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

by Patrick Dylan

  More silence.

  “Mia—”

  “I don’t know, Pat,” she grumbled. “Why don’t you figure it out.”

  I tried to stay calm. “Mia, you know this route, and I’d like to make sure we don’t go out of our way.”

  Nothing. I had about five seconds to make a decision.

  “Mia!” I cried. “Should I get off here?”

  “GET OFF WHEREVER YOU WANT!” she yelled back.

  I was so mad, but the kids were glued to my reaction. I took a deep breath, put on my blinker, and swerved into the exit lane. It turned out to be the right call, but it was an ominous start to our holiday.

  Once we made it to my mom’s place, Mia’s conduct became more restrained. She was putting on an act, but everyone could sense her tension. She mostly kept to herself, quiet and aloof. When she had to interact, she was anxious and impatient.

  “She seems like she’s on the verge of snapping,” said Brad the next morning, when we were out running together. “Jen and I are nervous about it.”

  “Welcome to my world,” I said. “Sometimes she does snap.”

  “Can you and the kids continue living like this? It’s been almost two months. It doesn’t seem healthy.”

  “I’m sure it’s not, but we don’t have much choice.”

  “You do have a choice.”

  I knew where he was going. For the past couple of weeks, I had been exploring inpatient programs. They were centers that offered psychiatric and psychological help along with support groups and disease-management programs. “I’ve looked into treatment facilities, Brad, but I don’t think they’re an option.”

  “Why not?”

  “First off, they are completely voluntary. Mia would have to choose to go, and I can’t see her doing that. And second, they cost a fortune. We’re talking, like, two grand a day or more, and most of them have mandatory thirty-day stays. We don’t have that kind of money.”

  “Jeez, really? I didn’t know they were that pricey,” said Brad. He paused a second. “We’d contribute if it meant Mia got better and you guys could live a normal life again.”

  “Thanks, I appreciate that, but she’s not going to go. She’d never willingly leave the kids for a month.”

  “Okay, but then what are you going to do?”

  “What I have been doing. I’m going to help Mia get better, and I’m going to make sure the kids don’t get screwed up because of it.”

  “Pat,” he said seriously, and quit running. “You need to start thinking about what happens if she doesn’t get better.”

  I stopped next to him. “I refuse to accept that the Mia I fell in love with is gone.”

  “Look,” he said in a gentle tone, “I don’t want to think that, either. But this isn’t healthy for you, and it isn’t healthy for the kids. You need to take that into account. I’m not saying that you should give up on Mia, but I do think you need to set a date—say, a month from now. If she isn’t better by then, you need to give her a choice: get serious treatment or risk losing her family.”

  “She’s not thinking clearly, Brad,” I said. “That’s not the kind of thing I can say to her. Besides, it doesn’t matter. I’m never leaving Mia.”

  As I said it, I started running again. Brad took the hint, and we ran the rest of the way in silence.

  The morning after Thanksgiving, we departed for my in-laws’ house. Luke would be meeting us there, as would Mark and Celia, along with their spouses and kids.

  Shortly after everyone arrived, I was in the guest room and heard an argument escalating. Mia was castigating Mark’s wife about something, a crescendo in her voice. I ran to the kitchen to find Mia shouting, “You’re not perfect, Kim! You’re no angel!”

  Kim looked startled, clearly unprepared for the verbal assault. From experience, I knew the correct response would be nothing. If one remained quiet, Mia’s initial lashing might subside quickly.

  Instead, Kim tried to reason with her. “I never said I was,” she responded evenly.

  “You implied it! Like all I need to do is go to church more often. Like I’m not a good Catholic!”

  “No, Mia, I did not say that.”

  “But you meant it!” Mia cried. “You’re so preachy! You’re not a perfect Catholic, either, Kim!”

  By this time, half the kids were gathered around staring at the altercation in horror. They were used to loud relatives, especially at Delgado gatherings. But this was Aunt Mia doing the yelling; she was usually the calmest one.

