Napoleon Kurt Cobain: From to

SETTING
SETTING NEW
NEW STANDARDS
STANDARDS IN
IN MENTAL
MENTAL HEALTH
HEALTH
FALL 2004
From Napoleon to
Kurt Cobain:
Cultural Legends with Mental Illnesses
A PLACE IN HISTORY AND SOCIETY
a publication of the Center for Reintegration
Visit the Center for
Reintegration Web site at
www.Reintegration.com
Visit www.Reintegration.com regularly —
we’re constantly adding new content to
keep you informed about the latest news
and trends relating to the reintegration
process.
Center for Reintegration
The Center for Reintegration is a nonprofit organization committed to helping
people with mental illnesses pursue a
meaningful life through reintegration —
the process by which a person with a
mental illness finds meaningful work,
restores his or her relationships and
moves toward independent living. The
Center for Reintegration pursues this
goal by providing useful information and
support tools for consumers, caregivers,
employers, family and friends. To learn
more about us, visit our Web site at
www.Reintegration.com.
Reintegration Today is published by the
Center for Reintegration and is made
possible by an unrestricted educational
grant from Eli Lilly and Company.
I would first like to thank all the consumers, family members, and friends who stopped
by our booth at NAMI’s annual convention, held in Washington, DC in September. It was
encouraging to hear such positive remarks on how often Reintegration Today is read,
enjoyed and used among a variety of groups and organizations.
If there was ever any doubt that people with mental illnesses are capable of fully
engaging in and contributing to society, one just has to look at the accomplishments of
those who grace the cover of this issue.
Spanning such diversity from the renowned French general and emperor Napoleon
to popular rock star Kurt Cobain, history is filled with famous figures who overcame the
life-altering effects of their mental illnesses (long enough) to make an indelible impression on society.
In our cover story: “From Napolean to Kurt Cobain” (page 10), you’ll see how various
famous figures with mental illnesses defied the odds to become some of the greatest
movers and shakers of society.
For those of us who champion the causes of people with mental illnesses, great
achievements by consumers are not a surprise. We see examples of consumers defying
the odds every day. Take, for example, the subjects of the article “Working Consumers
Sound Off” (page 14). This group of working consumers gets up every day and face work
and life much like the rest of the world — while also balancing some of the issues
unique to consumers (Should I risk disclosing my mental health status to my employer!).
Recently, on a very rainy, post-work evening, they opened up to RT about their experiences in the hope of helping other consumers. They are truly inspiring!
Speaking of consumers who make a real difference, consider Jim Leftwich (see
“NoLongerLonely.Com” page 8). His Web site, www.nolongerlonely.com, is a great
resource for consumers looking for friendship and love.
Famous or not, mental-health consumers through the ages have defied the odds by
proving they can lead reintegrated, productive lives despite their illnesses. In so doing,
they also help reshape society’s views, sweeping away some of the hurdles other consumers face while on their path to recovery.
Karen Carlson
Center for Reintegration
LETTERS TO THE EDITOR
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please include your name, address and telephone
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TION
EDITORIAL BOARD
Ralph Aquila, M.D., Chairman
Montclair, NJ
Beth Baxter, M.D.
Nashville, TN
Marianne Emanuel, R.N.
New York, NY
For a free subscription to Reintegration Today,
contact us at:
Phone: 800-809-8202
Email: [email protected]
REINTEGRATION TODAY
Fall 2004 (ISSN 1528-509X)
Writing and Editing:
RF|Binder Partners/New York, NY
Design:
DeSantis Breindel/New York, NY
2 SUMMER 2003
Fred Levine, J.D.
New York, NY
Gerald Maguire, M.D.
Irvine, CA
Jackie Shannon
San Angelo, TX
REINTEGRATION TODAY
FALL 2004
Contents
10
DEPARTMENTS
2 Perspectives:
Karen Carlson,
Center for Reintegration
4 Frontlines:
The latest news pertaining
to schizophrenia and
related disorders.
6 In the Spotlight:
14
8
FEATURES
17 Reintegration
Showcase
RT profiles Casita Unida
of New York, NY
COVER STORY: FROM NAPOLEON TO
KURT COBAIN: CULTURAL LEGENDS
WITH MENTAL ILLNESSES 10
6
COVER PHOTOGRAPHS:
1st row: Vivien Leigh, Abraham
Lincoln, Lord Byron, Winston
Churchill; 2nd row: Sir Isaac
Newton, Napoleon Bonaparte,
Kurt Cobain, Vincent van Gogh;
3rd row: Carrie Fisher; 4th row:
Robert Schumann, Florence
Nightingale, F. Scott Fitzgerald,
Martin Luther.
