Safe, Wanted, and Loved: A Family Memoir of Mental Illness, Heartbreak, and Hope

by Patrick Dylan

  “Are you a psychiatrist, Mr. Dylan?”

  “No, but—”

  “Then I suggest you let us do our job.”

  “Are you married to Mia?” I snapped back. “Have you watched her deteriorate from a loving mother to a paranoid psychotic?”

  I paused.

  “Have you ushered her in and out of emergency rooms and mental health facilities for over a month?”

  Another pause.

  “Mr. Dylan, you don’t need to become upset,” he said.

  “No, actually, I think I do.” And without much thought, I started tearing into the poor guy. “Listen, I’ve learned enough about these medications to know that psychiatrists are really guessing. And yeah, you each have certain drugs you like. Maybe you’ve had a patient or two do well on them. Whatever. They become your go-to drugs.

  “But you don’t really know how or why they work. And you don’t know how one interacts with another. Oh sure, you’ll check your little drug guide, like it has definitive answers. But it doesn’t. And every time you add a drug to the mix, it gets harder and harder to figure out what might be working and what’s not.

  “You give them something, hope they do better, move on to the next patient. But those of us who live with them and care for them, we’re trying to get them back. But can we do that if you’re complicating things with new medications? No, we can’t!”

  I was almost screaming now. Weeks of frustration were boiling over, but I couldn’t stop myself.

  “Mia hates the crisis center. And yeah, you keep her safe, and I’m thankful for that. But we can keep her safe at home. What we can’t do here is make her take her medication. That’s why I sent her back to you—so that she would have to take her medication. But what good is it if you’re not giving her the medication that SHE IS SUPPOSED TO FUCKING TAKE!?”

  It wasn’t like me, but I had never been so irate. For all I knew, Abilify would send Mia into a deeper state of psychosis.

  In the silence that followed, I wondered if I had been too harsh. No, my internal voice said, this is important. Don’t let up. Mia is depending on you.

  “Look, Mr. Dylan,” the doctor began again, “I’m sure this hasn’t been easy for you or your family. I apologize if giving her Abilify somehow compromised a plan that you and Dr. Martinez had set. I will speak with him when he arrives today.”

  “Thank you.”

  “But I want to remind you that I have dedicated my career to helping people like your wife, and I have been doing it for years. I wouldn’t give a patient medication if I didn’t believe it would help them.”

  “Fair enough,” I said. “I’m sorry to question your intentions, but it is absolutely imperative that my wife only be given Zyprexa, Seroquel, Ativan, and Restoril. That’s it. And she should be given those medications only in the doses and at the intervals that have been outlined to Dr. Martinez.”

  Hanging up, I immediately texted Dr. Martinez. He didn’t reply, and I felt uncomfortable bothering him again.

  But what would have happened to Mia if someone hadn’t been there to fight for her? Would every different doctor on call have given her whatever drug they happened to think she needed? I wondered if that occurred with other patients who moved through the crisis center.

  Later that day, I was apprehensive walking into the lobby. Maybe I would meet the guy I had just berated, or maybe Mia would shun me. But the receptionist gave me a sympathetic smile. “Oh, Mr. Dylan,” she said, “I was hoping we wouldn’t see you again.”

  Surprisingly, Mia allowed me straight through. She was on one of the couches, appearing sleepy. It must have been the Abilify from earlier that morning; her head kept nodding.

  We sat together for a while, but the conversation meant nothing. Half the time, I thought she had fallen asleep. Finally, I suggested that she take a nap. She jerked her head, trying to open her eyes wider, and then agreed. I helped her to the bedroom, tucking her into the mattress on the floor.

  On the way back to the lobby, Dr. Martinez stopped me. “Hold on, Pat,” he said, coming out of his office. “It’s a nice day. Let’s take a walk together.”

  We didn’t speak as we passed through the building, but as soon as we stepped outside, I said, “Hopefully, the folks around here weren’t too offended by my call this morning.”

