An Interview with Cass MacLean: Antisocial Like a Wolf

This interview is part of a series featuring individuals that have been impacted by mental illness. Each individual featured on the Uncustomary Housewife’s Not Alone Series has a valuable mental health story to tell. I hope that people will read these stories, find strength in them, and realize that they are not alone.

I recently conducted an interview with Cass MacLean. During our interview Cass discussed the importance of being honest with doctors and friends, the unfair stigma placed on certain mental illnesses, and the joy that an emotional support animal can bring. Cass also discussed her diagnosis history and talked about having the hyper-stigmatized diagnosis of Anti-Social Personality Disorder. Continue reading for the full interview:

EB: Elizabeth Banks (Interviewer)
CM: Cass MacLean (Interviewee)

CONTENT WARNING: This interview contains information about addiction, eating disorders, self-harm, and suicide which could be upsetting to some readers.

EB: If you don’t mind, tell me about your mental health diagnosis.

CM: I generally hate strings of acronyms that start sounding like a demented alphabet, but since you asked: I have Anti-Social Personality Disorder (ASPD). Yeah, I know, ASPD is one of the “big scary ones” that people don’t like to talk about. I’ve also been diagnosed with Post-Traumatic Stress Disorder (PTSD), and Bipolar Disorder Type I, with a psychotic overlay. I understand if you’re skeptical about my diagnosis, I was skeptical too. When my psychiatrist told me that I had “Bipolar 1 with psychotic overlay”, I thought they were making it up. So I understand your skepticism. There are also other things that bear mentioning…

EB: Okay, what are they?

CM: I’ve also struggled with an eating disorder since high school; a combination of anorexia and bulimia. I’m in a constant state of war with a pattern of self-mutilation and addictive behavior, which is “to be expected” – or so I’m told. The zinger of it all is a neurological disorder; Dystonia, that complicates my mental health treatments, as well as how I react to medications. Dystonia is a motion disorder that causes twitching and shaking in the body. Mine is a local dystonic tremor, it’s tolerable when it’s just in my hands. But at times the severity impedes my ability to eat or even stand. Currently I’m seeking treatment to try to find the cause of this, it’s quite frankly terrifying.

EB: When did you first become aware of concerns related to your mental health?

CM: I was showing signs of anti-social behavior when I was very young, it has always been an ongoing point of contention about me. However, my well-to-do southern parents avoided giving any medical credence too my anti-social behavior. This ultimately perpetuated many issues; it led to me being a better liar than I was naturally, because I had to learn how to hide the truth concerning my condition.

EB: Did hiding your condition impact you as you grew older?

CM: Yes. Leaning to hide my condition at such a young age became an issue, and it followed me as I grew older. I had several bouts of severe depression and self-harm, and went to a psychiatrist and therapist for a diagnosis. However, I avoided being completely honest with them because I had learned that honesty led to people being uncomfortable or “not liking” me.

EB: What do you mean by “I avoided being completely honest”?

CM: I hid the fact that I was having rampant hallucinations every week and struggling with violent fixations. At the time, I still believed that “being crazy” was socially unacceptable. I believed that I should do my best to hide my condition from everyone around me, even my doctors. So, at 17 I was initially diagnosed with Bipolar Disorder Type II, with a tendency towards ADHD. I found out later that it was a very incorrect diagnosis.

EB: How did this impact your life and health?

CM: I felt like I didn’t have any control over my mind, and it caused me to become completely obsessed with my physical appearance. I couldn’t control my mind, so my weight was the only thing I could control. This led to my struggles with an eating disorder; a combination of anorexia and bulimia. A strong narcissistic elevated sense-of-self guaranteed that I got hooked on making myself unreasonably perfect.

Add to that some incredibly unethical treatment, loss of insurance coverage, and a profoundly abusive series of relationships. My ability to trust any type of health care system was ruined. By the time I was 20, I was on a one-way path to “I got this on my own, forget all of the rest of you”. You’ve seen that image of a train on fire barreling down a track? That was me.

EB: You mentioned “unethical treatment”. What did you mean by that?

