What the hell is “mental illness”?: an introduction

I was 20 years old when I took a handful of pills. White, yellow, and blue pills marked with codes that mean something to drug companies but nothing to me. There was nothing memorable about that night. Nothing glamorous about the table or the beat up old sofa or even my life at that point. But, I will never forget the friction of each pill traveling down my dry throat as I took another sip of awful beer supplied by my fraternity house for the night.

At a glance, I wasn’t any different from everyone else in the room. They were my frat brothers, teammates, and friends. They took those pills. They drank those beers. They laughed. Sometimes, they cried. Except. I was filled with an overwhelming hope that what they perceived as just another normal night of partying would be my last.

I still struggle to recall exactly what happened that night. Why was I so torn apart? How had I ended up there? What was going to happen next? Was this a suicide attempt? It’s not like this hadn’t happened before. So — attempts? It all still seems to blur together. The only thing I remember for sure was thinking, ‘I need help.’ And, now, that I did a fucking fantastic job of hiding it.

The next week, I drove back to Chicago with my best friend before he flew home to meet his family for the Thanksgiving break. Did he know that something was wrong with me? As we barreled up I-65 in a snowstorm blasting Frank Ocean’s Channel Orange, I felt relieved to be away from school, but terrified to go home. I had scheduled an appointment with my primary care physician to talk about how sad I had been feeling. I had called my mom before leaving campus and explained that I needed to get in for a checkup NOW. She had seemed surprised, and was placated by a lie that it was for spring lacrosse. I’d been perfecting these lies for years, and it slid easily off my tongue. So, two days before I had to sit down with my family members that weren’t thankful to be at the same table with each other, I had to tell a stranger that I wasn’t thankful to be alive.

As I sat waiting for him, I picked out the rock salt in between the treads of my boots. I hadn’t showered in two days, was wearing dirty sweatpants, and still had my jacket on with the hood up when he walked in the examination room. If you’re going to take away anything from this post, let it be the age-old saying, “Always wear clean underwear in case you have to go to the emergency room.”

My doctor began a normal examination for a sport physical. I lifted my legs, took deep breaths, and said ahhhhhhhhhhhhhh when prompted. There was some light conversation about the upcoming basketball season as both of us attended BIG 10 schools. He asked how I was doing in my pre-medical coursework and about my family whom he all saw at his practice as well. He finished his examination and closed up my chart, which prompted me to make a sound that I can only imagine sounded like a car crash as I tried to get his attention for “one more thing.”

Apple usually releases a new iPhone when Tim Cook stands up on a stage and says, “one more thing.” I only managed to announce that I was feeling (overwhelmingly) sad and was wondering if I could try some drugs to make it go away. My doctor shouldn’t have been surprised. This wasn’t the first time I had expressed it to him, or to my family and friends. I started feeling “sad” years before, but it was written off as “seasonal” and I was told to just take Vitamin D and to use one of those stupid lamps.

As expected, he balked. I watched the look of judgment wash across his face. My ratty outfit became less of an ode to street wear and more of a representation of craziness and laziness. He pulled up a chair and made me repeat myself. I explained to him how I was stressed about my future in the medical world, how my life at home wasn’t great, how I was not finding any joy in the things I was doing, and how my drinking and drug use was moderate yet concerning. This was my way of saying, ‘Hey, doc, I am trying to kill myself.’ He was supposed to see that through all my words. But, he didn’t.

In the end, he told me that I should feel this way because studying medicine is hard and everyone’s family is just as dysfunctional as mine. He told me that he felt the same way during his residency. Was this supposed to make me feel better? I declined the Lexapro prescription (but called back a few months later with a desperate demand to have it filled), mumbled a thank you for the therapist recommendation that he had offered with such resistance that I knew I would never gather the courage to make an appointment, and went home having been stripped of my dignity and 140 dollars.

It has been three years since that visit, and, while I wouldn’t say that my sadness is gone, things are… better-ish. In that time, I have become involved in mental health advocacy work, which helps me the most in terms of staying positive about my experience. It allows me to be a creative, to tell my story in ways that break down walls, and to help others who have had similar experiences with mental health.

