I frequently come across an ad for my medication, which features a hunched over, miserable-looking wind-up doll. Finally, the ‘depressed’ subject will be 'fixed' by my shiny, eight-hundred-dollar-a-year Pfizer tablet. The company capitalizes on my sadness and I willingly participate in its attempt to "normalize” me. I’m not a creepy plastic doll with red hair who’s been impaled by a wind-up key though, and I'm not looking to be normal. We are all trying to feel better, to be authentic, and to pursue our dreams; and Pfizer, I need you to know I am more than a serial failure without your help, more than your passionless wind-up doll.
Advertisers perpetuate the stereotypical image of depression in a multi-billion-dollar industry. It is a narrative to which many do relate on some level: the low functioning woman (ever seen a man?) in slippers who is nothing without the heroic power of psychopharmaceuticals. I too have had mornings like these, but the misleading image only captures a small part of a bigger whole. The message to which millions are exposed invites stigma and preserves the notion we try to debunk when we say, “I am not my mental illness.” Who looks at that sad wind-up doll and believes she will succeed? (Perhaps ten very optimistic people, but not I). We are compelled by the ad to equate mental illness with personal failure.
To be the ‘invisible’ high-functioner is undoubtedly still a privilege in many ways. In unpacking the difference between mental illness and mental health advocacy, DJ Jaffe said, "trying to gain sympathy for mental illness by only showing the high-functioner is like trying to end hunger in Africa by only showing the well fed." The low functioning mental illness sufferer and those with Anosognosia (Google it) absolutely must have visibility and be advocated for. But systemic bias and public-fallacy have rendered them the only “face” of mental illness. I am invisible by virtue of my appearance, though I too have chronic and severe depression. I am among the fortunate to not be targeted directly by stigma as I walk through the streets of New York City. Online, I share my innermost thoughts with a community of friends, acquaintances, and strangers. Bullying does happen on rare occasion, but I remind myself that it’s a risk that comes with transparency. The message I’m determined to deliver stands in opposition to these ads, which I feel both demoralize the mentally ill and ignore the high-functioners who suffer behind closed doors. Life is a spectrum and those who fall on either end or in between must be acknowledged and supported. As a teenager, I lacked the self-awareness to understand my condition. The wind-up doll I have repeatedly condemned wouldn’t have been relatable to me or inspired me to seek treatment. The well-dressed man I stand behind at Gregory’s Coffee off of Wall Street, or the mom who appears to be juggling five kids seamlessly, may also be deterred.
We are programmed to think depression is only a can’t-get-off-the-couch affliction. I contended with that plot line my whole adolescence, clinging to the headboard of my bed just to avoid school. The person I am now is, in many ways, the product of years of training. I've put in the work to find clarity when it seems I have none, to pick myself off the couch when it feels like I've been filled with hot cement, to write when my mind is on fire or seems barren of all thought. Self-awareness is a byproduct of struggle - of constantly fighting to stand tall - but learning to articulate it takes time. People still look at me and assume I am the epitome of 'mental wellness’ every day. For now, I write endlessly, I wear my “this is what mental illness looks like” shirt in settings where the gesture might be considered ‘uncomfortable,’ or I tell the girls in the elevator that the term “insane asylum” is archaic and offensive. They stare at me like I have two heads but I walk away knowing they will now think before saying their peer was sent to the “insane asylum.” Small victories.
How many times have you overheard someone saying, “Wow, I had no idea they were suffering so badly”? Hopefully it wasn’t already too late for them. Comments like these expose how invisible high-functioners are, despite serious breakdowns and lows. How isolating it can be to live in a realm of such dissonance; a shatterproof façade so deeply inconsistent with closeted pain. It’s an insecure place to be. I sit here thinking about a writing workshop I want to go to tonight at NAMI but I’m afraid I won’t look “mentally ill enough.” I’m fearful that with just a quick glance at my face, it will seem I simply have too much and look too stable to be a sad person on the inside. Ironically, imposter syndrome wins again. Speaking out publicly has propelled me from this place of alienation. Someday, I will sketch my own ad and send it to the pharma-gods who may never see it: an image of life with adorable dogs, long-distance running, beautiful relationships, supportive friends, immense privilege, and yet, chronic emotional struggle. By my side in this picture will be a friend who suffers on the outside - the sometimes-exploited prototype of mental illness - because we exist in many colors.
