Bad Mother

by Ayelet Waldman

  But the kids are older now, and many of even the most diehard stay-at-home mothers have gone back to work, at least part time. When one of them comes up to Abe’s mother and says, a note of hesitation in her voice, “You’re Max’s mom, right?” Abe’s mother will just smile and then maybe suggest they go out for coffee. You can always find at least one kindred spirit, even in kindergarten.

  * Can I take a minute here to complain about the un-magnetic fridges? My fridge was cheap; it is not a twelve-million-dollar Sub-Zero, although I agree those are very lovely. It looks like it is in fact made of metal. On our first day in the house I stood in front of it with our lovingly-acquired collection of fridge magnets and watched as they fell to the floor. Would it have killed the fridge people to make the thing magnetic? Is this some kind of implied condemnation of the accumulation of crap on our fridges? Where do they think we are going to put the snapshots of other people’s children, the baby’s first drawing, the take-out Chinese menu, and the dry-cleaning receipt? Do they not understand that their sacrosanct fridge door is going to get covered with scraps of adhesive left over from hundreds of bits of tape?

  14. Legacy

  Rosie and Zeke have Michael’s eyes. The shade ranges, depending on mood and weather, between the color of cobalt blue glass and a paler, sweeter robin’s egg blue. Sophie and Abe have my eyes: sea green with splotches of hazel. The girls’ eyes are deep set and a little close together, like those of everyone on Michael’s mother’s side of the family. Abe and Zeke have long, tangled eyelashes, just like my younger brother, lashes so long they brush uncomfortably against the lenses of their sunglasses. The girls’ lashes are short, like mine, an injustice, according to Sophie, of near-monumental proportions. “What is the point of them getting Uncle Paul’s lashes?” she says. “Nobody cares how long a boy’s lashes are.”

  We know where the children’s eyes come from, just like we know where Rosie gets her little shiksa nose—Michael’s mother—and where Sophie gets her short waist and endless legs—also Michael’s mother; those are some seriously dominant genes. Sophie and Abe have their father’s lips, Rosie her grandmother’s, and Zeke mine.

  Each of our four children is a conglomeration of features and characteristics easily traced back to one of their immediate ancestors. The parts that seem to have sprung from nowhere, like Rosie’s waist-length blond hair or the fur on Abe’s back, are just legacies of relatives whom we have forgotten. Our genetic legacy is like a drawerful of Legos, hundreds of tiny pieces that can be snapped together in near-infinite numbers of ways. One of the delights of genetic parenthood is seeing the different unique and fabulous constructions that spring from that drawer of building blocks.

  But there are pieces of our genetic legacies, ugly brown blocks in the jumble of blues, yellows, reds, and greens, that I watch for not with excitement but with dread. Bipolar disorder so dominates my father’s side of the family that I fear there is little chance of all four of my children surviving unscathed. Of all my Bad Mother anxieties, this is the worst. The idea that lurking in my DNA is something that could hurt my children so profoundly is terrifying.

  In the scheme of genetically linked illnesses, bipolar disorder cannot compete with the pros. Unlike Huntington’s chorea or Marfan syndrome, it probably will not kill them. They won’t spend their young adulthoods waiting for a lung transplant like sufferers of cystic fibrosis. But bipolar disorder can make you terribly unhappy, so miserable that the rate of suicide is fifteen to twenty-two times that of the normal population.

  My family came to know bipolar disorder under its original name, manic depression, when one of my relatives succumbed in a manner that forced us out of our state of ignorance (or denial). One of the many miseries of bipolar disorder is that it causes you to do things that humiliate you and the people around you. It makes you ashamed of your behavior and of yourself.

  Suddenly things made sense, the way the right combination causes the workings of a lock to snap, tumble, and click into place. We understood the source of my father’s mercurial personality. While it was frightening to confront this truth, it was also a tremendous relief to give our experience a name.

