Further reflections on the void left by suicide: deeper appreciation for Miriam Toews

Miriam Toews is one of Canada’s most celebrated novelists. She has drawn heavily on her Mennonite heritage filtered through the ability to explore the messiness of ordinary life with a wonderful sense of humour. Recently I reviewed her Giller nominated All My Puny Sorrows, a novel which is deeply inspired her sister’s suicide. The novel itself, while wicked funny in places, left me wanting more of a connection to Elf, the deeply depressed character. Her “healthy” sister, the narrator, never really seemed to understand but rather struggled with her own reactions – the practical and the reckless.

Tonight I had the good fortune to attend a panel called “Darkness Visible” in which Miriam participated. The theme explored by the three somewhat diverse novelists was focused on looking at whether dark themes, personal or political, can be fully examined in literature. The consensus I suppose was that despite the challenges and limitations, the ambition is valid and important.

swing lowBecause I already own a digital copy of All My Puny Sorrows I purchased a copy of Swing Low: A Life for this event. Written in memory of her father, a well loved teacher and pillar of the community who took his own life about a decade before his daughter followed suit, this slim volume deals more explicitly with manic depression and suicide. I only recently became aware of it. Given my own recovery process I am thinking this is more the story I was looking for with All My Puny Sorrows. Coincidentally, an audience member at the event had grown up in the same Manitoba community as Toews. Her father had been his teacher and he began to cry as he shared his shock when he had learned how much pain and sadness the family was going through. Miriam had to dry her eyes as well.

That is the true impact of suicide and it spreads beyond families.

When I had the pleasure to speak to Miriam after the event I confessed my experience with All My Puny Sorrows, explaining that I was reading it in the aftermath of my own breakdown and, sadly, in the light of Robin William’s suicide. I told her I suspect that the book I was hoping for probably lies in part in this earlier, more serious volume. But then we both admitted that unless we are ourselves are burdened with the desperate desire to let go of this life, we can only ever observe from the outside. We also shared our mutual fears for our children inheriting the same genetic disorder.

I am deeply impressed with Miriam Toews’ desire to speak about mental illness and with her wide appeal in this country, hopefully her message will reach an audience that needs to hear it. I am looking forward to finding out how she explores the bipolar disorder in her family through her father’s story, unaware at the time of course, that the same event would strike her family again.

She told the audience that if writing her most recent book taught her one thing it is to hold tight to the joy in life.

A worthy goal for us all.

What fresh yellow is this? (With apologies to Dorothy Parker)

Typically I love autumn – the crisper weather, the bright blue skies, the excuse to pull out sweaters. Normally this is the busiest time of the year as new programs and courses start and activities halted for the summer resume. More than New Year’s, this can be the season for resolutions, goal setting and looking forward.

Copyright JM Schreiber 2014
Copyright JM Schreiber 2014

Unless you are depressed.

Without the structure of work I feel lost. And unlike regular unemployment I am in a holding pattern, uncertain what type of work I may be able to return to when I do recover, if I recover, should I even recognize recovered if I meet it in myself.

I feel tired and agitated. Irritable and unfocused. I try to push myself out every day and have an exciting literary festival to look forward to in just over a week. Yet I am terrified that I have taken on more than I will be able to manage and I find myself fighting off regular amorphous panic attacks.

I feel like a wrung out dish towel. I miss having energy and enthusiasm but I have to guard against a reckless flood of these sensations lest they indicate trouble at the opposite end of the bipolar pendulum arc…

Copyright JM Schreiber 2014
Copyright JM Schreiber 2014

For now I am looking toward the brilliant yellows of the moment. Apparently yellow is the colour of the mind and the intellect, it lifts the spirit, stimulates creativity but can also heighten anxiety and emotional instability.

Sounds like a bipolar hue to me.

When even a sibling’s love is not enough – All My Puny Sorrows by Miriam Toews

The title and binding imagery that fuses the latest novel from Canadian author Miriam Toews comes from a poem by Samuel Taylor Coleridge to his friend, the poet Charles Lamb. Both men had their own struggles with mental illness but Lamb’s beloved sister Mary had an especially prolonged and devastating battle. Coleridge commiserates with his friend’s tireless care for his sister, reflecting that he, Coleridge had had a dear sister upon whom he “pour’d forth all his puny sorrows”. Elfreida (Elf) the suicidally depressed character at the centre of this novel drew her signature theme from this line , but it is her sister Yolandi (Yoli) who brings her to life and devotes herself to trying to keep her alive as she narrates this funny, heartbreaking tale. As such, All My Puny Sorrows is well named.

all my puny sorrowsColeridge was the first poet who caught my adolescent attention, much to the shock of my high school English teacher. However I confess it was the rugged adventure of “The Rime of the Ancient Mariner” and “Kubla Khan” that sparked my enthusiasm. The Romantic poets, so many of whom seem to have suffered from mental illnesses seemed kindred spirits ( although this would have been long before my own diagnosis). They loved passionately, often tragically, and became addicted to opiates. For the teenager falling well short of cool, the appeal is not hard to imagine.

