This I Believe

James - Dallas, Texas
Entered on August 6, 2007
Age Group: 50 - 65
Themes: illness

I believe that mental illness hurts. It hurts as much, if not more than physical illness. As a psychiatrist, I see people in all states of mental health: illness, joy, sadness, hope and hopelessness. All of them have suffered; many have climbed from awe-inspiring depths to reclaim their lives. In their eyes, I see a constant reminder of one thing: Mental Illness is Painful.

Medicine taught me to look for the redness, swelling, pain and tenderness of physical illness. Mental illness lacks these observable symptoms, yet, I believe it causes deeper pain because its true pain cannot be seen, felt or heard. Daily, I contend with this pain in patients and those who care for them. Most of society never has directly touched the phantom pain that haunts every minute of a mentally suffering person’s life. If we could touch that pain for one moment, I believe our whole understanding of mental illness in all its forms would be transformed. When a person with diabetes or high blood pressure has symptoms, we encourage them, adjust their medication, assist them with diet, gather family around to help or we send in assistance. In short, we CARE for them. When the mentally ill have symptoms, we “put them away.” Who rushes to the depressed, schizophrenic or bipolar patient to “help?” Most people run. For those with mental illness, worsening symptoms mean more pills, more side effects and without success, time behind locked doors.

Woven around the margins of life is a subtle, but pervasive message that disorders of the mind are not “real” diseases. These illnesses have no parity with insurance; they yield time-limited disability. Together, this translates into a message that these illnesses either do not really exist, have a simple cure, or need no sophisticated medical treatment. Yet, in the eyes of those whose lives and spirits I share is a different and painful interpretation of this message. It is a distorted echo that needing the hospital or more intense management is a “treatment failure.” To those who suffer, the answer seems simple: the patient must be doing something wrong.

I doubt whether those of us who do not experience this pain can ever comprehend the confusion about which thought or voice is true and which person is actually looking at and talking about us. For many, depression is a pop-culture term to describe the feeling of some absurd loss, like a lover, a job, or a “perfect deal.” Few of us understand the excruciating ache pounding from the “black hole” deep within that seems to drain all feeling, hope, energy, sleep, hunger, love and joy from life, leaving one without a sense of meaning.

I believe the fear of the symptoms or the illness is not the thing from which we run. It is the pain. Maybe, on some level, we all DO know the pain of mental illness and cannot bear even to think about it on any conscious level. So we run. I believe mental illness hurts.