  For most of his life my father cycled through moods at a dizzying pace. Even those of us who know him best were never able to get used to it. When I was a kid, my father seemed to exist on a schedule of alternating days. One day he was energetic and lively, full of stories and opinions. He would make you a cup of tea for breakfast, drive you to school, and slip you a few bucks even if you hadn’t asked for it.

  When he was up, my father was magnetic. He’s a small man, no more than five feet five even before age lopped a good two inches off his height. But although he might not have had the actual inches, he had the stature of a much taller person. No one looked down on him. He was funny and fascinating, the kind of man other men liked to listen to. And other women, too, it turned out.

  But on his down days he was impossible. Wrapped in a cloak of impenetrable silence, he would sit at his end of the kitchen table, his head bent over his plate, slowly and methodically eating his dinner. Only an idiot would risk talking to him when he was in one of those moods. While his flashes of rage were rare, they were terrifying, much worse than my mother’s more frequent fits of temper. But most of the time he didn’t get angry. He just sat there beneath a dismal cloud of gloom that made its inexorable way over the rest of the table, so in the end we all felt nearly as miserable as he did.

  Despair was a virus working its way through the house like a pernicious flu in the wintertime. Before the diagnosis we had no words to describe my father’s moods, and because we didn’t understand them to be endogenous, we accepted his judgment about the state of the world, and of our family. In a sense, we suffered from bipolar disorder along with him. When he was happy and optimistic, we were happy and optimistic, too. Things were going swimmingly; the world was a delightful place, and we were the happiest family in it. His job was great, my mom’s job was great, my little brother and I were gifted students with rosy futures. When his mood plummeted, when he could barely rouse himself from his bed in the morning, we understood that we were fucked. All of us. We had no money, we’d never have any money, my brother and I would never live up to our potential, if we even had any potential. For years—no, for decades—we all cycled back and forth, unknowingly caught in the sway of his disease.

  My father was put on lithium, a common treatment for bipolar disorder. There was an improvement, although hardly as dramatic as we all had hoped for. He seemed to cycle less—his lows were not quite as devastating, his highs nowhere near as much fun. Without those regular bouts of hypomania, he was much less productive and took to spending more and more of his time sitting on the couch immersed in a book of Soviet history or a biography of Abraham Lincoln and drinking glass after glass of that toxic concoction of Coca-Cola and orange juice that I sometimes wondered might not be in part to blame for his troubles. (Surely something so foul can’t be regularly ingested without noxious repercussions.)

  Psychiatric medication is not a panacea, although it can be critical to keeping most bipolar patients from spiraling into an unconquerable despair or, worse, flying into a mania that, if left unchecked, ends up with them handing $100,000 checks to bankroll the lawsuits of heirs to Nigerian fortunes and donning foil hats to keep the government from using microwaves to insert thoughts into their heads. The various SSRIs and mood stabilizers rarely work as well as they should, and every one has side effects that often seem worse than the ailments they are trying to treat. What’s an aluminum hat when compared with morbid obesity, diabetes, and a loss of libido so complete that you can no longer remember your sexual orientation?

  After my father’s diagnosis, it became clear that at least some of his six children inherited the genetic aberration, the as-yet-unmapped bit of DNA that causes the disease. Two of my siblings have struggled both with mania and depression and have consequently led disappointed lives on the periphery of society and even th
eir family.

  On this evidence alone I would be terrified that my children would also fall prey to the disease, but of course it is not the fact of my family’s diagnoses that wakes me up in the night and sends me to stand over my children’s beds, searching their smooth brows and sleep-flushed faces for signs of melancholy or euphoria.

  I’m scared for them because I am bipolar, too.

  Like my father and my siblings, I resisted diagnosis at first, denying the inevitable, until I realized that I was doing to my own children exactly what my father had done to me. I was terrified that, like me at their age, my children had become little mood rings on the fingers of my hand, constantly calibrating and recalibrating my shifting temper. When I was happy and calm—which was most of the time—they allowed themselves to relax: life was good, all was well with the world. But when I lost control, when I yelled at the poor clerk behind the counter at the dry cleaner’s because of a burn mark on a shirt collar, or shut myself in my room and cried at the hash I had made of my life and career, they inched closer to their father, looking to him for reassurance that things were not as dire as they feared.

