For a long time, insanity was called normal in our family and we were chided for drawing attention to its symptoms. “That’s just the way she is” became a way to smooth over the rough truth.
Me: “Hi, Mom, it’s me.”
Mom: “Bonnie. Calling from San Fran-cis-co (the last word was sung to the tune of a popular song). How are things up there?”
Me: “Well, not great. Something’s wrong with Tilda.”
Me: “She hasn’t come out of her room except to eat once or twice, for a few days now. She’s sleeping a lot … you know … that kind of stuff, and I think she needs some, you know, help.”
Mom: “Oh? Like…what?” (Good, she was paying attention now. The wine buzz or whatever accounted for that giddy lilt in her voice had abated some.)
Mom: “Are you sure you’re not making too big a thing of it? You know how she is.”
Oh, I knew how my sister Matilda was, how she had been my entire life. I had early memories of watching her from the safety of my high chair when she was six and I was two. She would sprawl on the floor in a raging tantrum and all conversation would stop amid the roars and thrashings. It was a regular feature of our family meals.
But now we were sharing an apartment overlooking Twin Peaks and the San Francisco Bay. At nineteen, I was beginning to feel that my parents had sent my moody, socially awkward, and unemployed older sister along not so much to watch over me as to get her out of the family home in Los Angeles. My departure for acting school had presented them with a perfect solution to the question, “How do you solve a problem like Matilda?”
My parents met during World War II, having both joined the Coast Guard and been stationed in Seattle, Washington. Each felt they had escaped a problematic first marriage by “running off to war.” They were also both lieutenants—although my mother ranked higher than my father. As civilians, both had previously been active in the performing arts. In fact, the couple had more in common at the time of their first meeting—reportedly at an officers’ party at Eleanor Roosevelt’s vacation cabin—than they would ever have again in their 41 years of marriage.
My mother, Margie, a Chicago banker’s eldest daughter, instantly attracted my rugged father William with her brash style and theatrical antics. A struggling actor who had joined the war effort like others his age, my dad proudly served as a “damage control officer” on the weather ship USS Pocatello for most of the war. Cue the music for the wartime romance that ensued. At some point during 1944, my eldest brother Christian was conceived and carried through the stressful days and long nights of my mother’s service as a shipboard communications officer in charge of decoding radio messages from the enemy.
The Coast Guard had recruited my mother into its electronic communications program after viewing her high school and college transcripts and running a battery of entrance tests that illuminated her superior language skills. Most impressive, though, was her previous job at CBS Radio in Chicago, along with her proficiency at a word game called Double Acrostic. These were the days before computers did all our heavy mental lifting. The military needed to seek out humans with minds that were adept at picking words and sentences out of a jumble of random letters and word combinations coming across the wires.
The newlywed couple’s competency and patriotism did nothing to prepare them for the sudden death of their first child at the age of six weeks. No doubt, mistakes were made during the pregnancy. Possibly cigarettes were smoked and scotch was swilled. But they were engaging in the good and stressful fight of the “Pacific Theater.” Possibly they wondered if their loss been punishment for the adulterous beginnings of their relationship?
The peacetime that followed brought two daughters in quick succession. My mother conceived her eldest daughter alarmingly soon after Christian’s crib death. There could not have been enough time to recover physically, let alone emotionally. This child, whom they named Matilda for the song “Waltzing Matilda,” entered life in a problematic state. The official diagnosis was an endocrine disorder called achondroplasia. She might have become a dwarf without medical intervention and the use of androgen and thyroid hormone treatment.
More significant than any birth defects, however, was the painful baggage that was left unclaimed by my brother’s sudden and tragic departure. No doubt, this led to my parents’ lack of emotional attachment to their new baby during her first few months of life. Terrified of finding another deceased infant in its crib, my mother very likely withheld her crucial maternal bonding. First reported in the infamous 1950s study with primate infants, a newborn deprived of physical, nurturing love will thrive measurably less than one who is held and coddled. More than any other factor, this attachment failure would go on to take a toll on Matilda in the form of lifetime emotional and developmental difficulties. She never married nor, to my knowledge, even had an intimate partner or adult love interest, a deficit that she shared with the poorly attached Rhesus monkeys in the study.
Unlike our brother Will, Matilda’s life was never in actual danger from her congenital disorder. Yet, statements my parents made over the years, such as “She was a very sick little girl,” “She’s lucky to have made it,” and “Once she made it through that first six weeks” hint at the trepidation my parents felt in dealing with their infant daughter. Thus, when their next daughter emerged from the womb a scant year later, her skin the shade of golden daffodils and her liver’s bilirubin count off the charts, their chagrin must have been palpable.
Newborn jaundice (as opposed to hepatitis or cirrhosis of the liver) is fairly common and can usually be corrected while the infant is still in hospital. The treatment is often to “bake” the baby a bit more under phototherapy lamps. The lights change the excess bilirubin in the baby’s blood into lumirubin, which is then more easily metabolized by the infant’s liver. Baby Emma’s long, narrow, and yellow physique quite possibly did not appeal to her parents’ aesthetic senses, but at least she could accompany them home after her baking.
