Psychosis can be a very isolating experience.
It’s hard to explain to someone who has never had to question their own relationship with reality. Phrases like, “My mind is playing tricks on me,” can barely broach the depths of how completely detached from reality I can become when I am experiencing psychosis.
I just finished reading Neal Shusterman’s novel Challenger Deep, which follows a fifteen-year-old boy through a psychotic break. The book is uncannily accurate in its depiction of the gradual break from reality and onset of delusions and paranoia. Two things I thought the novel did exceptionally well were its portrayal of the uncertainties surrounding medications and diagnoses, as well as showing the chronic nature of many mental illnesses.
By the end of the novel, the narrator, Caden, has come to terms with the fact that the captain (a character who represents Caden’s illness) will always be there, beckoning him to come aboard on a mission into insanity. Throughout the book, Caden tries and tries to make sense of the captain’s cryptic instructions and maps, with little success. I liked this extended metaphor because it was highly applicable to what psychosis feels like: a ship being tossed in a storm raging all around. The other notable element about the captain’s character is revealed towards the end of the novel. We find out that when Caden was ten and on vacation in New York with his family, he saw a homeless man sitting on a street corner with a cereal box on his head, a Cap’n Crunch box, no less. There is a small, two-page scene in which Caden’s mother gives the man some change and then the family gets into a taxi, leaving the man behind.
I bring this scene up in particular because it so sharpy illustrates the way the mind can make such strange leaps and connections that make sense in the moment. For me, it was not a person, but a deer that lodged itself in my mind and became the harbinger of my psychosis. Even though it has been several years since I first saw that dead deer which coincided with the onset of my break from reality, I still feel strangely connected to it at times, as though it represents something essential yet intangible about me. As Caden says, “Even though part of me has come to sense the things that might be delusional, there’s the other part of me that has no choice but to believe them.”
Friday night found me alone in a crowd. I arrived at my university’s Hillel House early because I’d made plans to go over some details for a future event with one of my fellow board members. I was already on shaky ground mentally. I frequently have doubts about my efficacy in my role as ritual officer, and when my anxiety gets away from me, it’s easy to convince myself that everyone hates me, that they can’t wait to get rid of me, and on and on. After the meeting with the other board member, my anxiety was still sky high, and the walls seemed to be breathing. People were trying to talk to me, but I couldn’t hear them over the cacophony in my head.
While the rest of the group set up tables and chairs outside, I found myself pacing in circles around the island in the kitchen. “You cannot do this right now,” I admonished myself out loud. The noise in my head had gone from vague, staticy breathing and whooshing to sinister voices. They didn’t laugh at me, they just mockingly echoed my statement. One of the other members of the board saw me through the window and came in to check on me. “Are you okay?” he asked me for what seemed like the eighth time that day. “Hearing things. I’m fine,” I grunted at him, driving my fingers into my temples. I’ve discussed a few details of my mental health status with some of my friends in Hillel, so they’re at least aware that this is something that happens sometimes. What people don’t realize, though, is that while the next, most obvious question is, “What are the voices saying?” that’s also an extremely personal question. I did not have the mental stamina to explain that if I were to tell him what the voices were saying, then the horrible things they were threatening would come true, and it would all be my fault. “I’m fine, I’m good, really,” I insisted. He wandered off, I continued pacing.
The group went through the basic introductions while the voices continued to taunt me. I felt as though I were in a swimming pool with my ankles tied together. If I could push my way to the surface, I’d be fine. I would find internal silence. If I sank, though, then I would succumb to the voices and delusions. The question was, then, how to use my arms to simultaneously tread water and untie myself.
We played a few icebreaker games and went through some discussion questions in small groups. No discernable words went through my mind without my permission, though I still heard the breathing and hissing of a dragon or serpent. By the time twilight was upon us and we went inside to say blessings, I felt mostly okay. As I led the blessings, I expected the voices to crescendo, but all I heard was a tiny, childlike voice murmur, “You’re doing great,” and an abrupt silence. It’s been a very long time since any of the voices have said something nice to me. And still, I don’t trust them.
One thing I wish Challenger Deep had done differently was in how it portrayed medication. There were a lot of references to “happy pills,” and lots of details about the unpleasant side effects of psychotropic medications. I do understand where Caden is coming from. I was put on antidepressants when I was around his age (early teen years), and I despised taking them. It wasn’t about side effects or anything like that. I felt that medication was changing me, making me into a fake version of myself. I’ve noticed that this is a pretty common theme among the young people I meet who have mental illness. When I was in intensive outpatient treatment (IOP) at La Amistad, almost everyone in the group stated that they did not want to be on medicine forever, that it was a “crutch,” that they didn’t feel like themselves on their medication. What I know now is that without my medicine, I am so out of touch with reality that I cannot function at all, let alone go to class, read the books I love, and make meaningful connections with people like my friends at Hillel. I will gladly take medication for the rest of my life if it means I have a reprieve from the specters of dead animals and physics-defying snakes.
I read Challenger Deep as part of a class on mental health and literature, and the class has given me a lot to think about. Most of the reading material has been extremely sad; I’ve found myself crying over nearly every book on this class’ extensive reading list. On anthology in particular, Show Me All Your Scars, seemed to be a litany of woes, each story or essay more tragic than the next. I wondered what I was supposed to have taken away from the collection. I suppose one possible takeaway could have been that people need to take mental illness more seriously. Perhaps another goal of that collection and others like it is to make people feel less alone in their struggles, which is a totally valid and noble pursuit. However, I would propose a companion to these somber stories: depictions of people who thrive, not in spite of, but with mental illness.
At the onset of mental illness, when things are just beginning to change, people may be asking, “What’s wrong with me?” I know I was. I spent a lot of my middle school lunch periods in my school library’s tiny psychology section reading books about depression trying to answer that very question, What’s wrong with me? Later, I would find myself feeling understood less my my parents and peers and more by characters in books such as It’s Kind of a Funny Story and Willow. I felt validated and seen by these books and their teenage protagonists who were confined to psych hospitals, dealt with self-injury and eating disorders and on and on. What these books did not offer was hope.
Of course, there is a line between fiction and reality. I don’t mean to suggest that novels about depression or psychosis cause these illnesses any more than a novel about dragons encourages readers to breathe fire. But representation matters. I think it is important for readers (especially young readers) not only to have their pain validated in literature, but also to have protagonists that inspire them to improve their mental wellbeing. The literature we read teaches us a lot about the world around us, the world which is the context for much of contemporary literature. For example, Roxane Gay’s Not That Bad, a collection of short essays by survivors of rape is a gut-wrenching slog through hell. Although I did not finish reading the collection, I read enough to see that each story left the narrator broken and hopeless by its end. I think its intended message is that sexual violence is, indeed, “that bad,” and that people need to take it more seriously. The underlying message that I took from it, as a survivor of rape, is that I, too, was broken and would never be okay again. I had already assumed that was the case, and the book only served to reinforce that message.
I have also contributed to this surplus of victim-mentality stories, though many of them are languishing on my hard drive rather than finding a wider audience. Only recently, though, have I gone back and revisited them. I find a lot of angst and self-loathing in those pages, a lot of thinly disguised alter ego characters who feel they will never be okay again after the events of the story. I’ve gone back and given them better endings, asked better questions, and given them strength. In doing this, I have discovered the obvious: I cannot rewrite the past. I have also discovered that I no longer need to.