Coming out of The Dark – How I Recovered My Cognitive Abilities

I have mentioned before that during my psychotic break my cognitive functions were severely restricted. My concentration was below zero, and so was my ability to make even the simplest decisions. I was unable to put a list of items together that I wanted to have in the clinic with me, and it took me ridiculously long to pick an outfit for the day. Partly, this was due to my perceiving that even tiniest decisions could change the course of events obeying to a sort of butterfly-effect mechanism. The complexity of this idea was literally mind smashing. But to an even greater extent, I just could not hold on to an idea and follow it through. A thick broth of thoughts and notions was bubbling in my mind, and there was no way for me to put them in order or assign adequate degrees of relevance to them.

Being prescribed the anti-psychotic Olanzapine (Zyprexa) did calm the storm a bit, but it did not help my cognition. I still could not put two and two together. Even trying to complete an easy Sudoku was a major challenge. In addition, the Olanzapine seemed to dull my will and thereby actually accentuated my lack of direction. During my last hospitalization, the Olanzapine was substituted with Quetiapine (Seroquel), and I also took part in a structured program of coordinated therapies and received more thorough medical supervision for the first time. The therapeutic menu included arts therapy, social interaction practice, stimulation of sensory perceptions, psycho-educative sessions (basic information about mental health and illnesses), sports and outdoor activities and one-on-one conversations with the doctors. In your spare time, patients could do pretty much what they wanted: have a walk, go downtown, visit friends or family, sit in the park, organize table tennis or volleyball matches with other patients, etc. I soon became “famous” for devouring almost any sort of written text. With swarms of anxiety-ridden thoughts still frantically revolving around my mind, it was almost impossible to take anything in, but I knew I had to do it somehow in order to find even a little bit of peace and focus. I tried books at first, but I noticed I was not ready to follow the development of complex discourses, so I switched to reading articles in magazines. I read article after article, even if the topic of some was really outside my areas of interest, until I had read the whole magazine. Whenever I was done with one issue, I would go buy the next or lend new ones out from fellow patients. Gradually, I was able to digest longer articles, and eventually I returned to books, reading anywhere between one and three in a week’s time. Reading did not rid me of my anxiety and my racing thoughts, but it forced my mind to engage in the present moment and function, at least to a certain extent, in spite of the chaos.

I wasn’t the only one who instinctively turned to cognitive stimulation. Just as you would find me reading anything anytime and anywhere, a group of ladies used to crochet together. They tried to convince me of joining them, but I preferred to stick to reading. Although they were using a different activity, their need for focus also stemmed from an impulse to overcome anxiety and recover some degree of functionality, even if on a small scale.

As of today, my concentration and capacity for learning are healthy, possibly even improved in comparison to before my psychotic break, given that I have found myself embarking on explorations of my possibilities I hadn’t been able to open myself up to in earlier years. Maybe this is a sign of better cognition, but it may also be that after escaping a terrifying episode of zombie-like existence I have become more intrepid and willing to seize life. This is really not for me to determine, and I also feel my cognitive development has not yet come to completion. Many new – and positive – things and people have come into my life, prompting me to unlearn past thinking and emotional patterns to learn new, more constructive ones.

Although all of the aforesaid is based on my subjective perception, I would like to back it up with a few lines on recent trends in neuroscience. The regenerative powers of the human brain are being studied intensely, and the traditional idea of mental illness and brain damage as being irreversible conditions seems to become gradually dismantled in the process. In this context, it turns out to be untrue humans lose their ability to learn as they grow older, or that senile dementia is an unavoidable consequence of aging. What seems to be the case, instead, is that the brain can be exercised and strengthened through persistent stimulation just like a muscle can, throughout all stages of life. Cognitive training helps the brain stay fit and even regain lost functions. The term coined to denominate this property is “neuroplasticity”. I lack the scientific knowledge to competently explain neuroplasticity in depth, but I would like to recommend a book on it I believe everyone should have read, no matter from which background they come. The title of the book is The Brain That Changes Itself, written by Norman Doidge. It describes cognitive processes and neuroplasticity in terms understandable for the layman, illustrating its point through the narration of actual cases where a radical regeneration and reconfiguration of the brain appears to have taken place in an affected individual thanks to cognitive stimulation. The Brain That Changes Itself inspires without being inspirational in the sense of trying to lift anyone’s spirit by rhetoric means or philosophic meditations. The hope and encouragement inherent in this text derive from the portrayal of real people and real occurrences. Not in all cases described in the book all neurological functions are regained, but the overall improvement observed in the treated individuals’ quality of life is undeniable.

