When a friend asks me how I’m doing—and I intuit that they’re inquiring about my mental health—my default answer is, “Fine,” which, in most cases, seems to satisfy them. I assume they’re asking me how I’m interpreting the world because, since they know I have schizophrenia, that seems a legitimate question. It also seems there’s an underlying concern on their part that I might be unstable, an assumption based on preconceived notions informed by social stigma. I can’t help but wonder if they’re relieved by my response because it validates their narrative regarding their token Crazy Person. If they’re good, and I’m good, then all’s right with the world. They’re satisfied that, in that moment, I’m just like them—a normal guy living a normal life. It’s easier that way.
They might ask me if I’m still on my meds, an annoying question coming from anyone other than my psychiatrist. On the days when I experience symptom breakthrough, I’m as prone to worry as the next person. Not much difference there, save for the fact that psychosis—an abnormal condition of the mind that results in difficulties determining what is real and what is not—even in short bursts, can make daily living nearly impossible. After the burst I try to experience my thought process in the third person, but rationale often seems intangible in that moment. It takes talking with another person—usually my therapist—to ferret out the truth. When it can’t wait a week for the next scheduled session, I’ll call my best friend. I need people who won’t dismiss me or invalidate my experience. There’s no pat answers when we’re talking mental illness, no open-and-shut cases, regardless of how much someone in the know might want to quote the DSM-5® (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition).
To reduce the discomfort of being in the presence of a mentally ill person, many people will attempt to normalize their interaction by asking questions based on stuff they’ve heard about through social media and popular culture. There seems to be a morbid curiosity surrounding the mind losing its moorings, perhaps promoted through the misguided premise of freedom from social constraints, an experience some may believe is the domain of those inmates who’ve taken over the asylum.
Maybe some normal people have had a taste of psychosis through the use of recreational drugs or the overuse of alcohol. That might be the only way they can relate to it and, perhaps, to the mentally ill person.
I’ve been asked outright what it’s like to hallucinate, what the voices say to me, and if I’ve ever become completely unhinged. I try to answer those questions as honestly as I can, shying away from over-exaggeration, thereby inadvertently feeding into the misinformation delivered through newscasts and tabloid journalism. It’s not always easy. Sometimes I want to proselytize and rail against society, but I realize that’s a battle for another time. By staying in the present as best I can, I afford the curious person the benefit of the doubt, and try to paint an accurate depiction of my personal experiences and the data I’ve gathered from years of research. By responding sincerely with clear information a respect can be achieved, creating support moving forward. Should I need help, it’s good to have an ally.
That’s really the point of answering questions like these—to change someone’s mind about people living with mental illness. The impressions of different diagnoses will vary, but many of the questions about them are common enough that they practically answer themselves. What’s it like to hear voices? It’s disarming and scary, as one might imagine. Seeing things that aren’t there? Well, since I’m usually in an unstable state when that happens, I have no way of ascertaining that I’m the only one experiencing the hallucination. Voices and visions and disjointed thinking appear normal to my schizophrenic mind. I don’t know any different. I only know that others aren’t experiencing reality in the same way, and only because they tell me.
Education through accurate information, documented facts, and stories of lived experience, are the building blocks of change. It is vitally important to the mental health community to be diligent in this task. We need to be both transparent and boldly outspoken when answering questions about our mental health. We need to be patient and kind when the person with questions is sincere in their asking. We also need to be strong and set boundaries in our conversations about mental illness to avoid misconstruction and bullying. It’s a fine line we need to walk if we want to inform others appropriately. Being marginalized because of differences in brain chemistry and neurological function is unfair. We can counter that with real talk. So whether you see things, hear things, think fractured thoughts, or fight anxiety and depression, speak up, speak out, hold fast to the facts, and be strong. Change starts with one voice. One becomes many, and many informs the norm. That’s how we fight the stigma—by sharing the truth.