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People speak of schizophrenics as though they were dead without being dead, gone in the eyes of those around them. Schizophrenics are victims of the Russian word гибель (gibel), which is synonymous with “doom” and “catastrophe”—not necessarily death nor suicide, but a ruinous cessation of existence; we deteriorate in a way that is painful for others.
Some people dislike diagnoses, disagreeably calling them boxes and labels, but I’ve always found comfort in preexisting conditions; I like to know that I’m not pioneering an inexplicable experience.
diagnosis is comforting because it provides a framework—a community, a lineage—and, if luck is afoot, a treatment or cure.
To read the DSM-5 definition of my felt experience is to be cast far from the horror of psychosis and an unbridled mood; it shrink-wraps the bloody circumstance with objectivity until the words are colorless.
After all, it is easy to forget that psychiatric diagnoses are human constructs, and not handed down from an all-knowing God on stone tablets; to “have schizophrenia” is to fit an assemblage of symptoms, which are listed in a purple book made by humans.
Giving someone a diagnosis of schizophrenia will impact how they see themselves. It will change how they interact with friends and family. The diagnosis will affect how they are seen by the medical community, the legal system, the Transportation Security Administration, and so on.
According to the diathesis-stress model of psychiatric illness, a genetic vulnerability to a disorder blooms only if enough stressors cause those vulnerable genes to express themselves.
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.
The term is based on research on family homeostasis, and describes a pattern of behavior in which a dysfunctional family identifies one of its members as mentally ill, though their symptoms are actually manifestations of the family’s pathology.
key concept in the discussion of schizophrenia, psychotic disorders, and treatment is that of how far the possession goes—or, in psychiatric terms, the level of “insight” the individual is capable of.
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.
Humans might all be ciphers to one another, but people with mental illness are particularly opaque because of their broken brains. We cannot be trusted about anything, including our own experiences.
We see the possessions that have subsumed the sweet girl or the bookish boy, who are understood to be long gone. In the stories of who they were before the illness, or the evil, or the possession—including that of Beth’s family member—there is an expectation of not only normalcy but goodness.
When I think about the murder, I think about how excessive thirteen shots is. I also think about how a man who loomed over your bed in the middle of the night, a man who claimed to be sent by God to kill your daughter, might seem like a man possessed by evil, and therefore capable of anything, including surviving multiple gunshot wounds—even if you once loved him, or still do.
Schizophrenia and its ilk are not seen by society as conditions that coexist with the potential for being high-functioning, and are therefore terrifying. No one wants to be crazy, least of all truly crazy—as in psychotic. Schizophrenics are seen as some of the most dysfunctional members of society: we are homeless, we are inscrutable, and we are murderers. The only times I see schizophrenia mentioned in the news are in the context of violence,
Among psychiatric researchers, having a job is considered one of the major characteristics of being a high-functioning person.
Rarely did I experience such a radical and visceral imbalance of power as I did as a psychiatric inpatient amid clinicians who knew me only as illness in human form.
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.
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.
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.
