May is mental health month, with mental heath week having just concluded on the 21st. So I want to talk about mental heath. At the end of April, in “Part 2”, I shared the story of my husband’s suicide. Part of that story is still untold. It’s what I learned about mental health. I thought it was worth sharing.
Like any survivor of suicide loss, I have replayed in my mind the weeks, months, and even years, leading up to that event, trying to figure out what went wrong, what I could have done differently, what I could have said, to prevent that tragedy.
In February, I believe in some sort of effort to make peace with the thoughts – the guilt perhaps – racing through my mind, I took an 8-hour course to become certified in mental health first aid. As I attempted to joke to a friend, “no more suicides on my watch.”
The course was offered by Vantage Health System here in Bergen County, New Jersey, as part of the Stigma Free initiative (for more information on a course in your area, go to http://www.mentalhealthfirstaid.org/cs/). As explained in the introduction, “most of us assume mental illness is something that only affects others and believe it won’t affect our family or friends. The truth is that mental health problems are more common than heart disease, lung disease, and cancer — combined!”
When we think of mental health problems we often think of conditions like schizophrenia or bipolar disorder, which can be caused by genetics and biochemistry, but psychosis is far from the most common. The course explored mental health issues in five categories. In addition to psychosis, it looked at depression, anxiety disorders, substance abuse disorders, and eating disorders. The causes of many of these are far more common: difficult childhood, trauma, separation and divorce, loss of a job, financial problems, death of a family member, developing a long-term illness, caring for a family member with a long-term illness, to name a few.
In the first hours of the course, I saw my husband in the symptoms and causes being discussed…difficult childhood…a more sensitive emotional nature…substance use…long-term job loss…anxiety…depression…a break up of a relationship… And as I listened to the instructor share the dos and don’ts of what to say to someone in need of mental health first aid, I couldn’t help but beat myself up realizing I had done everything wrong…and was, at times, downright insensitive.
But then something changed. I began to see myself not as a caretaker or first aider, but as someone who had been in need of mental health first aid myself. I realized that I was in no shape to administer first aid to anyone. Not long after her father’s death, my daughter said to me, “you know I always thought you were the unstable parent.” I realized there was some truth to that.
I have mentioned before that prior to my cancer diagnosis, I was experiencing what I referred to as “toxic stress.” It came on gradually beginning in 2005. I was already a full-time working mother of a pre-school child; my husband was out of work. I took on the position of CEO of a struggling, young non-profit organization in January. They were celebrating the 5th anniversary of their founding and I was the 7th CEO. Later that year my parents moved back to New Jersey. I started to realize my father was becoming frailer. In the fall, in order to improve the financial position of the organization, I had to lay off a third of the staff.
Although the organization’s financial health improved somewhat, we were running short-staffed. I was working long hours. My father’s health was deteriorating. At that time, I was grateful that my husband was out of work, spending time with our now 6 year-old daughter and keeping things running at home. Having him as a “stay-at-home dad” worked for me at that time.
My dad died in October, 2006. A year later we moved into a bigger house and moved my mom in with us. That was supposed to make things easier. My husband was supposed to go back to work. However, it became obvious that my mother’s “senior moments” were something far worse. My husband grew angry and resentful in caring for my mother and juggling a 2nd grader. I spent my days trying to manage a non-profit on the verge of bankruptcy and came home in the evenings to chaos. My husband was struggling.
After moving my mother into an assisted living facility and taking a few months off from work to regroup, I went back to work full-time, commuting everyday now into New York City. My husband continued to stay home despite my pleas for him to find a job. Within a year, my mother’s condition exceeded the level of care available at her current home and she had to be moved. Not long after that, I was called on to be guardian to my aunt – her sister – also with severe dementia. For the next year I managed their financial affairs and healthcare, called out of meetings to talk to nurses, doctors and lawyers. My dog died. Then my aunt died and then there was planning her funeral and settling of her estate. In the year that followed, my mother had to be moved twice as she spent down her life savings.
After three years at my job, a new boss decided I needed to go. It was understandable. Maybe I was too distracted. So I was out of work six weeks when my mom died. I will always appreciate the time I had with her at the end. I buried her on the first day of summer in 2012 and it seemed to bookend nicely the difficult times. I found some work to do, the bills were getting paid and I went into 2013 with a new lease on life. I was ready to live…but with that the stark differences between my husband and me became more obvious. And I also began to need his support more, only to realize he wasn’t capable of being who I needed him to be.
Once both of my parents were gone, I was without my emotional safety net and my biggest fans. While I never doubted my husband’s love for me, because of his own struggles, he lacked the capacity to love the way they loved. I also felt an enormous strain in being the sole provider for my family and having very little flexibility in terms of what I wanted to do. I went where the money was because I felt I had no choice. The last stop of my career at that point was Chief Development Officer of a big adoption agency located on the Upper East Side. The average commute was 90 minutes – one way (on a good day). And if that wasn’t bad enough, I had a very difficult boss; absent at times, micromanaging at others. It was a snowy winter and I opted to work from home against her wishes on the really bad days. I remember a phone conversation with her one day I was working from home. She was frustrated I wasn’t in the office and a miscommunication between us resulted in a document not being ready for a meeting. After I hung up the phone, I sank to the floor and sobbed.
Why am I telling you all this? Because that’s mental illness. Life is not about being positive and staying optimistic. It’s not whether you see the glass as half empty or half full; it’s how heavy the glass is and how much heavier it feels when you can’t put it down. It’s getting to the breaking point…and then being diagnosed with invasive breast cancer six weeks later. Mental illness doesn’t mean that there is something wrong with you, any more so than when you catch the flu. It also doesn’t mean that you can’t get better.
At that point in my life, I couldn’t make simple decisions. I felt paralyzed. Alone. Angry. Frustrated. Hopeless. And Chris felt all those things too. But it was all I could do to support myself, so he lost the support I had provided for so many years. I had read something many years ago about marriage; how a marriage fails when both partners “go crazy” at the same time.
My mental health issues were caused by the cumulative affects of the stress of caring for my mother and aunt, loss of my parents, job losses, financial instability, and the trauma of my cancer diagnosis. I recognized that and got help. I started counseling a week after my cancer surgery. Chris refused to go for counseling and his issues were more deeply rooted in a difficult childhood and ultimately exasperated by the potential loss of the person who had kept it all together for him for over 20 years.
Thanks to two years of therapy, I no longer hold myself responsible for that. I mediate daily, and of course I run. When I got my certificate in Mental Health First Aid, I forgave myself and I forgave Chris for not being the people each of us needed in our lives at that time. My daughter told me too that she realized that “healthy” people get help like I did. One day recently when she was having a particularly stressful day she told me, “I’m going for a run.”
So go for a run. Meditate. Talk to a therapist. Call a friend. Find a coach. Realize it’s okay to ask for help.
My most happy place. Montauk, New York. June 2015