Not All Wounds Are Visible


A very popular ad campaign for PTSD awareness features the slogan “not all wounds are visible,” generally emblazoned across a graphic of the haunted, hunted eyes of a returning soldier revisiting the horrors of the battlefield.  As the wife of an active-duty Army infantry officer, I find the message of this campaign to be both true and vitally important. But the phrase has a broader applicability that I think we all too often overlook: most wounds ARE invisible.

There is an old and rather unfunny one-liner I first heard as a kid: ‘One in four Americans suffers from mental illness. Look around you. If your three best friends are all right, you’re it.’ Speaking as someone who has been ‘it’ in her circle of friends from a very early age, I can tell you from all-too-personal experience that the behavior a sufferer exhibits in public may be the farthest thing from the reality as experienced by the sufferer. No matter how joyous and exuberant and brimming with joie de vivre your mentally ill friend may appear over cocktails, that same friend may go home and cry all night, every night, well into the night; may be battling any number of brutal and all-consuming addictions eating her alive body and soul; may on any number of occasions during the period in which you have known her counted out pills in neat, symmetrical little lines ‘just in case,’ fingered the seductive steel of a .45 caliber pistol in the middle the night, or carved ‘WHORE’ into her arms with a rusty razorblade during a dark four o’clock in the morning of the soul. Shakespeare noted that one may ‘smile, and smile, and be a villain’; one may also smile, and smile, and wear death as close as Calvin Kleins.

The specifics of my own medical history are largely irrelevant here; suffice it to say I have struggled with substance abuse, an eating disorder, a mood disorder, obsessive-compulsive disorder, clinical anxiety, and post-traumatic stress disorder in my twenty-eight years on this planet. And it is only after a decade and a half of fighting the good fight that I am even beginning to come up for air. I am learning to breathe again. But the battle still rages within.

Here is what IS relevant: I am your friend, your mother, your sibling, your child, your next-door neighbor. I graduated summa cum laude with both bachelor’s and master’s degrees; I sat next to you in class. I have always been gainfully employed; I sat next to you in a cubicle. I am gregarious, popular, sociable, outgoing; I have written, directed, performed, taught, and jitterbugged through life with an enormous smile plastered on my face and a doggedly creative spark which has occasionally puttered but never gone out. I have never been homeless, friendless, or unemployable. I have never muttered to myself wearing a tin-foil hat or sleeping under a bridge. So maybe you never even knew. Maybe you thought mental illness only lurks in dark corners behind closed doors. It doesn’t. It lives in your own home, your own workplace, your own Facebook feed. It sets up camp in your own backyard, behind white picket and chain-link fences alike. Sometimes it wears a tin-foil hat. Other times it wears skinny jeans and Uggs, business suits and Prada heels, Levi’s and cowboy boots. We are America’s mentally ill, and we are legion.

So the next time you flippantly describe someone’s behavior as “bipolar,” the next time you say you wish you could “catch” anorexia before bikini season, the next time you describe yourself as OCD because you like your DVD collection alphabetized, please stop and think a minute. Please remember that your levity is my reality. I don’t laugh at your glib jokes about your boyfriend acting like a mental patient, for I have been a mental patient, spending a sizable portion of my late teens and early twenties in a locked ward in my own personal hell. Don’t mock me until you have lent your teddy bear to a sobbing little girl who was molested by her father and needed shots of Thorazine to sleep through the night. Don’t judge me until you have hidden your face in a pillow to muffle the screams down the hall as EMTs rushed to save your best friend who slit her wrists with shards of shattered lightbulb. Don’t dismiss my pain until you have buried a loved one who has starved herself to death despite the world’s most frantic efforts to save her from herself.  And don’t presume you understand me until you’ve seen a dozen therapists in as many years, all of whom repeat some version of the same tattered canard: “no one really knows why you’re so fucked up, but hey-here’s-some-pills-some-of-which-work-some-of-which-don’t,” until you’ve downed a charcoal milkshake or had your stomach pumped because that Molotov cocktail of prescription drugs with which you tried to kill yourself at age nineteen failed to take effect, until you owe your very life to a botched suicide job and sported the lifelong stigma of owing your life to a botched suicide job, until you’ve shaken your fist screaming at the sky and wondering why the world stubbornly goes on in the face of your pain.

It has been many years since then. These days, I’m doing a little better. I have found a modicum of joy in daily living. It doesn’t always hurt to smile now. I have come to some sort of peace, or at least détente, with my own existence most days. I have come to value my own mind, however fragile and fragmented, as something strange and beautiful and altogether unique in this world.  I have, like Rumpelstiltsken, learned to spin straw into gold. But sometimes I still wake up in pain and go to bed in pain. Sometimes I still think dark and terrible thoughts. Sometimes I still fear those I love would be better off had I never been born. Sometimes I still have crippling anxiety about the way I dress, the way I look, the way I am. While treatment and (the right) pharmaceuticals have proven themselves invaluable, no amount of therapy, acupuncture, 12-step groups, meditation, or medication will fully “cure” that. But I choose to go on anyway in the face of sometimes unspeakable pain. I choose to believe, like Albert Camus, that even in the dead of winter there is within me an an invincible summer. I choose to get up in the morning. I choose to fight. I choose to believe that life — even life with mental illness — is precious and lovely and worth fighting for. Some of my friends stopped believing that; they are dead now. They, like me, were somebody’s daughter, son, mother, father, husband, wife, sibling. They, like me, sat next to you on the subway, in class, at the DMV. They took zumba with you. They joined your book club. They got drinks with you at after-work happy hours. They were incredible, each and every one of them. They were achingly smart, blisteringly creative, desperately loved, terribly wounded — and I fight every day for them. By divine providence or sheer dumb luck, I’m still here to speak up for them, and I have been too silent for too long.

An internet meme that keeps popping up in my newsfeed says it all: “Be kind today, for everyone you meet is fighting a hard battle.” At whatever stage of healing, hope, and recovery in which we find ourselves, we are America’s mentally ill. Not all wounds are visible, but I promise you they still leave lasting scars.