Crazy is You or Me, Amplified

My personal story of recovery from the brain disease model of mental illness.

In interviews, I’ve often shared how I became a journalist after discovering the stories of detransitioners—stories that deeply resonated with my own struggles with mental health and identity. I’ve been very open about the severe mental health crises I faced in my youth and have frequently alluded to the "bad decisions" I made as a young adult. As my public profile grew, I was prepared for the inevitability that those bad decisions would become known. Now that they have, I want to use this moment to share my story in the hope that it can be instructive and bring attention to an issue I believe is preventing many from recovering from mental illness.

There’s been much speculation about the ongoing youth mental health crisis, particularly about why liberals—especially liberal girls—report the highest rates of mental illness. Some have suggested that locus of control plays a contributing role. Those with an external locus of control, who believe their lives are shaped by forces beyond their control, tend to be less mentally well and lean more liberal. In contrast, those with an internal locus of control, who believe they have agency over their lives, are generally mentally healthier and more likely to align with conservative values.

This idea resonates deeply with me and my own experiences, and I want to expand on it. I believe young people, especially liberals, are constantly bombarded with messages that reinforce an external locus of control. This concept is central to the book I am writing, where I lay out the origins of this mindset and the effect it has on people. A significant contributor is the brain disease model of mental illness. This biomedical model, which portrays mental illness as a medical condition, profoundly shaped my sense of self growing up and, I believe, continues to influence how many young people perceive themselves and their struggles.

The Brain Disease Model of Mental Illness

In the 1980s, psychiatry sought to establish itself as a legitimate branch of scientific medicine by adopting a biomedical model, which framed mental disorders as brain diseases. This approach offered a straightforward explanation: mental illnesses result from biological dysfunctions, such as chemical imbalances, and require medical treatment. One of the most influential narratives born from this model was the serotonin theory of depression, which claimed that depression was caused by low levels of serotonin in the brain.

Endorsed by professional organizations like the American Psychiatric Association (APA), the National Institute of Mental Health (NIMH), textbooks, and influential research papers, the brain disease model of mental disorders became a cornerstone of psychiatric practice and public understanding for 40 years. Pharmaceutical companies spent billions on advertising campaigns promoting psychotropic drugs as solutions to chemical imbalances. Public awareness initiatives claimed it would reduce stigma surrounding mental illness. As a result, surveys find that 80–90% of people believe depression is caused by a chemical imbalance.

However, this narrative was built more on marketing than science. Billions of dollars in neuroscience research over decades have failed to uncover clear and convincing evidence for a biological basis for mental disorders. The serotonin theory of depression, in particular, lacked substantial evidence and was debunked in 2022 by a systematic umbrella review. Despite this, there has been no major effort to correct public misconceptions or hold accountable those who promoted this idea without evidence.

The chemical imbalance theory remains the dominant cultural narrative about depression in the United States. Many states are now incorporating mental health education into K-12 curricula, but depending on how this education is conducted, it could cause more harm than good. For example, a Minnesota curriculum for middle and high school students, developed by the pharma-funded advocacy group National Alliance on Mental Illness (NAMI), teaches that mental illnesses are "brain disorders," emphasizing: "Biology, not a character flaw, causes mental illness."

This is a vast oversimplification. While hereditary components and traits like neuroticism may predispose individuals to negative thinking or mental health challenges, they do not determine their fate. Yet, in my recent interviews with young adults in treatment for mental health crises, every one of them described their mental disorder as a chemical imbalance or brain condition. They attributed the actions that led them into treatment to their disorder, viewing it as a lifelong condition, which they lacked control over.

Given the ubiquity of the biomedical model, it should come as no surprise that mental disorders are among the leading causes of disability—costing the U.S. economy upwards of $280 billion annually. As of 2022, over one in five adults in the U.S.—59.3 million people—report a mental illness diagnosis. For adolescents aged 13–18, the rate is even higher, with an estimated 49.5%—nearly one in two—diagnosed.

The lead author of the 2022 systematic umbrella review, Dr. Joanna Moncrieff, stated that "telling people they have a brain abnormality, or some physical medical problem, is profoundly disempowering." She is absolutely right. Such messaging undermines a person’s sense of agency and is particularly harmful to young, developing minds.

As a teenager immersed in a mental health system rooted in the biomedical model, I internalized the belief that something was fundamentally wrong with my brain and that I lacked control over my behavior. My story is one of breaking free from the constraints of this medical framework, overcoming the mental health challenges it reinforced, and reclaiming a sense of personal agency over my life.