PHOTOS: CORBIS IMAGES
19 The Source
A profile of some of history’s most notable figures
who, despite their mental illnesses have made
indelible imprints on society in such areas as
literature, politics, science, cinema, and more.
Using analysis from noted author and leading
bipolar disorder expert Dr. Kay Redfield Jamison,
RT uncovers these legendary “consumers.”
NOLONGERLONELY.COM
You don’t have to do marathon-level
training to become physically fit. RT
shows you simple, everyday steps
that can help burn away the calories.
Further information on
schizophrenia and related
mental–health issues.
8
When Jim Leftwich, a successful reintegration story,
realized that recovery did not guarantee romance and
companionship, he took action. Learn how his Web site,
www.nolongerlonley.com, helps other consumers make
a love connection through cyberspace.
WORKING CONSUMERS SOUND OFF
14
A frank discussion with five gainfully employed
consumers reveals the true realities of living and
working with a mental illness. In their own words,
this group shares the highs and lows that many
consumers experience on the journey to reintegration.
REINTEGRATION TODAY 3
IN THE NEWS
FrontLines
MUSIC FESTIVAL FOR
MENTAL HEALTH
RAISES MILLIONS
In September, the Music Festival
for Mental Health celebrated its
10th Anniversary. The festival is
the brainchild of the Staglin
family of Rutherford, California,
who started the festival when
their son Brandon was diagnosed
with schizophrenia at age 18.
Garen Staglin, Brandon’s father,
is a Napa Valley vintner and
owner of the Staglin Family Vineyard.
The 10th Annual Music Festival for Mental
Health on September 11th featured, in addition
to musical concerts, wine tasting, gourmet
food, and a lecture program. Dr. Thomas
Insel, director of the National Institute of
Mental Health was the keynote speaker for
the lecture program, and his lecture was
followed with a jazz concert by Norman
Brown, a 2003 Grammy Award winner.
The festival, in its ten-year history, has raised
more than $22 million in direct and matching
funds for mental-health research and treatment. Every year, the festival seems to draw
a larger, more diverse crowd of music lovers,
wine connoisseurs, scientists, and consumers
along with their family members.
Festivals like the Music Festival for National
Health are becoming more prevalent in the
communities throughout the Unites States.
These events, which present “mental health
issues in a positive light,“ have helped the
fight to rid mental illnesses of stigma.
PHOTOS: GETTY IMAGES
Source: Associated Press, September 10, 2004.
PROPOSITION 63 PASSES
IN CALIFORNIA
NEW STUDY SUGGESTS
ENVIRONMENTAL FACTORS
PLAY ROLE IN SCHIZOPHRENIA
New research published in the September
issue of journal The Lancet shows that
genetics is not the only factor that can contribute to schizophrenia. The study indicates
that economic, social, and cultural causes
can also play a role in schizophrenia.
A team of researchers from the University
of Hong Kong conducted analysis on census
data and information from the Ministry of
Health and other sources. The researchers
then estimated that 4.25 million people in
China have schizophrenia. Interestingly,
though, researchers found that schizophrenia
is more prevalent in women than men in
China. This differs from most parts of the
world where schizophrenia is usually more
common in men. Thus, researchers have
suggested that external factors can play a
part in the mental illness.
“Indeed the different cultural, social, and
economic characteristics of communities
could influence the onset and course of
schizophrenia,” comments Dr. Mao-Sheng
Ran, a researcher at the University of Hong
Kong who aided in the study.
Source: Reuters, September 16, 2004.
4 FALL 2004
On November 3, 2004, California
voters passed Proposition 63, which
will impose a 1% tax on all residents'
taxable income over $1 million. Funds
generated from this tax will be used to
expand community-based mentalhealth services and programs.
Sacramento Assemblyman Darrell
Steinberg authored the Proposition
63 initiative, which was devised in
response to an unfulfilled promise
made in 1969 to fund the state's mentalhealth system. Support for the initiative was
fueled by the success of Steinberg's Homeless Bill, which engaged Assertive Community
Treatment-type teams who brought homeless
individuals with mental illness off of the
streets into shelters and guided many back
to independent living. The Homeless Bill
achieved success on a humanitarian and
economic level — illustrating the potential
for success for other programs to assist
people with mental illness.
According to the Los Angeles County Director of Mental Health, Dr. Marvin Southard,
“Given the current fiscal environment in California and the long history of inadequate
investment in mental-health services, Prop 63
is our first real shot at building a clientcentered, family-focused, integrated mentalhealth system to treat the thousands of our
residents who need help.”
