160 years ago, runaway slaves in the American South were often diagnosed with “drapetomania” – a supposed mental illness that drove them to run away from their masters. Cures and preventative measures for drapetomania included whipping and cutting off big toes, making it impossible to run. It didn’t occur to the doctors that running away from slavery was perfectly natural. It was a lot more convenient to call it mental illness, because this took the “problem” away from the horror of slavery and placed it neatly within the individual brains of slaves. Now, with Robin Williams’s suicide last week, mental illness is again at forefront in public consciousness. But make no mistake: our ideas about mental illness still need reexamining.
First, disclaimers: unlike some other critics of psychiatry, I don’t deny that mental illness is real. I also don’t deny that brain chemicals play a major role in it. If you’re on psychotropic drugs and they’re helping you, please stay on them. But at the same time, many of our ideas of mental illness today are filled with almost as much quackery as New Age claims that we can all be millionaires if we just wish hard enough (because quantum physics!). And they’re hurting our ability to live and understand life.
Let me tell a personal example that will illustrate what I mean. This story is very painful, and it’s been hard to write. But will help explain where I come from as a writer and researcher, especially when I argue for the adaptive benefits of religion – and why I have a chip on my shoulder about scientistic liberalism.
When I was 14, my family lived in a very small town in Wyoming. My mother and stepfather were both problem drinkers. As a family, we had few social contacts, common for alcoholic households. We didn’t go to church, were involved in no organized sports, and possessed virtually no “social capital” – what Robert Putnam calls the tight network of bonds, relationships, and obligations that form community and keep individual lives stable.
Winter nights in northwestern Wyoming are very, very cold. And very lonely. Our village, Moose, sat 15 miles north of the nearest full-service town. Snow, whipped across the sagebrush flats, drifted up past the eaves of our house. The front windows – which, in the summer, offered postcard views of the Grand Tetons – were nothing but a white wall.
Isolated in a lonely village, in lethal cold, with unstable parents who drank too much, how should one feel?
If you are normal, you’ll feel terrible, and lonely, and frightened.
When, quite naturally, I started manifesting signs of depression, my mother eagerly herded me to a doctor in town. I was prescribed Zoloft, an SSRI (serotonin reuptake inhibitor) similar to Prozac. My mother, a reader, checked out a syllabus’s worth of books about the chemical basis of depression – a quirky imbalance in serotonin and maybe dopamine levels – and shoved them into my arms. Through these books, and through consultations with well-meaning psychiatrists and counselors, I became aware that I “had” depression, the way that some people have thyroid disease. I learned that, as a physical brain illness, depression was potentially fatal, and I would have to manage my disease. I learned that I might have it forever.
Like some other adolescents, I reacted badly to Zoloft, becoming inexplicably self-destructive and angry. I was taken off it after a few months. But the damage was done: I was a person “with” mental illness, a person who would always have to be kept an eye on, who might implode – for arbitrary reasons – at any moment, the rest of his life.
Later, we moved to the Twin Cities area, and my mother and stepfather got a lot more serious about their drinking. In high school, my youngest brother, Alan, was taken away for several months by child services, because my parents were simply incapable of caring for him.
Meanwhile, I earned a bachelor’s degree from the University of Wisconsin, lived abroad, and entered grad school in Boston. But despite my academic successes, I still regularly felt like I wanted to die. Existence could be unspeakably bleak. I was (I thought) marked by depression for life.
But my depression was arbitrary, remember. It was just a chemical problem. It came from my brain. I just had to deal with it. My “illness.”
In December 2009, I was home in the Twin Cities for Christmas. It had been a decent visit. Sure, for months, my youngest brother, Alan – by now 22 and eight inches taller than me – had been acting erratically, showing smoldering, even violent anger at my mom and going on wild crying jags. Still, we’d managed to have a family Christmas, after a fashion. And Alan had promised to get counseling.
On December 28th, a friend and I were walking down Hennepin Avenue in Minneapolis, after a delicious lunch at an uptown Nepalese joint.
Then my cell phone rang. My stepfather’s weak voice came through.
“Connor…Alan’s committed suicide.”
Just like that, I never saw my youngest brother alive again. Just like that. One minute he was here. And now he will never be here, ever again.
What ensued was the worst year of my life. Less than two months later, my mother – stricken by guilt and too drunk to function – followed my brother into the land of the dead, committing suicide on February fifth or sixth.
I turned 29 on the thirteenth of February. In the previous six weeks, I had lost half my family to suicide.
Now, before I lose my ability to keep writing, let’s look at two different descriptions of my family situation.
The first description is biomedical. Under this model, my family is clearly genetically predisposed to mental illness. It is not a choice. We are not at fault, but we are also very definitely not in the driver’s seat here. We “have” suicide, alcoholism, major depression, bipolar disorder. There is obviously something haywire with our genes. At best, those of us who remain – my stepfather, my brother Evan, and me – will need to be managed for the rest of our lives, probably go on regimens of drugs, and live under the sword of Damocles until we die – always aware that the fragile balance of our mental functions could suddenly snap.
The second description is complex. It focuses on relationships, and it takes our choices seriously. In this model, my family still probably has genes that predispose us to emotional problems. But these genetics don’t determine everything, nor do the chemicals in our brains. In this relational model, my mother and stepfather freely made some very bad decisions, and these decisions had some disastrous consequences.
I prefer the second model.
