The Grandeur of Fancy

“Dream not, Coleridge, of having tasted all the grandeur and wildness of fancy, ‘til you have gone mad.”

It is Saturday March 18, 2023, 3:42 p.m. and the police can break in at any time, without a warrant or a Miranda warning, and deposit me at a hospital, behind locked doors, where I can be tied, facedown to a bed, and injected with a chemical sedative. I will have the right to a hearing before a judge, in about three weeks time, to challenge my detention where I can try to convince a judge to rule in favor of me, a mental patient, over a physician. I can be detained for months without access to fresh air or exercise, at the mercy of the one person with more power than the police: the American psychiatrist. With the stroke of a pen, not subject to question or challenge, my constitutional rights evaporate, and not even a writ of habeas corpus can set me free. What is my crime, you ask? I have manic depression.

The medical profession has perpetrated the long-standing canard that there is something called mental illness that differs from physical illness, and the realm above the neck is some sort of fairyland that is not fed by blood vessels and oxygen like the corpus that exists below it. As a result, that estrangement of mind from body, the real from the imaginary, feelings from thoughts, has resulted in the alienation of psychiatric conditions from medical conditions. If you want to make an appointment with your shrink on Doctor On Demand, they will ask you if your appointment is a medical appointment or a behavioral health one, and when you ask what the difference is, they will ask if you would like to see a medical doctor, and when you play along and tell them you want to see a medical doctor because psychiatrists are not shamans but M.D.s, the resulting confusion is self-satisfying, even a customer service representative working for a telehealth giant does not know that psychiatrists are, in fact, medical doctors, too. This rift between our understanding of what goes on in the body and what goes on in the mind has caused the alienation of psych patients from the rest of medicine and has infected the entire fabric of society with discrimination and contempt. It has persisted not for years, not for decades, but for centuries.

When Prozac arrived in the eighties, it was the butt of office jokes, and society fairly roared at the idea that depression was a medical condition and not the product of the patient who simply lacks the fortitude to withstand the trials and tribulations of life. But it worked, and many more medicines followed, but the jokes remained, as if to medicate the horror that mental illnesses might be legitimate medical conditions. The invention of these new medications only gave people more fodder for the joke mill, and everyone kept quiet about their happy meds.

Bill Maher once asked on his late night show where Donald Trump gets his news. “From a passing mental patient?” An episode of "Untold Stories of the ER” featured a bedraggled, rambling patient who the doctor dismissed as just another psych patient. Shockingly, he turned out to be an English professor muttering James Joyce. Leo DiCaprio starred in Shell Island, which depicted psychiatric patients who must be shunted away on an island because they are not fit for society. Paranormal activity only seems to occur at abandoned mental hospitals, at night. These media portrayals forge the identity and reputation of psych patients as lacking intelligence and the necessary components of humanity. So let us examine some achievements of the psych community.

Francis Ford Coppolla

Five academy awards

Six Golden Globes

Two Palmes d’Or

Judy Garland

Wizard of Oz

Two Academy awards

Richard Dreyfuss

Best Actor Academy award

The Goodbye Girl

Catherine Zeta-Jones

Academy Award Best Supporting Actress

Chicago

Vivien Leigh

Gone With The Wind

Best Actress Academy award

Robin Williams

Best Supporting Actor

Good Will Hunting

Abraham Lincoln

The First American presidency

John Adams

The Second American presidency

Winston Churchill

British Prime Minister 1940-1945

Rosemary Clooney

Grammy Lifetime Achievement Award

Frank Sinatra

Presidential Medal of Freedom

Academy Award

Best Supporting Actor

Mark Twain

Honorary Doctor Yale University

Sylvia Plath

Pulitzer Prize Poetry

John Nash

Nobel Prize

Jane Pauley

4 Emmys

Dick Cavett

2 Emmys

Other notables

Isaac Newton

Beethoven

Van Gogh

Edgar Allan Poe

Ted Turner

Jesse Jackson, Jr.

Buzz Aldrin

Sting

Charles Dickens

If there are so many accomplished celebrities with stellar career achievements on this list who all have bipolar disorder (with the exception of John Nash who was schizophrenic), why are they still being depicted as stupid and incapable of normal functioning, and, moreover, why is there never any outcry over the blatant stereotypes perpetuated by the media?

People in the know love to spout off the going definition of crazy, as if they are letting you in on a secret. Craziness is doing the same over and over, and expecting different results. This is known as Einstein Insanity of quantum physics, a scientific theory of the universe, and something we all do, for example, look for love in all the wrong places. But the question is a valid one: what is the definition of crazy?

The treatment of mental illness underwent nothing short of a revolution with the invention of Thorazine, the much maligned “chemical strait jacket.” Prior to anything even approaching a medical understanding of these disorders, treatment amounted to no less than a parade of horribles. According to Robert Whitaker’s Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill, Benjamin Rush, signer of the Declaration of Independence, theorized that circulatory defects were to blame – the cure? Bloodletting and board spinning. Water boarding enjoyed the state-of-the-art spotlight, as did sterilization during the 19th century eugenics obsession when these illnesses ceased to be viewed as afflictions in need of care, but as the blight of the weak and feeble-gened. Henry Cotton, a New Jersey doctor, attributed them to tooth decay, so he yanked teeth and then eventually lopped off other body parts for a tidy kill rate of 43 percent. John Talbott and Kenneth Tillotson, both Harvard men, favored swaddling patients in freezing blankets until their temperatures dropped ten to twenty degrees below normal; Manfred Sakel induced insulin comas, and Ladislas von Meduna administered metrazol, a consulvant so violent it could crack bones, rip muscles, and dislodge teeth. Then, of course, electroconvulsive therapy and lobotomies entered the scene, the latter performed with ice picks generally inserted through eye sockets. The Kennedys maimed their eldest Rose by subjecting her to a lobotomy, and their horror at what they had done produced the Americans With Disabilities Act. We are able to visit these atrocities on them because of the moral arrogance that gives people the right to decide what is best for someone they believe cannot decide for themselves. This is an assumption so sweeping that it overrides any constitutional rights, especially the equal protection of the law. For example, you can walk out the emergency room against medical advice and put yourself at risk of further deleterious effects on your health, which is to say you are endangering yourself, but if you have a psychiatric diagnosis, you can be seized and locked up without any ability, at least in New York, to challenge your detention before an objective tribunal, AND, if concerned friends or family call looking for you, the one remaining you apparently do have - HIPAA-prevents the hospitable from confirming your whereabouts. In other words, you’ve been kidnapped, and you have fewer rights than if you had been arrested. But there is a double whammy at work that is so ruinous that it this blatantly illegal and discriminatory framework persists.