SamuelTaylorColeridgeFor Elf and her sister growing up in the confines of a small Mennonite town, the arts were an acceptable outlet. Elfreida channels her energy into the piano eventually taking to concert stages around the world and winning the love of a man so patient he’s surely destined for sainthood. Yolandi opts for a less glamorous route, including a couple of failed marriages, children, meaningless affairs and a career pumping out rodeo themed YA novels.

I was attracted to this book when I heard Toews on the radio explaining that this novel began from a deeply personal space. Her father, a respected teacher despite a lifelong battle with depression, took his own life in 1998. Almost 12 years to the day later, her only sister followed suit in the same very way and location. Having already memorialized her father in non-fiction, Toews felt that fiction would free her up to address this very real and difficult subject more openly. But that is also where it falls apart for this reader.

She is able to make some very astute observations about the failings of the mental health system and sadly demonstrates that, in the end, there is no way that anyone or any system can ever do more than delay the efforts of someone truly committed to stepping off this mortal coil. However I never felt that Elf was more than a tragic figure in a hospital bed. Yoli’s childhood memories and the accounts of her sister’s glorious career rang hollow. The real strength of this book for me lies in the the indomitable spirit of the characters who survive against all the odds and resist the despair that mounts around them.

And maybe that is the point. It is not for us – friends, family, observers or readers to judge. In a few weeks I will be able to see Miriam Toews take part in a panel exploring the ability – or limitations – in being able to make sense of the darkness in life through literature. I will be interested to hear what she has to say.

Some ghosts have rougher journeys than others

- Copyright JM Schreiber 2012
– Copyright JM Schreiber 2012

O! WHY was I born with a different face?
Why was I not born like the rest of my race?
When I look, each one starts; when I speak, I offend;
Then I’m silent and passive, and lose every friend.

Then my verse I dishonour, my pictures despised,
My person degrade, and my temper chastise;
And the pen is my terror, the pencil my shame;
All my talents I bury, and dead is my fame.

I am either too low, or too highly priz’d;
When elate I’m envied; when meek I’m despis’d.
-William Blake, from a letter to his patron Thomas Butts, 1803

I first encountered these words in the months following my first manic breakdown in the late 1990s. With a diagnosis at hand I needed to understand its meaning so I read  the standard popular memoirs of the time. But I found myself drawn into the work of William Blake. Although many readers reject the notion that madness may have fueled his tireless creative energies, his hours conversing with angels and his periods of darkness – I found comfort in his artistic conviction even if he was destined to die without ever receiving the recognition of understanding he deserved.

For every person who successfully rises above the challenges of mental illness and negotiates the pitfalls of drugs and alcohol, there are those who spend their lives living rough. And others who lose the battle altogether. But Blake drew inspiration from his angels and demons with his loving wife by his side until the end.

Today is my birthday, and having found myself back trying to figure out what I am supposed to learn from this second mania and unexpected fall from grace, Blake’s lament has a special resonance once again.

But this time I am reflecting on a very different face than that which I confronted 17 years ago. From the time I was very young I could not make sense of the face with which I was born. The eyes that looked out from within that visage threatened to give me away. The body I struggled to feel at home in never felt like mine. The girls I befriended seemed like aliens and, with no other explanation for my discomfort I assumed that I had never learned the tricks, never tried hard enough.

The idea that gender or identity could be misaligned never occurred to me when I was growing up. At least not in the context I needed to hear. And when It did start to seep into my awareness I was already well into marriage and motherhood. It was a complicated comfort to realize that there was an explanation for my feelings. It was even more terrifying to know what to do with this information.

I know well that my mood disorder runs back through my family, that it has a genetic basis somewhere. I have no idea what course it might have followed without this added sense of being out of step with rest of humanity. But my hospital psychiatrists were certain that my apparent gender dysphoria was simply a psychotic symptom that would resolve itself with the right dose of lithium.

They were wrong of course. Now, 17 years later, the average looking middle aged man who confronts me from the mirror is not special, but he is one I feel at home with. For many years I thought that was enough, as if I had found the magic bullet, the key to moving forward on all fronts. My family have been supportive, I recreated my identity and built a new career.

