Brilliant Madness

Living with Manic Depressive Illness


Mass Market Paperback

About the Book

In her revealing bestseller Call Me Anna, Patty Duke shared her long-kept secret: the talented, Oscar-winning actress who won our hearts on The Patty Duke Show was suffering from a serious-but-treatable-mental illness called manic depression. For nearly twenty years, until she was correctly diagnosed at age thirty-five, she careened between periods of extreme euphoria and debilitating depression, prone to delusions and panic attacks, temper tantrums, spending sprees, and suicide attempts. Now in A Brilliant Madness Patty Duke joins with medical reporter Gloria Hochman to shed light on this powerful, paradoxical, and destructive illness. From what it's like to live with manic-depressive disorder to the latest findings on its most effective treatments, this compassionate and eloquent book provides profound insight into the challenge of mental illness. And though Patty's story, which ends in a newfound happiness with her cherished family, it offers hope for all those who suffer from mood disorders and for the family, friends, and physicians who love and care for them.
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Praise for Brilliant Madness

"A groundbreaking guide for those who are manic depressive of who live with or love someone who is."--Publishers Weekly
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Brilliant Madness

I knew from a very young age that there was something very wrong with me, but I thought it was just that I was not a good person, that I didn’t try hard enough. As with many people, the overt symptoms of my manic-depressive illness didn’t show themselves until my late teens. And that was with a manic episode. From that time on, until I was diagnosed at the age of thirty-five, I rode a wild roller coaster, from agitated, out-of-control highs to disabling, often suicidal lows.
As the cycles increased in frequency, they also increased in intensity—this is what the experts call the “maturing” of the illness—and as the years went on, the span of level time became shorter and shorter. I would have a manic, then a depressive, episode every three to four months, with the depressions lasting much, much longer than the manias.
But when I make myself think about it now, when I look all the way back to my childhood, long before my first big, public manic episode in 1970, I know there were other signs, other portents that I was very, very ill.
I do not recall any manias before I was nineteen. Oh, I can look back at certain things and speculate that maybe there were some manias going on, recollections of exciting times, opening on Broadway and things like that, which were exhilarating. But I don’t think they really hold up to a test of mania.
But the panic attacks—they happened as far back as I can remember. I can remember them prior to having language to go with them. I’m not sure what they have to do with—feelings of loss, maybe abandonment—but they became very clear to me around the age of eight. I still have them, but very rarely now. When I do, the same exact feelings I experience now I experienced then. They always have to do with death, my death. The very few times that I’ve been able to intellectualize about these feelings, I felt guilty that I wasn’t ever worried about anyone else’s death, only mine. About my nonexistence. It’s only recently that I’ve been able to talk about this at all.
For instance, I can remember as though it were happening this minute a scene that took place outside the apartment house in Queens where my mother lived. I was about twelve—I was already living with the Rosses—and I had gone to visit my mother. I was getting ready to go inside the building, and it was a beautiful day. There was a little patch of grass in front of the building, and I thought to myself how very green it was. The light was bright, and across the street were a Catholic church and a Catholic school with a cross on top. There were milk bottles outside the apartment building, and I bent down to pick them up, then stood up. I could feel the air and see the light as it was hitting the building and that little grassed area. And then it happened. There was something about the beauty of that day, the smell, something that suddenly threw me into absolute terror that someday I would never see this again. I screamed and ran into the house with the milk bottles and dropped them on my way up the stairs. I just kept running in this frenzied, frenzied way. Then I ran into my mother and I was embarrassed. I couldn’t tell her what it was that had happened to me. So I did what I always did in those cases when there was another person around. I made up something: A mouse ran across the hallway and I got scared.
When I visited my mother, the bus I took back to Manhattan passed two cemeteries. As soon as we passed Calvary Cemetery, I would be hit with a panic attack. I did a lot of throat-clearing and wheezing, trying to pretend I was having an asthma attack. Sometimes it would be so late when I left that my mother would give me taxi money for the trip to the city. That was even worse. The statues at the cemetery’s entrance were lit up at night. You could see the cross and the Virgin Mary. It was worse because I didn’t even have anything else to look at to distract me. Plus I was drawn to that sight, fascinated by it. Once, when I was about ten, I jumped out of the cab just at the entrance to the Fifty-ninth Street bridge. I just screamed, “I gotta get out. I gotta get out.” And I got out. The cab driver was scared. I was a little kid. I ran across the bridge, ran and ran and ran and ran. That was the only thing that would make it go away—physical exhaustion—which makes me wonder now what physiological thing is happening in those panic attacks. At the time I only knew that the best solution was running, the next was screaming, and the next was clearing my throat. Finally I got smart and took the subway so I didn’t have to pass the cemetery anymore.
