A portrait of the author
A portrait of the author Credit: Hillary Bylund Credit: Hillary Bylund

There’s a perverse rationality to my psychosis.

It begins as whispers on the wind. 

A voice calling my name. Demonic faces appearing and then vanishing. A man narrating my thoughts and actions wherever I go.

Bizarre interpretations follow from bizarre experiences. 

I have a divine mission, like a prophet of old. How else can I explain the omnipresent demonic legions haunting my steps?

I exist on the schizophrenia spectrum. That puts me in the same camp as those with schizoaffective disorder; schizophreniform disorder; other specified and unspecified schizophrenia spectrum disorders; and, of course, schizophrenia itself. 

But aside from my propensity to lose touch with reality every few months, I’m a fairly typical twenty something-year-old woman.

And that “but” is everything.

I have schizophrenia. But I don’t usually talk to myself in public.

I have schizophrenia. But I’m usually pretty good about hiding my delusions.

I have schizophrenia. But it’s well-managed.

I have schizophrenia. But I can generally keep up with my law school classes, feed myself, and manage my hygiene.

I have schizophrenia. But, but, but…

But most days, you wouldn’t know I have an illness so horrifying some psychiatrists withhold the diagnosis from their patients for fear of triggering anxiety and despair. You wouldn’t know I’m a mad woman. 

That’s because, by the usual measures of psycho-social functioning—ability to hold a job, continue with schooling, maintain interpersonal relationships, care for my hygiene and general well-being—I am a “high functioning” schizophrenic. 

It’s a label some who share my diagnostic label wear with pride, all the more so in recent years as more and more people have come forward to share their stories of being both successful and schizophrenic. 

After all, advocates say, schizophrenics can be lawyers, business people, and teachers—anything we want to be—provided we receive the proper combination of treatment and support. Give us the right anti-psychotics, teach us to challenge our hallucinations and delusions with rational thought, make sure we’re getting a good night’s sleep, and you’ll see: we’re not so different from everyone else. 

But a person with a “high functioning” schizophrenia is still on the schizophrenia spectrum. And that’s the rub: it does make us different. 

For the past month, I’ve been keeping a close eye on the number of white cars on my street. By my count, there are currently seven of them.

The Illuminati drives white cars—I know this to be true the same way I know that a blue sky means the sun is out. They’re after me. They’ve been after me from the beginning. 

The more white cars there are on my street, the more closely I am being surveilled. White is the most common car colour. I am always being watched.

The delusions I’ve been suffering from off-and-on for the past month are known as “breakthrough symptoms on anti-psychotic maintenance medication.” It’s a technical way of saying that I’m still symptomatic despite faithfully taking my anti-psychotics. It’s a technical way of saying that I’m still sick. 

What the ‘high functioning’ label doesn’t capture

The “high functioning” label erases or otherwise minimizes more of my experience of life on the schizophrenia spectrum than it embraces. 

I will live with my illness for the rest of my life—there is no cure. And that means I will have to work every day to maintain my grasp on the real world; knowing that even if I take my medications, spend hour after hour in psychotherapy, and am diligent about applying the skills I have learned to manage my symptoms, my hold on reality will still slip every now and again. 

Whether because of stress or the capriciousness of fate, my madness will strike again.  

“High functioning” implies normalcy, remission, and recovery—when what I have is an illness that sometimes requires more support, sometimes less, but that is ever present. 

I can be high functioning one day and low functioning the next. I can be high functioning in some ways and low functioning in others. But regardless of the day or the way, I exist on the schizophrenia spectrum. That’s never going to change. 

In fact, I have more in common with my “low functioning” siblings on the schizophrenia spectrum than I do with people who do not share my illness at all. 

Where the “high functioning” label suggests that I am somehow different—better, even—than them, I see commonality. 

I, too, know what it’s like to lose touch with the real world. To be plagued by the hallucinations and delusions that are caricatured in Hollywood depictions of our illness—and by the cognitive and emotional deficits that aren’t so easily portrayed. To fear what the medical system will do—involuntary admissions, restraints, locked rooms—when its powers to heal fail. 

Above all, that reality is a gift not easily regained once lost. 

We need unity not division

Function labels divide when what we need to be doing is uniting: against stigma, medical violence, and our illness itself; and for a more hospitable world for the chronically ill. 

Whether low functioning or high functioning, we share the same illness and the same political goals. 

All of us stand to gain if comprehensive mental health services become freely and readily available to all, but especially those in the earliest stages of the illness when the prognosis is most malleable. All of us stand to gain if hospital psychiatric care is reformed to become more humane to patients in crisis, but especially those whose illness is most impervious to outpatient treatment. All of us stand to gain if those with schizophrenia are provided disability benefits sufficient to allow us to lead fulfilling lives, but especially those whose illness prevents them from working.

All of us stand to gain from these things because all of us stand to lose everything to our illness. And until all of us are secure in the knowledge that this world will accommodate us no matter how sick we become, all of us are at risk. 

Everyone’s experience of the schizophrenia spectrum is different. 

I’m symptomatic today, but I might not be tomorrow. 

I’m barely able to work today, but that might not be the case tomorrow.

I’m “low functioning” today, but I might be “high functioning” tomorrow. 

By using such labels, we flatten the schizophrenia spectrum into a two-dimensional binary when it is anything but. 

This is a set of illnesses for which different sufferers require different degrees of support at different times. 

So don’t minimize the symptoms I’m currently experiencing just because I need less support to live with them, now, than I did when they first appeared. At the same time, don’t stigmatize those with more debilitating symptoms just because they’re having more difficulty getting by. 

I’m no more or less schizophrenic than they are. I’m no better or worse than they are. My illness is just manifesting in different ways. And that might change tomorrow.

Stop calling me “high functioning.” It’s an ableist label I do not want and will not accept.

I’m just schizophrenic.

Charlotte Dalwood

Charlotte Dalwood (she/they) is a Student-At-Law at Prison & Police Law in Calgary, AB; and a Master of Laws student at Osgoode Hall Law School of York University. Find Charlotte online at www.charlottedalwood.com.