Snapshot: Does Anything Ever Really Change?

"In prosperity, our friends know us; in adversity, we know our friends"

John Churton Collins

I've never lacked for friends to have a good time with. In fact, especially after moving abroad, I've often taken on the role of social organizer.

During my darkest periods of active addiction, however, I felt completely alone. I had almost no one to turn to.

The handful of people who really are there for me - for life, whether I'm doing well or not - are miracles to me, gifts of the highest order; all of the purple-prose praise in the world isn't enough to express what I think of them.

My generation, the much-maligned Millennials, were the original Generation Diagnosis.

No one had typical teenage trouble focusing; everyone had ADHD, which required powerful psychostimulants, testing accommodations, and more.

Quotidian stresses and worries became Generalized Anxiety Disorder, and the sort of piquant melancholy that creeps up on all of us from time to time was mislabeled as Major Depressive Disorder.

As with many social trends that started in my generation, the Zoomers seem to have taken this one and run with it.

The population prevalence of Dissociative Identity Disorder seems to be around 72% (if Tumblr and Tik Tok are any indication).

Some Gen Z kids collect rare mental health diagnoses - "my friend the schizophrenic," "my friend with bipolar" - like particularly desirable Pokémon. (Just imagine when the pre-psychotic Charmeleon evolves into the psychotic Charizard!).

Part of this, I know, is the naivety and exuberance of youth.

In my experience, young people truly do support their friends through mental health crises with admirable loyalty and optimism.

Unfortunately, a lot of this rides upon them not understanding the true nature of the adversary, which becomes clear only with time. Protracted, difficult, repetitive, wearying time.

Mental health issues have been destigmatized in the sense that psychological problems are discussed more openly, people are encouraged to get treatment, and treatment is more accessible.

In terms of accepting the seriously mentally ill into mainstream society, however, I would argue that we have made little, if any, real progress.

De-institutionalization does not equal integration when the chronically mentally ill end up homeless on the streets or living threadbare, hermitic lives in Section 8 apartments where their only visitors are social workers.

I'm developing another layer of appreciation for this fact now that I'm in my 30s.

At this point, I can read the disappointment and exasperation in the faces of friends and family when they hear that I'm back on maintenance, which means, to them, that I'm still struggling with addiction: He hasn't grown out of it yet? God, he's still doing that to his mother?

These kinds of perceptions are particularly rough for addicts because A) we're judged more harshly for our disease because people believe that it involves choice, that it doesn't "have to" exist in the same sense that bipolar disorder or schizophrenia does (this despite the fact that all of the genetic and neurobiological evidence runs to the contrary), and B) people believe that we're using because we selfishly "enjoy it" and "get something out of it" (this despite the fact that while, yes, using drugs is sometimes pleasant, once you reach advanced addiction, it's about avoiding severe sickness more than it is experiencing any positive state - plus, the negative physical and psychological consequences are so soul-sappingly awful that they far outweigh any fleeting pleasure; no one in their right mind would choose this, not ever).

Treatment professionals who specialize in opioid addiction are starting to talk about recovery as a cycle, with intermittent relapse as the norm rather than the exception.

Based on my own experiences and observations, this seems on point.

The cyclical nature of addiction, too, is the rule rather than the exception.

After all, most problems in life don't follow the three-act structure. How many people lose / gain weight or struggle with relationship issues or financial management problems only once?

Most of the great struggles of life are lifelong. They manifest in different forms during the various seasons of our lives.

Many people have the desire and the internal resources to support a loved one through a one-and-done bout with depression or severe anxiety.

Some people might even stand by a friend who is exhibiting "serious" craziness - who mentions being surveilled by mysterious forces or who calls them during a manic episode talking a million miles a minute about exciting new business ventures.

Once people realize that mental health problems are here to stay, however, they vanish with astonishing rapidity.

Everyone wants that successfully recovered friend, whose hard-earned wisdom and strength of character benefit everyone around them, but very few people have the patience and fortitude to stand by and support a recovering addict; the gerund is a dealbreaker.

