Unhinged: A Memoir of Enduring, Surviving, and Overcoming Family Mental Illness
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Unhinged: A Memoir of Enduring, Surviving, and Overcoming Family Mental Illness
252eBook
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Overview
In telling her story, Berry uncovers the difficulties inherent in not only growing up with mental illness among family members, but also the frustrations of not being able to recognize or handle the trajectory of her own illness. Yet, after successfully finding methods of treating her symptoms, Berry goes on to become a successful journalist and author, who now helps educate the public about mental health through her writing, while also serving as her mother’s court-appointed legal guardian. This story shows the devastating impact of mental illness on whole families, but offers readers a message of hope and healing. Berry’s story is sure to resonate with the many people who deal with the mental illness of family members, and their own struggles to cope with their own diagnoses.
Product Details
| ISBN-13: | 9781442233638 |
|---|---|
| Publisher: | Rowman & Littlefield Publishers, Inc. |
| Publication date: | 08/14/2014 |
| Sold by: | Barnes & Noble |
| Format: | eBook |
| Pages: | 252 |
| File size: | 1 MB |
About the Author
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Unhinged
A Memoir of Enduring, Surviving, and Overcoming Family Mental Illness
By Anna Berry, Jan Smith
ROWMAN & LITTLEFIELD
Copyright © 2014 Rowman & LittlefieldAll rights reserved.
ISBN: 978-1-4422-3363-8
CHAPTER 1
HEARING VOICES
I've had a lot of psychotherapists. More than I can remember, actually. When you spend as many years in psychotherapy as I have, the therapists—male, female, psychologist, guidance counselor, licensed social worker, psychiatrist, ordained minister, whatever—all start running together like a melting watercolor painting, until I can no longer visualize their individual faces in the overstuffed archives of my memory. The region of my brain dedicated to self-improvement and self-analysis is stuffed to the brim. I'd need another ten years of therapy just to recatalog the scores upon scores of therapy-session transcripts, the passive-aggressive defense mechanisms, and the battles with insurance plans and employers over co-payments and time off that are stored between the thousands of neural synapses in my frontal lobe.
The true nature of my various psychoses rests buried somewhere beneath a tangled demilitarized zone that built up slowly from the subtle manipulations and emotional games of chess between me and many different therapists. I was often an uncooperative patient too, which didn't help matters.
There's an old joke that circulates around and around—I heard it first when I was in college over twenty years ago, and I still hear someone tell it at least once or twice a year.
Q: "How many psychotherapists does it take to change a lightbulb?"
A: "Just one, but the lightbulb has to want to change."
Truer words were never told—and that's precisely why this tired old joke always gets a laugh from me, no matter how many times I hear it. I spent many years in psychotherapy running around and around on the same hamster's wheel, sprinting and sweating yet never getting anywhere, simply because I didn't want to recognize my own role in my ongoing mental misery. But there comes a point in almost every mentally ill person's life when she concludes she doesn't want to live like that anymore, and finally she decides to put her nose to the grindstone and get to work. Whether that means finally taking meds as prescribed, or keeping weekly therapy appointments, or dumping all the liquor down the drain, or switching therapists—or just doing the hard introspection required to recognize and change destructive behavior patterns—it's all hard work.
And truly hard work is seldom fun. Hence, we avoid it.
And sometimes, the most difficult task of all is just finding out what is really wrong with you in the first place. For example, even after seeing at least (that I can remember) twenty different counselors, shrinks, social workers, psychiatric residents, and therapists over a period of fifteen years, I never once got the same clinical diagnosis.
Not once. Ever. Had I received overlapping diagnoses, I may have been more accepting of one, but it's difficult to see where I fit in when so many professionals have had so many different diagnoses. And I can't say that I agreed with any of the suggested disorders in my case anyway. Not only that, but some of the diagnoses I got at various times are either no longer categorized as illnesses by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) at all, or else they've gotten merged with other, "new" disorders. Trying to keep up with all the recent changes in diagnostic criteria isn't just hard for psychotherapists and medical billers—it can wreak havoc on patients too.
It's a common problem: few if any people fit perfectly into the rigid boxes constructed by the DSM-V, the manual the American Psychiatric Association uses to categorize mental illness, which the health insurance industry in turn follows when it comes to paying for therapy—or far more often, psychiatric drugs. If my own experience is any example, this is one case where the one-size-fits-all approach of so-called cookbook medicine just doesn't work. And if you can't even get diagnosed with the right illness, it can be downright hard to receive the right treatment—let alone get better. Let me show you what I mean.
I've been diagnosed as having any and all of the following at one time or another.
