Second Class Diagnosis – Psychosis

by Sarah Dubinsky

Up until two years ago, my mental illness was of no consequence to me. I was working full-time and fully functional.  I viewed my bipolar disorder as a quirk of genetics, the equivalent of having curly hair over straight. Yes, a little unusual. Yes, I have to treat it differently. So, I’m not wash and wear ready when I wake up. I take my medication. No big deal.

However, it walked with me and, sometimes, talked to me, and even created a fantasy life that I could slip into, hide under, and burrow within when my world was askew on its axis. I did not realize it was mental illness. I thought it was eccentricity, quirkiness, and creativity.

I was actively psychotic.  Shouldn’t someone have told me?

Probably not. If I don’t see it, why should anyone else?

Although, I knew I had bipolar disorder with psychotic features, I thought it was controlled. The voices had left me long ago.  They didn’t actually bother me too much. They didn’t speak English, and I only speak that.  Without subtitles, they lacked meaning.

However, being re-diagnosed was educational; I was schooled in stigma. I felt, for the first time in a decade, that I have mental illness.  This is odd because schizoaffective disorder and bipolar disorder with psychotic features are kissing cousins. They practically neck.  The difference is the frequency of the psychotic episodes.

Really, nothing has changed, other than my meds and the name of my diagnosis. But names have power.

What do people think when they hear bipolar? It depends on the stereotype and if a Hollywood star is disclosing their battle with it on a particular day.

My favorite one is that bipolar people are creative thinkers and doers, who span all kinds of industry. Innovators. Extroverts. They can even be engineers — groundbreaking, transformative creators.

Okay, yes they are moody and not always the most reliable, but they can achieve. Alright, some are tortured, but all have a fire in them that can turn into genius or arson. It just depends.

But there are only a few stereotypes for my new diagnosis.

Beware of those schizo people. They are brittle and damaged and if you view one, your cornea will shatter into the retina beneath, blinding you in a bloody mess that will spill onto your clothes and into your heart. Better to look away and let them blend into the darkness with the other things that frighten you.

I see you look away. I hear you in the silence.  You know that pause after I say, ‘I have schizoaffective disorder, I’m schizoaffective, I’m schizo.’ It doesn’t matter how I phrase it.

That pause is disquieting. Oddly, I get a similar response on occasion when I say I am a lawyer.

Being psychotic and schizo-anything is not the same as being psychopathic. My kind tends to be nonviolent. We are not the vampires in the stories; usually, we are the victims.  Being mentally ill is not the same as being a bad person. Bad people do bad things. Even good people do bad things. It is just an issue of to whom. Personally, I like to turn my anger inwards. It is an exquisite kind of torment that hurts like a splash of lemon juice on a wound. Not disabled people do that too.  There is a world of the worried well, taking their turn in the therapist’s chair.

And on Wednesdays, I go as well. Not because I am schizoaffective, I go because I am one of them too.

Dubinsky on Couch

Sarah Dubinsky’s stories, songs, and poems glitter like pyrite and have the depth of a puddle. She likes it this way and hopes you do too.

Visit Sarah at

5 thoughts on “Second Class Diagnosis – Psychosis”

  1. No doubt about it, that “Schizo-” label makes a social difference. And what happens if you tell people you are Schizo AND a lawyer – really scary. Of course, some people also who think lawyers are psychopaths. Wonderful post.

    Liked by 1 person

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