Jake's marriage to Louise is in trouble, and she has insisted he come and see me. If not for Louise, you wouldn't be here, would you? I enquire tentatively. He looks sheepish at first; then emboldened, he gives an emphatic No. As is almost always the case, Jake's wife has registered a problem that has passed him by, and prompted his visit.
If you saw something in the sky that you genuinely could not explain-something now officially categorized as an unidentified anomalous phenomena, or UAP-would you tell your therapist or psychiatrist? For many people, the honest answer is no. Not because they doubt their own perception, but because they worry about what might happen next. They fear being seen as unstable, having the experience reframed as a symptom, or having it documented in a way that could affect future care, employment, or credibility.
In the past, researchers studying peoples' experiences with addiction relied mostly on clinical observations and self-reported surveys. But only about 5% of people diagnosed with a substance use disorder seek formal treatment. They are only a small sliver of the population who have a substance use disorder-and until recently, there has been no straightforward way to capture the experiences of the other 95%.
After battling illness for years, Nancy Karipa tested positive for HIV in 1999. She had just given birth to her first child. It was a crossroads moment for me, with the fear of denial, but I chose action, Karipa, who is now in her 50s, said at an Aids awareness event in Papua New Guinea's capital Port Moresby in December. She and the baby received treatment, and her child remains healthy.
Most people think the hardest part of a mental health crisis is the illness itself. In my case that would entail the acute experience of psychotic depression. And it is often true that acute mental ill health is extraordinarily disorienting and frightening. I wouldn't wish my previous symptoms of psychotic depression on anyone and they have been the hardest experience of my life.
In the 1980s, one of my psychology professors at the University of Toronto advocated against using labels for psychological or psychiatric diagnoses. "Why not?" I questioned. "How else will we know what illness they have? Labels being bad sounds like psychological mumbo jumbo." By the end of that school year, I understood how labels stigmatize and limit recovery. Humans use labels to distinguish between themselves and those not like them.