CM: Once I was a legal adult, I continued seeing the practitioners that my parents had found for me, and those practitioners were cautious of diagnosing me with “anything serious”. Later, I found out that those practitioners were friends with my parents, so it probably contributed to making a bad situation worse. I assume that my parents didn’t want me to have “anything serious”, so their friends didn’t diagnose me with “anything serious”. I’ve done a lot of work to get over that resentment, and I still have to fight it.

EB: Initially, you weren’t completely honest with your doctors. You hid the fact that you were having hallucinations…

CM: Right.

EB: Do you believe that omission caused you to get an inaccurate diagnosis?

CM: My correct diagnosis for Bipolar Disorder Type I, I think, should have happened earlier. Even without my admission of hallucinations, I was showing multiple signs; I was cycling multiple times a month, etc.… but that medical history wasn’t taken completely into account. I became an Olympic-liar in attempt to manipulate my diagnosis… But, eventually, keeping track of all the lies got too hard, and it wasn’t worth it. I’m thankful that I finally got tired of trying to keep the falsehoods alive, and dropped all pretense entirely.

My eating disorder did get missed, though, because of my refusal to recognize it as an issue. I was also an athlete, and I could hide my eating disorder with fitness because I never got thin enough to be hospitalized. I was a very physically healthy looking person, but my blood sugar and heart rate were on the floor and I was anemic.

EB: Many people don’t understand the importance of being completely honest with their doctors. Do you have advice for people who are struggling with this concern?

CM: I think that being honest about what you need from a doctor is paramount. Honesty is a necessity, even when honesty makes you uncomfortable. I know that some people worry about what their diagnosis might be, so they lie – or fabricate the truth – so they will get a more “desirable diagnosis”; people shouldn’t do this. It’s necessary to be honest about every single detail of your mental illness. You shouldn’t try to manipulate your diagnosis; and this advice is coming from someone who has made that mistake.

But, like I’ve said, I wasn’t completely honest with my doctor in the beginning, so I’m a big believer in “do what I say, not what I do”. I’ll also admit that my coping mechanisms weren’t always the most reasonable. Additionally, I know that finding a doctor can be difficult; I have many friends who have stuck by doctors that didn’t mesh well with them and they ended up with subpar treatment because of it. But regardless of the doctor being a great fit or not – it’s still necessary to be honest.

EB: So, was there a turning point that caused you to start being more honest?

CM: Before I tell you about the “turning point” in need to tell you about my dog; my Rottweiler, named Elenor. In 2012, I hit a rough patch in my depressive cycles and really started craving the companionship of a dog. I started looking at the pound, and I found a pretty girl sitting quietly and waiting for someone to love her. She was 2 years old, had come from a really bad home, and was heart worm positive, but I didn’t care. I fought with my apartment complex to allow me to keep her because Rottweilers are considered an “aggressive breed”. I got her home, and took her through all of the training necessary for her to achieve a Therapy Certification. She’s been my companion, and recently recognized as an Emotional Support Animal (ESA) since then. She knows when my mood swings get bad and she interferes when I start getting fixated on self-harm cycles. I’m a wrist-knocker.

This brings me to the “turning point”. In October of 2016 I attempted suicide. Elenor, stopped me. Elenor interfered, and was very persistent, so I was ultimately stopped.

The National Suicide Prevention Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals. Call 1-800-273-8255 or visit their website.

EB: Dogs really are amazing. Aren’t they?

CM: I saved her life, and she saves mine.

EB: How did that turning point lead you to seek help?

CM: Well, the rest of that year was a ping-pong game between addiction, anxiety, eating disorder, suicidal thoughts, and hallucinations. The hallucinations were severe; I thought I was walking around in Silent Hill half of the time. I’m surprised that my friends even tolerated me – I was violent, mean, impulsive and completely unable to listen to anyone concerned about me. Additionally, I was looking down the barrel of a cocaine addiction and wondering why I couldn’t seem to get my life together. Last summer – July 21, to be exact –  I called a friend and asked them to take me to an inpatient center.

EB: What was your experience at the inpatient center like?

CM: I checked myself in for 5 days. However, I didn’t tolerate being institutionalized very well. I quickly realized that I was more likely to experience a violent incident while institutionalized. I checked myself out, and took time off of work, so I could stay at home and recover.

EB: Were there any positives to being institutionalized?

CM: I wasn’t institutionalized long, but that small stint changed my diagnosis significantly. I guess you could call that a positive. It offered more clarity.

