Uncertainty: Emotions Involved When You Love Someone with a Mental Illness

This post is the first of an ongoing series where we discuss the emotions involved in loving someone with a mental illness.

When I look back over my mother’s struggle with bipolar disorder, the most enduring emotion is uncertainty. I never knew what lay beyond the door. Which way will the pendulum swing? Will I come home to the depressed person, unable to function, or the hyper energy of a mania phase?

Sometimes she was irritable as hell; other times she was in a state of terrible, manic happiness. The stages themselves also offer varying degrees of uncertainty—will the mania manifest in relatively minor levels of incessant talking or out-of-control surges of activity? When she talked about her ideas and plans in a manic phase, I couldn’t tell what was real and what was an illusion of her disease.

The uncertainty seemed to increase as my mother’s illness continued. On her good days, I wanted to believe that she was finally, “Fine,” as she promised. I wanted to believe we had found the right doctor, the right pill, the right diagnosis. I wanted, in essence, the uncertainty to finally become certainty.

Except that never happened.

Each time, I let myself believe we had found the answer. And each time, I let my guard down, and then after weeks, days or sometimes minutes, I somehow ended up in the same place I was before—full of uncertainly about my mother and her illness. I never knew where I stood with her. Instead I tiptoed around her or tried to avoid her altogether.

I had to learn to deal with the uncertainty, which remains even years after she died. I mourn for the lost innocence that let me believe I could somehow fix everything—if I only tried hard enough. I know better now.

I believe this particular emotion is not unique to this particular mental illness, although bipolar symptoms in themselves lend to a huge amount of uncertainty. Uncertainty is perhaps the cornerstone of dealing with mental illness. The uncertainty of the disease transfers across to more uncertainty about treating it, and to coping with its effects. Never knowing exactly what the right thing to do is. Never knowing if you did everything you could do.

Never knowing anything again with certainty.

Breaking the Cycle of a Mentally Ill Parent

My sister and I spent a good part of last evening talking about our parents and our childhood. This is not particularly unusual when we get together. She has a better memory than I do, and yesterday she told me a few new stories that I didn’t remember. Even after 20 years of adulthood, she can still surprise me sometimes with new details.

I love these long, introspective conversations where we dissect small events and hypothesize on everyone’s thought process at the time. We are both parents now, so the actions of our parents are interesting to us in new ways. And, probably surprising to most people, it’s not our mother’s death that is the hot topic of conversation. Instead, it is her actions as a mother of small children that we find more interesting, probably because of the number of small children in our lives today.

It feels grossly unfair that our mother is not here to share in this conversation. At the same time, I wonder if my sister and I would be having these conversations if she were alive today. There is a lingering possibility that my sister and I would not be as close as we are today if our mother was alive; that our close bond was forged in tragedy alone. And our mother’s very presence may eclipse these conversations because she would be here to answer the now unanswerable questions.

I realized during this conversation that, even 20 years later, I still harbor some resentment and anger towards my mother. Not from her illness and her death, which were terrible and tragic, but from the very beginnings of our relationship as an unplanned pregnancy and spirited child. This animosity is completely missing in my sister, whose birth and personality meshed better with our mother’s plan for her life. And I realized that my mother’s mental illness, while a significant factor in my childhood, is not the only issue.

I tell you this because a lot of people find this blog by searching for information about the effects of mental illness on children. I can tell you from firsthand experience that there isn’t much information out there. The truth is that my mother’s illness is only one factor of our relationship that still resonates. Her actions as a young mother in an isolated military community with a daughter whom she didn’t plan on are far more relevant in my life today.

Our parents’ actions affect our lives. There’s no doubt about that. But the children of the mentally ill have choices too. I’m no longer a child, and I don’t blame my mother’s actions for any problems that I have in my life. I do try to learn from them, and with effort, avoid repeating the worst of them. I’m responsible for myself now.

