Fuck you, you fat faggot, she’d say. You’re nothing but a meth addict and you’re going to get arrested soon. Next I’d hear a teenager’s voice: You’re such a weak faggot for crying about your dog dying. Then a man would chime in: They’re coming for you, you know that? You’re so fucking stupid for trusting anyone. AIDS-ridden faggot.
“I try my best,” I’d reply—aloud, sometimes, or just in thought. “I’m not a bad person.”
I FUCKING HATE WHEN YOU SAY THAT, the voices would always reply in unison, enraged and using the singular pronoun for themselves. Good people aren’t tweakers. And besides, you’re fucking crazy. You’re talking to yourself.
As the voices morphed seamlessly into my own mental narration, I had to acknowledge the truth that these, my loudest and most vehemently hateful adversaries, were all myself. And yet though I realized the insanity of this—my daily life for years—I nonetheless endured it. Because confronting not just an addiction-spawned psychosis, but the underlying psychological issues that led to active addiction in the first place, is a terribly humbling process that necessitates opening one’s most honest self to the outside.
To stop the voices in my head from constantly screaming at me, I would sometimes sit for hours near I-95 overlooking the Philadelphia riverfront. It was the only place where even my hallucinations had to fall silent, drowned beneath the steady roar of the interstate. At night, the reflections of the city’s lights upon the Delaware River danced jauntily, happily. It was a whimsical, calming sight.
Sometimes, out of sheer gratitude for finding a fleeting moment of solitude and peace, I sobbed, pitifully wiping away snot and tears. Now and then, kind pedestrians would occasionally ask if I was OK, and I would reflexively say yes, sometimes making up a story about a romantic breakup. That way, nobody would think a crazy meth addict was sitting near traffic to silence the voices in his head; he was just a normal person having a rough go of things.
And that’s the charade everyone who’s suffered mental illness knows well: playing the part of sane person so as to avoid detection by all the sane people.
Whether one’s particular illness is drug-related or trauma-induced psychosis or PTSD, this process is incredibly alienating and lonely.
The first time I hallucinated, I freaked the fuck out in Washington Square Park and couldn’t understand why everyone else wasn’t terrified of the police officers I saw menacingly brandishing and pointing their guns at me. When I finally picked up on the fact that nobody was reacting to dozens of rogue cops—rather, everyone was reacting to a guy in a Puma track suit screaming about his ACLU membership—I realized I should just ignore my sensory input and shut the fuck up.
It was then that I started to learn that the worst part about being crazy isn’t losing your mind: It’s knowing that you’re losing it.
The National Institutes of Health says that “mental disorders are common in the United States” with “about one in four adults” living with a “diagnosable mental disorder in a given year.” During my “problems”—the hilariously polite way of describing publicly what I personally think of as my “batshittedness”—I was the one out of four. Even now, though, clean and sober and clear-minded, I’m still one of the 40 million Americans who live with serious anxiety at all times.
Treatment of anxiety disorders, such as PTSD, costs the U.S. medical infrastructure about $40 billion per year. What’s harder to quantify are the social and literal costs of those untreated. After all, even though a quarter of Americans are in the throes of, well, something right now, a lot of them are keeping it to themselves—and for good reason.
While the official American cultural response to mental illness is one of compassion and understanding, the reality of the social landscape is a bit less friendly. The Centers for Disease Control and Prevention notes that while nearly everyone agrees that “treatment can help persons with mental illness lead normal lives,” we’ve got conflicting ideas about whether or not American society follows through on this promise. The CDC reports that 57 percent of all adults without mental illness think that society is “caring and sympathetic to persons with mental illness”—but only 25 percent of people living with mental illness agree.
Coming clean about mental illness or seeking treatment inevitably leads to the well-meaning but mortifying expressions of care colleagues and associates express. And these expressions of care are logically followed by an underlying lack of trust. Attorney Zachary McDermott, writing for Gawker, describes his experience after being released, successfully treated, from a psychiatric ward in New York City: “Real or imagined, I felt a widened berth in the hallway and could only see [my co-workers’] shattered perception of who I was in their eyes. [I was now] the deeply troubled sad sack with ‘issues.’” Despite his colleagues’ expressions of sympathy, McDermott sensed that the true nature of their “understanding” was at best pity—and, at worst, terror. Well—either that, or the stigma attached to mental illness clouded his mind so much that he perceived something that wasn’t really there.
In either case, much like how my drug-induced hallucinations were illusory yet very real to my senses, McDermott still felt these insecurities.
“When I was experiencing one of the deepest episodes of depression in my life,” says Jake Bowling, “someone I loved dearly looked at me and said, ‘Jake, quit moping around and snap out of it.’ It’s difficult for some people to understand the experience of a mental health condition.”
Bowling’s the director of advocacy and policy at the Mental Health Association of Southeastern Pennsylvania. He’s an expert on both the legislation and the stigma surrounding mental illness.
“We need to view mental health as an important part of whole health,” he says. “Individuals, if possible, should ‘fight in the open,’ because being able to talk about your own mental health challenge will liberate others to be honest about their experiences and seek the support they need.”
Bowling insists that stigma—fueled in part by inaccurate media portrayals of those living with mental illness—need to go. Despite what the cable thriller of the week might suggest, he says, “people with mental health conditions make trivial contributions to overall societal violence.” Quite the opposite, in fact: People living with mental illnesses are “11 times more likely to be victims of violent crimes than the general public.” In other words, the overwhelming majority of folks suffering right now aren’t threats to society; they’re mostly threats to themselves—and targets for others.
With more open discussion, Bowling says, folks might be better able to overcome whatever impetus is presenting an obstacle to their return to a normal life—whatever that truly is, be it unfair perceptions borne out of insecurity or actual and pervasive lingering stigmas.
As McDermott writes, soon upon his reentry into his legal profession, his “projections began to melt.” And something else changed for him, too: “I was armed with a completely different understanding of my mentally ill clients. I wished I could tell them, ‘You aren’t crazy. Crazy people don’t know they’re crazy.’”
A while after I sought out both drug treatment and counseling for the underlying pathologies that had pulled me toward addiction in the first place, I realized I was able to appreciate the quiet in my own head again. On an impulse, I ventured to that bench I used to sit on near I-95, thinking I’d find some sort of profound epiphany now that I was sober and sane.
That didn’t happen.
The fact was, the traffic was just too loud for me to think. Also, the furious bustle going on everywhere was too distracting. Wow, I thought: Some of those people running around down near the highway look goddamned crazy!
But considering my experience, and the fact that over 70 million Americans are going through some sort of mental problem—whether it’s a genetic condition like schizophrenia or a condition born from coping with trauma—I didn’t feel like pulling away from those “crazy” folks I saw. Instead, I felt a profound sense of kinship. And I started to realize that, really, there’s nothing crazy about being crazy.
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