Tumultuous Teen Years

I received many diagnoses throughout my life, the most recent being Asperger's syndrome at age 30. While I remain skeptical of behaviorally-diagnosed conditions and mindful of confirmation bias, I can see, in hindsight, early signs from childhood that align with the traits ascribed to Asperger's. From a young age, my life was continually punctuated by one all-consuming interest after another. I struggled to make and maintain friendships, and spent most of my time alone and engaging in solitary activities like staring into puddles and overturning rocks to observe small life forms, catching tadpoles, arranging my toys in elaborate setups, and drawing.

I was rigid and found comfort in routines, rewatching the same VHS tapes or listening to the same cassettes on repeat. My eating habits were similarly fixed—I was a very picky eater, choosing the same plain foods every day. I was also particular about textures, always preferring soft, stretchy fabrics. Physically, I was clumsy and uncoordinated, and I was highly sensitive to my environment.

But the real trouble didn't begin until early adolescence, when my family moved to a new city and I started middle school. I was not socially successful and was teased by other kids. The rejection felt monumental, leading me to become increasingly self-critical and withdrawn. The noisy, chaotic areas where kids gathered were overwhelming, so I often sought refuge in teachers’ classrooms during breaks and lunch or found quiet, secluded spots to be alone. 

I began experiencing feelings of body dysmorphia, becoming hyperfocused on my flaws. I wore the same baggy black sweatshirt and stretchy blue jeans every day. I thought I was hideous and hid my face behind a wall of hair. I developed dermatillomania, compulsively picking at my scalp, as a way to self-comfort.

In class, I would repetitively draw the same figures and faces, retreating into a fantasy world—first Sailor Moon, then The Legend of Zelda, then Lord of the Rings—to escape from reality. Sometimes, I became so overwhelmed that I would get up and walk out of class, only to be sent to the counselor’s office. They recommended to my parents that I see a therapist. After school, I would go straight to my room and draw the curtains. I spent countless hours on the computer, teaching myself to code and designing websites dedicated to whatever my current interest was.

In 2002, when I was 13, my 7-year-old neighbor Danielle van Dam was raped and killed by our 49-year-old neighbor, David Westerfield. It was a big event in our community, and it deeply affected me. I followed the trial closely and collected the newspaper clippings about the case. I developed insomnia and obsessive-compulsive habits: walking around the house at night, checking the locks over and over, and washing my hands until they were raw. 

Entering highschool, my mental health further plummeted and my relationship with my parents deteriorated. I was 14 when I started carving up my body with knives and razor blades. My outward appearance started to reflect my darker inner world; I dyed my hair red and wore heavy eyeliner. I became anorexic, and at 5’8”, my lowest weight was under 100 pounds. My biceps showed brown discoloration from muscle wasting. I began feeling like it would be better if I died.

It was during a visit to the psychiatrist in 2003 that I received a diagnosis of major depressive disorder after a brief meeting reviewing a checklist of symptoms. This was the first time I heard depression described as a "chemical imbalance" in my brain. This explanation made me feel hopeless, as it implied that my brain was somehow defective—I was born with this condition, and had no power to change it. During that appointment, I made a long slice down my arm in the bathroom with a razor blade, resulting in an emergency room visit and my first stay in a psychiatric hospital.

In 2004, I was caught in a cycle of crises, repeatedly accessing emergency rooms, psychiatric hospitals, outpatient programs, and group homes. I received numerous diagnoses from different psychiatrists and was prescribed a range of high-dose psychotropic medications—including one that caused a life-threatening rash and another that required regular EKGs.

At every step, the idea that mental illness was a brain disease I suffered from, and would have for the rest of my life, was reinforced. The lexicon of the Diagnostic and Statistical Manual of Mental Disorders (DSM) shaped my worldview, and I became preoccupied with finding the "correct" diagnosis so that I could better understand myself. The way the adults in my life referred to me as "sick" and "mentally ill" and described my behavior as "out of control" influenced my self-perception, and I took on the role of a sick person. 

Due to my extensive absences from high school, I had an Individualized Education Program (IEP). As part of the evaluation process, they conducted psychological testing and classroom observations. The evaluator’s notes documented my monotone voice, "limited eye contact," "flat affect," instances of "stumbling while walking and almost falling," and that “test results indicate a large number of atypical perceptual experiences.” They also noted "social immaturity," "significant inflexibility in her thinking," "difficulty identifying feelings," "tendency to express emotions indirectly and impulsively," and that “when the teacher used humor in the classroom, Christina did not smile or appear to respond in the same manner as her peers.” 

I also received a near-perfect score on Raven’s Progressive Matrices, a nonverbal intelligence test that measures an individual’s ability to identify patterns—a result I later learned is common among individuals with Asperger’s. However, Asperger’s was largely viewed as a "boys' disorder" at the time and was not considered in my case. Instead, my IEP labeled my disability as “Emotionally Disturbed.”

