Personality or Pathology?
There is this funny thing about how society identifies mental illness that does not extend to other ailments; we have this tendency to identify (and self-identify) people as their mental illness, instead of a person with a mental illness. In my lifetime I have never heard anyone say “I am cancer”, or “that girl, she is multiple sclerosis”. However, I have heard a lot of people say “I am bipolar”, or “my uncle is schizophrenic”.
Something that reinforces this already established tendency is an increased focuses on all things brain related and the idea that calling mental illness as a brain disease will reduce stigma. The brain disease model thankfully reduces blame towards the individual suffering but it does not necessarily reduce stigma especially self-stigma, because we do not think of our brains the same way we think of other organs. Our brains are considered to be the epicentre of who we are, so when someone’s brain is sick that sickness encompasses their identity.
I understand the intent behind using the brain disease terminology and even the over usage of diagnostic terminology, and initially I was relieved to have a term to explain why my life was so chaotic, painful, and messy. My descent into mental illness caused me to feel like an incomplete person and at first being able to explain it to myself by saying “I am bipolar” or “I have a brain disease” took some of the weight off my shoulders. However, over time as the diagnostic terms began to multiply the concept that my brain was diseased, that my biological and genetic makeup made me broken, began to weigh on me almost as heavily as the symptoms did. There is a difference between acceptance and self-condemnation; I condemned my future self because I thought my biology wouldn’t allow me to have the life I wanted.
When a person spends a lot of time talking about their feelings as symptoms they can develop a tendency to reflexively pathologize their thoughts, feelings, and actions. I was not sad I was depressed. I was not happy I was hypomanic. I was not quirky I was compulsive. I didn’t talk too much I was hyper-verbal. My hobbies were not fun they were therapeutic. People say some medications make them feel numb; having your personality transform into a pathology makes you feel numb, detached, like a sleep deprived med student observing a case study that just happens to be your life.
This kind of transformation can result in a loss of authenticity. At times I was unable to tell what feelings and thoughts were authentically my own and what were the results of a diseased brain. Because I felt like strong feelings were symptoms and that symptoms were bad I revoked my permission to feel. I became despondent over statistics and the poor outcomes research studies indicated for my particular brand of crazy. I thought that because I had a medical problem that I should only be receiving medical treatment so I would push for medication over therapy, and when the medications alone didn’t ‘fix me’ I would feel more hopeless, more isolated, more broken.
This is why I strongly believe that medication and diagnosis are just a part (although an important one) of an INTEGRATED recovery that also includes proper therapy, peer support, and skill building. People are not pathologies; identifying a person by their illness and not their name increases isolation and self-stigma.
These days if someone says to me ‘so, you’re bipolar?’ I respond with ‘no, I am diagnosed with bipolar. I am Stella.’