The crack-up

Falling apart may have been just what this overachiever needed.


Steven Scott Smith
April 15, 1999 12:06PM (UTC)

I can laugh at it now because comedy equals tragedy plus time. A nervous
breakdown is highly underrated, and while I don't recommend it for everyone,
it can be the antidote and wake-up call that you needed to set your life in
order.

I am 41 and what most people would call an overachiever: obsessive,
intellectual and part of the dreaded cultural elite. I am strong-willed,
determined, opinionated and extremely headstrong. I would never consider
asking anyone for help. And yet, it happened to me. As Zelda Fitzgerald wrote to F. Scott, "It is
ghastly losing your mind" -- but sometimes that is your only
option.

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If you're going to do it, you might as well do it the right way. And you
should know that you are in good company. Susan Sarandon recently
admitted to Barbara Walters that when all her life myths were shattered,
she had a nervous breakdown and had to reinvent herself. And Otto Friedrich
in his 1976 book "Going Crazy" lists such real and imagined luminaries as Robert
Schumann, Jean Seberg, Vincent van Gogh, Edgar Allen Poe, King Lear,
Hamlet, Caligula, Sherwood Anderson, Martin Luther, Eugene and Carlotta
O'Neill, Elizabeth Taylor (both on- and off-screen), Patty Duke (both on-and off-screen), Virginia Woolf and Vaslav Nijinsky.

And there's the dean of the disorder, William Styron, who wrote a book called
"Darkness Visible" about his experience with depression and breakdown.
Having realized that most of the characters in his own books suffered
nervous breakdowns, (think Sophie in "Sophie's Choice"), Styron was unaware
that he was writing the blueprint for the course that his own life would
take. Trying to share a common bond with those who have experienced this
phenomenon, and understanding that there is no shame in it, Styron pinpoints
the beginning of his breakdown to the loss of his mother at an early age.

But it's not as practical a tome as I would have needed. My experience can
serve as a handy guide to those of you out there on the verge. See, I'm
like you. I'm a hard worker. And I don't do drugs, drink alcohol or smoke
cigarettes. I smoked marijuana three times and did inhale, but never
found it intellectually stimulating. I tried therapy three times and,
besides feeling smarter than my therapists, thought it was a waste of good
money. It was more
therapeutic to save the money. I graduated Phi Beta Kappa and have an
MFA. I have been a professor of humanities at NYU for
the past 18 years.

So when my breakdown crept up at age 35, it was the last thing I ever thought could happen to me. But in retrospect, it could have been predicted. I had lost several close
friends in the space of three months; before I could grieve for one,
another would be dying. "Multiple grieving syndrome," psychiatrists call it.
Holocaust survivors have it. I buried myself in my work.
I acted as if their deaths didn't affect me.

At the same time, the person I was dating decided that it was time to leave
me. Although I am fine alone, intellectually I could cope with losing
friends in death but could not understand somebody just leaving. I started
to grieve for all my friends at once. This led to an all-out collapse, or
nervous breakdown.

Dr. Clark Sugg, director of clinical services at the William Alanson
White Institute of Psychiatry, Psychoanalysis and Psychology in New York, says, "You would be hard pressed to find a definition of a nervous
breakdown because it is a term the psychiatric and medical world has not
embraced. They use terms like psychotic episode or major depressive
event, and for each person it is different, but behind closed doors of the
profession a nervous breakdown is an all-out collapse." He
went on to quote Carl Jung's definition: "The patient who is sick in mind in
the
highest and most complex of the mind's functions, and these can hardly be said
to belong anymore to the province of medicine."

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The American Psychiatric Association defines a "major depressive episode"
as one that includes at least five of the following symptoms during
a two-week period:


1. Depressed mood most every day

2. Diminished interest or pleasure in almost all
activities most every day

3. Significant weight loss or weight gain
when not dieting

4. Insomnia or hypersomnia nearly every day

5. Restlessness or slowing down nearly every day

6. Fatigue or loss of energy nearly every day

7. Feelings of worthlessness or excessive
guilt nearly every
day

8. Diminished ability to think or
concentrate nearly every day

9. Recurrent thoughts of death and suicide,
with or without a
plan

How'd you do? Well I scored a perfect nine out of nine. Remember, I am an
overachiever!

A nervous breakdown paralyzed my ability to make even the smallest decision. And getting out of bed was like climbing Mount Everest. Thoughts
of suicide are not far away. And it is the paralysis that spares you: If
you do not get
out of bed and drive, you won't swerve on the road "accidentally." But if
action is not taken it can be a painful road to a slow death: I stopped
eating. I could not sleep at night. I started hearing voices. I would get
into bed and shake and convulse. The real world seemed surreal.

One of the things that saved me was the phone. As long as I was connected
to people in some way I was fine. Hearing about other people's activities
-- even grocery shopping -- meant there was a world out there. I was
desperate to
hear about anything that didn't involve me. The worst time was 2 to 6 in
the morning, when I felt as if there was no life, and the world was asleep.
I would pace and have panic attacks.

