My Lovely Wife in the Psych Ward

by Mark Lukach

  But I also feared their friendship. Both were deeply frustrated with being told what to do by doctors and therapists, and they encouraged a rebellious spirit in each other. After all, Giulia and Marie had come up with the Medicine Nazi nickname together. There were times when both were stuck in the muck of their depression, and they talked each other deeper. They shared strategies for how best to kill themselves. It was Marie who told Giulia that overdoses are rarely successful.

  Their friendship was exactly what Laing wanted: patient supporting patient, empowering each other to choices that make the most sense to them. And as much as I wanted to encourage it, I couldn’t help having my guard up.

  Five months after her discharge, Giulia walked with me and Jonas at Ocean Beach. Even though neither of us was working, and Giulia was in IOP for only a few hours every other day, we spent a surprisingly small amount of time together. In her first bout with depression, we were inseparable. This time around, with her freedom to ride her scooter, Giulia was absent a lot more, leaving me and Jonas behind. This beach walk together was one of our first in a few weeks.

  I noticed her stride had more certainty and purpose. She wasn’t shuffling along apathetically. Her distant, blank stare was lifting, too, replaced by a spark and vigor of healthy times. She was also more communicative with Jonas, playing peekaboo and digging shapes in the sand for him to crawl through and smash.

  It was great to see her like this. “You seem like you’re doing better, Giulia.”

  Giulia looked down at Jonas, who was crawling toward her sand castle. She had sand up to her elbows and sweat on her brow from the digging.

  “I’m doing better because I stopped taking Risperdal,” she said, returning to her creations.

  “What?” I asked.

  “I said I stopped taking Risperdal.”

  “Did the doctor tell you to stop?”

  “No,” Giulia said. “I just did it.”

  “What?!?!” I screamed. “You stopped your fucking Risperdal? Do you have any idea how dangerous that is?”

  I had reassured myself that it was important to give Giulia more space, that maybe Cas and Laing and Marie and the director of Langley Porter were right: I had suffocated Giulia with how much I managed her care. But I was never really comfortable ceding control because I feared that she might make a reckless decision, and that’s exactly what she had done. I didn’t know how to process it.

  “Dangerous?” she said mockingly. “Look at me. I’m doing better. You said so yourself.”

  I jumped up and began pacing wildly away from Giulia, so angry I couldn’t even look at her. I punched myself in the chest over and over because I had to punch something.

  “Giulia, you don’t get to play your own doctor!” I screamed at her. “Last time you stopped your Risperdal, you were a complete mess, the most suicidal and weepy I’ve ever seen you. What if that happened again? While you were alone? Or with Jonas?”

  At the mention of Jonas I came running back, picked him up, and walked away. I shook with anger.

  A quarter of a mile down the beach, I finally felt more in control. I sat back down in the sand with Jonas, baby-talking him in faux cheery tones to try to quiet the anger ringing in my ears.

  A few minutes later, Giulia approached. At a distance she called out, “I don’t like those pills, Mark. I don’t need them anymore. They help me when I’m psychotic, but I haven’t been psychotic in months. They don’t do anything but make me feel bad.”

  “I don’t care,” I said calmly. I didn’t want to lose my temper again in front of Jonas. “Tell that to your doctor. Families lose when people treat mental illness like it only impacts one person. This is your illness, but it’s actually all of ours. Yours, mine, Jonas’s, even Goose’s. We all live through this. You can’t make decisions like this that could put so many of us in harm’s way. What if you had a bad reaction while walking Jonas and you decided to step in front of moving traffic? It is so dangerous to rip yourself off your meds. You have to taper off them. You don’t get to play your own doctor.”

  “You try to play my doctor,” she said.

  I didn’t respond to that, even though she was right. I was so angry that I didn’t have space for her to be right. I forced myself to smile at Jonas and pretend that I wasn’t furious.

  “Did you stop all your pills, or just the Risperdal?”

