I’m an alcoholic/addict (same thing to me) with bi-polar disorder, which I still name the much more evocative manic-depression. I am in recovery in both cases and generally feeling sober, sane and sometimes even serene. Nonetheless, I’m aware that freedom from the manic-depression is contingent on a particular chemical balance that I can easily throw off not only by getting careless with my pharmaceutical regimen, but also if my sleep gets thrown off, if I get jet lag, or even if I consume too much caffeine. A bipolar relapse carries with it a huge risk of committing suicide so this can’t be taken lightly.
Similarly, but with a different twist, I’m aware that my recovery from addiction is precarious. As they say in the big book of Alcoholics Anonymous, “We are not cured of alcoholism. What we really have is a daily reprieve contingent on the maintenance of our spiritual condition.”
I take both of these conditions as forms of insanity. That’s a powerful word, but cuts to the chase, for me, better than illness, disease, sickness, or disorder. Those terms have their uses, but when you’re in the presence of a non-recovering addict or alcoholic, or someone experiencing manic-depressive symptoms, you will surely agree that they are, in that moment, insane.
If you agree that insanity is not being able to distinguish fantasy from reality, not being able to conduct our affairs due to psychosis, or being subject to uncontrollable impulsive behaviour, then alcoholism, drug addiction, compulsive gambling, and manic-depression are surely forms of insanity.
I say this to be helpful and, I hope, more precise than the culture of caring euphemisms sometimes allows. In 12-step recovery rooms, we are encouraged to be direct and honest, and open-minded to what others are sharing. This honest and open sharing, unfiltered by professionals, is, in my opinion, the primary reason those fellowships work (albeit “it works if you work it”, so for those who are in the recovery rooms passively observing but not getting engaged, the likelihood of success is much lower).
For conditions like bi-polar disorder, schizophrenia, OCD, etc. there is no real equivalent to 12-step fellowships, which is really unfortunate. On the other hand, I do think some of those conditions like bi-polar disorder, are almost purely neurochemical and can only be wrestled to the ground with lithium and other psychopharmaceuticals.
I should be clear, however, that I don’t see an absolute demarcation between sane and insane. I am free, today, but it seems never 100% of extreme manic-depression. I feel like I’m always on the verge of depression, but I never quite fall into it the black jaws completely. My medication makes me a bit poker-faced: calm even when calm isn’t called for, neutral, sometimes indifferent when I should have an opinion, never excited when most others are. I’ll take that over the completely unmanageability of hypomania or full-on manic episodes (which is when I’m most at risk for suicide. I’ll take that over the darkest depressions. But I’m always aware that I’m not completely OK.
Similarly, I can’t have a drink. I can’t smoke a joint (some alcoholics say they can, but I know that I personally cannot). I can’t mess with drugs at all, because I know the minute I do, the silicone chip inside my head will get switched to overload. It might be fatal; at the very least, it will be catastrophic.
We’re all insane sometime. As Ray Bradbury put it: “Insanity is relative. It depends on who has who locked in what cage.” Addiction and manic-depression are just chronic forms of insanity that sometimes have acute flare-ups. But, based on the definition above, my mother was insane as she was dying from dementia. A relative of mine is suffering a bit of insanity right now, owing to a medical condition. Another relative is suffering a form of depression that is causing him to be suicidal. In both cases, I hope, their conditions are temporary.
We all get a quick taste of insanity when we fall in love.
This passage from Hesse’s Steppenwolf is a powerful take on the false dichotomy between sane and insane: “The judge who sits over the murderer and looks into his face, and at one moment recognizes all the emotions and potentialities and possibilities of the murderer in his own soul and hears the murderer’s voice as his own, is at the next moment one and indivisible as the judge, and scuttles back into the shell of his cultivated self and does his duty and condemns the murderer to death. And if ever the suspicion of their manifold being dawns upon men of unusual powers and of unusually delicate perceptions, so that, as all genius must, they break through the illusion of the unity of the personality and perceive that the self is made up of a bundle of selves, they have only to say so and at once the majority puts them under lock and key, calls science to aid, establishes schizomania and protects humanity from the necessity of hearing the cry of truth from the lips of these unfortunate persons.”
The radical anarchist in me wants to adopt the stance of R.D. Laing, Michel Foucault, Erich Fromm and others who generally argue that “Many psychiatrists and psychologists refuse to entertain the idea that society as a whole may be lacking in sanity. They hold that the problem of mental health in a society is only that of the number of ‘unadjusted’ individuals, and not of a possible unadjustment of the culture itself.” (Fromm) I am convinced by this, on the one hand, but the forms of insanity I’m suffering from are going to kill me, and I can’t wait for society to fix itself: my body and soul are crying out, “help me now!”
I am very open about my so-called disorders. I share in private recovery meetings, I share publicly, I let practically everyone I know in on everything. I don’t want secrets. I don’t want shame. I don’t want to worry about my job prospects. I don’t want to worry about what people might think of me. I am what I am.
I hope that, by being open, others who might be suffering will feel free to ask me for help. I don’t have much to offer: just my story, my journey from insanity to sanity, addition to sobriety. But sometimes that’s enough. If not, I can connect them with someone else. Or maybe someone can just get something out of my story by listening, even if we never meet each other.
I am bothered by two recurring phenomena that plague addicts and other mentally ill individuals. I’m glad we’re tackling stigma here, but how are we ever going to influence more people to simply be willing? Be willing to listen to fellow sufferers, be willing to listen to medical and community professionals, be willing to listen to writers and artists who have written eloquently about our afflictions? Lack of willingness is killing us. It almost killed me: my alcoholism was so advanced and so destructive - to me, my family, my friends, my colleagues - but for the longest time I didn’t care. I wasn’t willing to get help. I wasn’t willing to end the madness. Eventually I did, but I was right on the edge. Many others never quite make it over to willingness.
The other phenomenon is related to willingness, and that is simply taking our medicine. I heard from a psychiatrist and a psychiatric nurse that getting patients to take their medication, and to continue taking their medication, is the number one problem in the field. I get it: I miss the expanded mental and emotional field I used to inhabit. I miss mania. I’d like to not be thirsty 100% of the time. I’d like to not have to pee 100% of the time. I’d like my metabolism to speed things up a little. I’d like other medications I take to not make me so grumpy and dysfunctional. But I persist, because I also like living in that sane middle zone. I like having as little drama in my life as possible (except on stage and screen). I like not feeling suicidal. I like not being delusional.
Complacency, amnesia, denial, laziness, defiance: I think these human characteristics explain why we stop taking our meds. Or stop going to recovery meetings (even when we know that they saved our lives).
I don’t know how to solve those problems. I guess all I can do is talk openly about them, and to continue talking about my journey.
“I'm standing on the edge of some crazy cliff. What I have to do, I have to catch everybody if they start to go over the cliff— I mean if they're running and they don't look where they're going I have to come out from somewhere and catch them. That's all I'd do all day. I'd just be the catcher in the rye and all. I know it's crazy, but that's the only thing I'd really like to be. I know it's crazy.”J. D. Salinger, The Catcher in the Rye.