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I didn't care about my personal appearance. For a month I wore one pair
of khaki pants and a black turtleneck, which concealed my growing weight
loss. I had lost 30 pounds and looked like an Auschwitz survivor.

My friends were there for me, a key to my survival. My best friend got active. He
called several of my other friends and they went on a watch: all of them
taking turns being with me. I was never to be left alone. My friends
ordered the
best take-out food to encourage me to eat, but I couldn't. They made sure
that the clothes I was wearing were clean -- even if it was the same khaki
pants and black turtleneck. And although I tried to feel better to make my
friends feel good for their sacrifice, I was getting worse. Orange juice
was the only thing I could keep down. My friends could no longer take the
responsibility for my welfare.

They got me to a psychiatrist. Luckily, on the roulette wheel of therapists
I landed on one who was smarter than me and really understood my condition.
He said, "This is that rainy day: Treat yourself well. Take cabs instead
of subways, don't deny yourself anything -- it is time to take care of
yourself -- and let yourself feel your pain, because it is real." I was
taking the first step toward getting better. To help me with the physical
symptoms of my ailment he immediately prescribed Xanax, an anti-anxiety
drug, and Zoloft, an
anti-depressant. (Anti-depressants -- serotonin uptake inhibitors -- take
several weeks to help balance the chemical imbalance caused by depression.)
He checked me into the hospital for observation.

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Once there, I was finally able to relax. It's something I definitely recommend.
To relax. To have full-time
care. To be watched. And to put you in a situation you want to get out of
as soon as possible. (Hospital food, when you have a problem with food in
general, can be a great drug.) One night in the hospital was enough for
me. I had hit bottom with a resounding thud.

Remember, climbing out is done in baby steps. Therapy, anti-depressants
and anti-anxiety drugs can be huge safety nets, but you have to want to
take actions to make your life better and more stable.

This sometimes takes searching your past. I turned to my family -- the
last place I thought I would turn in a psychological meltdown. My mother
had noted my degrading physical condition, so I explained to my parents
exactly what had happened to me. I needed answers from them about them.

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The answers they had hidden for years were the touchstones to my recovery.
In their generation, depression and psychological disorders were considered
shameful and, like in most families, were covered over in organized
secrets and
lies. The aunt that I was told had a stroke had put a bag over her head
and asphyxiated herself. The cousin who had a "heart attack" had really
hanged himself as he was approaching 40. My mother had suffered a
miscarriage before she had me and because of her postpartum depression she
was put on Librium and Seconal by our family doctor. She became addicted
to them and was on them all through my infancy. My father's father, who
died when my father was just 9, who I had been told died of an embolism,
actually wasted away slowly from melancholia (as they called it then)
because his twin died in a freak accident.

There now seemed to be a genetic or historical basis for my own depression.
In some way I felt relieved. It united me to my parents like nothing
ever had
before. At the expense of having a nervous breakdown, things I had always
wondered
about were finally revealed. I asked my parents to come with me to a therapy
session. They came, even though my father doesn't believe in doctors and my
mother
thought that therapy was a luxury for the rich who needed to complain about
something. But it was their gift to me. They jokingly asked my
psychiatrist if they were the cause of my problems. If it isn't one thing,
it's your mother, right?

I made it clear to both of them, with my psychiatrist's help, that this was
not about blame, but about getting to the truth -- the answers that everyone
wants to those family questions. Some of the answers were startling: I
learned that my grandmother had two sisters I never knew existed who died
from "mysterious" illnesses. I learned that the cousin who hanged
himself did so as a reaction to my uncle's rendezvous with a prostitute. Some of
the answers were mundane, but the wall had been cracked.

The epiphany came after about three months of therapy, family interaction,
and drug treatment. I had a moment of clarity where I really saw life as
it is. I felt great. I can't explain the euphoria, but suddenly there was so
much to live for. Resurrected and reborn and now out to redefine my life, I
could do anything.

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It has been five years since my breakdown, and life has come full circle. Guess who is the strong one again? My mother's
health has deteriorated; I had to close down my father's business as he
approached his 70th birthday. This, and my mother's health problems, has
led to my father having a nervous breakdown. My father was always the
eternal optimist, and couldn't understand what was happening to him.
Luckily, when you have been to hell and back you understand the journey.

My gift to my parents is that I am
helping them through this time as they did for me. It has brought us all
closer together. Because of my own breakdown and subsequent healing, I
have the tools and the knowledge to help ease a very stressful situation. I
gave Styron's "Darkness Visible" to my father. Not admitting to his own
condition, he said, "Ya know a lotta people go through what he talks about
in that book."

I said, "That's the point dad -- you don't have to feel so alone."


Steven Scott Smith

Steven Scott Smith is a journalist and playwright in New York.

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