But I still found that the manic-depressive monster has followed me all along. Making sense of recovery this time around, I find myself doubly invisible. Behind a face that accurately reflects my sense of self identity, is a whole life I cannot fully share. Talking about being bipolar has been the easy part.

But moving forward from this birthday, I want to find a way to be whole.

Haunted by the unanswerable

Under the bipolar microscope, The who am I? question becomes Which me is me?

The depressed world weary me? The hyper productive hypomanic me? The over the edge manic me? Or that nebulous normal, somewhat sponged and effectively medicated me?

Or possibly all or none of the above.

I don’t remember exactly when I first started to swing between up and down, enthusiastic and anxious, outgoing and withdrawn. I suspect I didn’t really begin to articulate the patterns until my early 20s but I am sure the tendencies were there much earlier.

I was an awkward kid, lonely and odd. My brothers had friends in a our rural area but there was no one my age. I was frightfully shy and unpopular at school. I lived for books and music.

And it was music that offered a hint of another world gleaned through the Sunday edition of the New York Times that arrived each week, belated and a little worse for wear. Although I existed in a place where 70s rock bands dominated the radio and occasionally passed through, New York City was home to The Ramones, Patti Smith, Lou Reed and so much more.

For someone so miserably out of step with others, confused by questions of identity and smart when smart was not something to be, New York seemed like mecca. It was, after all, the city my mother came from and where my parents met even if we had ended up in another country some 2000 miles to the west. I was not the only isolated kid hunting out obscure copies of Velvet Underground albums back in the late 1970s, but in my hometown at the time I sure felt like it.

My mother tried hard to provide me with extracurricular activities upon the advice of a guidance counsellor who had picked up on my round-peg-square-hole. I started with drama lessons and moved on to guitar lessons. Not a natural musician like my son, I needed all the lessons I could get. My teacher was patient, guiding me along from “Jingle Bells”, through a year or two of classical, but his heart was with blues. Not a good move. I was too self conscious to jam and too bored to play twelve bar blues runs ad infinitum. So one day he asked me to bring an album and play for him something I really wanted to learn.

I arrived the next week with The Velvet Underground and Nico under my arm and played my favourite tune, “All Tomorrow’s Parties”. My teacher’s face fell.

That’s just discordant, he told me. I can’t do anything with that.

It was my last lesson.

The timelessness of that album and its influence on decades of musicians has amazed me. Both of my children even fell in love with it in their own time. And in honour of Lou Reed’s death an ensemble of Canadian artists from rock starts to opera singers and our own musical astronaut performed a tribute concert.

This most amazing cover of “All Tomorrow’s Parties” takes me back to a space before my mental health started its slow unraveling and reweaving of my self identity to bring me here. When I listen to this I feel like I am beginning to come full circle. Much older, much wiser but still figuring out who I am.

Enjoy.

The right book at the right time: Just Like Someone Without Mental Illness Only More So

“There are no people anywhere who don’t have some mental illness. It all depends on where you set the bar and how hard you look. What is a myth is that we are mostly mentally well most of the time.”
– Mark Vonnegut, MD 

A couple of years ago I happened to hear an interview on CBC radio, as part of a series on mental illness. I was, at the time, of the mind that my own issues with mental illness were well managed. A present fact but a distant reality. However, something about this conversation stayed with me.

The guest was Mark Vonnegut, son of the late author Kurt Vonnegut Jr. Mark grew up in Cape Cod, in the years before his father’s writing brought fame and fortune. I listened with interest to his very personal account of how, despite diagnosis with a serious mental illness, he applied and was accepted to Harvard Medical School. He went on to become a respected pediatrician. After my breakdown this summer I debated returning to the the fine accounts, like An Unquiet Mind, that had originally guided me to an understanding of my newly acquired label. Then I remembered Mark’s memoir Just Like Someone Without a Mental Illness Only More So and within minutes it was on my Kindle. But I only decided that I really needed to read it this weekend as my symptoms and anxieties continue to persist.

7816284Mark writes in an honest and matter of fact way about the trail madness has left through his family, tracing a legacy of depression, suicide and alcoholism going back generations. His mother heard voices and received message from license plates but once the episode passed she was able to rationalize it. When Mark’s aunt and uncle died within a month of one another leaving four troubled orphans, his parents took them in even though they had neither the money nor the capacity to manage. His oddly prescient mother had been stockpiling supplies for their arrival in advance, as her helpful voices had advised.

