by Gwen Olsen
The next several hours would be touch-and-go for me. I was hooked up to a monitor that would sound an alarm to staff when I stopped breathing. And I did stop breathing frequently. I broke out in an itchy rash all over my body. Benadryl was added to my IV to control the itching and swelling. Breast-feeding was out of the question because I was too weak to even sit up for long periods of time. So, I was given Parlodel, a drug to dry up my breast milk. (This was an “off-label” indication that eventually got the drug recalled for causing strokes in healthy postpartum women.) It would be ten hours before I was allowed to see or hold my baby. All that was a cakewalk compared to the postpartum depression that would follow later.
(Doctors can prescribe any drug to any patient for any condition he or she deems appropriate. This is legal even though the drug may only be officially approved for specific indications for which it has been tested. Drug companies heavily promote “off-label” and sometimes untested uses of drugs. It is another area in which drug reps often utilize key opinion leaders in order to establish a drug’s off-label indications.)
When my son was four days old, I was discharged from the hospital. We went to Austin (the city) to stay with friends and escape Hurricane Gilbert and the spin-off of tornadoes that would surely follow the hurricane. I was extremely weak and developed a uterine infection to further complicate my condition. The usual four-hour trip between Corpus Christi and Austin had been much longer, tedious, and crowded, as evacuees fled from the coast to inland cities. Hurricane Gilbert eventually hit land in Brownsville, further south of Corpus. So, the trek home was uneventful. Fortunately, our apartment had not sustained any damage.
My recovery from the complications during labor and delivery was slow. Although I was basically elated to be alive and have a healthy baby, an emotional storm was brewing internally that I couldn’t put a finger on. Yes, there were stressors resulting from Connie and the baby, but something else was happening. I couldn’t control my ruminating thoughts of sad, painful, disturbing memories. I was consumed by overwhelming despair and “gloom and doom” feelings. It took all of my energy and effort just to get out of bed, much less care for my infant son and twelve-year-old stepdaughter. I also felt irritable and teary-eyed, and would explode into uncontrollable sobbing without provocation. Now I really thought I was losing it! Moreover, I identified this behavior with my mother and her mother, and worried incessantly about my newborn baby.
“You’re crazy, just like your mother,” echoed the familiar phrase repeatedly in my head. I fought so hard just to act normal!
Connie was unable to adjust to her new environment, and she was lonely for her siblings. She began to act out and eventually returned to Wisconsin. Our relationship with Connie became more and more distant as the years passed. As an adult, she changed her name and moved. We lost total contact with her. Tina would keep in touch sporadically over the years.
Both of my husband’s daughters struggled with emotional problems in their adolescence and adult lives. Tina also had her own bout with alcohol and drug abuse, and she was forced to spend several months in a juvenile rehabilitation/ detention center. We would bear an immense sense of guilt and responsibility. At the time, I was a wounded young woman myself. It is painful to admit, but, at that point, I didn’t think it was my responsibility to rescue Rod’s children. We certainly didn’t do enough, but could we have spared them from some of their more painful childhood lessons? I’m not sure. In hindsight, my heart would later question, “What if we had taken both of them?” Once again, there are always lots of “what ifs” to be reflected on down the road. Always in hindsight, the truth is revealed and as it is often quoted, “The truth hurts.”
7
Another One Flew Over the Cuckoo's Nest: Geraldine's Story
“I must be crazy to be in a loony bin like this.”
—McMurphy, One Flew Over the Cuckoo’s Nest (1975)
I have long since determined the only thing that probably saved my sanity and/or my life was my ability to stay out of the psychiatric hospital. Believe me, I fought like hell to do that! All of my doctors encouraged me to be institutionalized in 1992. Of course, it was for my own safety. The impressions of psychiatric facilities that haunted me were the result of my exposure to them in my experience selling Haldol with McNeil, as much as they were disturbing remnants of my childhood memories.