Personally, I acquired and read The Brain That Changes Itself before my psychotic break, and I am glad I did. More than one psychiatrist and more than one website with supposed information on mental illness transmitted the idea that mental pathologies equal a life sentence in some existential limbos – that the affected face perpetual residence in a state of forced stillness, not really participating in life, yet not biologically dead. Now, in retrospect, I can see how wrong they were. Here I am, living a happy and active life. But back then I had no idea if there was any hope for me or not. I certainly wanted there to be a way out, yet indications that there would actually be one were scarce. The Brain That Changes Itself, I believe, has the potential to be a source of valuable information and invaluable hope for someone in crisis.

Looking back at the insanely lucky and very unlikely concatenation of helpful people and circumstances that lead me back into life, I have to believe some benevolent power has laid its protective hand on my shoulder to lead me out of the darkness. Subconsciously, I also must have vehemently refused to give up, even though my conscious mind was paralyzed with terror. Now I recognize that every chunk of driftwood floating by can carry you the missing extra mile. The Brain That Changes Itself could be such a piece of driftwood for you or for someone you know. I really hope you read it, even if you and all your loved ones are doing fine right now. One day, they may need strength to overcome a crisis, or maybe you just wish to explore your potential and tread on a new path. This book is an eye-opener as to what your mind is capable of doing (and no, I don’t receive any commission for recommending it).

Websites

Norman Doidge’s official website, where you can get informed on his book The Brain That Changes Itself. http://www.normandoidge.com/normandoidge.com/MAIN.html

Here are links to the stores selling it: http://www.normandoidge.com/normandoidge.com/LOCATING_THE_BOOK.html

 

Audiovisuals

An impressive and inspiring testimony by Barbara Arrowsmith-Young, a psychologist who overcame a severe congenital learning disability through cognitive stimulation techniques: http://youtu.be/o0td5aw1KXA

 

Some words on: Inspiration and Creativity

Mental illness is a dark, lonely and scary state. It brings with it a blackout of basic survival skills and thereby exposes the individual to the whim of circumstances and people surrounding them. Uncaring and abusive treatment facilities, health care professionals and relatives can turn such an existence into hell on earth. But even if you are in the best of hands, your recovery depends on one indispensable ingredient: you. It is understood that you may not be able to take care of yourself. Still, you can attempt to stimulate your mind and emotions.

In fact, many clinics offer arts therapy, music therapy, sports activities, animal therapy, walks, and other stimulating experiences. Those are not meant to simply kill time and break the monotony of another day in a dull hospital setting, although these are certainly important aspects. In the first place, they are aimed at “defrosting” you. Mental illness is, so to speak, a general paralysis of the spirit. Thoughts and feelings, which help a healthy person to evaluate situations, take action and define their direction in life, fail to develop that traction in someone going through a mental crisis. Instead, they form something like a ball of yarn, if you will, with no visible loose end to pull at. In more rational terms, the confusion and erratic choices associated with mental illness derive from the impossibility of prioritizing thoughts and feelings functionally. The result is a disabling, smothering information overload. Therapies providing sensory stimuli intend to focus the patient’s mind and reactivate its capacity for healthy judgment, in the hopes of making the individual find the end of the metaphorical thread again.

