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(/') (/') Q) -o -o 0 lJ J;l Q) _c +-' .8 1:: � (J) Q) 0 72 After 25 years, my aunt divorced her husband because he was an alcoholic. It was the first time that she revealed this to us that he drank too much--the first time we knew. Alcoholic families are experts at not telling. She did model for me a fairy tale marriage, and I do my best to emulate it. We all agree silently not to feel the humiliation of it all by not recognizing it, by not giving it the power of words. That is our lie--the lie that says not telling stories makes them just fairy tales. Table 2-5. Mood Symptoms and Nonpsychotic Cognitive and Perceptual Symptoms During Bipolar Depression a Symptom Mood Symptoms Melancholy 100 Tearfulness 94 Irritability 76 Hopelessness 52 Cognitive and Perceptual Symptoms Self-deprecatory 97 Insight Present on admission 91 Self-accusatory 91 Poor Concentration 91 Diminished clarity of thought 91 Diminished speed of thought 91 Suicidal thoughts 82 Poor memory 52 Fear of losing mind 48 Excessive concern with finances 45 Fear of death 33 Obsessions 6 a. Thirty-three depressive episodes in 21 bipolar patients . %
When my aunt first became ill, my mother and I finally talked in some depth, with some frankness, about their deceased younger brother, who had been diagnosed manic depressive, and about their father, my grandfather, who had committed suicide by shooting himself in the head in the barn when they were all still young children. His suicide had never been explained and it was a mystery to them- what had brought it all on? My grandmother never spoke of it. There was some subdued speculation that it was preceded by a diagnosis of cancer or some other terminal disease for which there was no hope in those years. But, I suggested to my mother for the first time, in light of my aunt's health, to my former uncle's health, that his suicide could have been related to his own depression, or even possible manic-depressed condition. Several years earlier, my aunt, who was the oldest and so remembers the most, had told me she vaguely remembered his drinking bouts. Suddenly, our normal, middle-class American family life was revealed to me to be filled with hidden alcoholism, hidden mental illness. And the denial by silence that had cut me off from the knowing, the understanding. Perhaps, my childhood was just a little too good to be true. The fairy tale childhood--my parent's myth. Untreated manic-depressive illness is, by any measure, gravely serious--complex in its origins, diverse in its expression, unpredictable in its course, severe in its recurrences, and often fatal in its outcome. The personal, interpersonal, and social consequences, which are usually severe, can include suicide, violence, alcoholism, drug abuse and hospitalization. It can push patients to the limits of their resources. It is a complicated and frustrating illness, seemingly impossible to sort through. It takes a heavy emotional toll on family members and friends, the repercussions of which add further psychological stress to the patient. The illness often seems within the patient's control, yet it is not. It often carries with it a psychotic 73
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