A Common Struggle: A Personal Journey Through the Past and Future of Mental Illness and Addiction

by Patrick J. Kennedy

  Amy also had family members who had struggled with mental illness and substance use—including a middle-aged cousin with schizophrenia she was close to and a grandmother who had died from alcoholism before Amy was born. As a schoolteacher she had dealt with students being treated with psychiatric medications and therapy, as well as their families. And she recently had been attending meetings of Al-Anon at a church near her parents’ house. A teacher friend had recommended Al-Anon as a good tool kit for her around the time when we met, and she kept going as a way of being supportive of me. She also stopped drinking completely, and the few times I ordered a drink at dinner when we were first dating it was very noticeable.

  At that time, I was not going to AA meetings as regularly anymore. Ever since my sponsor Jim Ramstad had left Congress the year before, I had been going less and less.

  It was a young, long-distance relationship—and a secret to the press, who were increasingly interested in covering my last months in office as the end of the Kennedy era in Washington. We would meet in Philly for a weekend at the Four Seasons, or in New York. We were both still a little gun-shy, especially about me spending much time with her adorable three-year-old daughter, Harper, until we knew where this might be going.

  —

  AS THE SUMMER WAS ABOUT to begin in earnest—the first summer since losing my father—I decided that instead of being with my family for July Fourth, I would join a congressional CODEL that was going to Liberia, Kenya, and several other African nations. Because of the large Liberian community in Providence, I had always wanted to visit there. This was going to be my last chance to go as an elected official.

  My staff was completely against this, because they knew I was not well. But unlike several years before, when I was trying to put the trip together myself, this was a journey organized by my colleague Representative David Price, the chairman of the House Democracy Assistance Commission, and already included Representatives David Dreier, Donald Payne, Allyson Schwartz, Keith Ellison, Mike Conaway, and Vern Buchanan. A significant group of staffers would be on the trip, including congressional doctors who already knew they had to keep an eye on me.

  By this time, I had dispensed with the medicines that prevented me from using opiates and was taking OxyContin pretty regularly. I thought I had enough pills for the entire weeklong, five-country trip. And I was doing fine when we were in Liberia. In fact, I gave an impromptu speech supporting the country’s current leader, President Ellen Sirleaf, who I greatly admired (and the next year would win a Nobel Prize), and loudly railing against the possible return of the regime of Charles Taylor, the former president who was awaiting trial for war crimes. The speech was controversial in a positive way, and a perfect example of why I had always wanted to visit Liberia.

  Unfortunately, not long after that speech, I finished all the OxyContin I had brought, and with several more days of travel ahead, I began to detox when we arrived in Kenya. I was sweating profusely, doubled over in pain. The congressional physician with us was kind enough to suggest that perhaps I had contracted malaria and needed to go home early—although I think a number of people involved with the trip knew that was a lie. The physician contacted my staff back in DC and told them exactly what was going on and that my physical condition was beyond their ability to treat me in Africa. And I left the trip, suddenly quite relieved that there was no American press coverage of the CODEL.

  I was flown home through London, where my staff had arranged for someone to meet me and fly with me the rest of the way home. I told them I didn’t need help, but they thought otherwise, and there was someone already accompanying a senator over who was available to fly back with me. But any time a legislator is walking through the airport like that on a trip, the embassy in London is alerted. So the US Ambassador, Louis Susman, who knew my family, was informed of my situation, and word quickly got back to my brother and Vicki—who were now facing their first-ever “Patrick crisis” without my father or his staff (and since I had announced I was leaving, much of my own staff had already moved on, too). They had every reason to believe that this might be the beginning of what my life after Congress could be like. They were worried about me and angry with me.

  And then I proceeded to make the situation worse. This fiasco had so completely exposed me, despite all my best efforts to disguise what I was doing. It laid me bare and vulnerable and I was very resentful and bitter and defensive. So, after I had been home a few days and had survived the worst of the detox, I had my assistant schedule a call with the Ambassador—so I could, of course, blame the whole thing on him.

  The minute he got on the call I started yelling, “I don’t know what school of diplomacy you went to, but you should know better than to be talking about such private things . . . ,” and I dropped a few f-bombs in the process. He was stunned and didn’t say anything, although I’m sure this just confirmed every image he had of what was happening during my trip back from Kenya.

  Luckily, this was never covered—because by this time, with the end of my term in sight, I was desperately trying to finish my congressional career without any more scandals. All I wanted to do was make it to December alive and reasonably intact, so I might still have some chance to go into a long-term rehab after I was finished and possibly retain the chance to reinvent myself.

  —

  WHILE I WAS IN AFRICA, Amy was getting to know me in a way I hadn’t planned. I told her she was welcome to use my house in Rhode Island, which I was getting ready to sell, for a vacation while I was away. She decided to go up there for a week with a friend, partly to relax, partly to help me start getting “organized.”

  They were having a nice time, but after a day or two Amy could no longer deal with what a mess the place was. I had been living there, alone, without any major relationships, for several years. So her vacation gave way to a pretty major cleaning. She hoped something like this would help me get a fresh start when I returned, but she also just couldn’t help herself, because the place was so dirty and disorganized.

