As the reader by now probably knows, I suffer from some type of psychotic disorder. Because my disorder is chronic and severe, I get symptoms of it despite being well-medicated. Sometimes, I experience a mini-episode, not severe enough to be called a mild relapse, but instead, at the level of seriousness of a bad cold.
A friend, who was chronically mentally ill, in a strange twist of the mind, compared his illness to that of another person, saying that he didn’t have the insight that someone else did about his condition. And this, by his own word, meant that he was truly ill. He said to me that someone retaining more insight about her or his condition would contract a mental “cold” rather than being truly ill.
(At the time, I found it odd that a person could have the insight of the fact of lacking insight. I will have more to say about this in a future column.)
A person has a mental cold when their brain is having a flare-up but their mind is essentially intact. A “nano” episode, as I’m calling it, means that the sufferer might need to cut back on activities, temporarily increase medication (if a doctor orders this), make sure and get adequate sleep, and give more “chill time” to oneself. It will also help to avoid unnecessary conflicts with people.
If I am dealing with the equivalent of a cold, rather than a significant relapse, the intensity of the symptoms will not be very severe. (Even mild symptoms can mean a substantial amount of discomfort, however.) As a person who suffers delusions, these erroneous thoughts must not be numerous enough or severe enough that I have begun acting on them. If I have begun acting on my delusions, then I have crossed a line and entered the territory of a significant relapse. My cold has become pneumonia.
Concurrent with some amount of delusions, in a nano episode, there is an emotional component in which I become more vulnerable to getting angry, upset or stressed out. My normal insulation against painful emotions (that I have cultivated with meditation) may be thinned out temporarily, or even absent. I might find myself to be stuck on a roller coaster of painful feelings. Although I don’t get physical, my wife isn’t happy being around me while I get angry. However, she realizes that I am having an emotional reaction to my paranoia, and I am not truly the verbal bully who I appear to be.
Persons with mental illness can teach themselves strategies for compensating for the brain’s problems. Some of these strategies are cognitive corrections, while others may be social. For example, teaching oneself not to act on certain thoughts and impulses, ones that most people may not experience in the first place, is a social correction. Teaching oneself how to identify and negate delusions (ones that the medication has only partly alleviated) and even teaching the mind how to do this automatically, is an example of a cognitive compensation.
Living with a severe mental illness is a continuous challenge, including those times when a person is essentially doing well. A person must deal with the day to day maintenance of controlling the condition. The alternative to this is to be hyper dependent on the mental health treatment system, and to constantly have the therapist fixing you on the inside—not a very good choice.