Saturday, June 23, 2012

No Place To Go

There is a fantastic article up on the New York Times website, coming out in print this weekend in the NYT Magazine, called When My Crazy Father Actually Lost His Mind, by Janeen Interlandi.  The author tells the chaotic story of how her family tried to get help for her 69 year old father who was ill with a manic episode.  In it, he bounces from hospital to jail to ER, to homelessness, over and over. She talks about the catch-22's with the legal/psychiatric system with a father who is dangerous enough for a restraining order to keep him from his family, but not dangerous enough for civil commitment, and she talks about stories of others families where awful things have happened.  Her love for her father comes through, mixed in with her frustration that there is no place or mechanism to help such people.  Ah, but the story has a happy ending.  It reminded me a lot of Pete Earley's book Crazy: A Father's Search Through America's Mental Health Madness.

Interlandi writes:

And so for weeks, we had been locked in a game of chicken: waiting for my father to do something clearly dangerous; praying like hell that it would not be his suicide or accidental death or the death of someone else. In the meantime, my mother had all but stopped sleeping and had started hiding the car keys and the checkbook. She would tiptoe around their one-bedroom apartment at night, waiting for him to doze off, then call my sister or me to unload her despair in a flurry of whispers. 

Oh, I can't begin to  do this article justice in a blog post, you'll just have to read it.


Tawny said...

It's a wonderful article and Pete Earley's book is exactly what it reminded me of too. Both are amazing and frightening.

chewing taffy said...

Fantastic article!! Unfortunately, much of it resonates with me.

My mother has also been diagnosed as bi-polar (with borderline traits); she refuses treatment or medication.

She's in and out of the hospital, bankrupt, and renting a room in someone's trailer. For now. She's constantly on the move, and I often don't know exactly where she is until the hospital calls to tell me she's there.

I've been around this block so many times, and there is very little I can actually do about any of it. I don't know how our story will end, but the journey has been hell.

Liz said...

the book looks interesting-- i'll have to check it out. wonder if it's at the library?

chewing taffy--

please excuse my presumption.

is there a dbt provider around you? i have a similar diagnosis as your mom, bipolar II and borderline, and dbt has been a tremendous help to me. it was life changing-- likely life saving...

if she'd was willing, it might help.

Liz said...

so i realize now that this is not a book, but an article.

i read it, and it kept my interest. but i already knew the system was broken. as is, no one benefits. but i don't think her ideas of solutions are good, either.

it's something to think about, certainly.

Anonymous said...

I read the article, and I have to say it was a moving story, and unfortunately terribly familiar one with a lot of people who suffer from mental illness. A great eye opener of an article for people who aren't already familiar with how things are nowdays in regards of the system.

chewing taffy said...


Yes, I've heard wonderful things about dbt. My mother was in therapy and a dbt program about eight years ago.

She dropped out and refuses to return. She insists she doesn't need therapy and / or medication...ironically, until she's hospitalized for a period of time and stable on medication. Then she realizes she needs it.

For awhile things are stable.

Then she goes off the meds because she a) can't afford them; b) they make her too thirsty, constipated, or whatever; c) she has nobody to drive her to the pharmacy, etc.

It's frustrating.

I'm really glad you've found success with dbt. I know my mother would benefit, but at this point, she's unwilling.

Jane said...

It's truly sad that our system could abandon people who are that frail. He's in jail, court, ER, and the PESS place like a merry go round.

I'm curious what his insurance was...and what his care would have been like if he had better insurance. Part of the issue in getting him help seemed to be the fact that a lot of people weren't taking his insurance, and it would have taken months to get him community outpatient mental health help.

Trébuchet said...

My mother was financially independent and paranoid enough to lawyer up early on. She went eight years before being committed and getting some help, during which time she successfully fought every charge and restraining order against her. Nobody would look at a preponderance of the bad behaviors for fear of impeding her civil rights.

And "bad behaviors" included brandishing a firearm, murder threats, actual battery, making false accusations (like you wouldn't believe). We all knew she was hallucinating and dangerous, but she could pull off 'sweet lady' like nobody's business.

Even the night we finally got her psych exam (PESS), these idiots were about to LET HER GO when finally, after hours of impressing the doctors (she was even dressed and ready to leave), she reared up and BIT the doctor's face and destroyed their cute little examination room.

That it had to go that far? Criminal.

Now she's on Haldol shots in a facility for life (no criminal convictions, but considered a threat to society). We were told we should have gotten her help a lot earlier.

Suji said...

Oh, wow! It is really an inspiring story. Some people who are suffering from mental illness are given less attention because some of the family members think that it's helpless.I believe that all of the patients will be given enough mental health support. If not totally treated, at least the signs and symptoms of the certain mental illness is lessened.

rob lindeman said...

I thought it was a terrific story as well, for two reasons: first, because the gentleman in question was not treated against his will; and second, because it has a happy ending, the episode passed. Don't get me wrong: it is a harrowing story. When it happens to your own family it is always harrowing. Ms. Interlandi communicates the horror well.

How many respondents here believe Mr. Interlandi would be better off if he were on drugs now?

My one quibble is that the author repeats the canard that her father's "illness" is chronic and will recur in the future, as though this were as certain as death and taxes.

Jane said...

Darn blogger eating my comment.

Anyhow, I basically wrote back at Rob that the drugs were too little too late. He was already recovering from the mania by the time they got him on therapy and meds, so we will never know if the meds would have helped the situation or made it worse while he was in crisis.

I agree that the author seems resigned to the fact that there is a larger issue:, her father is chronically sick, and his episode is likely to occur. This is all just a break from his illness. Maybe it will recur. Maybe it won't. But he is an older man and it may very well not. And even if it does, he would probably be too old, and physically incapable, for it to get to the point that it did before.

Anonymous said...

When a person has an alcohol problem like the guy in teh story, how is a psychiatrist able to determine he is bipolar when he's also abusing substances? It looks like it would be impossible to separate out what behavior is due to bipolar disorder and what behavior is due to his alcohol abuse.


Jane said...

That's a really good point Abbey. Something felt off to me in this story. I'm not a shrink, and I don't have any kind of degree or training in mental health issues, but I just "felt" (not very scientifically), that something else was going on with this guy. Something besides bipolar...which I didn't even know could strike that late in life.

rob lindeman said...

Another item in the differential diagnosis to consider, in addition to alcohol-related disease is dementia (happily, also a disease with well-described brain pathology!)