The phrase "mental illness" has changed connotations for me over the years. When I was first diagnosed bipolar, it was very very important to me to stress that this was a physical disease -- a physiological imbalance in my mood chemistry, treatable by chemistry. I don't think the doctor could have gotten me to accept diagnosis and treatment without presenting it that way.
But over the years, the phrase "mentally ill" has become more and more neutral to me, as the borders around it have blurred. There is such a range of ways our bodies can sabotage our minds, our minds can sabotage our bodies, our character defects can sabotage our lives. There is such a range of ways we can help ourselves and each other: some things that look like mental illness respond to nutrition or antibiotics; some things that look like physical illness respond to a receptive ear and a warm hug. Even after an illness is treated, a person may need other support to deal with the effects that illness created on the rest of life.
The borders are blurry, and I think that it's a good thing for the borders to be blurry.
You have a rare allergic reaction to lysine that directly affects your central nervous system, causing you to become anxious and irritable and start screaming irrational accusations at people. This is finally diagnosed and successfully treated by a special diet and emergency syringes of antihistamine. In the meantime, you have been divorced, disowned by all three generations of your family, fired, evicted from all homeless shelters, and you are sleeping under a tree that even the birds stay away from. Maybe you are seeing a counselor for help in building a life again. Maybe you can't afford it, there is no community mental health, and you spend the rest of your life outside, ragged and unwashed and talking to yourself because no one else will.
You apparently missed the kindergarten lesson on "be nice to your playmates or we won't let you have any more of them." You consistently alienate people by careless, rude and outright obnoxious behavior. By one of the freakish circumstances that convinces some people of the existence of Grace, you decide one day that you don't want to live like this anymore and begin seeing a behavioral psychologist to help you change. Perhaps one day you break down crying and talk for the first time about Daddy beating you with the broomstick and then buggering you with it. Or maybe you break down one day and talk about being a selfish and cruel little twit because you found it pretty rewarding to be a selfish and cruel little twit.
Daddy really did bugger you. You(A) went into the Magic Wood and You(B) took the pain. After Daddy dies, both You(A) and You(B) start running around in circles shooting off firecrackers, reality gets cloudy from all the smoke, and your family wonders what the blazes is going on. (And of course nobody knew what did go on.) Perhaps you see a psychiatrist who dopes you up to the gills and you never cause trouble again and always smile at all the nice people. Or perhaps you see a psychiatrist who helps You(A) and You(B) talk it over and team up, and You(Meta) turn your attention to present time.
You have a chemical imbalance that makes your moods swing wildly, regardless of what's going on in your life or your mind. A best friend of your mother's is a doctor who spots this immediately and after some trial and error settles on an effective medication that keeps your moods in synch with what's going on in the rest of your life. Life goes on.
You have a chemical imbalance that makes your moods swing wildly, regardless of what's going on in your life or your mind. Your parents regard this as deliberately annoying of you, and frequently berate you for "living in your own world" and "not fitting in" with the life of the family. Sometimes you do terrifically well in school. Sometimes you do nothing at all in school. After you leave school, your earning curve takes off like a roller coaster. Many years later, after many lost jobs and broken relationships, your disorder is diagnosed and a chemical is identified that stabilizes it. Now you have to learn to walk away from the roller coaster. The ground still feels wobbly under your feet. There are still a lot of people you love who won't talk to you.
You have a chemical imbalance that makes your moods swing wildly, regardless of what's going on in your life or your mind. After years of fuss and frustrations, this is finally diagnosed, and the doctor tries several treatment options. Then several more. Then you go to a different doctor. And another one. After twenty years, no one has found the treatment plan that works for you. The only thing that makes the pain bearable is that you know why you hurt. Sometimes you wonder whether this is enough.
You have a chemical mood disorder: you are permanently depressed. Your parents taught you to live anyway. You get up in the morning by an act of will, eat by an act of will, work by an act of will; you have no favorite weather or favorite foods, they are all pretty much the same. You are proud of your work, but it is not a belly-warming glow. You've never felt a belly-warming glow. You ache. You have ached every minute of every day of your life. You love your husband and you love your child and you take pleasure in their company; it is not what the rest of the world calls "love" or "pleasure", but you grip it fiercely.
Something so terrible happened when you were three years old that you have been staring 1000 yards away and babbling ever since.
You were born with either physical brain damage or damaged brain chemistry -- the doctors aren't sure which. But you have been staring 1000 yards away and babbling ever since.
What's physical illness? What's mental illness? What's a character fault or a behavioral disorder or the results of a trauma? Does it matter?
I wish I could tell everybody in the world, "Take people as you find 'em, enjoy them as much as you can, and do what you're able to help them. Labels are good for shelving the books, but they aren't much use while you're reading them."
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Last updated September 8, 2001