I have always lived life feeling outcasted. In fact, it was such a problem that my mother specifically bought a book for me entitled Leo the Lop, in which a lop rabbit whose siblings have upright ears, sets out on a quest to define what “normal” really is. Throughout the course of the book, the charming illustrations depict Leo’s journey of self-discovery which ultimately ends with the absolutely dissatisfying conclusion that “normal is whatever you are.”
I liked rabbits, I understood Leo’s wishes, and I was five, so I enjoyed the book, but upon closing it and going into kindergarten the next day, I was viciously reminded that regardless of what Leo thought normal was, my classmates did not share the same conclusion.
I have never been normal, no matter what I have been.
I recognized at that time as I still do that the whole argument for “normalcy” is supposedly subjective, and that was the point of the book. There is no straight, wholly accurate definition for what “normal” really is, and as Morticia Addams so eloquently puts it, “What is normal for the spider is chaos for the fly.”
So, there being no true definition for “normal” in terms of human behavior and character what must “abnormal” mean in psychology, which is, by very definition, the study of human behavior and character? because it does exist. It does exist, and I do find it funny, considering that according to NAMI, 1 in 5 American adults experiences mental illness during a given year. And let’s not play dumb. We know that’s what psychology means by “abnormal.” Forget that by mere observation, anyone aware enough can tell you healthy lifestyles — both physically and emotionally — are difficult to achieve and maintain even with the right circumstances, let alone being in positions in which you greatly lack resources or a support system. Forget that by mere observation, it is pretty obvious human beings are prone to unhappiness, dissatisfaction, and deteriorating health if not regularly maintained, regardless of whether or not they meet the criteria for a diagnosable illness. However, ask many professionals in the psychiatric industry, and they surreptitiously will tell you two conflicting things. First, out of their mouths will come, 1.) “There is no such thing as ‘normal,'” and then, throughout the course of treatment, you will start hearing the real message, which is, 2.) “But you are part of an abnormal statistic.”
Diagnosing the DSM
If you’ve been reading my blog for a while, you’ll probably know already that while I take medications myself, I am highly critical of psychiatry. I support psychiatry to an extent and am a strong believer that many people cannot get by without it. However, I am an extremely strong advocate for patient advocacy, therapies, and self-assessment and awareness. It is not a secret or at least should not be a secret that doctors are able to accept “legal” bribes from pharmaceutical companies. This is a way of developing and testing drugs, but let’s also be clear that it is another way doctors make more money, and it is extremely controversial for what I feel are extremely obvious reasons.
It is not entirely the doctors, though. I feel many times, especially in psychiatry, prospective or even well-established patients will come in and expect not only a prescription but also expect a prescription to solve their problems. That being said, they will also expect a diagnosis. Antidepressants are often called “happy pills,” which is not only grossly misleading but also toxic. While depression is very often organically chemical, I feel depression is more often situational or circumstantial, due to things that are entirely fixable with the right resources and support that do not involve drugs. Those fixable things include diet, activity, interpersonal skills, intrapersonal skills, stress management, etc. I feel drug intervention can be necessary to break the cycle of depression which I’ve said before is often a Catch-22 even in circumstantial depression, but I feel psychiatrists overmedicate needlessly without offering much authentic help.
Overmedicate. And overdiagnose. Which leads back to the question, what have I been?
Childhood on Drugs: A [Super]Brief Psychiatric
When asked by any new psychiatrist, “What meds have you been on in the past?” I always have to laugh. Not just snicker but throw my head back and give a hearty, long-lasting, “you’ve gotta be kidding me, I hate this fucking question” type of laugh. I usually follow with, “Do you want me start from my infancy or skip to when I was prescribed Ritalin for ADHD?”
It was the 1990s in the United States, and ADHD was the illness du jour. I was often restless and excitable and had difficulty focusing. Also, I was an insomniac. These symptoms were mistaken for the whole criteria of ADHD after I was taken to a psychiatrist who met me for 15 minutes and decided “what” I was.
I was about seven at this time and was often in the nurse’s office complaining of real headaches, stomachaches, and other aches and pains. I would stay in the office for quite a while, not wanting to go to class because of pain and discomfort that I realize now were manifestations of serious emotional distress.
I had other symptoms and contributing factors, as well, that the psychiatrist did not bother to explore. I was hypersensitive and felt chronically lonely, unheard, and felt the responsibility of everyone else’s happiness on my shoulders. I had terrible nightmares and feared men — not monsters — being under my bed. I saw things sometimes that I couldn’t explain. Heard things. Thought things that other people thought were strange. My father was on board with some of the things I said, but I realize now, my father is probably sick, too.
I felt filthy and disconnected from my body and often felt I was being watched and often stayed up nights at a time, thinking that if I awoke I would be in a UFO and being dissected on a table. I let people throw rocks at me until I bruised because I thought that’s what it took to have friends. I suffered from chronic pain, particularly joint paint, and of course, I felt absolutely like a freak: in the classroom, in my town, in my country, in my home, everywhere. In fact, I started believing I wasn’t even human. But I was put on Ritalin, Concerta, Strattera, Adderal, because according to the psychiatrist, I was a seven year old psychiatric patient who had ADHD. My current diagnosis is Schizoaffective Disorder which is in all fairness, similar, I suppose, to Bipolar disorder, which is difficult to differentiate from ADHD in children. Funny thing is, Adderal, among many other stimulants, is known to exacerbate and even create psychosis.
