Jack kills the giant; Simba defeats Scar; Elizabeth accepts Mr. Darcy’s marriage proposal.

Whether in fairy tales, Disney movies, or classic literature, the protagonists suffer, the plots twist, but in the end, it all works out for the good guys and their sidekicks. Only the villains are defeated.

To be sure, happy endings make for feel-good fiction. Yet memoirs with happy endings can send the wrong message.

David Sheff’s Beautiful Boy in which he describes his son Nic’s battle with addiction to methamphetamines, and Nic’s subsequent memoir, Tweak: Growing Up on Methamphetamines lead readers to expect that addiction to meth can be conquered.

Maybe it can, but it certainly is not the norm.

Kay Redfield Jamison’s An Unquiet Mind, and Elyn Saks’ The Center Cannot Hold: My Journey Through Madness leave readers with the impression that even the most severe of mental illnesses – bipolar disorder and schizophrenia – can be overcome when those who suffer these illnesses work diligently toward recovery. 

There is no doubt these authors have important stories to tell.  Jamison, who suffered the earliest symptoms of bipolar disorder as an adolescent, became a clinical psychologist and coauthored the classic textbook about bipolar disorder. Saks experienced the first symptoms of schizophrenia when she was 8 years old. She graduated summa cum laude from Vanderbilt University, earned her master of letters from Oxford University, and her J.D. from Yale Law School. She holds a Ph.D. in psychoanalytic science from the New Center for Psychoanalysis.  

Things turned out well for Sheff, Jamison, and Saks. Their stories are inspiring.

It’s good to have heroes and role models. But the message of these memoirs – that hard work, access to excellent medical care, and a network of supportive friends and family can overcome mental illness – is also dangerous because life doesn’t usually turn out that way.

Abusing methamphetamine can cause memory loss, aggression, psychotic behavior, damage to the cardiovascular system, malnutrition, and severe dental problems and contribute to increased transmission of infectious diseases such as hepatitis and HIV/AIDS.

Schizophrenia is a chronic, severe, and disabling brain disorder that causes some to hear voices other people don't hear. Many with schizophrenia have difficulty holding a job or caring for themselves.

Bipolar disorder causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. Sometimes symptoms are so severe that the person cannot function normally at work, school, or home. While treatment helps relieve many symptoms of schizophrenia and bipolar disorder, most people with these disorders experience symptoms throughout their lives.

When my daughter – diagnosed with ADHD, bipolar disorder, and borderline personality disorder – turned 18, she made the decision to stop her treatments and leave home. There was nothing my husband or I could do to stop her.  Despite the unanimous view of her doctors that she was not competent to make such decisions, she had the legal right to do so.  Three years later, she has become addicted to methamphetamine and is homeless, living on the streets when not in jail.

Distraught, I did what my career as a research psychologist taught me to do. I read about the science of mental illness and the law. And then, hoping to learn from the experiences of others, I started reading memoirs. Quickly, I plowed through dozens of memoirs – memoirs written by people with mental illness and memoirs written by the parents and children of people with mental illness. 

Each memoir told the same story: turmoil, more turmoil, and then a happy ending. These memoirs made me feel inadequate. Maybe I hadn’t tried hard enough to help my daughter. Maybe I wasn’t a good mother. 

Sometimes the memoir described extensive and expensive contact with the healthcare system – care well beyond the grasp of all but the wealthiest among us. Other times there was a miraculous recovery that I wondered whether a serious mental illness had ever been evident.

I tried to reconcile the story these memoirs told with the facts I knew about mental illness.  Where were the memoirs written by people whose experiences were like mine – those whose loved ones were homeless, in jail, or dead? Surely I wasn’t alone.

It was then that I realized that I needed to write my story. I needed to do it because I’ve seen mental illness through the eyes of a child, a mother, and a psychologist. I needed to tell families of people with mental illness that not all stories have happy endings and that they’re not alone.

Surrounded By Madness: A Memoir of Mental Illness and Family Secrets chronicles the experiences I’ve had as the daughter of a mother and mother of a daughter with severe mental illness. The book’s message is that mental illness and family secrets are a toxic combination. As a psychologist, my hope is that my book inspires others to tell their stories and that, together, we can fight stigma and improve the lives of those we love who suffer from severe mental illnesses like schizophrenia, bipolar disorder, and depression

Kirkus Reviews, the book news magazine relied on by acquisitions librarians across the country, placed Surrounded By Madness on its Recommended List of new books.  Kirkus noted that Surrounded By Madness is “penned in a vivid, literary style that bleeds anguish [and] leaves such a powerful impression, it would make a solid supplementary text for a college psychology course. Pruchno’s feelings of desperation and powerlessness speak more to the reality of mental illness than an academic case study ever could.”   Likewise, Surrounded By Madness has been lauded by our nation’s leading mental health experts for its informative value and revealing insights.  Other reviewers have called it “a must read, masterfully written, can’t-put-it-down, page-turner.” 

Surrounded By Madness’s book trailer on YouTube.com may be viewed at http://tinyurl.com/nozgcwv.  The book is available through online booksellers.

I urge you to read my memoir … because it is important for people to recognize and fully understand that very few stories about mental illness have happy endings.

1. drugabuse.gov

About the Author

Rachel Pruchno, Ph.D.

Rachel Pruchno, Ph.D., is the Endowed Chair and a professor of medicine at Rowan University School of Osteopathic Medicine. Her memoir Surrounded by Madness is available at online bookstores.

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