As my behavior escalated and became increasingly risky, I began seeking out drugs and alcohol. Things took a drastic turn for the worse when an internet predator found me on Myspace and began grooming me. He was 47, and I was only 15. He had deceived me, and when I met him in person, he raped me. The emotional pain was so unbearable afterwards that I tried to hang myself.

From the emergency room, I was placed in another psychiatric hospital—but this time there was no going home afterward. It became clear to my parents that I needed a higher level of care than they could provide. After running away from two lower-security residential treatment facilities, flunking out of a wilderness program in Idaho, and several more psychiatric hospital stays, I arrived at my final destination: a lockdown psychiatric residential treatment center in Utah called Provo Canyon School, where I would live for a year.

While other kids were getting their learner’s permits, celebrating their sweet sixteens, and attending school dances, I was in treatment. It was an intense, highly structured behavior modification program with a level system I had to work through to achieve a high status. It wasn’t easy or enjoyable, but it was effective in helping me break free from the cycle of crisis so that I could safely return home. (This type of treatment is in decline—a topic I’m passionate about and have several upcoming articles addressing.)

As for my rapist, he served less than six months in jail. This type of crime carried lighter penalties 20 years ago. I later learned that he reoffended four years later with another underage girl. He's still on the sex offender registry.

Young Adulthood

Things were stable at home for a while, and I managed to complete my GED at 17, but my relationship with my parents remained strained. By 19, living at home was no longer an option, and I found myself on my own. A friend’s family offered me a temporary place to stay, but I didn't want to be a burden on them, so I quickly moved in with a boyfriend I had just met.

We had a roommate who eventually moved out, leaving me needing additional income to cover expenses. I began doing photoshoots, which were initially clothed. However, after I was let go from my job as a nanny, the shoots progressed to unclothed. My boyfriend at the time, who had stopped working, either encouraged it or didn’t discourage it. This period is difficult to recall, as I’ve tried hard to forget it.

When the relationship ended, he left the country, abandoning me with significant debt, unpaid rent, and lease-breaking fees from our apartment. Our former roommate, who was also on the lease, was forced to cover the apartment fees to protect her credit and threatened legal action against me, leaving me desperate to find money quickly.

I eventually agreed to meet with a representative from an agency that had been hounding me, which led to my decision to make adult films to pay off my debt. At the time, and for several months thereafter, I believed I had bipolar disorder. However, I later realized that the instability I felt stemmed from other factors, including heavy drinking. My behavior mirrored my sense of self-worth—I saw myself as a mentally ill, degenerate loser, and I acted accordingly.

I was purely in survival mode, with no one to call for help and without the kind of stability one typically needs to think about the future and consider how my choices would impact me later in life. I was also very naive, believing that the content would remain on obscure, paywalled websites, unaware that free porn sites were beginning to dominate the internet.

While I don’t judge others who have chosen to do sex work, I would strongly discourage anyone considering it, as my own experience was traumatic and soul-crushing. I decided to work with an agency because I thought it would be safer, but my last assignment proved otherwise. They sent me to a hotel room with a man with a camera who choked me, hurt me, and ignored my cries and pleas to stop. Even after that, the agency relentlessly pressured me to continue, but I was done. In three and a half weeks, I had made enough to pay off my debt and avoid homelessness. How the owners chose to distribute, repackage, and republish the content at later dates and under multiple titles was entirely beyond my control.

Getting Better

Afterwards, I worked as a freelance graphic artist, but I was still directionless, turning to dangerous combinations of drugs and alcohol. That changed when I was 22 and began working for an employer whose family became a surrogate family to me. He believed in me, saw potential I couldn’t see in myself, and encouraged me to go back to school. For the first time, someone expected more from me—he didn’t treat me like I was a sick person or try to take advantage of me.

He introduced me to science, which quickly became my all-consuming passion. He gave me books on skepticism and debunking pseudoscience, which I devoured, and we watched debates on atheism that taught me about argumentation and logical fallacies.

I used to feel like a passive witness to my own life, watching myself make one bad decision after another, driven by emotions and impulses I couldn’t control due to my underlying mental illness. I had never been taught to think critically or base my beliefs on evidence, like a scientist. Learning how to think critically—and applying those techniques to myself—was the turning point when everything began to change.

There’s a meme I like that says, “Anxiety is just conspiracy theories about yourself.” The key is learning to debunk those conspiracy theories and spot the logical fallacies in your own thinking. This mindset shift helped me immensely. I also discovered Stoic philosophy, which taught me that I could choose not to react to emotional triggers and that no one could disturb my inner peace unless I allowed it—something I wasn't even aware was possible.

I believe many mental health challenges stem from the belief that we lack control over our thoughts and emotions. The truth is, you can train your brain. The mind is like a muscle; just as you wouldn’t expect to transform your body in a single day at the gym, strengthening your mind takes consistent effort and hard work. If you stick with it, you get stronger every day.

