Hot Take: I Don't Have Schizophrenia

Since my episode, I have worked very hard to be as open as possible about my psychosis. I have a very short bandwidth for small talk these days. If I think that someone could be my friend, then it's kind of like this blog. It's the whole story. It's unfiltered.

I'm through wasting my time on being intentionally misunderstood.

Let's get the bullshit out of the way and see if we're actually compatible as friends, you know?

I've developed a remarkably brilliant litmus test for this.

I tell them that I am schizophrenic.

If you look into the history of psychiatric medicine, you will find that it hasn't been regarded as a spectrum until recent history-schizophrenia. Similarly to autism, it is now regarded as a spectrum disorder. For the longest time, in western medicinal history, schizophrenia was what they diagnosed when there were no other clear-cut diagnoses. For context, the word schizophrenia translates to "split mind", per its Greek roots. It's vague. It's where the "splitting" aspect of Borderline Personality Disorder gets its name, but that's a concept that I have no personal experiences with. People forget just how little time it's been since we've had psychiatric asylums. There's a reason that that probably conjures images of lobotomies, restraints, and permanently closed facilities. It summons fear and violence and social segregation. Schizophrenia was the "other" box on the criteria list. It was the catch-all for the misunderstood. We aren't too far from these violent facilities being commonplace. Our social constructs, however, have stayed consistent with that time. We shun what we do not understand.

Many of my friends and colleagues who discarded me are also in the medical profession. The overall literacy for this condition/issue is severely lacking. Even in medicine, the stigma is there.

I am damn good at what I do. I am an exemplary nurse and team member. I had my entire credibility as a medical professional put in jeopardy because of something that I couldn't control. I did work before, during, and after my episode. It was incredibly difficult, but I did my job well. When I'm working, I can compartmentalize it. I can just turn off my outside life completely. I guess that's a thing in medicine, learning to be situationally detached.

I would like to once again reiterate that psychosis can happen to anyone. At any time. For any reason.

However, is this to say that schizophrenia is not real? Absolutely not. Schizophrenia is a very real illness, but it exists on a spectrum. There are levels of functionality and severity. Have I officially been diagnosed with schizophrenia? No.

Have I been diagnosed with bipolar disorder with psychotic features? Yes.

Do I exist on the schizophrenia spectrum? Yes.

Do I also have Complex Post Traumatic Disorder? Yes.

Can psychosis be caused by CPTSD? Yes.

Can psychosis be caused by anything? Yes.

Psychosis is a genuine break from reality, but I would like to emphasize, again, that psychosis can happen to anyone. At any time. For any reason.

It happens when the brain feels threatened and the amygdala highjacks control to sustain a chronic fight-or-flight response. Maintaining the levels of epinephrine and cortisol required for this state is never intended to be a long-term affair. It is a survival mechanism intended for acute survival. Like escaping being eaten by a saber-toothed tiger. Episodic.

Psychosis is like never coming down from that. It is palpable fear, terror, and paranoia with no rest. This actually causes neurotoxicity in the brain because it isn't meant to sustain emergency levels for so long. It is akin to a brain injury for this reason. It is intense withdrawal coupled with actual brain damage. It takes years to recover from. I had to relearn basic tasks without knowing why I had to relearn them at all.

You can look at my recent blog posts to get the full scoop of my episode, but I was hospitalized during it. I thought that I was in danger and wasn't being taken seriously. Not once was my diagnosis of psychosis brought up to me. Nobody discussed the science and chemical makeup of the condition to me. Nobody explained the beast of fucking antipsychotics. They suppress those fight-or-flight chemicals. HOWEVER, when you're already in recovery (and in active withdrawal from this hyper-manic state), these drugs suppress that even further.

Some of the normal side-effects of antipsychotics (independent of a recent episode) are: anhedonia, difficulty orgasming, extreme drowsiness, depression, and weight gain-to name a few.

This is exacerbated when you're fresh into recovery from psychosis. Again, I would like to reiterate that nobody told me this. I have found this all out through my academic reading of psychosis and preexisting medical knowledge as a nurse. I even went into my discharge paperwork to confirm my diagnosis.

Sure enough, it said psychosis. I was never talked to about it in any capacity.

I cannot imagine what it must be like to experience this with no medical literacy. When you're being treated as a defective human by the system that is supposed to be responsible for educating and treating you, it's difficult not to take that personally. It's difficult to not let it fucking destroy you. It's near-impossible not to give up. It almost was for me.

I cannot possibly portray what it is like to have to dissect through your own reality. It is agonizing. It is gradual. Slowly, you come to realize that some part of this might've not been real, and then it avalanches from there. It snowballs until you are confronted with the horrendous, awful truth: you had an episode of psychosis.

And then, holy shit, the shame hits you like a fucking truck.

You learn that the one constant asset of trust and companionship, your concept of a sound mind, can fail you. You learn what it is to not be able to trust your basic instincts. To not be able to trust your brain. You learn what it is to viscerally and catastrophically short-circuit.

I exist on the spectrum of schizophrenia. If I can get far enough to explain that to anyone, then I do. That has been nonexistent these day, though.

I've just started cutting directly to the chase.

I tell them, point-blank, that I am schizophrenic.

I usually never get far enough to say anything else.

If I could have the opportunity to explain everything, exactly how I did in these blog posts, then I think that it would be fine. The problem is preexisting bias. What better way to assess that than taking out the middle man? What if I just tell them myself?

The knee-jerk reaction to this revelation tells me all that I need to know. I can see the dismissal start to form in their eyes. I can feel the tension manifest out of thin air. I can see my credibility dissolve before my very eyes.

I am learning to appreciate this. I am very guarded these days. If anyone is going to be in my life, then I'm not about the bullshit.

You're in or you're out, babe.

It's as simple as that.

I am a loving, funny, beautiful, talented human.

No matter what anyone says.