Particularly artistic therapies challenge the patient to reawaken their power of judgment and decision. Creativity relies on the processing of given resources – materials, techniques and motifs – and their elaboration into a product that represents the uniqueness of its author’s interpretation. In a nutshell, creativity is the application of preexisting, generic ideas to a specific situation, in order to produce a new circumstance or object, the creative person’s individual experiences and capacities of judgment being the catalyst for this process. In plain English: when we are baking an apple cake, recipe in hand, and notice all our apples have gone bad, we will evoke the generic idea of “fruit” and look around our kitchen to see if we have something that could work in a similar way to apples. If we are lucky, we’ll find pears or plums, and use those. That is creativity. As the culinary example shows, creativity occurs not just within the fine arts. It is the motor of our survival and evolution both as a species and as individual beings. All our life decisions are necessarily creative, because we constantly attempt to adapt our circumstances to our individual needs and wishes. No matter how unadventurous and conventional a person is, they will always need to take decisions and create situations nobody else has ever taken before in the exact same way, simply because nobody else IS them.

Interestingly, numerous theories on the causes of mental illness sustain it can be triggered by dysfunctional or abusive relationships – may they occur in childhood or in adult life. If we try to define “dysfunction” or “abuse”, we will likely conclude that the destructive manipulation of the individual’s capacity to make healthy choices is an important part of these concepts. In other words, dysfunctional and abusive relationships affect or stunt the victim’s creativity, thus injuring their survival skills.

Herein lies the relevance of therapeutic approaches that involve the stimulation of creativity. Painting or making mosaics is more than a nice pastime producing pretty results. It stimulates vital cognitive functions and can contribute significantly to a patient’s return to a functioning and satisfying life.

Another aspect of creative therapy that should not be underestimated is the fostering of self-confidence. Not just mental illness, but also the stigma associated to being in psychiatric treatment can shatter your self-image. I have come across more than one person who suffered a painful transition from successful professional to hospitalized nutcase. Among them was a woman who used to be a psychotherapist and, after collapsing and having been diagnosed with schizoaffective disorder, will likely spend many years in supervised living facilities or in and out of mental hospitals. What I wish to say is that people who were socially “normal” can end up with the label “crazy” stuck on their foreheads. The stigma of it alone, even when it is the result of a misdiagnosis, is powerful enough to down individuals who so far had been high-flyers. While creative therapy will not magically reestablish anyone in their previous position, after a catastrophic collapse it can be one of the few things left showing you that you are actually able to accomplish something. Every ounce of hope counts. Accumulate many of them.

Now, at the top of the present article I stated the importance of the individual’s wish to get better. Mostly, what counts is for you to just give something new a try. Some people may argue they are not the artsy type, but as I have argued above, that is also not was creative therapies are mainly about. Creativity is an indispensable life skill because it empowers you to take your life in your own hands and make the best out of past experiences. Creative therapies also help individuals lessen the weight of trauma on a deeper level than spoken or written words ever could. Fear and pain can be nameless, but it may be possible to encrypt them in color, shape, sound or movement. Also, the socially established connotations of verbal language often provoke feelings of shame and defeat, especially when it comes to describing a victimizing situation. Not so the arts. They allow even humiliating experiences to be expressed in a shrouded and abstract manner, therefore being emotionally less taxing than a verbal account. Words are powerful on a conscious level, but in order to release pressure accumulated in the subconscious, the arts can be more efficient. Any activity that helps you exercise your creativity will ultimately strengthen your self-confidence and enhance your coping skills.

Creativity is also a source of joy and social interaction, which are also pillars of mental health. Just to add another anecdote, from my last stay in a psychiatric hospital, I remember a gentleman who, if I am not mistaken, worked as a transport entrepreneur and was treated for depression. He looked anything but an artist. Yet, through arts therapy, he discovered his passion and talent for oil painting. In an amazingly short period of time, he became skillful enough to produce a series of remarkable, very expressive floral still lives, which the clinic decided to display in its corridors. Both staff and fellow patients openly admired his work and encouraged him to stick to his new found love. Frankly, I have no information on whether he ultimately recovered from his depression. The last thing I know, before I myself was discharged from the clinic, was that he had become an outpatient and gone back to living at home. I would not go as far as saying that his mental health improved due to arts therapy, but I am convinced that his motivating experience within the clinical setting must have given him a good push forward in everyday life as well.

