Burning Down the House of Psychiatry During COVID

If there was ever a time to re-evaluate how we as a society deal with human suffering, I assure you, it is now. The particular nature of a pandemic’s mental health effects strains every false narrative and misguided practice of psychiatry. Especially the practice of medicalizing the very human reactions of severe depression and anxiety in response to isolation, deprivation, and suffering, as well as the claim that this response is indicative of chronic psychological disorders.

If there was ever a time to shed psychiatry’s influence over oneself, well, now is both a good and a horrible time to do so. This past fall and, so far, this winter —the last leg (hopefully) of this most recent episode of global human suffering—has been very hard for me. I live alone and with the consequences of a bipolar label, the consequences of trauma, and a mind that is just different enough to be in psychiatry’s constant queue for restraint and correction.

Sadness started to overtake me recently. While this past year has been hard, the challenges have been manageable – even, sometimes, joyous, an amazing opportunity to explore myself and my creativity, the way I work and sustain myself financially. But isolation is still a bitch of a mental poison. It has, in fact, been studied as one of the many leading social causes of mental distress in the world today. Throw in a pandemic, social distancing, etc., and we have an exacerbation of what was already an epidemic of loneliness, as reported by many health agencies around the world.

This situation has been a boon for psychiatry—a dying paradigm that seems to be in its final throes. Psychiatry has been handed a megaphone for its dangerous narrative, which labels natural, temporary reactions to situational, social, economic, and interpersonal distress as chronic “diseases.” Conveniently in need of many, many years of treatment with expensive drugs… despite that, by all accounts, we still don’t know all the ways these treatments act on the brain.

The first leg of the pandemic was different. People were almost frantic in reaching out to one another. Friends I hadn’t heard from in years wanted to connect. I had Zoom calls several times a week for the first few months. Living alone, this was so helpful for me. I never felt like I was losing a sense of belonging within my social circle until this past November. The light had changed, making mornings so much harder – derailing my hard-earned new identity as a quasi-morning person. I also had a medical issue, likely due to withdrawal from a mood stabilizer. A month-long migraine and crippling fatigue. And it seemed people had started to embrace the isolation I had been railing against like my life depended on it. People were starting to hibernate.

Self-isolation seemed to be how people were coping with this part of our collective journey through the pandemic. It was self-preservation. And I understood. And started to try and accept it. Actually trying to embrace it. Aloneness is an interesting concept in Buddhism, which I started reading about when this whole thing began. Stephen Batchelor aptly put out a timely book about solitude just as I got laid off from my bookstore job because of COVID in March. Tara Brach put out a bunch of talks around loneliness. I was trying hard to embrace it as a learning experience.

And in a way, it did come to feel like positive growth around depending on myself. We’re born alone and we die alone, right? But the sadness still came. I pulled out all the tricks. Telling myself the truth that emotions are temporary, suffering reasonable in a time like this. I tried to look at this suffering as a kind of nutrient, a bitter meal that one needs to eat to be well, or like apple cider vinegar by the spoonful. I fought off every feeling of resentment around each thing my insecurities tried to convince me was a disappointment of loving, each lack of connection that felt like a failure of it. I certainly did not want to live like that, resenting others for paying attention to their partners and their own sanity. This just felt like holding a razor against an ancient wound.

I recognized that I had been through a lot. In the years I was medicated for bipolar, I had suffered the side effects. In the years alone, I had suffered the effects of isolation on my health. So much of my existence felt like life had lain one boulder at my feet after another, erected sometimes entire sea walls between me and recovery. And I had climbed over them all. The brokenness, this past year, had started to feel sacred. I was not about to let this pandemic take me down. But at points the suffering felt endless. Indeed, it is endless for all of us, like life itself— which, as the Buddha said, is marked by suffering. And even he offered a nod to the essential aloneness we often feel and asked us to find strength in it.

It’s a strength no one desires, in truth. The strength to endure the pandemic alone. Yet, the promise of it seems like a love so tender and beautiful. That love of self that knows no one, no pill, no words can save them. That only we ourselves can offer the warmth we need to survive a winter such as this. It’s a lesson no one wanted to learn. A lesson I would rather leave to my next lifetime. But this is the curriculum of every life: the curriculum of aloneness. The curriculum of suffering. It’s a deep sadness that needs meeting.

As I’ve come off most psychiatric drugs and had been weaning off the last, people would say to me,  “This is intensely hard for everyone. Why are you putting yourself through this withdrawal right now?” As if to say I was doing myself a disservice by trying to survive it with less medication. But the truth is that life offers such things—pandemics, wars, economic depressions – and medicalizing such pain does nothing more than steel our language around our global grief and make the process of healing so much harder.

Instead, years from now, when the studies finally appear, we might find that people are being diagnosed with chronic illnesses stemming from the pandemic at record rates. The CDC and others have already found that symptoms of mental distress have increased to 40% of the U.S. population. This may or may not translate to official diagnoses, and if it does, that will not be a benign trend; it is extremely dangerous. I might say—almost without reservation—

that if you are suffering from severe depression, anxiety, and yes, even altered states or “psychosis” around this pandemic, you are not sick. You are human. This is suffering on a massive, global scale. Your brain is tired, overwhelmed, and in pain, not sick or chronically broken.

Recently I started reading Rebecca Solnit’s essay collection A Field Guide to Getting Lost and a quote struck me. It was within an essay about adapting to new cultures. To me, it struck at the heart of what I –and perhaps psychiatry, and maybe even the world—are facing:

…Sometimes an old photograph, an old friend, an old letter will remind you that you are not who you once were, for the person who dwelt among them, valued this, chose that, wrote, thus no longer exists. Without noticing it you have traversed a great distance; the strange has become familiar and the familiar if not strange at least awkward or uncomfortable, an outgrown garment…Some people inherit values and practices as a house they inhabit; some of us have to burn down that house, find our own ground, build from scratch, even as a psychological metamorphosis.”

We are all not who we once were. I am certainly not who I once was. I have spent the last year burning down the house of psychiatry as it lived in me. Shedding a harmful framework of understanding myself and my suffering. Detoxing from 20 years of psychiatric restraint and pharmaceutical colonization. And perhaps we all must do the same as we face this acute phase of human suffering. Psychiatry does not have the answers for us. They have always been in over their head, and they certainly are now.

There is no medical cure for this kind of suffering and there never has been. There is no chronic disease in suffering as many of us are now, alone and scared during a global crisis. The balm is the transformation of ourselves, of psychiatry, of our culture, realizing our possible newness on the other side of this pandemic, where we are surer than ever of the social determinants of suffering and dedicate ourselves to de-medicalizing it, connecting with our empathy for each other, and confronting the systems and circumstances we all face that actually cause it. Trusting in our own fragility and humanity in the face of adversity and consciously entering the path on which we burn the houses of medicalization we have built around it and do the hard work of learning to have radical compassion for ourselves and each other.