How I Beat Postpartum Depression

One in seven women experience postpartum depression. So the trick is knowing you're not alone. You just need to find your tribe.

“I cry so much I worry he will remember his childhood filled with tears. I cry because there are so many things I don’t want to forget—the way he pecks like a bird for my breast and sometimes mistakes his knuckle for me, his little knee bent while he feeds … his noises, his smell—oh God, his smell.”

“It’s just that sometimes I am a robot playing his mother. I still don’t know how to be his mother. I am always looking out of the robot’s eyes, never sure completely whether I truly feel this thing or that, or if it’s because I ‘should’ feel it.”

I wrote those words in my journal a few months after giving birth to my oldest son in 2010. The joy of bringing a new child into my family was often clouded over by moments of intense depression and anxiety, which lingered untreated even up to a year and a half later.

Sometimes I would write about “the robot.” On darker days, I wrote about hurting myself, what it would be like to just not live anymore. I was instantly aware of how selfish it sounded for a mother of an infant to think about killing herself. That guilt made the situation even worse—and of course, harder to talk to anyone about.

I was not supposed to feel like this.

I was not supposed to feel like this. My Facebook feed was filled with beautiful photos of softly swaddled, happy infants and mothers (in fact, I had put more than a few of those photos out there myself). Everywhere there were blog posts and even strangers in Target admonishing me to, “make every minute count” because “they grow up so fast.”

Was I supposed to make these minutes count, the minutes when I lay in bed, running a finger over my numb c-section scar and crying myself to sleep? I just wanted those minutes to be over.

As my baby grew older, I would structure my day around his naps, scheduling work that needed to be done in the hourlong scraps of time I thought I could rely on. When he didn’t fit into that schedule, I sank deeper into the hole. I was exhausted. There was never a time I didn’t feel like someone needed something from me, and there didn’t seem to be much left to begin with.

The author and her two sons today.

Complicating matters was the fact that I lived in a small town in Michigan. On the days I felt strong enough to advocate for myself and get help, I dialed number after number of psychologists and psychiatrists. I had the benefit of good insurance through my husband, but I was turned away due to not enough supply of mental health professionals to meet the local demand. One therapist told me, “I’ve got a waiting list for my waiting list.”

I called the local hospital one day and pleaded to be connected to someone who could help me. I was having thoughts of self-harm, I told them, but I wasn’t able to find a therapist who could see me. They asked if I had Medicaid to qualify for mental health services. I did not. They didn’t have any alternatives to the crossed-out list already in front of me, and I hung up, dejected once again. Moments later, my phone rang from my local 911 dispatcher. Was I OK? She had received a call from the hospital. How could she help? I laughed into the phone. “Can you find me a therapist?”

My phone rang from my local 911 dispatcher. Was I OK? I laughed into the phone. “Can you find me a therapist?”

When my son was about 15 months old, I finally got help. I started seeing a therapist once a week. It wasn’t a cure-all solution, and I still battled depression off and on. My therapist made me sign a contract that I’d call 911 or go to the ER if I had more thoughts of self-harm. I spent one January night sitting in the parking lot at the hospital, debating whether I should check myself in or not. Where would they send me? What would happen to our son? I was his primary caregiver in those days.

Slowly the fog lifted. With the help of my therapist, I was able to look at my situation with a bit more clarity and compassion. I needed help, and not just psychological help. I needed help taking care of my child, time for my own work (which had fallen by the wayside) and self care.

I didn’t know it at the time, but I also could have benefitted from a community that could help me navigate this transition into motherhood. I realized how isolated I had become. My family was scattered several hours away. I had few good friends in those days who were parents. I had always been so independent and self-reliant; the benefit of reaching out to a group of people who was going through what I was going through was a foreign concept to me.

The next time, I would change all of that.

In 2014, my husband accepted a new job in Texas, and I discovered that I was pregnant with our second baby. As we drove our loaded-up minivan across the country, I plotted how I would do things differently. And if I was lucky enough to escape postpartum depression this time, I vowed to do something to help other women in my situation.

If I was lucky enough to escape postpartum depression this time, I vowed to do something to help other women in my situation.

The first thing I did was create an online community, a private Facebook group, for other people who had struggled with postpartum anxiety and depression, and therefore could understand what each other were going through. Here we could speak openly and frankly in a nonjudgmental setting. I spread the word among all the parenting groups I knew, and instantly I connected with several people who understood my exact struggle.

That spawned real-life group therapy sessions, where local moms shared their stories with a local therapist, and we all helped each other come up with strategies and coping mechanisms.

I started volunteering for the Pregnancy and Postpartum Health Alliance of Texas, eventually earning a scholarship to study to become a postpartum doula specializing in helping mothers with postpartum depression and anxiety. I had never heard of a postpartum doula before—essentially, they provide the extra hands and hearts of a surrogate family member, coming in to help new mothers after the birth of their babies with everything from practical day-to-day tasks like washing dishes and playing with older siblings to just listening to moms and dads and their challenges.

These experiences opened my eyes to the heartbreaking reality of postpartum mood disorders.

Before when I struggled alone, I kept telling myself “this can’t be the reality for most women,” but unfortunately, in my talks with other mothers since them, I have found that suffering in silence is quite common. The American Psychological Association estimates that one in seven mothers experience postpartum depression.

The intrusive thoughts associated with postpartum anxiety and OCD are actually very common, and with help, can be managed and overcome.

We are conditioned not to talk about these symptoms. I learned that the intrusive thoughts associated with postpartum anxiety and OCD are actually very common, and with help, can be managed and overcome. However, because of headline-grabbing cases of women who harm their children due to postpartum psychosis (a rare but serious postpartum illness), we are frightened into not speaking the words that actually have the power to help us heal.

We have such a long way to go before women suffering from postpartum mood disorders are properly cared for and supported in a comprehensive, meaningful way and feel comfortable speaking their truth without fear, but I hope that essays like this in some way help to further the dialogue.

It’s almost guaranteed I will hear from other mothers after they read these words. Whenever I speak out about postpartum mood disorders (it’s becoming a bit of a soapbox for me), friends message me sharing their own stories that they too have suffered or are currently living in the shadow of postpartum depression or anxiety.

Talk to someone…you’ll be surprised at the number of people who will feel empowered by your act of strength.

For women living in rural communities or areas without access to mental health resources, my best suggestion is to talk to someone–a friend, your partner, your OB or physician. Maybe you can find (or form) a group like I did.

You’ll be surprised at the number of people who will feel empowered by your act of strength, even if you don’t feel very strong. Talking about postpartum mood disorders rather than living in the shadows is the first step toward taking away their power and finding your own once again.

Creative Commons photo by Barbara W.

The Good Fight

The World’s Only Classical Music Ensemble For The Mentally Ill

After his own career almost unraveled, Ronald Braunstein founded the Me2/Orchestra to help fight the stigma against mental illness in the classical music community.

Prizewinning conductor Ronald Braunstein had a much-heralded early career in the classical music scene that began to unravel due to his bipolar disorder. But his experience with this condition eventually led to the founding of the Me2/Orchestra: the world’s only classical music ensemble for the mentally ill (and their advocates).

The conceptual origins of Me2/ date back to 2007, when Braunstein, then living in Prague, observed the huge gap in music education between public and private schools. “I wanted to create an orchestra that was inclusive of students from all socio-economic levels. The idea never went anywhere in Prague but I picked up that seed a few years later in Burlington [Vermont] – only this time my heart was in it. The inclusion I sought had to do with mental health rather than economic disparity,” he says.

There was good reason why mental health was a priority: Braunstein had just been fired from a job because of his bipolar disorder. “I was in the process of sorting out my mental and physical health and I knew I didn’t want to get a job where I could be discriminated against again. I decided to create my own orchestra and ensure that it was a safe place,” he says, before adding, “I knew that if I was feeling so much pain from being discriminated against that there must be other people like me.”


Ronald Braunstein.

I knew that if I was feeling so much pain from being discriminated against that there must be other people like me.”

Braunstein, who was born in Massachusetts but raised in Pittsburgh, says that as a child his father took him to see a doctor, who diagnosed him with “bad nerves” and “prescribed some type of medication, maybe it was valium.” He adds how, “Over the years several people told me that I needed to see ‘a doctor,’ but this was during the ’70s when nobody spoke [about] mental health and I honestly didn’t know what they were trying to tell me.” For many years he contended with symptoms “but things started to get really revved-up in [his] early twenties.”

While studying at New York City’s famed Juilliard School his condition became severe. “I ate very little and didn’t sleep. I thought that food and sleep took away my brilliance. I experienced all of the classic bipolar behavior: delusions of grandeur, rapid pressured speech, irresponsibility in dealing with money, etc.”

