Marya Hornbacher Again

A few weeks ago, I took a survey by Marya Hornbacher, author of Madness: A Bipolar Life, which probed my feelings about mental illness. She has written back with more questions. Here they are with my answers:

Do you consider mental illness a chronic physical disease? Please explain your response.

There’s no other explanation for it. I have tried willing myself into better moods or trying to stop my impulsiveness, but they were just too massive a problem for mere force of mind. It was like trying to prevent my cold from generating mucous or insisting that my pancreas produce more insulin. I tried, believe me, I tried to stop the tidal wave of emotions that consumed me but they kept rolling over me and I drowned. When I stopped seeing it as a character flaw and began treating it as a disease of my brain, I got on medications. While my nasty habits didn’t vanish overnight, the moods that drove them achieved a halcyon state in which I was not thwarted in my efforts to change. Just as my heart medications lowered my blood pressure, so, too, my mood stabilizers calmed me.

Do you think the lives of people with mental illness can be substantially improved with sufficient resources over time? If so, what would that improvement require? If not, why not?

This bizarre political climate of the early 21st century holds that nothing can be done for the mentally ill that involves allocating more resources to their needs. Ideology, pure and simple, drives this notion. We have never been delivered the community mental health care centers that we were promised in 1963. Instead, states keep cutting funding for programs for the mentally ill, some to the bare bones, some to the dust of those bones. As someone who is fortunate enough to have decent insurance, I cannot begin to understate its importance in my life. I am well because I have the means to be well. I have a psychiatrist and a therapist. I have a stable home. I attend support groups.

Others don’t get to have these. They end up on the streets of our cities and in our jails because they lack the means to be well.

If the money is there and if it is properly directed, we will see people get off the streets and out of the jails. A new economic boom will arise as these people become consumers. The stinginess of our policy makers is the only obstacle to this. I despair that we will see any change for the better as long as they sway in Congress.

Do you think the current boom of research into the brain will result in better treatments for psychiatric disorders? Why or why not?

Yes, but they won’t result in a cure. I believe that once the problem of the blood-brain barrier is resolved, we will see better meds with few side effects. The more people who are looking into a problem, the more that will be discovered and verified. Science requires effort and interest on the part of the scientists. Grants and other research money will stimulate this, but I dread that the money will soon dry up.

Have you heard of the recovery movement? If so, what do you know about it?

Yes, but I don’t believe in recovery. We cannot shake this illness. It will always be lurking there, waiting for our bodies to stop responding to the drugs. But having said that, I believe in remission. Here is where I laud the recovery movement because it insists that we can live rich and productive lives. We get to make our own decisions about what we want to do with ourselves instead of being the thralls of our families, government programs, and insurance companies. That is a worthy and a possible end. If we cannot be free of the disease, let us live well during the intervals between episodes.

Do you think there is a need for more public attention to mental illness? If not, why not? If so, what do you think still needs to be addressed?

The public pays a lot of attention to mental illness, but it is not the kind that helps us. Every time there is a Sandy Hook massacre or a Germanwings crash, the media puts a hockey mask on our collective faces. There are those who claim to be working to support the mentally ill in America today, but their agenda too often implies control of us rather than helping us achieve the kind of support that lets us live well outside of institutions.

The gaze of the public needs to be swayed in another direction. The public needs to understand that what is needed is not destruction of our privacy rights, our freedom to choose, or our freedom to live on our own, but institutions and programs that help us get treatment and other supports. We need medicine, jobs, and housing, not strait jackets, prison bars, and homelessness.

It does not help us that prominent media figures deny that mental illness even exists! You cannot blink or click your ruby slippers three times and make this condition go away. It factors into my life and the lives of many of my friends. It may be here to stay, but that doesn’t make it beyond amelioration. The public needs to be taught that there is Science and there is folk belief; and that the former trumps the latter. Once we admit that there is a problem, we can look at the problems that affect the greatest number of us, and work sustainable solutions.

My previous responses



Joel is the founder of DBSA South Orange County. He received a degree in Anthropology from Pomona College, one of Forbes Magazine's ten top undergraduate schools. His manic adventures include traveling to former Yugoslavia during the 1992 war, believing he was the Creator of a messed up Universe, road rages, and running up $40,000 in credit card bills. He lives with his wife, dog, and cat in Trabuco Canyon, California.