Mike Barnes on being ‘upfront’ about mental illness

The author on the ways in which mental illness helps—not hinders—its sufferers

Later this summer, if all goes well, I will publish my ninth book, a crime novel called The Adjustment League. Along with the jitters common to anyone who brings a homemade artifact into the public square, I feel trepidation on a more fundamental level. As someone who cycles in and out of disabling mental illness, and whose swings are becoming more severe and unpredictable with age, I worry whether I will be able to perform the staid but exacting round of readings and interviews required by modern book promotion. Even more, remembering past outings, I worry that I will perform just fine but at too steep a cost to myself. Mainly, I worry whether I’ll be able to pass. Not just as someone who has written a book, but as that far more narrowly conceived entity: a public author.

So it was strengthening to come upon a recent NPR piece entitled “A Med Student Decides to be Upfront About Her Mental Issues.”

“Upfont” and “mental issues” weren’t the only things that caught my eye. “Med student” did, too. In my job as a private tutor, I frequently help my senior students craft the application essays that Giselle, the med student, calls “brag sheets.” My students come armed with the same advice that Giselle universally received: “Do not mention that you have any kind of weakness, especially a mental health one.” Buff and polish your assets, hide your deficits in a deep dark closet. Sometimes I’ll suggest they inject a little more reality into their breezily triumphal accounts—advice they generally resist, probably wisely, except when it can be framed as a clear triumph-over-adversity narrative.

I leave these sessions confident that I’ve helped inch my students toward their dream, but also with the guilty suspicion that I’ve played my part in creating one more robo-doc, her humanity locked in a closet, under whose ungentle treatments far too many of us have suffered.

Giselle wasn’t only upfront on her application, admitting to depressions that had begun in childhood and to a suicide attempt at sixteen. When, against all odds, she was accepted to the University of Wisconsin Medical School, she continued to be upfront about her struggles. After failing an exam and panicking on another, she was “called to committee”—faculty members standing around a table on which sat a “not subtle” box of tissues—and asked if, considering her “issues,” she was really cut out for medicine.

For three months last winter I was immured in psychotic depression. I can’t describe an ordeal that lies beyond any words I know. Only twice before have I disappeared as deeply into psychosis: the first episode, at age 22, landed me in hospital for two years; the second, at age 35, left me subsisting on disability payments for five years.

In late February, just as I was beginning to suspect I might survive, I received an email from my publisher, Dan Wells. He was ready to begin editing my manuscript of The Adjustment League, which I’d sent him in the fall of 2014.

It was a bit like Lazarus, one step from the tomb, being reminded of a job application he’d submitted two years previous.


When I received the edited manuscript in the mail, I waited a day before opening it. It sat on the coffee table in front of the armchair I’d spent the last three months in, whenever I wasn’t in bed.

This was, in some ways, the best part of the editing process. The thickish block of mail-rumpled brown sat companionably in front of me. I could glance at it over the rim of my coffee mug, take it in as part of the room. I could touch it, pick it up and feel its weight; I did so, now and then. It was perfect, just right. What I was doing wasn’t editing—not yet. It was potential editing, an option-to-edit.

Still, I could feel it: creeping tendrils of wanna do—shy, deep-underground stuff, sensing the possibility of warmth and light and lengthening towards it. Which was wrong—right? I would be getting way ahead of myself. Breaking the bargain I had made with the Universe, when my illness was at its worst. “If You, Life, the Universe, let me be right-minded again,” I’d said, “I won’t ask for anything more. Won’t ask to read or write again, or to return to work. Let me be right-minded in this armchair by a window, and I swear I’ll leave it at that.”

Now, just when that prayer was being answered—random minutes of okay-ness, nothing ghastly coming between me and my window—here I was, eyeing a brown-packaged temptor. Why shouldn’t the Universe simply stomp on such a faithless deal-breaker?

There was that. And there were other, more practical problems to work out. I’d come a long way up from the bottom, but my ceiling was still far below what most people—and definitely most writers—would consider their floor.

I could still barely read. I tested myself regularly, going to the bookcase and opening a book to a random page. I could make sense of a sentence, even a few sentences in a row, before their meaning started to wobble and dissolve. That was far above where I’d been a month before, when I couldn’t reliably perceive any objects including letters, much less make them line up meaningfully—but obviously, far below where I’d need to be. I was coming back. But how far back would I come?