However, he managed to graduate from Juilliard in 1978 with a degree in conducting. And at age 23, he became the first American to win the Gold Medal in the Herbert von Karajan International Conducting Competition in Berlin. This prize greatly boosted his early career and took him all over the world as a guest conductor at orchestras ranging from San Francisco to Norway to Japan. He later joined the Juilliard conducting staff.

Braunstein was first diagnosed with bipolar disorder in 1985. “I took a friend to his psychiatrist appointment,” he recalls. “And, through an odd turn of events, I walked away from that office with my own diagnosis.” He feels that the stigma surrounding mental illness has decreased since the time of his diagnosis, but “we still have a long way to go.” That said, he hasn’t encountered any stigma-related obstacles when trying to arrange a Me2/ performance. And he views the orchestra as helping to “change audience members’ perceptions” about the mentally ill by “showing what we are capable of in performances.”

Many believe a link exists between creativity and mental illness, and Braunstein notices a particular prevalence of bipolar disorder among the musically gifted

Many believe a link exists between creativity and mental illness, and Braunstein notices a particular prevalence of bipolar disorder among the musically gifted. Of brilliant composers likely afflicted, he gives a slew of examples: Schumann, Tchaikovsky, Mahler, Berlioz, Bruckner, Rachmaninoff, Elgar, Handel, Holst, Mussorgsky, and Rossini. Another prominent example is his favorite composer, Beethoven. He also admires Tchaikovsky, Johannes Brahms, Otto Klemperer (whose battle with bipolar disorder was well-documented), and Igor Stravinsky. Among his influences are Leonard Bernstein, Seiji Ozawa and, especially, his mentor Herbert von Karajan, the longtime conductor of the Berlin Philharmonic, who taught him “how to really hear the orchestra” while conducting.

Braunstein conducting the Me2/Orchestra.

Of his own dual experience with gifted musicianship and mental illness, he says: “When I am in a manic phase I can be brilliant, or so it seems. When I come to a more stable point I can see whether the brilliance was actual or an illusion. And then there’s the question I always have after conducting a great concert: whether it was my musicianship or my illness.” He says that his symptoms are managed more effectively these days and are less likely to distort his self-perception. Previously, he was more inclined to have a “lack of insight into how [he] was doing” and hold an unrealistic opinion of his performance.

The question I always have after conducting a great concert [is] whether it was my musicianship or my illness.

The flagship chapter of Me2/ was established in September 2011 in Burlington, Vermont. September 2014 saw the launching of the Boston chapter. Though many members have diagnosed conditions, Me2/ also includes those who support the mentally ill, along with mental health professionals, such as one psychiatrist who plays trumpet for the Boston orchestra.

Me2/ has performed at several formidable venues, such as prisons and psychiatric hospitals – settings that don’t exactly evoke thoughts of classical music, but actually have provided the most engaged and appreciative audiences. In such places, the music “reaches their souls,” observes Braunstein, who adds how Me2/ has “never been unappreciated” at any type of venue.


Currently, fifty musicians belong to the Me2/Burlington, and the Boston chapter has 35. The orchestras perform 5 or 6 times per concert season. Of the musicians who join, almost all stay for a long period. There are no auditions to worry about. Braunstein’s programs are “designed for the middle-level of the orchestra. For the people who are less experienced, we offer coaching but technical perfection is not what we are about. We have professional musicians sitting alongside near-beginners and it works.” Many other members are skilled amateurs who “received extensive training earlier in life.”

Among mentally ill members, conditions range from depression to PTSD to schizophrenia to dissociative disorder, among others. Members aren’t required to disclose their diagnoses, but some do so “within the first 5 minutes.” Others are less than forthcoming at first. Braunstein recalls one member who “didn’t want her name printed in materials because she didn’t want to be associated with ‘the mental health orchestra.’ She didn’t disclose her diagnosis for a long time; however, after playing with us for a few years she has now become an outspoken advocate about erasing stigma.”

Though a few members prefer to keep to themselves, many others become friends and socialize outside of Me2/. Braunstein describes rehearsals as “extremely social” and adds that the “positive energy is palpable.” He recalls one man who, after a few months with the orchestra, had reconnected with his long-estranged extended family because Me2/ “gave him the confidence and self-respect he needed.”

Another member considers each Me2/ rehearsal his “detox” from the remainder of the week. And for some members with a tendency to self-isolate, the orchestra “gets them out of the house and surrounded by supportive friends once a week.”

Braunstein currently lives in Burlington, Vermont, with his wife, Caroline Whiddon, a Me2/ cofounder who serves as Executive Director and also plays the French horn. They drive back and forth from Burlington to Boston each week, as the Boston orchestra rehearses every Monday and the Burlington one every Thursday.

“[Music] is a space to be in that is safe and beautiful… it has given my life meaning.”

The conductor’s future aspirations are “to continue to grow and learn as a musician and a human being. Me2/ is my project for life.” His life-project has grand plans in store: A Me2/ chapter has just launched in Portland, Oregon, and Braunstein anticipates another chapter launching this summer in Atlanta, Georgia. In three years, he hopes to have 20 affiliate programs in various cities. Ten years from now, he sees Me2/ having “affiliate programs nationwide, including orchestras and various ensembles.” He also envisions “hosting conferences where Me2/ members from various locations come together to rehearse and perform in massive events.”

Though some afflicted persons might view music as an escape from psychological duress, Braunstein prefers to think of music as “a space to be in that is safe and beautiful.” When asked about the effect of Me2/ on him personally, he concisely replies, “It has given my life meaning.”

Me2/ is open to ages 13-80+ and there’s no cost to participate. For further information, see the website.


The Adopted Artist With Her Head In The Clouds

Anxiety, depression, and the nature of memory intertwine in Andrea Joyce Heimer's unforgettable paintings.

Like many young artists, Andrea Joyce Heimer spent her early twenties stuck in an office job that she didn’t like while she tried to find her creative voice. Unable to afford art school, she was determined to teach herself to paint in a photorealistic manner — the only style she thought could convey the adolescent memories she wanted to depict. But no matter how many instructional books she bought or how hard she tried, she couldn’t master perspective. Eventually, she quit out of frustration.

Andrea Heimer.

Around the same time, Heimer, who had been struggling with anxiety and depression since high school, fell into one of her deepest depressions. She couldn’t get herself out of the house for weeks. “It was like I just hit a wall,” she says. “I thought, ‘I’m going to off myself unless I figure out something to keep me busy.’”

Still surrounded by art supplies, Heimer decided pick up a brush again. This time, however, she wasn’t going to worry about what the painting looked like. She told herself, “I’m just going to do it how it comes out. I’m going to return to childhood where I just draw for the fun of it.”

She ended up painting four pieces. The paintings were all flat, with no shading and the perspective was skewed. But there was something appealing about them. With encouragement from her husband, she reached out to some folk art galleries and received a positive response from the first place she contacted. She was still stuck in a depressive loop, but that positive reply gave her just enough of “a little oomph” to make another painting and then another. Slowly but surely, that momentum built on itself, eventually pulling her out of her dark hole.

Having dispensed with spatial perspective, her paintings are filled with layers of detail, all floating on the same plane

Today, Heimer is a full-time artist, splitting her time between an MFA program in New Hampshire and her home in Washington. Having dispensed with spatial perspective, her paintings are filled with layers of detail, all floating on the same plane. Objects and characters that might otherwise be hidden are brought into view, unveiling the mystery and violence hidden just below the surface of suburban neighborhoods. The effect is akin to Grandma Moses meets David Lynch. In her acrylic world, ordinary rites of passage collide with mystical rituals: cult members argue over wallpaper choices, giant wolves suckle teenage boys, and a devoted husband drinks his wife’s bathwater. At the same time, kids get bowl cuts in the living room, bad boys hang out at the baseball diamond “being dangerous and irresistible,” and girls cultivate crushes that are mythical in scope.

Often only 16 inches by 20 inches, or smaller, her paintings reward viewers who pause for a closer look. Minute patterns on wallpaper and clothing reveal themselves to be cowboys and Indians, thunderstorms and rainbows, or a starry cosmos of planets and comets. These repeated patterns are therapeutic for Heimer. Even when the painting doesn’t aesthetically need the patterning, Heimer needs it. “For someone who has tendencies to overthink things, it’s such a relief to go do something repetitive,” she says. “It’s that meditative process of drawing the same tiny design over and over and over again–you can lose yourself completely for two hours just doing that.” To paint these details, she leans close to the canvas, keeping her face only an inch away from the surface. “I’m sure that’s terrible for my spine,” she says. “But it’s that intimate time spent with that object that breathes more life into it. I miss that when it’s not there.”

It’s that intimate time spent with that object that breathes more life into it.

Heimer began developing a keen eye for detail early on. When she was in third grade, her parents pulled her aside after dinner and told her that she was adopted. Visibly uncomfortable, they kept the conversation short, and didn’t discuss it again. Determined to never be surprised like that again, she became a studious observer of life in her hometown of Great Falls, Montana.

