We Don’t Know What We Don’t Know

Today marks exactly 11 months since I wrote “The Right Diagnosis”, a piece where I documented the issues with having a diagnosis without a suitable treatment.

Again and again, I learn that a diagnosis, although medically relevant, has no significant bearing on one’s life whatsoever. A diagnosis does not necessarily breed action, nor does it inspire motivation. A diagnosis does not simplify your life, nor does it make it more difficult.

It is simply a label.

For far too long, I have recessed myself, tucked myself neatly into the  cozy cubby known as my DSM-V diagnosis. All these labels have described me nicely. All of my symptoms are there. If people know my respective symptoms, then there is nothing else to be done. My symptoms simply must be dealt with, I guess.

And this inaction, this falling back onto a dictionary definition of life-destroying, well-being threatening, relationship-obliterating diseases is the first step to ruining your life. Assuming treating the illness itself, without any other steps, is nothing more than a mistake.

Stagnation kills, and I’ve learned that the hard way.

Just as a person with diabetes must check their blood sugar and take their medications accordingly, is not all. They must adopt new regimens to manage their symptoms and pave the way for a longer, healthier life. Being more active, eating right, and being proactive in their medical care are just a few additional maintenance methods a diabetes diagnosis comes with.

Yet, with mental illness, the game is entirely different. While exercise, a wholesome diet, and self-care may help with the symptoms, they are nothing more than part of the standard routine. If anything, taking care of the body is a requirement.

Many mental illnesses require an additional layer of work, which is not always prescribed or talked about. It may come up with therapy, but in my experience, a lot of it has to deal with symptom management. Eat more food, exercise, make sure you have a good sleep routine.

Seldom has a therapist asked me, “why are you the way you are?”

“Why are you depressed?”

I don’t know.

“Why do your moods fluctuate so much?”

I don’t know.

Sometimes, we easily explain it away as a chemical imbalance and attempt to treat it with pills. Maybe it’s a lifestyle change, and we can address it through therapy. But why are we rarely tasked with introspection? I have explained how I grew up but never asked why I think I have anxiety. “It just is.”

I believe the solution lies in three steps: pain, discovery, and admission.

We don’t know what we don’t know. 

There are so many explanations for things we don’t know. Either it’s taught, or we stumble upon it by accident. Why the Milky Way exists, how weather patterns form, why we can’t have more than one ice cream sandwich, even though there are clearly six left in the freezer.

For mental health, it is the same way. We are either educated, through therapy and self-help, or we’re forced to do so. Something traumatic happens, we see a negative pattern in our lives, or we’re pushed beyond what we can handle.

Something triggers a response and perhaps, we’d like to learn where pain comes from. The pain we so desperately want to run away from, why does it happen? Are we not in line with our beliefs? Is our body not cooperating with our minds?

The DSM-V has no section on how to explore and evolve yourself. Most of our best explanations for why things get explained by “your environment and your genetics.”

However, I’ve learned I get depressed when isolated from people and nature or when my house is a mess. I’ve learned my moods fluctuate partly because my energy levels are driven by interest, curiosity, and caffeine.

These are simple discoveries I have made about myself, but they weren’t necessarily forced. They were just natural patterns I noticed over time.

I got dumped.

My girlfriend of seven months, Erin, made up her mind that I wasn’t healthy enough to be in a relationship.

She was right. I had grown complacent. I wasn’t myself when I was sick. I depended on her and my medications to solve all of my problems. I was constantly angry, negative, and bitter. I never wanted to resolve fights. I was too comfortable, and eventually, I was left because of it.

But there was another aspect of it I didn’t quite get. How was she so right about me not being healthy? After all, I thought the relationship was going just fine. How she described it later was the first clue in an incredible discovery about myself.

“For some reason, we are so close to being at our prime, but we can never get there.”

Why? What could I have done better? I kept thinking to myself I was always doing great things. Sure, we bickered once in a while, but nothing more. And I kept thinking on and on about it until I remembered a little word one of my friends had told me.

“Codependent.”

Defined by Melody Beattie’s “Codependency No More”, “a codependent person is one who has let another person’s behavior affect him or her, and who is obsessed with controlling that person’s behavior” (34).

The book further details common characteristics of codependent people. We’ve grown up in households of constant crisis, leading to constant worry and anxiety. We’re reactionary, solving problems when they come up instead of dealing with them ahead of time. We’re living our lives for other people, and have been for so long, we’ve lost our sense of self entirely.

Obsessive and controlling, fostered by a lifetime of trauma, demand for control, and constant need for validation.

I can no longer remember my childhood. Issues with money, family shouting matches, being held back from socializing, being bullied for being Asian, the specifics are lost to me. I had even forgotten that in middle school, kids had plastered “chink” all over my yearbook signatures.

A tyrannical parent duo and being shunned for being born as Asian — this was the lethal injection destroying my sense of self worth. I was never good enough at home and I was never good enough at school. Nowhere could I exist without pain. 

For me, pain, discovery and admission were simultaneous. All I want to do is get closer and closer to reaching my goal of being someone who’s healthy. Not necessarily cured, but an individual who does not tear the life out of the world around him. I am absolutely willing to carry the weight of being mentally ill and codependent, if it allows me to reach these goals. 

But for others, what if they come across another descriptor for them that’s equally toxic? What if the pain is all there is, and nothing is done about it? It isn’t always easy to admit you’re wrong or destructive. Pain leads to aversion, and exploration is painful.

Discovering new things about myself, explanations for why things are the way they are is a relief with each uncovered idea. It’s a logical path, not just wondering constantly why the hell we’re crazy. It’s steps to recovery, to change the negative behaviors, and to cause less pain for the people around you.

Unfortunately, this information came a tad too late. I’ve been left and the damage was done. But from now on, practicing self-care and having awareness of when I am obsessive, controlling, and dealing damage can go a long way. Even recognizing the negative behavioral patterns can prevent a situation from getting out of hand.

I tried running away from a past filled with pain and trauma. And I all of it along with me, only to spread it wherever I went. It is a vicious cycle that only I can stop.

While I can’t necessarily go back in time and fix my problems with the knowledge I have now, I can take a step back and be grateful this wake-up call has been handed to me at only 22. The push to action for many people with mental illness can be extremely painful. Having a loved one leave you, getting fired from work, even existing with no direction can all cause debilitating agony.

Erin was right. And it’s nothing but suffering to have to endure the pain brought on by her decision. But it takes pain, discovery, and admission of something completely new to jumpstart the path to becoming a better version of yourself.

Never become complacent like I did. Always strive for more, even if it’s uncomfortable.

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