The calls always came in the middle of the night. My grandmother had attempted suicide or had gone off the deep end again and required hospitaliza- tion. Because we were a working-class family, that meant admission to the state hospital. It was a dreary, depressing compound of buildings. The cold, austere feeling of the environment alone terrified me as a child, not to mention the moaning, screams, and other bizarre behaviors I had witnessed from the patients when visiting.
Because we lived in Indiana and Mamaw lived in Ohio, it was several hours drive before we would get to Toledo. We usually went straight to the hospital. Depending on the severity of the breakdown, I was often encouraged to visit. Sometimes my grandmother would be in a stupor—uncommunicative and expressionless—as she sat staring into the distance. Other times, she would be babbling incoherent, nonsensical conversation with anyone who would listen. It not only scared me, but it broke my heart to see my grandmother that way.
Mamaw was an intelligent, warm, humorous human being when she wasn’t sick. She loved to play cards and had taught me the game of canasta when my hands were barely big enough to hold the spread of cards. More and more as the years passed, I sensed her slipping away. The person she had been no longerexisted. What remained was a brain-damaged, confused, and pathetic shell of a person who spent the majority of her time smoking cigarettes, smacking her lips, and staring off into space. It was extremely sad.
My relationship with Mamaw had been forever marred by a childhood wounding I could not forgive. Even though I had been told she was ill, I would hold her morally responsible for the insane way she treated me during the Christmas of 1971.
My grandfather, Junie, was a big, jovial man who smelled like exotic pipe tobacco and cheap men’s cologne. As a little girl, I adored him and would slip my soft, little hands into his large, calloused palms when we walked together or climb onto his lap any chance I got. I heard stories about his philandering when he was young, but that never curbed my enthusiasm about Papaw. We didn’t see each other often, and I never knew anything except kindness and humor from him.
That Christmas, I was invited to travel in my grandparents’ motor home to Florida and vacation over the holiday. The first part of the trip was mostly uneventful. Mamaw and I played cards while chatting nonstop as Papaw drove the RV. I remember her raucous laughter that frequently erupted into hacking, coughing spells caused by a chronic bronchitis.
We stopped in Atlanta at a shopping mall to buy Christmas presents. Mamaw bought me a really cool pair of red, stretch, bell-bottom pants and a matching, flowered, button-down blouse that would be my favorite outfit that year. The weather in Florida was balmy and warm when we arrived at our campsite. Life was good, at least for a little while.
My memory of the details from here on gets sketchy except for the most traumatic highlights. Only a couple of days after we arrived in Florida, Mamaw began behaving oddly. She seemed agitated and argumentative. She had difficulty sleeping and would keep Papaw up all night talking. She would then bustle about to-and-fro as she engaged in meaningless activity the entire next day.
Papaw began worrying Mamaw either wasn’t taking her drugs or she wasn’t doing well on the new drugs she had been given most recently. He told me we needed to think about heading home early. By the time we packed our things and embarked on our long road trip back to Ohio, Mamaw was completely manic psychotic.
She accused me of sexual improprieties with Papaw. I was only twelve. I was mortified at the very suggestion and deeply wounded by her accompanying verbal attack. I remember the cynical tone in her voice as she hurled her vicious accusations, “I know he wants to screw yo
u!” she hissed. “.you let him, too, didn’t you? You little whore!”
I wanted to die! I could not process what was happening to me. This Dr. Jekyll and Mr. Hyde transformation had taken place in only a matter of days! How could she treat me this way? What had I done to deserve this?
Mamaw wouldn’t allow me to eat or sleep at all. When it was dark out, she would hold a flashlight in my eyes as we rolled seemingly endless hours through the night toward home. All of a sudden, out of nowhere, she would burst into heinous laughter, a sickening, shrill cackle, as though something evil possessed her.
Papaw finally had mercy on me and stopped at a bus station somewhere midway. He bought me a ticket and called my parents to pick me up. I could tell by the helpless, pained look on his face as he put me on that bus, he had no idea what else to do!