“You’re going along, you have this normal life … and then all of a sudden you find out that your parents aren’t who you think they are,” explains Heimer. “Then that opens a door. You’re like, ‘Okay, well what else isn’t what it seems?’’’

Great Falls sits on the northern Great Plains, surrounded by vast stretches of open prairie. “You can literally find the edge of town and go stand there. There’s nothing beyond it, which is an unnerving thing,” says Heimer. The neighborhood she grew up in, however, felt like a typical suburb. She lived a couple blocks away from her elementary school. There was a park across the street from their house and beyond that a golf course.

Heimer would spend hours riding her bike past the houses, coming up with narratives about the lives inside. “I don’t know if there’s some underlying perversion in me, or something. Maybe it’s a normal tendency. You ride the same route and you start noticing the same people and you wonder, ‘Are their lives like my life?’”

Heimer at work in her studio.

As a goth teenager, she’d go to music shows and sit in the parking lot because she was more interested in listening to people’s conversations than the bands inside. “I would sit in my car a lot with the window down pretending to read a book or something, but really I was listening to the people who were standing next to my car talking,” she says. “Saying it now, I’m like, ‘God, what a weirdo. Just go talk to somebody like a normal person.’”

All those years of listening have turned into a wealth of stories to draw upon — and led to conversations that Heimer could never have predicted as a teen. “The paintings are almost like — this is going to sound so stupid — but I feel like each one has its own personality or its own magnetic force,” she says. “I feel like they’re little people trying to help me along.”

I feel like each [painting] has its own personality or its own magnetic force… like they’re little people trying to help me along.

The lively, diary-like revelations in her paintings seems to help others open up as well. “I don’t know if it’s because a lot of them are very embarrassing, but you would not believe the things that people tell me at openings,” she says. “After a two-minute conversation, they’ll confess something really deep or embarrassing or touching. I wasn’t expecting those interactions, and they make me feel good in a way that nothing else does.”

Heimer has found that these moments of connection give her a sense of buoyancy that helps counteract the weight depression. She is pursuing her MFA in part so that she can teach part-time and make interacting with others a more regular occurrence. “I realized that I was spending eight hours a day alone in the studio painting. That’s not healthy either,” she says. “I totally love being around art students. It’s another magical thing, being around other people who are making things and learning.”

“I don’t want to be super dramatic and be like, ‘It’s given me something to live for,’” says Heimer of her art. “The pace and the momentum of it, I think, help. I still have medication. I do all the stuff that I’m supposed to. But there’s something about that forward momentum. It doesn’t have to come from a painting career. It can be anything that you care about that propels you forward.”


Guarding His LGBT Kids Against Depression

1/3rd of LGBT teens have attempted suicide. That scary statistic is why Evan Peterson is putting his kids' mental health first.

Growing up, Evan Peterson never felt he could be himself. Living in small-town California with a homophobic stepfather, Evan kept quiet when he realized he was attracted to boys as well as girls. Confusion and loneliness took its toll, culminating in clinical depression and a suicide attempt.

Now a single parent, Evan is determined not to let history repeat itself with his own family. Of Evan’s four children, three identify as LGBT. Lane, nineteen, is bisexual, while Jamie and Elliot, sixteen and twelve, are transgender. Their younger sister, Grace, is nine. (All names of the children in this piece have been changed at Evan’s request. – Ed.)

It’s a role he might not have expected but one he’s well equipped for. Evan spent the best part of the last two decades becoming more and more involved in the LGBT community, where he routinely speaks out against injustice and bisexual erasure as a writer with Bisexual Books

Evan Peterson is a writer on LGBT issues, as well as the parent of four kids.

“Finding where we’re marginalized and speaking about it and trying to give us a voice. That’s where I am now: I’m that guy,” he says.

He wasn’t always that guy. Around the age of eleven, Evan realized he was bisexual. The realization confused him: a situation exacerbated because he couldn’t discuss his sexuality with his “openly homophobic” stepfather.

“When I was a teenager I didn’t really trust my parents at all, I wouldn’t share any sort of problems I was ever having. At that time the word bisexual wasn’t a thing, people didn’t talk about that, just, you’re gay or you’re straight. I was really confused throughout my teens, I just considered myself straight and I was confused as to why I was also attracted to guys.”

His inner turmoil and sense of isolation made him deeply unhappy.

“When I was in the closet, I felt confused. I felt like I was drowning and miserable and had no way to come out of it. I self-medicated with alcohol and promiscuity. I attempted suicide – no one ever found out.”

When I was in the closet, I felt confused. I felt like I was drowning and miserable and had no way to come out of it.

Leaving his hometown for a new life on his own in southern California changed everything.

“I was twenty-one, sitting on a beach by myself after dropping everything and moving to the coast. The sun was a pre-dusk buttery yellow, and I found myself admiring the other people around me. For the first time, I felt no guilt or shame. I felt lighter and free. From that day forward I opened myself up and remained true to myself. [My new life] came with its own worries and complications, but it also filled every part of me with peace, with bliss.”

Evan began coming out to friends, and let his family find out through the grapevine. The relief of being open about his identity improved his state of mind. While  he still battles depression –he received a formal diagnosis in 2004– knowing who he is has given Evan the resources to tackle his mental health.

“I am a happier person having allowed myself the strength to be myself,” he says

Day-to-day, Evan manages his well being by taking a daily dose of Welbutrin, and by writing, which channels his energy into creativity. He also leans on friends, some of whom are far flung but still keep in close touch.

But even more important to Evan than his own mental health is that of his kids. LGBT youth are three times more likely to suffer from mental health problems than straight and cisgender kids. A third of LGBT youth have also attempted suicide. Harrowing figures like this have made Evan hyper-aware that supporting his kids.

LGBT youth are three times more likely to suffer from mental health problems than straight and cisgender kids.

“I’ve always raised the kids as [an] openly bisexual [parent], and we’ve always had queer friends around. The kids have always known that home is someplace that is safe, so it was easy for all of them to come out when they decided to come out. I think they felt reassured they’d have a supportive home here. They still come to me with problems and that’s a good sign.”

A small but significant part of that support is respecting Jamie and Elliot’s chosen pronouns. Jamie and Elliot prefer “they/them” pronouns, which Evan says some find confusing, or even use as a way to bully or belittle. At home, though, everybody respects Jamie and Elliott’s personal pronoun choice.

It’s important to Evan Peterson that his children be given constant acceptance and support, so they don’t grow up with the same depression issues he did.

Evan also respects his children’s chosen gender identities. Jamie, born female, is treated like Evan’s son. Elliot, meanwhile, doesn’t consider himself to be a boy or a girl. “Elliot’s still twelve so they’re still figuring all these things out. But they’re pretty open about it.”

Outside of his home, though, Evan has less control. Both Elliot and Jamie face a constant onslaught of negativity from schoolmates and extended family members. As a family, it’s something the Petersons work hard to address: by going to therapy, and by openly discussing what’s going on with their mental health..

“We do talk about [mental health], mostly as me checking in on the kids and how they feel their progress is in counseling, or if there are new issues they need help working on. We also discuss the ways we see other people, in reality or in media, treat themselves or others with mental health issues.”

Evan is a strong role model. But away from the safety net of home, there are some problems that are beyond his control.

“Most of Jamie’s friends have been really supportive through the whole transition, accepting Jamie’s name change and using the right pronouns, so that’s been positive. However, Jamie has also been the recipient of all the bullying you could expect to have at a high school when you’re a transgender kid, with other students deliberately misgendering them and name-calling.”

School’s a little easier for Elliot, who goes to an alternative school, where most of the students hail from left-leaning, hippy-type families.

“Elliot dresses mostly like a typical boy, but many of the kids don’t really dress or act like they conform to gender or societal norms anyway, so Elliot fits in no matter how they identify. I’m worried about Elliot going to high school because that will be a stark change for them.”

The family is concerned about the current political climate, which Evan says is swerving far from LGBT rights and acceptance.

“We have a lot of uncertainty about what our future looks like; how much support we’ll have, how many of our rights will still exist or be taken away; there’s a lot of fear about that right now.”

“I don’t really see [my depression] as negatively affecting my parenting; if anything, the kids drive me to keep going because they need me.”

He’s particularly concerned about Jamie, as the current climate could have a direct impact on their physical and mental health. It’s recommended that transgender children start on puberty blockers by around sixteen. Jamie’s hoping to start taking the blockers soon… something that in today’s political climate could stop being supported by insurance companies.

“There’s a lot of excitement, because maybe that will go forward, but also fears: what if we start puberty blockers and then lose that ability [to fund the treatment through insurance] in the next few months?”

The powerlessness over their fate in the face of political change has caused both Jamie and Evan a lot of anxiety.

“As they get older the amount of things you worry about grows and the worries are more severe and more complicated. I long for the days when my biggest worry with Jamie was something like crossing the road, or losing sight of them in the crowd for a few minutes. Not that I miss Jamie being anything other than what Jamie is now, but I miss the more simple worries that you have with the younger kids.”

