Beyond Madness

Lonely woman and the sea. Concept art of loneliness solitude sadness and depression.

I learned a lot about mental health in graduate school, but very little about mental illness. Sadly, my family taught me about that.

My first glimpse of mental illness came in 1966 when I was 12. That October, my 43-year-old mother—the beautiful woman with a master’s degree in economics who had put her career on hold to raise my two younger brothers and me—started crumbling. She paced. She cried. By the end of the year, she had lost so much weight that her clothes drooped on her slender frame. She’d lay in bed curled in a fetal position. In the spring, the color came back to her cheeks and she seemed to be her old self, but on summer mornings, she would awake by 4:00 a.m. and have the house cleaned and dinner cooking before the rest of us woke up. The alternating cycles of depression and mania, diagnosed as manic depression, continued until the winter of 1975, when she killed herself. 

When I was 54, doctors diagnosed my adopted daughter with bipolar II disorder.

Though my mother’s and my daughter’s mental illnesses broke my heart, I did not share my pain with anyone. I told no one about their illnesses. I was embarrassed, did not want to be judged, and hoped that keeping their illnesses secret might protect my family.  

In 2014, when my daughter left home with a heroin addict she had met at a psychiatric hospital, I was forced to stop the secrets. I had to explain her disappearance to family and friends. I told my story in Surrounded by Madness: A Memoir of Mental Illness and Family Secrets, and then traveled to colleges and universities across the country to deliver book tour talks to faculty, students, and community leaders.  I learned that talking about mental illness in my family freed up others to talk about mental illness in their families. The future social workers, doctors, and psychologists I met on tour kept asking me, “What can we do so that people with serious mental illness and their families stop suffering?” 

That question led to five years of research and my new book, Beyond Madness: The Pain and Possibilities of Serious Mental Illness. I learned that while there is much we still do not know about serious mental illnesses, there is much we do know. Sadly, that knowledge is not getting to the families of people with mental illnesses or to the teachers, clergy, and police who want to help, but do not know what to do.

Beyond Madness explains what serious mental illnesses are and identifies proven solutions for:   

  • Recognizing early signs of serious mental illness
  • Finding good medical care
  • Responding when a loved one is and is not in crisis
  • Minimizing the stigma of mental illness
  • Providing life-long financial support
  • Enabling those with mental illnesses to contribute as productive members of society

Writing Beyond Madness taught me that secrets and mental illness are a toxic combination. Reducing the number of people with mental illness who are homeless or in prison requires better treatment options. Finding better treatment options is expensive, but it’s well past time to take a lesson from anchorman Howard Beale who, in the 1976 movie Network, encouraged people to open their windows and scream, “I’m as mad as hell and I’m not going to take this anymore.”

Only when the number of lives affected by serious mental illness is no longer hidden will elected officials allocate sufficient funds. It’s time to end the hiding.


Cover image of Beyond Madness
Beyond Madness
The Pain and Possibilities of Serious Mental Illness
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Written by: Rachel A. Pruchno
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