Too many days ago I received a set of questions from forum member Meredith. She addressed some of those questions here.

What price do you pay for being high-functioning?
Upfront, once again, let me be clear on how grateful I am. OK. With the exception of most psychotic symptoms, most people experience something akin to the symptoms that get us diagnosed as “mentally ill.” The difference between the MI and the non-MI is the extent to which sadness, anxiety, dissociation, elation, fear, and a variety of other things interfere with one’s ability to “function.” I do not believe there is a clear-cut threshold that some cross and others do not. There’s a grey area in there, a No Man’s Land between the trenches. The price I personally pay is in that grey area.

By that I mean that I experience a level of confusion about my self. My self-conceptualization is neither here nor there, neither black nor white, not always “functioning” or “not functioning.” For me, personally, that is a significant price. While it has real-world implications, I acknowledge that this is a seriously vague answer. My hope is that the answers to the following questions will clarify.

How hard do you work at being high-functioning?
Well, now, that really depends on how I’m defining “functioning” at any given moment. Sometimes, if I’m being completely honest, I’m not working too hard at all. Those are generally the moments wherein my definition is based on how others see me. I can work at almost any time. I am NOT complaining about that, and we know that work is therapy for me. When I’m defining “functioning” in terms of how I feel or the extent I’m able to actually take care of myself or do things like, say, the dishes, then I have to work really fucking hard.

Do you ignore parts of yourself?
Everyday — ignoring a different part at different parts of the day. In the interest of conserving space in a longish post, I’ll just say that I ranted last weekend about Inside Me versus Outside Me (along with a stupid amount of mathematical allusion) on my blog. Self-sacrifice for self-preservation. (That seems to be my thing this week.)

What price do you pay for being in the closet (this may not apply to everyone)?
Ditto. Self-sacrifice for self-preservation. Confusion regarding my self-conceptualization. I feel I give up a level of comfort in who I am. I feel I give up a level of validation — particularly from myself.

How often do you pay it?
I pay said price when Inside Me doesn’t so much look or feel like Outside Me, which is to say that I pay that price when I’m experiencing some episode. That’s the answer I would’ve given four months ago.

The strange effect this forum is having on me is a growing dissatisfaction with my Closeted status. I’m starting to notice more times when I self-censor. Having a place to discuss where my head is seems to have a side-effect, namely that I’m noticing how frequently my head is in one place and I’m pretending it’s somewhere else.

Your turn.


I’ve been remiss.

It has just occurred to me that I’ve been arguing against a definition of “functioning” without ever actually stating the definition with which I have a metaphorical bone to pick. In the About the Site I wrote that “The Central Thesis of this site is the belief that the higher up a mentally ill person sits on the Functioning Spectrum, the less that particular spectrum (or its definition of “functioning”) actually describes that person.”

The most prevalent “spectrum” is the Global Assessment of Functioning Scale. Go ahead. I DARE you to find one (and only one) place where you could confidently put yourself on this scale.

I’ll go first: Given my everyday, normal life I could put myself anywhere between 35 and 65 (but not really in the 40s). Because I am in a good marriage, someone who knows me well would probably put me between 60 and 70. Precisely because they don’t know me, anyone else would probably see something above 90 when they look at me, my work, and my life. That being said, at least twice a month, I fall to about 25 for a day…but had I not just written that, no one would know.  Since those low points aren’t persistent states, I don’t think anyone who uses this scale would care about them. AND THAT’S THE PROBLEM.

The problem with the “high-functioning” label is that it’s based on these strange and seemingly arbitrary metrics. This is a scale that might make sense for some, but what happens to people who look like a 90 and feel like a 20?

OK, so doing something I’ve never done before usually leads me to think things I’ve never wondered before. The relatively new thing in my life is reading mental health issue blogs. (Again, the due diligence thing.) I’ve gathered many new thoughts, e.g. how different people seem to define “functioning” and how they situate themselves on that weird spectrum. Another thought is that we all have different perspectives and relationships to meds. So, as promised in a comment on Daily Bipolar, here’s the first Define Functioning Poll:

1. How many prescribed meds to you take daily (no need to specify, since we’re open to all diagnoses here)?
I’ll go first: two.

2. How many prescriptions do you have for “as needed” reasons, that you don’t necessarily take daily?

3. How do you feel about your answers to Questions 1 and 2?
I hate meds. After my reaction to the first psychiatric drugs I was prescribed ten years ago, I’ve worked very hard to keep all my dosages down. They help, but I’m terrified of over-doing it. That means that I probably deal with more symptoms than I might need to, but it’s a balancing act: I can think better taking lower dosages than I do at higher dosages, and I chose to live with residual and persistent symptoms. I will always add more therapy sessions before I up my meds.

Your turn.