Last night a subset of my extended family (eight of us altogether) went out to dinner. Since we are geographically disbursed every opportunity for group chitchat is welcome. It was a mixed crowd this time of siblings, in-laws, and nieces. Perhaps because of the preponderance of women we largely ignored the usual topic during such times: family gossip. Instead we talked about weightier issues. One niece, for example, spoke of all the medications she is on for her mental illness. That opened the floodgates. As the discussion evolved I was struck by how many in my family are or have been mentally ill.
Collectively on my side of the family I have two living parents, seven siblings, five brothers or sisters in law and eight nieces and nephews. As best I can tell this is our current mental health picture:
– Currently on medication: at least 6 out of 16
– Seeing therapists regularly: at least 7 out of 16
– Ever been diagnosed with a mental illness: at least 8 out of 16
Where did all this mental illness come from? My side of the family? I grew up in a large but “normal” Catholic family. The idea of sending one of us to a psychiatrist back then seemed ludicrous. We all had our issues but we didn’t see our issues as mental health issues. They were simply things we had to cope with as part of growing up. In retrospect looking back on my childhood and adolescence, time with a head shrinker would have been quite helpful. But in the 1960s and 1970s our notion of the mentally ill was limited to people wearing straight jackets and inhabiting rubber rooms. We always assumed we were in perfect mental health.
But admittedly there was the case of my maternal grandmother. My mother, a psychiatric nurse, spent the last months of her mother’s life taking care of her while she went through mental illnesses. And then there was my paternal grandfather, who suffered from Alzheimer’s disease. And perhaps some of the mental illnesses in my nieces and nephews came from my in-laws’ sets of chromosomes.
There is a marked amount of Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) in our next generation. But even among my siblings there are problems with ADD. While I have never been tested I have some ADD symptoms. I know I am easily distracted. I find it hard to concentrate on anything unless I find the task very engaging. I interrupt people often. I have to make a point of listening carefully but even when I do sometimes I cannot sustain the effort. My mind eventually fatigues from the effort. I’m pretty good at remembering tasks but others around me, such as my wife and daughter, frequently forget important things like homework or doctor’s appointments. I can see symptoms of ADD within my immediate family.
Then there is depression. I have had situation depression, as have many of us coping with life’s challenges. But I have never had chronic depression. But people who are chronically depressed surround me. My mother was recently diagnosed as depressed, which is understandable for an 84-year-old woman in declining health. But I suspect she has been depressed most of her life. Otherwise it appears that my siblings have been fortunate not to suffer chronic depression.
I am very grateful that within my extended family that we can afford to have our mental health problems treated. While there are lots of bad shrinks out there and it seems that medications they put people on are often hit and miss at least these options are available now. I am thinking of both a niece and a nephew who would likely to be unable to cope with adult life at all if it were not for the treatment they are receiving. Thanks to modern medicine they can become not just productive members of society, but have the promise of living full and happy lives. At the same time I recognize how fortunate we are. I know others who live marginally and who cannot afford health insurance. As a consequence mental health is a luxury they cannot afford either. Those with mental illnesses spend a lot of their lives in pointless misery and seem to stumble through life, often sinking into black mental holes.
Still I wonder if historically so many people have been this mentally ill. I have read about women suffering from melancholy, which I assumed was the name given to depression in days gone by. Until recently was brutal Darwinism at work? Without effective treatments were our ancestors with depression more likely to commit suicide rather than procreate and pass on their genetic predisposition to the next generation? Perhaps it is because depression can now be treated that means that we are seeing more of it. It is just as likely though that depression has always been around and it was never recognized as the serious problem it is until recently.
I am angered that mental health benefits are not universally available in this country. Of course I am also angered we do not have universal health insurance. If we are to provide any class of universal health insurance I suggest we start with universal mental health benefits. While it’s not a solution to our health care crisis being able to cope with life provides a foundation for so much more, including self-sufficiency. I think even my Republican friends would understand the natural logic of my suggestion. Collectively we shoot ourselves in the foot by not providing universal mental health coverage. To be a world-class country we need the best from all our citizens.