AUGUST 3, 2023 – (Cont.) After the immediate crisis was under control, the psychiatrist confirmed Elsa’s textbook-based diagnosis of Mother’s malady. The patient was put on a regimen of lithium and within a few days she regained a semblance of equilibrium. The equilibrium of the rest of the family, however, remained upset. Each of us reacted differently from the others, since each of us, of course, had a different relationship with Mother.
Since I lived in relatively close proximity to Elsa and Dad and saw them frequently, I was more familiar with their reactions than with Nina’s or Jenny’s. Dad was an accepting stoic—just how accepting I wouldn’t know until I discovered the cache of love letters after his death nearly 20 years later. Elsa was driven to understand better than any of us, the causes and treatment (and side effects) of Mother’s condition. Of us four siblings, Elsa was always the one most interested in details. As I would later see, Dad and Elsa’s responses picked up where they’d left off after Mother’s first psychosis—some 40 years before, when Elsa was a toddler and before I was born.
When Elsa expressed concern about the potential hereditary aspects of Mother’s newly diagnosed disease, my immediate reaction was denial: after all, our last name was “Nilsson,” not “Holman.” An inner voice was quick to remind me, however, that my middle name was “Bruce”—the fourth in a line of honor, starting with our great-grandfather, George (Bruce) Holman, continuing with our grandfather, Griswold (Bruce) Holman, Jr. and falling next on . . . our exceedingly eccentric uncle, “Griswold (Bruce) Holman, Jr.”
“Yes, I know,” I told my inner voice, “but didn’t I put ‘Eric Björn Nilsson’ on my calling cards that I handed out on my Grand Odyssey around the world?”
“You mean,” answered my inner voice, “the trip you took to run away from your inheritance, as it were—and yourself?”
Ouch!
The inner voice persisted, reminding me that over the years I had exhibited tendencies in the direction of manic depressive-like symptoms.
Double-ouch! In silent response I flirted with untenable logic: given Mother’s insistent denial of her diagnosis—a common trait of sufferers—perhaps I could self-inoculate against the same disease by acknowledging that I’m “on the spectrum.” Yet, if I was mildly anxious about having inherited Mother’s disease, I worried more about its psychological impacts.
There is no cure for bipolar disorder. It can be managed medically and perhaps therapeutically, as we tried earnestly in Mother’s case but with limited success. Elsa and I separately or together would often attend Mother’s therapy sessions, which as harbingers of my future dealings with UB, reminded me of Roadrunner cartoons in which Mother (or UB) invariably emulated the Roadrunner with its signature, “Beep-beep!” after yet another evasive maneuver.
A typical Roadrunner session with Mother nearly always started like this:
THERAPIST: How are you feeling today, Mrs . . . [The therapist’s eyes shifting downward, searching for Mother’s name on an informational sheet] . . . Nilsson?
MOTHER (looking sideways at Elsa/me): How do I feel? [Now, with her crooked smile, turning her gaze back at the therapist] How do you feel?
THERAPIST: This session is about you, not me, Mrs. Nilsson.
MOTHER: About me? What about me? You all are so interested in me, but I don’t know what’s so interesting about me.
[“Beep-beep!”]
The lithium, and in the course of Mother’s treatment, substitute and additional psychotropic medications, along with a few rounds of electroconvulsive therapy allowed her to function within a manageable range of behavior. Brain chemistry, however, especially in the elderly, is not static, and this reality required periodic adjustments in prescription combinations and dosages. Especially Elsa and I but later Jenny, who, as the years passed, spent more time in Minnesota and hence around Mother, constantly wrestled with the interplay not only between Mother’s brain chemistry and medications, but among her psychiatric condition, physiological changes wrought by age and psychological responses to her living environment and most notably, widowhood after 54 years of marriage.
When the interaction of these factors fell out of sorts, we’d readily know by Mother’s soiled clothes, the strain in her facial muscles, the downturn of one side of her mouth, the distant look in her eyes, and of course, her bizarre behaviorisms—for example, opening, then hiding behind the door after we knocked upon arriving at her apartment inside the Sunset[1] assisted living facility.
It was the conversations during such episodes, however, that could drive a normal person crazy; exchanges that Mother seemed to construct intentionally to torture the visitor into a spiral of frustration. The talk often went like this:
ME [at the outset of the visit]: What have you been up to today?
MOTHER [pausing, her face ostensibly pained by the question]: Why do you ask?
ME: To make conversation.
MOTHER [another pause]: Why do you feel a need to make conversation?
ME: Because that’s what I like to do when I visit you.
MOTHER: Are you sure it’s okay with the staff?
ME: What—that I visit you or that I make conversation?
MOTHER: Did you sign in properly?
ME: To be honest, no, I did not.
MOTHER: I don’t want to be in any trouble.
ME: Don’t worry. I’ll take the heat for any infraction.
MOTHER [pausing]: Easy for you to say, but they’re watching me, you know.
ME: Actually, I wish they were watching you more than they do.
MOTHER [assuming a perplexed look]: Why would you say that?
ME: Mother, can we talk about something else?
MOTHER [following another period of silence]: What did you feel a need to talk about?
ME: Pretty much anything except what we’re talking about now.
MOTHER [long pause]: Are you getting enough rest? I know you’re under a lot of stress.
[And so on to the end of the visit.]
Whenever Mother seemed to be slipping toward another psychotic episode, Elsa, Jenny and I hit the panic button. One of us would try to keep Nina informed. She lived in Boston and had her own hands full with her husband Dean, whose M.S. was growing increasingly debilitating during the period of Mother’s old-age decline. Anticipating Mother’s need for hospitalization was never easy: calling the psychiatric nurse hotline at odd hours; lining up a psyche ward bed in a suitable hospital—in some cases, any hospital; convincing Mother she needed hospitalization; transporting her in one piece and without her jumping out of the car at a stoplight, let alone while the car was actually in motion; monitoring her care once she was admitted; managing her medication adjustments and follow-up appointments after her release. (Cont.)
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© 2023 by Eric Nilsson
[1] The chain of senior living facilities isn’t named “Sunset,” of course, but I always thought its actual name—“Sunrise”—was too obviously ironic to be anything but sarcastic.