I have had to deal with other what I consider are “diagnoses du jour” that have only been combated through advocating for myself. I have had maybe the help of one or two professionals throughout my journey who have taken the time to try to understand me. For a lifelong history in treatment, that is grievously sad.
In the psychiatric profession, there may be no normal, but I suppose there is a way to be normally abnormal, and I am not it, either, even though they want me to be.
They’re not all wrong though, because I do think some people are.
It’s all about that Taste Bud Principle, even though it’s also not
While there are many people in mental illness advocacy, I constantly see two messages that are both extremely pervasive and probably extremely confusing to people who do not understand other people, regardless of whether those people are diagnosed with or have a mental illness, the same mental illness, or do not have any mental illness at all. Those two statements are: 1.) Do not pity us. We are the same as everybody else. 2.) Treat us more sensitively, because we struggle differently than you do.
While these are not converse sentences, I can see how these two statements completely fail causes, not only through outreach but within the community as well. To gain momentum and understanding, people have to see that mental health, like any social cause, brims with complexities and gray shades. There are varying degrees of illness. There are varying personalities and characters involved. No origin story is the same even between identical twins. I would wager that most people do not realize that not everyone who goes through a trauma or the “same” trauma in fact develops PTSD, for instance.
As I’ve said before, an illness is made of criteria. Some psychiatrists grossly underexaggerate the importance of how much criteria or what criteria needs to be met before a diagnosis is made — because honestly not all symptoms are equal — but an illness is still made out of criteria. That is how it is given a name and how, largely, it is approached in treatment. But like economic systems, political theories, religion, or anything involving abstractions and variables, applying it into human terms will produce different results than it does on paper.
E.g. Just because I am moderately low functioning and have schizoaffective disorder comorbid with c-ptsd does not mean I can tell someone who is high-functioning and has schizophrenia comorbid with borderline personality disorder — a diagnosis set with typically a much worse prognosis than mine — that their diagnosis is not real just because they are higher functioning than I am. That being said, the same person cannot tell me that I am not trying hard enough to recover despite the typical prognosis being worse for them.
Do you see how it works?
Any social cause is comprised of human beings which are all made up of their own stories, histories, chemical makeup, genetics, personalities, experiences, etc. If you can live a relatively normal life — and yes, relatively normal lives do exist — in which you are not constantly in and out of hospitals or in which you can maintain a job and die of old age despite your illnesses, psychiatric or otherwise, etc, then okay. You deserve to be heard. If you become a multimillionaire and die fat and happy surrounded by ten grandchildren who love you for more than your money, you deserve to be heard. If you die on the street at 50 by suicide after escaping from a state hospital after having been there most of your life, you deserve to be heard. If you are 35, have had a job, have a family, have been in some hospitals but not a lot, and are on your deathbed from an unrelated illness, you deserve to be heard.
Now for the plot twist:
Most people with mental illnesses are pretty damn normal.
I was not ostracized all my life because I am sick. I have been ostracized by whole life because I am fundamentally different in how I process my experience and how I live it.
But *ahem* I digress.
It’s more complicated than extremes, and truthfully, the extremes are rare. They’re the loudest examples, because they’re the most emotional; the saddest or the most inspirational. That doesn’t mean they represent everyone or everything. They should not be forgotten and they sometimes are when trying to combat stereotypes, but it’s because people — both within and outside the community — are so stuck on focusing on the wrong attributes of mental health advocacy:
It is not about one person’s journey. That journey is with them, their loved ones, and support network, professional or not or both. It is also not about the journey of the mentally ill. 1 in 5 American adults, NAMI says. It gives an appearance of high frequency but it still is misleading. Mental illness can be both extremely, fatally serious and mildly disrupting, but ultimately, mental health paints the future of human society.
I say again,
“Forget that by mere observation, anyone aware enough can tell you healthy lifestyles — both physically and emotionally — are difficult to achieve and maintain even with the right circumstances, let alone being in positions in which you greatly lack resources or a support system. Forget that by mere observation, it is pretty obvious human beings are prone to unhappiness, dissatisfaction, and deteriorating health if not regularly maintained, regardless of whether or not they meet the criteria for a diagnosable illness.”
Mental illness or mental health advocacy is not just about giving rights to the patient in the proverbial padded room or combating stigma against people who are totally average in every way with the exception of exhibiting symptoms that other people do not. It is about helping you to help yourself, and then you can help the world around you, and the sooner people start realizing that, the sooner we can talk about mental health correctly, with more awareness, and more authenticity and sensitivity.
I understand people want to express themselves and communicate their own life stories to the world, but I think we have to really be careful how we do it. Semantics actually do count, and “my experience with schizophrenia” can make a difference when you would rather headline your article with “the schizophrenic experience.”