  She told me she wasn’t surprised by anything she found of mine—the mess, the decades of worn and stained clothes that needed to go, even the handful of stashed porn magazines. She considered that all fairly predictable. She was a little freaked out, however, to discover a stock of Uncrustables—the premade peanut-butter-and-jelly sandwich pockets she never allowed her daughter to eat—in the freezer. That did make her wonder a bit.

  After I recovered from the detox after Africa, which Amy knew all about, we had a terrific summer. I spent a lot of my weekends with her. Mostly, we stayed in and around Atlantic City, where, after a while, she started feeling comfortable letting me get to know her family, especially her daughter, Harper (whose custody she shared with her ex-husband).

  I spent my first-ever Jersey Shore summer with them, hanging out on Brigantine Beach and eating pizza on the boardwalk in Ocean City. We would take Harper out to pick blueberries, or to visit Storybook Land, a kiddie amusement park. It was great, something I had never really experienced before, being at the shore with a small, low-profile family who were reasonably careful with each other’s hearts.

  It felt like something I’d heard about in the endless nautical metaphors of my family but had never really experienced myself:

  Safe harbor.

  The more I was around Amy and Harper and their family, the more they felt like home.

  —

  WE SPENT MORE TIME TOGETHER in New Jersey and at my shockingly clean house in Rhode Island. But, mostly, we just got to know each other. I was still pretty raw, and there were times when she wanted me to come join her for a walk on a beautiful day, or to visit somewhere and I just didn’t have the strength to do it. But I think she knew that I wanted to do it and just couldn’t. I was in terrible shape emotionally and physically, weighing a lot more than I ever had in my life.

  At the same time, I still had this burning political and advocacy ambition
, especially when it came to the diseases that were doing their best to try to destroy me. And not only because of the work we had already done and the political coalition we had built to pass the parity law (which was still fighting over the language in the federal regulations written after passage). There was, unfortunately, an entirely new front opening up in our war on inadequate treatment and medical discrimination: a new generation of veterans with a new generation of brain diseases.

  It was becoming alarmingly clear that veterans were facing an unprecedented problem with suicides. Some vets were suffering from primary mental illness—mood disorders, psychotic disorders, anxiety disorders, trauma-induced disorders. Some vets were suffering from mental illness secondary to traumatic brain injury, or TBI, the new signature wound of war.

  And as had always been true of war, the medical challenges among our soldiers and veterans held the most hope for advancements in medicine and public health, because they were the only patients for whom we could generally find money in federal budgets. It was a medical trickle-down effect hardwired into the American experience. It went back to the Revolutionary War, when young Dr. Benjamin Rush wrote in the nation’s first text on war medicine, “Fatal experience has taught the people of America that a greater proportion of men have perished with sickness in our armies than have fallen by the sword,” and prescribed some of the earliest forms of preventive care, including one of the first mass vaccinations for smallpox. It continued through the development of better limb amputation techniques in the Civil War; expanded use of transfusions, X-rays, and broken-bone setting in World War I; the government-sponsored mass production of the first true antibiotics to fight infection in World War II; and advances in trauma surgery and helicopter medical evacuation during the Korean and Vietnam Wars.

  And now, our first twenty-first-century war was insisting we finally focus on brain disease. And what seemed like very specific “invisible wounds of war” actually had broad connotations for those who were not veterans. New interest in the diagnosis and treatment of battlefield traumatic brain injuries could also call attention to the stateside issue of concussions from car accidents, sports, and other causes. New interest in suicide prevention for veterans could lead to more diagnoses and treatment for all Americans attempting to take their own lives. New interest in other mental illnesses among veterans (some of whom were ill before they enlisted) and the challenges of treating those diseases within their families could lead to better early diagnosis, individual treatment, and family treatment.

  This was the cause I thought I should devote my energies to after leaving Congress. If I could only get control of the diseases in my own brain.

  —

  DURING THE FALL, I kept visiting Amy at the shore. I was becoming well-known to the management of the Seaview Hotel. It was my hideaway from life in Washington, which was becoming increasingly frantic. I had hired a doctor to work with me as a medical coach and pretty much separated from the psychiatrists I had been seeing for years. I was finding it easier to hide from everyone who was concerned about my care, including my staff, who were desperately reaching out to my late father’s former aide Dr. Larry Horowitz and to the physicians at the Capitol. I was cutting back on my psychiatric meds, and becoming more and more manic.

  My mania had a good focus—I was really getting energized about connecting the dots between the mental health community, the addiction treatment community, the neurology community, the brain research community, and the military. But it was still mania. Everything you do when manic is not necessarily bad. It’s just that the way you do it will, eventually, be bad for you, because mania never stops when you want it to. You can win a big race, but you can’t get your foot off the accelerator, full-throttle, until you and the car run out of gas, crash into a wall, fall to pieces, or all three.