  I had to take control of the situation, but my typical approach with Mia wouldn’t work when she was already shouting. Instead of remaining quiet, I did the opposite. “Hey, what are you screaming about?” I bellowed, “KEEP IT DOWN!”

  If watching Mia yell was extraordinary, hearing me roar was inconceivable. Everyone turned my way, including Mia, and the room went deathly quiet.

  “Kim—” Mia started, but I cut her off.

  “I don’t care what Kim said! You need to calm down, Mia. You need to calm down now!”

  It was a command. Mia looked frightened but defiant. She had never heard me raise my voice to that level in all of our time together.

  “Good.” I took advantage of the pause. “You will behave yourself, Mia, or we will leave.”

  A change rippled across her face, a look of cunning. “Yes!” she agreed. “Good idea. Let’s leave. I don’t want to be here anyway!” She stalked out of the kitchen.

  Feeling all eyes on me, I followed in pursuit. “Mia! Mia, come back here.”

  “No!” she yelled as she marched into the guest room and picked up her luggage. “We’re leaving! I’m not staying here!”

  Mia’s parents had a full Thanksgiving meal prepared, and the kids were excited to spend time with their cousins. I felt guilty at the thought of leaving but knew it was probably for the best. Mia had clearly reached the end of her limited patience.

  “Fine,” I said, maintaining my confident tone, “I’ll tell the kids to get their things packed.”

  “No. The kids will stay here. Luke can bring them home on Sunday. You and I need time alone to figure things out.”

  I didn’t want to leave the kids. I feared it would be difficult for them, especially Will. The work with his therapist was going well, but he still preferred being close to me. I also wondered what we needed to “figure out.” It sounded suspiciously like getting back to “the truth.”

  “If we leave, the kids leave,” I said. “They’re staying with us.”

  “Why don’t you ever want to be alone with me?” Mia shouted. “The kids aren’t babies, Pat! They’ll survive here for two days on their own!”

  She was right, of course. The kids would be fine without us; in fact, they’d probably be happier in a normal environment. But it would be hard on me. The kids gave me the strength to deal with the challenges of Mia’s illness.

  I started to gather my stuff slowly, buying time to think. My first priority was to remove Mia from the situation. With her gone, the family might enjoy a semi-normal holiday, and no more bizarre memories would be created for the cousins.

  “Fine,” I said sadly, “put your things in the van. I’ll meet you out there.”

  Back in the kitchen, I found people trying to pretend that life was normal. I motioned to Mark to follow me into the other room. “This might be tough on the kids,” I said, “but I gotta get Mia out of here.”

  “Do what you have to do. We’ll take care of Will and Jamie.”

  “Thanks.” I went to find Will. He was playing upstairs with his cousins.

  “Hey, bud,” I said, pulling him aside. “Mom is upset, and it’s best if I take her home. But I want you to stay here with the family. Uncle Luke will drive you and Jamie home on Sunday.”

  “But I want to stay with you,” he whimpered. “I’ve been looking fo
rward to spending time with you.”

  “I’ve been looking forward to it, too. But Mom’s not doing well, and I have to take care of her.”

  His pleading eyes started to glisten.

  “Hey,” I said gently, giving him a hug. “It’s only for two days.”

  “But it’s two days that I don’t have school.”

  “I’ll make it up to you. Mom needs my attention right now.”

  “Okay,” he mumbled.

  “Thanks for understanding.” I released him with a fake smile.

  Jamie was downstairs, and if she cared that we were leaving, she didn’t show it. She was excited to play with her cousins and seemed relieved to have a few days free of tension.

  Ten minutes later, Mia and I were back in the minivan. Mia continued to curse Kim under her breath, ignoring me from the passenger seat. It was the worst Thanksgiving in memory, just like it had been the worst Halloween. I wasn’t looking forward to Christmas.

