Living with Schizoaffective Disorder

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One of the tools in my schizoaffective toolkit is counseling. I see a therapist named Rachel every other week. A session ago we wandered, the way a good hour wanders, from whatever we had begun with onto the tortured genius, the brilliant and suffering and doomed man the culture never seems to tire of. I have not been able to put it down since.

I have been thinking about the dead.

Not constantly. Not in the way the sentence makes it sound, as if I am sitting in a dark room with a stack of obituaries and a glass of something brown. The thinking arrives in the ordinary way most thinking arrives now, through tabs and songs and half-remembered interviews and the small traps that algorithmic memory sets for anyone old enough to have lived through several versions of the internet.

A Robin Williams set surfaces, the man on a late-night couch moving too fast for the host to keep up. A Kurt Cobain photograph, the cardigan by now more famous than some living musicians. Terry Davis at a computer, explaining an operating system he built almost alone, in language that slid between technical precision and religious certainty without noticing the border.

They do not belong to one category. This matters. They were not the same kind of artist, not the same kind of mind, not the same kind of sick, not the same kind of dead. Most of the names I keep reaching for died by suicide, and I would rather admit that than smooth it over. But not all of them did. Layne Staley, whose voice came out of a body that already looked like it was losing the argument, died of an overdose, and addiction has a grammar of its own that the word suicide does not cover. Terry Davis was struck by a train, and whether he meant it has never been settled. To group these deaths too neatly is to commit the very error I am trying to examine.

But culture groups them anyway. The culture does not need a clean category. It needs a shape. Brilliant man, damaged mind, early or violent or lonely end. The shape is old enough that we recognize it before the details arrive. Once the person is gone, the work changes temperature. The jokes become warnings. The songs become documents. The code becomes scripture. The novels become maps of the illness that would later be blamed for closing the life.

The dead get edited into coherence. The living almost never do.


This is not an argument for self-destruction. I want that sentence placed early, not because I think the reader needs to be reassured that I am against death, but because the subject has a gravitational pull, and I do not trust myself near it unless the furniture is bolted down.

There is a sentimental version of this essay that I refuse to write. In that version, death completes the artist. Suffering becomes the furnace. The final act seals the meaning of the life. The genius leaves because the world was too crude to hold him, and the rest of us stand around afterward pretending that the leaving was itself part of the work.

I do not believe that. I think it is garbage, and dangerous garbage at that. The dead do not become deeper because they are dead. The work does not improve because the person who made it is no longer available for interviews, apologies, relapses, bad albums, unfinished projects, strange tweets, disappointing later novels, or the simple indignity of continuing to be human in public.

Death does not complete the work. It freezes the frame.

That is the attraction. A life that continues is unstable. It keeps producing evidence. The artist can contradict himself. The programmer can turn out to be wrong about the architecture. The comedian can become tedious. The singer can survive long enough to make a mediocre record. The activist can age into compromise or repetition. The person remains capable of spoiling the myth, and death is the thing that prevents the revision, that closes the file while the image is still charged.

And then the living begin arranging the evidence backward.


David Foster Wallace becomes, after death, the man who saw the machinery too clearly. Entertainment, addiction, loneliness, irony, the unbearable difficulty of remaining a person among systems designed to consume attention. Once you know the end, it becomes almost impossible to read him without feeling the end tugging at every sentence. The jokes darken. The footnotes become less playful. The intelligence itself starts to look like a symptom, or a warning, or both.

Robin Williams becomes the saddest of clowns, the man whose comedy was supposedly a mask over a depression we now claim we should have seen coming. It is a tidy story, and it is not what happened. What was taking him apart was diffuse Lewy body dementia, a disease of the brain that went undiagnosed until the autopsy, that he himself had no name for while it was killing him. The culture reached for the sad-clown myth anyway, because the myth was ready to hand and the neurology was not. Every manic improvisation gets rerun under a light that explains the wrong thing. We tell ourselves we should have known, when the truth is that nobody knew, least of all him.

