part0047

Go ahead, you wouldn’t be the first to do it, and you probably won’t be the last. That’s because I am crazy. Loony tunes. Bananas. Bonkers. Stark raving mad. Certifiable. Insane. Loco. Nuts. Psycho. You’re not going to hurt my feelings if you tell it like it is, although my psychiatrist always looks faintly dismayed when I call myself crazy, saying, with a slightly pained expression: “Well, I mean, I wouldn’t . . .” and then sort of trailing off before handing me one of my insurer’s brightly colored pamphlets for crazy group. (Spoiler: They don’t actually call it that. I’d probably consider going if they did.)

But let’s back up a bit.

When I was in high school, I was perniciously, aggressively, horribly, sometimes violently depressed. It alternated with vicious mood swings, towering rages over nothing, and an irrationally extreme response to things that people around me thought were minor. I was consumed by anxiety and insecurity. I engaged in self-harm as self-medication, didn’t realize it, and functioned well enough that the people around me didn’t, either. At times, it felt like I was losing control of myself. Everyone muttered things about hormones and teenagers and this all being normal and something that would go away on its own. Consequently, when I went to college at fifteen and had a meltdown, it came as a surprise to everyone, including me. I was the bright young thing, maybe a little high spirited, but it was nothing I wouldn’t grow out of. I was not, you know, a crazy person.

I spent months in the dim upper reaches of the building that housed student health, dutifully meeting with the school’s psychiatrist every Friday afternoon. Within the student body, the running joke was that the school’s psychiatrist was performing some kind of prolonged research project, using impressionable youth as study subjects. I mentioned it to her once and she leaned forward intently, hand poised over her notepad.

“How does that make you feel?” she asked.

First she diagnosed me with depression, and then with borderline personality disorder.

A brief sidebar, if I may. You may have heard of “catchall” or “bucket” diagnoses—those that just kind of get slapped onto people without much thought. In the era when I first encountered psychiatrists, “borderline personality disorder” was often code for any young (presumed-female) person who didn’t have her shit together and was probably also crazy. It was also then, as now, a highly stigmatized and poorly understood diagnosis. People who actually had borderline personality disorder (BPD, which, somewhat confusingly, also stands for bipolar disorder)—who struggled with suicidal ideation, extreme mood swings, and difficulty in personal relationships—didn’t benefit from having their diagnosis used as a rubber stamp for recalcitrant liberal arts students with treatment-resistant something , and people who didn’t have BPD but were forcibly labeled with it didn’t do their actually BPD friends any favors by treating the diagnosis like a stigmata.

Psychiatry is an inexact science. The fact of the matter is that brains are weird, like, really weird, and we don’t fully understand how they work and why. Psychiatric diagnosis isn’t as simple as a blood test or a medical imaging study. It’s something that requires skill, practice, and time—meeting with a patient, growing to understand that patient, and developing a profile for a constellation of symptoms and experiences that can guide experts to a conclusion in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5 ).

The history of older editions of the DSM is a fascinating glimpse into the discriminatory history of psychiatry—homosexuality was once medicalized, for example. Historically and today, “troublesome women” are often psychiatrized in ways that silence them or minimize their experiences, using the stigma surrounding mental health conditions to marginalize patients. In the pre-DSM era, a dude named Samuel A. Cartwright came up with “drapetomania” to describe a curious cluster of symptoms seen in enslaved people, who for some reason kept running away from their masters. Clearly, he concluded, they did so because they were crazy. No, seriously, go look it up, but prepare to fall into the rabbit hole of scientific racism, because this wasn’t the first or the last time that perfectly rational responses to oppression were labeled as illnesses.

I’m not knocking the trade, I’m just saying that psychiatry is hard, complicated, fiddly work, and you’re bound to run into some underlying assumptions that color the way the medical establishment delivers patient care. When society is racist, well, that influences how everyone, including doctors, interact with people of color, especially if you are, say, trying to come up with ways to justify slavery. If you think women are depraved sluts, well, female sexuality becomes a pathology. And so on. Over time, changes in the way society views our most vulnerable have reshaped psychiatry, largely for the better, thankfully.

That history still resonates, though: People who are mentally ill may be deprived of civil rights like voting, making their own financial decisions, having children, choosing where to live, getting married, and exercising choice in medical settings. The state may compel people to take medication, flag them on background checks for employment, and otherwise stigmatize them because of their mental health conditions.

Some people resist psychiatry altogether, as detailed in a bit, but it is worth noting that two psychiatrists can come up with very different diagnoses for the same patient, often at the same time. Racism and sexism are just two of many problematic ways every mental health professional brings their own understanding, training, preconceived notions, and cultural background to their interactions with patients. Depending on who the patient is, when they’re diagnosed, and who diagnoses them, they may be given any number of psychiatric labels. Sometimes to their detriment, because misdiagnosis usually delays appropriate treatment.

And so it went with me when, in a gloomy office in the depths of a Vermont winter, I had been diagnosed with borderline personality disorder.

