On Schizophrenia and The South

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I’m in the back of my family’s station wagon, fighting sleep. My mother is in the driver’s seat, lazily sucking down cigarettes as the trees flash by on either side. Every so often she reaches over to adjust the gentle static on the radio. She is rushed and agitated and eager to reach our destination.

János Csongor Kerekes

The Georgia night is cool, whipping in through my open window and breathing softly on my face, though the air is still heavy from the heat of the day. My little sister slumbers soundly in the front, curled up in a plaid blanket. I know I should sleep too, but I can’t. I love these impromptu midnight drives, and I am determined to not miss a minute of them.

We are silent. In several hours we will pull off at a hotel near the South Carolina border. My sister and I will pile into a double bed and my mother will stay up smoking and watching news, her fingers tapping rhythmically on the beside table. In the morning, unshackled from the restraints of school, we will accompany her to visit Aunt Charlotte.

I’m 10 years old before the realization dawns on me that Aunt Charlotte is not actually my aunt. She and my mother look identical, from their white blonde hair to their freckled skin, with matching frown lines around their eyes. Charlotte’s voice is high and breathy, where my mother speaks in a low and husky tone, but their sentences sound the same—drawn out and slowly composed, their thick accents tumbling out word by word. As Charlotte sits in the hospital receiving room, I always notice that her pale gray sweatpants hang loose on her frame, and we have the same orange sneakers. I assume that she has to have Velcro shoes because she can’t tie a knot either.

The routine is always the same. Hugs and kisses, standard chitchat, then my sister and I will wander off down the hallways. While we nosily stare at the fellow patients and attempt to steal from the vending machine, my mother reads to Charlotte. Her tired eyes close and her head nods to the side, the pose of a woman who has been utterly defeated.

No one ever tells me what’s wrong with Charlotte or why she’s in the hospital. In snippets I come to understand that her disease isn’t visible or physical. It cannot be cured with rest and antibiotics. It’s a disease that my family never assigns a name to. In my childlike naiveté, I tell my friends that my aunt’s “thinking is broken.”

“Her thoughts are sick,” I remember telling my class during a second-grade family presentation. “Something in her head broke when she was younger and she takes medicine because she can’t control the broken thoughts.”

My teacher nervously ushers me back to my seat.

In the South, we don’t talk about mental illness.

It’s always there, lingering in the dark recesses of old memories, rolled up in thick family trees and locked in the attic of country houses. Squeaking floorboards cut through the stifling silence. When absolutely necessary, the terms “sick” or “not well” are curtly applied. Afflicted family members are glossed over, and the truth can remain hidden for generations.

In old families where tradition runs strong and prejudices still wave proudly on flagpoles, diagnoses is uncommon. These cracks in the perfect veneer siding of hundred-year-old houses are unacceptable. Keeping up appearances is as second nature as making sweet tea. If there is a fault in either, it will absolutely be discussed by all the ladies at the post-church Sunday lunch.

8676398910_bd642b2725_oIn those early days, my family lived outside of New Orleans in a house that has more paint peeled off than paint remaining. The stair banister is broken, the floors are crooked, the walls are puffy and the windows lopsided. This is the “charm” that comes with an old family home. The sagging ceiling above my bed is supposed to be a fair trade for getting to live amongst the ghosts of my ancestors.

I am told that the south will rise again, and as a small child I fully believe that the zombie remains of Confederate soldiers will one day gather in my front yard, pulling their tired bodies out of the nearby bayou and standing at attention in front of my porch. The spirit of General Braxton Bragg (who I am convinced lives in my closet) will float down to once more command his troops.

One day this crumbling relic of a bygone era will be left to me, with the expectation that I will be grateful for this unwanted inheritance. And yet, just like my mother before me, I will accept this burden out of tradition, and most likely leave it to my children, because that is simply how it’s done.

On cool nights we will sit out on the back porch and my mother will tell us about The South, about all the cities that nest themselves on the banks of the Mississippi, of her childhood and Aunt Charlotte. The words come slowly, which is usual for her, often drying up completely before a sentence has finished. The half spoken stories hang heavy and thick in the mosquito filled night, placing a feeling of unsettled anticipation upon my sister and me.

This house sits isolated from any neighbors at the end of a driveway that winds for two miles perpendicular to the Mississippi River Road, spitting itself out on an unmarked, dirt road. The only markers are a small aboveground graveyard and several low-hanging telephone wires covered in Spanish moss. If you are unfamiliar with Louisiana, I just described 80% of the state.

In those days my dad is gone for weeks at a time, traveling throughout the southern states on business. My sister and I are entirely reliant on my mother to drive us to and from school—a two hour round trip drive in and out of New Orleans.

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Most days we strike out, my mother often still wearing her pajamas as we pile into the car. On a normal day we arrive a few minutes after the first bell, but every few months or so there will be several days when we don’t even make the trip.

My sister and I, dressed and ready, will creak open the door to my mother’s bedroom to find her still in bed. She’ll ignore our whispered questions, turning herself over.

“Not today baby,” she’ll say as she reaches out from under a large comforter to stroke our hair. “Mommy just needs to sleep, okay?”

My sister and I will kick off our saddle shoes and squirm into bed with her, pressing ourselves against her side as we turn on the tiny old TV on her dresser. We spend the day watching “Law and Order” reruns. That night I will make my sister and myself eggs and bacon, and take my mother’s dinner to her in bed. It will be untouched the next morning.

This cycle will repeat, and then on the third or fourth day she will wake my sister and I up early with a smile on her face.

“C’mon sugar, get up and get dressed, we’re going to go visit Aunt Charlotte,” she whispers to us in the early morning light. “How about we stop off at IHOP on the way and get us some pancakes, hmm?”

By now we know this routine, and we get out of bed eagerly, glad that the “sleeping days” are past. Ahead of us lies one glorious day where we eat junk food to our hearts’ content and listen to music loudly. Our mother smiles and laughs easily and heartily, and we soak it in, stocking up on this precious commodity because we know that it will be in short supply soon.

Ten years later, as I sit on the back porch of that falling down house, I will drink sweet tea with my actual, biological aunt. She and her dark brown hair look nothing like my mother or me. Her mouth will be tight and her tone stressed as she lets me in on family secret number one, confirming a suspicion I’ve had for years: Schizophrenia has cut a direct line down my matriarchal family tree, claiming the minds of my mother and grandmother. It occurs to me sharply that at that very moment it was likely lying dormant as it decided who it wanted to visit next—my sister or myself.

The general populace has a painfully skewed and widely misunderstood idea of schizophrenia.

In fifth grade I had a crush on Jacob Willingsley. I told him so very directly. He told me he needed time to think it over. The next day I told him I wasn’t interested anymore, I had moved on.

“God, schizo,” he yelled at me on the playground. “Make up your mind!”

I don’t know how we came to associate schizophrenia with multiple personality disorder. While both are debilitating diseases, one is far more prevalent and deadly. True cases of multiple personality disorder are extremely rare, feeding into the mythos and fascination surrounding the disease.

“Schizo” has now become a slang vernacular for someone who switched opinions or personalities sporadically. “Bipolar” has been thrown in there as well, adding to the long list of diseases that Americans talk about frequently but have little to no true knowledge of.

Schizophrenia doesn’t have the remarkable or “interesting” symptoms of either bipolar syndrome or MPD. Instead, it manifests itself slowly, unfolding over time.

The effects can be severe, from distinct paranoia to auditory hallucinations. More commonly, schizophrenics develop a full breakdown in thought process and function. They lose all problem-solving abilities. Their sentences are fragmented, they trail off, and their thinking is scrambling. One of the earliest signs of schizophrenia is the “martyr complex,” where delusions and paranoia will morph into acute feelings of persecution. For some, this results in violent outbursts. For others, like my mother, it results in full social isolation and lack of motivation.

Few schizophrenics will develop all the symptoms. Some will only experience difficulty with connecting ideas together, or will suffer from additional depression. Others, like my grandmother, can lead perfectly functional lives. Aside from a severe fear of being left alone, she managed her condition without therapy or drugs for over 40 years.

15105821256_db432b4156_oThe disease is kind of a mixed bag—there is no “classic schizophrenia” because the disease itself is comprised of eight different genetic factors. Depending on your biological makeup and what genes you carry, the disease shifts. Severe schizophrenia, the kind accompanied by hallucinations and delusions, is 10% likely to be passed on to a direct relative. Mild schizophrenia, the kind accompanied by disjointed thinking, panic attacks, and depression, is almost 70% more likely to be passed down to a direct relative.

The genes necessary for the disease are commonly thought to be passed down through the mother, like colorblindness or baldness, but are far more likely to manifest in females.