  “Just the Risperdal,” she said. “I’m still taking my lithium. And look at me: I’m doing better.”

  “You have to call your doctor and tell her you stopped your medicine,” I said.

  “Okay,” she said. “Mark, I hate this medicine. I’m feeling better and I don’t think I need it anymore. You can’t take this so personally.”

  By now, Giulia was standing next to us. There was no way to not take it personally. I felt trapped by the impossibility of the situation. I didn’t trust Giulia to make her own decisions. I wanted to make them for her, which led to her resenting me for not trusting her. I didn’t want Giulia to resent me, but the only way to do that would be to allow her to make her own decisions, even if that included choices that could hurt or even kill her. It wasn’t going to work if I remained in charge, and it would be too risky if she was in charge.

  “Giulia,” I pleaded with her, “how can I trust you with medicine ever again?”

  “You just trust me.”

  ten

  April 2013

  Giulia’s doctor and therapist did not worry about Giulia stopping her medicine as much as I did. Her doctor was planning to taper her off the Risperdal soon anyway, and since her reaction was so positive, it wasn’t a big deal to him that she decided to stop her medicine herself. He discharged her from IOP and encouraged her to get back to living her life. At the last IOP meeting, he prescribed Giulia a full bottle of Risperdal to keep in the medicine cabinet, just in case. She shoved it behind her makeup, and we never talked about it.

  There was no celebratory text at the conclusion of IOP, no date night out for pho. We instead just returned to living. Despite Giulia’s abrupt return to “feeling better,” I still couldn’t remove myself, and my needs, from how Giulia wanted to manage her mental illness. I was adamant that we treat Giulia’s illness as a shared experience for our whole family, which meant we had to be open and honest about it. When I brought this up with Giulia, she reminded me of the many times I had spoken about her to her doctor, or therapist, or parents, without being honest to her about what I was saying. The dishonesty and betrayal went both ways, and we were once again in a fragile state of distrust and even resentment.

  Following the advice to get back to living life, Giulia and I both started to look for jobs. It had been three years since I had worked as a salaried teacher. I loved freelance writing and caring for Jonas, but I couldn’t shake the memory of how much pressure Giulia had felt as our sole income provider before her second psychotic break.

  I polished up my résumé, added some writing clips, and fired it off to some of the most progressive schools in the Bay Area. I was elated to get a job offer teaching history at a groovy school in the East Bay, but I knew that if I took the job, we would have to move. The drive across the Bay Bridge and through the Caldecott Tunnel was just too far.

  Giulia and I had lived at Ocean Beach for seven years. It was more than just a neighborhood to us. It was where we first built our home as a married couple. All of our closest friends lived there. Jonas had learned to crawl on the beach. Goose’s favorite activity was to dig rocks at the beach. The ocean nurtured my spirit through surfing. Our lives were defined by Ocean Beach.

  But Ocean Beach was also a cold and foggy place. While the rest of the Bay Area spent summers eating dinners on the deck and running through sprinklers in shorts and T-shirts, residents of the Outer Sunset bundled up in hoodies and corduroy. One summer I went a full forty-five days without seeing the sun. Besides, in the East Bay we could afford a place with more space and a yard and wouldn’t have to worry about the public school options when Jonas
was ready for kindergarten.

  Most of all, Ocean Beach was the place where Giulia got sick. Not once, but now twice. All of our favorite streets and restaurants felt tainted with psychosis and depression.

  I accepted the job offer, and we packed up our belongings. My heart was heavy, but I felt optimistic and relieved. I kept the wax on my surfboards. We were moving only forty-five minutes away from the beach, after all.

  In the rural outskirts of Martinez, California, we soaked up the sun. We hung a hammock in the backyard and immediately set up a garden with tomatoes, zucchini, peppers, and herbs. The house we rented was surrounded by fruit trees, and Jonas loved to watch as I climbed them to pick apples, apricots, and peaches.

