navigate freely through the four different solutions we have used to try to solve, treat, and adapt our society to individuals with mental illness. each section uses narrative essays to explain my research and highlight how each solution helps and hurts those struggling with mental illnesses.
there is no order you are supposed to read them in - each is meant to be able to stand on its own.
de-stigmatization
A Person
Hands shaking, she grabs the edge of her couch to stabilize herself: feeling as if she’s wobbling on stilts, she closes her eyes and falls to the floor.
With a loud thud, her head bangs into the
hardwood floor prompting her to forget it all:
the drinking, the smoking, the drugs,
the people: her sister, mom,
dad, who lost his life five years prior
to the same monster engulfing her.
She doesn’t love drugs.
Well okay, she does,
but it’s more of an escape than a love.
The only place she can escape to where she
doesn't have to be her.
Emilia.
The daughter of a strong business woman, who made the best chicken and wild rice noodle soup when her daughters were sick, but would never take time off work to stay at home with them. Emilia’s older sister wanted the best for her, but stopped being able to help her (for her sister’s own mental health’s sake).
Emilia understood. She didn’t want to be with herself either: so she let the monster take over, frequently. It was the haze, the nothingness, that she liked. She wasn't Emilia, she wasn’t a sister, a friend, she was nothing. And that was a lot better than being something most of the time. So she lost the person that was Emilia for years in the abyss of addiction.
Several years ago, society would call Emilia a lost cause. An addict with no sense of purpose, strung out on who knows what, isolated from her family.
But with the de-stigmatization of mental health and viewing addiction as a mental illness, we see Emilia for what she is:
a person.
Underneath all of the drugs and her behaviors, she is a human who needs help.
Maybe you, but not us
Addiction is associated with a spiral of shame. Addressing the shame related to addiction and the shame associated with many other mental illnesses begs the question: why? What is this shame from? Why do people with mental illness feel ashamed of the simple fact that
they aren't okay?
Merriam-Webster defines shame as "a painful emotion caused by consciousness of guilt, shortcoming, or impropriety."
We can think about each different mental illness as distinct facets: schizophrenia belongs to these symptoms, depression to these, and addiction to these others. But what we really brings them all together in this sense of "otherness" everyone with a mental illness feels in relation to the greater society.
Whether or not we discuss what normality is in our society, we all know what life should be like.
We don't hear voices.
We don't get addicted to drugs.
We don't let our emotions hold us hostage.
But what if you do?
If you hear these voices, if you aren't able to get out of bed because you are so sad your body can't physically move, if your whole being craves the nothingness found at the bottom of empty vodka handles then what?
In the most accepting and supportive relationships I've been in, I've still felt the cool steel of stigma cut into me from time to time.
It comes in through casual conversations
"My roommate freshman year was actually crazy, she ended up dropping out."
"I could never imagine taking medication because I'm stressed."
"Taking meds is so scary, I never want to do that."
The kinds of conversations where nobody meant any harm, but it's felt regardless of intent. It's echo bounces around and creates a distance between you and us.
A distance that shows that mental illnesses might be de-stigmatized, but the sense of being outcasted has not yet changed.
medication
The Validation
“20 milligrams, what about you?’ I say as I rip a piece of sourdough bread from my sandwich.
“Well 10 milligrams, but also 20 of my SNRI, and Xanax for panic attacks.” Mollie said as she took a sip of her smoothie and placed it back on the ring of condensation on the wooden table.
I thoughtfully nodded my head and responded, “My doctor prescribed me Buspirone because I told him I was scared of being addicted to Xanax.”
Mollie and I let out a shared laugh of a similar comfort. We had only met a few days before, but there is something about talking about medication dosage with other people that gives a small sense of security. We silently decided to take that step together. Holding each others' hand and stepping out of reality and into the world of our own objective perceptions of mental illness. The societal expectations released, we could freely express the thoughts that scare our friends and make our moms cry. Knowing we don't need to excessively worry about each other: we are finally able to just be.
Aside from the validation, taking medication helps me live a less burdened life. Anxious thoughts came to me the way riding a bike in your 20s does: instinctually. Feeling sadness weigh me down from the moment I wake up has become the norm. A weight I'm used to carrying.
Now, I realize that sometimes my anxiety and depression creates more obstacles in my life than there needs to be. With the help of medication, some of these obstacles are more do-able.
The Fog
I imagine myself sitting on a couch in the corner of my brain, watching the chaos brew around me. Usually there are dark monsters looming,
ready to attack at any moment.
They reach me as projections of myself, hideous loathing creatures reminding me of the dangers of the world:
-
What ifs morphed into two headed snakes slithering around the legs of my couch.
-
Catastrophic thoughts as fur laden wolves trotting back and forth across the tiny room.