Personally, I believe the all-encompassing benefits of creative activities are the reason why so many people engage in crafty pastimes. On the most immediate level, creating something beautiful or practical is an uplifting experience. It makes you feel productive and gives you aesthetic pleasure. But also, making something which has not existed before tells you that you are able to shape your surrounding circumstances. You may have only crocheted a doily or lined a shoe box, but spiritually it is a symbol for your power to contribute to reality and bring the things you desire into your life. It means you are capable of making choices which lead to a good result on a small scale, which in turn should encourage you to believe that, on a higher plane, you will succeed in the making of bigger decisions as well.

Arts therapy, as the term suggests, includes an element of systematic psychological support in addition to the application of creative skills. But even if you, or someone you know who is in need of help, have no access to arts therapy, taking up a creative hobby is always an option for you. Depending on the materials and the equipment some arts require, they can be more or less costly. Therefore, consider your budget before you get started. Also, if you don’t feel like committing to one specific activity right now, browse the internet for DIY blogs. They are literally everywhere, and many of them offer tutorials on smaller, varied arts and crafts projects. You can even look for tutorials on how to redecorate your home in an easy and low-cost way, or how to pep up your wardrobe with self-made accessories, if you wish for a practical rather than a purely aesthetic approach. Creativity has no limits, so take your time and enjoy the many ideas buzzing around on the www. Feel free to share your thoughts on creativity and mental health below in the comments section.

Websites:

The Art Therapy blog offers descriptions of various types of creative therapies, articles on related topics and information on educational options for people who are interested in becoming therapists. First and foremost, this blog is informative and inspiring. It is not a support website for those in crisis or otherwise in need of help. Still, remember that knowledge is always empowering. So, no matter on which side of the table you sit, it is a useful website to visit. The Art Therapy blog also runs a Facebook page. http://www.arttherapyblog.com/

What Made Me Crazy And How Do I Deal with It?

When I broke down with psychosis, I had already been struggling with myself for many years, if not for all my life. Although as a teenager and as a young adult I had always been hopeful about my future – and I still am – I was also experiencing major insecurities which made me fear I was incapable of survival, let alone happiness. Even if other people praised me as a person or liked the quality of my work, I always felt like a cheat who is using a promising façade to hide a putrid ruin. I felt emotionally and socially disabled. During the years leading up to the psychotic break, I had been working hard to overcome my mistrust in myself, but I never shook off the fear that I might be a failure by design. Something seemed wrong.

Now, there are many definitions of mental illness and also many theories about its origins. As no clear answer has been found yet, the consensus is that mental illness results from mixed factors such as genetic predisposition, dysfunctional upbringing, traumatic experiences and substance abuse. The presence of any of these, or any combination of these, can push someone over the edge.

In my case, I can rule out substance abuse and traumatic experiences, not counting extreme stress as the latter. Thus remain genetic predisposition and a dysfunctional upbringing. I cannot prove nor disprove genetic disposition, but looking at family history on my paternal side there might be some. I would have to find out more about that issue. Just for the sake of argument, let’s say I am genetically predisposed towards mental illness, and my symptoms were triggered by a dysfunctional upbringing and other stress factors. An unhealthy upbringing I can prove to have had. I lacked nothing material, and also received a good academic education, but my close family was and still is emotionally damaged.

