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The Thing About Mental Illness

The Thing About Mental Illness

Editor in Chief

We have all been thrilled with the response to our first essay contest, in which psychiatrists wrote about experiences with patients that had a profound effect on their careers. One of the aspects of the prize-winning works, the first of which were published last month, is the central importance of listening empathically to our patients. To emphasize this point, I thought it would be important to publish a piece from someone who has been personally affected by a psychiatric problem. To hear from the person on the other side of the interaction.

This month I share with you an essay written by Sam Pillersdorf, who was the winner of the prose award from the Depression and Bipolar Support Alliance (DBSA) in my home city of Louisville. I was present and deeply affected when Sam read her prize-winning work, “The Thing About Mental Illness,” to the audience at the celebration of all the winners of the various categories in the DBSA art contest, which included visual, written, and performance art.

Her description, at once poetic, raw, and haunting, of her experience of having a psychiatric illness is so powerful in revealing what I believe are common, but rarely articulated, thoughts and feelings that I asked her permission to publish her essay in Psychiatric Times. Sam, who works as an Adult Peer Support Specialist at Bridgehaven Mental Health Services, a wonderful community-based and recovery-focused program in Louisville, quickly gave her approval. I often think about her and what she expresses in her writing, and it has influenced my work with every patient I’ve seen since then. I think you will be changed too.

The Thing About Mental Illness

Sam Pillersdorf

The thing about mental illness is—it’s this: it’s that it sucks. That it’s terrible. That it’s deeply and profoundly unpleasant and even if it’s not due to a particular, single symptom to begin with, it makes you hate yourself because it’s your mind that’s sick. And if you aren’t your mind, who are you?

Other than often feeling completely and utterly miserable; other than being the stupid asshole in the back of class who can’t decide whether they’re there to learn or while away the time until they inevitably end their life; other than a mess of blood and entrails and squishy gray bits to dump out on an autopsy table and poke through with needle-knives and forceps after the “accident” that ended it all; other than all of that, the only part of you that can’t get shot or torn apart, can’t explode into red mist and bone shards, is mind. And when that’s diseased, where are you? What would Rene Descartes have to say about this? About you?

You think; you are a thinking thing. You are a thing. You exist, you are necessary. And as a condition of consciousness of yourself, you know there must be a self, an object made of consciousness. And that object, you are now told, is malfunctioning. It is unwell. It is ill. There is a disease, a sickness, creeping within you; in your thoughts, your mind, your consciousness, your self; your uniform, indivisible, nonphysical self.

You cannot mix souls. You cannot dilute them. You cannot infect them. This is you, eternal, essential, we’re talking about here. If it is diseased, then you are diseased. If it is diseased, you are disease. Disease is not a part of you; it is you. It is of you. It is part of you only in that every other thing about you is part of you. It is as much a part of you as your eyes or your brains or your intellect or your nerves or your curiosity or your affections or your words or your fear.

If your mind is sick, is ill, then you are that sickness. You are illness. You are unclean, you are impure. No, wait. You are not merely unclean or impure, you are uncleanliness, impurity. You are the filth that they say infects you. You are what the doctors say is wrong with you. You are what’s wrong. You are wrong.


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