  A lot of people were scared for me, and I was scared, too. But somehow Amy wasn’t scared. That’s partly because I was able to put on my best face for her, and in a long-distance relationship she was spared some of my day-to-day challenges in Washington. And we were taking things slow. But we were also falling in love—and she was seeing something I could be, with her, that I had never been myself. For me, that was a little scary, too.

  I remember taking her to talk with the person in the family who I felt had the most perspective on addiction and recovery—my cousin Chris Lawford. He had been sober for a long time—he credited my mom with taking him to his first AA meeting in the early eighties—and had written a bestselling book about his own and other people’s recoveries. Chris had always been very supportive of me and knew a lot of things that I would never share with others. For that reason, he also had only the most exceedingly cautious optimism. When Amy and I went to talk to him, he didn’t sugarcoat anything.

  “Tell her what I’m dealing with,” I said, “tell her the dirty dark truth, that we can go off the edge at any time.”

  And he said—I’ll never forget this—“I have never seen a case worse than you, Patrick. You’ve been at this for so long, and the fact that you’ve survived and you’re still doing it almost makes you more dangerous. You’re able to manage it, just like your father managed it. And that’s what should scare anyone who falls in love with you.”

  He told Amy, “If he doesn’t stick with recovery, you should run as far away from him as you can get!”

  He said he knew that at any given moment, I could say I wanted to go off to Australia with all my money and drink and drug myself to death. What he didn’t know, and neither did Amy, was that I had considered such a plan. After I announced I wouldn’t run for Congress and knew I would be inheriting money from my father’s estate, I had actually asked my financial adviser if there would be a way to transfer all my holdings to Australia so I could just disappear there. I always remembered that Nevil Shute novel I read in high school, On the Beach, about people going to Australia to wait for the coming apocalypse. Whenever I worried I would never be able to dig out of all the angst and depression and negativity, I imagined being Down Under, waiting out the end with whatever offered me even temporary relief.

  —

  IF YOU WANT AN INDICATION of just how manic I was at this time, in the middle of all this, in early October of 2010, I was negotiating to write a “sobriety memoir” with a publisher and a collaboration agreement with a reporter I knew. Fortunately, both Amy and my brother eventually convinced me that signing these agreements, at this point in my “sobriety,” would be an act of singular self-destruction.

  During this time, Amy sold the house where she and Harper had been living after her divorce and moved back temporarily into her childhood home with her parents. So I decided to prove my commitment to the relationship, during this very challenging time, by buying us a house in nearby Brigantine on the water. I started looking and found a place, but Amy was nervous about this: it all seemed too soon. We were in love with each other but I still didn’t have enough love for myself to commit fully to her, to her daughter, to my health, to anything. I was reliable only in small bursts. The rest was chaos.

  I was so torn. I had this bright-eyed, beautiful woman who said she really liked me and I knew she was good people—in my bones I knew she was good people. And I was still saying to myself, should I do this or should I not? Should I have a chance at a real life or not? Should I continue to live or not?

  It shouldn’t even have been a close call and yet it was a close call. Here’s how close:

  When Amy and I were apart during the week, I would still sometimes connect with women I had dated before. Basically, this was just me being an idiot guy who had made it to his early forties and still had no idea how to be in love and commit to a relationship. Amy had some understanding of this—we had not been going out for that long, and she knew I was trying to adjust to a lot of things that were normal for most people and not, so far, for me. She was patient and, generally, unshockable. Even when we sometimes spent hours together with m
e sitting in the bathtub almost catatonic, and her sitting on the closed toilet asking me what it would take for me to commit to my health and my life and, presumably, to her, she believed in me and believed I was trying.

  In early November, we spent a leafy fall weekend together at my house in Providence. On Sunday, I had to leave early to make an appearance with my mom and my brother to commemorate the fiftieth anniversary of JFK’s election; we appeared on the steps of Providence City Hall, where JFK had spoken the night before he was elected. Amy was going to close up my house and drive back to New Jersey herself. But, as she was packing her stuff, she came across some evidence that I was still in touch with other women—the phone at the house kept ringing, someone left a message. And she decided she was done. With me.

  When she called, I was on the platform in the Providence train station waiting for the Acela to New York, where I was scheduled to appear on the Today show the next morning. She was crying and packing. She said she couldn’t believe I was doing this to us. She had believed I was sincere about our relationship and had put up with a lot based on that belief, but now she realized I wasn’t capable of being all in.

  “You’re not serious about this,” she said. “It’s over.”

  And then she hung up.

  At that moment, I felt like the bottom dropped out of my life—and there had been very little holding it in place to begin with. I also felt that maybe it was just as well Amy had discovered that I wasn’t worthy of her love and support anyway. This was her way out, and she should take it.

  And as I stood there on the platform, my last chance to save myself lost, I imagined myself jumping in front of the Acela as it came into the station. I could see it. I could do it.

  While most suicide attempts are long considered, which is why so many are preventable, there are some that are wildly impulsive, of the moment—based as much on depression as timing and access to the means. The Acela was approaching the station, and I had just ruined my life, my last chance.