Clinical depression (also known as major depressive disorder). I'd definitely say I've been depressed. So have millions upon millions of other people. But I don't fit the criteria for clinical depression as outlined in the DSM-V, which requires I have at least five of their nine possible listed symptoms every single day. I had maybe two or three symptoms at best, and not every day. True, I often had feelings of sadness, even to the point of being suicidal at times—but I was missing several other criteria as required by the DSM-V. Despite what the diagnostic criteria say about depression, I never lost interest in my favorite activities, nor did I have difficulty concentrating at work or at school—quite the opposite, in fact. My weight didn't fluctuate up and down, nor did I have significant problems with my sleep patterns. I did have the inappropriate fascination with death and the dark moods that went on for weeks at a time that the diagnostic criteria require, but the rest of the picture was missing. Which might be why I wasn't given prescription medication for my depression, but then again, who knows? Whatever the reason, I got crammed in a box that wasn't the right size for me. If anything, I believe my depression was actually a symptom of other disorders, which I'll elaborate on later.
Manic depression. Well, sure. Many creative artists like me have this to some extent, as our creative juices ebb and flow in cycles that can seem like a roller coaster at times. We might be super-productive for a day or two, then tired and blocked the next. I've sometimes gone for weeks having to force myself to write despite a profound lack of inspiration, which can be downright painful. But I still couldn't agree with this diagnosis because I did not experience bouts of clinical mania. No going around for days without sleep, no frantic attempts to start a bazillion projects that I never finished (indeed, I'm known for my discipline, attention to detail, and ability to meet deadlines even when I'm feeling at my worst). I did have the occasional shopping spree, and I was what some would call promiscuous, but I wouldn't call either one of these tendencies manic. "Manic depression" is also an antiquated definition of what is now known as bipolar disorder—which itself now has two types according to the DSM-V: bipolar I and bipolar II. (And I haven't been diagnosed with either one of those.)
Severe bipolar disorder (non-artistic personality). Never bought this one. At the time I received this diagnosis, the DSM-IIIr was in vogue, and it used different diagnostic criteria than those in use for bipolar disorder today. This diagnosis also suggests that I would not be able to function well on a daily basis. But I could, just perhaps not always well. This disorder is now known as bipolar I disorder. A different variation is bipolar II, which wasn't even identified as a distinct illness until 1994 and still remains a difficult diagnosis for most psychotherapists to make. (If I had to choose between the two, I'd say I fit the criteria for bipolar II a lot better, but even then it doesn't seem to work because I don't really suffer from mania, and never have.)
Borderline personality disorder (BPD). I should point out that there is currently considerable dispute in the psychotherapy community whether this is a legitimate diagnosis at all—even to the point that some insurance companies refuse to reimburse for BPD treatment, and some psychotherapists will even refuse to treat BPD patients. It's even referred to rather flippantly by some in the psychotherapy community as the "garbage bin diagnosis," according to Psychology Today. But it's the label that has been applied to me the most often by far, so I'd say there's more than a grain of truth to it. But given the fact that none of my many therapists could ever agree on what was wrong with me, it seems fitting (and appropriately hilarious), then, that I'm chronically ill with BPD, a disease that many clinicians apparently don't consider a disease at all.
The current disease criteria for BPD in the DSM-V state that BPD patients have a history of unstable personal relationships and poor self-image, impulsive behavior (like overspending and sexual promiscuity), chronic feelings of emptiness, and difficulty controlling anger. But, frankly, most young people have all of these problems at one point or another—it's called being young. Indeed, the American College of Pediatricians says that young people's brain and emotional development, especially in the frontal lobe that regulates emotional impulses, are not fully complete until their mid-twenties—and therefore adolescents are especially prone to impulsive behavior and unstable relationships. If the disease criteria for BPD in the current DSM-V are to be believed, it seems to me most young, single women in America have BPD to some extent, which would make having at least some of the criteria for BPD perfectly normal for women in their late teens and early twenties. In HEARING deed, there is quite a range of behavior and severity chalked up to the disorder, covering the extremes of suicidal behavior on one end, mere serial monogamy on the other, and just about everything in between. Susanna Kaysen of Girl, Interrupted fame was locked up for almost two years for being "borderline" in the 1960s, while most contemporary psychologists say her condition at age eighteen would barely merit more than a few cognitive therapy sessions—or at worst, a very brief hospital stay followed by psychotherapy. Drugs tend to be ineffective against BPD, experts say, though they are still frequently prescribed.
It is in fact extremely common for persons eventually diagnosed with BPD to have had numerous other disease labels applied to them first, not only because many clinicians are not trained in recognizing BPD symptoms, but also because BPD tends to coexist with other mental illnesses, such as depression and anxiety disorders. Indeed, it is common for all mentally ill persons, regardless of their specific illness, to receive as many as a dozen different diagnoses from scores of different practitioners over the course of their lifetime. I think this helps explain why I've frequently been diagnosed with various types of depression—but whether that depression was actually a symptom of BPD or a coexisting condition is up for debate.
Psychologists who support the diagnosis of BPD state that the ability to "act" as if you are perfectly sane and stable to those around you while feeling suicidal and volatile inside is trademark "borderline" behavior. And my trademark "perfect storm" of near emotional collapse buried underneath a serene, happy exterior is indeed one of the classic symptoms of BPD.