Few can abide the presence of a struggling mentally ill person in their lives.

In some ways, it's almost crueler that we're encouraged to speak about mental health issues more openly these days.

Those of us who take the plunge and disclose our darkest thoughts and struggles - unaware that we're crossing tacit social boundaries in opening up about profound, long-term problems rather than short-term, situational ones - might receive some shallow accolades for our bravery or perseverance, especially at first.

But that certainly doesn't mean that our phone rings when we need it to (or that the person on the other end of the line answers when we call).

I understand that people have careers, kids, creative projects, their own struggles - prosaic and otherwise. They're scared; they don't know what to do; they don't want to make it worse.

The funny part of it is that I, like many mentally ill people, practice a policy of strict self-quarantine.

My good "normie" friends know that I don't expect or want to dump the baggage of my addictive struggles on them.

As I emphasize to them, I want us to enjoy our precious moments together as purely as possible - to form new, positive memories regardless of whether I'm impaired, in withdrawal, or feeling strong in recovery at the moment.

As is often the case in life, so much of this dynamic is guided by fear rather than reality.

When it really comes down to it, for those of us with mental health diagnoses like addiction, which have lifelong ramifications - severe ones that generate a complicating layer of trauma through the years - I'm not sure that we've made much societal progress at all.

***

I guess it's always been this way.

The older I get, the more I appreciate the true, sometimes staggeringly steep cost of the social contract that allows us to enjoy such shiny, technologically advanced lives (although unprecedented anxiety, unhappiness, and lack of fulfillment underly that enticing facade).

The many enjoying a higher quality of life seems very often to be contingent upon a collective disregard of the abject suffering of the few.

Maybe it's how things have to be.

Still, we're more than ever running the risk of creating at a societal level the sort of hell experienced by profoundly dysfunctional families that appear "aspirational": the kind of reality where everything seems perfect, and everything is awful.

Follow-up: After I posted this, my friend Rose, who is a brilliant epidemiologist, artist, and social leader, sent me an article about the experience of Maslow - of the famous Hierarchy of Needs - among the Blackfoot (Siksika).

Maslow himself said: "80–90% of the Blackfoot tribe had a quality of self-esteem that was only found in 5–10% of his own population."

He described a society in which the wealthiest gave away all of their superfluous possessions in yearly ceremonies; in which justice was restorative and people were truly forgiven after they left behind hurtful ways; in which children had their creativity fostered and were treated permissively and with great respect.

This reminded me of a passage from Howard Zinn's The People's History of the United States. In general, Zinn is careful not to look too rosily upon the "primitive" societies that existed prior to Western colonialism. He notes, for example, the dependence of the slave trade on African tribes' violence against each other. He is also careful to acknowledge the realities of starvation and poor (or no) medical care in early societies.

However, when he is discussing the Iroquois Nation - who inhabited the land that I live on now - Zinn notes that they were a uniquely at-peace-with-themselves people who seemed to have achieved an existence of physical and spiritual abundance that was interwoven with the rhythms of their land. He cites several examples of Westerners who ended up living with the Iroquois for some time, then declined to reintegrate with Western colonists when given the chance; in parallel, Iroquois children who ended up spending part of their youth with Western colonists, but who had been raised among the Iroquois long enough to remember what life was like for their tribe, almost invariably returned to the Iroquois when they had the chance.

Life doesn't have to be so brutal. People who came before us have done it better than we are now.

As I often note, the United States incarcerates more people per capita than any other nation on Earth - save perhaps North Korea. How can we call this a successful society? No wonder we're all getting f*cked up all the time.

We've reached a point at which the shiny facade of progress is being eaten away by the acid rain of the consequences that we've long ignored and averted. We're beginning to see and to sense the true cost of achieving a very specific, exclusive, and shallow vision of advancement.

No matter how bad it seems, though, it's always important to keep hope. The only thing standing between us and systemic change is ourselves.