The Fog of Mental Illness: I Know There’s Another Person in There Somewhere

Of all the midlife tasks I’ve encountered, caring for my ailing mother was hands down the most difficult.

That includes two job layoffs; getting fired from another job after seven years because of a personal conflict with a boss; a dispiriting divorce; a career change necessitating a six-year slog through graduate school; and a devastating injury requiring more than a year of rehabilitation.

I use the term “caring” loosely. I’m not the greatest caregiver – at least that’s what my first wife concluded.

I was the typical “sandwich” during midlife, raising kids while becoming a surrogate parent to my parent.

My mother tested my love, patience, tolerance and temper, down to my last nerve. And I have to acknowledge, when my mother was in her greatest times of need and was in her most depressed, ornery and bedeviling states, it was not me who truly was her prime caregiver and manager, it was my patient-as-a-saint second wife. I just tried – sometimes unsuccessfully – to follow her lead with an open heart and mind.

Now that my mother has died, I feel a little more freedom to tell a deeply personal family story, significantly abbreviated. I recognize most people wouldn’t air their family’s laundry, would keep it tight in the family, in the shadows. As a counselor, it’s part of my job to bring mental illness out of the shadows, to reduce the stigma. My mother had mental illness.

My mother’s depression occurred during various stages of her life, manifesting later in her life as bipolar disorder, meaning she cycled between depression and manic, or hyper, behaviors. The combination of mental illness and accumulating physical ailments, including intractable rheumatoid arthritis, fueled each other, contributing to an unremitting downward spiral in my mother’s final years and resulting in her sudden death from an undetermined cause at age 73.

Depression first hit my mother full force in her 30s, coinciding with her divorce. From my ages of 11 to 15, my mother suffered from several bouts of severe depression requiring a couple of months-long hospitalizations. When she was home as a single mother during that period, often she was barely functional, leaving my younger brother and me to largely fend for ourselves. There were times I was convinced she would die as a young woman, as her lack of appetite and insomnia caused her to wither away physically and treatment did not seem to work.

She eventually recovered later in my teen years, entered the workforce and went on to live a reasonably productive and stable life. She was a beautiful – but complicated (aren’t we all?) — person. She was a good friend to others, my number one supporter, and cared for me deeply. She wore her passions on her sleeve, such as politics. If not for her, I likely never would have run for political office, of course as a Democrat, the only party for her.

But she also carried demons from childhood that inhibited her life, and were amplified when her mental state was out of balance. Her parents were critical of her; she was never good enough, a “bad girl.” Her self-esteem suffered, compounded by her feelings of shame because of her family and home’s relatively impoverished condition. Her parents also were overly worried and fearful – neurotic, my mother would say – and as a result, over-protective. My mother responded in a positive way – by rebelling, asserting her independence, being stubborn, acting willfully, behaving in sneaky ways, including probably fibbing, to avoid her parents’ disapproval, and satisfy herself.

While those traits likely served her well during a challenging childhood, I believe they may have made her harder to deal with in later adulthood when mental illness flared, though dealing with anyone with bipolar disorder can be a nightmare regardless of personality characteristics. My mother had long periods of stability, stretching many years. But when in the grips of a bipolar episode, the illness was ferocious, grabbing hold of her like a rag doll and dragging her around at its whim. She was a wild card – we never knew what we would get from day to day.

During one manic episode, we had to literally restrain our mother from chasing police cars down streets in Washington, DC, so convinced she was that they were heading to Capitol Hill to intervene in a terrorist attack and she wanted to be part of the action. Without intervention, we were sure she would end up injured, abused, jailed or dead.

What many people don’t understand about dealing with people with significant mental illness is how difficult it is to get the sufferer help. Hospitalization is strictly voluntary, except in cases where it is evident the person is a risk of harm to herself or others, a standard that is quite difficult to prove to law enforcement.

During my mother’s two serious manic episodes in later adulthood, when her behavior was wildly erratic and mood swings drastic – essentially, like dealing with a person possessed by another being — we struggled mightily to get her to voluntarily commit to hospitalization so she could be stabilized. She resisted stubbornly for weeks on end, at times perversely turning those who loved her and were trying to help her into her enemies, behaving belligerently toward us and targeting us for biting comments, as if mental illness obliterated her filter and her subconscious assumed dominance.

She nearly torpedoed the sale of her house, a project on which her family had worked for months to get her into a better situation, where she would be safer physically, less isolated socially, and perhaps even receive care on site. She made the Realtor a target of her ire, as she did numerous medical and therapeutic professionals, out of frustration and distrust, believing they had consistently failed her or attempted to deceive her.

It was incidents and behaviors like these and more that caused my fuse to burn short and my temper to erupt more frequently than I like to admit. Even though I knew it was mental illness acting and talking, not my real mom, my frustration and despair at my seeming inability to influence a change or make a difference sometimes overwhelmed me and made me feel despondent and helpless. Counterproductively, I often relieved my anger by taking it out on my mother, feeling terrible afterward.

At the time she died – alone in her new apartment, with no one aware – she had come out of a manic phase and was stabilizing mentally and emotionally. As much as she fought in later adulthood against receiving professional help and being hospitalized – surely the result of wretched hospitalization experiences in her 30s – I believe she realized deep down that she needed help, that she couldn’t conquer the illness through sheer strength of will, that the people who cared about her had her best interests at heart. Because each time, after dragged out, emotionally exhausting battles, she did submit to voluntary hospitalization, and got better.

Unfortunately, her last go-round with the disorder must have taken a huge toll. She never got the chance to fully recover and get back to a normal life. We’ll never know what impact her mental illness had on her ultimate physical demise.

Unfortunately for me, my memories of my mother are clouded by that final intense, dramatic chapter, by the veil of mental illness shrouding the real person, when, try as I might have to be forgiving, accepting, patient and understanding, I was not always on my best behavior and didn’t always hold my tongue, just like my mother. And, perhaps worst of all, I never had the chance to apologize, forgive or say goodbye.