The problem with the diabetes metaphor


With my diagnosis of schizophrenia + bipolar, otherwise known as schizoaffective, I hear this explanation of my chronic illness all the time.

The premise is that drawing a parallel between a measurable health condition like diabetes and mental illness should give hope. All you need is the right medication, and life should be manageable. But let’s pick apart this metaphor. I find that a few steps further, and some aspects fall apart.

For one, I have never received treatment for mental illness that doesn’t come with severe side effects. Often, I find that the pills over medicate and leave me in a state worse than the initial condition. I am not staunch in saying that medication fails. But the positive treatment outcomes just barely exceed the negative results in comparison. Pros and cons must constantly be weighed for both short term and long term success.

The sheer breadth of antipsychotics, SSRIs, SNRIs, and so on… there is no one easy panacea. Insulin, the standard treatment for chronic types of diabetes, does not come with the same complications.

The very reason why I come into these conversations, whether it be with mental health professionals, jurors, or law enforcement, is that the suggested solution is not enough. I feel dull, tired, lacking focus. I make an attempt to “take it” for a few months at a time. But time and time again, over the past five years, my dissatisfaction with the truth emerges. I stop taking what I’ve been prescribed. It’s not out of spite or ignorance. If the suggested medication worked as advertised, I would never complain.

Somehow, I am at a happy medium now in terms of what I am taking. But it took years of refusing to settle, and coming to my own conclusions.

The last question I often ask myself is, if schizophrenia can be treated the same as diabetes, does this also suggest that a holistic cure is possible? With diet, exercise, social support modifications, can I stop relying on conventional measures?

Overall, I think the diabetes metaphor has a good heart to it. But for the lived experience of seeking treatment, I get a sense of throwing the baby out with the bathwater. Mental illness is so much more difficult to treat, elusive, fracturing one’s identity, among many other effects.

Loneliness, depression, delusions, fear, these should become as normalized as diabetes. Only then can we progress into better, deeper, more nuanced discussions.