Source: NAMI, September 4, 2004.
IN THE NEWS
FrontLines
RESEARCH ON MICE
MIGHT SHED LIGHT
ON SCHIZOPHRENIA
Jeffrey Eells, a veterinary researcher at
Mississippi State University, is hoping that
his “pet mice” in his research lab help him
unravel the mystery of schizophrenia. Eells,
recently received a $55,000 grant from The
National Alliance for Research on Schizophrenia and Depression (NARSAD) to study a
strain of mice that have a gene mutation
similar to that found in humans who have
schizophrenia.
Eells, who began his research at the
National Institutes of Health lab, plans to
compare the dopamine levels and dopamine
release of the mutant mice to their
normal littermates.
Dopamine, a hormone-like
substance, is an important
neurotransmitter. When present in
normal quantities, dopamine facilitates critical brain functions. He will test the dopamine
release of mice raised in isolation, under
stress, and when given drugs that target
specific parts of the dopamine system. Eells
hopes, through these tests and comparisons,
he will understand better how dopamine plays
a part in schizophrenia and how environmental
factors affect dopamine’s release.
Asked about his research, Eells commented, “Nobody really knows what causes
schizophrenia — it’s likely that there are a
number of different causes that can result in
the symptoms of schizophrenia. This gene
mutation may be one of a number of causes
or predisposing factors that could signal
schizophrenia. The hope is that it will lead to
a better understanding of the mechanisms of
the disorder and potentially to other avenues
of treating schizophrenia.”
NARSAD FUNDS NINE
RESEARCHERS AT JOHNS
HOPKINS UNIVERSITY
The National Alliance for Research on
Schizophrenia and Depression, NARSAD,
recently announced that it would fund nine
Johns Hopkins researchers in 2004, aiding
their study of the causes and treatments of
mental illnesses. NARSAD is the largest
donor-supported organization in the world
devoted exclusively to funding scientific
research on psychiatric disorders.
NARSAD is awarding one Distinguished
Investigator Award (one year/$100,000) and
eight Young Investigator Awards ($60,000) to
researchers at Johns Hopkins University.
NARSAD council president Herbert Pardes,
a former president of the National Institute
of Mental Health and acting president and
CEO of New York–Presbyterian Hospital,
commented on the grants saying,
“The research NARSAD is supporting
with these grants represents all
phases of the leading-edge
research on the human brain and
mental disorders.“
All of the funded researchers
plan to focus on one of the complex
pathways or one of the multiple genes
that have been attributed to the onset
of schizophrenia or other mental illnesses. For example, Distinguished
Investigator grantee Christopher Ross
will develop models for schizophrenia and other
diseases by focusing
on the DISC-1 gene.
Mutations in this
gene can cause rare forms of schizophrenia.
NARSAD’s dedication to the funding of
research on psychiatric disorders continues to
be key to the future understanding of mental
diseases.
Source: The Gazette, September 20, 2004.
Source: Associated Press, September 10, 2004.
REINTEGRATION TODAY 5
HOW SIMPLE PHYSICAL ACTIVITIES CAN GET YOU FIT
Fitness Alert:
“Do ANYTHING!!!!”
PHOTO: GETTY IMAGES
The greatest leap in fitness you will ever make will not be when you progress from running 3 miles to 10 miles a day,
it will not be when you go from climbing 10 flights of stairs to climbing 20 flights daily, either. The greatest leap in
increased fitness that any of us will make is when we go from doing nothing for our health to doing something —
heck, ANYTHING. This according to author and host of the syndicated radio program “The Dr. Dean Edell Show.”
6 FALL 2004
Dean Edell, M.D., is known for absorbing complex medical studies
and putting them into language understood by ordinary people.
He provides simple take-away messages from long-term clinical
studies, and he is a firm believer that overall fitness needn’t be
overwhelming or uncomfortable to achieve. Perhaps his philosophy is best expressed in his summary of “Effect of Exercise
Duration and Intensity on Weight Loss in Overweight, Sedentary
Women: A Randomized Trial.” The study appeared in the Journal
of the American Medical Association in 2003. As Dr. Edell so aptly
sums it up on www.healthcentral.com (the Web site which features his commentaries), “high intensity long duration exercisers
did not lose more weight than those doing lower intensity exercise
for shorter periods of time. Seems that getting off your sofa and
doing any walking at all was more important than major amounts
of activity.”
But what does it really mean to be “fit”? Medical experts say that
to be fit is to have a healthy heart and lungs, good flexibility, muscular strength and endurance, and a healthy body composition
(muscle vs. fat). And the reason for wanting to be fit goes beyond
limiting our risk of heart disease, cancer, and diabetes — the ultimate goal of fitness is to be able to comfortably and easily do the
things you enjoy.
Interestingly, most of us think we have to be slender, skinny,
thin, and trim in order to be in good health — but that’s not what
the most recent studies are saying. In fact, the health community
is beginning to take note that many factors add up to optimal
fitness, and while a low body weight can help to ward off
diabetes, it has been shown to have little impact on cardiovas-
125
PHOTO: GETTY IMAGES
70
255
155
160
185
175
210
135
50
180
145 155
cular health. In other words, as far as your heart goes, you can
indeed be fat but fit. And, according to the American Heart Association (AHA), to be fit you need only take a brisk 30 minute walk
5 days a week...that’s it.
In fact, in the September 8, 2004, issue of the Journal of the
American Medical Association, results of a study conducted by
Carl J. Pepine, M.D., director of cardiovascular medicine at the University of Florida College of Medicine indicate that women who
have trouble losing weight can do themselves some good by staying physically active. “Women who have difficulty losing weight
might not have difficulty maintaining their fitness level,” said Dr.
Pepine. And he too notes that 30 minutes of moderate physical
activity, five times weekly, is enough to ensure fitness.
Of course, this still brings us back to the weight issue and risks
like diabetes. While daily walks can impact good heart health, it
may not be enough to change the reading on your scale. Unfortunately that is primarily impacted by what you eat, and as Dr. Edell
writes in his book Eat, Drink & Be Merry, the ugly truth is that diets
don’t work — and for one simple reason: one day you go off of
the diet.
Instead, Dr. Edell suggests that we eat a variety of food, enjoy
every morsel, yet eat less. He points out that no matter what we
eat, it still gets down to a matter of math: “A pound of fat equals
3500 calories. If you eat 500 fewer calories a day, at the end of a
seven day week you could lose a pound. Exercise away another
500 calories a day and you could lose two pounds by the end of
the week.” Lastly, his golden rule is “You will lose weight on any
diet where you consume fewer calories than you burn.” The entire
medical community and the basic laws of science agree.
So achieving fitness can actually be a much easier proposition
than subjecting yourself to all those depriving menus, restricted
calorie counts, low-carbohydrate options and low-fat meals. Just
eat less than you do right now — that’s a start. And take any steps
you can to be more active. If you can’t fit in the 30-minute walks
noted by the AHA, try some of the options opposite. Your body
will thank you. RT
Burning calories by the numbers
Going up to the 5th floor? Don’t hit the elevator’s up button
Instead look for the stairwell. If you run up stairs for 4 minutes,
you’ll burn 70 calories — or 20 M&Ms.
Instead of putting your dog in the yard — take him for a
brisk walk. If you walk 2 miles in 30 minutes, you’ll burn up
to 125 calories or one piece of toast with jelly on it.
Turn off the TV, turn on the radio and dance for 30 minutes
— you’ll burn 160 calories, about 1 oz. of dry-roasted
mixed nuts.
Are you in charge of cooking the family dinner? During
that hour of meal preparation, you could burn 175 calories
just rinsing, cutting, chopping and stirring — that’s the
equivalent of four Chicken McNuggets.
You are expecting guests and it’s time to clean house. It
may be hard work but it’s not all bad because one hour of
mopping the floors, dusting the furniture, cleaning the windows, scrubbing the sinks and more — can burn up to 180
calories, about three Fig Newton cookies.
No time to work out? That’s understandable. But do you
ever have time to watch the news? Terrific! Next time you
do, walk in place — or even march in place — right there in
front of the TV. If you walk the equivalent of 4 miles
during that 30–minute newscast, you could burn 155 calories — or 1 oz. of barbecued pork rinds.
NOTE: These calculations are based on a 150-lb. person —
the good news is that the more you weigh, the calories
burned will actually be higher. But, overall, calories burned
for any activity is dependent on both a person’s weight and
the intensity of activity.
FIRST PERSON
Nolongerlonely.com
At Last — an Online Dating Service for Consumers
PHOTO CREDIT
By most measures, Jim is successfully reintegrated. After
being treated for his schizoaffective disorder, Jim Leftwich
went to college, obtained a bachelor’s degree, and he even
continued on to get a master’s degree in library science.
Then, he got a job and found a place to live. At 34 years old,
Jim can be proud and grateful for his accomplishments. But
still, there was a nagging missing ingredient.
One of the last and toughest challenges for the reintegrated consumer, as Jim found out, is finding romance, or even
just close companionship. Jim needed to find someone.
“It’s really a problem of stigma,” says Jim. “When people
attach the ‘mentally ill’ label to you, it makes relationships
difficult. How and when do you tell the person you’re
8 FALL 2004
PHOTO: GETTY IMAGES
dating or seeing socially that you’re
a consumer? Do you hide your medications? How do you explain what
you were doing during the time
when you were recovering?
“I may be lonely,” Jim continues,
“but I know I’m not alone in my loneliness. There are thousands
of consumers out there in the same boat.”
So, Jim took action, not just for himself, but on behalf of all the
other reintegrating consumers out there looking for friendship
and love. Jim began an online matchmaking community, the only
one of its kind, for people, gay or straight, with serious mental diseases, such as schizophrenia and bipolar disease.
He struck a resonant chord. His site, www.nolongerlonely.com
went live last January, and today, Jim has more than 850 enthusiastic users.
“With lots of consumers out there able to stabilize their conditions with new meds and support from family and professionals,
I knew people could move on to resume their lives,” Jim observes.
“But then they had that personal relationships problem. I knew a
site like this would help me, or someone like me, to find someone.
So, with lots of encouragement from my doctor, I took the plunge
and went ahead and hired someone to develop code for the site.”
The “About Me” section of Jim’s site states his motivation and
mission well:
“In my experience I’ve observed that there is a certain comfort in
associating with others that have shared the struggle with mental
illness. NoLongerLonely seeks to relieve the anxiety that accompanies dating someone unaware of the challenges of managing a
mental illness. My hope is that by removing this stumbling block of
potential misunderstanding, intimate and nurturing relationships
will be easier to achieve.
I felt that I could facilitate the healing process by offering a
safe, secure, and free way to assist people with mental illness in
finding love and companionship. My goal literally is to make you no
longer lonely.”
Now, thanks to Jim, consumers who
are recovering and are looking for
friendship and love can log on to
nolongerlonely.com and register.
They get online, and then they can
scan the photographs and profiles of
other consumers in the virtual community Jim created, and they
can then contact the people they find interesting and attractive. By
posting their own profiles and photos, other site users will be
sending emails to them.
Jim is scrupulous about protecting site users’ anonymity and
security. The only information he gets from participants is an
email address that’s kept completely secret. When people use the
site, they employ a special site user name and a separate nolongerlonely.com email address that protects their actual email address.
“We strongly encourage users to submit a photo,” says Jim,
“because we know from studies done on other dating sites that
posting a photo with your profile makes you six times more
likely to be contacted by someone.”
But, does the site work? Do consumers find people to date and
fall in love with or just to be friends with? Just ask Jim:
“I know I’m doing something right because I receive an email
a day from someone who’s writing to thank me because they’ve
met the person of their dreams through the site. One young
woman said she met a guy who came to visit her from out of
state, and he never left. They’ve been living together, deeply in love,
ever since.
Someone’s mother even emailed me to tell how her son stayed
inside all day long doing nothing. Now he goes out with friends he’s
made through the site.”
His Web site is established, and Jim’s reintegrated life is going
well. But, there’s an irony to the story. As the webmaster, Jim
believes it is inappropriate for him to actually participate in the site
he manages. So, at least for now, Jim, himself remains unattached.
Consumers, visit www.nolongerlonely.com and register today to
find your soul mate. RT
REINTEGRATION TODAY 9
From
Napoleon
to
Kurt Cobain:
Cultural Legends with Bipolar Disorder
From poetry to politics, religion to science, some of the world’s most famous artists, leaders, and innovators have had
bipolar disorder, also known as manic-depressive illness.
Dr. Kay Redfield Jamison is one of the foremost experts on the disease, and she has distinguished herself by drawing
on examples from some of the most well-known persons — whether they are alive today or are long-dead figures from
history. In Touched with Fire: Manic-Depressive Illness and the Artistic Temperament and also in her textbook ManicDepressive Illness, Dr. Jamison retrospectively diagnoses the illness in great leaders, artists, and scientists. Applying modern
clinical criteria, historical documents, medical records, and personal diaries, Dr. Jamison analyzes family
lineage, age of onset, incidences of severe and uncontrollable mood swings, evidence of self-medication, history of
psychiatric hospitalization, and suicide rates. Her findings bring a new and fascinating perspective to our views of some
of the world’s most famous and influential people.
As these examples show, many people with bipolar disorder and related mood disorders exhibit exceptional
discipline and can harness their illness to accomplish legendary feats. Unfortunately, some of these same people, and
many others, lacking the therapy, medication, and community-based support available today, have been defeated by
their illness. We can only imagine what they might have achieved had they received modern treatments.
Nevertheless, individuals with manic-depression and other mental disorders are all around us, in all walks of life, and
are sometimes among those who play the most celebrated roles in shaping our society.
Science
Some scientists and medical professionals with bipolar disorder also believed
they had personal relationships to God, but ironically this
conviction motivated them to study more objective truths.
FLORENCENIGHTINGALE
As early as adolescence, Florence Nightingale (1820–1910)
experienced auditory hallucinations and severe depressive
episodes, symptoms consistent with the onset of bipolar disorder. She believed that God had called her to her vocation.
Inspired by her belief, she committed herself to medicine, and
modern historians credit her as the founder of modern nursing.
SIRISAACNEWTON
PHOTOS: CORBIS IMAGES
Sir Isaac Newton (1642–1727) discovered calculus and the laws of
mechanics and gravity during a manic phase in his early 20s. So
energized was he during this period, Newton hardly slept, and often
forgot to eat, sleep, and bathe. However his illness also had negative
effects on his career, as he experienced frequent memory loss, confusion
and paranoia. His obsession with sin and preoccupation with death
further burdened his work.
10 FALL 2004
R
Leadership
Symptoms of hypomania — a milder manic episode and lower overall
impairment — often include feelings of grandiosity, immense energy, confidence, and risk-taking. For leaders, these symptoms can be advantageous for
inspiring others to action. Hence, it may be unsurprising that
some of the most influential political leaders — such as Alexander the Great, Oliver Cromwell, and
Theodore Roosevelt — had, according to Dr. Jamison, either hypomanic or bipolar disorders.
NAPOLEONBONAPARTE
Despite mild depressions, Napoleon Bonaparte (1769–1821)
achieved extraordinary military and political success, probably due,
at least in part, to the confidence and euphoric energy of hypomania. His biographers report that “the little corporal” saw himself as
guided by a “star of destiny,” urging him toward “greatness.”
ABRAHAMLINCOLN
According to biographers, Abraham Lincoln (1809–1865) suffered from severe,
incapacitating, and occasionally suicidal depressions, as well as milder episodes
of hypomania. Interestingly, his Civil War opponent General Robert E. Lee
(1807–1870) also battled against depression throughout his lifetime.
WINSTONCHURCHILL
Winston Churchill’s (1874–1965) bipolar swings contributed
to heightened energy, drive, and impetuousness. Psychiatrist
Dr. Anthony Storr suggests that “All those who worked with
him [Churchill] would also agree that he needed the most severe
restraint put upon him, and that many of his ideas, if they had
been put into practice, would have been utterly disastrous.
TEDTURNER
Ted Turner (1938– ) looks to Alexander the Great as his mentor, which is interesting because Turner, too, is said to have bipolar disorder. Despite the obstacles
of his illness, Turner has been a member of the Forbes 400 Richest in America
since its first publication in 1982. In an act of extraordinary philanthropy,
Turner pledged one billion dollars to the United Nations, outdoing even the
United States federal government’s contribution.
Religion
Symptoms of mania — such as inflated sense of self worth and grandiosity (e.g. perceived
special relationships with a deity) — might explain the spiritual ecstasy of many religious
leaders. George Fox (1624–1691), founder of the Quakers, and Sabbatai Levi (1626–1676), considered
the Messiah by a substantial portion of 17th- century Jewry, experienced visions and alternating
bipolar moods of exultation and anguish.
MARTINLUTHER
Starting in adolescence, Martin Luther (1483–1546), the leader of
the Christian Reformation, suffered intense periods of suicidal
melancholy, and other times experienced tireless energy, ecstasy
and hallucinatory visions. Luther described “quite palpable visions
of an almost stroboscopic oscillation between Christ and the devil.”
REINTEGRATION TODAY 11
Literature
The energy, heightened verbosity, and risk-taking often associated with the manic
and depressed states of bipolar disorder may provide creative advantages for writers.
Perhaps these characteristics of the illness help explain the disproportionate number
of great writers with bipolar disorder. Dr. Jamison diagnoses poets — such as Emily Dickinson, T.S. Eliot, Samuel
Taylor Coleridge, Walt Whitman, Dylan Thomas, Alfred, Lord Tennyson, Sylvia Plath, Robert Lowell — and writers,
such as Victor Hugo, Honoré de Balzac, Hans Christian Andersen, Mark Twain, Joseph Conrad, Ralph Waldo Emerson, William Faulkner, Ernest Hemingway, Graham Greene, Henry James, Herman Melville, Eugene O’Neill, Robert
Louis Stevenson, Leo Tolstoy, Tennessee Williams, Mary Shelley, and Virginia Woolf — with bipolar disorder or
other major mood disorders.