The bad choices weren’t limited to the adults. As a family, we chose not to be involved in any community functions, churches, or neighborhood groups. And of course we collectively disdained or merely ignored religion as the province of the uneducated and the foolish, never realizing that whatever their silly beliefs, the religious had tools for living that we did not have, or which we scoffed at. We chose to become isolated, to wall ourselves off from others, to turn to alcohol. I chose to start drinking in early high school. Despite the lack of guidance from my parents, nobody made me do that. And nobody made my mom drink entire bottles of sherry and drive off into the cornfields to wreck our family cars. She did that. That was her choice. No one else’s.
But choice was never part of the story told by the psychologists – or by the books on Prozac. Remember my “diagnosis” of depression in early high school, on the lonesome sagebrush flats of northwestern Wyoming? Wasn’t it convenient that the problem – my depression – was in me, not the situation? Wasn’t it convenient that my mood swings could be written off as the unpredictable product of difficult brain chemistry? That my problems were individual and physical, rooted in the weird confines of my skull?
Because if they hadn’t been – if I hadn’t been diagnosed with a treatable, biochemical illness – then the unthinkable might have happened: my family might have had to face the fact that we were making terrible choices about how to live. Instead of being enmeshed in a web of community and friendship, we were isolated and alone. Instead of confronting our emotions head-on, we avoided them through drink and other escapes. Our house was a literal hell.
The thing is, when you’re stuck in hell, your emotions often flare up. This isn’t to make your life miserable. Your life is already miserable. It’s to convey an important message: you are in hell!
I eventually listened. Despite the tragedies we endured and the hells I have experienced, I am doing surprisingly well. I have gone through years of therapy. Rather than focusing on my own supposed biochemical problems, my therapy has focused on learning about my primary relationships and the habits I learned as a young person. In the four years since I lost half my family, I’ve filled my world with friends, relationships, sports, fulfilling work. I eat well and don’t drink. When I’m not injured, I exercise a ton. And it’s clichéd, but I make it a point to be grateful for things like blue summer skies and kittens and Motown music.
Somehow, through these new habits, the horrible feelings I used to experience nearly all the time have gradually dissipated, receding into the sometimes charming, sometimes dissonant music of life. I actually feel good – really good – most of the time. I don’t feel that crushing despair about life that used to be my constant companion.
When we pathologize our chronic bad feelings, we forego the opportunity to hear their powerful messages. This, in turn, can insidiously cover up serious wrongdoing on the part of powerful people. The slave isn’t reacting sensibly to horrible life conditions – she just has drapetomania! The 14-year-old boy isn’t watching his elders drink themselves to death, his family spinning further and further into oblivion. He’s just depressed, don’t you see? It’s chemical.
When Robin Williams died last week, the Internet flooded with messages of grief and sadness. It also filled up with late-modern pieties about raising awareness of the thing called “mental illness” that killed him.
I put this phrase in scare quotes not because mental illness is unreal, but because it is too real to be a buzzword. I don’t know why Robin Williams ultimately chose to end his life. His years of alcohol and cocaine abuse almost certainly played a role – alcoholics (like my mother) are many times more likely than average to commit suicide. But make no mistake: ultimately, it was his choice. Yes, by that final moment he may have been completely compelled, by illness, addiction, and misery, to do what he did. But his life, like all lives, was a kind of extended choice, spread over years of habits and triumphs and despairs and tiny decisions. In every life, our freedom is real – but it is not always immediate. Over a lifetime, we can work ourselves into corners from which escape becomes nigh impossible.
Regardless of how Williams’s extended life of choices actually played out, I have to flatly reject our boneheaded cultural agreement that mental illness is always only a thing that “happens” to people – like getting hit by a truck – or that it is only “individual,” in that it arises from the brain outward. Yes, there are times when mental illness strikes at random. I’m not arguing that every case of mental disorder is simply curable by exercise or a girls’ night out. It’s not your fault if you’re depressed or have OCD or need psychotropics (even Zoloft!) to feel okay. Don’t let anybody tell you otherwise. But nothing in human life arises solely from the brain outward. We are the world’s most social vertebrate species. Everything that happens in our brains feeds back on our social lives, and vice-versa. Our choices actually matter, and so do the choices of the people around us. We have the freedom to choose how we deal with life, but in order to do so we have to deal with the people in life. In fact, the two are often the same thing.
I am not disrespecting Robin Williams’s memory by suggesting he was not merely a victim. I’m taking him seriously enough to state that he made a terrible mistake. We only politely ignore the errors of people we no longer respect enough to take seriously. The attempt to morally exonerate Robin Williams by calling him the victim of mental illness shows we do not respect him, and betrays our toxic perfectionism. We cannot fathom respecting or admiring people unless those people are perfect. We conflate legitimate criticism for wholesale rejection, body and soul. But people aren’t perfect. They make mistakes. Even terrible mistakes. And we still love them. Robin Williams made a terrible mistake, but this doesn’t make him a horrible person. It makes him someone who erred – someone we can still love as a fellow journeyer on life’s contorted path, and forgive for making a wrong step.
My mother and brother made horrible mistakes. I still love them. (I am working on forgiving them.) I still love my stepfather, who has grown tremendously since those deaths, and my remaining brother Evan, and my biological father, Roy. I will never fully recover from my mother’s and brother’s terrible choices. But I have chosen to live well in spite of this. Our choices really do matter. And it’s not okay to tell each other anything else.