I was, as I’d heard people so often say, “a borderline.” I dutifully went through a pharmacopeia of medications, therapy (group and individual), and a slew of other treatment options in a desperate attempt to get less crazy.

Because being crazy turned out to really suck. I’d spent my whole life being told I was exceptional: special and unique and powerful. And now my brain was trying to kill me. I struggled for years and nothing seemed to work—not uncommon for some people with borderline personality disorder, and especially common for people who have been misdiagnosed with it.

It took nearly a decade to figure out what was actually making me crazy, and years after that of tinkering with medications to attempt to manage it. Some people like to say “control”—I don’t, because I view my crazy and myself as an uneasy partnership. We’re working together, here. To exert a degree of control on my part is to suggest that my crazy can do the same. I am also aware that we will be harnessed together for life, my crazy and me—though my crazy might try to make that life shorter. Thanks to flukes of genetics, circumstances—and honestly, people really don’t know; they can only offer theories—this constant balancing act is part of my life forever.

Over that decade of searching for the right diagnosis, I was introduced to the disability rights movement, and with that the notion that you could be disabled and happy, disabled and proud, disabled and content in your body and your identity. There are a lot of ways to view the movement, but for me, perhaps the most empowering element was the realization that there was nothing wrong with me. That my brain worked differently from others, and presented challenges, but that didn’t mean I was irreparably broken.

I wish that fifteen-year-old me had known that. Disability can be horrendously isolating when you live in a world where you’re told that you are a broken inconvenience and no one pops up to tell you otherwise. The narrator of your life instead drones on about tragedy and lost potential. Young people like that lonely undergrad in the snow-covered reaches of Vermont are often cut off from the connections, resources, and community they need to learn more about disability—including mental illness—thanks to a combination of adult ignorance, disablism, and social structures.

It took even longer for me to discover the Mad Pride movement: people who are out, proud, and unabashed about their madness—they do not say “mental illness,” because what they have is madness, and they own it, and love it, and it is a part of them. Many choose not to pursue treatment, because they see nothing wrong with themselves. Many highlight the injustices of institutionalization and the limited range of treatments available for those who do want to pursue treatment. Don’t just listen to me, though—go read Mad Pride , an anthology edited by Robert Dellar and Ted Curtis, all about the movement that gives you a much more lengthy, nuanced, thoughtful, detailed view than I can offer here.

In the initial years after my diagnosis, I wanted to distance myself from my brain’s wacky doings, so I created as many barriers as possible. I had a mental health condition, or a mental illness—I was a “person with . . .” It was an unwanted appendage, something to be hidden away, definitely not something to be acknowledged.

As I delved into the disability rights movement, I found myself challenged to rethink the way I looked at and defined myself. First, I learned about the differences between the medical and social models of disability. The medical model posits that there is something wrong with people that needs to be fixed, and if not fixed, grudgingly accommodated. The medical model exceptionalizes disability by using “person first” language like “a person with BPD” or “a person with depression,” with advocates cheerily telling you to “focus on the person, not the disability!” The social model posits that individuals may have impairments that affect how they interact with society, but society chooses whether to disable them or not. The social model uses “identity first” language because disability is part of our identity; I am a disabled person, a mentally ill person. (Think about other identities: we do not say “a person with blackness” or “a person with gayness,” because those sound weird and are also offensive, yes?)

As I started to explore the social model, an entirely new and exciting world opened to me. If disability is a value-neutral part of my identity, neither good nor bad but simply what I make of it, and my disability is just part of who I am, and I am proud of myself and my accomplishments, can I also be proud of my disability? Can I embrace it? And, in a society where disability is highly stigmatized and people are constantly sternly warned against admitting that disability exists, can I reclaim it? Defiantly? Loudly? Can I make people uncomfortable?

Reader, it turns out that I can—and you can, too. In a world so troubled by the existence of disability that it prefers we be seen and not heard, admitting that you don’t mind being disabled, or even enjoy it, can be a radical act. Disability may present inconveniences and frustrations at times, but honestly, so does being alive.

Yet, while people are reluctant to talk about disability, some are certainly not shy about using the language of disability as a pejorative. You’ve probably heard the considerable debate over the R-word, driven by intellectually disabled people who are tired of having a defunct clinical term used as an insult. But alongside the R-word march “lame,” “crippled,” “gimp,” “crazy,” “insane,” and a host of other words that have come to be collectively known as disablist. Along similar lines, language like “handicapped,” “special needs,” and “differently abled,” which cloaks disability in euphemism and cuteification instead of just being up front about the situation, is also viewed by many as disablist.

You probably have used disablist pejoratives, often thoughtlessly and reflexively, because they’re just ingrained. You say them because you have always said them, because they’re an easy way to describe a thing that is bad or frustrating or perplexing or weird or wild. But you usually—and specifically—use the references to describe a person, or concept, you dislike. Politely asking people not to use these words to describe things they don’t like often doesn’t work out well, but oddly enough, deciding to reclaim them for ourselves also ruffles a lot of feathers.