  “It’s okay, Pat,” he laughed. “Actually, no one was surprised when they heard about it. Mia is lucky to have you. Psychiatrists will always forgive a spouse who cares so much. We wish we saw more of it.”

  We continued walking around the parking lot. After a silent pause, I confessed, “She hates it here. I swore I’d never send her back.”

  “I’ve spent enough time with Mia to know that’s true. But you did the right thing, Pat.” He stopped, turning to face me. “I have to be in court next week, to testify. Months ago, a psychotic woman woke up and didn’t realize it was her husband beside her in bed. While he was sleeping, she got a baseball bat and beat the hell out of him.”

  “Jesus!”

  “Yeah, terrible. It’s not her fault, not really. She doesn’t even remember doing it. You don’t mess around with psychosis.”

  “Guess not.” I thought of all the time that Mia and I had spent trapped together in our bedroom. “Man, though, I really wish you wouldn’t have told me that.”

  “Sorry, but you have to know the truth about this. No one needs a hero. I’m glad you called 911. It was the right thing to do.”

  Later that afternoon, my dad brought the kids home. They were in a good mood, having enjoyed time away from the stress of our house. I informed them of their mom’s relapse. Neither seemed surprised or troubled.

  Their apathy worried me. It was like they were giving up hope, as if Mia would drift in and out of the treatment center indefinitely. But I couldn’t think of anything to do about it. Plus, it was probably their best coping mechanism.

  I was also finding ways to cope. Lately, I had taken to playing the piano at night. I wasn’t a good pianist, but the song “The Scientist” by Coldplay had become therapeutic. The lyrics seemed written specifically for our struggle; the band must have been familiar with mental illness. I began playing it incessantly, finding strength in the knowledge that other people had been through a similar ordeal.

  In the same vein, I knew that our former student David had survived something similar. I hadn’t spoken with him in years, but I tracked him down. He couldn’t believe that Mia was sick; the empathy in his voice was palpable. David had a unique perspective, and I found his insight on managing the kids especially heartening. “Just spend as much time with them as you can,” he said, “even if they don’t want to talk about it. They need you now more than ever.”

  Fortunately, that had been my approach. Sunday night was Halloween, and the kids and I had spent weeks planning costumes. Jamie was a fairly ghastly vampire, with a black cape and self-applied makeup. She ran around practicing the line “Good evening, it will be your last,” sounding as much like Vincent Price as possible. Will had decided to be a British punk rocker, complete with a London subway T-shirt and Mohawk wig. We had been playing a lot of the Clash for inspiration.

  But now that Mia was back in the crisis center, I told the kids that I didn’t feel comfortable leaving their mom alone on Halloween night. They quickly agreed; I was proud of them. Luckily, Uncle Luke came to the rescue. He eagerly volunteered to walk the kids and their friends around the neighborhood, donning my karate costume and pretending he knew martial arts.

  I was disappointed to miss Halloween, but my visits with Mia hadn’t been bad. At least, she wasn’t making me wait in the lobby. But she always seemed on the verge of sleep, and spending time with her zombie persona demanded tremendous patience.

  On Monday, Dr. Martinez called me at work. “Look, Pat,” he said. “I know that you and Dr. Rojas have a plan. And I respect the approach of making a
gradual switch. But at this point, in my opinion, Mia is overmedicated. She can hardly keep her eyes open.”

  As soon as he said it, I knew it was true.

  “I think we should stop the Seroquel altogether,” he continued. “She’s already on plenty of Zyprexa.”

  “Okay,” I said, “but removing the Seroquel abruptly could cause issues.”

  “I know, but let’s do it now, while she’s in the crisis center. There’s no reason for you to deal with it once she gets out. Plus, her psychosis seems much better, at least when she’s not sleeping. At this point, all the medication is just overkill.”

  He was giving me the chance to make the final decision, and I welcomed it. When our journey with mental illness had begun, I was looking to others for answers. Now, I had the confidence to make important choices. I knew Mia better than anyone, and I had seen how she reacted to these drugs.

