On Mental Illness as a Disease

The greatest risk for completing a suicide following an attempt is in the first few hours, the first few days, and finally, the first six months immediately following admission. It has always astonished me that, while mental health consumers are marginalized through the lens of iconoclastic criticism, the hospital experience itself, and the window that it offers patients into the discrepancy in treatment due to the stigma surrounding mental illness, is scarcely addressed by the literature. After my first hospital visit in my freshman year of high school, I remember exactly how I felt upon discovering on the internet that 20% of people who attempt suicide will do so again by the end of the year. Clearly, sharply, intuitively, I understood the provenance of psychiatric reaction to social and institutional exile. The psychiatric ward is truly the hospital from hell. With visceral force, its protocols and stance on rigid confinement create a physiological diaspora of sorts, a dispersal of people on the basis of neurotypical supremacy from science, medicine, and compassion, actively scattered and estranged from the heart of humanity because of their emotional and mental heritage. Most notable is the psychiatric ward's tightly riveted armor of resistance to hospitality and comfort, the duration of a stay in this hopeless place typically devoid of even the diaphanous veneer of visitor hours. But technically, these small comforts and familiarities cannot be denied because they were never volunteered to begin with. For the psychiatric patient is star crossed and loveless, their white walled rooms furnished with the aesthetics of silence and perhaps the distanced disdainful eyes of the whoever was summoned to sign their release forms. Impoverished by nihilism and shrunken aspirations for themselves and their prospects, purged by emptiness and isolation, but not of feelings, these patients return, not to their lives, but rather, to the remarkable fulfillment of prophecy. For although they die by the thousands-some of them the most gifted and talented that society has to offer-and might become tremendously disabled, robbed of their capacity to work and form relationships, are afflicted during the primest period of their lives with sickness, and endure clinical stages marked by severity and chronicity, these individuals are denied the compassion that often accompanies patienthood and instead are demoted to the status of vexatious, uncontrollable, unwanted wild cards in society. I, too, had long rejected the label "mental illness" for a litany of reasons that I will not delve into here. What I will say is that I can understand from my own personal experiences with bipolar disorder and psychosis that the very real advantages conferred by the manic-depressive mind in particular present the imperious front of a terrifyingly, seductively exotic internal world which remains at variance with the scientific understanding of disease. For most of my life, I have asserted, and still do, that my unique mind has been a source of overwhelming creativity and, ultimately, the best that I had to offer. Bipolar disorder is prolific in our culture for its close relationship to the ingenuity, imagination, fervor, and zeal that advances the arts, sciences, politics, and business. It confers to society a copious expansion of cognitive styles, personality traits, and creative endeavors that are conducive to success in various vocations. Hence, the true cost of bipolar disorder-roughly 25% to 50% of those with bipolar disorder attempt suicide at least once and about one in five will die by it-is often eclipsed by the intoxicating paradox of a life lived so intensely yet in such close proximity to death. The the high mortality rates and cyclic upheavals are interposed by the pinnacles of human achievement make it easy to cast bipolar disorder in a romanticized, demonized, but rarely intellectualized light. But my own recent downward spiral forced me to confront these often divergent notions of oneself-for example, the squandering and descent of of a creative, intelligent, and highly educated mind-and mold them into a new framework that captured the toll, the taxation, the deterioration, and the potential for toxicity. Suddenly, my ability to rely on "And this too shall pass" became had become provoked beyond endurance. Existence became synonymous with torture, those pinnacles of achievement lacerated by foreign objects that had entered the brain. I am sure that, in a manner consistent with disease, corticosteroids and other stress hormones contributed to the loss of brain mass like a stick of dynamite, turning my once philosophically convoluted gray matter into a medically, unquestionably, murderous cauldron. Neurons fired with the intensity of arterial spatter. The search for any oasis of stability, frozen in certainty and kept chilled over ice with the tenure of neurotypical promise, was dissolved by this high grade fever that becomes welded into the framework of one's life. At one point, I became handcuffed to an intolerable state masquerading as a mind, its dangers as highly orchestrated as the animal kingdom forcing its inhabitants to decline from active life into a moribund state. What little of an active life I had left seemed as though it would acquiesce to the civil war assigned by Hobbes to man living in a state of nature: "solitary, poor, nasty, brutish, and short." I aged at a frenetic pace. At times, I have had to surrender, slowly at first, and then increasingly more so, not only participation in my favorite activities, but also the parts of myself that I had known as a student, a thinker, a writer, a friend. I now accept the label of disease because contextually, it seems the most appropriate, and I have suffered as any patient might. But unlike the cancer patient, the person who experiences bipolar disorder or psychosis must grapple with the self-incriminating notion that these violent, deadly struggles are an extension of ourselves, a magnification of our moods, and not a medical emergency. Essentially, stigma robs us of the ability to resolve and make sense of our own biological design and expressions, to read our own minds and conjugate our own futures. This helplessness turns the axis of our free will into feather instead of spines, the resolve to improve ourselves dampened by the exclusivity with which others decide our fate in abstract, and not anatomical, terms. Bipolar disorder is noted as being a giver and taker of life. But ultimately, it cannot create nor destroy, because only we as a society can define who matters. When we accommodate people with mental illness as pupils do sights of horror, it reinforces the conviction that we are not people, nor patients. The banality of diagnostic code, unlike most medical jargon, becomes distilled in the ever divisive popular psychology and produces toxic, unchecked colloquial equivalents. But enough. I find solace in my own worldview. And it is precisely because of this mercurial encasement that I have overturned every corner of cranial exploration and rounded every base only to find that when I connected the dots, there was a diamond. Diamond after diamond. Maya Angelou found hers where her thighs meet, and I found mine where, unfortunately, no one can ever see. My rise, my fall, my strength, and my struggle are all closeted. Diamonds can destroy only each other, and mine often do. But sometimes, diamonds find that they do not have the heart to tarnish the surface of something that they can sympathize with. This is self-love. It means that everything important enough to define me will endure. And if we are to extend this concept, if we see people with mental illness as valuable enough to love and be sympathized with, if we prioritize their health as that which is important enough to endure, then our beauty and value will finally be evinced. Up until this point, bipolar disorder had been, not a disease, but my life's work at digging up diamonds. Now I see that it can be both.