Too Short for a Blog Post, Too Long for a Tweet 376

Here are a few excerpts from a book I recently read, "The Collected Schizophrenias: Essays," by Esme Weijun Wang.

A diagnosis is comforting because it provides a framework—a community, a lineage—and, if luck is afoot, a treatment or cure. A diagnosis says that I am crazy, but in a particular way: one that has been experienced and recorded not just in modern times, but also by the ancient Egyptians, who described a condition similar to schizophrenia in the Book of Hearts, and attributed psychosis to the dangerous influence of poison in the heart and uterus. The ancient Egyptians understood the importance of sighting patterns of behavior. Uterus, hysteria; heart, a looseness of association. They saw the utility of giving those patterns names.

Medicine is an inexact science, but psychiatry is particularly so. There is no blood test, no genetic marker to determine beyond a shadow of a doubt that someone is schizophrenic, and schizophrenia itself is nothing more or less than a constellation of symptoms that have frequently been observed as occurring in tandem. Observing patterns and giving them names is helpful mostly if those patterns can speak to a common cause or, better yet, a common treatment or cure.

Some have suggested that schizophrenia persists because it promotes creativity, much like the argument emphasized in MacArthur Genius Grant winner Kay Redfield Jamison’s Touched with Fire: Manic-Depressive Illness and the Artistic Temperament. As tempting as this perspective is, I worry that seeing schizophrenia as a gateway to artistic brilliance glamorizes the disorder in unhealthy ways, therefore preventing suffering schizophrenics from seeking help. If creativity is more important than being able to maintain a sense of reality, I could make a plausible argument for remaining psychotic, but the price of doing so is one that neither I nor my loved ones are likely to choose to pay.

 

 

The story of schizophrenia is one with a protagonist, “the schizophrenic,” who is first a fine and good vessel with fine and good things inside of it, and then becomes misshapen through the ravages of psychosis; the vessel becomes prone to being filled with nasty things. Finally, the wicked thoughts and behavior that may ensue become inseparable from the person, who is now unrecognizable from what they once were.

Depression is often compared to diabetes—in other words, it’s not your fault if you get it, and you’ll be fine if you just take care of it. Schizophrenia, on the other hand, is compared to Alzheimer’s—it’s still not your fault if you get it, but there’s no fixing it, and though you may not intend to be a burden, you’ll still be one until you die.

I’m still trying to figure out what “okay” is, particularly whether there exists a normal version of myself beneath the disorder, in the way a person with cancer is a healthy person first and foremost. In the language of cancer, people describe a thing that “invades” them so that they can then “battle” the cancer. No one ever says that a person is cancer, or that they have become cancer, but they do say that a person is manic-depressive or schizophrenic, once those illnesses have taken hold. In my peer education courses I was taught to say that I am a person with schizoaffective disorder. “Person-first language” suggests that there is a person in there somewhere without the delusions and the rambling and the catatonia. 

But what if there isn’t? What happens if I see my disordered mind as a fundamental part of who I am? It has, in fact, shaped the way I experience life. Should the question be a matter of percentages of my lifetime, I’ve spent enough of this lifetime with schizoaffective disorder to see it as a dominant force. And if it’s true that I think, therefore I am, perhaps the fact that my thoughts have been so heavily mottled with confusion means that those confused thoughts make up the gestalt of my self; this is why I use the word “schizophrenic,” although many mental health advocates don’t. 

My friends with anxiety disorders, for example, tend to speak of anxiety as a component of their personalities. Laura Turner writes, in her essay “How Do You Inherit Anxiety?,” “It is from Verna Lee Boatright Berg that I inherited my long face, my quick hands, my fear that someday soon I will do something wrong and the world will come to a sharp end.” In their minds, there is no tabula rasa overlaid by a transparency of hypochondria, generalized anxiety disorder, or obsessive-compulsive disorder; such thoughts are hardwired into their minds, with no self that can be untangled from the pathology they experience. Another friend’s obsessive-compulsive disorder has calmed significantly since she began taking Prozac, but she continues to be most comfortable when things are tidy, even though her tidiness is no longer disruptive. She still washes her hands more thoroughly than anyone I know. 

There might be something comforting about the notion that there is, deep down, an impeccable self without disorder, and that if I try hard enough, I can reach that unblemished self. 

But there may be no impeccable self to reach, and if I continue to struggle toward one, I might go mad in the pursuit.