I helped start a program at my University that is focused on mental health stigma reduction and uses student input to develop initiatives that compliment bleeding edge research. Bring Change 2 Mind, a non-profit organization co-founded by actress Glenn Close, backs the program and their unreal Scientific Advisory Council measures the work — you should look them up. Through this, I had the pleasure of almost peeing myself while speaking at BC2M’s gala in front of a full room, including about a dozen famous people, about my experience and college mental health reform. But it was worth it as we raised over a million dollars for mental health programs that night. (I’ll be in attendance again this year so, if you’re in NYC in two weeks and passionate about this cause, donate here.)

I served on a national student board for the JED Foundation to help implement and evaluate national college programs aimed at suicide prevention, and developed focus groups at my University that bolstered insights into early intervention and transition year programs to protect students facing mental health issues.

I befriended my abnormal psychology professor when she let me into her office not to talk about exams but about how I was doing and cared about me more than any college professor should. (Irene, if you’re reading this, thank you.)

I graduated from college and am continuing my education at medical school where I’m working on a graduate degree and a translational project that focuses on the functional neuroanatomy behind panic, fear, and anxiety in relation to new anxiolytic drug treatments.

I finally talked to my friends and family about how I felt three years ago, how I feel now, and how I strive to feel in the future. I am stable, accomplished, and — at times — happy. Perhaps most importantly, though, I feel like I have something to live for.

I still have days when all I can do is hide in bed and cry. When I’m consumed by waves of suicidal thoughts. When I think I am going to have to check myself into inpatient. This is the unfortunate reality of having this disease. And, I still feel scared to admit those things. Especially when I feel completely helpless because all of the drugs that have been thrown at me do nothing but give me side effects without any actual treatment benefit and when good therapists are impossible to come by due to access and funding issues.

But, despite this harsh reality, I continue to live. And, all things considered, I feel like I have made (and continue to try to make) the best of my situation. Somewhere in this experience, I have found the knowledge and drive to build projects and talk about experiences that can actually help make others’ lives better.

Most articles would end here. (Albeit, most articles also have a much more profound and uplifting ending.)

This one will not.

My story is not the point. And, I do not share it with you in the hope that someone will send me a congratulations card because I did not kill myself or offer me self-esteem boosting comments. I’m not looking for a round of applause for sharing my story to overcome stigma. I only offer it to you as a way to validate my perspective. And, to show you some transparency in a field where writers, speakers, and leaders are generally too scared to offer up anything too real because of the fear that their words will follow them for life. My story is a plea to convince you, the reader (hopefully, a reader that is passionate about understanding and fixing mental health issues), that I know a thing or two about suicide, mental health, sociology, neuroscience, and how to create (or, at the very least, dream up) effective mental health care programs and organizations.

My story aims to portray that I have a general understanding of the lay of the land when it comes to the many ways that we as a society try to treat / fix / hide / cure / obscure mental illness because I have inhabited these spaces and spent a decent amount of time looking around in them. I am not claiming to know it all. I am not trying to invalidate anyone else’s experience by asserting that mine is more important or robust. My take on this topic is formed through the lens of my experiences. And, what I am going to try to do now is synthesize some of my views to attack a topic that I believe to be deeply flawed — mental health advocacy and suicide prevention.

It is no secret that mental healthcare is broken. (Yes, some things have worked. But, in general, the system is a train wreck.) Over the next few weeks (that will probably turn into months because studying science has a way of taking over your life), I will be posting a series of blogs that will attempt to explain what isn’t working and why it’s not working, what is kind of / maybe working, where I believe we should be investing our time and money now to make things work in the future, and what I would do if I could start with a clean slate to make a cohesive and functional mental healthcare system.

I’m talking a serious deep dive into topics such as rhetoric and language; the history of mental health and mental health treatments; non-profit roles; government programs like the VA, the ACA, and Medicare / Medicaid; health insurance company regulations; #hashtagactivism; how I think suicide prevention is a total fucking myth; academic research funding; big data struggles; the implications in using the word ‘stigma’ versus ‘prejudice’ and ‘discrimination’ in mental health descriptions, etc.; and how all of these things work together in a space that is supposed to create positive treatment outcomes, but, in reality, has more or less failed hundreds of thousands of people.

Obviously this is a topic that has greatly affected me. Some of the takeaways here are going to be surprising and some are going to be pretty common sense. But, if you are mildly interested in mental health, healthcare, politics, history, technology, or just enjoy attempting to make the world a better place, I think that I will catch your attention in the coming weeks.

So, please take some time out of your coming days to think about this issue more than just in passing. You not only owe it to your family, friends, co-workers, and random people on the street, but also to yourself. Mental illness may only affect a few of us, but mental health affects everyone.