My parents had a miserable marriage, yet never split up. They shared a strange need to destroy, despise and blame one another for everything that had gone wrong in their lives. Fights and insults were their means of communication. My father retreated into a socially isolated lifestyle. He was super-sensitive and irritable, displayed signs of OCD (he feared the presence of germs and dust everywhere) and held no power of decision within the family. Hardly anyone took him seriously, or so I perceived it. My mother personified the theories about “schizophrenisizing” parenting you find in psychology literature. She loved me, but had no clue how to do it. She was possessive, controlling, over-protecting, manipulative, and eternally ambiguous about everything. She exerted power by instilling fear and feelings of guilt in me. Despite her addiction to control, she herself was desperately insecure and fickle. At times she was excessive in her demonstrations of motherly love, and at times she condemned me for being my father’s offspring. One day she could be encouraging and generous, the next she would make me feel unworthy. I could never confide in her because she might use whatever I said against me. My siblings, way older than me and living far away, just got the idea that I was a problem. My mother used to evacuate her complaints about me with them and other family members. When the first thing your cousin says to you, after a decade of not seeing one another, is “I know everything you’ve done to your mother”, you know for sure you’re the official fuck-up of the tribe. Now add years of bullying at school and you get someone who logically – with or without genetic predisposition – had to go nuts at some point.

So what was the ultimate trigger? My psychotic break was not my first crisis, but other than the previous ones it was cataclysmic. The breakdown was immediately preceded by the end of a long-term relationship (if not a very healthy one), a life-changing move to another country and a personal confrontation with my family I was unprepared for, and which threw me right back into my old conflicts with them. All of these together produced an acute feeling of having been uprooted and set adrift in existence. It was an extremely frightening and painful experience. There was nothing I could hold on to for catching my fall, most of all not myself. That is ultimate loneliness. I became shock-frozen in life, and a case for the mental clinics. Mental illness had always been presented to me as an incurable, invariably disabling and socially annulling condition. My terror was nameless when I got diagnosed as psychotic and medicated. None of the first bunch of doctors I saw gave me any hope of reconquering life ever again, and my initial medication regime also was not helpful. I literally became a zombie – wishing for an end to everything, but my body would go on functioning, keeping me prisoner in a biological existence devoid of meaning and direction. There was no curtain call for me yet. Back then, during my crisis, staying physically alive felt like a curse. I just wanted out! The winds began changing during my last hospitalization. After that, I hesitantly but firmly took up the reigns again. I cannot tell what exactly made me recover. A combination of many physical and immaterial factors must have come together in my favor, including an unknown energy deep in my essence that refused to let me go under.  Nowadays, I am glad I made it through. Nothing guarantees me psychosis won’t strike again, but as things are I am not fearful about it. Right now, I have a lot to live for and I love my life as it is – full of beauty and love. But getting here sure was heck of a trip!

Once you break down in crisis, society isn’t exactly forgiving, including people you had felt close to so far. They may give up on you for various reasons: they think you are just putting on an egocentric show and this unnerves them; in their opinion your problems are your own fault and you are an irresponsible fool for having invited them in; your shallower acquaintances simply don’t find you fun anymore; firmer bonds suffer because they find dealing with you and seeing you ill too painful. Your former co-workers or fellow students may prefer to forget your name forever. In the eyes of many, craziness is not an ailment which can attack anyone and eventually subside again. Society stigmatizes mental illness as an inborn, rotten part of the befallen individual, who is therefore worthless.

