Lot's of people in my family could hold it together for forty hours a week, only to fall apart at home. Their illness was hidden first so they could get a job and then so they could hold it.
One of my grandmas was insane, but she had a simple job and could keep up appearances at work. She was a valuable employee, just a bit eccentric. But her home life was an endless catastrophe, a living hell. When she retired there was nothing, no scheduled times of normalcy. She became a recluse, a hoarder, and a danger to herself and others. Eventually she had to be removed from her home. She was dragged out by the paramedics, kicking, biting, cursing and clawing all the way.
She was the only person in her world who didn't know she was crazy.
When I think about it, sometimes it's not denial so much as the loss of some biochemical ability to monitor one's own mental state. In many sorts of mental illnesses the feedback loop that tells a mentally healthy person, "Hey, this is CRAZY!" simply vanishes. I know that's how it works with me. Furthermore, calling it "denial" also tends to aggravate the very destructive cycles of guilt and shame some people suffer.
I picture myself as a young man, it's two o'clock in the morning and I'm cheerfully running down the street with bare bloody feet. The police know me as a harmless nut so they stop to chat, we joke around, and they take me home. And not for a single instant is there anything in my head saying "STOP! THIS IS CRAZY!"
I was asked to leave university twice, both times it was by "gentlemans agreement." I was simply asked to "take some time off" because they didn't want to expell me. I remember conversations with the deans very clearly -- they were very careful to avoid the stigma of mental illness, but it was made very clear to me and without saying so explicitly that I would be expelled if I did not agree to the break.
I think our society is more up front and open about mental illness today (maybe because there are better meds) but we still have a long way to go.
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