  Reflecting on the conversation with Brad, I wondered if he had a point. Maybe it would be best for the kids if Mia weren’t around. Maybe it would be better for me, too? I thought. Her presence reminded me of the way our lives were before her sickness. The sadness and loneliness were crippling. Despair permeated my thinking during most of the drive.

  But then, as we neared the end of our trip, I recalled the fear of waiting for Mark to deliver the results of her brain scan in the ER. As bad as things seemed, at least we still had Mia. And that meant that we still had hope.

  I put all thought of abandoning her to an inpatient facility out of my mind. I was afraid of the consequences if we didn’t keep her close.

  Our family seemed to be hanging on by a thread as it was.

  16.

  The Long Titration

  Indigo Girls

  “Love’s Recovery”

  3:33–4:00

  It was a perfect fall day, and Mia and I were walking through Harvard Yard during our second year as proctors. People were enjoying themselves, lounging among the fallen leaves under the tall oak and elm trees. As we strolled along, we passed a father sitting with his two-year-old son. The boy was perched on his dad’s lap, leaning back, staring down at a picture book. The father read in an animated voice, arms wrapped around the child, holding him securely.

  Suddenly, the incredible desire to become a parent flooded over me. “I want one,” I said to Mia.

  “Me too,” she responded simply.

  Will was born ten months later. Jamie came along twenty months after that. Mia and I read every book we could find to prepare ourselves for parenthood. We took the classes and organized our apartment. We picked out names, assembled the crib, and childproofed the kitchen. We thought we were ready.

  And then we discovered that nothing can really prepare you. Parenthood is like jumping off a cliff into the ocean without a life jacket. You crash in headfirst, and then you’re swamped. If you’re lucky, you have a partner who can hold you steady while you recover from the fall.

  When I graduated from college, my mom gave me a scrapbook. Alongside the old photos, she had pasted notes that offered advice for life. One read: I’ve learned that if your children feel safe, wanted, and loved, you are a successful parent. That phrase struck a chord, mostly because it captured how I felt growing up. When I became a father, it became my guide.

  I turned to it often when I found myself in unfamiliar situations where the right word or action was paramount. What would my mom do? I would imagine. What would she say? But I didn’t have to face it alone; Mia was always by my side.

  And then she became sick. And then she became a different person. And then everything that made our family strong and special started to crumble away.

  Keep them feeling safe, wanted, and loved, I kept repeating to myself. Safe, wanted, and loved.

  ***

  Mia and I spent Thanksgiving weekend together, but we never figured anything out. She insisted that we organize our files, so we spent hours reviewing old insurance policies and tax forms. It was awkward and weird. We did go out to dinner together, our first date since her illness started. But we were like two strangers, sitting mostly in silence. I was glad when Luke returned home with the kids.

  By early December, an entire month had elapsed since Mia had been hospitalized. The Zyprexa had stabilized her thought process. Even though the medication wreaked havoc on her personality, I was thankful that we had it. Anything was better than dealing with the psychosis.

  About that time, Dr. Rojas and I decided to move to the generic form of Zyprexa, olanzapine. As I was learning, he took a conservative approach to everything. We phased in olanzapine gradually, mixing it with the brand-name version over time. It worked well, and after a few weeks, Mia had fully transitioned from Zyprexa without any issues. It brought the cost of her medication down by over 95 percent.

  Mia still took half the dose of Restoril at night, more as a precaution to ensure that her sleeping patterns remained normal. We had cut the Ativan considerably as well, only including a small portion now as a complement to the antipsychotic. Once we lowered the olanzapine dose a few more times, Dr. Rojas was planning to eliminate the Ativan altogether.

  The effect of decreasing both the Restoril and Ativan was that Mia’s short-term memory improved. It meant fewer fights and suspicious looks. We weren’t continually being blamed for things we didn’t do, and we weren’t being asked the same questions over and over.