Right along the lines of supposedly being damned by birth, you will hear it said that what you didn’t receive in your cradle, you will never acquire. In other words: if you had a bad start you might just as well throw yourself off a bridge, because there is no remedy for you. To everyone out there who was lulled into believing this popular la-di-dah: it is utter and complete BULLSHIT. Certainly, teaching yourself is harder than having everything served to you on a tray. Still, your capacity of learning and growing is your lifelong gift. No-one but yourself can keep you from enjoying it. Never resign to thinking you are merely the outcome of your parents’ joined genes and educative efforts. Have you ever heard the saying “the sum is bigger than its parts”? It is true! There is much, much more to you. An unlikely source of wisdom, among many others, is the subtitle on the posters of the Hollywood movie “Gattaca”. It reads: “There is no gene for human spirit”. Neuroscience, in fact, backs this philosophy up. It turns out the human brain remains capable of rewiring its networks throughout our entire life. This ability is called neuroplasticity. How remarkably flexible and versatile our brain is, is impressively described in Norman Doidge’s book “The Brain That Changes Itself”. It is quite a fascinating and edifying read. According to the principle of neuroplasticity, any unhealthy behavioral and thinking patterns you fear were hardwired into you during your childhood and youth do not predetermine your future. You can modify them through willpower, practice and positive reinforcement. Thereby, you can even activate or deactivate certain genes. In other words: no matter where you are coming from, you are able to become someone you love and respect. Probably you will need help and also some powerful insights gained from difficult experiences, but you can mend your psyche. In this context, I would like to recommend another book. It is really written for therapists and the loved ones of people in need of help. Yet, as it portrays clearly which kind of help is the right one, I found it extremely useful for myself, because it taught me what my therapeutic needs are. This, in turn, allows me to seek out adequate help and instruct those closest to me how to deal with me should moments of crisis come up. The book I am referring to is Dr. Peter Breggin’s The Heart of Being Helpful”. This is a must-read for you, both if you are the one who is in crisis, and if you are a potential helper.

And finally, don’t let yourself become the problem. Also, don’t allow others to make you that. Unfortunately, even in the medical field, a mentally ill patient is treated as the personified problem. This does not happen to such a great extent in other areas of medicine. For example, a patient can HAVE a heart disease, but they ARE not a heart disease. Possibly out of general ignorance about the causes and nature of mental illness, someone with, say, schizophrenia, is considered to be inherently dysfunctional rather than suffering from a dysfunction that may well be temporary. Also, what if mental illness is actually not an illness in the conventional sense, not a medical defect? Could it be a reaction to the richness of observations an exceptionally sensitive and perceptive psyche is able to make of reality? Maybe some people are simply able to feel the pea under multiple layers of bedding, while others have a thicker skin and fall asleep anyways? It is easy to just stick the label of mental illness onto someone whose takes in a greater variety of stimuli, and who cannot always process their complexity. At first glimpse, you may judge extreme susceptibility as a weakness. In general, the psychiatric discipline and mainstream opinion fail to recognize that psychological hypersensitivity can also be a gift that stretches way beyond madness and alienation. In my personal view, it offers an opportunity for learning, healing, and growth that is less accessible to all those who are robust enough to just leave their conflicts unattended and carry on with their emotional load on their backs. If you break down under your world’s weight, you will be forced to sort the clutter and take only the useful things with you. Mental crises are a nightmarish ordeal, but they can also be your chance for renovation. I am not saying you necessarily need to become psychotic in order to make something out of your life. Of course not! What I suggest is that facing mental illness does not have to end in absolute defeat. Instead, it could well be the first step towards a more conscious way of living. I do believe that the destructive forces of madness can be turned around and redirected. Consider mental illness as a challenge, not as a final verdict. You can move on.

The following are links that lead you to people who are dealing with their conditions in inspiring ways, and to institutions which can help deal with your situation.

 

Websites:

Directory of organizations which can help people who are first diagnosed with a mental illness (UK based): http://www.bbc.co.uk/programmes/p01b3s86/features/info-and-support

This is the blog of Natasha Tracy, who fought herself back up to her feet despite her diagnosis: http://www.healthyplace.com/blogs/breakingbipolar/

 

Articles:

Christopher Tolmie writes about his documentary “Mental: A Family Experience”, which he exposed at the Scottish Mental Health Arts & Film Festival 2013 in Glasgow (http://www.mhfestival.com/). Here is the link to the article: http://www.changingmindschanginglives.com/2014/01/mental-illness-does-not-necessarily-incapacitate-someone/ Or go to:  http://www.mhfestival.com/news/interview/item/77-festival-blog