  My children are luckier than I was. Michael has a far sunnier disposition than my mother, he is by nature optimistic and cheerful, and the force of his goodwill has kept them from losing their faith in the world or in their mother. But there is no doubt that I can be scary, especially when I lose myself in what psychiatrists call a “mixed state,” when one’s mood is low but one’s energy is high. In a mixed state, a red haze of anxiety and rage takes over my brain and makes me say and do unforgivable things, until my better nature shakes off the demon and promptly sinks into depression as I realize the damage I have wrought.

  After a lifetime of struggling with my moods, of cycles of rage and euphoria, of bouts of optimistic productivity alternating with pessimistic despair, I finally went to see a psychiatrist when I realized that things had gotten to the point where they threatened the stability of my marriage and my family. I had to get treatment, for the sake of my kids and my husband.

  I began taking a low dose of an SSRI, and I noticed the change right away. I no longer found myself exploding with unwarranted anger at Michael, at the kids, or at bank tellers. I did not wake in the morning and consider my life, my family, and my work with a morose and helpless gloom. On the contrary. I felt light. It was as though the acrid gray fog that had been poisoning my perception simply blew away and I could finally see and be myself.

  Then, after two weeks of pleasant calm, I found myself sitting in my bathroom, pants around my ankles, staring in shock at a pregnancy test flashing two cheerful pink lines.

  I stopped the drugs right away. I made the decision on my own, not so much consulting my psychiatrist as informing him. I’d never allowed myself to indulge in much of anything during my other pregnancies. I didn’t drink coffee, I went off ahi and Gorgonzola, I avoided the products of both Napa and Humboldt counties. It never occurred to me to stay on the meds. I wasn’t profoundly mentally ill; I wasn’t about to leap off the Golden Gate Bridge. I was just mean and unpleasant, given to fits of weeping and flashes of inexplicable rage. And isn’t that how pregnant women are supposed to feel?

  Except that I’d had two weeks of something different. I had had two weeks of contentment, two weeks of being in control. For two weeks when Sophie and Zeke fought over whether to watch Thomas the Tank Engine or The Simpsons, when Michael forgot to pick up the dry cleaning, when baby Rosie wouldn’t stop crying, when an editor passed on one of my essays, I responded with equanimity, with disappointment perhaps, but never with apoplectic gall or soul-crushing misery. I now knew what it was like to be a person whose happiness was governed by the conditions of her life, not by those of her brain chemistry. Even more important, my family now knew what the experience of stability was like. Did we really have to give it all up?

  I turned to the Internet. The pregnancy Web sites gave forth with a chorus of reassurance. Care should be taken, of course, but if my well-being required it, I should go ahead and take my antidepressants. Define “required,” I thought as I read. How bad did things have to be before I could safely put myself in that category? I read further and found a Danish study that showed no damage to infants from maternal use of SSRIs. An analysis of Swedish birth records confirmed this. I was especially comforted by this last report. The inventors of the Volvo, the very architects of safety consciousness, seemed to be telling me that even if I wasn’t in danger of slitting my wrists without it, I could still take my medication. I didn’t have to be suicidal; miserable and unpleasant did the trick. The Swedes gave me the green light.

  This time, before I did anything, I called both my obstetrician and my psychiatrist. The research I had found reassured them, too, and they agreed that I could go back on the meds. I took Celexa for the rest of the pregnancy, and managed to weather events, among them the death of my best friend, that would otherwise have sent me rocketing into bouts of volatile despair.

  Since then, however, there have been studies showing that taking SSRIs during pregnancy can cause a series of neonatal problems. Nonetheless, the CDC recently concluded that antidepressants are safe for women and their developing fetuses. And by and large, they are. The vast majority of the babies of women who use antidepressants while pregnant are perfectly normal. But some infants present with a variety of birth defects and symptoms of SSRI withdrawal.