That responsibility means I need to deal with that anger towards my mother that lingers more than 38 years later. I have resources. It’s time to use them again. Because that anger may be playing out in subtle ways in my relationships with my own children. I don’t have any control over my mother’s actions, but I have control over my own. Understanding the difference is one of the key elements to recovery. You can’t choose your parents. But you can choose how you parent your own children. Breaking the cycle is hard. But it’s worth it. I’m worth it. And my kids are worth it too.

Play About Mental Illness Wins Pulitzer Prize

We’re pleased to report that Next to Normal won the Pulitzer Prize for Drama. This rock musical is about a mother who struggles with bipolar disorder and the effect that her illness has on her family. (Wow, sounds familiar to us!) The musical apparently addresses such issues as grieving a loss, suicide, drug abuse, ethics in modern psychiatry and suburban life. Not living anywhere near Broadway, we have not seen it, but please leave a comment below with your personal review if you have.

It’s nice to see an artistic work about mental illness recognized with an award of this caliber. We hope it’s just one more step in breaking the silence about mental illness in our society. For more about the play, visit the Next to Normal website.

The Long-Term Impact of My Mother’s Suicide, Part III

This the last part of a three part essay where I explore a few of the issues in my adulthood that stem from my mother’s suicide when I was 17 years old. Read Part I and Part II.

Becoming a mother myself—something I put off until my early 30s—held an enormous amount of risk for me. I instinctively knew the stability I had tried so hard to create would be at risk by starting my own family and being responsible for another small life. Yet the birth of my son was the most profound moment of my life. Parenthood has let me discover more about my mother, nearly 20 years later, because my children have brought me a new level of understanding about her life and her death. I know now a mother’s love for her child can be etched on her very soul, yet love doesn’t always prevent her from making decisions that are resolutely against her child’s best interests. In only three years, I’ve come to know my mother on a different level. I’ve heard her words come out of my mouth. Seen her temper in my flashes of anger. And in the most despondent moments of post-partum depression, I glimpsed the void that must have made her tie the rope and jump.

Even today it is hard for me to accept my mother’s last decision. Having children of my own, it’s impossible for me to see how she could have made that choice. It is unthinkable to me to simply walk out of their lives, leaving me with one of two very undesirable possibilities. My mother was so sick that her instincts were completely skewed and she thought we would be better off without her. Or she never loved me like I love my own kids.

The second is the reaction of the wounded child, and its large flaw is the changing nature of the parent-child relationship. It’s far more complex than I ever imagined, or could ever have felt, at age 17. I suspect this complexity will simply increase with time as my children age and our relationship becomes even more multifaceted. Years of analysis, of therapy, of pharmaceutical assistance and of late-night philosophizing with my sister have not dispelled one truth: I know my mother loved me, even if her death felt like a choice to leave me.

Then I’m left with the first, and still undesirable, reason. Suicide is excruciating for the people left behind. It is the ultimate act of abandonment for a child. Sometimes there is no happy ending. Sometimes parents are sick. Sometimes mothers leave by their own choice. Sometimes parents die. It is a painful truth, and I face it every day.

I’ve had to deal with a lot of painful truths in my life since my mother died. My children have four grandparents, although one is not biologically related to them. My father remarried four years after my mother died. I won’t pretend his choice was an easy one or his decision didn’t tear apart the fragile bonds we rewove after my mother died. Yet, after years of strife, I now see my stepmother as a valuable asset, filling her role in a way that I’m not sure my own mother would have managed. She is an excellent grandmother. And my children adore her. When Grandma comes to visit, I’m happy to put them in her care, knowing they will be adored and loved. I am grateful for her presence in my life and in theirs.

Also, being happy with myself also creates a bit of a conundrum for me. My life is the result of my mother’s death and the choices I made since that day. If I like who I am now, I cannot wish away the pain and tragedy of her death. I cannot deny its influence in making me a stronger, more resilient person. It has brought me much closer to my sister, who has become my dearest friend. It propelled us to better ourselves, working through college and graduate school, taking on challenging careers, and attempting to make the world a better place. It brought me to the man I married and the two adorable children we created. I look at the good in my life, and I see how it sprung from the pain. The paradox does not escape me.