Audiovisuals:

“Ask A Schizophrenic – My Answers”: Questions and answers with Rachel Star (NOT Rachel Starr), who got diagnosed with schizophrenia and talks about how she manages her life and makes the best of her condition. To me, she appears quite admirable and inspiring. http://youtu.be/BAUlllDZqxg

This moving story recently went viral. In case you still haven’t come across it, it is about a man named Johnny Benjamin. He had been diagnosed with schizoaffective disorder and decided he was going to take his life. This was prevented last minute by a passer-by. After the incident, Benjamin began to turn his life around and is now giving thanks to his rescuer. http://www.bbc.co.uk/news/uk-england-london-25959260

Some Words on: The Social Stigma of Mental Illness

I am very careful about whom I tell I had a psychotic break and am still taking psychoactive medication. It is only a few people who know. This is not because I enjoy being dishonest, and I am also not ashamed of my condition. The reason is that, no matter how intelligent or good natured most of our social and professional contacts are, they are very likely hardwired to start questioning your capacities and interpret whatever you do or say in terms of your supposed craziness from the moment they learn about it. It is not their fault. It is what society has taught them.

The mechanics of prejudice work like this: imagine you are at a dinner party. An acquaintance leans over and whispers in your ear: “See Henry over there? I think he’s gay!” For the rest of the evening, you will be looking for signs of Henry’s homoerotic preferences. He prefers Piña Colada over beer, strawberry ice-cream over chocolate and also dresses tastefully? Oh my God, he is SO gay! How could you not have noticed before? He brought his long-time girlfriend along to the party? Not a problem at all – he is probably in denial and hasn’t yet come out of the closet.

Along these lines, people who know about your diagnosis and your medication routine will read your every move as a sign of your condition. You forgot to send an email? That’s because you’re demented either by your illness or by your medication. You get pissed at a colleague who snatched a customer away from you? You have uncontrollable anger issues caused by either illness or medication. You tell someone in the office you had trouble falling asleep last night? Of course, you are a lunatic! Any of these situations happening to a “healthy” person is just stuff that happens naturally from time to time and need not worry anyone – after all, nobody’s perfect, right?

Again, I emphasize that this kind of over-diagnosing is not ill-intended in most cases. It occurs pretty much automatically. Most people, although educated and cultured, simply don’t know enough about mental illness and therefore are uncertain what to expect. This uncertainty generates mistrust, fear, and ultimately discrimination. I must admit I used to be no better. Years before my psychotic break, a fellow student at university admitted to being schizophrenic and taking medication. Although I didn’t want to be mean, I couldn’t help but fear that if I invited her home she might, out of the blue, snap and pull a kitchen knife on me. Now I know how unfair that was. Mental illness seldom is a threat to others. It is, unfortunately, a huge danger to the sufferer’s own happiness. The cruelty of my own prejudice hit me like a truck when I got diagnosed as psychotic myself.

My recommendation to you is: think through the possible consequences of telling any- and everyone. It is true that mental illness should finally be discussed more openly in order to put an end to discrimination. However, I warn you against thinking it up to you to make that happen all by yourself. Do not turn yourself into cannon fodder. Imagine calling up the Gestapo in the middle of the Holocaust and telling them “Hey guys, I wanna come clean, I´m Jewish…” No way! You need your lifelines intact. You need a job, you need your studies, you need your social contacts, you need a life! If you wish to make this world a better place for people with psychiatric diagnoses, there is a host of organizations you can support who will appreciate your contributions to their cause. See the appendix of this article for relevant links. Also, ask yourself if your diagnosis or your medication plan is relevant information at all, say, at your workplace. Can you do your job efficiently, just like everybody else? If your answer is “yes”, then what is the use of drawing attention to your problem? As long as you’re an accomplished, say, software programmer and reliably fulfill all demands, why would your boss or your co-workers need to know you’re receiving psychiatric treatment? It is not relevant. Imagine being at a job interview at some lab and saying: “Hi, I have a Master’s degree in molecular biology and graduated with honors. Oh, and I guess I should mention that I enjoy visiting swinger clubs on the weekends.” Why would you shoot yourself in the foot like that by disclosing a superfluous fact that will cast a shadow on your merits? It is neither intelligent nor honorable. Of course things are different when your condition does affect your performance negatively. If you suffer from an anxiety disorder which makes socializing difficult for you, you will not wish to be placed in the customer service department. In that case, your superior and your co-workers need to know and understand. Give them a chance to pick tasks for you that are manageable and offer you the opportunity of performing at your best.

To sum it all up, only tell someone you are on psychiatric medication when you are absolutely sure this person will not make your honesty backfire on you. The slightest doubt, the tiniest hunch that you feel, may well indicate it is not the right person to trust or not the right moment to speak. As a rule of thumb, do not trust people more than they trust you.

Your social network is made up of three kinds of contacts: those you must tell, those you can tell and those who – at least for now – you should not tell. Make sure you identify them correctly. People who absolutely need to know about your condition are your partner, your roommate, close family, your closest friends. Everyone else you have to gauge for suitability and trustworthiness first.

Is this way of proceeding ethical? Is it alright not to be an open book? If it is not relevant to the situation, there is no need for exposing yourself. Society seems to impose an absolute moral obligation to be open and sincere. But remember that the reactions you’ll get from people who can’t handle your confessions can be unethical and harmful to you (this is a parody of what I mean – watch this tragically funny NAMI sponsored commercial: http://youtu.be/Dw_I-G1smoo). It is one thing to be sincere and give others information they actually need in order to coexist with you, but it is another to unnecessarily feed yourself to the dogs. Being inappropriately heroic might cost you your job, your social circle, your inner peace and your dignity. Think twice. Decide wisely, for your personal integrity, independence and even your prospects of recovery are at stake.

 

Websites:

The following organizations aims to improve the life quality of individuals diagnosed with mental illness. This includes educating the public and those diagnosed with mental illness to create more awareness and better integration. Anyone can register as a member.

National Alliance of Mental Illness (USA, in English and Spanish): http://www.nami.org/

Mental Health Foundation (UK) has a similar mission as NAMI: http://www.mentalhealth.org.uk/

Rething Mental Illness (UK): http://www.rethink.org/

Canadian mental Health Association (CA): http://cmhanl.ca/

Articles:

http://www.psychologytoday.com/blog/why-we-worry/201308/mental-health-stigma

http://www.mentalhealth.org.uk/help-information/mental-health-a-z/S/stigma-discrimination/

Article for the Canadian Mental Health Association (in English): http://www.cmhanl.ca/pdf/Stigma.pdf

http://www.changingmindschanginglives.com/2013/11/a-diagnosis-of-schizophrenia-set-me-apart-from-the-rest-of-the-world/

Audiovisuals:

Information video by the IWK Health Centre and the Canadian Mental Health Association titled Stigma and Mental Illness: http://youtu.be/LTIZ_aizzyk. Brief interviews with health care professionals and psychiatric patients portray the stigma of mental illness within the health care system. A must-watch!

Symposium about mental illness stigma hosted by Carleton University. You will find an extensive watch-list with videos of the speakers of the symposium here. http://www.youtube.com/watch?v=RMVfVuI0zwE&list=PL23BEAD8F06537216

A bold discourse not everyone may agree with, but that everyone should have listened to. Canadian essayist Stefan Molyneux talks about his theory on mental illness: http://youtu.be/J_O24tnqs_U (part 1) and http://youtu.be/mgqIUf8Jg-c (part 2).

Jayme-Lee Pablos, a psychology student reads her paper on social constructs and social stigma of mental illness: http://youtu.be/X3hJqB20r1g (part 1) and http://youtu.be/oiTCgxhKPok (part 2). Her work portrays an academic standpoint rather than looking to provide help, but it is interesting information.