I write extensively about manic depression and related ills, and without fail, I will receive a return missive that goes like this: I am concerned for your well-being. Please check yourself into a facility. However, if I were not on the Diagnostics and Statistics Manual, writing objectively, I would have credibility, and it is this loss of credibility and the persistent need to treat all patients through the lens of their diagnosis that fuels the silence and stigmatization of “mental illness” and is the reason why there is never any protests in the streets in defense of a schizophrenic who the police have shot and killed. Once you disclose, everything you say and do will give people the right to question you and your treatment. I was once in a situation where I was being harassed by the police, and the first thing someone asked me was, “is it possible you did something in a manic state you don’t remember? Maybe it was your meds,” to which I replied, “why would I be in a manic state? First, her assumption that I am symptomatic and not fully in control of my responsibility to see a doctor every month and take medication was bitterly offensive, and her casual conclusion that my medication was the culprit when she did not even know what medication I take. Once you disclose everything you say and do will be questioned. Other people get angry, but you are unstable. So many people have these diagnoses that they would fill the United States five times, yet it is a community without a voice.

There is no such thing as mental illness. It is just as physical as any other disease, and the use of this descriptor stokes the falsehood that these diseases are the making of the sufferer. It is derived from the inability to see or measure the pathology at work in the brain like we can in neurology, and apparently, when doctors - who themselves have a clinical ability to admit when they do not have an answer- just make shit up. They will tell you it’s all in your head before they simply say I don’t know.

Disturbances in sleep and appetite are the first indicia that psychiatrists use to detect nascent disturbances in the brain, and this Exhibit A in our indictment of psychiatric conditions as mental. Second, dementia causes extreme changes in thought and behavior, yet it is classified as a neurological disease. The reknown neurologist Oliver Sacks treated a patient who had mistaken his wife for a hat, but if a schizophrenic did the same, it is now a mental illness. The word mental connotes ‘of the mind,’ and implies that you can think yourself sick.

In the span of a under a year, Robin Williams, Kate Spade, and Anthony Bourdain died by suicide. Each shocked the nation because nobody saw it coming, there was nary a warning sign, and suicide seemed wildly of character for people we knew as rich, happy, and living the dream. Our collective heads shook, and then we moved on. One hundred and thirty Americans succumb to suicide every day, more than those who die from guns, and there is never any national need to figure out why people kill themselves. Not a single committee has ever been formed to address the fact that psychiatric disorders are lethal conditions.

Suicide has traditionally, and continues to be, understood as an act undertaken by one’s own hand, hence it’s Latin name. It is regarded as an act by the weak and a selfish undertaking. Life insurance will not cover it, the Vatican sends your soul straight to hell, and no one will ever send you flowers in the hospital, emergency room doctors will ram catheters in you for discomfort to show their disapproval, and then you will be locked up.

But what if this is all wrong? But what if suicide is the work of a pathology that infects the brain and hijacks it just like any virus would? In fact, this is exactly the case. Depression and suicide are clever and conniving parasitic invaders that kill their hosts with nauseating efficiency. They fit together like puzzle pieces and are so villainous that victims will resort to gruesome tactics to stop their suffering. No other patients jump from rooftops. Why?

If we are to understand suicide, we must recognize that there is a pathology to suicide, one which guides the hand of the victim, not one which the victim himself induces. It infiltrates a healthy brain, and transplants healthy thoughts with its own set of invective. This process generally begins with the implantation of impenetrable thoughts of hopelessness, although similar nefarious ideas can surface like a spider spinning its web of no escape. These are the building blocks of suicide: life loses all meaning, hope vanishes, and the sorrow that sets in is so profoundly painful because you are weeping at the end of the world. Depression is like grieving at a funeral, only the funeral is for all of mankind. And then, suicide presents itself and coos in your ear like a snake oil salesman to tell you that “I and I alone am the solution to your problem,” at which point some are so rejuvenated they can appear sunny and smiling on the day of their death. Depression is a force so ferocious that it can overcome the very thing that guarantees our species’s survival: the will to live. It is an act of profound courage. Sylvia Plath did not stick her head in an oven because she thought it was a good idea; she was driven to it, and we continue to chuckle while thousands of people die and families are ripped apart. Change will only come when the silence is broken and equality and humane treatment, including the discontinuance of restraints, are demanded, loudly and by all. Anything else is just plain crazy.

Once down on my knees to growing plants

I prodded the earth with a lazy tool

In time with a medley of sotto chants.

But becoming aware of some boys from school

Who had stopped outside the fence to spy

I stopped my song and almost heart.

For any eye is an evil eye

That looks in onto a mood apart.

ROBERT FROST slipcre