Navigating this path as a single parent can be difficult and lonely, Evan says. “When there are problems it can feel overwhelming because you don’t have a partner to lean on, to vent to or give you a break. I’m less miserable than I was when I wasn’t a single parent though, so I take the good with the bad.”

“I don’t really see [my depression] as negatively affecting my parenting; if anything, the kids drive me to keep going because they need me.”

But life’s mostly good, he emphasizes. He wouldn’t change who he was, or who his children are for anything. And like any parent, he just wants his children to be happy.

“It’s more important than anything else. Happiness is the most important thing for me. That would tell me that they’re at their best emotionally, they’re content with life – and it’d give me less to worry about.”

The Good Fight

The Criminologist Who Came Out Of The Closet As Mentally Ill

When Risdon Slate stopped taking his lithium, he ended up in jail. Now, he helps train cops to know the difference between a criminal and a person in crisis.

Risdon Slate knows first hand what can happen when a law-abiding man suffering a mental episode gets handcuffed for behaving strangely in public. He knows this because it happened to him. What he endured in that jail cell–locked up during a manic episode that befuddled police–has fueled Slate’s long campaign to lessen the chances that others with mental illness will needlessly wind up behind bars.


Risdon Slate tours the country, helping train law enforcement officials on how to deal compassionately with the mentally ill. Photo: Jamaica Gillmer

“At no point—not when I was arrested, not when I was booked into the jail, not when I stood before that judge—did anyone see that my problem had nothing to do with me being a criminal,” says the 57-year old, who heads up Florida Southern College’s criminology department. “I wasn’t a criminal. No one paid any attention to what was really wrong with me.”

Slate’s one-and-only arrest happened when he was 34. The police were called after he was discovered marching around a makeshift fortress of books that he built in the parking lot of a South Carolina apartment complex. When Slate’s wife told the officers that Slate has bipolar disorder, they let him off with a warning. The warning didn’t take: the next day, Slate–off his meds–was arrested. He had just dived naked into the apartment complex’s pool.  

I wasn’t a criminal. No one paid any attention to what was really wrong with me.

After that run-in with the law, Slate got back on lithium, which helps control his disease to this day. But in a very real way, that incident continues to be a driving force in his life. His tours around the country to train members of the criminal justice system to have a more nuanced view of mental illness.

Right now, the nation’s prisons house more mentally ill people than psychiatric hospitals. That’s partly because many police officers don’t know what to do with a person experiencing a mental episode. Slate advocates a more informed and humane approach, where the mentally ill–particularly those who are nonviolent–are locked up as the last resort, not the first.

Slate poses with some of his “students.” Photo: Jamaica Gillmer

Being open about his own mental illness is central to Slate’s work. Yet, the fact that he is on lithium surprises some of the law-enforcement officials he trains; he doesn’t “look” mentally ill, they’ll say. But Slate is quick to point out that mentally ill people don’t usually appear out-of-place unless they are having a crisis: for example, because they have gone off their meds, or their medication has otherwise stopped working.

In other words, just because a person in crisis is acting strangely doesn’t mean they are a de facto criminal.

“I let officers know they may be the one person that an individual, particularly if it’s their first psychotic break, can look to and hear someone say, ‘There is hope for you. You can make something positive out of this,'” Slate says. “They can be that crucial individual that can get the person to a place where they get medical help, recover, and become productive citizens.”

Just because a person in crisis is acting strangely doesn’t mean they are a de facto criminal.

Slate’s own arrest was triggered by such a crisis.

When he was a 34-year-old parole officer, a new psychiatrist took Slate off the lithium he’d been on for several years. Slate didn’t have bipolar disorder, the psychiatrist argued. Instead, he was merely stressed.

But stopping Slate’s meds cold-turkey had some quick and furious effects. At a South Carolina college’s football game, Slate began hallucinating. On the field, players morphed into kings and knights on a chessboard right before his eyes. By the game’s third quarter, Slate was in full-tilt manic mode. Worried, his wife led him to the stadium parking lot, where she called EMTs: her husband was having an episode.

When they arrived, Slate–fast-tongued and persuasive–countered: his wife was the one in distress, not him. They checked her soaring blood pressure–understandable, Slate says, under the circumstances–and sent the couple on their way.

When he got back to their apartment complex, Slate immediately began building his parking-lot fortress of books. He was arrested the next day.

“Those police back in South Carolina? If they’d had better training, they could have diverted me from lock-up.'” Photo: Jamaica Gillmer

“The rest is history,” Slate says. “This is my spin on it: Getting arrested was God’s way of saying to me, ‘You’ve got to come out of closet about your mental illness. Maybe, that will be your way to help others.’”

He helps himself by rigorously following his regimen of prescribed meds and overall self-care. Being open about his mental illness and how he treats it shows other mentally ill people how they, too, can thrive. It also bolsters his mission to help foster a criminal justice system whose dealings with the mentally ill are understanding and compassionate. Slate’s core expertise and beliefs landed him on the National Alliance of Mental Illness’ board of directors for several years. He was called as an expert witness during the September 2000 congressional hearings on mental health, which, in turn, resulted in funding for the nation’s first mental health treatment courts.

The most recent data from the Bureau of Justice Statistics suggests that a quarter of those in prison or awaiting trial are mentally ill. Slate believes that number will decrease if police have proper training in mental health issues, as well as access to community-based mental health programs.

“Those police back in South Carolina? If they’d had better training, they could have diverted me from lock-up. They could have told people at the jail that I was mentally ill,” Slate says. Luckily, though, things are getting better. “These days, there are [jails whose intake papers] have a little block to check off: ‘Does this person have signs of mental illness?’ People running things know they need to take a different tack.”

You’ve got to come out of closet about your mental illness. Maybe, that will be your way to help others.

Which isn’t to say some correctional facilities aren’t doing a good job. A handful of states have made major strides on this front, Slate says. But even the best available treatment won’t work if cops don’t know what to look for.

“There are some beautiful, perfect models of what to do out there,” he says. “But they’re perfect models for an imperfect world. That’s one of the reasons this training is so key. But, again, if you don’t have treatment to link people with mental illness to, that model isn’t worth the paper it’s printed on.”

The need for stronger methods of dealing with the mentally ill within the criminal justice system is what compels Slate to continue his work. “Ever since coming out of the closet [as mentally ill], my mission has been to prevent others with mental illness from coming into contact with the criminal justice system,” says Slate.

And if they have to come into contact with that system? Slate hopes he’s made it friendlier to the mentally ill than it was when he got arrested during his own mental breakdown. During an episode, the mentally ill who commit crimes often are totally unaware of what they’re doing. But that doesn’t necessarily make them criminals, Slate says. The criminal justice system should exist to protect victims of all stripes…  including those who are the victims of their own minds turning against them.


Inside The Rhyme Sayer’s Brain

Hot on the heels of the international Hey Kirby tour, musician and producer Aesop Rock talks to Folks about his lyrics, latest album, and life-long battle with mental illness

At times impenetrable, at times hilarious, almost always infuriatingly impressive: Aesop Rock, the New York-born rapper is known for his dense and complex songs, A 2014 study named his the largest vocabulary in hop-hop, surpassing 85 other major artists, as well as historic writers including Shakespeare.

With seven studio albums under his belt, Aesop released his latest solo effort The Impossible Kid in April last year. The album confronts mental illness, aging, and includes the tour titled track Hey Kirby, an ode to the cat who helps him deal with depression. It’s considered his most ‘accessible’ work to date.

“I’m not trying to be the lyrical miracle anymore,” he says. “I just want to be a better writer.”

In 2002, the documentary Bazooka Tooth, which shares the name of Aesop’s fourth studio album, first gave a glimpse into the rapper’s life. It was also the first time that he opened up about his struggle with mental health to a wider audience. 

“Emotionally I’ve seen the bottom of the barrel, just based on some the things that have happened to me,” he said. “I set my standards really high and end up stressing myself out to the point where I can’t do anything… I’ve had problems just operating. I’ve had issues with depression.”

He’s more guarded these days, shying away from interviews that approach his personal life, though his music remains as unflinching as ever. 

Following mention of his therapeutic relationship with Kirby, his companion cat, in Folks, the artist agreed to answer a few questions. We caught him on the last night of tour.


Looking back through interviews and videos, I can see you’re not necessarily super open about your mental health, though you have a lot of allusions to it in your work. Why is this particular card one you keep close to your chest?

I guess I just try to walk the line.  It’s on my mind constantly, so obviously it works its way into the music in some form or fashion–where I can choose to be as cryptic or forthcoming as I want to be.  At the same time, I’ve had a life long struggle with a lot of this stuff, and it make me feel like less of a human to not have been able to get it sorted by now.  In short–it’s embarrassing.  At the same time, what is there to say? I’m not asked that often about it, and the reality of the answers about those kinds of questions can go on for years.  There’s no easy, quick answer, and it’s never fun to talk about.  Even having people approach and thank me for being somewhat open about some of it–I mean, it’s nice, but ultimately it doesn’t solve my own issues.  I wouldn’t even really know how to describe to people what goes on upstairs for me, so often times it’s easier to steer around it. 

‘Kirby’ was one of the earlier songs you wrote for The Impossible Kid, the track that helped “break the ice.” As an “MD recommended sense of purpose,” how does having this cat around affect your life and wellbeing?

I think she just gave me some sense of purpose day to day.  She needs me to survive, and it feels good to be needed, even though she doesn’t really have a choice. Taking care of something at least gives you a mission for the day, so if all else fails, I still kept this other living creature alive, and maybe that’s worth something. 


After ‘Kirby’ and ‘Rings’, ‘Shrunk’, which deals with therapy, is probably my favorite track on The Impossible Kid. I think because I feel like you’re really just trying to have fun with a topic that’s not fun at all. Is the way you feel at therapy akin to the way you feel when fans or critics pull apart your lyrics to look for the deeper meaning?

Not necessarily. I learned very early that nobody will ever interpret these songs in the way that they were intended, at least not 100%.  That’s something you just come to terms with. The relationship I have with my music is mine only. Therapy is it’s own monster.  Some love it, some hate it; I’ve been to more than I can count starting very early in my life. It’s such a crap shoot.  I guess you walk in expecting someone with wisdom and answers. Really it’s just a person who took some classes and read some books.  They can certainly hit you with a nugget of information here and there, but it’s basically a paid set of ears. The entire concept is odd, and it’s pretty easy to find the stuff off-putting.  Obviously it’s all about finding the right person, but that can take years.  Then you have to see if you can afford it, or how often your insurance will allow you to go, etc etc.  There’s so many roadblocks.  Not to mention, when it’s time find someone new, for whatever reason, you then have to go back in and start from square one… again.  The entire process is daunting and difficult and occasionally just humorous. 

I learned very early that nobody will ever interpret these songs in the way that they were intended, at least not 100%.

You’ve said that ‘the impossible kid’ is you, and that that’s something to do with beating yourself up for “struggling to be happy.” Do you think writing the album has helped you come to grips with that?

I was aware of it before writing the album, it’s really been stuff I’ve been aware of for so long I can’t even tell you.  The album just kinda came out how it did.  It wasn’t supposed to be some foray into mental health or anything, but a couple things of that nature were swirling around at the time and made it into the narrative.  I wouldn’t say there’s anything on there that I wasn’t already aware of, and I don’t know it’s the type of stuff I’ll ever come-to-grips with. It’s everyday.  

You’ve said you “avoid social experiences at all costs,” and even the more pointed “fuck the conversation.” How does that marry up with being a public figure, going on tour and using social media? 

Social media is pretty difficult at times. I use it to promote my music and occasionally just let people know I’m out here and alive, working, etc.  I guess it’s essentially part of my job.  I’ve never done Facebook and would probably hop off Twitter and Instagram if I thought I could maintain my work without it. I already don’t follow anyone on Twitter because I just find it all depressing. I use Instagram to look at artwork and skateboarding, nothing really music related. Tour life is something that took me years to get used to, or put a system in place that allows it to happen. I quit my last day job in 2001 and had my first-ever national tour set to rollout about a week after.  I ended up sorta being overwhelmed in the 11th hour, and I skipped out on the whole thing.  That’s my starting point.  Nowadays I can make it work, I keep my tour party small, and I can power through it. I like to shake hands and say thank you to everyone after the show, because I’m truly grateful that I am allowed this job and that people follow my music, but even with that stuff, I sorta have to psyche myself up to go and do it. Maybe since it’s a couple hundred very quick interactions with almost no depth, I can just close my eyes and walk forward.  I don’t have to get close to anyone in those circumstances.  It just a big explosion of surface-level interaction.  


I watched the Bazooka Tooth documentary, which is 15 years old now. Do you relate much to it, to the person you were then? You’ve talked a bit about what turning 40 has meant for you. Do you think your work has the same identity and purpose?

I haven’t watched that in a long time. I’m sure I’d relate on some level.  I’ve actually always found it extremely difficult to see what my work even looks like from the outside looking in. I don’t know how it comes off, or where people place it in the musical landscape.  My life is very different than it was 15 years ago, and there are elements of my purpose that evolve and adapt, but some of the foundation is there.  I like to put words together.  I like to piece sounds together. I’ve gone through periods where the music was all about the crew experience, being around people, collaborating and rapping with others.  These days it’s a much more introverted endeavor. I guess maybe that’s how it was too in the very beginning, when you’re just writing alone in your bedroom with no expectations that anyone will even hear the stuff.  Then it turned into a social endeavor, a way to meet others into the same craft. Now I’m back at square one, just seeing what I can do, and attempting to block out the idea that one day these songs may actually get heard.

Do you think there’s much truth or value in the concept of the tortured artist: that people who face tragedy or mental illness make better art or tell better stories?

I think that’s probably true on some level and bullshit on some level.  That’s actually a tough one to answer.  Perhaps feeling pain on any level breeds the kinda introversion that leads to spending a lot of time alone making shit.  But you’d also think that there’s gotta be a way to just be creative without the baggage.  Yeah. I really don’t know.  Most of the musicians I like are insane, so there’s that. 

For me, one of my favorite lines of yours ever is in ‘Homemade Mummy’; “Take the brain out/leave the heart in.” Do you have favorite lines you carry round with you, that you’re particularly proud of or feel meaningful? What are they? 

Sure I guess, it’s hard to kinda think of them off the cuff, and I really only have the most recent stuff logged in my memory.  I like “even his prize horse rides a wolf into battle”, from ‘Tuff.  I kinda like some of the 3rd verse of Shrunk that you mentioned. I always liked “armchair hater, I wouldn’t piss on your coffin, but when I see your picture I draw dicks on it.”  I guess I like the ones that summon up some real imagery, lines that make a picture in your head.  I’d have to listen to the songs to really pull more. 

The Hey Kirby tour’s over now. What’s next for you?

I have a few collaborative projects in the works, but it’s probably a bit early to announce any of them.  Beyond that I’ll be finishing up original music for the feature Infinity Baby right when I get home.  Other than that I just stay working. I never really know what project my days work will go towards, I just chip away and see if I can come up with something cool, a line, a beat, whatever.  Just stay busy. 


A Bird’s Eye View Of Depression

By attaching a time-lapse camera to her ceiling, Leah Miriam Cooper is turning her depression into an animated flip book

Nestled in her two-bedroom walk-up located just outside of Boston, Massachusetts, Leah Miriam Cooper is prone to staying awake through crisp New England nights. Alone in her living room, Leah uses her personal experiences to forge connections with the outside world through her art. “I know this sounds hokey,” she says, “but my art is my home.”

Leah is a freelance designer, an imager, and a photographer. “I’ve always been creative,” the 27-year-old native of North Kingstown, Rhode Island explains. “When I was five or six, I filled out one of those books that asked what you wanted to be when you grow up. I wrote ‘artist’ and it’s been that way ever since.”


Photo: Leah Miriam Cooper

Leah navigates life’s changes with her camera in hand. “Since I work in photography, I am always shooting,” the artist explains. “I love the accessibility of digital photography.” Digital also makes sense on a practical level. “The work I do often needs to be in color, but I don’t always have access to color dark rooms.”

Unlike other artists who seek studio space, Leah creates art in her home, especially when depressive episodes strike. For her latest project, Leah secured a point and shoot camera to the ceiling of her living room with a handful of barrettes and hair-ties. Over the course of four months, the camera documented Leah’s life within the scope of her living room. From there, Leah is compiling the images into a flip-book.

Leah creates art in her home, especially when depressive episodes strike.

On her recent project, Leah notes that it is very much still an experiment. “I realized that time lapse work tends to be a time-based form of media and felt that this was the answer for this project,” she explains. “It allows my project to exist as time-based as well as in print, combining the best of two worlds. It’s still an experiment- but it’s important to experiment.”

Thematically, the combination of still images and a flip-book speaks to what is depicted in the photographs. The still images remind viewers of how often we feel stuck in time and unable to escape our space, while viewing them in a flip-book module reinforces the rapid passage of time, and the subsequent blur effect we so often feel when looking back at transitional periods of our lives.

“In my newest series, I felt stuck and isolated and really wanted to show that,” Leah explains. “I felt that staying in the apartment on my computer was somewhat universal, that post grad life often leads to a career limbo where you’re stuck. Of course, what I was going through was heightened by my illness, but I’m hoping others relate to the work.”

“I’m bipolar,” Leah says. “I am generally open about my illness with the world. I believe that part of kicking the stigma is not treating it like it should be shameful.”

