David Foster Wallace. (Photo: Steve Rhodes / Flickr)AKIRA WATTS FOR BUZZFLASH AT TRUTHOUT

"The so-called 'psychotically depressed' person who tries to kill herself doesn't do so out of quote 'hopelessness' or any abstract conviction that life's assets and debits do not square. And surely not because death seems suddenly appealing. The person in whom Its invisible agony reaches a certain unendurable level will kill herself the same way a trapped person will eventually jump from the window of a burning high-rise." -- David Foster Wallace

This piece doesn't have a hook. It reacts to nothing that's happened out there in the news, either nationally or internationally. It's a bit more personal than that. At 39, I seem to have entered the phase of my life in which those around me start dying off. I've buried more than a few people over the past couple of years, but two of them sting more than the others. Both took their own lives. One did it with pills, and spent twelve agonizing hours slowly dying. The other was more efficient and used a gun. Both are dead and both suffered from mental illness.

And both might still be alive, had they not been caught in the grips of an utterly wretched mental health care system. New Mexico doesn't do all that well, when it comes to mental health, and our governor, Suzanna Martinez, has been doing her damndest to destroy the few bits of a functioning system that remains. And that leads to a particularly neat phenomenon that has been observed elsewhere: the criminal justice system has become a de facto wing of the mental health care system. New Mexico is no exception, and both of my friends bounced from mental health care providers to prisons and nowhere did they receive the anything that actually helped. For them, their illnesses proved terminal.

But then I think of David Foster Wallace, dead six years as I write these words. He was, for me, the finest writer of my generation the closest thing I have ever had to a literary role model. He had every resource that my two friends lacked. His insurance was the best and he would have been able to avoid the wretched indignities of public mental health care. But, after fighting his fight for 46 years he, too, succumbed. His illness also proved terminal.

And then there is myself, still breathing. I'm a bit luckier. I have moderate anxiety and it's mostly controllable. I muddle through. True, now and again, I lose control, and it manifests as explosions of rage. In those moments I've lost friends and lost relationships. But, mostly, I muddle through. For me, it has not proved terminal. But it's also something I never speak of, which is funny. If by funny you mean not funny at all.

Mental illness scares us and shames us. Those who suffer are often, like me, ashamed to speak of it. Those who are lucky enough to be free of mental illness are terrified of it. When it comes to mental illness, we still don't quite get how it all works. Our treatments, while sometimes effective, often are not. And the symptoms, involving a fundamental breakdown of our perceived reality, are existentially terrifying. There is something almost random about physical illness, in how it comes upon us – a physical illness can strike anyone – and that is almost comforting. Were mental illness to fall into that same category, then it too could strike any of us, without warning. And that is terrifying.

But more than simple fear, mental illness brings out a judgmental streak that would be unthinkably grotesque when applied to physical illness. Imagine telling someone with a broken leg to "snap out of it." Imagine that a death by cancer was accompanied by the same smug headshaking that so often greets death by suicide. Mental illness is so qualitatively different that we feel it permissible to be judgmental. We might even go so far as to blame the sufferer.

Oh no, most of us wouldn't dream of verbalizing this blame (though some, of course, succumb to the temptation), but the fact is: it exists.

The problem is we persist in seeing mental illness as something qualitatively different than physical illness. I blame Descartes, and his idiotic mind-body dualism, which held that the mental and physical were two distinct things. That notion has rightly fallen out of favor, but it persists, I would argue, in our approach to mental and physical illness.

Despite all evidence to the contrary, we persist in believing that mental illness occupies a special category, distinct from the physical. And that opens the door to doing what we do so well: shaming and blaming. Since this special type of illness is mental and not physical, then surely it's nothing more than a lack of mental fortitude on the part of the sufferer. "Snap out of it," we say. "Get over it." And with those words we create the insulation between ourselves and the illness that terrifies us.

And that provide us with an excuse for the absolutely awful state of our mental health care system. Yes, my current location, New Mexico, is on the bottom, but it is bad all over. The system is in such abysmal shape that its biggest branch is the criminal justice system. And our failures in mental health care are justified, on some deeper level, by the comforting knowledge that it's not our fault at all. If only those who suffer just tried a little harder, all would be well. If only they asked for help a little sooner.

My friends spent their lives asking for help. David Foster Wallace spent a lifetime seeking a cure. But their illnesses were terminal and as physical and as fatal as a heart attack. If we don't change how we see mental illness, these terminal cases will continue, to our eternal disgrace.

---

Akira Watts failed to graduate with a B.A. in philosophy from Amherst College and is now an itinerant IT worker. He resides in Santa Fe, New Mexico where he has written a wretchedly unpublishable novel. He has been making another go of it with a literary choose-your-own-adventure work about the rise and fall of an avant-garde artistic collective. Contact him at This email address is being protected from spambots. You need JavaScript enabled to view it. .