  Abe had none of the birth defects described in the studies. Nor did he experience convulsions, constant crying, or breathing difficulties. But he did have that malformed palate, those feeding problems; he never learned to nurse, despite six months of aggressive intervention. When I read about these studies, I felt a nauseating twist in my gut. It sickened me to think that the treatment I took for my disease might have damaged him. For a long time I assessed every one of his flaws and minor disfigurements with the cold eye of a clinician, appraising and evaluating for subtle hints of gestational damage. I wondered if his chin failed to drop forward at seven weeks’ gestation when it should have because of the medication I took. I wondered if his failure to latch onto my breast was a sign of something deeper and more profound. I Googled the words “hirsute” and “birth defect.” I cupped his sweet, long foot in my hands and worked his little ankle, trying to figure out if the limp he had when he first learned to walk could really be blamed on womb positioning, as the doctor said, or if, somehow, the drugs that made me feel so good could have caused my baby to hover uncomfortably in the very place in which he should have been most secure.

  I feel for the pregnant women facing this decision. It’s hard enough to be either pregnant or depressed, let alone both, without having to make sense of conflicting medical research and objectively evaluate the quality and seriousness of your own despair. Add to this the cacophony of condemnation from the Bad Mother police, damning you if you expose your baby to medication and if you don’t, and the decision seems nearly overwhelming.

  Had these various studies been published before I became pregnant with Abraham, I would have tried harder to do without my medication. I would have tried, knowing the toll it would have taken on my older children, my husband, and myself, in order to spare Abe any potential harm. I would have done this, whatever my doctors’ considered sound advice, bracing myself for months of upheaval and unhappiness and strapping my family in for a very bumpy ride.

  But I didn’t know. Those studies weren’t available to me. It is of course not my fault—you can only make the calculus based on the information that you have. And so, even as I fret over the chances of any of my children becoming bipolar, I am especially worried about what I may have done to Abe.

  Since my diagnosis, my disease has been more or less controlled. Unfortunately, however, medication and cognitive behavior can only go so far in reining in the bipolar demon, especially if you resist, as I do, the more hard-core drugs. Although I always take my medication, and never miss a therapy appointment, there are times when, in spite of my diligence, I
begin to cycle. The red haze descends and I find myself lying in bed, weeping with shame because I sent a hateful e-mail, fought with my husband, or screamed at one of my children at the top of my lungs.

  Of my various concerns for my kids, I think I am marginally more worried about my disease hurting them, warping who they will become and how they will live in the world, than I am of what will happen to them if they are themselves bipolar. But that’s sort of like trying to compare my fear of being attacked by a shark with my fear of being eaten by a mountain lion. It depends on where I am; in the ocean I am in a semi-constant state of shark panic and don’t waste worry on land predators; when I am hiking alone in the hills above our house, where the paths are posted with mountain lion warning signs, I’m not particularly concerned about being mistaken for a seal. I frequently wake up in the middle of the night with terror clutching at my throat and belly, wishing my beloved children had a mother who deserved them, and just as often I lie awake parsing out their temper tantrums, looking for signs of an unusual loss of control.

  When I am feeling stable, I understand that there are worse legacies. I tick off the myriad of genetically transmitted fatal diseases. All four of Michael’s grandparents died of cancer, as did his aunt and his uncle. God forbid he passed on some as-yet-unmapped cancer-related genetic defect.

  Moreover, the dirty little secret of bipolar disease is that it’s not all bad. It is often strongly correlated with creativity. I’m not the only writer who does her best work while hypomanic. When I am feeling most like a literary fraud, like a lawyer who managed only by dint of a lucky marriage to publish ten books and dozens of essays, I take great comfort in knowing that although I might not share the talents of the writers whom I best love, I share their disease. If my kids are crazy like me, they’ll also be crazy like Virginia Woolf, F. Scott Fitzgerald, Leo Tolstoy, William Faulkner, and Henry James.