I have a mental disorder.
That is difficult for me to say, still. I know my brain is a physical organism, and that neurons and synapses follow the same physical laws as blood glucose, say, or cell growth. And I have a diagnosis to cling to (generalized anxiety disorder) for the last 10-13 years, one whose existence has been verified with current scientific methods. I look at this paper with test results from time to time to remind myself that, yes, I have a condition which I am learning to effectively manage, but that has been, like many physical disabilities, decades in the making (through lack of diagnosis and treatment). Looking at this paper reminds me that I have many years of treatment and growing self-understanding to better help me manage, and possibly reverse, my condition.
The physical tendencies that have become habitual in my head-organ manifest in my nervous system as chemical imbalances creating “emotions” and “thoughts,” invisible behaviors, but physically based, nonetheless. These behaviors catalyze observable physical actions on my part that are different from ones I might take, did I not have these physical tendencies and chemical imbalances.
I have to remind myself of these things for the same reason that I usually speak only to few, trusted others about my condition: like many, if not most, in this country, I’m still somewhat trapped in an old way of thinking, that anxiety and many mental health conditions are just character flaws.
I grew up overseas. Although I come from a middle-class American family and landed in a wealthy, highly educated county in the U.S., my family was behind in understanding even the basic fact of mental illness- that it is a category of increasingly scientifically understandable and treatable physical conditions, no different in their basis from any physical condition. Again, we’re talking physical laws, people. Though very scientifically oriented, my family, like so many even to this day, knew very little about the chemical origins of my type of condition. This despite the fact that members of my extended family had suffered great physical harm to themselves due to mental illnesses, and had severely damaged the lives of others around them. Later, members of my immediate family would grapple with mental health issues, and these would still go largely undiscussed, misunderstood, and not fully dealt with; again, this is sadly the norm in so many families, even families like mine, that I think are very enlightened, otherwise.
It was cultural and familial conditions, as well as my illness, that kept me from understanding that I had a physical illness over which I had little control, up until I started effective treatment. The first time I was terrified of going to school was when I was nine. At age 11, this became a nearly daily thing. My anxiety and depressive disorder developed, at least in part, because my family moved frequently, internationally. I don’t remember specific traumas that caused me to look upon having to to move and sever old friendships and make new ones, in new cultures. There may not have been any. I know that at some point, part of my brain said, “Enough. This is too hard. There is too little constancy. Any time I attempt to open up emotionally and make dependable bonds with others, they are forcibly severed, sometimes with little or no warning. I don’t want to deal with the pain of that anymore. Opening up is no longer worth it.”
I was too young to see these responses as understandable reactions to circumstance, or to understand that those around me did not want to part with me- circumstances forced the issue. Instead, I took my never-continuing relationships to be a function of my inadequacy and unloveability as a human being. The more I frequent and difficult the moves, the less I reached out, and the deeper this belief took root. Or to put it in terms of a developing physical disorder: more frequent releases of, say, monoamine oxidase A, made releases of this chemical more likely to become a tendency, and the less serotonin and serotonin production capability I would have to counter the effects of the former chemical. This is like tearing a ligament frequently. The more the tears, the longer the healing time/ more intensive treatment needed.
I’m not a doctor, and these may not be the best analogies. The point is, a great percentage, perhaps the majority of the public, does not realize that a disorder of the brain is a physical disorder. I internalized my anxiety and my deep fear of taking success-building risks (trying out for sports/ clubs, taking tests, asking for promotions, asking people for dates, etc.) as character issues. I never discussed my frequent racing heart and sweating with my family. This was at least in part because I was convinced these attacks and their effects on my successes were an inherent weakness in my personality, a lack of moral strength. I wish I could go back in time and tell that little kid that he is wonderful and strong and dealing with something that no one should have to deal with, alone. Can you imagine a child with a repeatedly torn ligament, in danger of losing the use of that limb, masking incredible pain and pretending to walk, even run, normally, without medical treatment? All because he is afraid that if someone finds out, it will confirm that he is a spineless, worthless, inadequate human being?
This shame-induced silence about pain that was, during some months, a daily anguish, was due in part to my illness, to the growing chemical imbalances in my brain. But a large part of it, the part I hope my story can help others with, was a cultural-based shaming and misunderstanding. And it wasn’t just my silence. Family, teachers, counselors and other adults who must have seen some aspect of my fears or pain did not know how to identify or follow up with what is, again, an illness. To many, chronic fearful behavior or depressive behavior is still misunderstood as a lack of character. Workplaces, financial institutions, even health institutions, have yet to catch up with the science behind such illnesses, and to treat them with as much rationality and compassion as they do other illnesses.
After 20 years of suffering from chronic anxiety and depression and their devastating impacts on my finances, career, and relationships, I finally took a big long-term step toward understanding that I had an illness, and moved toward treating it. Without the support of someone who had a more progressive understanding of mental health, it might have been years longer before I stepped into that first therapy session. That deeply help belief that I was physically no different from those who didn’t suffer anxiety, just a much weaker human being, was still there. As it was, it took another few years before I understood my condition was chronic and involved the physical structure of my brain, whose change would take a long time to effect. Then it took more years to have an accurate diagnosis, and ten more years before I had the start of effective treatment.
I write this because I think creating awareness about and speaking of my disorder is an effective, maybe necessary way to help transform the old beliefs about mental health, in myself, and in others. I don’t want my son to go through the anguish and long years of suffering that I have. I don’t want others to have to, either.
I plan to talk more about my lifelong struggle. If you have such a struggle, please help us all and do the same. Illness is illness, and it all deserves the same compassion and attention.