That would be the last time I ever really spent any significant amount of time with my grandparents. Papaw had a couple of heart attacks before he died in 1978. Just like Mamaw, he was a heavy smoker. Although I would see her again on rare occasions over the rest of her life, for all intent and purposes, that trip was really when Mamaw died for me—in my heart.
A Search for Answers
My product training on neuroleptic drugs included education in the syndromes of psychosis and their treatments. This area greatly interested me because Mamaw had been diagnosed first with major depression, then with schizophrenia, then as bipolar, and, ultimately, with a schizoaffective disorder. She had been institutionalized, off and on, throughout her adult life. She responded poorly to treatment, and her condition deteriorated with time. This is known in psychiatry as the revolving door syndrome and is common in patients diagnosed with mental illness and treated with drugs.
Once, while institutionalized in a psychiatric ward, she obtained a knee injury from being wrestled to the floor by an attendant and then restrained. (She had gotten up in the middle of the night to get coffee.) The knee was operated on repeatedly and got infected. It never healed properly, and her leg eventually required amputation. She developed a severe case of buccalfacial tics and made gross lip-smacking and cud-chewing movements involuntarily with her mouth. I knew Mamaw had been on a variety of psychiatric drugs over the years, but I often wondered if this was the result of the Haldol she had taken.
Mamaw finally died of congestive heart failure at the age of seventy-nine. However, the grandmother I knew and loved was dead decades before they buried her body. I regret to say that I didn’t even attend her funeral. I didn’t know the woman being buried that day, and I had already mourned the loss of the one I had lost many years before that. Apparently, I wasn’t the only one who felt that way. Mamaw’s “illness” had taken its toll on the family overall. I was told a confrontation erupted when one of my mother’s half-sisters emphatically remarked, “Let’s plant her and get it over with!”
Her behavior caused me such significant trauma as a child that I wanted desperately to understand her “disease”. In addition to that, there had been an ongoing dispute between family members for years about whether her medications and treatments were helping or hurting her. Opinions on this subject were passionately heated and divided. My mother was adamant the drugs seemed to make Mamaw worse:
It was apparent by her speech alone that she had suffered brain damage. She sounded mentally retarded when she talked!
My aunts sided with the doctors. Mamaw would only get worse without her medication! Ultimately, I just wanted to know the truth. An underlying current of fear was growing in me that I carried some “defective gene” that would eventually make me “crazy” like Mamaw. Perhaps it was a premonition of things to come.
(It should be noted that schizoaffective disorder is characterized by chronic psychotic symptoms and recurrent manic or depressive episodes. It is considered more severe and complicated than schizophrenia or bipolar illness. Treatment generally involves a more complex regimen of medications. Antidepressants often worsen the psychotic symptoms) (Drummond 127).
The Seeds of Sorrow: Gertrude’s Story
My great-grandmother, the family matriarch, raised several of her grandchildren. I adored my great-grandmother, who had an endearing Southern drawl and a funny phraseology when she talked. She was also a cat lover that took in every stray kitty around. At times, nearly forty to fifty cats were living in the barn and on the hillside behind her house. Only a special few were allowed inside her house. She would feed them by lining up pie tins on the sidewalk out back, filling them with dry food and calling “kitty, kitty, kitty” as a sea of felines emerged from under the porch, around the house, out of the barn, and seemingly everywhere! My most poignant memories today are of the smell of Ivory soap in her bathroom and the taste of her chocolate chip cookies with 7-Up. I can easily conjure a mental image of me as a child, swinging my legs under her kitchen table while gobbling down the cookies. The big, floor radiator groaning and spitting as it fired itself up to produce heat.
My mother had lived with my great-grandmother, Mamaw Wheeler, from the time she was three years old until she married my father at the age of sixteen. Mom’s biological father, Wayne Cole, was an alcoholic who had impregnated two women at the same time and married the other woman. He was never a significant part of my mother’s life, and she would not meet him until she was an adult.