I hope my experience provides some comfort for others who have experienced tragedy. When I watch my children sleeping safety in their beds, I think about everything I want for them. First and foremost, I want them to have a safe and happy home with healthy parents. What’s more, I wish all children around the world could have the exact same thing. I don’t want any family to go through what we did. Since that wish is unobtainable, I have to settle for telling this story in order to help others know that even in painful times, there is still a chance for good. Recovery can and will happen if you work toward it. Life does not necessarily give you what you want or what you deserve, but you can find good in life again. I survived. I am living proof.

The Long-Term Impact of My Mother’s Suicide, Part II

This the second part of a three part essay where I explore a few of the issues in my adulthood that stem from my mother’s suicide when I was 17 years old. Read part one here.

I’ve lived more than half my life without my mother now. How I got from the 17-year-old girl to the 35-year-old mother of two is a story that would encompass more than book or two. I can confidently say not everything in my life is a reflection of my mother’s death. However, after becoming a parent, I’ve realized my actions do reflect her life.

My sister and I jokingly refer to these situations with our catch-all comment: “Does EVERYTHING have to relate back to HER?” We’ve been through enough therapy to recognize the glint in a therapist’s eye when we get around to the inevitable conversation about the bipolar mother who takes her own life. It is the fact about us most people use to define who we are. And for a long time, my mother’s death was how I defined myself. That changed with the birth of my son. I am now a mother first, and being a motherless daughter has shifted backstage.

Yet being a mother without a mother does affect the way I parent my own children. I don’t think this is unusual. In fact I highly suspect I’d be revisiting issues from my childhood even if my mother was living today. It’s a journey all children must embark upon—learning to not repeat the mistakes of our parents when we become parents ourselves. (And in turn, make our own mistakes.) But I suspect because my mother was mentally ill, I pay more attention than some other people would. The biggest “mistake” I don’t want to make as a parent is dying too early. My inability to control accidental deaths or catastrophic illness leaves me with a constant feeling of unease. Because I know, from experience, you can wake up one morning and your world is upside down.

I do take comfort in the many loving people in my children’s lives, and I know the seeds are already sown for them grow into happy, confident adults even without me. I also know, from experience, tragedy doesn’t always result in more tragedy. Many people thought losing our mother to suicide would undo both my sister and me. But it didn’t. Today both our lives are as average as they can be. They are full of bedtime stories and client meetings. Making dinner and watching mindless television. Husbands who are as steady as rocks. Children who alternatively charm and frustrate, usually in the same minute. The normalcy of our lives is a testament to my mother’s work before her illness and death. One year of tragedy did not undo the 16 years of reliability that came before.

This stability in our lives today is not accidental. After the chaos of my mother’s last year and the turmoil after her death, my sister and I purposely designed our lives to honor calm and commitment and dependability. We want to feel safe. We’ve done our best to insulate ourselves from potential storms. We know we can’t prevent it. We do our best to prepare for it, a common reaction for people who have experienced tragedy young.

To be continued…

The Long-Term Impact of My Mother’s Suicide, Part I

This the first part of a three part essay where I explore a few of the issues in my adulthood that stem from my mother’s suicide when I was 17 years old.

My 3-year-old son is sitting beside me on the bed holding Dr. Seuss’ Cat in the Hat. We are in the midst of the bedtime ritual—stories and talking before it’s time for lights out. I decided the moment is right to explain his mother and father are leaving on a short trip, and Grandma and Grandpa will stay with him and his baby sister for a few days.

He listened carefully, then said, “You left me.”

This statement made no sense to me, but after three years of parenting, I’m used to it. “When did Mommy leave you?” I asked.

“You left and Daddy put me to bed and read me the elephant book,” he said.

I realized he is talking about last night, when I went to the gym and Daddy was responsible for bedtime. “Yes. I did. But I came back.”

“Yeah,” he grinned at me, his whole face crinkled with glee.

I looked straight into his hazel eyes and said without hesitation, “Mommy will always come back.”