-
Suicidal thoughts dripping from the ceiling, leaving trails of black sludge across the carpeting.
Ping.
I throw my arms across my bed and reach for my buzzing phone. Sighing, I click open my messages and see my mom’s haphazard attempt at asking me if I’m in another depressive episode.
How are the meds working?
Are you getting some relief?
I never know what to say when people ask if my medication is working.
I recently switched over from Lexapro to Wellbutrin: hoping that this new formulation of drugs would change my brain chemistry enough so I stopped thinking life was too hard to continue existing.
The reason I went on them is because I didn’t care enough about life to somehow fuck it up with more medicine. My head is not a great place to live, and at least for now, the drugs are keeping a dim fog over the messiness that permeates my thoughts. I can still see the creatures, but it’s easier to forget they exist now.
As I lay in bed contemplating her text, I decided to let my brain think freely and darkness seeped over me. The previous fog morphed into a cloud of hatred and self-doubt that made my eyelashes feel heavy. A storm swirling, but I could handle it. My antidepressants help with that: it’s not that they make me less sad or change my thoughts, they just make it a different sadness. It’s less present. It’s as if I’m watching the sadness in my head from box office seats. Removing myself from the immediate wake, but watching the tsunami tear apart myself nonetheless.
Knowing how medication affects my brain is weird. Thinking of my mythological creatures as a chemical imbalance has a weird way of contorting that way I see my own thoughts. Instead of validating my own emotions, I wonder if I’m crazy.
My two headed snake of what if spiraling around my wrists is just...a serotonin deficiency?
The heaviness I trudge through life with is just...a chemical imbalance?
Why do I see the world through this distorted lens?
Is there something so completely wrong with me that people need to change my brain chemistry just so I don’t find out that life is purposeless and just stop living it?
Yeah mom, they are really helping.
I click send and throw my phone back to the edge of my bed
and watch it teeter,
deciding if and when it will fall.
In the United States, several million adults are diagnosed with Generalized Anxiety Disorder, yet less than half of those diagnosed receive treatment: whether that is therapy or medication or a combination of both. A lot of people think that getting a mental illness diagnosis is as simple as that: a description of what is wrong with you, a prescription, and maybe a therapist to talk about your feelings.
It’s much more complicated than that.
Before I made the decision to take antidepressants, I found myself struggling with toxic thoughts: Does taking medication mean I am acknowledging that my brain is fucked up? Am I giving up? What does it mean if I admit to myself that my brain isn’t working right? Has it always been malfunctioning and it's just at a point other people can notice? Will they change who I am? Will they change anything else about me?
I started to feel like a walking science experiment.
How are the meds working?
Talk about confounding variables. I honestly have no idea. Am I feeling anxious today because the meds aren’t working or because I had one too many cups of coffee and my heart is just beating fast from the caffeine? Am I sad because someone on Tinder ghosted me or because I haven’t been keeping my depression in check?
All of the sudden, everything I do to my body is under scrutiny.
Does exercise actually help my mood or do I just feel tired and my mind doesn’t have as much energy to work? Does it even matter? Sometimes, I wonder if the way I’m experiencing something actually matters, or if just the way I articulate it to people matters.
Imagine this: all of the sudden a new study comes out that says eating bread makes you think about your future more. You see this and kind of pass it by, planning to live life the way you usually do. But now, you are acutely aware that each time you eat bread you could be thinking about the future more than usual. After you eat bread once, you think about the future: is it because of the bread, or because the inherent idea of knowing something makes you do it? In order to test this, you become hyper aware of each time you think of the future: is it because of bread or because it’s just a natural human experience to think about the future?
How are the meds working?
Whether or not my mom asks this question, I am ever aware of if my mental health interventions are “working” or not: and what that statement even means. The interwinding of biology and the personal thoughts of one’s self is a hodgepodge of confusion, self doubt, and abstract conversations with my therapist that I’m not even sure I understand.
Honestly, I still don’t know how to tell if the meds are working or not.
a dsm diagnosis
Ryan was really popular. The kind of popular that you don’t hate though, just a nice guy who happened to be athletic and really good at writing poems. Most people liked him, and teachers loved him. The kind of guy who smiles as he struts down the hallway, with an inflated sense of the world the rest of us don’t have: the confidence that the world is a good place full of good people with good intentions. Elected class president, voted most likely to be famous one day, soon enough attending his parents’ alma mater: his senior year of high school was going great.
Screeeeech.
Ryan could feel the ligaments tied around his bone electrify as he pressed the brake pedal to the floor of his Jeep Wrangler. Cold sweat precipitating on his ghostly skin, Ryan shook in place. His brain kept short-circuiting trying to process the past 15 seconds of his life.
9:00:01 p.m. Whitney Houston. Going the speed limit. Headlights beaming ahead.
