When I was four, my mother noticed my obstinate tendency to stay angry long past when it was appropriate. At seven, I started listening to Evanescence religiously; by 11 I was talking about painting my room black. I was 12 when they told me I was sick, and by the fresh age of 14 I had already planned my suicide.
My disease, which was first diagnosed as a nonspecific mood disorder, had apparently manifested as bipolar disorder by the time I was in high school. However, I was recently re-diagnosed with borderline personality disorder (BPD), which is a much closer match with what I actually experience. Regardless of what you call it, however, I have what I have, and what I have is an intense mental illness that envelops me with many scattered symptoms daily.
I think one of the most fascinating, if not terrible, aspects of my disease is how early in my life it developed. I wasn’t even out of elementary school yet when the darkness started creeping under my door, and because of that, I grew up skewed. The trajectory of my entire life and personality were altered permanently by the state of youth I hadn’t yet exited when BPD took over. But what exactly does a childhood mental illness do to a person? What are the dimensions of change that psychological disease brings about in an immature mind – one that has not yet even entered middle or high school? This is an especially salient question when you consider that about half of mental illnesses start taking effect in people age 14 and under.
The biggest difference between being diagnosed with a mental illness as a child and being diagnosed as an adult, in my experience, is actually a good thing, unlikely as that may seem. Because my young personality lacked the life experience and neural maturity to function at its full potential, I was not yet psychologically whole when I begin experiencing symptoms of my disorder. I was barely learning to conceptualize myself as a person who is separate from other people – I didn’t know who I was. So, when a mental illness entered my world and tried to scramble my sense of self, there wasn’t much there to scramble.
As a child, I didn’t have to re-form my mind to accommodate an all-consuming mental illness nearly as much as an adult would. Adults already know who they are (mostly), they’re attached to their sense of self, and they have traits that they like, presumably. All of those things are susceptible to distortion by any kind of psychological disease – which is, understandably, a traumatizing experience. When I was a 12-year-old kid, I found it much easier to restructure my understanding of my own personality in a way that worked with my symptoms. Whereas grown people hold obstinately to their previous sense of self as it stood in their pre-diagnosed life, I was constantly restructuring my personality anyway when I was a junior high school student. My brain was, literally, more plastic, which made it easier for a disorder to slip in unnoticed – at least at first.
It’s morbidly wonderful to be able to bypass the excruciating process of making space in life for symptoms to manifest, because life isn’t stable yet. Because I learned quickly that mental illness would be a part of my life forever, I was able to more swiftly move into the treatment stage of having a chronic illness. I was better able to accept the long-term nature of my condition as well, because as a child, I was less able to realistically conceptualize long periods of time. It was also less of a life-changing ordeal to begin comprehending that my symptoms would last forever when it felt like they already had, because I was diagnosed so young.
However, there are downsides to attaching so readily to such destructive mental forces: A young child who identifies quickly with their illness at its onset may not remember how to function like a healthy person again, which has overwhelmingly been my experience. Because borderline personality disorder has always been a part of who I am, I’m usually at a loss to be able to act like a human being who’s separate from a mental illness. When I try to be independent, I find myself falling back on whatever my depression would have me do, not what I want to do. There are many times, like when I’m tackling substantial life changes or trying to make friends or writing a blog, that behaving like trauma is a part of my core being has disabled me. It keeps me from taking a step forward. I stay in my cage where it’s familiar, because that’s where I’ve been since I was 11.
The trauma of diagnosis is also important to consider: What does it do to a small child’s fragile brain to tell them they’re very sick and always will be? Personally, I feel like the world was pulled out from under me like a giant rug when I first saw a doctor ten years ago. It changed things I couldn’t even begin to perceive at the time; I just had the overwhelming feeling that everything was going to be worse from that moment on.
For example, maybe I couldn’t see it then, but there are a lot of differences between a relatively normal, stable childhood and the chaotic childhood of a chronic mental patient. When I was frequently missing class because I was sick and turning in special tests and assignments that had been modified for my limitations and lashing out at friends because I was always angry, I started to believe inherently that I was different from everyone. That belief became so ingrained that it will likely last me a lifetime. Whereas a recently-diagnosed adult may feel essentially normal and the same as their peers in important aspects, spending all of my time away from my rational mind as a kid caused my identity to branch off from everyone else’s early in life, before I had had a chance to mentally tie myself to the understanding that I was still human. A social rupture like that is not easily stitched back together.
Sadly, the experience of being so fundamentally different from the group and not relating to anyone in my formative years meant I became accustomed to misery. Depression causes pain. Bulimia, ADHD, dissociation, whatever your mental diagnosis may be – they all cause pain, and frequently, as a physical disability might. At a basic level, nearly any mental disorder (except, perhaps, for mania and hypomania, but even those come with consequences) is a black hole of joy, not to mention the secondary social, academic, and professional issues it inflicts as well. Dealing with this chronic pain growing up caused me to acclimate to it at a young age, which helped me come to a basic understanding: This is always going to hurt. In a way, it’s actually a good thing: I can’t miss adult happiness if I’ve never had the chance to experience it. And I can’t be as disappointed that my life might not turn out well if I never expected it would, because I’ve been sick form such a young age.
That comprehension might be harder to accept when it dawns on an adult, who may have expected their lives to be mostly pleasurable and without major stressors prior to the onset of their condition. As a kid, I had no life expectations yet, and could more easily factor into my worldview the knowledge that things are just going to continue to hurt.
The issue of suffering frequently and not feeling much happiness brings up a question about one of the most important human cognitions: hope. What does chronic mental illness do to a child, as compared to an adult, and their ability to see a positive future? Unfortunately, for me – and I don’t know any other way to realistically put this – being diagnosed young destroyed my sense of hope. I simply never developed one; it was eaten many years ago by borderline personality disorder. A sick adult can hold onto the dreams and aspirations they’ve been growing for a lifetime; in my experience, though, a sick kid never gets the chance to nurture those things. When I think about the future, I still see a vast expanse of nothingness, mostly devoid of hope: There is no cure for my illness, no magic bullet drugs, and I know I will suffer for many years to come and encounter setback after major setback in life because of my condition. It’s the reality of my diagnosis. No matter what I do – even if I’m able to achieve every last one of my goals – I’ll still carry BPD, and it will still often break through to the surface of me and make me miserable.
Pertinently depressing as all of this sounds, knowing what mental diagnosis is like for young children is applicable: It can help us treat them. Being diagnosed at 12 instead of 22 may change the nature of the therapy a person needs. Therapists should understand that many people in this situation inherently feel they can never truly be rid of their disease, and are deeply attached to it. Setting goals with a patient whose symptoms appeared when they were young may be less appropriate than teaching them how to have goals to begin with. Helping them learn social skills they never developed in school is likely more helpful than assuming they already posses those skills. And devising ways to give a person the capacity to hope could do wonders for the treatment of those like me whose outlook on life was darkened at a very young age by mental illness.