WARNING: this post contains brief mentions of eating disorders and self-harm.

Which is harder to deal with: physical pain and physical disability / ill health, or mental pain and distress and poor mental health? Is there a difference for you? Does one seem more real than the other?

At the moment my physical health is poor and my physical pain and limitations have been worsening fast, in particular in the last couple of weeks. Any standing or walking is painful and shaky. I need to use my walking stick again, having had 5 years or so not needing it (apart from one time for a few weeks).

Physical health problems can be tangible and visible in a way that mental health isn’t. People can see that I’m using a stick or that I need to rest often. They can’t see in the same direct way when I’m having obsessional thoughts or hearing the voices. I’ve posted before on how many people I’ve met who have Borderline or other mental health problems, feel a shame about their mental health condition and support needs and a guilt for needing help or “not being normal” or not being able to cope. Many of these people, again myself included, have physical health issues too, and the common feeling seems to be that these are more allowed and acceptable (in others’ eyes and also our own thoughts) than the mental health needs. Often that does ring true with me and I’m sad so many people find that. I’ll post on that topic more separately.

Just now I’m struggling to trust that my physical pain is real and allowed too rather than being something I’ve invented, is my fault, not real…

Physical pain is still subjective. Nobody can objectively see how much, say, my back hurts or there are weird numb sensations then burning pain in my feet. Anatomic problems can be seen and measured on scans and tests but what our experience of pain and weakness is, can’t be.

I have been desperate for more visible and concrete proofs of what I experience physically. I have some, for example, a scan has showed some degeneration in my lower spine, the GP performed various tests which diagnosed they inflammatory condition in my knees, and so on. However much of my physical struggles aren’t documented in the same way. You can’t see nerve pain or nervous system inflammation, painful joints, muscle spasms, poor regulation in the autonomic nervous system (well not directly anyway, although some tests can show disrupted adrenal or thyroid function or high white blood cell counts)…

The lack of physical, external evidence of what I’m experiencing is a real problem for me. If i let myself think on it the voices get loud. I think I must be going mad. It must be my fault. It must be my invention or my imagination. I should just get on with it and push through. I’m weak. The worst thing is the thought I must be a fake. I hate using my stick because of it even when I’m in more pain and more unstable without it. I’m deceiving everyone, the voice tells me. Look. Everyone knows. Everyone’s looking at me. Everyone’s talking about what a fake I am. They all know nothing’s wrong with me really. I’m terrified it’s all made up and I’ve faked it all without realising. I’ll never stop it but my whole life I’ll be a fake and at the end I’ll be judged and punished for it. Other voices tell me I’m doing it for attention to make people worry about me. Don’t you know how much upset you’re causing, they ask…

In the past I’ve felt I’ve deserved physical pain. That it’s safe if I have pain or cause myself pain. It means I’m being punished and suffering and that’s safe. It means I won’t be so bad. I won’t be so dangerous. I’ll be weak and that’ll be safe. That was how I thought during my anorexia. That was how getting thinner and thinner and more ill kept me safe. It is/was part of how self harming was safe too because it punished only me, just only me, stopped the evil emotions as I saw them getting out. I say “was” because I’ve managed not to self harm for a month and I’m grappling with the feelings that come to be now I’m not doing it.

The physical pain from my illnesses that I can’t control is different. It is overwhelming. It isn’t safe. It might show my badness (because I’m fake). It’s overwhelming and can feel inescapable but I feel I don’t have the right to think it’s real.

It interacts with my mental control too. When the pain is bad part of my mind freezes. I cannot be warm or present for other people. Trying to interact at all is a fight. Sometimes I want to hide and sleep. Being around anyone can be too much. I panic and want to be safe at home in my secure place. I mix up words and sounds and can’t get a simple sentence out straight. The all encompassing nature of emotions and especially anxieties and fears and psychotic thoughts increases. I feel shut tighter into the world of my Borderline.

I doubt the reality and truth of my physical and emotional experiences. The only pain I knew was real and undoubted was the pain of self harming or starving. The rest of my experience I doubt, as though the real me that’s bad really, angry, fake, deceitful, will be found out in the end, but I can’t escape from it/her. I only just realised that in writing this post. Trying to stop self harming is going to change a lot, I think.

Ginny xxxx

• BPD
• Eating Disorders / Disordered eating
• On the borderline
• Physical pain and physical health
• The emotional and the physical