Kurt Cobain becomes the patron saint of alienation, which is a terrible thing to do to a person and a very effective thing to do to a brand. He was young, gifted, beautiful in the careless way the nineties knew how to make suffering look accidental, and angry at a machine that immediately learned how to sell the anger back to everyone who recognized it. The death did not create the myth, but it hardened it. It made the refusal permanent.

Aaron Swartz becomes the brilliant idealist crushed by systems. Programmer, activist, prodigy, defendant, symbol. His death is inseparable, in the public memory, from institutions that appeared too large and punitive for the human being caught inside them. The story acquires a political clarity that life rarely grants while it is happening. In death, he becomes an indictment. What the indictment drops is that he had written, while alive, about his own depression; the martyr story has room for the prosecutors and none for the illness.

And then there is Terry Davis, who is the difficult one for me.

He built TempleOS, an operating system of astonishing singularity. Kernel, compiler, language, shell, graphics, scripture, private cosmology, all of it bound together by one man’s mind. It is technically extraordinary and personally heartbreaking. It is also embarrassing to talk about honestly, because honesty requires refusing the two easy positions. He was not merely a joke the internet passed around. He was not merely a misunderstood prophet either. He was a brilliant programmer with schizophrenia whose public deterioration was treated, by many people, as content.

The work is real. The illness is real. The exploitation was real. The laughter was real. The pity was real. The awe was real too.

That combination is harder to metabolize than the cleaner myths.


What happens to the brilliant dead is not mercy exactly. Mercy would have helped earlier.

What happens is conversion. The disorder, addiction, despair, or collapse is converted into aesthetic information. The suffering becomes legible because the work gives it form. A song is easier to love than a symptom. A novel is easier to admire than a hospitalization. A compiler is easier to marvel at than a delusion. The culture can tolerate madness if it arrives with a product attached.

This is the deal the dead genius gets from the public. We will look at your suffering if it left us something to consume. We will call it depth if the artifact is good enough. We will forgive the mess if the mess can be arranged into a legacy.

The ordinary mentally ill do not get that deal.

A man with schizophrenia muttering to himself in a gas station does not become a symbol of the unbearable clarity of modern life. A woman cycling through hospitalizations does not get described as having seen too deeply into the structure of reality. A person whose medication causes weight gain, tremor, sedation, or the flattening of the emotional range does not become aesthetically interesting, because the cost is not attached to an album everyone knows by heart.

The symptoms are similar enough to make the distinction morally uncomfortable. The public response is not.

When the brilliant sufferer produces work, the suffering can be read as the soil the work grew in. When the ordinary sufferer produces only inconvenience, the suffering becomes a problem to be managed. Family members become exhausted. Employers become wary. Friends become less available after the third or fourth crisis, because compassion has a calendar and most people do not tell you when yours has run out. The person becomes, in the administrative language of modern life, complicated.

Complicated is what we call suffering before it becomes useful.


I should put myself in this. I have been looking hard at the dead; the same look belongs on me.

I have made this comparison before, in another essay: a writer and a programmer, brilliant and ill, set beside two men who were a writer and a programmer, brilliant and ill, and are now dead. I am not going to re-stage that comparison here. I bring it up only to admit that I know its pull from the inside, the way the public record offers the names and the mind throws a bridge across to them before I can stop it. It is a bad instrument. It measures the wrong thing with dangerous precision.

The point of Wallace is not that depression sharpened the prose. The point of Davis is not that schizophrenia built the operating system. The point of Cobain is not that pain made the songs true. The point, if there is one, is that the same culture that romanticizes suffering once it produces art or code tends to abandon the same suffering when it produces only need.

I know what it is to be need.

I know what it is to have the mind turn against the body with the full force of its intelligence. I know what it is to sit across from clinicians who are trying to work out how much danger is in the room. I know what it is to take the medication and live with what it removes as well as what it holds steady. I know what it is to become administratively complicated: forms, appointments, dosages, side effects, insurance, leave paperwork, the small bureaucratic weather of a life that has to be maintained by systems that do not love you and are sometimes necessary anyway.

None of this is romantic. It is not even especially dramatic most days. Most days it is boring, which is one of the great underreported achievements of psychiatric treatment. The pills go down. The calendar holds. The meeting starts at nine-thirty. The code needs review. The prescription needs refilling before the weekend. The recycling goes out tonight or it does not go out for two weeks. The living remain inconveniently unmythic.

