Two years ago, when Giulia and I were 27 and in our third year of marriage, she suffered a psychotic break. She had no history of mental illness preceding the abrupt arrival of delusions and paranoia. It was a bewildering decline that snowballed from typical work stress to mild depression to sleeplessness to voices speaking to her in the night.
The medicine combated the psychosis by slowing everything down: her metabolism, movements and response time. I didn’t like what the medicine did to her, but I liked even less what her unmedicated self was like and capable of doing, so I gave her the medicine. I observed her as she took it, making sure she did not hide it in her mouth and spit it out later. She still managed to do that a few times anyway.
To try to make sense of why she had to live in this medicated haze, I thought of her condition as being like an old television, the type where you have to turn the dial to change the channels. For some reason, Giulia had become stuck between channels, so all that was broadcasting in her mind was crackly white noise, and it drove her mad, right into the halls of a psychiatric ward.
The medicine was like turning down the volume. It was what had to be done until the channels could work again. And while the volume was turned down, her entire life was on mute. She wasn’t psychotic, she wasn’t delusional, she just kind of wasn’t.
She didn’t communicate much when she was on the medicine. When she did, it was mostly just “Yes” or “No.” More often than not, it was “Yes,” because I think she wanted to make me happy. If we had to go through this hell, she at least wanted to be agreeable. During this time I thought of her as the Great Validator.
The fact that she did not speak much also meant that I spoke a lot, about silly things, things that filled the silence so that I could try to keep her mind here with me, and not adrift in her illness.
But occasionally she spoke on her own, without prompting, and beyond “Yes” or “No.” Those rare moments of self-initiated conversation were always about one of two subjects: suicide or love.
The suicide conversations were never fun. They happened over and over. Out of nowhere, in the midst of one of our agreed-upon dog walks, or while washing the dishes or whatever, often as I talked about something insignificant, Giulia would interrupt and say, “Mark, if someone kills themselves, do they still get a funeral?”
Long pause on my part. “What do you mean?”
“Well, I know that if you kill yourself you go to hell. But does that mean they don’t let you have a funeral? Do you still get a funeral if you’re going to hell?”
“We don’t have to think about that, Giulia, because you’re not going to kill yourself.”
“Maybe.”
“No ‘maybe’ about it.”
“We’ll see.”
She’d smile. Thoughts of suicide tended to make her smile, like she was a little child being told you can have your ice cream later. It was something to look forward to.
When suicidal thoughts made her happy, I knew it was my cue to remind her of other reasons to feel happy. So I told her I loved her. And that so many other people loved her, too. That she was so strong for holding on. That none of this was her fault. That the feelings would go away. That she just had to keep holding on.
These suicidal conversations could be quick or they could be slow. One time we were biking to yoga together, and we had to pull over and sit on the sidewalk for almost two hours while she sobbed and begged me to let her kill herself. I pleaded with her to just hang on through this moment, and that it would pass, and that she would someday, somehow, start to feel better again.
Mark Lukach lives in San Francisco and is writing a memoir about taking care of his wife during her struggle with mental illness.
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