EB: What was the change to your diagnosis? 

CM: My diagnosis was changed from Bipolar Type II with a tendency towards ADHD, to Bipolar Type I with psychotic overlay. Additionally, this is when I received my hyper-stigmatized Anti-Social Personality Disorder diagnosis.

EB:  How did the change to your Bipolar Disorder diagnosis impact you?

CM: I was originally diagnosed with Bipolar Type II (with a tendency towards ADHD), and that was changed to Bipolar Type I (with psychotic overlay) … Honestly, I was kind of annoyed by the diagnosis change. I had known for years that Bipolar II diagnosis was wrong. But, at the same time I felt justified, and I found a lot more peace with my new Bipolar I diagnosis.

EB: How did you feel about the addition of an Anti-Social Personality Disorder diagnosis?

CM: Well…. That one was harder. I already knew that I was generally bad at being a person… but it never made sense to me.

EM: What do you mean by “bad at being a person”?

CM: Like, expressing and experiencing emotions. But when the doctor looked at me and said; “yeah, your brain doesn’t work the way it’s supposed it”, and explained ASPD, a lot of things started making sense. For years, I thought that I didn’t understand how to express my emotions. The truth was that I wasn’t having emotions the way I was supposed to.

Ironic enough, I didn’t have an emotional response to diagnosis. I simply added the diagnosis to the list. Then I moved on with an active thought process that I needed to redefine how I lived my life. Additionally, I don’t think I could have been diagnosed with ASPD sooner. At the time of my initial [incorrect] Bipolar diagnoses, I was under 18. I grew up in a very conservative family and it wasn’t until I was on my own that I really started to act out with “classical ASPD behavior”; which is probably what most people think of when they stereotypically say “sex, drugs, rock and roll”. When I got older, and started living on my own, I started collecting the “conduct disorder bucket list”, and the diagnosis fit.

EB: Outside of institutionalization, what other experiences have you encountered with treatment?

CM: I know that being medication compliant is completely necessary for my survival. I wouldn’t do well without the assistance of my medications. I have a wonderful General Practitioner (GP). My GP has been there for most of this craziness, and is willing to take over my medication management when I inevitably get iced out of a therapist’s office or loose a psychiatrist (I’ve had 3 retire, and 1 pass away – who gets odds like that?!)

My experiences with formal treatment has been notably bad. In the past I’ve had difficulty in finding a medical professional who was willing to treat me. On multiple occasions I’ve filled out new patient paperwork, just to be informed that the doctor was not able to “take my case because my diagnosis was not their specialty”. Therefore, I’ve formed a general mistrust for mental health professionals, but medication compliance is important, so I must persist.

EB: So, why do you speak publicly about your mental illness?

CM: Some types of mental illness are more socially acceptable than others. People who talk about anxiety and depression are socially acceptable. But, people like me [people with Anti-Social Personality Disorder] aren’t so well received.  I’m all for destigmatization of mental illness. However, I’m aware that my diagnosis might never lose that “Oh, they’re that kind of mentally ill” reaction. It’s an unfortunate fact of the human psyche, and something I’ve watched for years.

EM: You make a good point. Would you mind if I asked you a few more questions about this topic? 

CM: Thank you. That’s fine…

EM: Why do you think that “some types of mental illness are more socially acceptable than others”?

CM: In the last 25 years, the stigma on certain kinds of mental illnesses has been lessened; eating disorders, depression, anxiety, PTSD, even Bipolar Disorder. At the same time, the stigma surrounding other mental illness has stayed the same, if not worsened; BPD, NPD, ASPD, psychosis or schizophrenia.

Too often, Cluster B Personality disorders are the “these are the bad guys” disorders. For example, last week on Facebook I saw three videos claiming that people with Borderline Personality Disorder (BPD) and Narcissistic Personality Disorder (NPD) were “always abusers” and that people should “stay away from them”. It’s a sadly active and unfair demonization, but this is what people see on Facebook, so that’s what people believe… and that’s what people remember when I tell them that I have ASPD.

EB: What can people do to help change this unfair perception?

CM: Ultimately it’s just a matter of continuing education. People like me must be willing to speak out about their experiences, and other people must be willing to listen and learn. If our experiences can be normalized, then they can be added to the human social narrative.