Survival is not cinematic. It is repetitive.


The problem with the afterlife of the brilliant and ill is not that we remember them. We should remember them. The work matters, the books and the songs and the strange operating system, and I am not interested in stripping the dead of their brilliance to make a point about the living.

The problem is what the culture asks of you before it will hold your suffering with any care. It asks two things, and the dead genius is the rare figure who supplies both. He is gone, which means he can be simplified: arranged, quoted, fixed in place, turned into a lesson that will never talk back. And he left an artifact, which means the suffering came with something attached, a song or a novel or a compiler, a reason to keep looking. Death buys the simplification. The work buys the sympathy. Remove either one and the care thins. Remove both and it vanishes.

The ordinary living ill have neither. They are alive, which means they are still moving, still unresolved, still able to need something from you next week. And they made nothing the culture knows how to price, no song or book or working invention, only the bare uncut fact of a hard life. They are disqualified twice over: too alive to be tidied into a lesson, and carrying no artifact that would make the suffering worth a stranger’s tenderness. Death will not rescue them later, either, because death only flatters a life that left something behind to be flattered. They go on being people: still here, still asking, still impossible to finish.

People require response. Lessons require only interpretation.

The person with schizophrenia who is still alive does not become a lesson. He becomes a case. A chart. A concern. A person the family discusses in lowered voices. A person strangers angle away from on the bus. A person whose brilliance, if he has any, is not legible, because it never came with a culturally approved artifact attached.

We have warm categories for the brilliant dead. Visionary. Tortured. Prophetic. Ahead of his time. Too sensitive for this world. We have categories for the living ill too, but they are colder. Noncompliant. High acuity. Treatment resistant. Poor insight. Unstable. Some of these words are clinically necessary; a doctor needs language that survives contact with a hospital shift. But language has a temperature, and the distance between “tortured genius” and “treatment resistant” is wide enough to feel on the skin.


I do not want to be canonized by suffering.

I want the medication to keep doing what it does, imperfectly and expensively and with side effects I have made my peace with on some days and not on others. I want the essays to exist, but not at the cost of the person writing them. I want the code to compile. I want the next unremarkable morning and the one after it. I want the kind of evening that produces no anecdote at all, the ordinary continuation that makes no myth and offers no clean ending.

There is a way to honor the brilliant dead without envying the shape their lives took: to hear the songs and read the books and use the code, and still refuse the romance that gathers around the final fact, still decline the lie that their dying is what made them matter.

The harder task is to extend some of that reverence backward, into life, before the frame freezes. To hear the person in crisis before the artifact appears. To grant complexity to the man in the gas station and not only to the novelist with the footnotes. To understand that a mind can be brilliant and sick and still need the unglamorous things: appointments, medication, housing, patience, money, sleep, structure, someone who will answer the phone. To stop requiring beauty as the admission price for compassion.

I have been thinking about the dead because the living are harder.

The dead stay where we put them. The living keep moving. They relapse, recover, contradict themselves, say the wrong thing, take the pills, stop taking the pills, get better, get worse, miss the appointment, disappear for a week, come back. They do not resolve. They do not become symbols without remainder.

That is what makes them difficult. That is what makes them real.

The afterlife of the brilliant and ill is a room the culture knows how to decorate. The present life of the ill, brilliant or not, is a room we mostly leave underlit. I am interested in that room now. Not because it is beautiful, though sometimes it is. Not because it redeems the suffering, because it does not. I am interested because I live there, and because many people live there, and because the mercy we save for the dead would do more good if we spent some of it earlier.

In two weeks I have another session with Rachel. We will start somewhere ordinary, the way we always do. Maybe this will come up and maybe it will not, but either way the hour is its own small argument against the thing I have been describing: a person still here, still moving, still able to contradict himself next week, being attended to anyway, before there is any artifact to justify the attention. It is not reverence. It is just an appointment. But it is the kind of looking the dead can no longer use, spent on someone who still can.

Death freezes the frame. Life keeps asking to be seen while it is still moving.

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