It’s not just crazy people who have reclaimed words like “crazy.” Other members of the disability community refer to themselves as cripples and spazzes, gimps, deafies and disableds. We have taken language that is often weaponized against us and turned it into a badge of pride. We have rolled with the punches, risen, and thrown them back. We attempt to take the sting out of these words by defining ourselves with them, and we’ve also used them to create a community. To find our people. Have you found your people yet? You absolutely must: they are going to make your life so much more enjoyable.

I know my fellow crazies by the language they use, and it makes us closer. I also know those who hate us by the language they use—calling me “crazy” sounds very different depending on who is speaking the word and in what context. Since most people assume (incorrectly) that I’m a lady, I get a fair amount of “crazy as descriptor for unreliable and suspect” thrown my way. Conversely, when people (incorrectly) assume I’m a man, I’m made party to comments about “crazy women” under the assumption that I share their views.

You may have heard that you’re not supposed to call people crazy. Maybe people have told you that it’s not nice, that it’s stigmatizing, that it’s disablist. And in one sense, those people are right: Please don’t go around randomly calling people crazy. But if they identify themselves as crazy and invite you to do so, well, have at it. Do it judiciously, of course, because there’s a time and a place for everything and context is important. In a space populated with mental health activists who understand the nuances of how we talk about these things, you’d probably be safe. In mixed company where someone might think you’re being cruel, or might hear you and assume that we are now on board with calling mentally ill people crazy whether they like it or not, consider maybe holding it in.

And more importantly, decide for yourself if you want to call yourself crazy. If you want to allow others to do so, and if so, under which circumstances. Because one way to fight stigma is to look it in the eye and control it. You take the sting out of crazy when it’s how you talk about yourself, so go nuts, if you know what I mean. Other people don’t get to tell you how to define and talk about yourself.

You don’t need to explain yourself or justify your self-descriptors. You’re a crazy person, and you want to call yourself crazy? Seems reasonable to me, since you’re the best authority on yourself and your own experience.

This is a case of fighting fire with fire, of tackling stigma by deciding to laugh in stigma’s face and then file our nails. It can feel incredibly giddy and intense, so treat yourself to a nice glass nail file that will hold up through the years. You’ll need it.

Call me crazy; it’s a perfectly apt descriptor, and there’s nothing wrong with being crazy. There is something wrong with the way that society thinks about madness. We endure the sharp, infuriating pain of watching society blame crazy people for every horrible cruelty that mankind can perpetrate. Set aside the ample research demonstrating that we crazies are actually less dangerous than sanies, statistically speaking, and that we are at a grossly increased risk of sexual and physical violence because of our vulnerability, particularly in the case of multiply disabled people, women, people of color, and trans people. When so many people dislike you because of something you can’t control, it turns out that you become an easy target for abuse.

The average age of onset for mental illness in the United States is often in the late teens to early twenties, according to the National Institutes of Health. Many people are diagnosed with mental health conditions at precisely the moment that they are undergoing huge, scary life changes. This is not a coincidence. It’s also not a coincidence that diagnoses are often handled poorly and people are provided with inadequate resources to cope with a big and scary and new thing.

Mental illness is not the end of your world. Choosing to use medication to manage it in the short or long term doesn’t mean you’re weak or reliant on Big Pharma or buying into society’s myths. Wanting to explore therapy in individual or group settings isn’t pathetic—and neither is firing your therapist, if they’re just not working for you, and trying someone new. Pursuing a variety of other treatment modalities, including magnet therapy, electroconvulsive therapy (ECT), ketamine therapy, yoga, and many more, doesn’t make you someone who believes in magical thinking—you need to use what works for you. (And yes, magnet therapy—or transcranial magnetic stimulation, as the pros call it—is a real thing, and so is ECT, which has come a long way since the horrors of the “shock treatment” days.)

The best thing about being crazy is meeting other crazies and learning about how they live their lives. In the past decade, the number of people openly talking about mental illness—like Sara Benincasa, John Corey Whaley, hilary t. smith, Terrie Williams, Bassey Ikpi, Cindy L. Rodriguez, Demi Lovato, S. Jae-Jones, Carrie Fisher, and many, many more—has exploded. They’re demystifying mental illness, making it less scary, and challenging the way people talk about it.

That helps break down the stigma surrounding the need for treatment; it’s less terrifying and awful to get mental health care if you feel like this is a normal part of the human experience, not a freaky thing that freaks do. It’s a lot easier to assert yourself in conversations with your health care providers when you live in a world where you’re treated as an actual person. Getting help for your crazy will make your quality of life significantly better, and it will allow you to find the clarity of thought and calmness of being that allows you to get on with great and important things in your life. Those things include how you want to think about your relationship to mental illness and your own identity.

Maybe you’re not crazy—maybe you just have a mental health condition, and that’s okay. Our brains are all in this together, and the only way out is through, unless you have a line on a tesseract, in which case, let’s talk.