Kathryn Cohan Who am I now?

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Young adults, in their late teens and early twenties, generally receive a diagnosis in the midst of living through conflict; as he or she is trying to come to terms with "who am I?" and "with whom do I belong?" The diagnosis changes everything, as there is no template for asking these questions in the context of extreme states. The experiences that comprise the term "mental illness" may well be so overpowering as to overshadow the questions for the first part of the journey. But that does not mean that the rest of life's journey should be aborted, nor should people with mental illness -- as is current practice -- be encouraged to assume that the question of identity has shifted from "who am I?" to "what am I?"

A more useful question might be "what does this mean to me?"

I spent the first few years of my adulthood feeling uncertain and inauthentic, not sure if I could come to terms with being both "epileptic" and "a whole person." The identity conflicts with which I was previously occupied took a back seat to my new identity as a young woman with epilepsy. Finally, toward the end of the third year after my first episode, I made the decision to move to a new state, set down some roots, and try to start fresh with a life that did not center around being "handicapped."

I moved to a new state with my boyfriend. I took epilepsy medication as prescribed. I found work, shared an apartment, lost that relationship, found another and married. A few years later I wanted children. I had a thorough neurological -- approximately seven years after the first one that established the temporal lobe epilepsy -- and was given a clean bill of health. I did not then, nor had I ever had temporal lobe epilepsy. I did not give this news a second thought... I was twenty-six years old and wanted a baby. It had never occurred to me not to have children.

I went off my epilepsy medication right away and proceeded to conceive very quickly. In nine months my 7 lb. 8 oz. daughter was born by cesarian section. I was successful at breast-feeding, and nursed her for 13 months. I then decided to try again, and achieved my son. His birth, however, was under less than ideal circumstances, as he was born two months premature and had a low birth weight of 5 lb. 3 oz. He spent the first weeks of his life in the neonatal intensive care, and I spent the first weeks of his life re-experiencing moments of intense fear and mood swings that I vaguely remembered from my past. I did not make the connection, since the episode of my late teens seemed to have no precipitant, while this episode -- at age 30 -- was, it seemed, clearly in response to crisis.

I remember not sleeping for the first few weeks of his life, and spending day and night hovering over first the tray on which he was kept, and then, later, the isolette into which he was placed. I longed to touch him, but it was forbidden. I would call every morning and ask the nurses not to feed him, just so I could hold the bottle for his morning feeding. One morning, a nurse screwed up and fed him anyway. I made a scene, and a social worker was called to extract me from the nursery.

She told me I looked like I needed sleep. I remember being so overwrought that droplets of spittle sprayed all over the room as I spoke. I ranted about the rage I felt at the nurse who had made the mistake, I accused the hospital of taking my son hostage, I accused the staff of incompetence. She escorted me out to the parking lot and sent me home. I don't remember the drive home. I do remember feeling that I was more out of control than I had ever been before.

I turned up the next day and folks in the nursery looked afraid, but were nice to me.

Motherhood afforded me certain protections. My outburst was regarded as nothing more than the hysterics of a freaked out and sleep deprived mother. Earlier I cited Erickson's Stages of Psychosocial Development, stating that "intimacy vs. isolation" was the conflict of young adulthood. For me, a baby solved it. Motherhood provided:

1. A legitimate role, proof of overcoming handicap

2. Intimacy, in the form of a child, and "cementing" of the marriage

3. Closure to a lifetime of curiosity about what kind of parent I'd be

4. New curiosity about what person my child would become

Motherhood irrevocably changed my relationship with my husband. Also, I was feeling the need to finish certain unfinished business from my "youth," namely completing my college degree abandoned thirteen years earlier. I had my hands full: I worked full time in mental health; I had two small children; and I was a full- time (non-traditional) student. I found myself compelled back into therapy to help me take inventory of my life and soon made the decision to divorce.

I lived through this period of my life with certitude and empowerment. I knew I was doing the right things to take care of myself and my children. My career was blossoming and the college degree attained. I had my first article published in a national newsletter, which was the fulfillment of a lifelong dream. I was working on my second article with a trusted friend and colleague, approximately six months after separating from my husband of twelve years. I was having a little depression in response to the divorce, and taking prozac to help with my mood.

I was writing coherently, precisely, and constantly. On a Sunday night, having been awake for four days, and hearing my colleague say she was going to sleep, I began to wonder. I had no need of sleep. I could not remember the last time I had slept. I could not remember the last time I had eaten, or bathed, or done anything besides write the article we were working on. I felt good, I felt strong, I felt elated and motived to continue writing. But I knew this didn't make sense, especially since my writing partner had been working at a much different pace... a pace that included sleeping and eating and bathing, and I hadn't -- until that moment -- noticed.

Trained in diagnostics, I turned to the DSM-IIIR. I read my life on the page that described bipolar disorder. In pencil I checked off five of seven criteria.

On some level I was reassured. There was a name for what I was experiencing and it could be treated. On another level, all I had was dread. If this was true about me -- this manic-depression -- and I never knew about it, what else was there about me that I didn't know?

No matter when in life mental illness occurs, it brings with it certain core crises.

There is first the recognition -- internal or external -- that something is wrong. Until we have accumulated a great deal of experience, and, sometimes, in spite of the accumulation of experience, the idea of "something being wrong" usually comes as a surprise. This is the first shock to self-concept.

Next there is a simultaneous recognition that something was wrong and something might still be wrong, and, even if it is not now, something could be wrong again. The "if 'A' then 'B'" thinking that we have relied upon up until that moment is no longer truth. There is no certainty anymore. This overpowering uncertainty is the second shock.

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[Who am I now?] [Strategies for Self-Determination] [Talking Points]
[Inner Science] [The Hard Questions] [Provider Psychopathologies]
[Inviting In The Wolf] [Recovering Self Esteem] [The ECT Suite]
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