"Have you had any serious health conditions?" asked my son's psychiatrist Dr. C.
I had just brought Alex to UCLA's Neuropsychiatric Institute to find out why, over the course of the prior twelve months, he'd lost the ability to finish a coherent sentence, wear shoes, sleep through the night, or face the other kids at school. (Later, I would learn the term "psychotic break" to describe his frightening transformation which had begun at age 16.)
"No, none." I answered.
"All right," she said. "Shall we go on to your siblings?"
I was giving Dr. C a family mental health history, after she explained its importance in coming up with a proper diagnosis for Alex's strange behaviors. We were apparently trying to track down the most likely culprit among several candidates in my family's past who might have passed a fatal flaw to Alex.
I didn't expect to have to talk about myself.
I'd just told Dr. C that I was forty-three year old single mother of two sons; and that I worked as a freelance TV writer. I'd also told her I was in fine health. Of course I didn't say I'd been depressed for as long as I could remember. Nor did I mention my drinking. I'd always worked around it, hadn't I?
I flashed on the debris I'd left at home after staying up all night waiting for word of Alex's whereabouts and then rushing to get him to the hospital first thing that morning. The empty bottle of cheap chardonnay on my coffee table; the expensive concealer I'd used to cover the dark circles under my eyes left on the sink; the flinty smile still imprinted on the bathroom mirror, the one I'd practiced in hopes it would disguise my pain when I delivered my first-born son to this state-of-the-art kiddie psyche ward.
"Do you think I might be depressed?" I asked her timidly.
"Without a thorough interview," Dr. C began. "I can't diagnose you."
Of course, stupid me. She's not going to want to mix it up here.
She then continued. "But I do see indications . . . certainly with your family history. If you would like a referral-"
"No, not yet," I interrupted.
We moved on to the next possible suspect in the three generation family portrait of undiagnosed and untreated mental disorders, addictions and one likely suicide that I would go on to paint. Alex, carrying such a heavy genetic load, made worse by smoking a lot of pot and taking speed in the months before his hospitalization, had put himself in a category mental health researchers now call "ultra-high risk." Knowing all this about him, Dr. C was able to make an important and ultimately successful treatment decision--to intervene immediately, prescribing Alex antipsychotic medication and regular psychotherapy in order to stop his progression from early psychosis to full blown schizophrenia.
My Part in the "Family Illness"
Another six months would pass after Alex's stay at UCLA before I was ready to deal with my own deadly dance with depression and addiction. By then I was broke, alone, and drinking--more. I had no job and no health insurance, so my only option was to go to the nearest public mental health clinic--where they take everyone, no questions asked, and where, it turns out, very good care can be gotten.
"There's no question you have dual depression," the balding middle-age psychiatrist I call Dr. B told me after a five minute conversation.
"Can you explain that?" I asked him.
"The mild depression you've had since late childhood. As you get older, you're having longer episodes of severe major depression, which your alcohol intake is only making worse. The crisis with your son has pushed you into the severe episodes you're dealing with now."
Dr. B nailed what was wrong with me in an astonishingly short time. Still, getting a diagnosis for something that has always been part of you-as well as
