Searching for Normal - A Review

Could we have prevented this suicide? - Every survivor asks the question in the aftermath of a loved one's death. In Searching for Normal: The Story of a Girl Gone Too Soon, Karen Meadows traces through her daughter Sadie's entire life, reexamining every decision that affected Sadie's illness. No, Karen, for God's sake, you even paid professionals to find the best options out there for Sadie's care.

Sadie was a bright, lively, inventive child with obvious gifts and potential. A victim of bullying, things turned dark in middle school. The school's routine screening for depression yielded an awkward phone call to her parents - they should get her treatment.



Depression is the DSM's junk drawer. Lots of people start their sojourn in diagnosis by getting slotted into it. Lots of them get moved to another drawer when antidepressants prove less than helpful. Sadie's first suicide attempts followed closely upon beginning treatment with antidepressants.

Another doctor said bipolar. Another doctor said, no. A treatment center said she shouldn't be on meds at all... Meanwhile, Sadie's parents struggled with their own concerns about medication. What does it do to a developing brain? Or was it because she was on the wrong meds? Or because they withheld meds? Or because she wasn't monitored when she started them?


Or because she was adopted? Or because they moved? Or because she got rejected by schools? Or because they couldn't find the wrap around services that had been recommended? Or because...


Beyond the second guessing is a thorough listing of what help is available to families facing severe mental illness and what help is not. The author moves from grief to advocacy for better care, better services, better understanding of mental illness and what this epidemic of suicide costs us -- lives of promise and brilliance. Sadie was one such person of promise and brilliance whose life ended too soon.

One of the heartbreaks in the story for me is that the Meadows family went through this alone. They didn't know that there were others who have walked this path before, who could have supported them, helped them. National Alliance on Mental Illness, NAMI offers classes, Family to Family for family and friends of those with mental health conditions and now Basics, specifically for family and caregivers of young people. Alas, these programs are not available everywhere. But the websites can help you find the ones closest to you.




Karen Meadows didn't find NAMI until after Sadie's death. The last chapter of the book is a wide ranging list of resources. Out of tragedy came a determination to help others. That will be Sadie's legacy, one of them, if those whose stories are beginning like hers can come to a different ending.
book cover image from Amazon.com

Prozac Monologues - Happy Anniversary!

Ten years ago I retired on a mental illness disability. It was a relief. It was dreadful. It was a heartbreak. And I was pretty sick.

Being a priest is a public job, and mine had been more public than most. So between retirement and the mental illness that led to it, I felt isolated and had a serious case of Who the hell am I, anyway?

But I sat down, signed up for a blog, wrote my first post, and there it was, my new life, Prozac Monologues: Reflections and Research on the Mind, the Brain, Mental Illness, and Society.

This is the place where I have recorded my learning about what happened to me: genetic variation, childhood trauma, wonky wiring, unhappy mitochondria, that broken internal clock... followed by misdiagnosis of Major Depressive Disorder, inappropriate antidepressant medication, a bit of psychiatric manipulation, a new diagnosis of Bipolar 2. And then recovery. Not cure, but recovery, as in the way I live the rest of my life.

It is where I have puzzled through philosophical issues about mental illness and its treatment, political issues about society's response, stigma/prejudice, the use of language, how art can soothe the savage brain, how mental illness comedy can give voice to what cannot otherwise be said.

It is where I have discovered psychiatrists and others whose work I admire: Ronald Pies, David Conroy, Hagop Akiskal, Jill Bolte Taylor, John McManamy, Nancy Andreasen, Nasser Ghaemi, and some others... not so much.

My readers have read my rants, my musings, and even my sermons. And some of you have made comments that told me I needed to keep going.

Which I did.

Thank you for that.

To mark the occasion, Prozac Monologues, the blog has been given a facelift. There may be a few more tweaks in the days to come. Actually, I'll invite you to make suggestions. Broken links have been removed from the Mental Health Break list on the right. I could use some new ones. What are your favorite videos and sites that would fit the category? Click the link for comments at the bottom of the post.

One more thing: Prozac Monologues: Are You Sure It's Just Depression -- promised so long ago in that first post will be coming to your local bookstore in September 2020! Published by She Writes Press, distributed by Ingram Publication Services, you can follow its progress on my author page. And Twitter, that thing into which authors are dragged kicking and screaming by their publicists (mine is JKS Communications), yes, I am on Twitter, too @WillaGoodfellow.

Again, thank you for reading. That will be my dedication in the book: I wrote this for you.


Anosognosia and Amador

Anosognosia. It means lack of insight. But from the mouth of Xavier Amador, it’s his ticket. He tells you he knows why your son or daughter won’t take meds. And you are desperate for the answer, aren’t you. Because schizophrenia is a terrible disease and your beloved child is sick and won’t take the meds. The meds would make everything alright. So you are desperate and Xavier Amador throws you a lifeline, a promise that once you understand this unpronounceable word, you can learn how to get your child to take the meds.

