Mental Illness: The View From Within

WBUR Cognoscenti, May 14, 2013

Amid the search and subsequent capture of Boston Marathon bombing suspect Dzhokhar Tsarnaev, and in the weeks since, I was riddled with fear, dread, and curiosity.

I think that range of emotions was fairly common.

Perhaps slightly less common was the other emotion I felt: a vague sense of shame.

As someone who struggles with mental illness, I was waiting for everyone to start speculating about depression, bipolar disorder or schizophrenia as a possible explanation.

Assuming that violent perpetrators are mentally ill is common. (Sometimes they are. Sometimes not.) We theorize about mysterious disorders and imagine the dark demons that must lurk within killers like Tsarnaev or Newtown’s Adam Lanza. We assume something must be wrong with them. How else could they be capable of such unspeakable destruction?

So I was relieved when people who knew Dzhokhar Tsarnaev started coming forward. Former classmates and teachers describe him as a friendly, social guy. A person they would never have suspected capable of such devastating actions. Someone who was not depressed or despairing. This time, at least, I would not have to listen to ignorant comments about mental illness.

That ignorance is painful for me as someone who has bipolar disorder 2, the milder form of the condition. It’s scary to talk about, because I never know what people will think of me once they know. Will they think I’m kind of broken? Somehow lesser?

Mostly I get one of two reactions: skepticism or quiet sorrow. People don’t get it. No, I don’t have voices in my head — other than my mother’s. What I live with is basically terrible mood swings. I have phases of deep depression: pockets of emptiness, times when I feel I orbit around people, detached and yet in deep, inexplicable pain. These times are interspersed with normal, stable periods and also with times of troubling highs called hypomania — not to be confused with full-on mania, which can necessitate hospitalization. During the highs, I have endless energy, I accomplish many tasks, I join groups, I try new things — perhaps too many. This might sound like what everyone experiences normally; we’re all part of the wide spectrum called the Human Condition. Even someone like Dzhokhar Tsarnaev.

But the common misconceptions of mental illness — and the often mistaken associations between such illness and those who commit atrocities — make it hard for those of us who are “garden-variety” people who happen to be struggling with cycles of deep pain. Even I hadn’t quite accepted my diagnosis until recent age-related hormonal activity forced me to. I also feel a little embarrassed taking up diagnosis space when there are so many more needy than I. But more than that, I feel the fear of contempt. I’m a public speaker, a college professor and a former local politician; because of the widespread ignorance, my mental illness may damage my credibility — which it should not. It might cause people to pity or fear me, which they should not.

Despite my fears, I am speaking out for the first time because I think it will help. As a society, we need to know that the mentally ill are among us, and we have to understand what they — we — need: acceptance and support. As with any disability, those affected need help, access to health care, and a society that follows the facts, not Grimm’s fairy tales. Indeed, if society makes it impossible for even a bipolar 2 person like me to acknowledge the disorder for fear of ostracism or worse, how much harder is it for the more extreme cases?

The fact is, most people with mental illness are not dangerous — particularly if they are under a doctor’s care. According to a July 2011 piece in Scientific American, “Surveys show that 60 to 80 percent of the public believes that those diagnosed with schizophrenia, in particular, are likely to commit violent acts… [yet] in reality, severely mentally ill people account for only 3 to 5 percent of violent crimes in the general population.”

Ignorance and fear about mental illness are understandable, particularly during a crisis, when emotions run so high that it’s hard to think rationally. But they are not acceptable. Our ancestors blamed demons or parenting or original sin because they didn’t know any better, and they didn’t know how to help. But we do. We have educational, sensory, behavioral and medicinal therapies for people on the autism spectrum and for mental illnesses. We should embrace these developments and make them widely accessible.

The way I have come to understand my diagnosis is in terms of neurology and brain chemistry, not morality. Until we as a country and culture understand and support those with mental disorders, we will not make headway against human suffering. We have to know what really made the Tsarnaevs or Lanza act as they did. Was it something as simple — and yet utterly complicated — as pure Evil? And what does that mean? How is evil created in a person and defined by science? We need to be able to tease apart the real causes of violence to begin solving our most terrible problems, or else we face the prospect of isolating and endangering even more innocent people around us.