  “I’ll call Dr. Rojas and tell him,” I agreed. “If we make the change now, she’ll probably get out faster, and she’ll be on a much better path once she comes home.”

  Without the additional Seroquel, Mia slowly gained more energy. She wasn’t herself, but at least she could stay awake. No wild mood swings occurred, and her psychosis remained at bay. Instead, the blunted personality reemerged, the one that had appeared at the end of her last stay. It was darkly apathetic and paranoid, but not explosive.

  Although I was spending afternoons and evenings at the treatment center, in the mornings I was busy searching for the right therapist for Jamie. If a candidate sounded appropriate on the phone, I would book a thirty-minute consultation to meet in person. It took a while, but Jamie was a tough case. I had to choose carefully.

  Meanwhile, without Mia at home, the mood was happy and relaxed. Will and Jamie continued playing the question game with Luke whenever they had a chance. “Uncle Luke, where’s the strangest place you’ve ever slept for the night?”

  “Easy,” he said, looking up from his food. “Sahara desert.”

  “Sahara desert?” I choked. “You spent the night in the Sahara?”

  “Sí, Patricio, several nights.” He reveled being in the spotlight again. “Yo, I was traveling with these Bedouins. You know, the guys with the camels and whatnot?”

  “Bedouins!” I spluttered. “You were traveling with Bedouins?”

  “Yeah, I was in Tunisia,” he said nonchalantly, “and I’d never been to the desert. I wanted to see it, yeah? I asked around and . . . pa pa pa, pe pe pe . . . next thing I know, I’m heading out on the dunes, following these guys with their camels.”

  He looked around at the mesmerized faces and knew his audience was hooked.

  “It was real last-minute, though, and mira, I paid for that. The desert’s hot during the day, but at night it turns hella cold, bro. The Bedouins had their tents, but I was laying out on that sand, just freezing my ass off.”

  I had given up trying to control Luke’s language. The kids giggled.

  “The cold wasn’t the worst, though. Mira, I was starving. If you be near the water, you got food. You be in the woods or forest or whatnot? Food. But when you’re on the dunes, man, you got nothing.”

  “Didn’t you take food with you?” I asked.

  “Nah, no time. I’m used to catching my own food, yeah? That’s the way things meant to be, hermano. That’s why I like the ocean. Always something in the ocean.”

  He was changing topics, moving away from his desert memories as quickly as possible.

  “Like for instance, a week or so before I came here, I was out diving. It was getting late, yeah, and I thought I was gonna go hungry. But then at the last minute I caught an octopus. Good eats, octopus.”

  “You ate an octopus?” I asked. “Like, an octopus that you just caught?”

  “Claro que sí.”

  “You ate it raw?”

  “Nah,” he laughed. “You can eat them raw, but I prefer to cook them. You ever put an octopus in the microwave, Patricio?”

  “Why would I put an octopus in the microwave?”

  “Yeah, probably not.” He shook his head at my lack of worldly experience. “Those suckers pop, bro! Makes a hell of a racket. Sounds like popcorn going off.” He started making loud popping sounds.

  By this time, the kids were laughing hysterically. It was yet another story that became legend. For weeks, whenever I asked the kids what they wanted for dinner, they yelled back, “Microwaved octopus!” and started making popping sounds.

  On Thursday morning, I was going through the mail at breakfast and found a surprise. It was a card from David, offering me encouragement and a guarantee that Mia’s condition would improve with time. He also sent twenty dollars in cash, with the postscript: The money is for the kids. Do me a favor and take them out for ice cream tonight.

  I was thinking about David’s thoughtfulness on the way to work, when Dr. Martinez called. “Pat,” he said, “I’m glad I caught you.”

  “Thanks for calling. Mia has seemed pretty good lately, at least as far as the psychosis goes.”

  “I agree. In fact, it’s time that she come home.”

  “Great. We’ll all be excited to have her back.” But it was a lie; the house was way more tranquil without Mia around.