Then all of the sudden,
9:00:05 p.m. A deer? On the side of the road? Wait, a man?
9:00:08 p.m. In the middle of the road?
9:00:11 p.m. He moved. Where? What?
9:00:15 p.m. Brake, brake, brake. FUCK! Swerve, swerve, swerve. FUCK!
Then...
9:05:07 p.m. Nothing.
9:15:58 p.m. Nothing.
9:20:34 p.m. Nothing.
9:46:01 p.m. Sirens. He could hear sirens.
“Sir, are you able to step out of the car?” An officer tapped on the window as Ryan seized in place.
It was all over the news for a few months.
[Young Man Commits Suicide by Jumping into Ongoing Traffic; Man Dies Instantly in Suicide Mission; Could Man at Wheel At Fault? Sources say Likely No]
Ryan didn’t watch the news though, but he didn’t do much anymore anyway.
For him,
it was a slow decline. His grey sweatpants he wore every day began to hang at his hip bones that pierced through his skin. A red long sleeve t-shirt, permanently wrinkled and peppered with condiment stains, began to reek of body odor. His eyes drifted away from every conversation with his parents, sister, and therapist. Then the unread texts, unanswered calls, and missed assignments. He stopped showering, stopped eating, stopping leaving the house,
for months.
Initially, his family and psychiatrist thought it was a mood disorder, and Ryan went on an assortment of mood stabilizers. He dealt with the side effects: the grogginess, weight loss, and confusion, mostly to satisfy his family.
His feelings of paranoia were constantly building, but who wouldn’t after such a traumatic event? Not wanting to worry his family, he didn’t tell them about it - or about the voices constantly reminding him of what he did. But sooner than later, Ryan started to slip up.
His sister first noticed: he would mumble to himself as he paced in the backyard. And at random times, he would emerge from his bedroom and ask them to be quiet: most of the time when nobody was making any noise. Constantly spouting facts about organized crime and crime rates in small towns, Ryan was fixated. He was constantly lost inside his own mind, according to his mom. His drug screens were negative, but a part of his mom wanted to blame a substance for taking away her son.
Ryan soon agreed to seek mental health
treatment and signed himself into
a mental facility.
Sitting across from a therapist,
Ryan broke down in tears,
“Am I crazy?”
He finally detailed the paranoia and voices
he heard -
the doctor reassured him and explained
the symptoms of schizophrenia and
began walking through treatment options.
He got used to telling people the prognosis:
persecutory delusions,
auditory hallucination,
and negative symptoms
associated with schizophrenia.
But he didn’t have them anymore. The Risperdal, therapy, and wellness check-ins took away most of those thoughts and helped him gain about 100 pounds - but he knows his triggers now.
Sometimes getting a diagnosis, the right one, can be genuinely life-saving. Feeling validated - that someone has a scientific definition for what they’re going through - helps people feel less alone, feel less like an outcast, and not to mention can help treat the embarrassing symptoms (telling your parents you are...hearing voices, isn’t a shameless endeavor).
Fitting into a Box
June first saw a therapist when she was 18. She sat on a brown coach, legs criss crossed, and spewed the last four miserable months. Apologizing for her sobs, June waited for the therapist to look at her and solve her problems. After all, she was just really sad about going to college - no unfamiliar feelings to anyone else.
Until,
"I would go ahead and say it seems like you are struggling from depression. I think I'd like to see you every week for the foreseeable future, if possible."
Red hot cheeks pulsing, June wiped her tears and muffled a okaythankyougoodbye and quietly shut the door. Driving home, she was in a trance. Her mind tracing her body looking for signs of depression she might've missed. She was confused, but the therapist had let the words slide so cooly off her lips. Per her therapist's suggestion, she started journaling her thoughts.
June's Diary
03.23.21
I just had the worst week of my life - emotionally, mentally, physically, everything. I didn't eat or sleep for days. I was constantly shaking. I hated everything. I cried for hours. I genuinely could not handle living my life. I am so confused though. Am I acting like this because I haven't been able to sleep/eat or because I have DEPRESSION? I think anyone would constantly cry if they hadn't been able to sleep or eat for several days. I need help but nothing is working.
04.17.21
I'm so sad all of the time. I don't hate anyone. I know people like me. I'm good in social situations. I even like hanging out with people. I just hate myself. I make living so hard for myself. The only solace I find is in the soft comfort that one day I will die and won't have to deal with the stresses of living my life anymore. I'm not going to kill myself. I care about my family and honestly myself too much. I just make it exhausting living with myself.
05.02.21
I've been putting in a lot of work. Like a lot. School has been on the back burner, but maybe for the best? My time alone is spent constantly analyzing my actions: do I act out of an anxious mindset or am I living in the moment? Where are these thoughts coming from? Do I have the ability to stop them if I need to? Things are honestly starting to feel better.
