Mental Health Issues Strike Close to Home

The Thinker by Rodin

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.

Engage

The Thinker by Rodin

Right on! That’s what I thought, anyhow, after reading an article in today’s Washington Post about psychiatrist Gordon Livingston. After 33 years of listening to people tell them about their problems he finally decided to talk back in the form of a book, “Too Soon Old, Too Late Smart: Thirty True Things You Need to Know Now“.

Most of the heartbreak of life, he says, comes from ignoring the reality that past behavior is the most reliable predictor of future behavior. Good intentions aren’t a substitute for good acts. Sweet nothings mean nothing. Just do it.

I confess I am losing patience with those who spend their lives whining about the bad things that have happened to them over the years. It’s not that I don’t have some empathy for their problems. I have plenty of it because I went through many of those miserable experiences myself. I do know that dwelling on my problems never solved them. If anything it just made me worse. It was when I stopped dwelling on my problems and figuratively stood up, rolled up my sleeves and engaged the world that things started to improve. I haven’t looked back.

Now clearly this is not something everyone can do overnight. Therapy and antidepressants have their part. But they are only part of the solution to happiness. The other part is to engage the world. It doesn’t matter so much how you engage it as it matters that you just engage it. Life happens through living: through engagement. It withers like a parched garden when you do not engage. This is a truth of life borne out by simple experience, and stated so unambiguously by Gordon Livingston. If we are a garden we make our own rain. This rain though does not come from us directly but through interacting with others. Engagement is essential to our growth and our mental health. It’s really that simple.

I think I can finally say that I’ve cleared my midlife crisis hurdle. It has lasted about ten years, which is about nine years too many. And maybe I was one of these people that needed ten years to get through my stuff. But I know it didn’t happen by staying in my little mental black hole. It happened because I decided the only one I could change was myself so I had better get busy.

Resolution began with graduate school. That consumed three years of my life with no difficulty. And it was a good but very exhausting experience. I discovered that I had the perseverance and smarts I thought I had. It positioned me well in my career. I rode my degree and my work ethic to more interesting and better paying positions. But it was not enough. I was still mired in midlife muck.

It seemed with every couple steps forward there were steps back. I put on weight that I shouldn’t have. Taking it off was yet another difficult and time consuming chore but it focused me. Meanwhile around me members of my family went through mental health crises and physical traumas. Dealing with it drained and depressed me. But I never wholly gave into despair. As best I could I kept fighting it and moving forward.

I discovered that the only one I could change in my life was myself. There was no point in wasting time or energy trying to solve problems that I could never own. My wife has her own issues. I wasn’t helping her any by taking ownership of them. She has to take ownership of them. The same was true with my daughter. She is an A student pulling C’s. I can offer her support but I cannot change her either. She has to feel the impact of her decisions. It’s her life, not mine.

I have learned that you can love someone with all your heart and soul but you cannot change them. You can only choose to be pulled into the gravity of their problems, or you can choose to stay above, weightless and in orbit, yet nearby.

Instead I started to use my time in more meaningful ways. I attended services at my Unitarian church regularly even if I couldn’t get my wife out of bed to come with me. I started teaching in my spare time. I ran the church web site for a couple years. I thumbed my nose at society, which seemed to be saying to me that I should only have friends in the context of my marriage. I found my own friends. If I found someone interesting in the course of life I engaged with him or her. And it turned out I found the hers often more interesting than the hims so be it.

I have chosen to step outside the boundaries of what is expected of me. I’m not sure why I was in bounds in the first place. No one was holding a gun to my head. Perhaps I felt I should do what was proper, whatever that meant. Now I do what brings me some satisfaction. That is not to say that I spend my days in reckless hedonism. Rather I spend my days in ways that give me the most personal satisfaction.

So I no longer watch television. I want to engage with the world, not watch images of it pass by on a phosphorescent tube. I blog because I find it fun. It gives me an excuse to write, which I enjoyed so much growing up. If it engages a few friends and others who arrive serendipitously via search engines so much the better. If I cannot find a friend to see a movie, or if my wife is not interested I go alone. While I wait for that day when my wife decides to exercise again I am off on my bike on 20 or 30 mile trips alone.

Maybe it’s a tad myopic of me. Maybe it is selfish. Maybe, but I don’t care anymore. I am in command of my own life again. Life will continue to have its ups and downs. The downs will doubtless change me but suffering is an inevitable part of life. But suffering doesn’t last forever. If things are good then the day is a blessing: I am free to make the most of the day given to me. Good or bad as long as I engage in the experience of the day at least I will feel fully alive.