On Friday, between arriving at JFK Airport and getting on the plane, I forgot my suitcase on five separate occasions. My invisible illness leads me to overcommit constantly, makes me jittery and forgetful; I may as well just be an overachiever on too much coffee. But in moments of high stress or over-stimulation, an intense crash will surely follow. I can run fifteen miles but God forbid I try to focus forty-five seconds of my attention on an email I need to get out ASAP. And on those fifteen miles, I will run to my audiobook because how could I allow myself 2 'unplugged' hours free from the intellectual rigor of dense prose? Busying myself is a solid defense mechanism for the avoidance of a low, so onward I go with each failed attempt at “leisure time.” Grabbing a Pilot pen, black never blue, I write down everything I need to accomplish in the next twelve months to feel like I’m not failing. Just by doing so, I set myself up to fail. Using creativity to ‘produce’ gives me a momentary high I ride until I crash or I produce something else. When I come up short and my mind is thoroughly drained, I get down on myself and blame a lack of this or that skill. Creativity is innate to some of the most tortured people; the late David Foster Wallace and Robin Williams erected timeless works from a fight they both shared. We all have important things to show the world.
How many iPhone ‘notes’ have you accumulated lately? I currently have 263 even though I try to delete them as I check things off the running list. It's the 'Etsy Shops & Semicolons' problem and it means I may always feel just a little bit inadequate. My poor shoulders; every ounce of stress, anxiety, and guilt I contend with weighs down on them and naturally, I tense up to brace myself for the blow. I’ve Googled “weighted suit” to see if something like that even exists; gravity can’t compete with the load of a thousand worries. I can crank out 5,000 words in no time but I can’t go to my mailbox from the 26th floor because that feels like a redeye to California. I have the clarity of mind and privilege of an education to write about my experience in a way people find relatable. But I’m such a perfectionist that it detracts from my ability to ever be fully satisfied with my work. I’m fixated on learning more and more, but doubt my own capacity to become better; I fear I’ll run out of ideas. As a high-functioner, espresso makes me a human energizer bunny – if only for a minute – and alcohol makes me plummet. With my morning coffee, I’ll write poetry no one will ever read or lyrics to a song no one will ever sing. I’ll discover new music and braid my hair into some intricate design only to ruffle it up before I leave the office. I’ll apply for something or map out an epic road trip for someday. But with a glass of wine, I’ll stare off as the spark inside me is extinguished by what people call ‘liquid courage.’ I call it liquid despondency.
On the outside, I look so functional that people think I’m full of it when I share my struggles. But only I have been with myself at both my best and my worst, and I can assure you that I’m the real deal. To be high functioning is to smile through it all. I did this flawlessly for two decades until I finally realized that if they really love you, they’d rather have you in a heaping mess than not have you at all. They’ll meet you at the door with eye drops if that’s what you need. Most importantly, they’ll ask, “How are you really doing?” You don’t owe it to anyone to be full on the outside if you're empty on the inside. Many people have asked me for advice on how to speak out, or at least live more authentically. Most of them believe they can’t do it even though they know that for me, my mental illness is an asset I want written on my face. Visibility is an essential component of change. We are not obligated to anyone but ourselves to fight the stigma that surrounds us. But as more of us find our voices, we will begin to see we deserve to.
Prozac, Valium, Pristiq, Zoloft, Celexa, Paxil, Lexapro, I love you for what you’ve given both others and myself, but you are not the reason I’ve survived. You get me out of bed, you give me courage, and sometimes you frustrate me, but you are not me. Some days, I think that if I stopped taking you, I would still be the no one I felt I was before I met you. But the truth is, you give me strength to pick up the pencil, but you do not give me the language I spit onto a page. Depression, mania, headaches, and chills, self-doubt, pain, and hopelessness, I hate you for what you’ve taken from me, but you are the reason I’ve survived. You’ve filled me with words and given me more than any pill can, taught me what empathy is, and shown me the value of compassion. You’ve inspired me to fight out loud, to reach into the homes of kids clinging to headboards, and tell them it gets better. You are an opportunity; a gift I will never stop fighting.