Once I left the hospital, I left a message for my therapist in a torrent of animated, angry words. I stated to him, “I got past a doctoral school interview, a therapist job interview, but I can’t get past a psychiatric hospital interview?”

That irony has a powerful truth to it. Those first two interviews had required me to dress well and speak intellectually and openly. Apparently I had done the same thing with the psychiatrist at the hospital, only the content was different — I was telling him of my pain, self-destructive behaviors, and suicidal ideation. I was also engaging the doctor in some light debate, based on a question he had asked me in regards to hypomanic mood and creativity.
I couldn’t get past a psychiatric hospital interview because I was acting too much like myself.

I came to this conclusion a couple of days later as I sat with the women in my borderline personality disorder support group. I recounted the story of my failed hospitalization and a couple of the women stated that perhaps I had been too intellectual and not enough emotional. As we talked about the possibility of trying admission into another hospital, the women suggested that I “leave the adult at home” next time I go for an evaluation.

I didn’t understand why I would have to leave an entire compartment of my personality at home, or put it to sleep. This was my true self. I felt it unfair that if I showed up as my true self, with all of the pain and need for help underneath, that I wouldn’t be perceived as “sick” enough to be in the hospital.

Obviously a stigma exists in within all aspects of mental illness. However, I have always been aware of a separate stigma for those who are mentally ill, but functioning at a high level. When I say functioning at a high level, I am referring to a variety of factors in any combination: these individuals may have graduate degrees or are actively involved in attending school, hold professional jobs, are of a middle to high economic status, and have optimal daily living skills (in regards to hygiene, dressing, grooming). They may present well, speak well, and not appear “sick” to even the most seasoned therapist or psychiatrist.

My saddened affect has been perceived by my coworkers and school peers as though I am stuck-up, unapproachable, or isolative. At home, I was writing research papers through tears and cutting myself, sometimes up to 20 times each night. However, it was winter so I was able to easily cover my cuts and I was just viewed as being just a bit unfriendly — certainly not ill.

One summer semester I was taking a psychopharmacology class. We were learning about the mood stabilizers and antipsychotics. My professor made a passing comment pertaining to how he was sure that “no one in the class had a serious diagnosis such as bipolar disorder or schizophrenia,” which, in effect, meant that nobody in the class could be taking such medications. Little did he know, one of the few individuals who got an A in that class carried three mental health diagnoses and had been on 15 different psychiatric medications by that time.