He must be right, right? Because he is a psychologist and he can pronounce it. And then the kicker, he also loved somebody with schizophrenia, and he says he got him to take the meds. So NAMI invites him to give the spotlight lecture, and for the rest of the convention, parents hear every other presentation through the filter of this new word that they cannot pronounce.

Here is how you pronounce it:



But really, why bother? It means lack of insight. But you have heard of lack of insight before. And you can pronounce lack of insight. So those words don’t have the power to claim you and get you to buy his book like anosognosia can.

Actually his advice is not bad, once you get past the power play. Stop fighting your sons and daughters, stop trying to convince them that they are sick. Instead, build a relationship.

Listen: reflectively with respect and without judgment
Empathize: strategically with emotions stemming from delusions and anosognosia
Agree: find areas of agreement - abandon the goal of agreeing the person is sick
Partner: on those things you can agree on -- not being ill




I like that advice and have given you a clip of the best part of the presentation.

Now if you will permit a word of advice about relationship-building from somebody who has a mental illness and occasionally does not recognize when her symptoms are showing - ask us why we don’t take our meds.

I met a new friend at last month's NAMI convention. I explained that I wasn't going to this presentation, I had heard it a number of years ago. Then I said, "Ask us why we don't take our meds." She said her son says they make him feel terrible. Bingo.

Now it's true, sometimes people with schizophrenia have delusions that make reality testing difficult. Sometimes people with bipolar in a psychotic or manic state do not recognize that state. I have on occasion rejected my spouse's concerns about my hypomania. And some of us do go off our meds in these temporary states.

But NAMI does a disservice to family members by giving them this fancy word that substitutes for believing what their loved ones tell them. These meds suck. They cause ballooning weight gain, leading to heart disease and metabolic disorders which shorten our poor pathetic lives by ten years on average. They evaporate our sex lives (not that parents want to hear about their children's sex lives.) They fog our brains and drain our energy, leaving us with lives that are not worth living.

Nobody talks about what Nancy Andreasen discovered after fourteen years worth of brain scans of people with schizophrenia -- the more antipsychotics you take, the more brain volume you lose. National Medal of Science recipient, one of the world's foremost experts on schizophrenia, yes, Dr. Andreasen remembered to control for things like severity of illness and alcohol/illicit substance use. Neither affected the results. It was level of dose and length of treatment. The more antipsychotics you take, the more brain volume you lose.

[Funny thing, soon after she published her preliminary results, her funding evaporated.]

A conversation about why we should take our meds anyway really has to include an acknowledgement of the fact that these meds suck. True acknowledgement, not some sort of mental crossing of fingers behind the back, with the all-knowing family members chanting Amador's magic power potion, anosognosia, under their breath.

Half the people who won't take their meds think they are not sick. Those are Amador's numbers and I won't dispute them. And if you don't already know that delusions are not the sort of thing that somebody can be talked out of, then I suppose he does a service to tell you that. But are you sure that's why your loved one doesn't take the meds? He's got a whole ballroom filled with people who now believe it, and who take any other protestation to the contrary as proof of anosognosia.

Okay, that's my first objection to NAMI's sponsorship of Xavier Amador's presentation at not one but two of the three NAMI conventions I have attended. Dammit. His half truths.

The second is that his presentation is a parlor trick. Really, two parlor tricks. The first is that unpronounceable word by which he's got you. He has established the power of his credentials over you. He is the expert.

The really disturbing parlor trick is his demonstration of what a delusion is. He gets a volunteer from the audience. Then they do a role play. The volunteer answers questions about his/her spouse. Then Amador does an "intervention." He tells the volunteer that s/he has been stalking said "spouse," who is not actually married to the volunteer after all. The marriage is a delusion. The volunteer has violated no-contact orders, and they are going to get the person help. There are people just outside the door who are going to take him/her to the hospital. This goes on for a while, demonstrating that Amador is indeed not able to convince the person that the so-called spouse is a delusion. Voila! Anosognosia.

Now one interesting thing about this demonstration is that we are to take it as a demonstration of the power of delusion. But in fact, the volunteer is not deluded. The volunteer genuinely is married to his/her spouse, and ends the demonstration still sure of the fact.

What Amador has actually demonstrated is called gaslighting. The volunteer does not fall under the spell, does not forget the spouse. But the audience does. The audience is convinced that this demonstration demonstrates something more than mental cruelty, that they have learned something about the power of delusion, which, again, never existed in the first place. And he knows that this parlor trick is harmful, because at its conclusion he gives the volunteer advice about how to recover from it.

