The Cost of Insanity

All that is lost and gained in mental illness

Photo by Cherry Laithang on Unsplash

In my last article, I informed my audience that something terrifying was happening in my brain. For the entire month of June, my mind opened a portal to hell, and I suffered the scariest mental health episode in a decade. It had been brewing since December and reached its horrific climax this summer.

I am sorry if my previous post frightened some of my readers. I was emerging from the bottom of the ocean and came up thrashing. I owe it to my paid subscribers to let them know if my health prevents me from creating content. But I also didn’t mean to alarm my readers.

Since I am doing better, I thought I would provide an update, and a few disjointed reflections.

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What is it like to come out of a mental health crisis of such magnitude? It’s a strange, disorienting feeling of being pieced back together. Parts of myself are reemerging from emptiness. I'm remembering things that I had forgotten: I enjoy Magic: The Gathering. I enjoy music, philosophy, and fantasy novels. I love electronic music and horror movies. I find meaning in work. I can now remember periods of my life that I had forgotten – seasons of joy and contentment. There is more to life, I now see, than regret and anguish and fear.

 This re-forming is slow. I still feel too burnt out to produce any audio or do any work beyond the barest minimum. I still have scary moments, and I still feel fragile. But the tiny, suffocating dot of survival is expanding, allowing for more life, memory, and experience.

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This experience has re-emphasized the necessity of practice, discipline, and forethought. We train off the field for what happens on the field; we develop disciplines when times are good to weather the Three AM Test.

When I had my last serious mental health collapse, I told myself that I would rebuild my life to ensure that I would never experience such suffering again and that if I did, I would be able to survive it.

This became the project of my 20s — to build the skills to weather the next asteroid strike on my mind. I always knew another one was coming, I just didn’t know when.

This is a strange cost of madness since it has forced me to be healthier than many of my peers. I can’t smoke — nicotine triggers death spirals. I can’t drink — my meds prohibit me from consuming alcohol. Consistent sleep, exercise, and diet keep me sane. While so many people can get sloppy with their health and suffer no immediate consequences, for me the cost of straying from these habits is swift and punishing.

I am now immensely grateful to my past self. Like the main character in Memento, who tattooed clues and reminders all over his body, my past self built me a system to fall on.

Past Stephen knew I couldn’t survive alone, so he built a network of friendships and social support systems. As a result, I had friends to give me company when I shouldn’t be alone, to text with at all hours of day and night, and to call when I needed help.

Past Stephen knew that exercise is medicinal, so he set up physical disciplines so rigorously practiced they would kick in automatically during times of distress. This is why, when I woke up in torment, I would put on a backpack and go rucking on a trail. It was better to weep in nature than in my bedroom – I did so without thinking. Having to think about it would have left me mired in inaction because it was my mind that was broken. My past self made sure that exercise was automatic and unthinking.

Past Stephen understood that contemplative practice was crucial to transforming my relationship to suffering, so he meditated every single day. At the height of my breakdown, seated meditation practice was impossible, but the insights from my meditation practice shone through the cracks in my life. I would remember that thoughts are just thoughts, that I can endure any suffering for a minute at a time, and that anything which has the nature to arise must also pass away.

These skills felt barely sufficient. They only reduced the pain from a 10 to an 8. I spent entire days feeling that the pain was simply too much to bear and that I couldn't go on like this. Even with all the disciplines and strategies, I still felt that I was holding on by my fingernails. But they also saved my life, if only because they were a life raft that carried me to the evidence-based therapies and medications that have drastically reduced my suffering.

I'm now working with a CBT therapist who, thank god, doesn't indulge in talky bullshit but provides evidence-based corrections to my mental posture, like a physical therapist for the mind. He's having me focus on resilience, healthy routines, and mindfully catching cognitive distortions. It's saving my life. I'm also on a treatment plan for Bipolar II that essentially has me living like a monastic – consistent sleep, rigid routines, and healthy habits to keep me grounded.

I am emerging from this crisis feeling stronger, and even grateful. I have survived some of the most hellacious mental torment of my 30's, and I'm coming out the other side. I want to be resilient and strong – physically strong, mentally strong, emotionally strong. I want to invest in the things that matter most: the present moment, loving others and making a better world.

