Unshrunk

Preface

My youth was shaped by the language of psychiatric diagnosis. Its meticulous symptom lists and tidy categories defined my teens and twenties and determined my future. I believed that my primary con­dition, bipolar disorder, was an incurable brain disease that would only worsen without medications, therapy, and the occasional stay on a psych ward. This belief was further reinforced each time I heard of the tragic destruction befalling someone who stopped her meds because she thought she could outsmart her disease. I embraced the promises of a psychopharmaceutical solution, welcoming the regi­men of pills I ingested in the hope that they’d bring me stability, reli­ability, functionality. That they’d show me what it felt like to be happy or, at the very least, have some peace of mind. That they’d maybe, one day, even provide me with the chance to feel something close to normal.

I took all of this as objective fact; who was I to question any of it? I wasn’t a doctor. I hadn’t gone to graduate school to become an expert in brain biochemistry. I didn’t know how to interpret scientific re­search or comprehend dense pharmacological information. Doctors made an oath to, first, do no harm, after all. If there was a better way to resolve my dysfunctional suffering, I surely would have heard about it. My parents had the financial means to get me top-notch care from some of the nation’s best doctors and psychiatric hospitals, and so we dove right in, desperate for answers, eager to get me needed relief. We accepted the grave reality that came with a disease like bi­polar disorder: the unpredictable ups and downs, the inability to take on too much stress or responsibility, the many impulsive mis­takes and destructive behaviors I’d engage in during unmanageable episodes, the risk I’d kill myself. For fourteen years, I lived tethered to the belief that my brain was broken, and redesigned my entire life around the singular purpose of fixing it.

If you’d told me back then that I’d one day decide to face my ago­nizing emotions, twisted thoughts, and relief-seeking impulses with­out translating them into symptoms to be treated with prescribed pharmaceuticals, I’d have called you crazy. If you’d told me that I’d eventually decide to leave behind the idea that I had serious mental illness, the only framework for understanding my emotions and be­haviors that had ever made any sense to me, I’d have been offended, convinced as I was that the only way for my pain to be properly ac­knowledged was through its medicalization. And if you’d handed me a memoir like this, I’d have glanced at the book jacket and handed it right back, outraged at the mere insinuation that my fourteen years of self-destructive madness might never have needed meds in the first place, or been symptoms of a brain disease at all.

The simplest way to put it is that I became a professional psychiat­ric patient between the ages of thirteen and twenty-seven. The best way to describe what happened next is that I decided to leave behind all the diagnoses, meds, and professionals and recover myself.

There is no “antimedication” or “antipsychiatry” moral to this story; to be clear, I am neither of these things. I know that many peo­ple feel helped by psychiatric drugs, especially when they’re used in the short term. I find it counterproductive to orient myself “against” anything. In fact, there is much that I am for in the context of this labyrinthian ecosystem we clumsily call the mental health system. First and foremost, My Body, My Choice, and the right we each have for this choice to be fully, accurately, and therefore meaningfully in­formed. This book is a story about informed decision-making: what it takes to make a true choice regarding psychiatric diagnoses and drugs, the repercussions when you don’t have the information neces­sary to do so, and what happens after you realize the choices you thought you’d been making were never really choices at all.

For a long time after I made the decision to leave behind my psychi­atric diagnoses and drugs, I flailed and floundered, overwhelmed by raw emotion as I faced the menace of the unknown: How will I ex­plain my agonizing struggle, if not with the language of mental illness? What will I strive for, if not the right treatment? What will it mean for me if I can no longer explain away my hurtful behaviors as symptoms of a faulty brain? I navigated the brutal aftermath of stopping psychi­atric drugs in constant panic: Can I really survive without my meds? What if it was a terrible decision to think I don’t need them? What if I’ll never be stable? What if I actually do have bipolar disorder and it gets far worse? What if those doctors were right and I can’t manage on my own? What if I kill myself? I was unsure of truth and delusion, right and wrong, and where I even belonged, but in the eye of that storm—at the culmination of this disintegration of self—I realized there was a force pushing me forward: curiosity. If I don’t actually have a chronic, serious mental illness that requires me to take meds for the rest of my life, what could my life become?

It’s been fourteen years since I last took a psychiatric drug or looked in the mirror and saw a list of psychiatric symptoms looking back—and not because I no longer experience intense emotional pain and paranoia and debilitating anxiety and unhelpful impulses, which I still very much do. Right now, were I to go through the Diag­nostic and Statistical Manual of Mental Disorders (DSM), psychiatry’s diagnostic bible, I’d meet the criteria for several of its diagnoses. But here’s the thing: I no longer view this textbook as a legitimate or rel­evant source of information about myself, nor do I have any use for the various diagnoses it would tell me I have. While a lot in my life has changed for the better as a direct result of healing my brain and body from psychopharmaceuticals, much of what happens in the space between my ears is as dark and messy as ever. (In some cases, more so.) When it comes to the inner workings of my mind, the pri­mary difference is that I’m no longer afraid of what I find there.

I was once mentally ill, and now I’m not, and it wasn’t because I was misdiagnosed. I wasn’t improperly medicated or overmedicated. I haven’t miraculously recovered from supposed brain diseases that some of the country’s top psychiatrists told me I’d have for the rest of my life. In fact, I was properly diagnosed and medicated according to the American Psychiatric Association’s standard of care. The reason I’m no longer mentally ill is that I made a decision to question the ideas about myself that I’d assumed were fact and discard what I learned was actually fiction. This book is a record of my psychiatric treatment, my resistance to that treatment, and what I’ve learned along the way about my pain. I decided to live beyond labels and cat­egorical boxes and to reject the dominant role that the American mental health industry has come to play in shaping the way we make sense of what it means to be human. This book—these pages, this story, my story—is a record that has been unshrunk.