For example, the world seems to be morbidly obsessed with serial killers (real and fictional), and it further romanticizes the idea that everyone with one of “those disorders” is a “bad guy”. Again, it’s an unfair stigma… People need to be educated, so they understand that not everyone with ASPD is a serial killer. Some people might think that my diagnosis [of Anti-Social Personality Disorder] makes me “a monster”, but that’s because they have never been told otherwise.

EB: Why do you think this is such an issue?

CM: Many pop-psychological shows, like Criminal Minds, turn characters with ASPD into soulless villains. Fictional characters with my mental illness are normally the bad guy; a character who is bad, or a character that others want to stay away from. In the real world, people with ASPD aren’t always evil… The only “good guy” I can think of is Benedict Cumberbatch’s “Sherlock” and even then, it’s not a completely fair portrayal.

EB: Is that why you’re so candid, to debunk the myths?

CM: Yes. I’m candid about my experiences because I want anyone who’s ever felt like “a monster” because of their diagnosis to feel like they have a right to exist. I hope that people will be able to identify with me, and my story.

EB: I’m sure that people will identify with your story. 

CM: I hope so. I want my illness to be just as socially acceptable as anxiety and depression. When someone with anxiety asks for help, it is socially received. However, when someone with hallucinations asks for help, people tend to get scared of them, or even react in a way to make a joke of it. If someone says “I’m seeing hell-hounds everywhere” their fears should be validated, and they should be offered help. Just like someone with anxiety or depression.

EB: Validation is important, and you make a very good point. 

CM: Thanks. Additionally, people struggling should start viewing themselves differently. They need to appreciate themselves. It’s important for people to realize that perception isn’t important. People struggling with my diagnosis should appreciate themselves, despite how the world looks at them.

EB: How can people do that — appreciate themselves more? 

CM: Too often we look at our mental illnesses and personality disorders as things that hinder our lives; anxiety affects how we interact with the world, phobias define how we handle certain things, personality disorders dictate our interpersonal relationships. We focus too heavily on that, and we get stuck on the hinderance to our lives. We need to consider that we may have something else that a neuro-typical person may not have.

EB: How are you implementing this in your own life?

CM: In my experience, people with anxiety are more empathic, in general. Therefore people with anxiety are sometimes more strongly suited for job fields that require empathy. I, myself, am pursuing a nursing degree because I have the ability to emotionally shut myself completely off and hyper-focus on the task ahead of me. In my opinion, that is something that a good first responder should be able to do. It will allow me to keep my personal life and professional life entirely separate.

Accepting a diagnosis, and folding it into the fabric of who we are, happens easily. We are creatures of this planet, we’re only human. However, It’s also important for us to focus on our strengths. People who live with a mental illness don’t typically “fit the norm”… But sometimes we also have strengths that other people don’t have. So, not “fitting the norm” can be a good thing, at times. So, I don’t “fit the norm”… I’m a werewolf.

EB: You said that you don’t line using a “string of acronyms” in regard to your diagnosis. So, “werewolf” is what your prefer?

CM: If you’ve spent any time on my social media platforms, you’ll regularly see me refer to myself as a “werewolf”. Bear with me, while I explain: “Werewolf” has become my shorthand for describing my diagnosis. It also helps me to feel a little bit better about my diagnosis. I think it’s a much more accurate word that evokes the kind of image that I want displayed when I talk about my mental illness. To be fair, I’m aware that no one understands what I mean by “werewolf”…

EB: So, “werewolf” isn’t a coping mechanism, it’s a form of acceptance. It’s you owning your diagnosis? 

CM: Yes. Owning my diagnosis hasn’t been easy, it is a struggle. It’s easy to feel like I’d be better off gone from this planet, but I don’t want that stigma to negatively impact others like me. Other like me are demonized because of the societal belief that “we’re the bad guys”, and I’m not willing to let that mindset continue… I appreciate myself, and I know who I am, despite how the world sees me. That’s why I call myself a “werewolf”. I think it’s a whole lot cooler to be a werewolf than to be a person who “can’t be people”. It’s a title I enjoy, and I’m owning it.

EB: What challenges are you still facing?

