The Beauty in Mental Illness

Look more closely and you'll see.

Posted Jun 30, 2018

The illness is not beautiful.  But there is beauty in the person.  This is what people who do not understand mental illness or who do not know anyone who has a mental illness (and there actually aren't many such people) don't get.  They think the illness defines the person, consumes the person, colors the person altogether, becomes the person, is the person.

 After all, we use the verb "to be" in designating someone who has a mental illness: he's crazy; she's a nut; he's weird; she's bi-polar; he's depressed; she's schizophrenic; he's a drunk; she's OCD; he's a fruitcake; she's manic; he's not all there; she's agoraphobic. And on, and on. Not only do we allow ourselves to use coarse slang that political correctness has cleaned up everywhere else, we also, in using the verb of identity, define a person by the description. You are your diagnosis. As if everything else about you suddenly takes a backseat. What matters is your mental illness. It is who you are. And by it being who you are, it severely limits who you may become. We do not have or allow great expectations of the mentally ill.

How wrong we are. There was this lawyer from Illinois. He was famous for helping people beat the murder rap. He was a slick talker and a tall glass of water, ungodly thin with an Adam's apple the like of which you've never seen. He dressed in black a lot, which was in keeping with his temperament, because he could be pretty gloomy some days. He could be a downer. But you give him a jury to address or a hayfield full of voters to talk to, and the spirits above filled him up and he delivered like Cicero himself on his best day in the forum. Of course, this mentally ill, strange, weird, too tall, ungainly fellow went on to become our greatest president in history and maybe our greatest orator as well, Abraham Lincoln.

I've just spent the past 3 days at the NAMI convention, the gathering of the National Alliance for Mental Illness. About two thousand people gathered in one of my favorite cities, New Orleans, where I went to medical school, and heard presentations on all manner of subjects related to caring for people who have chronic mental illness. The driving force behind the convention is the Medical Director of NAMI, Dr. Ken Duckworth.

Ken is a true American hero. Now 59, he grew up with a dad who had what was then called manic-depressive illness. A traveling salesman, Ken's dad would sometimes come home fine and dandy, but, like as not could come home crazy as a bedbug and throw the whole house, Ken and his brother and sister and mother, into a topsy-turvy tailspin. Ken grew up managing chaos, along with his mom and sibs. He learned as a little boy how to ride the bull called a manic episode, only a manic episode, unlike a rodeo bull ride, lasts more than a few seconds.

Ken turned those years of growing up on guard, not knowing what would come next into a stellar college career at the school he still loves dearly, the University of Michigan, then on to medical school, then on to a residency at the Massachusetts Mental Health Center, a Harvard teaching hospital, but also a state hospital specializing in the care of the severely, chronically mentally ill, people like Ken's dad.

Ken went on to become the Commissioner of Mental Health in Massachusetts and now the Medical Director of NAMI, in part as homage to his father and his family. He saw—and sees, boy oh boy does he ever see—the beauty in the people who have the illness. Just as he saw the beauty in his dad, not the beauty in his disease but the beauty in the rest of his person, he sees the beauty in the millions people he now serves through his work with NAMI. He gets paid little, but he tells me he feels rich with the rewards he feels as he walks around the convention, which some people call the Ken-vention, and sees the gratitude on the faces of the people lucky enough to find the money to come to New Orleans for this event.

The illness colors the person, it can separate the person for a time from the world, it can make it all but impossible for others to connect with that person, but, if you look closely, you can find the beauty in the person. You may have to wait a while. People with severe mental illnesses—I don't even like the term, I prefer eccentricities, but no one funds research into eccentricities—usually have trouble connecting and communicating. You may have to wait a while.

But then there will come a moment like the one with my patient who when psychotic—which means not living in the same reality as the rest of us—was refusing to take the medication that would have brought him back to the reality the rest of us lived in. I was talking with him about maybe giving the medication a try, and he was having none of it. I said to him, "Well, of course, you don't have to take the medication of you don't want to, but could you possibly tell me why you don't want to take it?"

His response constitutes one of the most poignant and beautiful insights I've ever heard, and this from a man who was psychotic. "It's personal," he said to me. "It's so personal, even I don't know why."

How much of who we are and what we do and why we do what we do is personal, so personal even we don't know why. This is the beauty in these people, in us all, if I may. The beauty that Ken Duckworth saw growing up, and sees today, and serves today, the beauty in a population that is perhaps the most neglected of any minority population we have.

The chronically mentally ill do not constitute a powerful voting bloc. Few of them are rich. Not many of them command armies or large organizations or have the power to change the world, at least not today. But they are some of our most heroic people, going about their homeless business, finding a way. And they can change your world if you will let them, if you will notice them, if you will join Dr. Ken Duckworth and his growing, gathering herd of people who care, of NAMI, of you, me, and all the people you can tell.

The fact is that most people who have exceptional creative talent are touched by one or another of the conditions we psychiatrists diagnose—from anxiety disorders to depression to ADHD and dyslexia to substance use disorders to bi-polar disorder to post traumatic stress disorder to name the most common—and it is shame and stigma that keeps these talented people from getting the help they need.  

I tell people "I don't treat disabilities, I help people unwrap their gifts." If we can see the beauty in the rest of the person, if we can see past the damaging part of the condition, we can begin to tear down the stigma that wreaks so much damage. It's time to celebrate difference, while also providing treatment for the ill part of the whole person.

Remember Ken Duckworth, on alert when his father came home, and instead of learning to hate and fear him, learning how to love him in spite of his unloveable side, and not only that, turn his love for his dad into his life's work, his love for all people who contend with minds in need of help.

I hope you all will consider joining NAMI (NAMI.ORG). Moreover, I hope you will look past the illness and find the beauty. It's there. I guarantee you, it's there. And how much more gratifying to find a diamond not in a setting of other diamonds, but among coffee grounds and egg shells on the side of the road.