Unhinged, page 1
A Memoir of Enduring, Surviving, and Overcoming Family Mental Illness
ROWMAN & LITTLEFIELD
Lanham • Boulder • New York • London
Published by Rowman & Littlefield
A wholly owned subsidiary of The Rowman & Littlefield Publishing Group, Inc.
4501 Forbes Boulevard, Suite 200, Lanham, Maryland 20706
16 Carlisle Street, London W1D 3BT, United Kingdom
Copyright © 2014 by Rowman & Littlefield
All rights reserved. No part of this book may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval systems, without written permission from the publisher, except by a reviewer who may quote passages in a review.
British Library Cataloguing in Publication Information Available
Library of Congress Cataloging-in-Publication Data
Berry, Anna, 1974–
Unhinged : a memoir of enduring, surviving, and overcoming family mental illness / Anna Berry.
Includes bibliographical references.
ISBN 978-1-4422-3362-1 (cloth : alk. paper) — ISBN 978-1-4422-3363-8 (electronic)
1. Berry, Anna, 1974– 2. Mentally ill—United States—Biography. 3. Mentally ill—Family relationships—United States. I. Title.
TM The paper used in this publication meets the minimum requirements of American National Standard for Information Sciences Permanence of Paper for Printed Library Materials, ANSI/NISO Z39.48-1992.
Printed in the United States of America
Although this is chiefly a work of nonfiction, certain portions of this narrative have been altered from the actual events. Names and identifying characteristics of everyone depicted in this book as well as certain institutions and locations (including the city and state of my birth) have been changed in order to protect the privacy of the persons involved; certain details of actual incidents have been altered for the same reason.
I have also compressed the timeline of certain events for narrative purposes. Some conversations between me and other depicted persons have been reconstructed to the best of my ability from long-ago memories that may have altered over time. The two psychotherapists who figure prominently in this narrative—Dr. Chatterjee and Dr. X—are composites of several different psychotherapists I had over a period of many years, and the therapy sessions I describe with these characters are composites of the discoveries and insights I made over more than fifteen years worth of psychotherapy.
I hold no personal malice against anyone depicted in this memoir, even those who may feel they may have been portrayed negatively. I believe that in all cases I have been true to my own recollections and opinions of events, and I have also tried to be fair in my depictions of those events. My purpose for writing this book is solely to help educate the public about the crippling effect family mental illness has on society at large, as well as to help reduce the stigma associated with it by showing that while mental illness is a chronic condition, it is also a treatable condition—not to mention a condition that affects a majority of American families in some way, shape, or form.
It is my sincere belief that no one should be ashamed of mental illness, whether they have it themselves or whether it affects someone they love. I hope this book helps you, the reader, learn more about the challenges of living with mental illness, while offering hope and healing to the afflicted.
Prologue: Chicago, April 2002
I am sleeping in a flophouse. An actual flophouse.
The kind of joint where heroin addicts and transient alcoholic men sleep. The kind of joint twenty-eight-year-old women with master’s degrees from the University of Chicago should only encounter on the pages of a fifty-year-old pulp fiction paperback procured from the rare-book store on the corner of Belmont and Sheffield.
I am sleeping in a flophouse. Well, not sleeping, really. Crying, shaking, shuddering with disbelief at how this could possibly have happened to me, yes. Sleeping, no.
An old man is screaming obscenities at the stale air in the room next door. The bedspread smells like a mixture of urine and imported clove cigarettes. The dirty, cracked window has an old-fashioned roller blind stained brown with at least fifty years’ worth of tobacco smoke and grime.
The bed sags so far in the middle that the mattress touches the floor, which is carpeted with an ancient horsehair rug that smells like a stable. The lamp has no shade, and the desiccated remains of a horsefly are stuck to the stark yellow bulb.
I am sleeping in a flophouse with a cheesy name—I’ll call it “The Sunflower Arms,” though the rundown joint isn’t sunny, and no self-respecting flower would be caught dead in the place. It’s a six-story pile of sooty bricks complete with the stereotypical flickering red-neon sign advertising “FREE COLOR TV” and “TRANSIENTS WELCOME.” The Sunflower Arms is the only lasting remnant of the skid row that this posh North Side neighborhood once was, until the real estate developers and Yuppies took it over in the late 80s and early 90s. It’s the only place where a poor girl down on her luck like me can flop for the night with no luggage, no change of underwear, no contact solution or deodorant—not to mention no dignity—all for the bargain price of $29.99, plus tax. Except I don’t have the money for the tax. I have only thirty dollars and a nickel, and that’s not enough to cover the room and the $4.97 in Chicago and Cook County hotel taxes.
I also have no credit card, only a debit card linked to a checking account that is at least a hundred dollars overdrawn. But that’s okay with The Sunflower Arms. The emaciated, bearded man who gives me the room doesn’t even ask for my ID, let alone a credit card. When I tell him I don’t have the extra five bucks to cover room taxes, he shrugs, hands me my key, and says, “Just pay it next time, hon.”
As if there will be a next time.
