“No one,” she retorted, frowning at me. “I want to talk to you, Pat. I want the truth.” She looked furious.
“The truth about what, babe?” I tried to act relaxed even though my palms were sweating.
“I want you to tell me the truth about everything.” Her response was slow, her voice loud and firm.
“Mia, I wish I had the answers to everything, I really do. But I don’t.” I said it with a forced smile, pretending like we both knew that what she was requesting was impossible. “Before I left, you wanted to review what had happened, didn’t you?”
“Yes, I did,” she replied, her demeanor suddenly changing. My muscles relaxed slightly. Maybe I could manage her like a toddler, changing the subject when necessary.
“Okay, let’s grab a piece of paper, and we can go through things,” I suggested. She seemed interested in this new line of discussion, so I wasted no time in snatching my notebook and pencil.
We spent the next hour reviewing the events of the past week in excruciating detail. We had to list incidents chronologically, broken down into fifteen-minute segments. Mia had always been meticulous, and she approached this like a scientist recording the results of an experiment:
Sunday, 5:30 a.m.: wake up Pat, concerned about prison
Sunday, 5:45 a.m.: get into shower
Sunday, 6:00 a.m.: start getting ready for church
Many times, she would demand that we go back to the beginning to make sure we hadn’t missed anything. She didn’t remember much from Sunday or Monday, but she was certain that clues were hidden in the past, so she kept asking the same questions over and over. It took every ounce of my patience.
After an hour, it appeared that the Ativan was kicking in. She no longer seemed as angry, but her thoughts were becoming more scattered. She kept hopping around the conversation like,
“What happened after we arrived at the emergency room?”
“Well, then you went back with Mark while I filled out the paperwor—”
“What kind of bird is that out back?”
“It looks like a—”
“Is that a stain on the drapes over there, or is that blood?”
“It can’t be blood, it must be—”
“Why can’t it be blood, Pat? What do you know about those drapes?”
After this last accusation, I rubbed my eyes with my hands in frustration.
“Why did you do that, with your hands right there? Why did you do that?”
That was our afternoon, going around and around in circles. At times, she would become hung up on specific words, finding links among them that weren’t there. It was like playing connect the dots with homonyms. She would say things like, “Look at that pair of shoes. I need to pare down my thoughts. I think I have a pear in the kitchen. No, someone ate it. Eight. 3, 6, 8, and 9. Those are the numbers: 3, 6, 8, and 9 . . .”
At one point, I proposed watching a movie, hoping it might help to focus her attention. We had a television in our room, and I noticed a disc lying nearby. She half-heartedly agreed, so I put in the film. It was the animated movie Up.
I had never seen Up and had no idea what it was about. In the first ten minutes, a couple grows old together and then the wife dies. That started Mia talking about death, about how one of us was going to die before the other. She was trying to figure out which one of us would go first, like maybe those special numbers had something to do with it. “Will I die first? 3, 6, 8, and 9. Nine. Nine. Is that right? Nein. I don’t know whether it is. Check the weather. It looks like rain. Someone needs to take the reins . . .”
Quickly turning it off, I suggested instead that we watch home videos. We had taken hours of movies of the kids when they were little, and we had them all nicely organized by the bed. I hoped they would keep thoughts of death and secret connections out of her head.
As the movie started, a three-year-old Will ran around the house in a Spider-Man costume. A one-year-old Jamie followed closely behind, dressed like a fairy princess with wings and a magic wand. Our little dog raced after them both, barking loudly.
“Look at Celia, she’s so frustrated that Luke is getting all the attention,” sighed Mia, not realizing that she had replaced our kids’ names with those of her two youngest siblings. I let it go; correcting her didn’t seem necessary. But as the movie played on, she became even more confused.
“I should have given Celia more attention,” she said. “I really should have. Wait, is that Luke? No, that looks like Will.” She stared at the screen intently, concentration creasing her face. “It must be Luke. No, no . . . that looks like Will.”