As I heard my own voice say the words, my stomach turned over. The lie violated a pact I had made to myself on the day he was born: to be honest with my children. And it is so huge, I am shocked by my own words and the conviction with which I said them. Who knows better than I that Mommy doesn’t always come back?

Even months later, I continued to dissect this evening in my mind for clues to why it resonated with me. I shared the exchange with my friends who have children; and they were quick to appease me—I’m a parent of a small child and I wanted to reassure him. It was a simple statement his three-year-old brain could process; because in spite of my ever constant worries that I will meet an untimely end and my children will be left without their mother, the odds are against that happening.

While I left these conversations temporarily feeling better, later I realized these friends all still had their natural parents. Of course they could easily dismiss my concern. For me, the answer would never be simple.

This scene, which occurs in nearly every household with a preschooler, triggered a different response from me because of my mother’s suicide. Two factors were at play for me in this simple scenario. I know my ideal of being honest with my own children stems from those chaotic last months with my mother when I was never sure what was true. Was she sick? Was she fine, as she insisted regularly? Was it a hormone imbalance or a chemical imbalance in her brain? Was it both? The answers to these questions will never come. I’ve accepted that now. The best I can do is accept the full truth of the situation. Something was wrong with my mother. And she chose her own death as the solution. It is brutal. It is the truth. And I’ve learned to value the truth in spite of the pain it brings. In turn, I try to be truthful with my children to save them from the painful realization I had at 17—that I could not trust my own parent.

The second element in this scenario relates to my greatest fear—that I will die before my children are grown. I would never wish on them what I have endured—not only the life-changing events missed by my mother, but the thousands of small moments: the care packages that never arrived at my dorm room, the birthday cakes selected alone because no one else thought to do it, and the midnight phone calls to commiserate about colicky babies. These little things hurt more than the empty seat at the wedding and the pitying looks in my friends’ eyes when I explain no one is coming to help after the birth of my first child because my mother is not alive and no one else will do.

To be continued…

Military Condolence Letters, but not for Suicide Survivors

Here’s another surprise: the president doesn’t send condolence letters to families of soldiers who’ve committed suicide. According to cnn.com, a review of this policy is to conclude “shortly.”

I hope that’s true and that the Obama administration changes this policy. Such a practice adds to the stigma of suicide. I’m trying to be charitable and try to imagine why such a policy would exist in the first place. After all, I imagine that these condolence letters, as kindly written as they may be, are probably form letters. Perhaps it’s harder to write a form letter about a suicide. Also, I can see how it may seem that a soldier who is killed in combat, by enemy fire, may seem to have made a greater sacrifice. But with the extreme burden our soldiers are under currently, what with back-to-back tours, extended tours, etc., who is to say that they’re not making an extreme mental and emotional sacrifice? I would not be surprised to find out that such situations make soldiers all the more fragile, mentally and emotionally.

May the Obama administration recognize this, and recognize the families whose loved ones have taken their lives while serving our country.

Coping with the Holiday Blues

The holidays are upon us. I was pleased to find in my research that the rumors of increased suicide attempts during the holiday period has been proven inaccurate. In fact, the opposite seems to be true — with more people reporting improvements in mental health, possibly because we typically interact more with other people during this season than during the rest of the year.

But what if, due to no fault of your own, the holidays reflect more about what you’ve lost than what you have?

That was my feeling about the holiday season for many, many years. Memories of happier times did not comfort me. I went through the motions, but felt like Christmas — the major holiday of my childhood — was simply another day where the thing I wanted most (my mother) was missing.

Not only was the thing I wanted unobtainable, but gifts in general felt like a poor substitute. Carols? Cookies? Reindeer? Nah. Didn’t do a thing for me. I was looking for something that could not be found in a store or under a tree or even in a church.  Like the first part of the song, “Where Are You Christmas?”, I had changed, but the holidays were a chain to my past.

This is my 21st Christmas without my mother. That’s a lot of crappy holidays. Too many. But I’m please to report some improvements over the past few years. The major reason is the birth of my own children, who are enchanted by the magical side of Christmas. They believe in Santa, and I love watching their excitement. It has brought a new joy into the season. Hang around with young children during the holidays. It’s much more fun.

