I WAS CRAZY NOW I’M NOT
The author, a Harvard-trained paediatrician, has endured four mental breakdowns. Each one taught him to think more clearly>
couldn’t sleep or eat for several days. Then I started hearing voices. Not gauzy, special-effects voices, but actual, real voices coming from outside my head. It’s the kind of thing that can’t be ignored. When somebody says hello, it’s impolite not to say it back. Hi. Hello. Hello? So you end up in a conversation with yourself, but it doesn’t feel that way. It feels like you’re talking to somebody else. Somebody outside yourself.
In the beginning the voices were fairly friendly, but then they became more insistent and critical. Unfortunately, they have a lot of inside information that can and will be used against you. You don’t know you’re mentally ill, so you simply assume that things have changed for everyone. Maybe hearing disembodied voices is just part of the new deal. I remember sitting down next to a friend and saying, “So what are your voices telling you?” He got up and found himself a different place to sit. This was 45 years ago.
Ultimately my friends couldn’t put up with me because I did things like break a big picture window. (I thought we were suffocating.)
Everything I did made sense to me and much of it was heroic. My friends got hold of my family who did the sensible thing to do with someone who’s floridly psychotic: they put me in a psychiatric hospital. The hospital gave me large doses of antipsychotic medication and put me in seclusion.
Bipolar disorder and many other mental illnesses are heavily influenced by genetics. It helped that my mother had had similar symptoms. When I complained about the voices, she was able from her own experience to say, “Why don’t you just go along with them?”
When I told her I thought I could foresee the future, she said, “Well, who doesn’t?”
I wasn’t unique. She normalised the symptoms and showed me that having psychiatric issues wasn’t the end of the world and that I wasn’t alone.
My mother came to live with me after my first series of breaks. Among the many things wrong with the theories that blame parents for mental illness is this one: who else is going to put up with you/me/us?
Recovering from mental illness is not a delicate, touchyfeely business. Here are four things to keep in mind:
Talking with a therapist or psychiatrist might or might not be useful. It’s worth a try.
Medication might or might not help. It’s worth a try.
Ignoring the symptoms of mental illness won’t help you or those around you.
Eating well and getting more exercise is never a mistake. Having mental illness gives you a better reason than most to eat well, run, lift weights and go to the boxing gym.
HALF OF US will have some sort of mental health problem in our lifetime, but only a small proportion of us will seek professional help. Unlike red wine and stinky cheese, serious problems like anxiety, depression and psychosis tend not to improve with age and neglect. If you wake up one day and think you might need help, then you need help.
Hearing voices and having delusions and paranoia, the hallmarks of conventional lunacy, are thought disorders. Mood disorders – feeling obnoxiously happy or paralytically sad, or nothing at all – can be just as devastating. Bonus: the two can go together.
Mental illness is not about having quirky thoughts or being a little up or down. Mental illness makes it hard to take care of yourself. Hallucinations, delusions, bizarre behaviour – especially the violent kind – get the most attention, but the real deal is often more static. It’s being unable to get out of bed, go to work, be part of a family. More people are affected by mental illness than by diabetes and heart disease combined. Add the burden it imposes on loved ones and everyone feels the pain.
But the loneliness is toughest. When I had my second episode I was again isolated. I’d tossed my medicine because it made me sluggish. I didn’t think I had an illness anyway. It was just a weird thing that had happened to me, I figured. So when the symptoms returned, the only medication available was marijuana – not the best choice. It made things worse. The next prescription available to me, as a foolish person, was from Jack Daniel.
Depending on your point of view, turning to drugs, alcohol and other substances may not be morally bad choices. But these are not optimal treatments for anxiety and depression. The problem is that alcohol works well in the short run. If you’re anxious or depressed, alcohol makes the pain go away. It can also tone down the voices and agitation, but it leaves the door open for them to return stronger. Drugs and alcohol abuse waste your time, destroy relationships and make you sicker. Addictive behaviours may make it easier to get through an afternoon, but they won’t make it easier to get through life.
