What’s in it for me? An intimate look into living with mental illness.
What’s the line between sickness and health?
For many physical ailments, the distinction is fuzzy. But for mental illnesses, things get even more complicated. Although the stigma in society is slowly lifting, mental illness remains hard to quantify. The systems meant to treat it often fail to see the humans behind the diagnoses.
By telling intimate stories of those afflicted, this Blink illuminates the complex forces that can shape psychic crises. It exposes the limitations of our current frameworks and reveals the porous boundary between sickness and health. Most importantly, these stories prove a testament to the resilience of the human spirit.
Rachel
Many kids are picky eaters. But few refuse to eat altogether.
Rachel Aviv, the author, was diagnosed with anorexia nervosa at the remarkably young age of six. During one of her school lunches, she started rejecting food. She got the idea during Yom Kippur, a Jewish holiday her family had recently celebrated, which includes fasting. To Rachel, not eating felt powerful and holy. It also gave her a lot of attention from the adults in her life, who were desperately trying to feed her.
They failed. After two weeks of barely eating, Rachel was sent to the Children’s Hospital of Michigan, in Detroit. She was placed in the eating disorders unit. There she met two older girls, Hava and Carrie. Her new friends, almost twice her age, became her mentors in disordered eating.
Although Rachel didn’t fully understand the competitive thinness that Hava and Carrie strove for, she was drawn to their secret society of starvation. She began imitating their behaviors, such as compulsively exercising and comparing body measurements. Their fervor now reminds Rachel of medieval Christian women who starved themselves to become closer to God. Hava in particular romanticized their suffering.
Eventually, the nurses made Rachel’s visitation rights contingent on finishing her meals. After going 12 days without seeing her parents, she finally relented. Reunited with her family, the spell was broken. Within six weeks, Rachel made a full recovery. The illness never returned.
Looking back, Rachel contemplates how narrowly she avoided a full descent into a lifelong eating disorder. She questions whether she truly had anorexia. Because she was so young, she had limited exposure to cultural messages about thinness. She also didn’t truly grasp the meaning of a psychiatric label like “anorexia.” If she had, how would her life have been different? How does a psychiatric diagnosis change a person’s self-narrative?
Barely understanding her experience, Rachel narrowly escaped a lifelong affliction. The older Hava wasn’t so lucky. Rachel later learned that she continued to struggle, spending her life in and out of hospitals. She died at just 41, due to a medical emergency likely related to her condition.
Ray
In 1979, a curious patient checked into the prestigious Chestnut Lodge psychiatric hospital. Once a charismatic, albeit overworked physician, Ray had descended into a deep depression after his ex-wife and children moved to another country. At the Lodge, he spent his days obsessively walking the halls – about 18 miles a day – while ruminating on his professional downfall.
The Lodge specialized in treatment via traditional psychoanalysis. This therapy method, pioneered by Sigmund Freud, focused on unearthing unconscious desires, fears, and conflicts to resolve them. The therapists at the Lodge urged Ray to gain insight into his destructive behavior, interrupting his self-pity.
But Ray’s depression proved persistent. After months with no improvement, his mother transferred him to another hospital. The Silver Hill Clinic in Connecticut had taken a radical step for the time and embraced the newly available antidepressant medications.
Once admitted, Ray was put on a combination of the antidepressants Thorazine and Elavil. He rapidly improved, regaining his sense of humor and creativity. After his recovery, Ray became an eager student of the new biological model of mental illness. He was convinced that his depression had simply been a chemical imbalance that the antidepressants were able to correct.
Yearning for vindication, Ray sued Chestnut Lodge for failing to properly treat his depression with drugs. His case shook the field of psychiatry. It pitted the old psychoanalysts who embraced talk therapy against the new “biological psychiatrists” who embraced drug interventions. Ray’s lawsuit became a referendum on the proper way to cure mental anguish – through insight or medication?
In the end, Ray settled his famous case for $350,000. But the vindication never came. Ray’s career and family relationships remained strained. He spent decades revising a memoir of his experiences, unable to craft a peaceful resolution to his story. Ray still felt rootless and alone, writing poignantly near the end of his life: “Am I really this? Am I not this? What am I?”
Ray’s unresolved search for self-understanding shows the limitations of both the psychodynamic and biochemical models in explaining the complexities of human suffering. “Mental” illness is neither merely mental nor purely physical.
Bapu
Her family believed that Bapu was a lucky bride. Despite a limp that she’d had since childhood, her father was able to arrange a marriage to a wealthy businessman named Rajamani. Bapu’s family belonged to the Brahim caste – India’s upper class – and they’d bought a house for the married couple to sweeten the deal.
But Bapu didn’t think much of her new life. After the wedding, she quickly became unhappy with her critical in-laws and materialistic household. She began spending much of her time praying and writing devotional poems to Krishna. She likened herself to the sixteenth-century Indian poet Mirabai, who renounced her marriage for devotion to Krishna.
Soon, Bapu started acting on her desire to leave family life behind and live as an ascetic, devoting herself fully to her spirituality. Her family found these desires bizarre. They sent her to a local doctor, who diagnosed her with schizophrenia. But Bapu rejected this explanation as well as the antipsychotic medication offered to her. In her mind, she was simply seeking spiritual fulfillment.
She continued living at temples as a wandering saint, finding community among worshippers. But her concerned family repeatedly forced her into hospitals against her will, where she was given electroconvulsive therapy.
In her later years, Bapu reconciled to some degree with her family. She lived in her house again under the care of her daughter-in-law before dying from a stroke at the age of 60.
For a long time, her adult children, Bhargavi and Karthik, struggled to understand their mother’s life. Indian spiritual traditions celebrated their mother’s experience as sainthood. But the Western framework they learned about later dismissed their mother as mentally ill.