“Yeah, that’s Will and Jamie, babe. These are our home movies, not your parents’.”
She was upset that she had made the mistake and wanted the movie turned off. It was too difficult for her to follow. We reverted to poring over events of the prior week. I kept glancing at the clock, like a student in class who can’t wait for the bell to ring. We heard the kids return from school, but we never left the room.
After a while, I sensed that Mia was aware that something was wrong. I used the opportunity to broach the use of her phone, suggesting that she limit calls to only her closest friends. She agreed, and we wrote down the people she could contact. It wasn’t a long list, and I hoped it would curtail her external communications.
When Lucia finally knocked on the door to tell us that dinner was ready, I was willing to chance an interaction with the kids. My mind was exhausted from trying to follow the thoughts racing through Mia’s troubled mind, and I needed the escape.
I greeted Will and Jamie in the kitchen, but Mia remained subdued, barely addressing them. The food was already on the table, so we all sat down. I was watching Mia closely; it was taking all of her willpower to stay quiet.
Jamie’s imagination usually came alive at the dinner table. She was talkative and liked to share whatever had transpired at school that day. “Let’s play high-low,” she suggested. High-low was a game we played most nights. It consisted of going around the table with everyone saying both the best and the worst thing that had happened to them that day. “I’ll start!”
“Okay,” I said, hoping that Jamie’s talent for make-believe wouldn’t become an issue.
“My high was: I found out I have a superpower today!” She smiled broadly. “I can hover off the ground. Watch this. Just watch my feet, and you’ll see!” She stood up, putting a hand on the chair to either side of her. She then used her arms to push herself up, bringing her feet off the ground. “See? See my feet? I’m flying!”
Usually, Mia and I would play along, exclaiming that we always knew that she was a superhero and bragging about what lucky parents we were. Instead, my reaction was muted, and Mia was scandalized. She was looking from Jamie to me and then back to Jamie again.
“Oh, Celia, you don’t really have the ability to fly,” she said. She turned to me. “Pat, she doesn’t really think she can fly, does she?”
“No, she doesn’t think that,” I muttered, feeling awful. Jamie was devastated and certainly noticed that Mia had used the wrong name. “But you know our Jamie, she definitely has superpowers!” I said, tousling Jamie’s hair and stressing her name.
The game stalled after the kids realized that their mom was acting weird. We finished the rest of the meal in a combination of broken conversation and awkward silence.
After dinner, Mia and her mom returned to our room. Lucia had offered to take over so that I could spend time with the kids.
I always read to them before bed. That night, after they were ready and settled, I paused before launching into the book. “Have either of you noticed that Mom hasn’t really been acting like herself?” I asked, unsure if I was making a parenting mistake. But I knew that in their position, I would want answers.
I looked first to Will. He sat silently, but I saw relief on his face. He was clearly thank
ful that I had broached the subject. Jamie was fidgeting with her sheets, perhaps still feeling the sting from the game of high-low.
“I only ask because . . . well, I have noticed,” I admitted. “That’s why I was home today with her while you were at school.”
“Mom was already in the hospital,” Will whispered. “I thought she was all better.”
“Yeah, that’s what Uncle Mark and I thought, too.” I tried to sound as confident and soothing as possible. “But sometimes, you know, when we get sick, we might think we’re better, but we still have some of the sickness lingering around.”
“Sometimes I have a runny nose even after my sore throat goes away,” said Jamie, helpfully trying to support my argument.
“Right, and that’s what Mom has right now. Well, not really a runny nose,” I said, attempting to get a laugh by implying that runny noses were gross. They both giggled a little.
“Look,” I said, “you know how when you have a cold, and your nose isn’t working right—it’s either runny or it’s stuffed up, and you can’t control it?” They were both nodding. “Well, that’s what’s going on with Mom right now. It’s like she has a cold, but the cold isn’t in her nose, it’s in her brain.”