Mark was a loner spending a lot of time fishing and playing imaginary games in the woods around his home in Cape Cod. The oldest child of the family he grew up poor in the fallout of the the Depression. His father was a ineffectual used car salesman for many years. Mark was 21 before his father became a rich and famous author seemingly overnight.

Caught up in the hippie movement of the 60s, Mark followed many of his peers to Canada to join a commune in BC. He lived off the land, contemplated the meaning of life and experimented with drugs. And that is where he first encountered his own voices. In 1971, at the age of 23 he experienced three major psychotic breaks that landed him behind the locked doors and plexiglass windows of a Vancouver hospital.

“Among the things I grew up thinking about mental illness was that it was caused by other people or society treating you badly.I also knew that once people were broken they didn’t usually get better and the ones least likely to get better were paranoid schizophrenics, which is what I seemed to be.”

Retrieved by his father, Mark returned to the US where, with ongoing treatment, he continued to recover. The voices faded to the background. He published a book about his experiences and articles advocating for an understanding of mental illness as a biochemical condition, in strong opposition to the RD Laing inspired philosophy that was popular at the time (and has recently resurfaced). Somewhere along the way he decided that he wanted to go to medical school himself. Against all odds, and with pathetic math and science marks, he applied to one school after another. Incredibly Harvard gave him a chance.

Over the years that followed, Mark dedicated himself to his studies and his internship. By this point he had recognized that he was bipolar (not a schizophrenic who responds to lithium as he had been told), but even then, the schedule of an intern is grueling. During these years he also married, bought a house and started a family. The model of normal and healthy he figured his mental health issues were history.

Then 14 years after his third psychotic break, several years into a successful pediatric practice, the voices returned to taunt him. The trigger was his realization that he was fueling his high stress schedule with a two pack a day smoking habit along with 5 or 6 beers, half a bottle of wine, a few shots of bourbon and a sleeping medication to round off the day! Hardly a surprise then that his effort to quit cold turkey should trigger a psychotic break.

Although he sensed things were falling apart he resisted seeking help in a hospital. Driven by an absolutely irrational fear planted in his head by his voices he attempted to throw himself through a third story window. The window smashed but he fell back into the room. Unfortunately he ended up in a straightjacket on a gurney in the hallway of the very hospital where he had completed his internship and taught a course.

Although my own manic resurgence following an extensive period of wellness was somewhat less dramatic than Mark Vonnegut’s, it is only a matter of degree. Yet in time he was able to return to work and it has now been more than 25 years since his last manic break. His ability to rebuild his life and career even in the face of abject humiliation is an inspiration. And I am fortunate that I have neither smoking or alcoholism to contend with. But his story stands as stark reminder that with bipolar you must take the medication that keeps you stable and monitor your own level of energy. If we become complacent we risk an unwanted replay, no matter how long we have been well.

This book was published in 2010, so It was not available when I was first coming to terms with my diagnosis. Perhaps if I had read it when I first heard the interview I might have been able to head off my more recent experience. But then again, a manic person is a slow learner because that high just feel so good. Especially in contrast to the draining and  despondent opposite end of the cycle.

I would recommend this memoir to anyone interested in mental illness, especially those who understand what it is like to experience psychosis. Its casual, relaxed style makes for an easy read but, as a practicing physician, Vonnegut has some depressing observations about the decline of health care in his own country. Most importantly though, he leaves those of us who live with mental illness with a sense that we can get better, we can stay better and if we fall, we can get up and move forward.

That is exactly what I need to remember right now.

The unbearable invisibility of being mentally ill

For years I worked with brain injury. Depending upon the cause, damage to the brain can mark the survivor with more or less obvious physical impairments. But frequently the greatest impact leaves no obvious trace on the outside. The injury takes its most significant toll on memory, behaviour and fatigue.

Not unlike mental illness.

Copyright JM Schreiber 2014
Copyright JM Schreiber 2014

For many who have never had direct experience of mental illness the tendency is to imagine the extreme – psychotic, eccentric, suicidal behaviour. But the reality is so much more complicated, so much more subtle and, on the outside it is often so apparently normal. Especially for those of us who live with anxiety and mood disorders.

We look like other people. We have lives, families, jobs when we are well enough. But sometimes those things are tenuous. And yet there is this inability to step away from the condition and observe it, no CAT scans or MRIs to chart the progress of the illness or mark remission.

Copyright JM Schreiber 2014
Copyright JM Schreiber 2014

Recovery is a slippery concept. It depends so much on how we feel.

And the deeper we look the harder it is to know exactly how we feel.