I’ve also focused less on myself and more on others.  Giving to others is one relatively simple way to find the spirit of the holidays when it feels like it’s missing. I make donations during this time of year. They are small, but I make sure they count. I give to people and charities doing work I believe in. I donate time to organizations that make a difference. In helping others, I help myself reconnect with what is truly important in our lives. And in this economy, the need is greater than ever.

I also have given myself permission to give up parts of Christmas that feel more burdersome than celebretory. I made three batches of simple cookies instead of 10 batches of those tasty, but very complicated, recipes handed down by my grandmothers. Our dinner is also simplified — only the dishes we truly enjoy will find it to our table this year. No homemade gifts from me either — great idea, but I don’t enjoy crafting enough to make that my priority. I still do Christmas cards because I enjoy receiving them, but the letter inside is printed from a computer instead of handwritten (my preference).

Another idea that I like is simply skipping the holidays. Leave the decorations in the attic, find someone to pick up your mail, get a cheap flight and hotel on the Internet, and then take off for someplace tropical. If the holidays are painful, I think doing something radically different is an okay way to cope with the situation. I confess that I have not put this option into action, but I reserve the right to in future years.

My own experience has led me to believe that time does help.  Those 20 years of cruddy Christmases are not a life-long sentence. Each year is gets a little easier as I find ways to make the holiday season reflect what I feel is important. It’s a journey, not a destination.

My Struggle with Postpartum Depression

After my son was born, I was deliriously happy for a few weeks. His first night at home, I remember feeling happier than I ever remember being in my life. It was if we had known each other before, and only recently found each other again. He completed us — we were a family at last.

Then I started into a slow decline – so slow that neither my husband nor I realized what was happening in the confusion of caring for an infant. I ended up in the hospital after complications from gallbladder surgery when my son was six months old. He got a very nasty virus from visiting me in the hospital. He was sick for a month, and my decline spiraled out of control, compounded by my own struggles to recover from surgery and too many sleepless nights. The official diagnosis was postpartum depression. All I knew is that the world felt bleak and hopeless. I glimpsed the void that caused my mother to take her own life. For a few nanoseconds, I understood.

My husband made an appointment for me with my doctor, who put me on Zoloft and recommended a therapist. I hated going. And I’m not sure I would have if my husband didn’t insist. But he did, and I went. The Zoloft help stabilize my mood, and the therapist helped me work out some issues that parenthood brought up.

It wasn’t an easy thing to do – I resented the time and the expense. However, with hindsight, I now see that I really needed to address some major issues, mostly around my parents. And it was important that I break the cycle – my mother was also prone to depression as well as bipolar. I was beginning to repeat her patterns, and I wanted to be a different mother to my kids. It’s still a constant battle, but I feel like I’ve made some progress.

I’m off the Zoloft now, but we’re all watching me very carefully, as the stress of parenting two small children could trigger another round. Motherhood, particularly when it involves small children, does not provide many opportunities to care for yourself. Yet as the family member of someone with a serious mental illness, I know how important it is for the ill person to seek care. It was far harder than I originally thought it would be, and I understand at some level why mentally ill people resist their own treatment.

I tell this story because I believe two people were key to ensuring I got the care I needed. The first is my husband, who went so far as to make the initial appointment with my doctor himself and ensure I had babysitters so I could make every appointment with both my doctor and therapist. The second is my ob-gyn, who took action immediately — getting me quickly to the people who could help me. They did the right things.

If you are the depressed person, and you don’t have a partner who is as proactive as my husband is, know that doing the right thing for your health is HARD. You will have to force yourself to make that first phone call. And you’ll have to force yourself to keep the appointment. And you’ll have to resist the excuses to back out or not show up or stop your medication.

But I’m here to tell you that you are worth it. Whether you are the ill person or the family member of someone struggling with mental illness, take that first step. Pick up the phone. PSI Postpartum Depression Helpline: 1.800.944.4PPD