Staying healthy – lifting those weights, walking those kilometres – will. Knowing that about yourself can truly save your life, not to mention many dollars. Taking yourself and life seriously makes you a much more authentic and empathetic friend – which, if you ask me, is more important than achieving any state of so-called normalcy. If a medicine or a therapy isn’t making you more accessible to genuine friendship, then it’s a waste of time.
break 45 years ago I’ve had four more. For almost a half century I’ve had a life crowded with psychiatrists and upholstered by psychiatric medications.>
But one way I’ve given my life meaning has been by demystifying my mental illness and helping other people be less afraid of theirs. These illnesses are terrifying, but fear doesn’t help. Being alone and trying to go one-on-one against them is even worse. I’m grateful for the care I’ve received. I want to give back to those who made it possible and help others understand what works and what doesn’t.
What works better now than 45 years ago? We know more about mental illness. We have better drugs. Mental illness is about neurochemistry and not something we should blame on the individual. Shame, blame and guilt often cause as much suffering as the mental diseases that trigger these things.
If you are suffering, you can improve without perfect professional care. The things you can do to take care of yourself are predictable: eat well, sleep well, exercise, don’t drink, don’t isolate yourself and don’t take a drug unless it’s prescribed by a doctor. Mental illnesses are diseases of loneliness. Proper medication makes healthy relationships possible.
But the best way to get out of yourself is to be useful to others. Contributing – to friends, a local library, a community, the world in general – is a great way to get back your health and balance.
Like everyone else, I had an imperfect childhood and engaged in occasional unwise teenage behaviours, but until my first crisis, I was holding it together. I graduated from university. I had friends and girlfriends. I had lofty goals, aspirations, energy and a mostly positive mood. After working for a while I started a commune in British Columbia – which was not a sign of mental illness, by the way.
We did not sit around smoking dope and saying “Wow”. We worked hard towards our goal of being a self-sufficient refuge. We built a house, had enough food, lived healthy lives. But then, partly in response to things that shouldn’t have been enough to make me crazy, I stopped being able to eat or sleep. I felt overwhelmed by empathy for all living things, even trees. I started hearing voices, imagining that the world was coming to an end and that I was supposed to do something about it.
Much as I would like to say that love, kindness and wisdom saved me, what helped me acutely – and helps most people – were hospitalisation and medication, which eventually made it possible for me to have healthy relationships again.
I had been raised to believe that there was no such thing as mental illness, that psychotic thinking was a reasonable reaction to an unreasonable society. This theory doesn’t help you get well. I hated being sick and fought to get better. As my mind cleared, I did things that made me better. My ability to do maths and science came back. I returned to school, took pre-med classes and applied to 20 medical schools. The only one that accepted me was Harvard. As a friend said, “Well, at least you got into one.”
I graduated from medical school and have practised paediatrics for over 35 years. I have a wife, three sons, five grandchildren and two dogs. I coach soccer and have written a few well-received books.
The fact that I don’t behave and look like someone who needs medication means I’m taking about the right dose. It helps that I have a professional and personal life I don’t want to lose. Psychiatric drugs have serious side effects and you’d be crazy to take them if you didn’t need them. However, they can be very effective and you’d be even crazier not to take them if you did need them. I had a fourth break 14 years after the first three. Getting better was harder that time because I was older. But I knew recovery was possible and roughly how it would go.
A BRIEF LIST OF treatments I have tried over the years:
Megavitamins: they might work, as a placebo.
Electroconvulsive therapy (ECT): it’s a last-line therapy for patients who are not responding to other therapies or are at risk for suicide.
Mood-stabilising meds: this is a primary treatment for people with bipolar disease.
Antipsychotic drugs: they help ease symptoms such as hallucinations but can have some serious side effects.
Straitjackets and isolation: they’re a way to control patients, not treat their illness.
Talk therapy: it’s useful once you’re no longer psychotic.
Exercise: it’s lifesaving. Find activities you like so you’ll actually do them.
THE PROBLEM WITH most mental patients is that the illness in their head makes them not trust their feelings.
When medications work, they make it possible to be with others. The arts can be helpful (some of my favourite possessions are paintings I made in mental hospitals.) Reading good novels can be too.
Stigma is still alive and well, adding to the pain of mental illness. Fear of being found out and judged makes for loneliness, and fear of asking for help makes it hard to get help. Talk to friends and family you trust. While we’re far from perfect, we know more about mental illness and are less fearful of it than we used to be. It’s not always easy to access good care but many of us get by with help from friends, family members and other patients.
‘‘These illnesses are terrifying, but fear doesn’t help. Being alone against them is worse”
Life is a series of swings and roundabouts.