My mother lives with the disease for the majority of her 47 years before she is diagnosed. The cycle has become shorter the older she gets. Instead of several months between sleeping days, we’re starting to get weeks. My father finally makes the decision one night when he comes home to discover my mother hasn’t been to work in almost two weeks. There is no food in the house. When he looks at her, she isn’t looking back.

The months following the forced hospital visit are difficult on my family. She refuses to accept the diagnoses, insists she doesn’t need medicine. My sister misses her LSAT because my mother spent the morning locked in the bathroom. I’m at work when I get the call, my sister’s voice quiet and exasperated.

“Can you come watch mom for me? I can’t leave her right now,” she asks me in between puffs of breath. It’s clear that she is hurrying up the stairs, away from my mother’s shrill voice in the background. I check my watch. There’s no way I can get in from the city in time. Her voice is sharp when I tell her so, and the phone disconnects quickly.

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That night my mother and I sit together on the porch in our usual silence, drinking tea and passing a crossword puzzle back and forth. It’s a routine I have started for her, to force her to think critically. I can see her struggling, but the crosswords are working. Her speech is more connected, there are no heavy unanswered sentences hanging.

13945459640_750c271604_oI use them as a practice for myself as well. I tell myself that if I continually flex my brain muscles, it will fight back any trace of the disease that could be lurking. I also use the puzzles to monitor myself, timing how long it takes me to get through them. Some days I’m slower than others, and these days are always accompanied by deep breaths in the privacy of my bathroom, repeating to myself over and over that failing to complete a crossword once does not mean I’m going crazy. It’s crazy to be worrying about being crazy anyway. Oh God, am I crazy?

When I’m at my worst or breathing into paper bags, I always turn to my mom.

We call her the Iron Lady, because she’s tough. She doesn’t take crap from anyone. It’s a fitting name, especially since she carries a steel rod infused into her spine, the only remnant of childhood scoliosis—another genetically passed disease that I was fortunate enough to bypass.

On that day I am obsessed with the idea that I am a ticking time bomb. I have been moody and withdrawn lately, lacking in motivation. I struggled to complete a crossword the day before, and this worry has consumed me entirely as I do the familiar math. Symptoms begin to show as early at 19 or as late as 25.

“You need to calm down and take deep breaths. Don’t let this get to you, you’ve got more important things to worry about,” she tells me. Her voice is clear, her eyes are bright. There are no traces of the disease as we walk down the aisles at the grocery store. This is the mother I know, the mother I love.

Her blonde hair is in a messy bun piled tall on top of her head, and she strides toward the carrots with a grace I will never possess.

“Easier said than done,” I mumble as I shuffle behind her grouchily. She stares me down out of the corner of my eye and tosses the carrots in the basket.

“If you want to spend your whole life worrying about something that might not ever come true, be my guest. But I’m not gonna stand here and watch you tear yourself apart with anxiety. I won’t watch that happen again.”

There’s an awkward silence.

“Why don’t you ever visit Aunt Charlotte anymore?” I ask her carefully, inspecting a package of green beans too closely. My sister and I have been wondering it for months, too afraid to ask. My mother tenses beside me.

“Because….” she stops, pondering if she wants to divulge her deepest thoughts in the produce section of Food Lion. Her mind, unusually quick today, is mind up.

“Because I don’t want to be Charlotte,” she says, faster than she normally talks. “She gave up. She gave in. She handed her life over to her problems a long time ago and can’t see anything past that.”

I can see the doubt and fear creeping back into her face as her posture loosens. But then it’s gone.

“I’m not going to do that. I don’t want to give up.” The beans are snatched from my hand and unceremoniously dumped into the cart, and she is gone, striding down the aisle and away from me.

She still doesn’t say the words schizophrenia or depression. None of us do. We don’t talk about the disease in any clear terms; we rarely talk about it at all.

“That’s just what this family does,” my biological aunt tells me in between a sip of tea. “That’s how it’s always been done. You don’t talk about these things.”

She pauses for a moment and laughs tersely. I can’t help but notice that, even untethered from the weight of mental illness, my aunt never laughs as freely and openly as my mother does.

“Anyway,” she continues, “It takes everyone in this family so damn long to say anything, why waste that time talking about something so unseemly? Pass the sugar please.”

The author encourages readers to learn more about schizophrenia at the Brain and Behavior Research Foundation.   [analytify-stats metrics=”ga:users” permission_view=””]

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