There was a ticking time bomb in my head that deactivated at the age of 26: the probability of schizophrenia. That’s when, for first-degree relatives, the statistical likelihood of developing the disease drops from 13 per cent to that of the general population: 1 per cent.
My mom is afflicted with schizophrenia. Despite never having had signs or symptoms, I used to live in constant fear that, one day, I might develop it. The path of my life was driven by this fear. I overworked myself to ensure a livelihood that would enable escape from the stigma of mental illness and unemployment. Becoming a doctor seemed the best I could do to champion my own mental sanity, and to further understand an illness that has never made sense to me.
For some, Christmas aggravates their heart failure – all those salty holiday indulgences. For others, the season precipitates their “brain failure” – the stress, anxiety and loneliness is amplified by the process of reflection on years past.
For part of last year’s holiday season, I found myself on the crisis-psychiatry team at one of the busiest inner-city centres in Canada: St. Michael’s Hospital in downtown Toronto. “Crazy” became the new norm, all day, every day, suicide and self-harm an acceptable and prevalent psychological exit.
My worst moment of flashback to my own experiences occurred when I had to make a phone call to the Children’s Aid Society. I’d just spent an hour developing a good rapport with a newly divorced, newly unemployed, suicidal single parent – courageous in seeking help. Calling CAS was a decision that would result in the removal of her children from her home – at Christmas.
To me, it was the ultimate betrayal of her trust. I felt as though I had betrayed my own mother. Instead of going home for the holidays last year, I externalized my distress by going to Haiti as a volunteer physician working on cholera-relief efforts.
As early as Grade 3, I had an understanding of the societal taboos around mental disease. That year, our art-project assignment was to “depict your parent’s career in a drawing.”
My mom? Unemployed. And so I developed a knack for creativity. I didn’t understand exactly what was wrong with my mother, so making up a career for her wasn’t a big stretch.
In high school, my sister and I were recruited for a University of Alberta study of children with a parent who had schizophrenia. Enrolling in this was like facing my biggest fear. I was sure the survey would uncover that, secretly, my mental stamina of steel had been blocking out symptoms that would eventually resurface with a vengeance.
Quite the opposite happened: It was a first step toward freedom. Not only did they declare my sister and I mentally “healthy”; they did something far more important to me – they normalized the disease.
I understand now that “mentally healthy versus ill” is an often unhelpful dichotomy. The psyche of the population exists on a spectrum. Scientifically, we have constructed an arbitrary standard. Past a certain point of dysfunctionality, some will be labelled, recommended for therapy and medically treated.
The rest of us can retain our status as “normal” and obtain socially acceptable therapy in the form of free counselling from family members and friends, self-therapy in the form of reflection, and perhaps moderate doses of self-medication.
Even for one individual, mental wellness fluctuates immensely over time. Practising medicine has reaffirmed for me that there is not one among us who is 100-per-cent mentally sound in all day-to-day exchanges and decision-making. Most of us could probably cite one or two mental hang-ups they could do away with. Thankfully, we escape any permanent labelling and write these off as a mood, an anxiety, impulse or worry.
I realized I'm tired of the silence around mental illness. I'm tired of contributing to the stigma by hiding the reality that these patients are our sisters and brothers, our parents, our closest friends – the ones in our lives whom we love but don’t know how to reach out to.
The reality? My mother is a great parent. With age, I’ve come to appreciate that her demeanour has given me a positive outlook on life; and it has imbued me with an inordinate capacity to tolerate chaos and disruption. They are traits that have served me well as an emergency resident physician in Toronto and working overseas in resource-poor settings in South America, Asia and Africa.
It's also taught me to value my clarity of mind and to put it to use. It gave me the opportunity to benefit firsthand from Canada’s social safety network. It has bred a doctor and a teacher (my sister) who will be strong lifelong advocates for redressing social inequity.
To my colleagues who work with those affected by mental illness: Thank you for showing them patience and understanding and treating them as equals, even when society, or sometimes their own family, doesn’t.
My mom has really done her best. She’s spent her entire life struggling to cope with the mind inside of her, as well as to cope with the reactions of the world around her.
She’s amazing, really. My sister and I will probably try to micromanage her symptoms until the end of her days. But we love her. And we owe her and her illness everything.
Anne Aspler lives in Toronto.