A literary picture of mental illness....

I read an excellent book over the weekend.  The book was written by a new (to me) author, Wally Lamb. It was published in 2008 and was made an Oprah Book Club selection. When I picked up this book, I was motivated by seeing a perceptive comment by Lamb about another author I read.  So, I knew nothing about what he writes.  The name of the book is “I Know This Much is True”.  I  was a little startled when I started reading to find that the book is essentially about living with a family member who is mentally ill.  The main character is Dominick Birdsey, whose identical twin Thomas is mentally ill. Thomas is a paranoid schizophrenic. The story is wonderful.  It follows the Birdsey family through multiple generations.  It traces Dominick’s experience attempting to ensure his brother’s safety as Thomas decompensates and cuts off his own hand because he is the only one able to prevent an unjustified war.   (Thomas’s delusions are religious in nature.  He believes that he is in danger because the KGB is after him. Not all of his delusions make logical sense, but there is a core of truth.) The book traces the family history, including past mental health issues and abuse.  And because Dominick deals with the guilt of being the identical twin without mental illness, it explores survivor guilt.

I’m not going to tell you how it all unfolds because I think that reading it will give you a very realistic look at how mental illness impacts families.  It’s an interesting and well-written story.  I don’t want you to know how it all turns out.  So, here’s what I saw in this book: 

• I could see the multi-generational impact of mental illness and how patterns get passed down.

• I could see the horrible conditions that the mentally ill cope with as they go through treatment.  This focuses on inpatient treatment.

• I could see the impact of mental illness on family members.  Dominick had his own issues to work through.  Dealing with a mentally ill loved one is exhausting and overwhelming.  It led Dominick to significant depression and the potential for suicide.  It also led to lost relationships.  Dominick found himself totally focused on the problems of his brother.  This prevented him from dealing with problems in his own life.  I think that’s a common experience.  I know this because I experienced the same with Maxine.

• I could see the difficulties with getting stabilized on medication and the tendency to over-medicate to make the lives of caregivers in the hospital easier. I saw how the mentally ill essentially become a political football.   

• I saw the reality that people with mental illness are vulnerable.  I also saw that there is a high potential for an early death due to the mental illness.

• I saw stigma.

In short, this was an amazing book.  It led me to want to understand how Wally Lamb could write about mental illness with such accuracy and insight.  I’ll also look for other books from this author because he has apparently written other books on the topic.  If you aren't familiar with his work, I really do recommend reading this book.  It’s a long and complex read.  But it's well worth it.