Medicine for madness

I relate to physical sickness more easily than mental illness. So does our culture.

As someone with a bone disorder leading to injury, surgery, and disability, I’m intimately acquainted with what Susan Sontag called “the kingdom of the sick.” When I meet fellow citizens of that kingdom—other people with my disorder or a friend with rheumatoid arthritis—our common experiences forge an immediate connection.

The kingdom of the mentally ill has some terrain in common with the kingdom of the sick. I have friends, for example, with whom I share the burden of taking daily medication—for them an antidepressant, for me opioid pain relief. In both cases it’s necessary for daily functioning and also widely stigmatized in a culture that likes to believe that with the right all-natural diet or physical practices we can avoid Big Pharma’s wily clutches.

But the kingdom of the mentally ill lies in a poorly mapped corner, a foreign landscape I struggle to understand. I have a childhood friend who has cycled in and out of psychiatric hospitals for more than two decades. Every few months she starts calling, sometimes several times a day, to tell me what simple thing she needs (money, a place to stay, a job, a lawyer, her ex-boyfriend’s love). I can relate to a condition that leads to loss of control, stigma, isolation, and pain. But I struggle to relate to a condition that alters someone’s reality so deeply that she doesn’t perceive herself as sick.