My Lovely Wife in the Psych Ward

I had the great pleasure of reading Mark Lukach’s memoir “My Lovely Wife in the Psych Ward” recently. It was interesting to read from the perspective of a loved one and their experiences dealing with the mental health of their significant other. It’s easy in the struggle to maintain sanity to forget that it is not just you struggling but rather your family is right there with you. Lukach details the account of his wife Guilia’s several stints in the psych ward in a relatively short span of time. Mark speaks about his feelings of abandonment from the  professionals at the Emergency Room who sent his wife Guilia home with medication instead of admitting her when she was having delusions of the Devil.

Mark and his in-laws would ultimately have to bring her back to the ER when she had more ramblings about the Devil and how he is still here and that she protected them from him. They gave her Ativan to calm down and through the fog of it she said “Mark, I am the Devil.” The on-call psychiatrist stated that she would need to be admitted and treated. Mark remembers this moment, “I knew that this was coming, that this was the inevitable next step in the process, but it still felt surreal.”

I realized while reading this book, I never truly thought about my parents and what they had to go through when I was admitted to the psych ward. Did it feel surreal to them? Were they upset? Did they feel as though they had failed me? Dealing with the pain of being forced to be hospitalized left me with no room to consider these questions until now. I feel so incredibly selfish that it took until now to reflect upon them. I hope they know they did everything they could to take care of me but that psychosis is inevitable when untreated for bipolar disorder. I wonder if it was a shock to them that I was being diagnosed with bipolar and sometimes I wonder if they think less of me for it. I know my mother never likes the word being uttered around family or in public as if I was saying God’s name in vain.

Mark’s wife was admitted on a form 5150 which means she was involuntarily checked in and needs to spend 72 hours there as required by law. He describes his first visit with her at the psych ward and it is heart wrenching. She screams at them to leave and that the Devil is there and wants them. She was hysterical with fear and screamed “Don’t you dare come near me!” At one point she rolled onto her back and started to chant “I want to die, I want to die, I want to die.” Mark recalls this moment, “I’m not sure which scared me more: listening to my wife whisper her death wish or scream it.” Throughout all this Mark continued to support his wife and assured her that the Devil would not get her or him and that their love was stronger than any of it, they would get through this.

I similarly had a moment in the psych ward where I wanted to die. They had me on a heavy dose of lithium which we have now learned does not work for me and actually makes me more depressed and suicidal. I laid in the hospital bed crying that I wanted to be with my father and that I thought I was ready to be with him (my father died years ago). My mother just held me crying and I eventually drifted off to sleep and waking to a new day in which they decided to take me off lithium  and instead put me on a nice healthy dose of anti psychotics. Anti psychotics have worked for me then and ever since – keeping me stable.

Once Lukach’s wife was discharged from the hospital she slumped into a eight month depression following her psychosis where she fixated on suicide and was extremely lethargic from the medications she was put on. She was discharged with no firm diagnosis but the doctors had ruled out schizophrenia. Lukach writes, “We had no clear explanation for what had gone wrong. It was probably related to a combination of lack of sleep, stress, hormones, and chemicals in her brain, but not even her clinicians knew what it was.” This meant they did not know if it would come back, however, ninety percent of the time psychosis recurs. They went on with their lives hoping that Guilia  was of the ten percent but as time would tell she was in fact part of the ninety percent.

The reason this book stands out for me not only because it is a memoir about a husband’s experiences with his bipolar wife’s psychosis, but also because it highlights the other side – the caretaker’s struggle with mental health. Lukach mentions he also started seeing a therapist while Guilia was unwell. The therapist wanted to know why Mark wanted so badly to be Guilia’s hero. Mark writes: “I wasn’t too interested in understanding why I devoted to much of my caregiving to Guilia. To me, the answer was simple and cliched: love.”

Mark mentions feeling like shit all the time and wanting to know why. He had never felt so disinterested and lethargic before in his life and was used to having an excessive amount of energy. His therapist said of course he feels like shit because he has been through a lot the past nine months with one month of his wife’s psychosis and following eight months of depression. She also points out that “the worst is over but everything you once knew is gone. The love you had with Guilia, the way you once knew it, is gone.”

Mark reflects on this realization: “Nothing could ever be the same. Our bliss, our puppy love from college, our charmed lives, it was all gone. Guilia’s psychosis and depression would color the rest of our relationship. Maybe even my own happiness wouldn’t come as easily as it always had. I would have to work for it and have the courage to do the work.”

Guilia would eventually end up back in the psych ward following the birth of their son Jonas, after tapering off lithium mostly because she would not be able to breast-feed on it. Instead of a psychosis fixated on hell though this psychosis would fixate on the notion of heaven. After days of not sleeping and rambling about heaven being earth she was admitted to the psych ward for her second time in three years. The doctor believed Guilia was suffering from postpartum psychosis. The doctor would eventually officially diagnose Guilia with bipolar disorder I, characterized by soaring highs and crippling lows. Guilia somehow experienced both as negatives with her mania fast-tracking into psychosis, with paranoia and delusions. The doctor made it clear she will have to be on lithium for the rest of her life.

Guilia would be released from her second stay at the psych ward after thirty two days. Mark would end up feeling uneasy with the two hospitalizations and begin to research bipolar more thoroughly. He spoke with Sasha Altman DuBrul, one of the founders of the Icarus Project, an alternative medical health organization that calls mental illness “the space between brilliance and madness.” Sasha introduced to Mark the concept of a mad map. Mad maps allow psychiatric patients to outline what they’d like their care to look like in future mental health crises. They are designed to encourage patients to plan ahead in order to give them more control and avoid, or at least minimize future mistakes.

They came up with a plan for if Guilia starts to relapse again. If she can’t sleep again, she will take one milligram of Risperdal (an antipsychotic) by midnight. If she still can’t sleep by two a.m., she will take two more milligrams for a total of three. Guilia would relapse again and even though she followed the mad map she would end up in the hospital a third time. However, this time, she was discharged after thirteen days – the shortest of all her stays. This may be because they had the safety net of the mad map which lessened the blow of her episode with medication ahead of time instead of only after the fact.

This book was a beautiful account of a husband’s struggle and triumph being his mentally ill wife’s caregiver. It addresses resentments felt and issues with the mental health system. Mark stands by his wife through three psychotic breaks and proves what true love looks like – it is kind, understanding and supportive. He even struggles with his own depression as a result of his wife’s mental health but finds solutions such as exercising regularly and seeing a therapist. The one thing Mark never does is give up on his wife. He genuinely stands by the vow “in sickness and in health” which some not as strong as him may have taken Guilia’s illness as a way to cop out.

If you are looking for a book that shows the other side of mental health – the side with loved ones who struggle to grapple with and understand their significant other’s mental illness – then look no further. This book has shown me what a true caregiver looks like and how they struggle with a variety of feelings. This book is called “My Lovely Wife in the Psych Ward” and it is written by one of the loveliest husbands who in my opinion is a hero, a hero to Guilia.