Who Are We Beyond Our Mental Health Diagnosis?
In collaboration, our volunteers Yuri and Ibrahim explore the idea of how we can frame our identity around and beyond our mental health conditions through the book Strangers to Ourselves and Ibrahim’s own lived experience.
Book review: Strangers to Ourselves: Unsettled Minds and the Stories That Make Us by Rachel Aviv
Where does the self end, and where does a mental health condition begin? A perceptive and valuable book, Strangers to Ourselves is an ambitious investigation into how mental illness diagnoses might shape the kinds of stories people tell themselves. Because, as we know, a diagnosis might suggest that your thoughts, behaviours, and actions are the result of a chemical imbalance or trauma. Is there truly a self, then?
The essays that make up this book are incredibly nuanced and in-depth examinations of six people including Aviv herself and her friend, Hava, and their difficulties surrounding their diagnoses and how they view themselves. There’s Ray, a doctor who sued the mental health institution he stayed at for neglect as he wasn’t given medication; Bapu, a woman in South India who believed she had a special relationship with the gods and ran away repeatedly to live in temples; Naomi, a Black mother living in the US who was arrested for a crime she committed—seen by others as a result of her psychosis, but understood by herself to be the result of the oppressive racism she faces; Laura, a wealthy, white woman who believes she was overmedicated and turned to antipsychiatry. Threaded through each of these stories is also the question of whether our personalities and behaviours define our diagnoses, or whether it’s the other way around.
But Aviv doesn’t speak as an outsider looking in—when she was six, she was admitted to a mental health institution because she stopped eating, and was likely America’s youngest person diagnosed with anorexia. But how did the stay transform her? Did the diagnosis give a name to her behaviours and thoughts, or was it instead a subconscious self-fulfilling prophecy?
Aviv resists presenting a tidy conclusion, but that’s perhaps what makes the book so powerful; her inquisitiveness and commitment to raising such questions are probably more important than the answers themselves. The takeaway from this book is instead that there is no one singular truth, never a catch-all to life’s varied miseries.
Ibrahim’s POV: Living with ADHD
Where does the self end, and where does the mental health disorder begin? This was a question that crossed my mind when I was diagnosed with ADHD (Attention Deficit Hyperactivity Disorder), a condition that is marked by symptoms of hyperactivity and impulsivity. For me, it means I can get really hyper and behave erratically in front of people. I can also have severe attention problems in which I am unable to pay attention to something for more than 10 seconds.
I wasn't really sure whether my behaviour was already altered because of my mental condition in the first place, but upon taking my prescribed medication such as Ritalin, I began to notice an increase in attention levels and my erratic behaviour being dialled down to being more of a quiet person. This made me think that, “Oh this might be what I look like before I take meds,” but it still did not confirm where the mental health disorder begins because my goal was to find the boundary between myself and my mental health disorder.
Thus began my days of observing my own body and throughout the observations, and I realised that there were certain triggers that actually caused my mental health condition to kick in, influencing my behaviours and actions.
One of the behaviours I have realised is typical with my ADHD is that during my interactions with people, I tend to jump to different topics very quickly, and I have a tendency to read between the lines too much that it causes me concern even though there is nothing to be concerned about. This causes my mind to go into overdrive, become more hyper, and take drastic actions such as withdrawing from the conversation and isolating myself to ruminate on my fears.
For example, one time, I was texting a friend about my hobby of people-watching, and I asked her whether she would like to join me at the Starbucks outlet at 313@Somerset. As soon as I said that, my brain suddenly kicked into overdrive because I was afraid she would interpret it as me asking her out for a date, which I did not intend. I wanted it to be two people observing the interaction between others, how people walk, and how people think. I grew concerned and started to criticise myself for it and decided to end the text conversation with her suddenly as my ADHD had taken hold of me exhibiting behaviours of being too over-worried. I hurriedly found a safe space and isolated myself with my thoughts, running the same scenario again and again. When I checked my phone, I saw messages from my friend asking about what happened and I explained to her the scenario. She got confused as there was no indication I was asking her out on a date, and that I shouldn't worry.
When I realised that there was something wrong with my reaction, I took my medication and started to observe myself dialling back all of my emotions to be quieter. Seeing that I was in that state of quietness, I started to realise that this was my real self all along. In my real self, I have started to indulge in writing articles, reading books, listening to music, and doing house chores as they are therapeutic to me. Seeing my real self made me want to learn how to master my real self and distinguish between my real self and the mental health disorder that I have even more. Thus, I began my journey, which is not easy, to being to accept the real self which I discovered only recently. However, there are still some questions that remain, such as whether I can actually achieve this “true self" when I am off medications, or if there are certain parts of my ADHD that I want to keep as part of my identity?
Like Aviv presents in her book, mental health and identity are interwoven with each other such that it will be hard to truly separate ourselves from our diagnosis. The process of finding out one’s true self is a lifelong quest of discovery of exploring our behaviours, interactions and decisions to understand what makes us essentially us.