“To be alive and sick is a far more complex endeavor than we like to admit,” Esmé Weijun Wang wrote in an essay for Catapult, in 2016. Wang would know: as a teen in the Bay Area, in 2001, she was diagnosed with bipolar disorder. Twelve years later—eight years after her first auditory hallucination—she was diagnosed with schizoaffective disorder. When she began to experience new symptoms—weakness and fatigue, peripheral neuropathy, fainting, extreme weight loss—in 2013, doctors at first suspected an autoimmune disease, or even cancer, and eventually diagnosed her with late-stage Lyme disease. In the past two decades, Wang has been committed to a mental hospital three times. Her symptoms sometimes got worse with treatment instead of better. “I was so sick for so many days that I could feel hopelessness nipping at my edges,” Wang wrote in the Catapult essay, of one particularly rough period. “What I feared was the in-between space: a purgatory for those too sick to truly live.”
Wang’s recently published essay collection, “The Collected Schizophrenias,” explores the peculiar questions of identity that the ill, and especially the mentally ill, must contend with. Wang says that it is far more common for people who suffer from mental illness to be written about—by caregivers, by researchers—than to offer their own accounts. Her book, in offering hers, joins a small but significant canon, including Kay Redfield Jamison’s “An Unquiet Mind” and Elyn R. Saks’s “The Center Cannot Hold,” two books that elucidate the experiences of high-functioning women whose minds are both their proudest assets and their biggest liabilities. The latest edition of the Diagnostic and Statistical Manual, a clinical diagnostic tool created by the American Psychiatric Association, emphasizes that schizoaffective disorder portends “a lifetime of illness, and not an episode of illness,” Wang writes. While some might dismiss this characterization—indeed, some reject the notion that schizophrenia is a sickness at all—Wang embraces it: “Under its auspices, I remain a rare bird who . . . will likely be sick forever.”
Click Here: Liverpool FC T Shirts
Wang is certain of her fragility, but she cannot always parse where it begins and ends. She begins “The Collected Schizophrenias” with a meditation on the question of diagnosis. She speculates that her own psychiatrist, having treated her for years for bipolar disorder, may have shied away from assigning a different disease: “I believe she was wary of officially shifting me from the more common terrain of mood and anxiety disorders to the wilds of the schizophrenias, which would subject me to self-censure and stigma from others.” Wang deftly articulates how a diagnosis can shift a patient’s sense of self, prompting simultaneous confusion and relief. “Some people dislike diagnoses, disagreeably calling them boxes and labels, but I’ve always found comfort in preexisting conditions; I like to know that I’m not pioneering an inexplicable experience,” Wang writes, but she also wonders about the stability of the identity that one takes on when one is labelled schizophrenic. “It is easy to forget that psychiatric diagnoses are human constructs. . . . To ‘have schizophrenia’ is to fit an assemblage of symptoms, which are listed in a purple book made by humans.”
Does someone with depression remain a depressive if her symptoms are kept fully in check with medication and treatment? What about someone diagnosed with the schizophrenias? (Wang refers to schizophrenia in the plural to encompass schizophrenia, schizoaffective disorder, and schizotypal personality disorder.) For Wang, the experience of schizophrenia is defined as much by the spectre of her symptoms returning as by periods of actual psychosis. She refutes a line in Rebecca Solnit’s book “The Faraway Nearby,” about how illness “takes away all the need to do and makes just being enough.” This “has not been my experience,” Wang writes. “Prolonged and chronic illness stitches itself into life in a different way than acute illness does. . . . The absolution from doing more and dreaming big that I experience during surgeries and hospitalization is absent during chronic illness.”
Many of Wang’s essays explore how navigating a chronic illness that brings so much stigma can complicate even the most basic life choices. What should she wear in order to continue to appear capable, confident, and mentally sound, even if she’s locked in hallucinations and delusions or hasn’t had the energy to bathe in days? What movies or TV shows are safe to watch—that won’t trigger psychosis or dissolve the borders of her sanity? Today, Wang manages her condition with medication, therapy, journaling, and a spiritual practice of what she calls “the sacred arts”: Tarot, divination, candle magic. She no longer holds a full-time office job—as she described in an essay for BuzzFeed, leaving it felt like “I surrendered my last benchmark of sanity”—and instead carefully balances her writing and other freelance work with her physical and mental needs. Wang is married—another signifier, she says, that she is high-functioning—but she does not plan to have children.
“The Collected Schizophrenias” is not a memoir, nor does it tell a linear story about the author. Wang prefers to use her own experience as a point of departure for philosophical inquiry. In “Toward a Pathology of the Possessed,” she digests a horrifying story of a violent, schizophrenic man who was shot and killed by his sister while their mother waited in the car. She considers the burden that schizophrenia presents for family caregivers, and what remains of a person, and their relationships, when their personality has been mutilated by illness. Both the idea that mental illness destroys the person who existed before and the question of whether a self exists apart from illness trouble Wang. Elsewhere in the book, she considers involuntary commitment, the treatment of mental illness on college campuses, the border between psychiatric illness and supernatural abilities. Throughout her wanderings, Wang points readers to a multitude of complicating and enriching sources, from Nellie Bly’s 1887 exposé “Ten Days in a Mad-House” to Susan Sontag’s “On Photography” and Marilynne Robinson’s “Home.” I sometimes found myself wondering if this reliance on outside perspectives was another way for Wang to reassure herself of her own competence. She is not just a sick woman with stories of illness but a woman with a vibrant mind who can do scientific research and formulate complex cultural criticism, too. The very fact of her book, she seems to assert, is proof that she can rise above her limitations.
Ambition and achievement are central to Wang’s sense of herself, and throughout the collection she weighs the possibility that her illnesses might lead to failure, or worse. In a lovely essay titled “L’Appel du Vide,” Wang writes about her encounter with the work of Francesca Woodman, a young photographer known for her self-portraits, whose promising career was cut short when she committed suicide, at the age of twenty-two. (Wang, too, is a photographer, and she confides that she often photographs herself, as Woodman did, when she is at her most psychically fragile.) Woodman’s demise haunts Wang. Is there something ingrained in Woodman’s work that explains, or predicts, her doom? And, by extension, is there a way to divine whether Wang will survive? Woodman may have cut her losses by ending her life so young, whereas Wang, who is thirty-five years old, can track the damage that her illnesses have done over time. “The obliteration,” she writes, “can also be gradual.”
While reading “The Collective Schizophrenias,” I often thought about the toll that writing it must have taken on Wang, physically and mentally, and the bravery it took for her to do it. In one of my favorite essays, she writes from within the cloud of a particularly haunting delusion, known as Cotard’s syndrome. For several months and the duration of the essay, Wang believes that she is dead, trapped “in perdition” and “doomed to wander forever in a world that was not mine.” Whatever coping mechanisms Wang had developed up until that point—journaling, scheduling, articulating goals and “core desired feelings”—suddenly fall by the wayside. “Ritual, my therapist told me later, would help, but it was not the solution; there was no solution.” There was no solution—this is the level of uncertainty, even hopelessness, that Wang lives with. And yet she perseveres, however imperfectly. It’s Wang’s ability to reconcile these opposing realities, to allow them to persist in contradiction, that feels most radical about her approach to being sick.