Shouldn’t it be the easiest of questions to answer? If they gave you a pill, if transcranial magnetic stimulation works or some new gene therapy could cure your “disorder”; would you accept it?
Yes is the obvious answer, as far as any “sane” or “rational” or “healthy” person would have it. The reasoning behind this is obvious and with some validity – mental illness tears at the fabric of society, it destroys lives. It kills.
Why can’t I just answer yes? A friend of mine once told me how much she hates my scars, how she hates that pain was caused and that they were required. She also noted that I wouldn’t be the person she loved if I hadn’t lived through all that. Maybe that’s what she truly dislikes – that parts contributing to someone she values were born of misery and chaos.
I can’t answer yes. No. No I’m lying. Yes. Yes, yes yes. YES. In my darkest times I wanted it to stop. ‘It’ was so many things. Fear, uncertainty, misery, pain, loss. More besides. Anything I could try to cut out or ethanol-cleanse or suffocate at the bottom of the Roding.
The interesting question isn’t whether I would have such a treatment today, but whether I would have then.
In The Pits and the Pendulum Brian Adams highlights what he considers ‘manic-depression propaganda’: adding names such as Einstein, Coleridge and Alexander the Great to “our” pantheon. The only stories I ever read about paranoid schizophrenia in newspapers detail failures of hospital administration and the inevitable murdering resulting from it. Black and white thinking saturates the question of mental health on every level, in a dizzying array of permutations.
For my part I cannot recall any upside, nor any down. There was only the maelstrom, punctuated with moments of relief and release when I thought it was over or the torment had been tied off. Contemplation of any benefits of my condition were impossible, not because my mind wouldn’t have been open to such heresy, rather it was otherwise engaged.
I wrote a hell of a lot of bad poetry back then. Wrote a lot of awful songs and failed to play them on my guitar. Writing has been a constant throughout my life, but back then it had to happen in bursts. Narratives or long tracts like this one were almost impossible, contributing to my collapsing academic standards. Perhaps my point is that any creativity I had wasn’t birthed or enhanced because of my crises, simply that the flavour of it had changed.
When was I diagnosed with depression? An SNRI was prescribed at some point, which I find curious in retrospect. ‘Suicidal ideation‘ came later: dying was a practical consideration. A demarcation was under construction between myself and a world opposing me on principle. Incompatible.
Things were happening to me and from me. Any revelations or revolutions in me were carried on shockwaves, and if there have been any benefits their emergence relates to these shattering blows. The same way you blast precious minerals from the earth.
No safety protocols. Imagine if you will an accelerating train; brakes failing, wheels red from friction, the whole mechanism groaning with metal fatigue. Disengage any “sensible” prejudices you may have around the fear of pain, the fear of death. When the wheels buckle and the rails yield and you are carried off the mountainside. The contortion of colours and shapes, new sounds and unimagined sensations.
‘Reality is a postage stamp‘ musician Katiejane Garside once told us. J. G. Ballard claimed a debt to the mentally ill and was himself denounced as ‘beyond psychiatric help‘ thanks to the manuscript of Crash. Shanghai Jim took it as a compliment.
If the propaganda folds and we’re not all murderers, perhaps what we find is a neutral shift in perspective. As social animals bound by the laws of natural selection, we have to agree on certain conventions in order for our continued survival. The model falters however, because all thought is infinite and our awareness of this fact is too much to handle. Finding ways to co-operate has helped us thrive as a species, but knowledge of its cost undermines the remarkable gifts nature instils in us.
I recently read a paper published in Molecular Psychiatry back in 2008, accusing a gene called diacylglycerol kinase eta (DGKH) of being complicit in the onset of bipolar disorder. Statistics were never my strong point so a great deal of the article was lost on me, but the focus on ‘risk alleles’ and ‘polygenic disease‘ was interesting, though seemed to somehow miss the point.
An engine is very useful if you maintain it. See to its needs and it’ll take you where you want to go. Ignore it or push it too hard and its breaks down. You might swear at the car when it fails to live up to your expectations, but you don’t fix it by restricting its component parts.
This is an emotive analogy, courtesy of someone fearing an extinction event. ‘In a completely sane world, madness is the only freedom.’ Ballard again. Potential methylation of this proposed epigenetic, polygenic complex will sterilise people like us. Return us to a statistical norm that the Holy APA cannot actually quantify.
I can’t say I consider myself special, and maybe I hinge too much of my sense of self on identification with the Mad community. But conversely aren’t researchers similarly hinging too much on the existence of a disease and the possibility of a cure? Approaches on either side will inevitably suffer from ideological taint – participants in the aforementioned study were drawn from the US Department of Health and and Human Services, the National Institute of Mental Health and the Brookings Institution’s Center on Social and Economic Dynamics; arguably institutions with a vested interest in the biopsychiatric model and its social implications. The test samples came from subjects and controls who’s suitability was judged according to DSM-IV criteria, which is always reassuring. The paper also notes that similar, albeit larger genome-wide association studies are only possible thanks to organisations like the Wellcome Trust; which was founded by a pharmaceutical entrepreneur.
I have to acknowledge my own biases, and it’ll be an interesting day if irrefutable scientific proof of the biopsychiatric model emerges. Yet I still cannot shake the idea that just because bipolar disorder may have a genetic basis, it wouldn’t be proof of a disease. I’m not a anthropologist and I’m certainly not a evolutionary biologist, but I can imagine certain evolutionary benefits to mental “disorders” which arguably retain their value.
My experiences of depression: an intense focus on ills to myself and a sensitivity to those of the world. A warning sign, a pain response. Bipolar disorder: creative leaps and unique problem solving, married to an intense motivation to leave the cave and cross the valley. Here we share the depressive sensibility; both as a consideration of our situation, but also a crash dynamic – our bodies and minds slowing down in an equal and opposite reaction to the manic impulse. Schizophrenia: hyper-real processing of the world around us, drawing out the inward significance of who and what we are. An attempt to emphasise the individual so we do not stagnate.
I talk to the voices in my head, sometimes telling them to shut up, but more often than not as part of a dialectic. This post owes much of its content to a late night of augmented energy levels and accelerated thinking. Patty Duke, echoing an apparent trend amongst manic people, emphasised her ‘incredible command of the language,’ while a patient of Darian Leader’s remarked: ‘the right words were just there, I didn’t have to think anymore.’ Right now, as I feel myself ascending yet again, I know exactly what they mean.
My answer is no. I can’t say I’d want to be “cured.” I won’t speak for everyone. My rights are restricted to what I feel and what I believe. Science is not the enemy. The spiritual isn’t irrelevant. All we can work with are the qualities we have and the ways we work with them in kind.