Wayne Cole was an odd character. (He passed away some years ago.) The few times I saw him when I was young, he sort of frightened me. He had one arm that had been severed in an accident just below the elbow. He never wore a prosthesis that I knew of. On the other hand, his hairdo, slicked back with pomade, and a thick hillbilly dialect made him kind of funny. Still, I could sense a deep wounding suffered by my mother because of his abandonment. For that reason, I refused to like him.
My grandmother, Geraldine, married my mother’s stepfather, Junie, who had a quick temper when he was young. He was said to have been abusive to my mom. So, Mom was sent to live in Kentucky with Mamaw Wheeler, or as my mother called her, “Mom Wheeler”. (She would always refer to her biological mother as Mother.)
Mamaw Wheeler re-married several times following the tragic death of my grandmother’s father, who was accidentally shot by his own father when she was only five years old. Subsequently, a couple of the men Mamaw Wheeler married were explosive, mean alcoholics. One even tried to burn down their house when my mother was a small child. The only one of these men I would ever know, Cecil Wheeler, lived in the unfinished basement of the house and never came up to the living area. Apparently, he was banished to the basement to live several years before because of his drunken behavior. Even after he stopped drinking, he decided he would stay there. I never questioned the oddity of that arrangement until I was much older. There were so many unique aspects about my family and its history. That little tidbit seemed negligible.
Mamaw Wheeler had also raised my great-uncle’s children, Nina, Sam, and Alvin. That was the first family funeral I ever attended. Their father, Jennings, ended his own life by eating a revolver. He was said to have suffered from PTSD, severely depressed following WWII, as did his younger brother, Glen, who eventually died of alcoholism. The children’s mother, Thelma (no relation by blood) had a nervous breakdown following her husband’s suicide. She was institutionalized. None of these second cousins would fare well as adults. All suffered from serious psychological problems and/or drug and alcohol addictions.
My great-grandmother’s only offspring that appeared to be normal was my Great-Aunt Kathleen. However, I can’t help but wonder if her youthful wild rebellion, promiscuity, and party-girl reputation didn’t stem from alcohol and drug use, and if perhaps her recreational drug use wasn’t an attempt to stabilize her moods. Kathleen was known by other family members to still use marijuana late in life. Witty, fun, and youthfully spirited to this day, she remains one of my favorite relatives.
8
The Genetic Theory of Mental Illness
“There probably exists in the mental life of the individual not only what he has e
xperienced himself, but…an archaic heritage…The archaic heritage includes not only dispositions, but also ideational contents, memory traces of the experience of former generations.”
—Sigmund Freud, Moses and Monotheism
In his book, Blaming the Brain, Dr. Elliot Valenstein says:
Genes are responsible for establishing the scaffolding or fundamental organization of the brain, but a large amount of the neuronal growth that leads to the establishment of connections has been shown to be influenced (if not guided) by experience. There is no way that the one hundred thousand genes in the human genome could determine the precise configuration of the estimated 10 trillion synaptic connections in the human brain.
He further explains that biochemical and other biological changes in the brain may be the result of a patient’s mental and behavioral state. Therefore, it cannot be assumed that any “biological marker” found in patients with a particular mental disorder is the cause of that disorder (Valenstein 144).
Genes do not necessarily determine our destiny. When it comes to behavior, it would be highly unlikely that any single gene could be responsible for mood instability. For example, if one parent is bipolar, there is still less than a twenty percent chance that the children will develop the disorder. Natural selection will generally weed out major genetic defects, and this does not prove to be the case in mental illness. Our attachment in infancy, the kind of nurturing we receive, the trauma we sustain, and how we are impacted by others in childhood remain an important part of how we adapt to our environment and stress our entire lives (Whybrow 258).
Richard Lewontin, an outspoken critic of the exaggerated claims made in genetic studies, is a renowned geneticist and Harvard professor who wrote Biology as Ideology. In it, he says: