Mental illness … and the Nature of Evil

The past fifty years have seen a huge change in society’s understanding and attitude toward mental illness, but stigma still remains. Just this past week, the news that caught my ear (since most of my news comes to me via NPR) was that lawmakers are attempting to make it easier to force people with mental illness into care and treatment.  These efforts are motivated in large part by the incidents such as Sandy Hook, and Adam Lanza, who seems to have needed treatment, and didn’t receive it.

I’m deeply sympathetic to this urge to force treatment on the severely mentally ill.  After all, my sister and I suffered years of instability because of our mother’s untreated bipolar disorder.

And, sometimes, mental illness really can look like Evil.

I’ll never forget one night, when my mother was in the clutches of one of her more manic swings, not sleeping, and becoming delusional, and she seemed to have confused me with my dead father, her ex-husband.  She repeated accused me, as my father, of raping her, and causing her indescribable pain and suffering (not something a daughter wants to hear, ever!).  She wouldn’t calm down, but rather, escalated.  It was after midnight, and my one thought was that my daughter, then about 5 or 6 years old, really didn’t need to wake up and witness this scene of complete chaos and anger!  (thank goodness my children all seem to sleep like logs, and it would take a hurricane or some other natural disaster to wake them, but not just screaming).  We ended up calling the police to have my mother escorted from our property.  Such a shameful experience, but families are left with few options.  Despite being clearly delusional and irrational, since she wasn’t at that point a danger to herself or us, she couldn’t be hospitalized.

A number of years later, my poor sister was faced with going before a judge to argue that our mother was not competent to make her own decisions (at the time, our mother was threatening to leave the security of the assisted living my sister had arranged for her, and seemed bent on living in the street).  As soon as our mother started talking to the judge (and making no logical sense), the decision to grant my sister guardianship was made.  But, that didn’t mean that she would agree to treatment to help her get back to some semblance of sanity.

Living with mental illness can be intoxicating – particularly when the mood disorder is mania, which makes one feel omnipotent, and able to achieve anything.  Schizophrenics can similarly feel that their delusions are a special gift.  I had a patient who would go off his medications, and then believed that he was communicating directly with Jesus.  He would go off and live in the woods of the parklands around Baltimore.  When he was on his medications, he was the most lovely, intelligent and interesting person.  I haven’t seen him in years, and I fear that the woods (and his disease) may have conquered him.

You can read the writings of prophets like Ezekiel, and, with a modern sensibility, it seems like these folks must have been high on some mind-altering substance, or their perceptions were altered by internal chemical imbalance.  And, it seems likely that many of the poor women who were murdered under suspicion of being witches in Salem, MA, may have suffered mental illness.

The conundrum is that most mentally ill people are not violent.  They may hurt themselves in many ways.  They often hurt their families, and cause tremendous exhaustion, stress, and economic cost.  It’s so difficult to argue that treatment should be forced on people when the treatments often carry with them intolerable side effects, and sometimes are of unclear benefit.

We need desperately to destigmatize mental illness.

We need more rational solutions to the problem of trying to offer help to people who may not want to be helped.  We need to offer support to their families.

And, we definitely need to work on the abuse and violence that can predispose people to have their brain chemistry altered early on and lead them to a life of confusion and disorientation.

I see it daily in my patients, and I have lived with it in my own family.

Ruby-by-Cynthia-Bond This post was inspired by Ruby by Cynthia Bond, an gripping novel about overcoming our past and embracing love in a racially charged rural 1950s Texas. Join From Left to Write on May 8 we discuss Ruby. As a member, I received a copy of the book for review purposes.

13 thoughts on “Mental illness … and the Nature of Evil

  1. Chava Gal-Or says:

    Powerful piece!!!

  2. Chava Gal-Or says:

    Powerful piece!!!

    As someone that suffered at the hands of a mentally ill mother, I have dealt with many of the memories by detaching. On a very rare occasion I feel a moment of sadness for my mother's realities, but mostly I have had to detach as my way of healing.

    Your compassion is really beautiful. Thank you for sharing so many of your thoughts. Amnesia really isn't a horrible thing sometimes; perhaps that gives your mom some peace.

    1. jkuruppu says:

      I completely understand that, and, I felt the same way for a long time. I am fortunate that I am able to remember some clear gifts my mother gave me, and an example of passion and commitment to social justice, even when those impulses sometimes got led astray due to her mental condition causing her to confuse priorities at times. And, I definitely believe that forgetfulness helps a great deal, to allow us to move on.

  3. Laura says:

    It is so difficult to know what to do, but I also worry that laws like this stigmatize mental disorders even more, making them things people want to hide. I appreciate your thoughts and perspective so much in this post – and I I feel like you have the compassion needed to truly understand both sides of the discussion.

    1. jkuruppu says:

      we have to have compassion, don't we? we all struggle with different challenges in life. It took me a long, long time to come to a point where I could have compassion for my mom – there was a lot of anger and resentment to get past. Now, I'm mostly filled with sadness for so much wasted talent – she is an extraordinarily talented and intelligent woman, who was never able to fulfill her potential.

  4. Alicia S says:

    I am so sorry that you had to live through that especially as a child. And so sad for your mother as no mother wants to put her children through that. I hope they find an answer soon better than just medicating them.

    1. jkuruppu says:

      Thanks for your kind words. Sadly, I think that my mother does have regrets now – although, blessedly, there is a certain amnesia for the past that keeps it a bit remote. Also, when the person is in the middle of delusional thinking, the memories don't last. Thankfully, medications are getting better, and have less side-effects than they did in the past. We have a lot of work to do to get better treatments, but, if you assume, as I do, that most of these severe mental disorders are, in fact, biochemical imbalances, medications are probably the only real hope for improvement and successful symptom control.

  5. Briana says:

    That sounds like a scary experience :- I definitely think that it can help extreme cases, but I worry about where the system will draw the line. It's very difficult.

    1. jkuruppu says:

      it is so difficult!! I appreciate your understanding of the challenge. Thanks for commenting.

  6. ThienKimL says:

    Thank you for sharing your experiences. I'm with you. Mental illness isn't Evil. It's our health care system that makes it hard for the mentally ill to seek the proper care.

    1. Anonymous says:

      Thank you, Kim. I'm not sure it's our health care system that makes it hard on the mentally ill, as much as it is the structure of our insurance schemes, which definitely put mental disorders in a separate category from physical illness. I have plenty of providers to refer my patients to, but their insurance coverage often prevents me.

    2. jkuruppu says:

      Thanks, Kim, for the kind comment.

      I'm not so sure it's the health care system that is the problem, as much as our payment structure. The insurance companies put mental illness in a completely different category from physical conditions. It's one of the reasons I feel so strongly that we need a single payer system in this country.

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