06.29.21
It got bad again. I feel like anytime anything in my life changes I just can't handle it because I'm constantly analyzing everything. When something actually abrupt happens, how the fuck am I supposed to be prepared for that when I'm already always on the lookout for the next bad thing?
07.18.21
I'm done overthinking my thoughts. Who even does that?? It's so hard. Am I not allowed to have thoughts like everyone else? I have to critically analyze each and every one for signs and symptoms of depression and anxiety. I know if I don't I'll start feeling depressed again.
Is the absence of depression just preparing for it to come back?
Is the absence of depression just preparing for it to come back?
This is a question I often ask myself. The lull period in between depressive episodes feels like it's spent constantly checking my emotional wellbeing for any signs of sadness or low self esteem.
One of my favorite books, The Bell Jar by Sylvia Plath put this feeling into beautiful prose, crafting the wiles of depression into a concrete object: a bell jar, saying:
"How did I know that someday—at college, in Europe, somewhere, anywhere—the bell jar, with its stifling distortions, wouldn’t descend again?"
Being told you have depression is terrifying. Especially if in a certain moment the depression isn't vividly attacking. The agonizing wait time between depressive episodes is made so much harder not knowing when the bell jar will descend: who you will be with or what your role in society will be at that time. It either feels like I'm waiting for the bell jar to collapse on me, or I'm trapped in its rotten air - thinking I will never be freed again.
The diagnosis of depression feels like someone saying, if a bell jar isn't caging you right now, it will in the future.
normalization
A quick google search and a million hits
Jordie lays quietly in her room. Staring at the ceiling after a few hours on TikTok. She feels her hip bone piercing the top of her comforter and sighs.
That kind of feeling used to bring her a sense of comfort -
feeling her bones against her stretching skin.
But she's not supposed to have those thoughts anymore.
TikTok has given her a surplus of information about recovery, too. It helps her find solace in numbers. Other people who had or have the same feelings as her. Who understand a little bit what it's like.
She doesn't talk to anyone in her life about it because, well, her mom still only eats a Lara bar for 2/3 meals and her dad doesn't really provide emotional support. Her friends don't get it either. They joke about only having iced coffee for breakfast, but Jordie would only drink iced coffee for days. Starving her soul not of calories, but of life.
TikTok, Instagram, even Google searches have helped her more than the people in her life most of the time.
But not all of the time
Sometimes she watches girls on TikTok go through what they eat in a day. As a six foot athlete, she knows she should be eating more than these influencers, but she doesn't want to.
She listens to girls talk about their recovery stories, slightly different in one way or another, and she feels a pull deep inside of her to revert to her old ways. She knows what society is telling her to do and she knows she needs to eat, but the control she finally feels over her life when she skips a meal satisfies her mind.
It's her individual perception she has to fight against, not society's. I mean maybe society told her that skinny was pretty, but it's her thoughts that are craving to run on the treadmill until she's about to pass out. What is she supposed to do with that?
Society acts in many different ways. There are actual societal norms and expectations, but then there are perceived norms that are rooted in individual's experiences. Everyone perceives the world differently: but is that dangerous for those who struggle with mental illnesses?
I know this project is about mental illness, but let’s talk about math for a second.
Let’s think of a single human life on a graph.
One axis is simply the progression of that human’s life, and let's call another logic.
Logic that is curated by society, of course.
For all of us, there is an inherent logic to living life:
we can see this as what society sees as normal, right, and just.
This includes things like living every day:
Eating three (ish) meals a day. Showering.
Communicating with others.
Fitting into your role within our system.
Being successful (whatever that means).
This logic can be defined by culture, parents, peers, and many other different things. We tend to follow this logic. Because it’s the way everyone else does, it’s laid out very nicely for us.
But, there is another dimension on this fake graph of our lives.
An individual’s perception.
Each individual has a third dimension that does not take into consideration either axis. It’s the way he or she interprets the world.
Their hot takes,
their thoughts,
their opinions,
all the stuff that makes humans wickedly cool?
That’s this axis.
But this axis is where mental health is too. Mental health can contort the individual’s perceptions to be completely different than everyone else’s. So let's say someone's perception axis is clouded by severe depression.
Not only is this person completely aware of the logic axis (they should be sleeping and eating, they shouldn't be crying in their rooms every day), but their perception axis is conflicting with these pieces of logic that society has put into place.
What the fuck happens then?
What happens when everything you see goes against what what society has deemed normal and right and just?
Mental illness is not just an individual perception flaw or blip in a graph. It is inextricably interwound with the operations of societal norms and thought.
People diagnosed with mental illnesses will never be able to look at their individual axis and mental illness and separate it from society. We can normalize mental illness as much as we want, but it will never be normal.
An individual perception can never be normal.