  Less than two hours later, I was walking into Dr. Martinez’s office at the crisis center. Mia was already sitting in front of his desk. She looked more tired than she had the previous day, but it was still early.

  “Pat, we’ve been talking about Mia’s recovery plan,” said Dr. Martinez.

  “Okay,” I replied, waiting expectantly.

  “You have the details of her medication?” he asked, and I nodded. “Let’s make certain she takes it exactly how it has been prescribed.”

  “Right.” I reached out to take Mia’s hand. She didn’t seem that interested, but she didn’t recoil, either.

  “Also,” he said, “I’ve told Mia that I would recommend therapy for her. Not right away, but as she feels stronger. Her stays here have been traumatic. She should talk through the experience with someone qualified to help.”

  “I’ll make sure we do that.” I glanced at Mia. She wasn’t registering much of the conversation. “I believe Dr. Rojas works closely with a trained psychologist.”

  “Good, good.” He looked at Mia. “Please try to relax when you get home. Take it easy, and don’t put yourself in any stressful situations, okay?”

  She nodded, eyelids drooping.

  “I don’t want to see you back in here again,” he joked, but Mia didn’t catch the humor. “So, take your medications and get plenty of sleep. If you have trouble sleeping, or start to feel that people are after you, tell Pat.”

  After the obligatory paperwork, Mia and I drove home in silence. This time the quiet was more familiar, and that made it more depressing.

  Once in the house, Mia withdrew to our bedroom for the rest of the day. The kids came home, and I told them that she was back, but there wasn’t any interaction. I thought about the first time she had come home, how I had forced the family to spend time together. It hadn’t been successful then, and we had another month behind us, a month filled with nothing but strange behavior, sour moods, and detachment.

  Making dinner, I thought about the challenges ahead. First, we had to figure out what was going on with Mia. Second, I had to make sure the kids dealt with the stress of our lives in a healthy way, without letting it affect their development. And finally, once Mia recovered, we had to reclaim the intimacy of our family.

  Mia joined us for dinner that night. That meant no stories from Uncle Luke, no talking about the school day, and no laughing. We suffered through an uncomfortable silence, the kids with their heads down and me desperately attempting small talk. Things loosened up after Mia sulked back to the bedroom, and then I surprised the kids with a trip for ice cream, David’s gift.

  After tu
rning up the music in the car, my mind wandered. When Mia and I had started out, we dreamed of building a loving family together. We wanted to form positive relationships with our kids that were based on mutual trust and admiration. But her illness was threatening that dream. The kids were drifting further away from her while at the same time deepening their dependence on me. Nothing about the situation was good.

  Shaking my head, I refocused on the sound of the music and Jamie singing along to it. I had no idea what the future held, so I had to set short-term goals.

  Keep Mia out of the crisis center, I thought. If you can just do that, maybe the rest will fall into place.

  15.

  The New Normal

  Big Head Todd and the Monsters

  “Dinner with Ivan”

  0:44–1:04

  Many of my peers at Harvard Business School wanted to become billion-dollar CEOs, or advisers to them, and others wanted to be financial tycoons. But the thought of spending the next thirty years on Wall Street or climbing the power structure of a big company made me nauseous.

  Unfortunately, for someone still paying college loans, a lack of enthusiasm didn’t justify rejecting potentially lucrative paths. In addition, Mia and I wanted children, so supporting a family was a primary concern. I certainly wasn’t looking for sympathy—most people would have loved to be in my position—but the internal conflict was unsettling.

  While glancing through course options, I stumbled across a class called Self-Assessment and Career Development. The summary read like a self-help book, something about “determining what’s important in your life and finding a path that will bring you true happiness.” I had never heard of the professor and was skeptical, but I mentioned it to Mia.

  “Are you kidding me?” she replied. “Of course, you should take that class.”

  “I’m not sure. I only have a few slots, and it would mean I’d have to forfeit Investment Management or Incentive Structures.”