  The beach was no longer at our fingertips, but our new home was across the street from Briones Regional Park, a six-thousand-acre open-space park I had never even heard of until we moved to its front door. We translated our beach walks into hikes through the golden hills. I was struck by the unexpected beauty of the place. John Muir had set up his family home in Martinez. Good enough for John Muir, good enough for me.

  Jonas took his first steps in our new front yard. When he started to wobble around, Giulia and I bounced and shrieked in celebration. The neighbors poured out of their houses, drawn by the commotion, and then returned back inside, smiling and shaking their heads in pleasure. What a joyful relief to experience a milestone together, like normal parents.

  We missed our friends, but I was surprised by how little I missed surfing. Instead, I turned to trail running. I had always run for maintenance, but I’d never identified as a runner and always did my best to avoid hills. I didn’t consider running the Briones trails until I met a retired firefighter while out on a hike with Jonas and Goose. He invited me to join him for a trail run. I agreed. The firefighter turned out to be the fittest fifty-year-old I’d ever met. He ran me into the loopy, sultry glow of a runner’s high. I was hooked.

  Running became my meditation, a hot, sweaty replacement to the now distant surf. I ran early, before Jonas woke, or at dusk, after he fell asleep. Once the school year started, I even ran on my lunch break. The twenty thousand acres of Mount Diablo State Park were only a few hundred yards from my classroom door.

  There was something beautifully primitive about stripping down to a pair of shorts and shoes and running through the grass and forest. I felt like I was doing what we humans had evolved to do, a pleasant alternative to my thoroughly modernized life. The pace of my thinking slowed to the rhythm of my footsteps. I could lesson plan on my runs, but I mostly spent the time thinking about Giulia and Jonas.

  I didn’t find any answers to the questions surrounding Giulia’s illness or solve the riddle of my marriage. But I did find the patience and perspective to deal with them and the optimism that we would work through them.

  The more I ran, the more deeply I appreciated my surroundings and running. The runner’s high is so much more immediate and reliable than the elusive surfer’s stoke. A surf session can be ruined by tide, wind, attitude from other surfers. A run is just you and the landscape. I occasionally ran with other people but mostly took the time to myself, to set my own pace, to choose when I wanted to soar and when I wanted to suffer. Running gives you plenty of both.

  On a painfully hot Saturday afternoon, when the only available window for a run was during Jonas’s afternoon nap, I trudged out into the sun and was drenched in sweat within the first few minutes. A mile into the run, my head was spinning and I could see spots around the perimeter of my vision, but I kept going. I loved to push myself to my limits. I knew this could get dangerous—it was hot, I could pass out, no one knew precisely where I was. But courting risk, and the surge of adrenaline that accompanies it, was another reason I ran on these trails.

  While I stumbled over roots and struggled against the hills, the spots somehow faded and my head felt solid on my shoulders again. Not just that: I became invincible. I charged through the tall grass at a rip-roaring pace, scaring grasshoppers to flee ahead of me, but I caught them a few steps later, and we ended up racing against each other on a single-track trail. It felt so right to be out there in the heat with those bugs, running myself into a deluded frenzy, thinking about my son and my wife, knowing that these eye floaters and our spinning heads were just a part of being a family together, and we would run through them together.

  School began in August, and I felt exhilarated to be back in the classroom. I immediately remembered why I had been so drawn to teaching in the first place: the curiosity, the energy, the constant stimulation, the frantic, consuming pace.

  Soon after my school year started, Giulia landed a job, her third in five years and the fifth since we moved to California. In the job interview, her new employer admitted that they loved a lot about Giulia’s résumé and how she presented herself, but they were wary of her checkered past with working at companies for only a year or so. Giulia set the goal of staying there for five years. Her career trajectory had been nothing like what she had planned.

  We had become a family with two working parents, which meant we needed to find a day care for Jonas. The search was heartbreaking, since he had been home with one of us, but mostly both of us, for his first fifteen months. We visited a few day care centers, curiously watching how Jonas interacted with the teachers and the other kids in the class, and knew we had come to the right place when we found one whose tagline was “A child’s work is to play.”