  She also began contributing around the house again, sharing basic chores like laundry and shopping. In addition, she resumed cooking, which was a godsend. Mia was an excellent chef, and no one missed my mediocre attempts at dinner.

  Although she became more active in the house again, she remained somber and unpleasant, mostly keeping to herself. And with Mia either busy or isolated during the day, Luke began to feel superfluous.

  “Yo, I need to give her room,” he told me one day in mid-December. “She’s never gonna feel normal with me hanging around.”

  “You’re probably right,” I agreed, but I didn’t want him to go. What if Mia turned psychotic again? He sensed my hesitation.

  “I’ll stay close, Patricio. Mark got some land up in Georgia. I’ll go up there and live rustic for a bit, eat deer and fish and whatnot. I been getting too soft here anyway.”

  I laughed. “Yeah, imagine how weak you’d be if you actually used the bed.”

  He scoffed, and then turned serious. “It’s six or seven hours away. If Mia starts to get trippy, I’m back in a heartbeat, yeah?”

  I reluctantly capitulated, and he set a departure date. I wanted to do something for him, given all he had done for us, but I knew he would never accept a gift. The timing was fortuitous, however; he couldn’t refuse a Christmas present from the kids.

  Knowing his love of electronic gadgetry, the kids and I bought him an iPad and had a blast loading it with wacky, survivalist-type programs. One provided navigational charts for every body of water on the planet. Another was an electronic manual for existing alone in the wild. After inscribing the back with the words Cubano Perdido, we enclosed the whole thing in a rugged waterproof case.

  On the morning of his departure, Will and Jamie presented Luke with their gift. He was caught off guard and flashed me a wary expression, but once he opened it, he became mesmerized. The kids showed him how to use it, excitedly pointing out all the functionality. But Luke wasn’t one for long goodbyes. After twenty minutes and a few hugs, he was out the door.

  I followed him to the car he was borrowing from Marcos and Lucia. “Luke, I really don’t know how to thank you. We couldn’t have survived—I couldn’t have survived—”

  “No need for that,” he said, cutting me off as he secured his spearguns in the trunk. He threw his rucksack next to them. “She seems good now. Let me know if things change.”

  “I will.”

&
nbsp; “Family, Patricio.” He gave me the familiar bro handshake. “I got nothing but love for you, brother,” he added, pulling me into a hug.

  After Luke left, we struggled through the holidays in discomfort. Typically, Mia and I would have enjoyed planning for Christmas, figuring out how to make it special for the kids and spending time with family. But Mia wasn’t at all engaged, and it was miserable wrapping presents by myself.

  By this time, Mia had gone from sleeping barely six hours a night to getting eleven hours or more. It wasn’t surprising, given all the medications she was taking, but it made Christmas morning especially challenging. The kids woke me up before 6:00 a.m., happy and excited, but Mia refused to rise. Desperate, I took the kids to the back room and made a big deal of watching Christmas movies. Three hours later, Mia was yet to be seen.

  The olanzapine made her self-centered. She didn’t seem to care about anyone else, not the kids and certainly not me. It was so strange for us, given that she was previously so loving and affectionate.

  I thought back to the few moments of clarity when she was psychotic, when the old Mia had surfaced. She must be somewhere inside this despondent stranger, I would tell myself, but my own conflicted emotions started to cloud my thinking.

  When a loved one suffers from mental illness, you become trapped. You want to remain positive, believing that they will find their way back to health. But faith becomes a cruel torture, tricking you with false recoveries. Your heart breaks so many times that you build defenses against hope. You become torn between confidence and skepticism, between supporting your loved one and protecting yourself.

  I found myself living in the present, trying to survive on a daily basis. Any thought of the future was quickly banished.

  We had moved out of the acute phase of Mia’s illness, when I was concerned about her safety. Surrendering the car was a first step. I had also stopped trying to control her phone usage, having long since given up hope of keeping her illness a secret. I could still track her location, but I never did. And with Luke’s departure, she spent most of her days alone.