The ability to act as if everything is all right when in fact nothing is leads many BPD sufferers to pursue careers in the arts, especially the performing arts. Indeed, "unusual artistic talent" has been identified as having a strong correlation with BPD. The day-to-day torture of having to create inner and outer selves simultaneously, and maintain both convincingly, is perfect real-world training for a professional actor. It's just as effective for someone who wants to be a writer too. When your mind is split into two complete selves—one peaceful, self-lobotomized, and seemingly perfect;the other a raging, screaming, frightened, depressive monster—your entire existence revolves around fabricating scenarios for both of those characters (neither of which represents your true self) in which to dwell. Living with BPD is like living inside your very own custom-made, three-dimensional soap opera, with your split self playing all the roles and doing all the histrionic backstabbing on a TV series that runs only in your own mind.
What else have I been diagnosed with at some point or other? Let's see.
Multiple personality disorder. Again, I couldn't buy this one because I never had other personalities, so I'm not sure why this one was even offered.
Episodic depression. This means you only have depression at certain times, cycling with either normal behavior or mania. Your depression becomes a series of episodes, popping up at regular intervals like a running gag on a TV show. I suppose you could make the argument that I did have this because I had episodes of depression starting in my early teens through my late twenties; but that seems to me more "chronic" than "episodic."
Seasonal affective disorder. I suppose this diagnosis is common for people who live in the Upper Midwest like I do, given how dark, long, and cold our winters are. But I'm not sure it applies to me since some of my worst depressive and psychotic episodes occurred in sunny, warm weather. My moods never depended on the weather, per se—I just happened to get this applied to me when I saw a psychotherapist during a January cold snap.
Cyclothymic disorder and/or dysthymic disorder. These are both mood disorders related to depression. Cyclothymic disorder involves cycling between mild to moderate depression and mania and is considered a less severe version of bipolar disorder, while dysthymic disorder means you've had a constantly depressed mood for two years or more, feeling hopeless and unable to concentrate, without necessarily being suicidal. As with their more severe counterparts, I was missing several of the required criteria for these diseases, and since I considered suicide more than once, I don't think either was the right fit for me.
Antisocial personality disorder. I take particular offense to this one. I don't appreciate being placed in the same basket with murderers and rapists. Antisocial personalities possess a profound lack of empathy and act without conscience or regard to the well-being of others. That can mean anything from being a career criminal to the guy who steals his coworkers' lunches from the office refrigerator and then lies about it. Since I've frequently been plagued by guilt or fear of what and how others will think of me or do to me if I make this or that choice, it seems a profound lack of empathy isn't one of my problems. I'm also the first to cry at sad movies, I often beat myself up for not giving enough to charity, and I frequently do way too much volunteer work at the expense of my personal and professional obligations. In that regard, I'm really more of a codependent with a guilt complex.
Histrionic personality disorder. The DSM-V also calls this disorder the "theatrical" or "dramatic" personality disorder. Since I'm a trained actor and playwright, I suppose I can see why I got this diagnosis, given that my livelihood depends in part on a flair for the dramatic. But I don't think it fits me because when I'm not participating in theater (which isn't much these days, now that I'm raising two young children), I actually cannot stand being at the center of attention all the time, as the disease criteria require. Unlike when I'm on the stage, in reality I'm more of an introvert. I prefer a quiet evening at home catching up on reading or cleaning the bathroom to making a spectacle of myself at the discotheque or in the returns-and-exchanges line at the mall.
Schizotypal personality disorder. The DSM-V states that this disorder is one that elicits behavior of "extreme solitude." Sufferers tend to show deep anxiety in social situations, have odd or strange social behaviors, and be extremely uncomfortable maintaining close relationships with others. None of those criteria apply to me. While I am a bit of an introvert, I have a wide circle of friends and enjoy going to parties and gatherings, and I'm frequently complimented on my politeness and knowledge of social etiquette—hardly a symptom of being socially awkward. The only reason I can think of why I might have received this diagnosis is because at the time I was choosing to hang out with people who didn't share my values and often belittled me, but that had more to do with my own low self-esteem than social anxiety.
(Continues...)
Excerpted from Unhinged by Anna Berry, Jan Smith. Copyright © 2014 Rowman & Littlefield. Excerpted by permission of ROWMAN & LITTLEFIELD.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Table of Contents
Contents
Author's Note, vii,Prologue: Chicago, April 2002, ix,
1 Hearing Voices, 1,
2 Vienna, Austria, October 1999, 15,
3 Chicago: October 2001–April 2002, 71,
4 1993–2002: Nine Years to Enlightenment, 109,
5 Mom: A Relapse, 129,
6 Mark: The Lost Cause, 157,
7 Where Are They (and Where Am I) Now?*, 199,
Epilogue: The State of Family Mental Illness in America, 205,
Recommended Reading, 213,
Notes, 215,
About the Author, 221,