  When Giulia began work in mid-September, Jonas began his new routine at school. The first day I lingered in the classroom after I put him down. He didn’t want to let go, and he cried when he realized that I wasn’t staying. I cried the whole drive to school. When I picked him up that afternoon, he leapt into my arms, and we had never hugged more tightly.

  Within a week, we had settled into our new routines. This restart pushed us to move beyond Giulia’s second episode.

  We worked hard to put Giulia’s sickness behind us. We didn’t have a word to talk about normalcy the way we used “sick” to talk about the times of crisis. Health? Stability? Bipolar management? Whatever it was, we now knew that these good times could be punctured by another bout of the sickness. Giulia was in the 90 percent who relapse. No one knew when or if the psychosis would return.

  One night Giulia stayed up late, until almost midnight, painting furniture. She usually went to bed early, only an hour or two after Jonas fell asleep. Sleep was important, and we both knew it. I suggested she go to bed.

  “But I’m having fun,” Giulia said.

  “Good,” I said. “But it’s midnight. Go to bed.”

  “No,” she said.

  “You realize what this looks like, right?” I said.

  “No, I don’t. What are you talking about?”

  “I’m not saying that you’re manic, but on the surface, this looks like mania. Staying up late, painting, feeling full of energy . . .”

  Giulia exploded. “How dare you tell me what to do? Stop running my life! You’re not in charge.”

  The fight lasted days. Anything that echoed how we acted when she was sick became a sore spot for us. We played nice in front of Jonas, but for the next few days all tiny missteps triggered titanic reactions.

  Then, a week later, Giulia had a tough day at work. As we got in bed to go to sleep, she said, “I’m scared about how stressed out how I feel.”

  I responded in high alert. “What do you mean? What’s going on? Let’s talk about it.”

  She stonewalled. “I don’t want to talk about it because I need to sleep, but I’m scared.”

  Which in turn scared the hell out of me. She was worried about her mental health. I tried to swallow my anger and fear that she wasn’t taking care of herself, but I couldn’t calm down. I didn’t sleep that night, I blamed it on her, and we fought for another few days.

  As much as I loved running, I regularly checked a surf forecast app on my phone, in the desperate attempt to sneak in a surf session when possible. I found a Saturday mo
rning that looked promising and cleared it in advance with Giulia. She agreed, but I could feel her tension. She and Jonas still didn’t spend a ton of time alone together, and as she agreed to let me go surfing, the unspoken question hung in the air: What would Giulia do with Jonas while I wasn’t there?

  I woke up at four thirty a.m. so that I could be in the water for almost an hour before the sun even rose and could be back by nine a.m. I left out clothes for Jonas, fixings for his breakfast, puzzles, books, and Goose’s leash, with a map of Briones. I figured they could eat breakfast and then the three of them could go for a hike. Easy enough morning.

  The surf was fun, but nothing memorable, which was fine if you lived only a few blocks away, but since I left my house at four forty-five a.m. and surfed in the dark in order to get waves, I was a bit disappointed. Granted, I had gotten into the ocean and caught a few, so it was hard to call it a waste of time. But Ocean Beach will do that to you: make promises of sparkling fun waves based on the tide and swell period and wind forecast and then serve up midsized, sloppy mush.

  I came home, expecting that Giulia and Jonas would either be out or doing a puzzle. Instead, they were cuddling on the couch, watching a movie. Goose greeted me at the door, his tail a frenzy with the impatient wagging of a dog who had not got his morning walk.

  “What’s going on in here?” I asked, trying but failing to not make my question sound like an accusation.

  “We’re watching Cars,” Giulia said. Jonas cheered in agreement.

  “What about the books?” I asked.

  “We didn’t read them.”

  “Did you guys go hiking?” I didn’t need to ask. They were all still in pajamas.