The Collected Schizophrenias: Essays

by Esmé Weijun Wang

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.

A diagnosis is comforting because it provides a framework—a community, a lineage—and, if luck is afoot, a treatment or cure.

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.

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.

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.

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.

I read in the New York Times that a child of a parent who has bipolar disorder is thirteen times more likely to develop the disorder than a child of a parent who does not.