Forty years later, in the late 1980s, my two older sisters began to melt down like the twin towers later would on 9/11. First to go was my sister Matilda, who by now was on her tenth course of antidepressants after prolonged periods of dysfunction and “the blues” interspersed with vehement rejections of any formal treatment. After a fight with our mother over her financial indebtedness one evening, she took all of her pills and then called the paramedics. She would repeat this behavior a few more times, over the next decade. After her mandatory 15-day stay in the psych ward, I was called in to “babysit” her for a summer while she stabilized on medication for her newly diagnosed bipolar disorder.
The problem with treating bipolar disorder is that there is a part of the person that doesn’t buy into the program. This is especially true when her mood disorder has been a constant companion—a comfort even—since she was a teen. (Recently I saw a t-shirt slogan that perfectly expresses this dichotomy: “I hate being bipolar. It’s awesome!”)
Losing the rages, the creative power surges, and even the familiar blues to that narrow balance beam of equilibrium the world calls “normal” is bound to cause its own ambivalence toward treatment. Matilda did not go quietly toward sanity. She ranted on by phone, by letter, and in person to any family member who would hold still. Her medications often sat untouched by her bedside until her inevitable slide into catatonia.
A psychotic break preceded her third suicide attempt—not uncommon in a disease that escalates when untreated over time. After she recovered from a four-day coma and again completed her mandatory hold in the psych hospital, we adult and very fed-up siblings intervened and placed her under guardianship.
My sister Emma’s “tower” went down during a particularly stressful time in her life. Her bipolar disorder had been evident since adolescence, particularly during the two years that she and I shared a bedroom together. Even so, she had managed to individuate from the family, and carve a life for herself. She had friends, a job in publishing, and a passion for raising and breeding Quarter Horses that had proven as financially crippling as it was emotionally rewarding.
One day, not long after I’d moved to a different state, I answered the phone and could hear nothing but pitiful, gasping sobs. I thought I could make out Emma’s voice so I answered.
Me: “Emmy…? What’s going on?”
Emma: “He’s gone… He just fell over and died.”
I was alarmed, thinking of my aging father, now in his ninth decade. Now that I was five hundred miles away, my great fear was
Me: “Who…?”
Emma: “Rocket. He’s dead. I can’t stand it. (A long bout of sobbing.) He just collapsed while breeding a mare. I can’t—”
According to the DSM-IV, bipolar disorder can occur with or without psychotic features. Hallucinations or delusions can accompany severe episodes of mania or depression. The psychotic symptoms tend to reinforce and reflect the person’s extreme mood, whether it be mania or depression. For instance, in Emma’s case, she was wracked with guilt over her horse, convinced that she’d actually killed him.
She began to have sleep disturbances and some trouble functioning and went to stay with our younger sister, Dani. The day came when Dani called our mother with her concerns about Emma. When she related the conversation to me, it sounded eerily like the one I’d had with Mom some twenty years earlier about our other sister, Matilda. Dani insisted that Emma had become irrational and was possibly a danger to herself or others. Mom chided her for being excessively
Emma stayed in the hospital for a time, stabilized on medication, and then moved into a halfway house. Slowly, she regained her sense of mental balance. For the first time, she reported to us, she began to feel free of the overpowering mood swings that had hounded her since early adolescence. She found friends that supported her and a church where she was able to build her faith and gain confidence in the future. A future in which she wanted to live. She started a website design business and eventually bought a home. Slowly she began to rebuild her relationships with her family members. “The hardest people to come back to, after this kind of illness, are your family members,” she
I and my two younger siblings collectively held our breath as we each passed into our 40s, eventually realizing the insanity gene had passed us by. However, we are not completely unscathed by our sisters’ stories. When mental illness occurs in a family, it happens to everyone. Our parents’ failure to recognize it in our siblings, and their resistance to getting help early on, warped our own senses of reality. For a long time, insanity was called normal in our family and we were chided for drawing attention to its symptoms. “That’s just the way she is” became a way to smooth over the rough truth and pretend that today was as normal as yesterday had been.
Throughout my lifetime, neuroscientists have been attempting to decipher all the maps and programming that go into human brain formation and function, to determine what is nature and what is nurture in human behavior. It looks like the answer is a little of both. Certainly, my two sisters suffered from a hereditary chink in their DNA that was expressed through their faulty brain chemistry. However, I hold on tenaciously to the possibility that if a critical six-week period right after birth had gone differently for each of them, it might have helped them deal with conditions and disorders that came later in their lives.
When the Twin Towers suffered a devastating blow on 9/11 and fell so completely to pieces, structural engineering flaws were suggested as the cause. Similarly, it could be argued that my sisters’ core structures weren’t what they should have been— that an attachment flaw in their development may have accounted for their utter midlife meltdowns. We who witnessed the devastation and who now assist the survivors can never know for certain.