CM: I have to make the active choice to be a healthy person every single day, and not just in respect to myself – but in how I interact with other people. To use a ridiculously inaccurate example: the way Dexter Morgan [from the TV show, Dexter] lives his life according to a set of “laws”. Dexter’s “laws” about morality give him the order he needs to get by in his life. The show is ludicrous in its depiction of the psychological representation of a serial killer – but I’ll be very honest, sometimes I feel a lot like Dexter Morgan; over-analyzing every action to make sure that it’s going to be socially acceptable, because my gut reactions are definitely not. And yes, I’ve definitely got an active and ongoing internal monologue.

EB: I’m glad to hear that you’ve made an active choice to be a healthier person. In addition to that, what other positive coping strategies do you have?

CM: Routine, routine, routine. I’ve built an almost ritualized day-to-day routine. I wouldn’t say that fanatical adherence to a routine is best for everyone, but I strongly believe that consistency in home life is very important for mental health. Healthy diet, fitness and daily routine have become important for my stability – I don’t deviate much from my routine. My “sanity” is based on a rote series of behaviors that takes much of the spontaneity out of my life. It helps me avoid impulsive, outrageous, or aggressive tendencies when something I can’t control crosses my path.

Everyone always says “self-care” when asked about coping. As for self-care, I picked up taking selfies. I take selfies on my bad days and my good days, then I use them to demonstrate the actual feelings I had about the day. This is a project that I picked up from a friend of mine, and it’s had an overall positive effect on me. The “snapshot factor” of snagging a moment can be powerful. Many of these photos populate my Instagram and I look through them when I’m doubting myself.

EB: Do you have advice for individuals who are living with mental illness?

CM: Be brutally honest with yourself about your diagnosis. If you have a support system, don’t lie to them and don’t ever make the mistake of thinking that you can actually do this alone. Everyone needs a support system. Even me, who distrusts the mental health field on a pathological level, knows that I still need my doctors.

EB: Do you have advice for the friends and loved ones of someone living with a mental illness?

CM: A long time ago, I wrote a blog post about mental health support system. I wrote about how mental health support systems need to be about more than just kindness. In addition to kindness, we need accountability, we need people to call us out on our bad behavior. Friends and family who are willing to “become a villain” to us in order to protect us, even if that means getting us dragged into an in-patient facility against our will.

Just a Thought, By WOLF.
“Just a thought. People with mental illnesses need friends who challenge them. Friends who have done the work to recognize our unhealthy behaviors and cycles. Friends who don’t let us abuse them. Friends who pissed us off. Friends who made us cry. Friends who called us out.
And friends who brought us coffee. Friends who help clean the kitchen. Friends who don’t let us run. Friends who make us angry.
Yes. We need friends who understand us and support us and care gently for us.
We also need friends who are willing to kick us in the mouth. Because sometimes we need it.”

EB: In addition to your blog post, have you given any direct pointers to your own friends and loved ones?

CM: They are encouraged to basically kick my tail around the room in order to get me to pay attention. I want them to redirect me when I’m walking down a path that’s going to lead me to somewhere I have no business going.

My father once put it in a really great way, based on something his sponsor did for him when he was struggling; “be willing to make the difficult phone call and have the difficult conversation. Then take them out for a steak dinner and love them”. Of course, in my case I’ll take the steak and some whiskey, but I can’t be completely appropriate for all audiences. 

About Cass MacLean:
Born and raised in Tallahassee, but more comfortable calling the highway her home, Cass lives with her soon-to-be husband and two canine companions. When not holding down the fort as a retail manager, she runs an event production company and reads absurdist fiction. Cass enjoys working on her illustrative projects, painting, writing music and poetry, spoiling her motorcycle, and tending to her miniature garden. In a life where creating something happens as often as breathing; she often has a story, anecdote or insight a side-effect of having lived too many lives for her years. Contact her at ulfgrimsocial@gmail.com, follow her Instagram and read more deeply about her world at her blog Armed to The Teeth.

A huge thank you to Cass MacLean for sharing her story with me. I really appreciate it.

Do you have a mental health story to tell? I want to help you tell it. If interested, you can contact me and/or view the Not Alone Series: Introduction and Questions page to see the next steps. You can also subscribe to my blog, and connect with me on Facebook, Instagram, and Twitter.