of who you are; finding it hard to make and maintain relationships; acting impulsively; having suicidal thoughts or self-harming; feeling angry; feeling paranoid, having psychotic experiences; feeling numb; or feeling empty or alone a lot of the time”.

To me, it was more like going from feeling suicidal and totally despairing, to reasonably positive within an hour. The intense mood swings were terrifying because they were – and still are – coupled with impulsive urges to harm myself or do things I know I’ll later regret. The negative emotions I have are immobilising. They crash over me like huge waves, knocking the wind out of me and forcing me underwater. It means living with a devious voice in my mind that whispers ugly thoughts and orders. It tells me that I’m a shitty person, don’t deserve to exist and that my life is meaningless.

Author, pictured right.

According to the NHS, personality disorders often become apparent during a person’s teenage years and are commonly associated with childhood trauma, with eight out of ten people with BPD experiencing physical, emotional, or sexual abuse during childhood, or parental neglect.

I wasn’t neglected by my parents. I had a very happy childhood up until I started secondary school. It was the kind of school that concerned middle-class parents tend not to send their kids to. Discipline in classrooms was practically nil and I was bullied badly, branded a “lezzer” and a “dyke”, greeted with laughter whenever I entered the room, pelted with chewing gum, dismissed by boys as a “rat” and a “dog” that “no man would ever want to touch”. Girls would pretend to be scared of me in the swimming pool changing rooms because I hadn’t realised, age 11, that I was meant to shave my legs.

This continued for about two years, and by the time I was 14, I’d become completely disconnected from myself and overwhelmed by feelings of worthlessness and anger. This was when my impulsive behaviour kicked in, and I started self-harming, drinking, taking drugs like cocaine, mephedrone and speed, and looking for attention from dubious men. I didn’t know what Borderline Personality Disorder was. I began limiting myself to 1,000 calories a day and visiting pro-anorexia websites. I told myself that I’d feel calmer and people would like me and the raging hurt would leave me if I just became thin enough.

It wasn’t until the end of my second year of university – when I was finally accepted on to an eating disorders treatment programme – that I was finally diagnosed with Borderline Personality Disorder. I did a course of Compassion Focused Therapy, which is designed for people with high levels of shame and self-criticism. I learned more about how to navigate my overwhelming emotions, and not listen to the hateful voice that pushed me to starve myself and hurt my body. The therapy was coupled with medication to help me sleep and negate some of the crushing depression that so often accompanies BPD.

Some BPD sufferers hear voices outside their heads, usually with instructions to harm themselves or others, and at the more extreme end of the spectrum, some sufferers also experience prolonged delusions or beliefs that they cannot be talked out of. Others – like Rachel Rowan Olive, a girl I talked to who also suffers from BPD – tend to disassociate or shut down when their emotions become too difficult to deal with. “BPD is hard to describe to someone who doesn’t have it. I never liked the label ‘Borderline Personality Disorder’. It’s the kind of term that makes people back away slowly. I used to think that a lot of the criteria for BPD didn’t apply to me, but as time has gone on, I can connect things that have always been part of me to the diagnosis.

“My main problem is self-harm and that’s the most outward and obvious symptom of my BPD. I experience a lot of anxiety, so I feel like if I’m going to be frightened anyway for absolutely no reason, I might as well make myself frightened of something that’s real and within my control. I experience a level of emotional dysregulation, where I end up feeling really empty a lot of the time. I think a big part of it for me is finding it hard to tell the difference between my emotions and other people’s. I notice it even with fiction – if I’m reading or watching TV I can end up getting panicky because it’s like I’m feeling what all the different characters are feeling at once and I don’t know which emotions are mine any more.”

Nowadays, I try to keep my environment as calm as possible, and use distracting and soothing techniques to mitigate the effects of bad episodes. Most of the time I keep my emotions under control, but there are still times when I swing between crying and not being able to get out of bed, hyper productivity and manic states where I’m tempted to be super-impulsive.

I still have a hard time forming long-lasting friendships. The majority of my friends from school and university are no longer in my life. Part of BPD is forming intense relationships that don’t last very long, and the illness ends up being very isolating. My emotions are so overwhelming that other people find it hard to understand why I’m laughing and bouncing around for no reason, and then suddenly in floods of tears. I don’t usually tell people that I have BPD because I’m afraid they’ll judge me.

Managing Borderline Personality Disorder usually involves a combination of medication and talking therapy. There’s no drug specifically licensed to treat BPD but mood stabilisers, antidepressants and antipsychotics (all of which I take) are commonly used. Rachel uses Dialectical Behavioural Therapy to manage her BPD, coupled with art therapy at a studio in Hackney. She will also plan her week out in advance to give herself a sense of structure and control.

The stigma that surrounds all mental illness is vastly unhelpful, does much to damage sufferers and can prevent them from getting help. As a “personality disorder”, BPD gets more than its fair share of social stigma. People with BPD aren’t cold and emotionless, as Rachel felt others perceived her to be, or attention-seeking and deserving of social isolation, as I was dubbed at university. They are merely trying to manage an illness that’s every bit as real as a physical condition, with the tools they have at their disposal.

It’s very easy to succumb to feelings of frustration and hopelessness when you’re stuck on a waiting list and it might be six months to a year before you even get an assessment appointment for any kind of therapy. Despite this, it’s essential that anyone experiencing BPD-like symptoms informs their GP. No one should have to get to such a breaking point with their mental health that they try to end their life. It’s five years since I was unconscious in intensive care, unable to breathe, with a nurse washing my hair because of all the sweat that had run into it. I owe it to my partner, my parents, my sister and myself not to end up back there.