Columns

ON MENTAL ILLNESS:Dealing with a Diagnosis

By Jack Bragen
Friday November 30, 2012 - 08:31:00 AM

Becoming diagnosed with schizophrenia hurts. Just prior to the diagnosis, a person with mental illness very likely had an episode of psychosis that caused them to be diagnosed. An episode of full-blown psychosis is nothing to sneeze at-it is usually a horrible experience. Being told that you are mentally ill and that you will probably have this problem for the rest of your life adds insult to injury. 

Coming to terms with a diagnosis of having a major mental illness is a difficult feat for someone who has difficulty living in reality to begin with. Denial, usually in the form of the belief that the diagnosis is wrong, is common. Accepting the reality that you will be dealing with this illness for years to come is a major hurdle. Yet, doing so is the key to getting better and to making progress in life. 

It is difficult for someone who has experienced a psychotic episode to have the necessary clarity of thought that is needed to grapple with their diagnosis, to accept it as real and to move on from there. 

For some people, psychiatric illness was precipitated by illicit drugs. That opens the door for that person to believe the drugs solely caused their illness, and to believe incorrectly that they are not ill and don't need medication, that they will be fine if they merely remain off of the illicit drugs. There are numerous avenues of rationalization available to someone who tends to be in denial. 

(It is not uncommon for someone to be in a mental hospital after taking illicit drugs. The narcotics in some cases triggered a psychotic episode that would have happened without illegal drugs, but would have happened a little later. Still others are permanently damaged by illicit drugs and thus they entail the psychiatric diagnosis and the medication that goes with it.) 

How can you blame someone for denying a diagnosis that seems like a life sentence to taking medication (that often has awful side effects) to living with the label of mentally ill person, to being institutionalized (even if sometimes on an outpatient basis) and to not having the good things in life that he or she was looking forward to upon reaching adulthood? How can you blame someone for not wanting to believe that he or she is a "defective" person, someone whom society often ridicules or shuns? Having a diagnosis of mental illness is harsh, and it takes a lot of work to get used to the idea. 

Denial of the diagnosis, believing it isn't correct, and sometimes imagining other causes of one's difficulties, is one of the main paths to being medication noncompliant. 

Part of the problem is, when the brain isn't working right to track reality, it can't deal with the information that it has a deficiency. Clarity must somehow be arrived upon in order to be able to digest the information that the brain has this problem. Under circumstances like these, it is sometimes necessary to force medication on someone. Once someone is medicated, we might hope that clarity will arrive and help the person get "on board" with their treatment. 

It took me several repeat episodes over a period of decades to be able to finally admit for good that my disease is real and that I must remain in treatment, probably for life. The admission comes with some relief, since I am no longer battling against admitting the truth. Admission of the disability part of my illness allowed me to stop masochistically getting low-end employment which did not suit me. 

The reader should note that denial of the diagnosis is more common when someone has a psychotic illness like schizophrenia, and does not happen as much with depression or with those cases of bipolar where there is no psychosis. With illnesses other than those that create psychosis, often the consumer embraces their diagnosis because they are glad to know what is wrong with them so that they can get it treated accordingly. 

* * * 

Just to remind you that my new self-help guide is available in both electronic format and hard copy on Amazon. You will find my books for sale if you put my name into the Amazon search box. As always, I can be contacted at: bragenkjack@yahoo.com however I can not give advice to individuals as I have no license or credentials to do that.