By Ingrid Silvian
I’m Not Sick, I Don’t Need Help is the title of a book I
read before I understood that the inability of my daughter’s
recognition of her bipolar illness had much more to do with
the resistance to her treatment for it than anything else.
I went down this road with her for all the many years it
took, with 42 hospitalizations in three states, mostly
involuntary. We fought the demon of anosognosia together,
the term used to describe the illness as a double
whammy of stigma turned inward, as it was in Linda’s case.
After all, who wants to be labeled mentally ill?
This cruel, neurobiological no-fault brain disease was
relentless in the cyclical course it took. The ups of her
mania were as bad as the downs of her paralyzing depression.
As for me, this was caregiving at its most critical stage
for Linda’s crisis states, during which I had to concentrate
mostly on keeping her safe—safe from herself, safe from
others, safe from self-neglect, safe from victimization
during episodes of a reality she had lost, and a fear of
what she heard that no one else could hear. At such
times, her medications could never be found, nor could she
account for them.
I could always tell by talking with Linda when she took a
downward spiral. She lived in a subsidized housing
apartment by herself. One day, she called and said
abruptly, “Mom, can you bring me something to eat? I’m
hungry.” “Linda, can’t you drive down to the store and get
yourself something to fix?” I tried calming her down. “No, I
can’t; my car won’t start,” she said flatly. As she had
often used her car as an excuse not to leave her apartment,
I knew that at this point she was too afraid to go anywhere
A psychiatrist once told me to imagine myself in a
dangerous and fearful situation and magnifying the feeling
by 100 times to understand what Linda was going through when
she was in crisis. How then, could I turn my back on
her as her mother, the only family member she still had in
her life? For me, this often called for switching gears to
tough love in order to communicate with Linda.
I drove over to her apartment house and she let me in,
staring at me with that all-too-familiar look of suspicion
and panic. “I’m freezing,” she declared, when she saw me
looking at her wrapped in a winter coat in mid-July.
Her window blinds were all closed and the air conditioner
was off. I knew the tell-tale signs only too well.
“Linda, how about if we go for a little ride together to
the Crisis Intake Center? Let’s just go in my car,” I
tried to convince her. “Oh no, I’m not going anywhere, and
you’re staying right here with me, Mother,” (no
longer Mom), her eyes following my every move.