Is it unreasonable to say that, sometimes, mental illness can make it really tough just to get through your day? 

I have OCD, but my particular brand of anxiety sometimes takes on the rancid bouquet of depression;  suffice to say, it can be extraordinarily challenging to complete ordinary tasks and responsibilities while trying to manage depressive, self-destructive thoughts. 

Everyday mistakes, like arriving at work a few minutes late, may become moral failures so atrocious they can only be rectified by suicide. You pray no one criticizes you, even if their complaints are reasonable and well-intentioned, because any disapproval may become a screaming indictment of your basic value as a human being. And if your slip-up occurred because of your internal struggle: expect to despise yourself all the more, to be swept up in a maelstrom of self-loathing where your condition is a sign of weakness and cause for self-recrimination that worsens your state.  Your brain becomes the audio book of a lesser Dostoevsky novel, but personalized like one of those gimmicky children’s books with your name substituted for that of the protagonist. 

It would be nice if the afflicted could request special accommodations, the way someone in a wheelchair might have access to a ramp. Sadly, mental illness continues to be viewed differently than other disabilities. 

If you tell someone you have cancer, after all, they will probably be sympathetic. But crazy is not cancer. Mental illness is more like cholera, or a difturbance of the humorf;  people see it as quaint, archaic, some vague condition from the Victorian era that may never have existed in the first place.  Or they treat it like it’s AIDS in the early nineties, when people were convinced they might die if they shook a victim’s hand, because RENT and Angels in America hadn’t been invented yet. So until we get a massively successful, Tony-Award eligible elucidation of the plight of the mentally ill (Sondheim, Sweeny Todd is great but I’m afraid it doesn’t quite fulfill this assignment) these misunderstandings will continue to exist.

Even if you open up to a friend who is sympathetic, awkwardness still ensues. There’s no proper etiquette for how to tell a coworker, “Hey, just a heads up, but you may have to fill in for me for a few minutes today because I might lock myself in the restroom, tearing at my scalp til it bleeds, praying to God for the strength not to destroy myself.” It’s kind of a conversation killer. Or worse, that friend might turn it around and confess to you that he or she had an uncle who killed himself, or that they suffer from an eating disorder, or any of the countless other afflictions that plague about one in five adults. In these situations both the confessor and confessee are further burdened, now concerned for the wellbeing of their suffering comrade-in-arms as well as their own. It is like a Yankee Swap of pain, a Secret Santa of psychosis.

I wish I had the answers. I wish I knew how to better manage my symptoms while also keeping up with my everyday responsibilities. And I wish I knew how to tell my friends, family, classmates and coworkers when I’m in the Satan’s armpit of mental anguish, in a way that’s informative and helpful instead of distressing for both parties. 

The sad truth is that the disclosure of mental health problems is still taboo in this country, where we prize self-reliance and judge harshly those who appear to shirk their responsibilities.

As a society, we need to sit down with a family counselor and hash out how to talk about this stuff.  The only thing worse than suffering is suffering in silence.

Copyright, Fletcher Wortmann, 2012. 

Author of Triggered: A Memoir of Obsessive-Compulsive Disorder (St. Martin’s Press), named one of Booklist’s “Top 10 Science & Health Books of 2012”.

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