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And yet, allow me a moment of bitterness. I am grateful that I have survived, but I am also angry. I am angry at the cost of illness, and I am angry at the internet’s portrayal of it.

I wish, with all sincerity, that I didn’t have to live this way. I wish I didn’t have to monitor my mind the way a diabetic monitors her blood sugar. I wish I didn’t have these enormous black holes in my life that devour entire months and years. Those are years that could have been spent building a career, succeeding in school, and doing meaningful work. I will never get those years back. The cost of Bipolar II over a lifetime is devastating. It takes relationships, money, and time. I will never get those resources back. I have effectively lost the entire first half of 2024 to this battle, and I have spent an obscene amount of money on treatment. I canceled voice acting contracts because I couldn’t work more than the bare minimum. I will never be 35 again, and that makes me unbearably sad.

I do my best to absorb these setbacks with equanimity because acceptance is preferable to bitterness. For good or for ill, this is the life I have been given, and I can only do my best with what I have. But I would lie if I said there wasn’t a worm in the acceptance.

Online discourse surrounding mental illness often tilts into the twee and cutesy. TikTok and Instagram are full of Insanity Influencers, and they make it oh-so relatable and so very camera-friendly. OCD is a cute obsession with bullet journaling and color coding your Tupperware. Bipolar is dressed up as quirky. I hate this trend because it’s like dressing up a child predator in a Disney costume. Insanity is a monster, as malignant as Pennywise, and it will drag you into the sewers and devour you.

There is nothing cute or loveable about insanity. Waking up screaming in the morning because your brain is on fire isn’t adorable. Chasing risky sex until five AM on a bipolar manic bender destroys your life. Throwing yourself out your window because of night terrors isn’t cute. Carving your arms and legs for a decade isn’t charming. Dropping out of high school after you slashed your arms in the school bathroom isn’t delightful. Being delusionally convinced that you are going to prison because you accidentally broke non-existent laws isn’t quirky. Having a psychotic breakdown and being convinced the ceiling fan is a monster isn’t Instagram-worthy. Yes, this has been my life, and I wish it wasn’t.

And yet, of the mad, I am among the blessed. Growing up, I had a solid family unit that fought valiantly for my survival. I have a partner of a decade who is financially successful and can provide for me when I can’t provide for myself. I am mercifully responsive to treatment. Most importantly, I know that I am ill.

Spare a prayer for those resistant to treatment, those who were not raised in stable families, or don’t even have the insight to know they are sick. They are the lost, and I could have been one of them.

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Every serious mental health crisis is, in my experience, akin to a regeneration of a Time Lord in Dr. Who. It's a savagely painful rebirth of a new self. Every major episode I’ve experienced has rearranged my psychic innards. The last time I went through an episode this cataclysmic, my relationship with God fundamentally shifted and I eventually lost faith altogether. The aftermath of such a cataclysm is similar to how psychonauts talk about “integration” after a powerful psychedelic trip.

I often wonder if immense psychological distress serves an evolutionary purpose — that of shedding an old skin, emerging from an old psychic chrysalis. Coming out of the depths is an opportunity for transformation and rare introspection.

This is a blessing, but also a cost: I don't really know who I am right now. I don't know what to write about, what to create, or where to go in life. I'm struggling to figure out what kind of person I am in the aftermath of such suffering. This has made it hard to sit down and put words on the page.

I’m trying to focus on what remains. I am still a meditator. I am still a writer. I still have my friendships. I still have my day job. But so much else feels intangible.

What will come of this new reformation, if anything? I don't know.

On a practical level, I'm not pushing myself too hard. I'm still struggling enormously in the mornings, and I still have scary moments of feeling like the ground beneath me has vanished. I'm still healing, and I don't want to hasten that process. The podcast is on indefinite hiatus, but I will do my best to return to consistent writing.

Again, thank you for all the love and support throughout this time. I have gotten some incredibly thoughtful and caring emails from some of you, and while I wasn’t in the headspace to respond, it was heartening to receive them.

Let me end this reflection with a question: since I am struggling to know what to write about, please offer suggestions. If you received this article in your email inbox, feel free to reply to the email with suggestions. If you are reading this on Substack, feel free to leave a comment.