Mind Fixers

I just finished listening to Mind Fixers last week and am looking forward to hearing the author, Anne Harrington, a history of science professor at Harvard, speak at our DBSA-Boston speakers series in 2020. (I’m the coordinator of the series.) I’ve recommended the book to several people, including R'el, my psychiatrist daughter at Bellevue.

The full title of Harrington’s book is Mind Fixers: Psychiatry’s Troubled Search for the Biology of Mental Illness. It’s a thorough history of American psychiatry, from its roots in Europe through the 2010s. She chronicles the jockeying for position between the ‘neo-Freudians’, who advocate psychoanalysis and the psychiatrists who believed in a purely biological cause of mental illness. According to Wikipedia, neo-Freudians have been defined as "American writers who attempted to restate Freudian theory in sociological terms and to eliminate its connections with biology.”

I had a manic episode in the early eighties, when our first child was just turning two and our second was six months old. I had a more severe, more psychotic mania in 1995. When Jim could no longer recognize me, and feared for our children, he signed me into a locked psychiatric unit. When I emerged I was convinced to take psych meds, told that my episodes would get more frequent (than every twelve years) and more severe. Seven years later, against medical advice, I stopped the psych meds, cold turkey, with predictable results: another ambulance ride to the same psych unit. Since then, I’ve taken meds for sixteen years. I don’t like it, but don’t see a viable alternative.

I’m an active member of DBSA-Boston, a local chapter of the national Depression Bipolar Support Alliance and have facilitated support groups about once a week for nearly ten years.

Quite a while ago, based on my own experience and my observations in DBSA groups, I rejected the ‘chemical imbalance’ view of mental illness. As far as I can tell, and as Harrington states persuasively, no one knows the deep cause of mental illness. There’s no blood test, no diagnostic brain scan, just a list of symptoms in the DSM (Diagnostic and Statistical Manual of Mental Disorders). It’s rather like diagnosing an illness by the type of fever produced (that's a effective simile I read). And why do the meds fail so many, especially those who are depressed? Why does cognitive behavioral therapy (CBT) work as well as anti-depressants? Why are the same classes of drugs prescribed for different types of mental illness?

I’m deeply grateful to psychiatry and the efforts of many professionals (including my daughter and my deceased father-in-law) to alleviate pain and suffering. I have been psychotically manic three times in my life. Since I was first prescribed psych meds, in 1995, I have only been severely manic one time, when I stopped taking them (against medical advice). Much of what I have accomplished in my life since 1995 would not have been possible without them.

I highly recommend Mind Fixers by Anne Harrington. And I’d love to hear what you think about it.

St. Davids

I’ve always loved the name of St. Davids in Radnor Township, Pennsylvania (outside of Philly). When my parents and sister came for my graduation from Bryn Mawr, they stayed at St. Davids Inn. Many of the original European settlers were Welsh and they named their church for the patron saint of Wales.

I suppose that’s why the tears sprang to my eyes as I drove past the Battlegreen in Lexington a few hours ago listening to “Ar Hyd y Nos” (“All Through the Night”), the Welsh lullaby we’d just sung as a women’s chorus at church. It’s another Christmas season and my David won’t be visiting.

I find I’ve developed different approaches to talking about my children to newly-met friends. I remember flying west a few months after David’s death. I didn’t mention my children; I had no interest in the role of the mourning mother. Then there was the phase where I’d describe my kids in a way to obfuscate their numbers: “We’ve got a few in New York, one in Massachusetts, and the rest are out west.” But sometime in the last year, I’ve wanted to talk about David. I want to remember him and let new friends know about him, about his existence in our lives.

Sometimes I hesitate, concerned that the other person, hearing about David’s death for the first time, suffers more in hearing than I do in telling. I talk about David without anguish, but I don’t want to cause distress. Do I also worry that I seem heartless and unfeeling in my delivery?

I had lunch with my good friend, Christy, the other day, and I talked about David. She asked if it was painful, talking about him. No, it’s not. In fact, I want to talk about him, keep his memory alive.

Five days after David’s death, we all packed up and went to a rented house in the Catskills. We’d planned our reunion for the customary third week in August, but didn’t know whether or not we’d use the house, since David was so sick. But he died and we used the trip as a time to be together for a week in new surroundings.

As I sat at the kitchen table, looking out a large picture window towards a forested hill, I made a chart for meal planning. Jim, Mary, R’el, Peter, Matt… A bottomless chasm gaped before me, and I struggled to keep from plummeting. For nearly twenty-six years, David had always been between Matt and Annie. I skirted that chasm, with varying success for a long time. Then I discovered I could switch the order of Annie and Sam, but was always distracted from the conversation, nervously counting and re-counting in my head, feeling that I was missing someone. The other day I used my five fingers to count my kids and and wondered that it took over four years to discover the method. But my heart resists fitting my children on one hand. I rebel. I have six children. I always will.