A question that continues to come up for me is whether or not I have a mental illness. Over breakfast this morning I spoke with my friend Jeff, pondering the possibility that perhaps the four psych-evals I’ve had were rigged and that the dozen or so psychiatric professionals I have spoken with over the years had all come to the wrong conclusion. They think I have schizophrenia. But what if I don’t. What if I’m as sane as the next person, despite what the evidence shows?
Jeff chuckled. Not in a condescending way, but in the way that your best friend will laugh along with you when you realize that what you’re saying is too outlandish for words. It helped to ground me. After all, he’d been to the hospital with me for panic attacks and psychotic breaks as often as three times a year over the past nine years. He was by my side in the psych ward when I’d attempted suicide. There’s a history there which supports the doctor’s findings, yet sometimes I still question the diagnosis.
Of course there’s the medication and the hundreds of hours of therapy to consider. To what end? They say that when one feels normal it’s because the meds are working. So where is the root of my suspicion? Why would a dozen professionals lie to me? How far does this conspiracy spread? Is it all being done to line the pockets of the insurance companies and Big Pharma? Am I just being paranoid?
Ninety percent of an iceberg is typically underwater. Only the tip can be seen above the surface. There is no nefarious plot against this party of one for the reasons of “just because”. Nine-tenths of what I can’t see is stuff I’m keeping to myself—things I won’t discuss in therapy, fears I won’t express, self-stigma I won’t face up to. If I don’t speak about it, it’s not real. Which is not true. That’s just fear and naïvety. What do I have to gain by sabotaging my mental health? Nothing.
I worked hard to achieve and maintain the stability I do have. In the maelstrom of voices and hallucinations I was a tiny titan. Letting go of those tireless efforts meant trusting that the doctors were right. The preponderance of data collected should have been proof enough but I couldn’t see it, resulting in a trace of the symptom called anosognosia, a lack of insight or awareness of one’s illness. My question today is how this symptom, transient though it may be, continues to shove my back against the wall. I should know better. I’m educated. I’m medicated. But there it is nonetheless, punctuating my breakfast conversation, the query to beat all queries: what if I’m not sick? What if everyone else is wrong?
It’s easy to take the position that I am not my diagnosis, which, on the one hand, is absolutely true—to “be” one’s illness would be patently absurd. On the other hand, if I meet the criteria, then, yes, that diagnosis is mine. I live with schizophrenia. There is no fault or blame. It’s a genetic disease, one I’ve had all my life and will have until death—chronic and debilitating, yet manageable to some degree. If I don’t like those odds, what’s my recourse? Pump up my ego and act out defiantly? Protest? Against whom? Who do I hang in effigy? Myself? All that aggro is so counterproductive.
My mind is locked in an argument with itself. I have no way to override it. Logic doesn’t work. Proof does. So it gets down to surrendering my self- conscious position and allowing the doctors I’ve entrusted to implement their practice. The psych-evals were not rigged and the therapy sessions were not futile. Their conclusive evidence spells it out; I can’t, or sometimes don’t want to, concur with their findings. Symptom or self image, one or the other, blocks the truth. I can live with the pain or find relief. It’s up to me to take that step.
It gets down to this: I can’t see what I can’t see. It’s beyond my control. My only course of action is acceptance. That’s where empowerment is found.
Is it a challenge to sail by the tip of that iceberg, navigating waters I’m still learning about? Yes, it is—that’s the process. Do I have what it takes to steer clear of the missteps and pitfalls? I think so. That’s where faith comes in. Can I see my situation through the lens my doctors and therapist do, see a pathway to something better than a tumultuous crash with no future? Absolutely. That’s called participation. But does this mean that I won’t question my situation from time to time? No, it does not. Because I’m only human.