LORDBYRON
George Gordon, Lord Byron (1788–1824) is so greatly associated
with heightened moods that the term “Byronic” has come to
mean brooding, romantic, theatrical, volatile, etc. The severity
of Byron’s moods, his promiscuity, often reckless behavior,
violent rage, paranoia, intemperate financial decisions, along
with his family history, strongly suggest bipolar disorder.
Although his illness grew increasingly severe as he aged,
Byron’s poetry is highly structured and marked by clarity.
F.SCOTTFITZGERALD
F. Scott Fitzgerald (1896–1940) exhibited extreme egomania, insisting he possessed
“some sort of epic grandeur.” Even against the backdrop of the Roaring Twenties,
his erratic financial behaviors seemed extravagant. But while depressed, Fitzgerald
drank himself sick, ruined lifelong friendships, demolished valuables, and thought
obsessively of death. Mental illness is a theme in many of his greatest works and
The Crack–Up touches upon his own emotional collapse.
Music
As music is a language communicating moods, the emotional intensity of bipolar disorder
apparently can add depth to musical expression. Biographic evidence strongly suggests that
many musicians and composers, such as Peter Tchaikovsky, Ludwig van Beethoven, George
Frideric Handel, Charlie “The Bird” Parker, Charles Mingus, Noël Coward, Irving Berlin, and
Axl Rose also had to struggle with mood disorders during their music careers.
ROBERTSCHUMANN
PHOTOS: CORBIS IMAGES
Starting in adolescence, Robert Schumann (1810–1856)
experienced violent mood changes that greatly influenced both
the frequency and style of his musical composition. During a
hypomanic period in 1840, Schumann composed 130 songs —
a productivity level extraordinary for even the most prolific of
composers. But, when severely manic, he was “so full of music,
and so overflowing with melody” that that he found it “simply
impossible to write anything down.” When depressed, Schumann
was incapable of composing and became preoccupied with suicidal
thoughts. Ultimately, he died in an asylum from self-starvation.
12 FALL 2004
KURTCOBAIN
Popular rock star Kurt Cobain (1967–1994) alludes to his bipolar disorder
in his work; he even wrote a song called “Lithium.” In 1994, the illness
and his subsequent addiction to heroin overcame him, and he ended
his own life. Today he is credited as the founder of the grunge music
movement, and his best-known song, “Smells Like Teen Spirit,” is
recognized as an anthem for Generation X.
Cinema
As movies are a synthesis of the written word, music, and visual arts, many modern day
people with bipolar disorder use it as a vehicle to express their creativity. Actors in particular
— such as Jean-Claude van Damme, Margot Kidder, Burgess Meredith, Linda Hamilton,
Patti Duke, Ben Stiller, and Marilyn Monroe — drew from their experiences with bipolar
disorder to portray a wide range of human emotions.
VIVIENLEIGH
When Vivien Leigh (1913–1967) was diagnosed with bipolar
disorder in 1944, little was known about the illness, and doctors
treated her with electroconvulsive shock therapy. Leigh’s greatest
roles — Scarlett O’Hara in Gone with the Wind and Blanche
DuBois in A Streetcar Named Desire — were volatile and
emotionally troubled women, and her interpretations of these
impassioned characters earned her Academy Awards.
CARRIEFISHER
Carrie Fisher (1956– ), most famous for her performance as Princess
Leia in the Star Wars trilogy, discusses her bipolar disorder openly with
the media. She even wrote a semi-autobiographical book and screenplay,
Postcards from the Edge, and a sequel novel, The Best Awful. In these
she depicts how family support, medication, and psychiatric treatment
for drug addiction and manic-depression helped her resume her
successful career and mend her broken relationships.
Visual Arts
Biographic evidence strongly suggests that many artists, such as Paul Gauguin,
Thomas Eakins, Arshile Gorky, Jackson Pollock, Georgia O’Keefe,
Michelangelo, Mark Rothko, and Edvard Munch, had
bipolar disorder or various other mood disorders.
VINCENTVANGOGH
Vincent van Gogh (1853–1890) suffered from profound seasonal
fluctuations in mood and relocated in southern France solely
to combat his illness. Foretelling his eventual suicide, van Gogh
divulged, “If I could have worked without this accursed disease —
what things I might have done....But there, this journey is over
and done with.”
