What Happens When You're Labeled as 'High-Functioning'

The hardest part of having a mental illness is pretending you don’t.

I have schizoaffective disorder. It’s a form of schizophrenia that includes symptoms of both a thought disorder, such as hallucinations or delusions, and a mood disorder — in my case, depression. At my sickest, my psychiatrist declared me to be a “five out of seven” in severity of mental illnesses.

I have to take seven pills a day just to function like a “semi-normal” human being. I regularly see a therapist and psychiatrist, and have been hospitalized four separate times. For about two years, I had to regularly partake in ECT (electroconvulsive therapy). More than three years after the onset of my illness, I still have to fight suicidal thoughts every single day.

I am an attorney with a successful and very rigorous practice. I have a lot of friends and an active social life. Yet beneath it all, I still feel incredibly broken.

When I first got sick, I spent six weeks inpatient, thinking I was in hell and that God was trying to speak to me. Thinking my parents and the doctor were all demons scheming against me to keep me locked up against my will. I thought I was supposed to save the world. I clearly qualify as someone with a serious mental illness. In fact, the doctors thought I was never going to recover. 

Miraculously, through medication and ECT, I pulled through my delusions. It took close to a year before I finally began to come to peace with the fact that God was not talking to me. But, as the closeness I felt to God was melting away, depression began to sink in. I missed God and missed my delusions. I missed thinking I had a bigger purpose in life. I felt so empty inside, so I began ECT again, even though I was enrolled full-time in law school. Somehow, despite all this, I graduated.

Then, as I moved on with my life, I sought continued treatment for the severe depression I faced. Yet, I was repeatedly told time and again that certain programs — even basic therapy and psychiatry at major hospitals — are for people with serious mental illnesses, those who cannot make it on their own.

This was a tough pill to swallow. When I tried to do something proactive for myself when I felt myself slipping, I was met by statements that I am too “high-functioning” to qualify for treatment. I have had to fight my insurance company over and over again for not qualifying for medications or treatment or programming. Just because I have a career and haven’t ended my life does not at all mean that I am high-functioning. I have to fight bad thoughts every day. I wake up multiple times every night from my PTSD-related nightmares from trauma. The trauma from the repeated times I was wheeled into a cold hospital room, with nurses digging for my veins and anesthesia coursing through my body, all for 250 volts to be shot into my skull. The trauma where the devil followed me constantly, sneaking into my hospital room every night, bombarding my thoughts and begging me to let him share my body. And they still don’t always treat me.

Being “high-functioning” is challenging when you have to fight traumatic flashbacks and suicidal thoughts every day. People think a missed day of work means I am lazy. But it really means I don’t even have the will to pull myself from under my covers and get out of my bed. It means I was up for hours the night before because even sleep doesn’t bring me peace anymore. People think a closed door or cancelled plans means I am anti-social. But it really means that I am tired from fighting my own thoughts. 

Being labeled “high-functioning” means people don’t understand the thoughts you have to fight off every minute of every day. The thoughts that tell you it would all just be better if you went to sleep forever. People can’t see into the fight you fight every single day just to stay alive and not give into these demons that exist deep in your head. The ones that make you believe it sure would be easier if you were gone from this earth. 

Being “high-functioning” means you know you need help and support, but you can’t always get it because programs and treatments don’t accept you; because somehow against all odds you can force yourself out of bed and put on a smile most days.

Being “high-functioning” means having to take pills that make you put on weight and people just thinking you’ve “let yourself go,” constantly giving unsolicited advice about new diets you should try without realizing that maybe just maybe it’s not your fault.

Being “high-functioning” means that friends crack jokes about mental illness right in front of you, without even possibly thinking for a second that you might have one. 

It’s a blessing, of course, to be able to by all measures thrive in this world while battling a severe mental illness, but damn it sure gets lonely when no one knows the darkness you face.

I live in a world where I have to hide what I go through from nearly everyone in my life. Maybe soon we can take a few steps in the right direction, of letting people whose brains feel broken like mine know that it’s safe to show your struggles.