I will preface this by saying that there is probably nothing you can say to convince me that I am not a burden. It’s not that I don’t hear your words, but my mind will counter them with a million examples to prove to you just what a burden I am.
Suicide for me has never been about escaping pain. I suspect for many it is not. Rather, I have attempted suicide time and again because I come to a place where I feel like too much of a burden and I am utterly convinced that the world would be better without me. When I look at the bigger picture, I have taken more than I can ever give back and thus I should not exist.
Suicide has NOT been a threat – each time I’ve been dedicated to end my life. In fact this last time, the psychologist at the medical hospital told me I made a “valiant effort.” Suicide has NOT been a means to manipulate others for attention, though I’ve often been accused of this. As Marsha Linehan says:
It is rare that a person with [Borderline Personality Disorder (BPD)] is actually trying to “manipulate,” that is, to manage, control or influence in a subtle, devious, or underhanded manner; or to handle with mental or intellectual skill. A suicide threat or attempt is certainly not subtle or devious. It is right out in the open! … Folks with BPD are usually not skillful in their interpersonal communication styles. The problem is that they often can only express their emotional pain by screaming out how much they want to be dead, which is likely true. Self-harm, alas, regulates emotions for many.
In other words, though when I am not in the midst of extreme emotional distress, I am quite capable of manipulation, but in moments when I am beholden to my borderline or PTSD symptoms, I am not in fact capable of being subtle, devious or underhanded. And I’m not doing it just to get attention for my feelings, I am truly feeling them with no good way to address those emotions (see the post on Coping Skills).
Besides the underlying emotional instability that comes with my diagnoses, the words play in my head of those who have accused me of being manipulative. Of “ruining others’ lives,” of being a “fucking self-centered little bitch,” of being a “spoiled brat,” of acting “rude” and “selfish” and “demanding.” And honestly the worst epithet in many respects, “not empathetic.” Those words which have been drilled into my psyche for years and years, words that come from the trauma that makes up my PTSD and others who do not understand mental health illness. And with these words in mind, I come to a place where I KNOW with all my being that I AM these things. I am worse than these things. I am not just worthless, I am actively draining others and taking more than I can ever give. I AM A BURDEN.
To be fair, I did grow up very spoiled. I was raised in a very well-off family, the daughter of a doctor and pharmacist, rarely really told no. I was sheltered and naive – perhaps a somewhat typically self-centered teenager. I believed I was better than others because I did well in school and didn’t get into the troubles my peers did. My eyes weren’t really opened to others’ suffering until I left home that senior year in high school.
I can never take back those years of selfishness no matter how hard I try.
And I am demanding – I demand that people do as much as they can for others, and I often think they can do more than they actually do. I demand that others not make the mistakes I made in being selfish and self-centered but will give of themselves.
But what cuts deepest are the ideas that I am rude, ruining others’ lives, and the idea that I was/am not capable of empathy. If I am that bad, than I should not exist for I am simply a burden.
This feeling of burdensomeness is incredibly powerful for those of us with BPD. In fact,
- Conflictual family relations relate to beliefs about thwarted belongingness and perceived burdensomeness, which, in turn, relate to BPD pathology.
- Perceived burdensomeness is associated with elevated suicide ideation.
Especially these last few years, I’ve felt like a bottomless pit of need. I’ve had to ask again and again for support – particularly financial and emotional. And I fear the investment others have made in me may never come to fruition. I fear that I will always be in need, always taking, always a burden. With that line of thought, I am convinced that in dying I would be making the world a better place.
My thought process goes something like this:
- I am a bad person – selfish, self-centered, demanding, etc.
- I have taken too much.
- I am trying to give back.
- I cannot give back enough.
- On balance I am a burden.
- I should die.
Yes, many point out that my death may be a burden, but I would counter that in time, people would be able to move forward and they would not continue to waste time, money, energy on me. In fact, not only would they not waste time on me, but my things could be given to others and my body could be dedicated to science (I have signed an anatomical gift act). Even as I sat dying in my car a week before Christmas, I thought, I better not throw up in the car so they can donate it when I’m gone (it was in opening the door to puke outside that led to a lady finding me and calling an ambulance – a lady who happened to be walking in to Target in the busiest of seasons and happened to stop and happened to care). Thus in my mind, in death I would actually be giving.
It is the not being able to give back – or give back enough – that becomes the crux of it all.
By give back, I mean both giving to those who have given to me and paying it forward. I mean giving money, time, my professional services, goods (food, water, clothing, toiletries), love, and anything that might help make someone’s life better.
I don’t have money to give back. I don’t know that I ever will. I don’t have the funds of Mark Zuckerberg or Bill Gates. Not to mention that I have the worst business model of anyone trying to make a living – wanting to help those without and never able to charge for services provided to them.
I don’t have a lot of goods, but I’ll give what I can. I do have more than many. I’m not without. If I have an extra shirt, I’ll make sure to pass it on. I have extra toiletries from trips I’ve been able to take for patient advocacy. And when possible, I can get a few extra of those lunch bags of chips and give them to those begging for alms on the streets.
I will always offer my professional services to the extent I’m not violating any rules about the practice of law. If I can offer advice, I will. If I can’t, I’ll find a resource to point to that can help.
I love to give my time. Frustratingly, with my physical health has prevented me from even offering my time these past few years. How can I help if I am having spine surgery? How can I listen when I’m in the hospital? But if I can, I will. And though many are reticent to open up, worrying that they would be placing too much on me by expressing their issues, it is in fact that very thing that helps heal me the most.
Giving saves me. Giving allows me to live. I just wish I could give more.
My therapist says I need to learn to give sustainably – as in don’t give everything I have to my own detriment but find a way to get my needs met first (that whole put your oxygen mask on first idea) so that I can give more to others. This concept is completely foreign to me. In my mind, asking for anything – taking anything – means that I have to be giving anything I can (and perhaps a little more). Not because I’m some sort of saint, but because I both see the suffering of others and want desperately to address it and because I want to make up for being a burden.
How then do I ask for help with housing funds (friends have started a crowdfund to help me which you can find here) and balance that need for a stable home without feeling like I’m taking too much? I can only justify it by telling myself that if I have stable housing and I can improve my mental and physical health, I can help others. I am alive, so I have to do something with my life and that something should be to dedicate myself to giving back – to helping others not feel the way I feel. I do not want any other person to feel a burden. I want them to feel that someone has at least seen them, heard them, felt for them.
As long as I can give at least that, I can live. When that is taken from me, I do not want to be a burden anymore.
 Linehan, M. (2009). Expert answers on borderline personality disorder. Consults: New York Times Blog. Found at http://consults.blogs.nytimes.com/2009/06/19/expert-answers-on-borderline-personality-disorder/
See also: BPD patients are not manipulative, “they are in excruciating pain that is almost always discounted by others and attributed to bad motives.” 
 Brody, J.E. (2009). An Emotional hair trigger, often misread. The New York Times: Health: Personal Health. Quoting Marsha Linehan. http://www.nytimes.com/2009/06/16/health/16brod.html
 Kalpacki, A. et al. (2014). Beliefs about unmet interpersonal needs mediate the relation between conflictual family relations and borderline personality features in young adult females. Borderline Personality Disorder and Emotion Dysregulation 1(11).
 Jahn, D.R. (2015). The mediating role of perceived burdensomeness in relations between domains of cognitive functioning and indicators of suicide risk. Journal of Clinical Psychology.