Meanwhile, how—how on earth—could I edit a book? I needed practical procedures. I wrote down a list of rules to follow and amended it continually over the next ten weeks, erasing methods that hadn’t worked and adding others worth a try. It became its own short book: The Dummies’ Guide to Post-Psychosis Editing.

The first step was to warn Dan. Sketching as best I could my last three months, I advised him that I would be starting the process in an impaired state, and I didn’t know yet how impaired, or whether I could find ways to work around the impairment, or to what extent the impairment would improve. I asked him to be patient with me. With apologies in advance, I said the whole thing might simply be too much.

Dan, bless him, never went further than saying, “We could always push it back a season.”

Next, I opened the brown package. I read the manuscript slowly. Very, very slowly at first—with my finger under a line until I reached the period, then going back to the beginning to see if I’d really understood it, to see if it meant the same thing on a second pass. I read Dan’s marginal notes in the same way—like fragments in another language I had only a rudimentary grasp of and must parse in short bits with many revisitings. As I gained confidence over the first few days, I picked up the pace slightly, though it never got very fast. Meaning veered and crashed past a certain careful jog.

I didn’t allow myself to write on the pages themselves. I ventured things on Post-It notes. Sometimes what I wrote on the Post-It notes were alternative wordings. Sometimes questions to myself to consider later. Sometimes they were the same phrase or sentence I’d read on the typescript—to see if it would stay the same, mean the same, transposed to the little yellow square. The warpings and bucklings of the walls of my room were becoming less frequent and shorter: I needed to see how walls and floors were holding in the house of words.

This phase took a slow three weeks. I gave myself frequent breaks. Walkabouts, dish-washing, leaning-back-in-chair-breathing-deeply: after a phrase or two, then after a sentence, a paragraph, never letting myself go for more than two or three pages without a rest. The end. Now, how to set about revising it, if it could be done. More ground rules to devise:

  1. Keep the sessions short, at least to start. Twenty minutes, half an hour tops. Come back for another if things are holding.
  2. Enter the new versions in another colour—I chose red—and never, ever delete the original, not till you’ve lived several days with the new and preferably not till it’s gone past Dan.
  3. At the start of each session, test yourself with verbal assays to see what kind of work might be possible. For example: try to write a sentence about your room, something you did yesterday. After making coffee, I phoned Tina and rescheduled our appointment. Successful tries at that kind of sentence licensed me to handle the same level of sentence in the manuscript, hopeful that I wouldn’t do much damage to moving people about rooms or streets, or having them fix a snack or beverage. Or try, if things are holding, more metaphoric stuff: …tiny violin scrolls of the first ash leaves… With a few such under my belt, I might venture to tinker—in red, provisionally—with a more figurative passage.
  4. If the assays show serious scrambling, try re-reading bits of yesterday’s work. If that too is wobbling or dissolving, close the book. Take a walk, do some housework. Perhaps just try to picture a scene: if you can stabilize it as a movie short, you may be able to describe it later that day. Or the next.

There’s a world more that could be said about these strategies, which mutated and ramified with the work, but I’ll stop there for now. The processes of art-making interest me endlessly. Properly explored, they speak to far more than art. They speak, I think, to all the other varieties of self-knowing and self-tinkering we engage in—and beyond that, to individual and societal toleration of difference. Differences of being, differences of doing.

Giselle answered the faculty committee by doing very well on her next two tests, and by posting on Facebook her affront at the “medieval process of judgement” she’d been subjected to.

Her mentor, a senior doctor, admitted to being surprised at first by Giselle’s openness about her struggles. But, he said, “we need Giselles in medicine.” He seemed to mean that Giselle might better understand the suffering of others. But I wondered if, equally or more, Giselle doesn’t offer others a glimpse into the healing process itself. Many, of course, would run from a doctor who acknowledged herself as her first, lifelong patient. Me, I’d feel bolstered by the thought that she was always on the job—that she knew it inside-out.

Inside-out I know that, while it hinders me, mental illness also helps me as a writer. It helps make more fine-grained my portrayals of psychological states, including the various pathologies that intertwine and collide in The Adjustment League. It requires me to monitor the changing health of my thinking, and to be patient and resourceful in improving it. And, because I periodically lose words entirely and must fight to regain them, it keeps fresh my sense of gratitude and wonder at their power.

One detail of Giselle’s story came as a surprise—though after a moment’s reflection it made perfect, if dispiriting, sense. “Giselle” was not her real name, “out of concern for her future career.”

Mike Barnes is my real name.

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