I give you advice a lot. I try to tell you that there is more in store for us than disability and despair for the mentally Ill. I hope I can inspire you to look at life differently. But sometimes, we all need to stop and be reminded of what we know about ourselves. We are sick. We have dysfunctional brains. I came across this comic today while I was browsing the web and for some reason, given events of my life recently, it really resonated with me (Source: http://imgur.com/gallery/CWFTYoV). Trust your intuitions about your illness when you are stable and can think about it clearly. We can’t think ourselves to a solution. Mental illness is just that, illness. I don’t like to talk about the stigma we face, as much as it is plain as day, because somehow I feel like avoiding discussing the subject to much will help us move past it. Generally, not a realistic expectation, but I suppose part of is that the constant reminders of that stigma I see everyday are as much as I can tolerate. I don’t want you to think that you can’t change your prognosis by choosing your actions to promote that improvement, but to a certain extent, like a man with a severed arm, our own capacity to change the course of our illness is not entirely under our control.
When I talk to people about my symptoms, they usually do one of two things. They relate my issues to the problems that they face on an everyday basis (This tends to be frustrating unless they are also mentally ill) or they try to counsel me about how I should take my life back and get over it (Which tends to be both painful and frustrating at the same time). The people who understand or are just plain caring and hoping there is something they can offer say, “How can I help? What can I do to make your life easier?” I honestly wish everyone would do that. When you have a cold or the flu, your friends and family bring you chicken soup, buy you boxes of tissues and medicine, and offer to walk your dog for the week. They don’t question whether you’re making yourself worse by lying around the house for days. They don’t drag you out of the house or chide you for being antisocial. When you’ve broken your wrist, they whisk you off to the hospital to get x-rays and sign your cast so you can look cool to everybody in school despite being unable to sign your name or write notes in class. They might even copy their own notes for you. They don’t ask why you’re using your cast to get out of taking notes or suggest you take an online survey that will indicate whether or not you have a problem. When you have a visible chronic health problem, like diabetes, they afford you consideration and understanding and should your insulin or sugar levels get out of whack, they will scrounge up a candy bar to put you back on track or give you due privacy to administer an injection. For those of you reading this post who are caregivers/friends/family of the mentally ill, it is really important to remember that the pathophysiology in mental illness is real. Our brains actually don’t function like yours. They might not even look like yours. Many of us living with schizophrenia have reduced white matter in concert with reduced overall cortical surface area, which may be involved in regional reductions in gray matter in the brain. A few references, in case you’re interested in reading more…
Colibazzi, Tiziano, et al. “Anatomical Abnormalities in Gray and White Matter of the Cortical Surface in Persons with Schizophrenia.” PloS one 8.2 (2013): e55783.
Chan, Raymond CK, et al. “Brain anatomical abnormalities in high-risk individuals, first-episode, and chronic schizophrenia: an activation likelihood estimation meta-analysis of illness progression.” Schizophrenia bulletin 37.1 (2011): 177-188.
My point, without getting too fancy into the science, is that we are biologically different. We are physiologically different, meaning that we have not only structural differences, but differences in how our neurons communicate with each other in different parts of the brain. I will probably devote a few posts to talking about pathological anatomy and physiology in the near future, but that’s not the focus here. When you talk to a person living with mental illness, you could imagine that they are missing a limb. Mental illnesses are life-altering. Maybe they have been there for a long time, maybe not, but all have a significant detrimental impact on our daily lives. Because we are biologically different from people who do not suffer from mental illness, we must be treated medically in order to improve the regulation of our brain functions. And there are side effects, to be sure. When a soldier loses his leg in battle, his new prosthesis will be tailored to fit their remaining anatomy (stump, as one might say), but they will still suffer from discomfort due to the prosthesis rubbing against their skin and the pressure between the synthetic material and their own tissues. Treatment plans are tailored to fit each person living with mental illness, just like the amputee’s, but there are invariably consequences of treatment.
One thing that is not a negative side effect of treatment, which I have myself often wondered about, is that the treated person becomes a different person entirely. The illness is responsible for that. The person inside possesses the same soul, the same passions, the same capacity to make an impact. There is no change in who the person really is. The point of treatment is to expose that person, to take away the negative aspects of the disorder and let the person’s real spirit shine through. We are not our illness, but we are hidden from the world by it. If someone has cancer and receives chemotherapy or radiotherapy, they may lose their hair and lots of weight because they are having difficulty keeping food down. They will be tired often, struggle to perform everyday tasks that they previously did with ease, and may even be sad or lose hope. But they are still the same person. They are not their illness, but their true spirit is hidden from the world by it. The treatment is a necessary part of making their body whole, just as antidepressants, mood stabilizers, antipsychotics, and anxiety medications make people whole mentally. There are always consequences, but clinicians make every effort to minimize those consequences that impact a person’s daily life. If you’ve ever read the information about the medication you are taking, you’ll recognize phrases like this…
“Your doctor has deemed the benefit of this medication to be higher than the potential risks associated with this treatment.”
I know that this was more of a rant than a cohesive narrative, but I want you to take away a couple of things:
1. If you live with a mental illness, know that it is NOT your fault. You, at some point during your life, were made this way. You are not weak or lazy or over-dramatic. Trust yourself to know better than the people who might tell you otherwise. You have an illness that makes functioning everyday difficult and there are options to find ways to live with it, therapy and medication, just like there are ways to minimize the symptoms of most chronic illnesses.
2. If you do not live with a mental illness, be sensitive to the fact that your friend/co-worker/relative/acquaintance has an illness. A chronic illness. If they have not sought treatment, get them to a doctor if you are able to do so or try to find someone that can. If they are in treatment, ask them how you can help them to feel better and if there is anything that would make things harder for them. Be the kind of support they need, without judgement or criticism.
Thanks for listening.