The emaciated clerk watches me climb the moldy stairs (the rusty cage elevator is Out of Order) and shakes his head. I hear him say to some unseen person in the back office that I am the first single white woman he’s seen check into The Sunflower Arms in more than a year.
I guess I can understand why. The Sunflower Arms isn’t exactly the kind of place that makes a single, white, graduate-educated female in her late twenties feel safe. I’m only up one flight of stairs by the time I see my first dead rat. The whole place smells of death, actually. Old cigarettes, dust, moldy 1940s-era upholstery, and death. I’m sure that most of the women who’ve stayed here over the years were prostitutes. I can almost feel their collective shame oozing from the peeling plaster walls.
My room is on the fourth floor, at the end of a dimly lit hallway. My key sticks in the lock; I have to jiggle it several times before I can open the door. That’s heartening, at least—maybe that means it will be hard for anyone to break into the room during the night. Still, it isn’t as if I have anything valuable left to steal. And I doubt any of the drugged-out, strung-out old men staying in this hotel would have the stamina to try raping me, anyway.
The room is awful, of course. But I suppose it could be worse. There isn’t the corpse of a dead junkie in the closet, or a pile of shit in the bathroom sink, and the toilet and shower work fine. Most of the room is filthy and reeking, but the bedsheets are clean, cool, and pressed. And there aren’t any dead rats or bedbugs behind the headboard. (I check.)
When you get to the end of your rope, like I have, you learn to
As I settle into the sagging, creaking bed, my mind settles on one thing. Why am I stuck sleeping in a flophouse, flat broke and with no toothbrush or change of underwear when my place of residence—a cozy bedroom in a decent-but-not-fancy Lakeview apartment with a marble bath and remodeled kitchen (the very same bedroom I share with my boyfriend, Dean)—is less than two blocks away? How can a sagging flophouse bed and one city block be the only things separating me from that decent-but-not-fancy Lakeview apartment and life on the street?
The answer to that one is easy.
Wacko. Looney-Tunes. Insane. Psycho. Disturbed. Distraught. Unstable.
Or, as my boyfriend’s best friend has so aptly put it, “The misbegotten spawn of Satan, a female succubus witch-bitch.”
And a crazy Satanic female succubus witch-bitch at that.
It doesn’t matter that I have a good education. It doesn’t matter that I used to have a good job. It doesn’t matter that my home (or it had been my home until an hour or so ago) is only a block or two away. It doesn’t matter that I am young and single and attractive and alone.
None of it matters.
Because when you’re a nutjob, sleeping in a flophouse with five cents to your name is all you might ever expect.
I’ve had a lot of psychotherapists. More than I can remember, actually. When you spend as many years in psychotherapy as I have, the therapists—male, female, psychologist, guidance counselor, licensed social worker, psychiatrist, ordained minister, whatever—all start running together like a melting watercolor painting, until I can no longer visualize their individual faces in the overstuffed archives of my memory. The region of my brain dedicated to self-improvement and self-analysis is stuffed to the brim. I’d need another ten years of therapy just to recatalog the scores upon scores of therapy-session transcripts, the passive-aggressive defense mechanisms, and the battles with insurance plans and employers over co-payments and time off that are stored between the thousands of neural synapses in my frontal lobe.
The true nature of my various psychoses rests buried somewhere beneath a tangled demilitarized zone that built up slowly from the subtle manipulations and emotional games of chess between me and many different therapists. I was often an uncooperative patient too, which didn’t help matters.
There’s an old joke that circulates around and around—I heard it first when I was in college over twenty years ago, and I still hear someone tell it at least once or twice a year.
Q: “How many psychotherapists does it take to change a lightbulb?”
A: “Just one, but the lightbulb has to want to change.”
Truer words were never told—and that’s precisely why this tired old joke always gets a laugh from me, no matter how many times I hear it. I spent many years in psychotherapy running around and around on the same hamster’s wheel, sprinting and sweating yet never getting anywhere, simply because I didn’t want to recognize my own role in my ongoing mental misery. But there comes a point in almost every mentally ill person’s life when she concludes she doesn’t want to live like that anymore, and finally she decides to put her nose to the grindstone and get to work. Whether that means finally taking meds as prescribed, or keeping weekly therapy appointments, or dumping all the liquor down the drain, or switching therapists—or just doing the hard introspection required to recognize and change destructive behavior patterns—it’s all hard work.
And truly hard work is seldom fun. Hence, we avoid it.
And sometimes, the most difficult task of all is just finding out what is really wrong with you in the first place. For example, even after seeing at least (that I can remember) twenty different counselors, shrinks, social workers, psychiatric residents, and therapists over a period of fifteen years, I never once got the same clinical diagnosis.
Not once. Ever. Had I received overlapping diagnoses, I may have been more accepting of one, but it’s difficult to see where I fit in when so many professionals have had so many different diagnoses. And I can’t say that I agreed with any of the suggested disorders in my case anyway. Not only that, but some of the diagnoses I got at various times are either no longer categorized as illnesses by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) at all, or else they’ve gotten merged with other, “new” disorders. Trying to keep up with all the recent changes in diagnostic criteria isn’t just hard for psychotherapists and medical billers—it can wreak havoc on patients too.
