This week, a family emergency necessitated an unplanned trip home. Spurred by stress, my mother was in rare anxious, nagging form. This sounds like your average “my mother drives me crazy” story, but my mother really drives me crazy because she is crazy. Not “put bells on your doorknob so the neighbors can’t sneak in” crazy (like some of my patients), but crazy nonetheless. My mother has Generalized Anxiety Disorder, Major Depression, chronic pain and a personality disorder. For my entire adult life, almost every conversation with her has included a discussion about her pain and/or depression. She has gone through more than 15 years of psychotherapy, over 10 years of pharmacotherapy, 2 partial hospitalization programs and several friends and acquaintances who couldn’t deal with her anymore. And the sad thing is, I don’t see many changes. I’m writing about this not only because I need to vent (and after a few days with family, I do need to vent!), but also because I can speak firsthand about the effects that chronic illness can have on a family. It is not fun. It is soooo not fun.
There has never been a time when my mother was perfectly healthy. During my childhood, the problem was constant headaches, back pain and insomnia. Luckily for me, the depression was less severe. As I left for college, things got worse. My mother’s job was lost due to depression. The house got dirtier. Mom stayed in bed at all hours. There was an awkward episode involving my mother sobbing to me that she wished she were dead. Then, partial hospitalization #1. There was some improvement after that. There was also a scary event when my mother’s meds interacted and she fell down a flight of stairs, hallucinating. In the intervening 10 years, there have been peaks and valleys of the depression. Mostly valleys, though. And through it all, her personality disorder makes it very difficulty to be empathetic.
I came to realize that serious depression causes a certain navel-gazing narcissism. It’s hard to be a good parent, friend or partner when all you can think about is how miserable you feel. And if you’re the friend or family, it’s hard to remain supportive upon hearing the 5,000th variation of “My life sucks.” I spent a lot of time dealing with the uncomfortable combination of anger and pity. Compassion is something that’s easier for me to give to my patients than to my own mother, as sad as that is. And there are other emotions that wait beneath the surface: jealousy, grief and anger. And worst of all, the sneaking suspicion that part of me may feel relieved when she dies. These emotions aren’t pretty. Though I am sure I’m not alone in my feelings, they’re not the type of thing I drag out at a cocktail party, either. (“Gosh, your family member has a mental illness? OMG! Mine too! Do you ever feel like smothering them with a pillow when they start to complain? No? How about slapping them and shouting ‘pull it together!’?”)
It’s interesting to me–and maybe pathological?–that I chose a job in which most of my patients have mental health issues. Perhaps I am attempting mastery over my own emotions by recreating similar stressors. And it’s easy to play the “Well, I don’t have it as bad as so-and-so” game when you work at my clinic. Sure, I may have a mother who is almost incapable of an authentic human interaction that doesn’t revolve around her needs, but at least I’m not that patient who had to quit his job to be on 24-7 suicide watch for his wife! My mother may drive me crazy with her constant litany of pain, but at least she can see a specialist with her private insurance plan! See, it’s easy to find the positives when you’re surrounded by negatives.
On the bright side, I like to think that my personal experience has given me a little bit more understanding of the complexity of depression and chronic pain. I may not win any awards for compassion (especially not after this post!) but I do understand how mental illness and chronic pain wreak havoc on both patients and families.