Today, Bhargavi and Karthik can reconcile the spiritual and psychological aspects of their mother’s condition. Bhargavi has tried to revive this pluralism through her mental health nonprofit, recognizing the importance of finding shared cultural narratives for psychic distress.
Bapu’s story shows that mental illness is never just in one person’s head. It has social, cultural, and spiritual dimensions that Western psychiatry often neglects.
Naomi
On July 4, 2003, Naomi Gaines stood on a bridge over the Mississippi River, holding her twin sons over the water. She kissed her boys goodbye, one after the other. Then she let go of them. She leaped in after them, arms outstretched, shouting “Freedom!”
A bystander who’d witnessed the scene dove in after them. He was able to rescue Naomi and one of the twins. But the other boy died.
For Naomi, years of punishment, both court-ordered and self-inflicted, followed. The world was appalled by her horrific act – a mother who’d killed her child. But at the time, Naomi believed that she was saving her young children from a hostile world.
Naomi grew up poor in Chicago housing projects, one of several kids of an overwhelmed mother. She longed for the warmth of the foster home that took in her sister. But for her, the rescue never came. When Naomi was in high school, her mom moved to Minnesota, fleeing from a violent boyfriend. Naomi, now with a child of her own, soon followed her. Shortly after the move, she experienced her first bout of depression and attempted suicide.
After somewhat recovering, Naomi got back together with her baby's father. They had another child together. Later, she started a relationship with a new boyfriend and had twin boys.
As a young single mom of four, Naomi tried to better herself by getting an education while trying to make it as a hip-hop artist. But as she read more books on Black history, she only sank deeper into crisis. Increasingly, she felt that the odds were stacked against her. The psychiatric institutions she frequented diagnosed her first with depression, then psychosis, then bipolar disorder. But they failed to understand the systematic pressures of racism that weighed on her.
Naomi’s downward spiral culminated in the horrific bridge incident in 2003. Afterward, Naomi served over a decade in prison. She got inconsistent mental health treatment and spiraled even further. But prison librarian Andrea Smith, was able to relate to Naomi’s struggle beyond her diagnosis. Relating to Naomi’s curiosity and instinct for social justice, she was able to convince her to take her medication again.
Now out of prison, Naomi manages her illness while working to unite with her surviving son. She wrote a memoir to process generational trauma and draws on her hard-won insights to uplift others. Her story conveys the need for more holistic, socially conscious approaches to psychic suffering in poor Black women.
Naomi’s story conveys the glaring inadequacies of our mental health care system to recognize the psychic strain of social and racial injustice. It highlights the vital need for more pluralistic, holistic approaches that integrate the personal, cultural, societal, and spiritual contexts of psychic suffering.
Laura
Laura grew up under immense pressure. Born in the wealthy town of Greenwich, Connecticut, she was taught to achieve and excel. From a young age, she felt compelled to present a facade of perfection that obscured her true self. This wore on her.
In eighth grade, after confiding suicidal thoughts, Laura was diagnosed with bipolar disorder. Over the next years, she was prescribed several medications for the illness, such as Depakote. But Laura resisted taking them, believing her emotional struggles stemmed from societal expectations, not brain chemistry.
Despite her mental health struggles, Laura was admitted to Harvard. There, she continued feeling as if she wore different masks – the high-achieving student, the party girl, the nihilist – without a stable identity underneath. Once more, she spiraled into another depression. A new psychiatrist diagnosed her with Bipolar II and prescribed high doses of Prozac, up to 80mg daily. This time, Laura embraced the diagnosis, feeling it absolved her of blame for her troubles.
Over the next decade, Laura cycled through countless psychiatric drugs and shifting diagnoses, including borderline personality disorder. She surrendered to the disease model, letting experts explain and treat her suffering. Her self-concept became defined by her diagnoses.
After a failed suicide attempt at age 25, Laura discovered Robert Whitaker's book Anatomy of an Epidemic. The book questions psychiatry’s chemical imbalance theory, arguing that long-term use of psychiatric drugs may turn episodic disorders into lifelong disabilities.
Laura came to see her diagnoses as masking deeper issues related to social and gendered expectations. She slowly withdrew from years of benzodiazepines, antipsychotics, mood stabilizers, and antidepressants. She endured months of unfamiliar sensations and emotions. But she also rediscovered aspects of life dulled for so long, like her sexuality.
Ultimately, she pieced together a new narrative – she was not fundamentally defective, just struggling to find herself within a restrictive context. Now off meds, thirty-something Laura has built a community around alternatives to the medical model.
Our health-care system still has a habit of overmedicating ambitious, high-achieving women who struggle with their mental health. But medication shouldn’t be our only answer to societal pressures. In mental health and illness, the personal, social, cultural, and political intertwine. If we want to address them properly, we must think about them holistically.
Final summary
Psychiatric diagnoses have the power to shape our identity and self-narrative. But mental illness isn’t just biological. It has a personal, social, cultural, and political dimension. As a result, the line between health and illness is thin.
As the nation’s youngest anorexic, Rachel herself narrowly escaped a lifelong struggle with mental illness at the young age of six. Former doctor Ray came to believe that medication was the only proper treatment for mental illness but never found the vindication he longed for. For Bapu schizophrenia and spirituality intertwined in a way that is hard to fathom for Western medicine. Naomi’s mental health buckled under the weight of racial injustice. Laura absorbed her diagnoses readily until she began doubting psychiatry’s biochemical model.
These stories reveal the loss of self behind psychiatric illness but also the potential for crafting new identities and purpose. They also show that mental illness isn’t an isolated phenomenon. It needs to be considered in the context of the society that begets it.