“She has a cold in her brain?” asked Jamie, trying desperately to follow my explanation.
“Well, not actually a cold, but like a cold,” I replied. “What it means is that Mom’s brain isn’t working properly right now, and she can’t control it. She’s still the same Mom who loves you more than anything, though. She just isn’t acting like herself right now.”
“Okay,” said Jamie, who seemed satisfied with the explanation. Will sat looking down at the pillow he was sitting on.
“But she’s going to get better, I promise, just like you get better every time you have a cold,” I vowed. “It’s going to take some time, though, and so we have to be patient with her. You know how she’s always patient with you when you’re sick?”
They were both nodding again. “So, let’s be as patient as we can and remember that Mom really needs our help right now.” I was going to leave it at that, but then I added, “Oh, and one more thing, let’s keep Mom’s sickness to ourselves. It will be our secret, okay?”
Looking back, this last part was shameful. I was reinforcing the stigma, teaching our kids that mental illness shouldn’t be discussed openly.
“Right. Now, it’s time for a group hug and then on with the story!” I exclaimed in a happy voice, oblivious to the inexcusable way that I had ended the conversation.
Later that night, after the Restoril had taken effect, I crept to the back room and started dialing every person on Mia’s contact list. It included her closest friends, not only from Sarasota but also from college and her hometown in New Jersey.
A half dozen people were on the list. For some, I left a message and followed up with an email. A few answered my call, and I provided a full update. I tried to keep the conversations short, given that it was past 10:00 p.m., but it wasn’t easy. Understandably, Mia’s friends were in shock. It felt good, enlisting other trusted individuals in my crusade to support her.
By the time I crawled back into bed beside Mia, it was past 1:00 a.m. It was my first chance to relax all day. Lying there in the silence of our room, I relished the tranquility. I knew it wouldn’t last.
The next morning, after seeing the kids off to school, the torture with Mia began again. She continued to believe that clues to some kind of cosmic puzzle were hidden in the past. Mia was now scrutinizing an actual calendar day by day, recording every detail. This included not only the events of the recent week but also several weeks prior.
Her thoughts remained scattered, and she jumped from one idea to the next. We talked about memories from her childhood, things that had happened at Harvard, and incidents with the kids. We would kind of hover over an issue for a while, and then we’d abruptly skip to another topic. Periodically, she would stop and brusquely demand the truth.
Once, when I was a kid, my parents took us to Mexico. As the taxi pulled into our beachside resort, I saw a row of security guards holding machine guns. I didn’t feel immediately threatened; the guns weren’t pointed at me. But the atmosphere had a sense of potential combustion, like one wrong move and the bullets would start flying. It was the same sensation being trapped in a room with my psychotic wife.
By the time we were in the car headed to Dr. Martinez’s office, I had become more experienced in dealing with the situation. I kept my movements to an absolute minimum. Any action of my limbs or turning of my head would trigger Mia. She would try to find the underlying meaning in anything and everything. If the tenor of my voice changed, or even if I sighed, it would instigate an investigation:
“You just scratched your cheek, why did you do that?”
“Um, because I had an itch there.”
“Why the hesitation, Pat? Why won’t you tell me the truth?”
It was an acquired skill, concentrating mightily to stay absolutely still, talk without emotion, and carefully choose every single word. The guise took effort, but it was certainly easier than dealing with the repercussions.
Walking into Dr. Martinez’s lobby was my first experience with a psychiatrist’s office. I have found that they are all similar. You have the quiet receptionist to greet you and wave you into the waiting area. This usually consists of a leather couch, a couple of chairs, and a table. On the wall, you will see comforting pictures of landscapes or sunsets with phrases like “Take the time to smile” or “Tomorrow is another day.” And then there is the noise machine; there’s always the noise machine. The sounds of white noise or falling water cover any voices that might leak out of the doctor’s office. They also give the patient something to concentrate on instead of searching for the underlying meaning in every sound.