It’s a common problem: few if any people fit perfectly into the rigid boxes constructed by the DSM-V, the manual the American Psychiatric Association uses to categorize mental illness, which the health insurance industry in turn follows when it comes to paying for therapy—or far more often, psychiatric drugs. If my own experience is any example, this is one case where the one-size-fits-all approach of so-called cookbook medicine just doesn’t work. And if you can’t even get diagnosed with the right illness, it can be downright hard to receive the right treatment—let alone get better. Let me show you what I mean.
I’ve been diagnosed as having any and all of the following at one time or another.
Clinical depression (also known as major depressive disorder). I’d definitely say I’ve been depressed. So have millions upon millions of other people. But I don’t fit the criteria for clinical depression as outlined in the DSM-V, which requires I have at least five of their nine possible listed symptoms every single day. I had maybe two or three symptoms at best, and not every day. True, I often had feelings of sadness, even to the point of being suicidal at times—but I was missing several other criteria as required by the DSM-V. Despite what the diagnostic criteria say about depression, I never lost interest in my favorite activities, nor did I have difficulty concentrating at work or at school—quite the opposite, in fact. My weight didn’t fluctuate up and down, nor did I have significant problems with my sleep patterns. I did have the inappropriate fascination with death and the dark moods that went on for weeks at a time that the diagnostic criteria require, but the rest of the picture was missing. Which might be why I wasn’t given prescription medication for my depression, but then again, who knows? Whatever the reason, I got crammed in a box that wasn’t the right size for me. If anything, I believe my depression was actually a symptom of other disorders, which I’ll elaborate on later.
Manic depression. Well, sure. Many creative artists like me have this to some extent, as our creative juices ebb and flow in cycles that can seem like a roller coaster at times. We might be super-productive for a day or two, then tired and blocked the next. I’ve sometimes gone for weeks having to force myself to write despite a profound lack of inspiration, which can be downright painful. But I still couldn’t agree with this diagnosis because I did not experience bouts of clinical mania. No going around for days without sleep, no frantic attempts to start a bazillion projects that I never finished (indeed, I’m known for my discipline, attention to detail, and ability to meet deadlines even when I’m feeling at my worst). I did have the occasional shopping spree, and I was what some would call promiscuous, but I wouldn’t call either one of these tendencies manic. “Manic depression” is also an antiquated definition of what is now known as bipolar disorder—which itself now has two types according to the DSM-V: bipolar I and bipolar II. (And I haven’t been diagnosed with either one of those.)
Severe bipolar disorder (non-artistic personality). Never bought this one. At the time I received this diagnosis, the DSM-IIIr was in vogue, and it used different diagnostic criteria than those in use for bipolar disorder today. This diagnosis also suggests that I would not be able to function well on a daily basis. But I could, just perhaps not always well. This disorder is now known as bipolar I disorder. A different variation is bipolar II, which wasn’t even identified as a distinct illness until 1994 and still remains a difficult diagnosis for most psychotherapists
Borderline personality disorder (BPD). I should point out that there is currently considerable dispute in the psychotherapy community whether this is a legitimate diagnosis at all—even to the point that some insurance companies refuse to reimburse for BPD treatment, and some psychotherapists will even refuse to treat BPD patients. It’s even referred to rather flippantly by some in the psychotherapy community as the “garbage bin diagnosis,” according to Psychology Today. But it’s the label that has been applied to me the most often by far, so I’d say there’s more than a grain of truth to it. But given the fact that none of my many therapists could ever agree on what was wrong with me, it seems fitting (and appropriately hilarious), then, that I’m chronically ill with BPD, a disease that many clinicians apparently don’t consider a disease at all.
The current disease criteria for BPD in the DSM-V state that BPD patients have a history of unstable personal relationships and poor self-image, impulsive behavior (like overspending and sexual promiscuity), chronic feelings of emptiness, and difficulty controlling anger. But, frankly, most young people have all of these problems at one point or another—it’s called being young. Indeed, the American College of Pediatricians says that young people’s brain and emotional development, especially in the frontal lobe that regulates emotional impulses, are not fully complete until their mid-twenties—and therefore adolescents are especially prone to impulsive behavior and unstable relationships. If the disease criteria for BPD in the current DSM-V are to be believed, it seems to me most young, single women in America have BPD to some extent, which would make having at least some of the criteria for BPD perfectly normal for women in their late teens and early twenties. Indeed, there is quite a range of behavior and severity chalked up to the disorder, covering the extremes of suicidal behavior on one end, mere serial monogamy on the other, and just about everything in between. Susanna Kaysen of Girl, Interrupted fame was locked up for almost two years for being “borderline” in the 1960s, while most contemporary psychologists say her condition at age eighteen would barely merit more than a few cognitive therapy sessions—or at worst, a very brief hospital stay followed by psychotherapy. Drugs tend to be ineffective against BPD, experts say, though they are still frequently prescribed.