I believe that part of kicking the stigma is not treating [depression] like it should be shameful.

Leah, like roughly five million other Americans, lives with bipolar disorder, a chronic mental illness that is often stigmatized and stereotyped in the media. For most people, bipolar disorder is categorized by experiencing periods of mania and depression that can range in time from days to months. Bipolar disorder is often characterized by severe shifts in mood, activity level, and energy, though for many patients with bipolar, symptoms vary in relation to factors outside of chemical imbalance, such as stress, relationships, and even the seasons.

Leah is open about her mental illness in both her professional and personal life, but being transparent about an often misunderstood illness isn’t always easy. “I feel like people think that if I’m medicated, go to therapy, and am mildly successful, then the illness is magically cured,” she says.


Photo: Leah Miriam Cooper

Unfortunately, treating chronic mental health issues is not so simple. Leah resists societal pressure to stay silent about life with a mental illness, and asks for help when she needs it.“Lately I talk it out with people and remind them that I will have bad days and still need support,” she says.

Though Leah is a solo artist, she is happy to have support from those who know her best. “My roommate is one of my main supports,” she explains. “We met in grad school and since he’s an artist he’s been able to give me emotional friend support and art support. I’d say that I turn to him whenever I need help making artistic choices.”

For Leah, the depressive episodes and phases of mania that come with bipolar do not stall her art. Instead, Leah copes with the highs and lows of her illness and the tumultuous nature of life in general by generating art in ways that reflect her life.

Leah, seen from eye-level.

Leah, seen from eye-level.

“I’ve always been very interested in incorporating my own domestic space within my work,” she explains. “I started with my bedroom at my parents house in undergrad. Then my grad school apartment in Baltimore was the center of any work I was creating.”

Now, Leah’s living room is the hub of her work. “I originally thought of doing this project in my bedroom,” she says, “but realized it would be more interesting to take photos in a shared space, especially since I spent more of my time in the living room.”

Leah’s recent work engages notions of the uncanny into everyday life. A small living room, a coffee table, and the people who come in and out of her home. “I’m sort of fascinated by the complications of daily life that we often overlook,” she says. “I turned to this project when I was experiencing a depressive episode after finishing grad school.”

“I’m sort of fascinated by the complications of daily life that we often overlook…”

“I turned to more of a documentary style of photography after focusing on constructed images for the majority of my career. I felt that making images in a new way as well as creating a portrait of an extremely hard time for me would help.”

Living with bipolar disorder has an impact on the themes Leah explores in her art, as well as the practical side of working. “When I’m depressed, I’m much more likely to make work at night, whether that’s editing, coming up with ideas, anything. I tend to mess up my sleeping when I’m depressed and sleep all day,” Leah admits. “I stay up all night and become hypomanic.”

Leah’s moods and energy levels eventually shift, as does her approach to her current project. “When I’m feeling ok, work takes place during the day and is a lot less manic. My actions need to be more thought out and the series itself becomes more concept based.”


Photo: Leah Miriam Cooper

As an artist, Leah creates her own boundaries about where her work ends and she begins. “I try my best to create work no matter my emotional state, but I do give myself art vacations,” she explains. “I tend to need to reload, especially after a large project.” Self-care is important for any artist when it comes to preventing burn-out, but treating one’s self with forgiveness and recognizing limits is especially prudent when living with a chronic illness.

“My creativity is always around, but a little harder to harness when I’m depressed,” Leah explains. “If I’m feeling a block when I’m depressed I spend a ton of time at museums and galleries til I’m inspired again. I try to stay motivated no matter what.”

Leah’s work largely involves self-portraiture and strong investigations of the self in relation to the world around her. After a traumatic event in the Spring of 2011, Leah became both photographer and subject to document her process of healing and recovery.

Leah's earlier work dealing with her depressive episodes was a lot more violent.

Leah’s earlier work dealing with her depressive episodes was a lot more aggressive.

“When I was still unpacking what happened to me, I did a lot of skin pulling imagesself portraits where I pulled the flesh on my face or my body,” Leah explains. “At the time I didn’t notice how violent they were, but looking back they’re very aggressive.” For Leah, this trauma manifested in her work, and she transitioned from creating art for aesthetic purposes to creating art that is rich in emotion and raw imagery.

Now, Leah describes herself as creative, empathetic, and driven. Though she works through her depressive episodes, Leah also recognizes when she needs to step back from her work. “Working on art always helps me feel productive, which makes me feel better overall. Though, I have taken time off from art to work on myself from time to time. I try to be very self-forgiving when in a rough spot.”

Leah’s work has caught the attention of international reviewers and chic showrooms in New York City alike. Her master’s thesis, titled Projections, too involved domestic settings, as Leah scanned family photos into 35-millimeter slides before projecting them onto her apartment walls. These manipulated images give the sense that her grandparents, long deceased at the time, were in her bedroom or at the dinner table, for instance. As a whole, Leah’s work is at once tender and unsettling, urging viewers to voyeur into her life before taking a step back and investigating their own.


Photo: Leah Miriam Cooper

In spite of much success with her art, Leah admits that she struggles with imposter’s syndrome. “I’ve always been geared towards creativity,” Leah explains. “But I didn’t feel like I earned the right to call myself an artist until I had my work accepted into a show.” But for Leah, art is not about acclaim and attention from critics; it’s about expression, identity, and forging connections.

For Leah, life doesn’t imitate art life is art. “I’m not my art,” Leah says. “But my art is me.”



The Scholar With Schizophrenia

Elyn R. Saks was just a teenager when she started believing her thoughts could kill other people. But with treatment, her schizophrenia didn't stop her from living a happy, intellectually-fulfilling life.
Elyn Saks - S_0048

Elyn R. Saks (photo courtesy of Gould School of Law)

One morning, when Elyn R. Saks was in high school, she suddenly decided to leave class and head home. During the three-mile walk, the world around her started “becoming very intense,” and she began to think that the houses were sending her messages: Look closely. You are special. You are especially bad. Look closely and ye shall find. There are many things you must see. See. See.

This was Saks’ first psychotic episode. Her mind quieted for a while and, after high school, she became class valedictorian at Vanderbilt University and received the Marshall scholarship to study philosophy at Oxford. While there, the 21-year-old Saks experienced a complete schizophrenic break. This time around her dark fantasies took a frightening, suicidal cast. She told a doctor that maybe she should douse herself with gasoline and set herself on fire. “That might be best, because I am bad and deserve to suffer.” This episode led to one of two lengthy hospital stays in England. When she completed her master’s degree 1981, she had lost two years to her illness.

At one point, Saks was told that she “would live in a board and care facility and work at a menial job at best.” Today, she is a recipient of the MacArthur “genius” grant, a law professor at the University of Southern California, and a mental health policy expert. Partly inspired by her own experience of being forcibly hospitalized, which she vividly describes in her 2007 memoir, The Center Cannot Hold: My Journey Through Madness, she often advocates for greater patient rights and autonomy.  

In Saks’ 2012 TED Talk, she closes by saying that if there were a magic pill that would instantly cure her, she would take it in an instant, but she doesn’t regret the life she could have had nor does she want pity. Says Saks, “… the humanity we all share is more important than the mental illness we may not. What those of us who suffer with mental illness want is what everybody wants: in the words of Sigmund Freud, ‘to work and to love.’”

The humanity we all share is more important than the mental illness we may not.

Here Saks discusses the realities of dealing with schizophrenia, the importance of her husband and friends, and the and the biggest misconceptions about mental illness.

Would you mind describing one of your more powerful psychotic episodes?

It was November, first semester of my first year at Yale law school, and I started slipping. I walked outside on the roof of the Yale law school library, which was flat and safe. Some friends came and I started gesticulating, dancing around, and singing, “Come to the Florida sunshine bush, where there are lemons, where they make demons.” My friends asked if I was on drugs. I said, “No. No drugs at all.”

I had delusional beliefs that I could kill people with my thoughts. And my speech was incoherent. For example, I said “Are you having the same experience I am of words jumping around in our legal cases? Our cases have been infiltrated. We’ve gotta case the joint. I don’t believe in joints, but they do hold your body together.” These are called “loose associations,” where words are loosely associated, but don’t make sense together.

Eventually, we all went home. The next morning, I went to see my professor to ask for an extension and I started behaving the same way. He took me to the Emergency Room, where I was restrained for the first time. It was extremely toxic and traumatic. From there, I ended up hospitalized for five months. That happened around ’82, ’83. I haven’t been in a hospital since then. That is sort of my proudest accomplishment, which is a weird thing to say. You wouldn’t say you were proud of not relapsing from cancer, but I think there are small choices people can make that will lead to better or worse outcomes. Thank God my analysts have all been willing to sit with a certain amount of anxiety about my well being for the sake of respecting my wish not to be hospitalized.

What symptoms of schizophrenia do you still experience?