After ten minutes, Dr. Johnny Martinez came into the waiting room and greeted us. He was about our age, in his late thirties or early forties, thin and athletic looking. He seemed jovial, guiding us with a smile into his office. Mia and I sat together on a couch facing his desk.
“So, how are you feeling today, Mia?” he asked.
Mia’s response was haphazard. He asked a couple of other questions. She was meandering through disjointed thoughts, telling him about her search for hidden meanings. I sat quietly, without moving a muscle. He must have noticed my discomfort; he kept glancing at me while Mia struggled through her answers.
Finally, Dr. Martinez turned my way. Mia was in midsentence, but he kind of cut her off. He picked up a whiteboard.
“Pat, this is what is happening. I want to explain it to you.” He grabbed a black marker, drawing a person’s head and then outlining a brain inside. “Let’s say this is your wife’s brain.”
Mia looked angry. She didn’t like being ignored and was trying to get his attention.
I gave him a wondering look like, Why aren’t you talking to Mia, too? He dismissed my glance with a shake of his head. “She’s not going to remember any of this, so I am telling it to you. You are the one who needs to hear it.”
“Okay,” I said, hoping that Mia didn’t see it as some sort of betrayal.
“As I was saying, let’s say this is your wife’s brain. The way the brain functions is through neurotransmitters. There are a whole lot of these, but I want to focus on just two, dopamine and serotonin.”
He grabbed a green marker and started writing little D’s across his cartoon brain. He then switched to a red marker and added little S’s. “This is a normal-functioning brain. You see how the dopamine and serotonin balance each other out?”
“Yes.” I liked the way he was explaining it, simple but not patronizing.
“Well, in your wife’s case, that is not happening.” He started to erase the S’s until only a few were left. He then grabbed the green marker and added a bunch more D’s. “Your wife’s brain has an overabundance o
f dopamine, and it’s causing her thought disorder and paranoia.”
“Okay, so what do we do?” Mia had given up trying to get Dr. Martinez’s attention, but she wasn’t listening to his explanation. She seemed focused on the light fixtures.
“How much Seroquel did you say she was taking?”
“She’s taking twenty-five milligrams twice a day.”
“No, that’s not nearly enough. I want her taking six hundred milligrams per day.”
“What?” I cried. “Dr. Martinez, that is more than ten times her current dose!”
“I am aware of that,” he said. “Has your wife struggled with depression?”
“No, she hasn’t. I mean, she felt down for a week or two after our son was born, but nothing major.”
“That doesn’t really count,” he said, pulling a huge book off the shelf. It was the first time I had seen that particular book, but it wouldn’t be the last. It was called the Diagnostic and Statistical Manual of Mental Disorders, or DSM for short. It was the holy grail of answers for mental health practitioners. It included descriptions for every accepted mental illness. “Interesting,” he commented.
“What’s interesting?” I liked Dr. Martinez and wanted to learn more from him.
“I’d be willing to bet that your wife has bipolar disorder. I mean, this looks like classic manic psychosis.” He was talking to me while flipping through the large textbook. “There it is. Yep, that’s what I thought.” He glanced up with a look of concentration. “One doesn’t need to suffer from mania to be bipolar. You need only have depression to be considered bipolar. But mania alone doesn’t do it.”
“Okay . . . but I’m not following.”
“Your wife is manic. At least, that’s how she is presenting. But she doesn’t suffer from depression. The DSM would say, therefore, that she is not bipolar.”
“So, you haven’t seen this before?”
“Well, mental health is not an exact science, Pat.” He closed the book. “But no, I haven’t. I see many patients that are bipolar. And that’s how I’d suggest we treat this. We’re going to increase the Seroquel dramatically. We’ll continue using the Ativan and Restoril, that won’t change.”
Safe, Wanted, and Loved: A Family Memoir of Mental Illness, Heartbreak, and Hope Page 7