Challenging my negative self-talk was one of the hardest things I’ve ever done. After over a decade of habitual self-criticism, catastrophizing, and black-and-white thinking, breaking those thought patterns felt almost insurmountable. But this process—essentially cognitive behavioral therapy (CBT) in practice—was transformative. While a therapist trained in CBT can offer valuable guidance, real progress comes from consistently applying these strategies in your everyday life.

Through this work, I developed an internal locus of control and a sense of agency that had been missing for most of my life. For the first time, I no longer saw myself as mentally ill and destined for a life of failure: I felt like I was truly in charge of my thoughts, my actions, and my future.

Aftermath

I eventually reconnected with my family, and we’re very close now. While making friends became somewhat easier as I got older, maintaining those friendships remained a challenge. Throughout my twenties and early thirties, I still struggled with identity issues, which led to a somewhat unconventional life as I searched for direction. I moved frequently, even living in Switzerland at one point, changed my college major several times, changed my appearance often, worked as a caregiver for special needs children and adults, tagged along on tour with Alice Cooper, illustrated children’s books, and became a social justice meme-maker for a short time before undergoing a political realignment.

Clarity came at age 30, when I was assessed for and diagnosed with Asperger’s syndrome. This often presents differently in girls and can go undetected, as comorbidities tend to emerge around puberty, shifting the focus away from the underlying condition.

Hypersensitivity to light and sound, social difficulties, obsessive interests, repetitive behaviors, struggles with abstract thinking and executive functioning, auditory processing challenges, food intolerances, motor-balance issues, and possibly even the cerebellum abnormalities revealed in my MRI all finally seemed to fit into a cohesive narrative. However, I am now cautious not to let any diagnosis define my identity. Instead, I focus on accommodating myself to better manage the associated symptoms so that they don't interfere with the life I want.

Even after this revelation, my life still lacked purpose. It was only in recent years, after becoming a journalist, that I truly felt like I had found my calling. Journalism has given me a sense of accomplishment and self-worth. It’s an exciting career that allows me to leverage my strengths in research and writing, along with traits like hyper-focus, an obsessive drive to deeply understand topics, attention to detail, and the ability to work long hours without fatigue. It’s a profession where I can pursue my love of learning while helping others stay informed.

In my work with detransitioners, I conducted a survey revealing 85.7% reported that their healthcare providers, including doctors and therapists, described being transgender as a biological characteristic beyond their control—a medical condition necessitating treatment. Additionally, 49.2% recalled providers framing their transgender identity as a brain condition, using the phrase "male brain in a female body" and vice versa. This framing drew striking parallels to my own experience with the brain disease model of mental illness. Both present psychiatric conditions as innate and immutable traits, profoundly shaping young people's self-perception and undermining their sense of personal agency.

Learning about the history of psychiatry, combined with my personal experience, and the experiences of detransitioners, has really shaken my faith in the field, leading me to wonder if it deserves the outsized trust we place in it.

Diagnostic categories within the Diagnostic and Statistical Manual of Mental Disorders (DSM) reflect the opinions of appointed experts rather than being grounded in consistently replicated scientific research. Psychiatric diagnoses are often unreliable because they are based on subjective criteria, such as self-reports from patients, behavioral observations, and clinician interpretation, all of which are susceptible to bias and error. Recent research has highlighted a significant amount of overlap within DSM-defined disorder categories, leading some researchers to conclude that psychiatric diagnosis is "scientifically meaningless." 

And yet, the DSM has become a globalizing force, spreading predominantly Western concepts of mental health to other cultures, often driven by the interests of pharmaceutical companies and professional organizations. This has contributed to the rise of diagnostic fads and diagnostic inflation, where increasingly broad criteria pathologize human behavior, labeling it as mental disorders. 

We have to consider how the DSM serves as a powerful cultural script, and influences how we express and communicate our distress. While there is some utility in classifying mental and emotional distress, diagnoses are often misunderstood as the cause of a person’s struggles, leading many to define themselves by these labels. This can create a self-fulfilling prophecy, where belief in a diagnosis influences the manifestation of symptoms—even when the diagnosis is incorrect.

We need to step back from the brain disease model of mental illness and rethink how we understand life’s difficulties. Unwanted thoughts and emotions are not simply the result of abnormal brain chemistry requiring chemical correction. In many cases, they can be changed with effort and persistence—but that process begins by rejecting the idea that you lack the power to make those changes.

Mental illness should not be viewed as a permanent condition or a defining aspect of one's identity. Instead, it should be seen as something to work toward overcoming—to the extent it is possible. This perspective may not apply uniformly to all conditions, such as psychotic disorders, but in most cases, recovery even from serious mental illness is attainable. Believe you are sick, and you will be sick; believe you can get better, and you can.