My husband likes to say that psychosis is not an on-and-off switch but a dimmer. At one end, I’ll have a crazy idea, like I’ll think I’ve killed people with my thoughts, and I’ll recognize it immediately: “Oh, Elyn, that’s just your illness acting up. Pay it no mind.” And then further along the spectrum, say we have house guests. I love my friends but I find it hard to be around people a lot. I may have three or four days when I’m in and out of psychosis. At the far end, I’m crouching in a corner shaking, scared out of my wits. That hasn’t happened in a good decade. I still have some transient symptoms, but nothing really severe or really long lasting.

It’s sort of silly to quantify but, when I was in England, I would say like 70-80 percent of my waking thoughts were psychotic. At Yale, in New Haven, I would say 30 percent. Now we’re talking about three to four percent.

Psychosis is not an on-and-off switch but a dimmer.

How do your husband and friends help monitor your illness?

My husband and my closest friend Steve serve as another set of eyes if I start slipping. I’m very happy to have them involved. Occasionally, one of them will want to call my doctor and I say, “If you want to, that’s fine.” One time Steve called my doctor and said, “Elyn seems really unwell. She’s talking about going to China in advance of your trip to clear out of all the bad people.” To which my doctor responded, “How very considerate of her.”

Do you think having these strong social connections is a big part of dealing with schizophrenia? I imagine it’s very difficult for some people with the illness to maintain those connections.

I’ve been very fortunate. Some of the so-called “negative” symptoms of schizophrenia [meaning behaviors that are absent or diminished compared to people without schizophrenia – ed.] are a lack of relationships, a hard time working, and withdrawal. I’ve been spared those negative symptoms. Having people in my life makes my life much better and gives it meaning and depth. I sometimes have students with the illness. We’ll have lunch and they’ll ask me, “How do you manage to keep your friends? I haven’t been able to.” I don’t really know what to say except that if you are a good friend to people, they’ll be good friends back.

What are some of the biggest misconceptions people have about schizophrenia and those who suffer from it?

First is that we’re violent. In fact, people with mental illness—that’s not just schizophrenia but everything—commit only around two to three percent of violent crime. We’re much likelier to be victimized than be victimizers. I think we need to educate the public that mental illness doesn’t mean dangerousness. The more flamboyant crimes usually do involve mental illness, but those are so rare.

The second thing is that people cannot live independently, cannot work, cannot have relationships, cannot get married, cannot have kids. It’s just not true. A lot of us can do those things.

I think we need to educate the public that mental illness doesn’t mean dangerousness.

I’ve read that, when it comes to treatment, you’re against force being used, for example: to restrain someone during an episode, or to force them to make a decision they can’t choose to make. How should we help someone is who is having a psychotic episode get treatment?

I’m not totally anti-force. I think there are cases were force is needed. For example, if someone’s imminently dangerous, or if they cannot understand their situation and make a competent choice. If my loved one said, “This anti-psychotic medication has really helped me in the past, but I cannot take it now because I’ve been told it will cause a nuclear explosion,” I would want to step in and say, “Give her the meds.”

I’d also like to say that I think force is not good. It causes humiliation and shame. And it’s a very unstable solution because once you stop administering the force the person has no incentive to go back. We should use it as little as possible. What I propose is studying ways to get people to want treatment, so we don’t have to use force. I think that should be a big research focus of psychiatrists and psychologists.

What are some ways to help people want to get treatment?

Well, I want to do a study that has three arms. One will be someone who’s gotten on medication right away and stayed on it. The other extreme would be someone who has resisted medication for 10 years, tried to get off every couple of months, or stayed off for a year or two. In the middle are people who kind of tip. These people start off noncompliant and not wanting medication, and then something happens that makes them want it. I think by studying those three groups, we can learn some of the things that make people tip. Then we can help other people tip sooner and more completely.

Why do people refuse anti-psychotic medication?

I think people refuse meds for all sorts of reasons. One, they don’t like the side effects. But to me, if the choice is between gaining some weight and being psychotic, I’m going to take gaining weight. I gained about 20 pounds. If I gained 100 pounds, I might feel differently. Second, they feel better and don’t think they need it anymore, similar to the way people stop antibiotics before they’re supposed to. Third, they’re in denial that they have an illness.

To me, the most powerful reason [to refuse anti-psychotic medication] is the narcissistic injury of having a mental illness and needing medication. That’s the thing that most affected me. It’s just very painful. I wanted to get off medication to prove that I really wasn’t mentally ill, that it was all some big mistake. Ironically, once I got on the medication consistently and accepted the illness, it became much less front and center. I’ve found that the more I embrace it, the less it defines me.

I’ve found that the more I embrace [my condition], the less it defines me.

There are ways you can encourage people to take meds. Try to get a sense of their needs, wants, and values, and how meds fit into that. For example, I think you can tell people, “Whether or not you’re ill, this med will help you with the restlessness you’re complaining of or the sleeplessness.” There’s a really good book by Xavier Amador called I’m Not Sick, I Don’t Need Help! that walks families through trying to get their loved ones to agree to meds.

What helped you decide to start taking medication?

I always took it, but I was trying to get off of it for about 10 years. Actually, my doctor kind of coerced me. He said, “Look getting off medication keeps you going in and out of episodes. You want to get on with your life. If you want to keep seeing me, you have to take your meds.” Once I got on the meds consistently, my life got much better. I wouldn’t think about going off of them now, because I just have a much better life than when I was going on and off.

What meds are you currently on?

I’m on Prozac for anxiety and Clozapine for schizophrenia.

How has psychoanalysis helped you cope with schizophrenia?

Elyn Saks - S_0266

Photo courtesy of the USC Gould School of Law

First, stress is bad for any illness, particularly mental illness. Analysis can help you identify and either avoid or manage your stressors. Second, it fortifies an observing ego, so you can stand back and view what’s going on in your mind and assess it and understand it. Third, it’s a safe place to bring your crazy, violent, and chaotic thoughts, sort of like a steam valve. If you say [these thoughts] in therapy, you don’t have to say them in your outside world. Also, therapy can involve insights. I remember once I was saying violent things and my doctor said, “Elyn I think you’re saying violent things because you’re scared. The violence is your defense against the fear.” That helped make it go away.

Then finally, having a kind, smart, and well-meaning person who accepts you not only for the good but also the bad and ugly is very empowering and helpful. Another way to think about it is that people with schizophrenia have relationship and work issues just like everybody else, and therapy can help with those issues. In the field today, we think not so much in terms of reduction or remission of symptoms, but quality of life. It’s for the person herself to say what that is for her. Therapy can help achieve that.

Do you think that with the right help many other people with schizophrenia could lead similarly high-functioning lives?

I’m doing a study on high-functioning people with schizophrenia with some folks at UCLA and USC. People sometimes say I’m unique, but in fact we fairly quickly got 20 subjects—two MDs, two JDs, Ph.D. candidates, full-time teachers, a CEO of a not-for-profit organization. There are people out there like me. It’s just so stigmatized that they don’t come forward.

There are people out there like me. It’s just so stigmatized that they don’t come forward.

I asked psychiatrist and schizophrenia expert Stephen Marder what percentage of people with schizophrenia he thought were high functioning in our sense, which would be professional, managerial, technical, etc. He said, “I don’t know, Elyn. But the real question is how many could be if we provided proper resources.” I thought that was the right answer. I think it’s a mistake to tell people, to lower their expectations. I think many people can live up to their premorbid potential with enough help and enough support. And it does them a really big disservice to basically tell them to stop trying.



Destigmatizing Mental Illness In The Church And Beyond

A feminist priest shares the story of her own bipolar disorder, and gives advice on what the spiritual and unspiritual alike can do to fight mental illness.

An Episcopalian priest shares the story of her own bipolar disorder, and gives advice on what the spiritual and unspiritual alike can do to fight mental illness.

Last year, Katharine Welby, the daughter of the Archbishop of Canterbury, began to speak openly on her blog about her long struggle with depression — a condition that remains stigmatized despite being the world’s leading cause of disability. Soon after, a Bishop of the Church of England recommended a book to the Archbishop: Darkness Is My Only Companion: A Christian Response to Mental Illness, by Kathryn Greene-McCreight. Welby was initially skeptical, having been bombarded with suggestions for supporting a child with mental illness. But he ultimately found the book so profound that he wrote the foreword to its second edition, and invited its author to dinner with his family at his 13th century home of Lambeth Palace.

Kathryn Greene-McCreight, author of Darkness Is My Only Companion, has struggled with depressionfor years.

Greene-McCreight is a feminist theologian, associate chaplain at the Episcopal Church at Yale, Elm City National Alliance on Mental Illness (NAMI) board member, and mother of two. Darkness is My Only Companion is her poetic and painful account of her struggle with bipolar disorder. Part memoir, part theological reflection, the Archbishop of Canterbury called it “one of the most profound and eye-opening reflections on the grace and love of God, and above all the nature of human relationships, that I have had the pleasure of reading.”