But there are those who do not fall under the spell, those who have seen it before, in some other psychologist or psychiatrist's office during a professional visit. That's why one person left last month's demonstration sobbing, and why I spent an afternoon in concentrated self-care after my exposure to this presentation years ago.

Here is an example: I call my psychiatrist to get help for symptoms I am having from withdrawal from Effexor. She says I don't have withdrawal symptoms, because it is not possible to become addicted to Effexor in the short time that I took it. I persist, I am having the withdrawal symptoms described in the literature and need help. Now who do you believe? She, after all, has a PhD in psychopharmacology as well as her MD. And I am a self-confessed mental case who insists on stopping this medication that she thinks I should be taking.

I took my wife with me to my last appointment with that psychiatrist, so she could report what happened in the office to my therapist who had slapped a new diagnosis on me based on my own reports.

Amador is not that psychiatrist. He is the trigger for the reliving of that psychiatrist because he uses the same techniques:

1. Establish the extreme power differential, in one case her academic degrees over my addled mental state, in the other his five-syllable word over the uninformed audience who cannot wrap their tongues around it.

2. Take the moral high ground of compassion, trying to help, a position over the other.

3. Say whatever the hell you want.

4. Refer any protestation back to #1.

Yes, there is a kernel here. Stop fighting your loved one. Build the relationship. But the parlor tricks do real damage. Isn't it time to retire this presentation from its position as the major Friday night presentation at NAMI conventions?

[By the way,  to add some context: adherence runs at around 50% for people taking high blood pressure medication.]

still from tv show M*A*S*H* from IMGflip.com
graphic of Zombie by Jean-nöel Lafarge, used under the Free Art License
still from the movie Gaslight from vox.com


God and Suicide

Eight years ago I wrote "I don't believe in God anymore." It was the title of a book chapter, a book reflecting on suicide from a Christian perspective, though probably not the Christian perspective that you think about when I say that. More like what goes through the mind of a Christian who is suicidal and is bringing what is left of her theology to the experience and desperately trying to tell the truth about it. The truth. Not what we want the truth to be. Just the truth. It wasn't exactly a suicide note, though it might have been taken that way if that's the way it turned out.

It didn't turn out that way. I recovered. "I don't believe in God anymore" anticipated that I would recover, but that wouldn't make the problem go away. Relapse was statistically probable. I might be in that darkest of places again. This chapter dealt with the problem of suffering. Oh, how tidily that phrase expresses the chaos of a believer's brain when looking into the abyss. But I wouldn't let the tidy answers stand, and I still won't. While I am not so bitter anymore about this remitting, recurring condition of mine, as far as God goes, well, I just don't know as much about God as I used to.

Here is a piece of that chapter:

Although my own soul is a dry desert, I have deep wells from which to draw. While I do not believe in God, so I cannot say the creed, I cannot set my heart on the One who has broken it, I still believe in the communion of saints. As a Christian, I have a big family, across space and time. For now, I ask the rest of my family to do my believing for me.

The lament psalms persist in worship, and worship is how I persist. I listen to Gospel music. I sing along with those whose music it is. I do not have their faith. But I cannot dispute their testimony, what God has done for them, and the power they find in God to get through. I believe in them. I believe in the Brooklyn Tabernacle Choir.


Those whose ancestors survived the Middle Passage, survived slavery, survived Jim Crow, survived the Klan, who still survive today, I don't know how they survive. But they assure me, and I listen to them tell me over and over:


             Everything He said in His word,

               He will do it for you.
               Every prophecy he gave, every promise He made,
               He will do it for you.

Eight years later, I am in remission, not depressed, not even a shadow for the last six months. An eternity! I have challenges. I manage my condition every single day. And my life is good. I work toward a publication date of September 2020. There will be something that comes out of that old hellhole, a book, a different book that offers help and hope to others who have been misdiagnosed and inappropriately treated as I was. And I am very proud of it, Prozac Monologues, the book.


I am not saying it was worth the price. I am not saying that my God issues have been resolved, that some promise was kept, and it's all okay because there was a happy ending. You can say that if you want. But it's a slippery slope, hanging your faith on the happy ending.


David Conroy wrote, Suicide is not chosen. It happens when pain exceeds resources for coping with pain. There is some truth for you. I have been blessed by enormous resources, and they have kept me alive through enormous pain. One of those resources is an unshakable experience of the communion of saints, those who have been there for me across the centuries, from Jeremiah to John of the Cross to the friend who said my prayers for me when I confessed I couldn't pray anymore to the Brooklyn Tabernacle Choir.

I went to church on Sunday with a CD by The Brooklyn Tabernacle Choir. It reminded me of that chapter. And I thought it was time to say thanks. They carried me through.





photo of candle by anonymous, used under Creative Commons license

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