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Of all media representations of mental illness, I’ve always particularly loved Crazy Ex-Girlfriend.
If you’ve never watched it, CXG is a four-season television series that spans comedy and drama, and offers acerbic social commentary with a satirical edge. Through the unfolding of main character Rebecca Bunch’s “unhinged” romantic misadventures, it’s silly, delicate, tongue-in-cheek, witty, honest, compassionate — with all this packaged up in sometimes outlandish, often infectious musical numbers.
There’s one particular track that’s always hit close to home for me: A Diagnosis, Season 3. As Rebecca sings: I’m aware mental illness is stigmatised / But the stigma is worth it if I’ve realised / Who I’m meant to be / Armed with my diagnosis.
I always thought — maybe hoped — that diagnosis would help me to feel real.
A little numb. A bit empty, hollow. Reliant on a juggling act of assorted commitments to stave off the agonising state of feeling not much at all — because at least the anxiety means I am still alive. Bored, restless. Not quite a sense of wanting to die; more an odd comfort or apathy towards the idea of never existing in the first place.
I’ve had psychologists on and off for years now, and these are all words / phrases / sentences that I’ve used before, to describe so what brings you here today. None of them, nor even the combination of them, quite fit; emotions are often too slippery to articulate. And of course, unlike snapped bones, hacking coughs, or a nasty rash, usually there is only tell, no option to show.
And when there’s no option to show — well. I’ve had a lot of medical folk describe me as “functioning”,* because my words don’t quite do enough to reframe what they do see. I’ve had a lot of mental health professionals look at me and decide that, because I can still get out of bed and hold down a full-time job and clean my apartment, I am really Not Doing So Bad. I am clinically Just Fine, Actually. My distress keeps me gasping for air, but it has not drowned me — so I do not yet need to be fished out.
It wasn’t that I wanted to be unwell, no; the opposite, really. I was already feeling so unwell, and in a cycle of denial about it. I just wanted somebody to give me the permission to admit it.
*My current GP and psychologist team are stellar, and I am deeply grateful. I just wish it hadn’t taken years for me to get here.
For the record: at the same time, I struggle with the concept of diagnosis.
Psychiatric conceptions of mental ill-health reflect the medicalisation of social inequalities — and so to an extent, I think they should be challenged for individualising and pathologising macro-level, structural forces of oppression.
How much of depression, for example, is just the inevitable state of being in a capitalist political economy that valorises neoliberal values of productivity, such that any spare moment to just sit, breathe and feel joy is a moment wasted? How much of social anxiety is simply the distress of being a young woman of colour in a settler-colonial, White supremacist state, that requires me to confirm to standards of Whiteness? We live in systems that, by design, compel us to survive, but do not allow us to thrive.
Psychiatry has its roots in discrimination: think, for example, the condition of hysteria, once considered a mental illness afflicting women. We should be conscious of how it continues to be discriminatory today, because it has been and will continue to be used to uphold structures of power.
And yet, despite knowing this, despite my best instincts: I find comfort in being classified. In the authority of science. In being told that it’s not me, it’s just my brain.
The problem is — diagnosis is not an end, but a beginning.
Rebecca Bunch learns this all too quickly. Diagnosis sends her into a panic when she makes the fatal mistake of googling BPD. And I, too, am learning this now; that having a clinical label, a description, still cannot guarantee a magic bullet cure.
I still have to do the hard work of therapy — knowing the acronyms that describe the style of my treatment doesn’t relieve me of that. Medication won’t necessarily be effective for me, the way it might be for somebody else — I might need to wash out and taper in a few more times before I nail the right one. Having a term to describe my state of being does not fundamentally change that state.
But hey, it’s a start. And I am still trying.