Greene-McCreight looks at mental illness through a theological lens, but her insights transcend creed; even hardened atheists might see something supernatural in her resilience. We spoke with Greene-McCreight about how mental illness affects one’s sense of self, and how meditation and mindfulness can help believers and non-believers alike deal with their depression.

What was it like when you were first diagnosed with bipolar disorder? How did you initially cope with it? 

It was absolutely horrid: for my career, for my studies, for my family. I had two really little kids, and my husband traveled about every other week at the time. I didn’t reach out to enough people, just one or two friends, which was too bad, because you cut yourself off if you don’t reach out. Before I ever went to a psychiatrist, I went to a friend and told him that my mind was playing tricks on me. He said, “You need to get to a doctor right away.” That was the first part, around 1992, when I was diagnosed with postpartum depression, before later being diagnosed with bipolar disorder. I started going to therapy and later went to a psychiatric hospital.

That was the first time I was diagnosed, but looking back, there were times in my childhood, young adulthood, and college years during which I was depressed. It’s only now that I recognize what was going on. There were symptoms of depression that I didn’t know to categorize as depression. My parents took me to a medical doctor, but I never went to a psychiatrist. When I was 12, for example, I was sick and missed school for a month, staying in bed. I attributed it to an incident in a pool: people said I’d dived and hit my head, but in fact I hadn’t hit my head. That period of staying in bed happened after the death of a friend of mine. And then later, when I was 17, I again stayed in bed for four weeks . We chocked it up to mononucleosis, but I hadn’t tested positive for mono. It seems to me now that these times [of staying in bed] were depressions. But there was far worse shame then about [seeking help from a psychiatrist].

I initially coped with [the diagnosis] by just keeping as busy as I could. I used my waterskiing analogy: when you’re waterskiing, if the boat slows down, you’ll fall over and sink, but if it goes too fast or hits a wave too hard, you’ll also fall. By keeping the boat going fast enough, I could stay above water. If I slowed down, I felt pain. Over the years, I [developed a support system.]

Many people who struggle with any given diagnosis — but especially a diagnosis of mental illness — can have a hard time separating the illness from their sense of self. There’s often a feeling, when ill, that you are your illness. At this point in your life, how does your diagnosis of bipolar disorder factor into your sense of identity, of who you are? How has this changed over time, and how has your theology affected this understanding of yourself?

That’s a very good question, and a very important question, one that comes up often in my work on the board of NAMI. The answer is always no, we are not defined by our illnesses.

Recently I found myself at a loss for words,  which for me is very odd, when speaking to members of the NAMI council. I was saying how hard it is to have a chronic illness, and one of the men on the council turned to me and said, “But you’re not defined by your illness.” And I said “Well, uh, that’s a good question.” Because a chronic illness doesn’t define us, but obviously it impinges on our lives. There are all sorts of things I cannot do that quote-unquote “normal” people can do. A diagnosis changed my self-perception: Some people just grow up with [mental illness] as part of their identity from time immemorial, but that wasn’t my experience. Mine was of being a very strong, capable person, then all of a sudden I was in this pain and a state where not only could nobody understand it, but it affected how I saw myself and how everyone else saw me once they knew what was up. But I think a lot of people would get angry at me if I said I was defined by my illness, because it’s not politically correct.

The answer is always no, we are not defined by our illnesses.

I recently said something that was really not PC, which was that part of me would rather be in a wheelchair and have a handicap that was visible than have a mental illness. Because then I wouldn’t have to continually be trying to hide it, because my mental illness is hideable. It would be a type of handicap that was socially acceptable. We had a president who was in a wheelchair, for example, and he was incredibly effective. But if you have a mental illness, you’re lumped into a group of people, some of whom commit heinous crimes, some of whom can’t work because they’re so debilitated by their depression or the voices in their head. The idea that I almost wish that I had a broken leg instead is linked to this question about a sense of identity. At one point, in a phase when things were very bad, I said to my psychiatrist, “Who is the real me? How do I know who I am?” And he said to me, “you are you.” That wasn’t the most helpful thing to say, but at least he was trying.

How does the language we use to discuss mental illness affect people’s perceptions of it and the stigma that surrounds it?

We’re always trying to say we want parity. But the problem we run up against is that advocacy agencies that are meant to help, like the National Institute of Mental Health (NIMH) and the NAMI, in the interest of trying to lessen stigma, often actually [end up increasing stigma with ill-chosen words]. The NIMH decided about a decade ago to move from the language of calling [the mentally ill] “patients” to calling us “consumers.” During a conversation about this with the board of NAMI, I said, “Look, I am a patient. The word ‘patient’ is derived from the Latin word for ‘to suffer.’ I suffer. I am not a consumer–a consumer buys things. I choose the car I consume, the food I consume. I would never ‘consume’ the services of a psychiatrist.” The word ‘consumer’  is so materialistic, so capitalistic. It becomes a little bit of a joke. They don’t call cancer patients “consumers.”

There’s also recently been a movement to stop using the term “mental health” and instead call it “behavioral health.” I’d rather have it be called mental health, because it’s more accurate. We’ve pretty much established the scientific fact that mental illnesses are brain disorders. They’re caused by structures in the brain, synapses malfunctioning in the brain. In that regard, they’re no different from something like kidney disease. But by calling it behavioral health, in an attempt to destigmatize “mental illness” — it implies that, now, if I’m mentally ill, that means my behavior is bad? That seems to me very problematic.

You write a lot about the power of prayer in helping you with your depression. How do you pray? What prayers do you find provide the most solace in your darkest hours?

Greene-McCreight helped the Archbishop of Canterbury understand his daughter’s depression.

I think first I would back up and ask, what is prayer? As I see it, it’s a conversation with God… When I think about how I pray, I think about how was I first taught to pray—with short, easy prayers for specific times and places, like table graces said with my family before a meal. Those were often for little kids. One was, “Come Lord Jesus, be our guest and let these gifts for us be blessed.” There were also prayers in church, like the Lord’s Prayer. These are forms of set prayers, which I still use — like in the Book of Common Prayer, which I find very helpful. But it doesn’t always have to do with set prayers. I think prayer is mostly being encouraged to let God know what’s on my mind and in my heart.

For me, the prayers I find provide most solace are often the psalms: Psalm 27, “The Lord is my light and my salvation, whom then shall I fear” Psalm 139 talks about God knowing me even before I know anything about God, which is a very helpful one for me. A lot of people use Psalm 23 — “The Lord is my shepherd, I shall not want.” The Psalms about the Lord being our all, and satisfying our appetites, and also the ones that talk about joy — those provide the most solace.

How have attitudes and approaches to mental illness changed in the church in recent years? What still needs to change?

I think we have a long way to go. Trying to get rid of stigma is important, but we need to go farther than that. What we’ve been focusing on in the church is a lot like what [evangelical pastor] Rick Warren and his wife have been doing [after their son committed suicide] — trying to get rid of stigma. Trying to simply say “don’t be afraid of admitting to struggling with mental illness” is great, but it’s reactive—I think we need to be proactive.

Creating beauty and being around beauty is really important.

There are some basic things pastors need to know and do — they have to know the symptoms of mental illness. Some very high percentage of religious people who suffer from mental illness go to their pastor or clergy first for help, but unfortunately, most clergy don’t know anything about this. We need the clergy to be educated about the symptoms, to know how and when to refer parishioners to psychologists or psychiatrists. Our job is important, but it’s not to diagnose and treat people who are mentally ill. It is to stand by them and pray with and for them and treat them with spiritual care, but sometimes pastors think they know more than they do. I think the clergy should have a list of professionals in the community with different types of expertise. And I think the church should do suicide prevention training with clergy. That’s something I’m trying to do in my church.

What do you recommend for non-believers suffering from mental illness? What secularly spiritual practices do you think are most effective? 

Mindfulness meditation is really important. I do it, it’s very helpful. I’d also suggest group therapy — it’s been very helpful to be in a group of people with similar problems. It offers a reality check — they’ll say, “You weren’t like that last week, it’s not true that you always feel this way.” And getting out with other people is very important, which group therapy helps with. Isolation is very bad for any mental illness — whether it’s bipolar disorder, schizophrenia, even anxiety — it’s way bad. Exercise is also very important — probably, number one, actually — but sometimes it’s very hard to do that if you’re depressed. If that’s the case, take an exercise class, which also helps decrease isolation.

Any kind of art-making, even if you’re not an artist, can be therapeutic — splashing watercolors around on paper, dancing, working with clay, pottery, making music. Creating beauty and being around beauty is really important. That’s what the whole religious life is about.

Another one: Volunteering. Giving your time to someone else can be very helpful. It’s a way of practicing the art of compassion, even if you’re not religious.

Kathryn Greene-McCreight’s books about faith and mental illness can be purchased on Amazon.