But it wasn’t just passing a cemetery that brought it on. I can’t, even to this day, track a pattern of what triggers it. That gorgeous day at my mother’s house did it. And once it happened right here in my house. I woke up. It was a beautiful morning. I was listening to the birds, and all of a sudden it hit.
The panic attacks usually occurred in that sleepy zone in the morning, just after awakening, or at night, just before going to sleep. My symptoms would be deep, heavy breathing, hyperventilating, and screaming and running. I would jump out of bed. I couldn’t stop myself. I’d just run around and scream, and the attack wouldn’t stop until I was physically spent from either screaming or breathing funny for long enough to just about pass out. Sometimes I was able to contain my running around to the bedroom so I didn’t disturb the children. But my screaming was so ungodly I’m sure the children heard it. The easiest thing to tell anyone was that I had been dreaming.
When I lived with the Rosses, the panic happened just about every night when I was going to sleep. Early on, I would scream, and I’m telling you it was a bloodcurdling, horrific scream, so it scared everybody who was around. I always lied and said it was a dream, a bad dream. I lucked out because the Rosses never asked me what the dream was about.
The panic happened during fully awake moments, too, when I was watching television or doing my homework. And there would be other people in the room. So I didn’t scream, but cleared my throat so loud and vigorously that it was very disruptive. First I would be told to stop doing that. But I couldn’t. I remember one time Ethel saying, “Why are you doing that? What’s the matter with you?” And I blurted out what was bothering me. I told her I was afraid of dying. I didn’t know exactly how to say it, but I tried to explain to her that I didn’t mean I was afraid I was going to die this minute, but that someday I was going to die. The Rosses’ response was logical and unenlightened. They said, “Oh, you don’t have to worry about that for a long time. Look at us. We’re not worried about it, and we’re a lot closer to it than you are.” I was embarrassed and I felt belittled. I don’t think they meant to belittle me. That’s just what you say to somebody who’s saying things that are alien to your ears. So I went back to lying. And that’s how it went for my whole life with them. I guess they never thought it was unusual that I had so many nightmares. And the coughing and the throat-clearing became a real habit, a crutch so that I wouldn’t scream.
This is the kind of thing people don’t talk about much. But one night when I was playing in Meetin’s on the Porch, in Los Angeles, I did a very dangerous, too-revealing thing. A group of women had come to see the show, and they stayed afterward for a question-and-answer session. The play is about the friendship of three women from the time they are seventeen until they are eighty-five. All of the scenes take place on the porch of Haley’s house—Haley’s the character played by Susan Clark. In the first scene we’re in our midforties, in the next we’re eighteen, then we’re all the way up to eighty-five, and in the final scene we’re in our thirties. Well, we were talking about the first scene where Haley tells us that she killed her husband; but it is never mentioned or referred to again. One woman in the audience asked about that, and I jumped in without even thinking. I said, “Perhaps it speaks to the extraordinary ability we have to deny. I guess we have to be good at denial or we’d be running around twenty-four hours a day screaming, ‘I’m going to die. I’m going to die.’ ” And as soon as it was out of my mouth I couldn’t believe I had exposed myself that way. But what interested me was all the nodding of heads out there. Yes, it told me, we all do think about it. You’re not the only one. It is a question that fascinates us all and terrifies us. It really is the question that we all have in common. But it’s true. We have developed this unbelievable ability to deny. We have to. If we didn’t, we’d go crazy.
Now, I know that a lot of people who have panic attacks do not have manic-depressive illness, that panic attacks are not a symptom of manic depression. But people who go to doctors complaining about anxiety often describe symptoms such as sweaty palms, fast-beating heart, jumpiness, dizziness, faintness, upset stomach, and trembling—symptoms that they call “anxiety.” Sometimes that’s just what it is—anxiety manifested in panic attacks. But sometimes it is depression. Many of the symptoms are similar. In my case, I believe that my panic attacks and my manic-depressive illness are probably independent of each other.
Oddly enough, I’ve not been incapacitated by panic attacks. When I was younger, I used to think they would eventually go away. I’d say to myself, “When I’m nine, I won’t feel this way.” Twelve. Fifteen. Well, when I get to be twenty. Thirty. Well, here we are forty-five, and from time to time up jumps the devil.
It’s as annoying as hell that I’ve gone through all of this—the highs and lows and the treatment—and I still have this other stuff to deal with. But deal with it I will!
Random House Publishing Group