REINTEGRATION TODAY 13
WORKING
CONSUMERS
SOUND OFF
PHOTOS: SEPP SEITZ
WHAT THEY REALLY THINK
OF WORKING, DISCLOSING
THEIR ILLNESS TO EMPLOYERS,
AND SELF ESTEEM
14 FALL 2004
A
sk working consumers how they feel about their employment,
and they will likely agree with their support teams’ views:
Work is a key aspect, if not the key aspect, of reintegration.
Not only does working enable them to earn an income, it
helps boost confidence and feelings of self-worth. But, even
with all its rewards, working consumers also know that
getting and keeping a job presents many challenges
unique to consumers.
We wanted to hear directly from consumers about the realities
of their working lives — their feelings, uncertainties, and hopes.
Five consumers — Lawrence Rothschild, 50s, administrative assistant and clerk; John Kelleher, 64, receptionist; Peter Maraia, 50s,
special projects coordinator; Lina Sorenson, early 40s, actress and
writer; and Bob Scholer, 55, senior peer advocate — sat down with
RT recently in New York and spoke openly about their experiences.
“The relationship
between work and self-esteem
is very powerful. When you feel
, you feel your
rise.
competent
self-esteem
”
RT: What relationship do you see between work and self-esteem?
Peter: The relationship between work and self-esteem is very
powerful. When you feel competent, you feel your self-esteem
rise. The more you work productively, the more you keep away the
feeling of worthlessness.
Lina: I really had to struggle with the self-esteem issue when I had
to go back to performing this summer. I had a breakdown several
years ago while on stage during a performance. So for me to get
back on stage, it was really a big deal, and I was scared to death.
But, I’m so proud because I made myself do it, and I succeeded.
To prove to yourself that yes, you can pick yourself up again, and
you can get right back on the horse and ride. So, Peter is absolutely
right. Self-esteem cannot be overestimated.
RT: Have you ever experienced discrimination at work because
of your illness?
Lina: Believe it or not, I’ve had nothing but positive experiences.
The very first [acting] class that I took, we had to stand in front of
the camera and tell them a bit about ourselves, and I said, “I’m
mentally ill.” My teacher said, “Wow, you’re really together.”
[laughs] Obviously he’s demonstrated that he does not consider it
to be a stigma or a problem for him because now, he employs me.
Lawrence: After I was stricken with mental illness, even after I
was medicated, I felt that I could never work again. In my mind,
the fact that I had a mental illness meant I wasn’t capable of working, and no one who knew about it would hire me. This stigma
was self-inflicted.
RT: Do you believe a consumer has a responsibility to disclose
their illness to their employer even though there’s risk in doing
so? And if you believe you should disclose, how and when do you
do it?
Lina: I personally prefer to get it right out there, be honest about
it so that nobody has any after-the-fact, “Oh my God, why didn’t
you tell us you were mentally ill?” What I’ve discovered is that,
and it may have to do with what profession I’m in, everybody is
completely understanding.
Bob: I think disclosure is a good thing. But I also think it’s up to the
individual. [Consumers] are distrustful of other people’s reactions
and have experienced stigma and have not gotten jobs, so I respect
when they decline to be open. Otherwise, I advocate for it.
Lina: Personally, I think we have a great responsibility to disclose.
The more we’re out there, the more we’re being perceived as very
Lawrence Rothschild
Lina Sorenson
Peter Maraia
Bob Scholer
John Kelleher
REINTEGRATION TODAY 15
“Personally, I think we have a
great responsibility to disclose.
The more we’re out there, the more we’re being perceived
as very competent human beings.”
competent human beings and that our disability is not preventing
us from working. I feel very strongly that I can be a role model for
people to see that mental illness is not a bad thing.
Lawrence: I’m not sure whether I agree that, right off the bat, first
interview, a person should admit they have a mental illness. You
see now in the media that all of a sudden a well-known person will
come out and say, “Well, I’ve been working all these years but I
have bipolar disorder...”
Lina: Right, Jane Pauley [formerly co-host of NBC’s Today Show]...
Lawrence: ...I don’t think it’s something that should be put out
right up front. Certainly, if anyone asked me, “Are you suffering
from a mental illness?” I would say so, but I would have a hard
time saying that in a first interview.
Peter: Sometimes I disclose and sometimes I don’t. When I do it,
I fear rejection. The truth is, I’m not really sure why you should
do it...
Lina: That’s a good point.
Lawrence: A diabetic doesn’t have to come out and say it.
Bob: I think that mental illness is a reality, and therefore, when we
disclose that we’re mentally ill, we’re really saying that we’re in
recovery from mental illness. We’re saying, “Look at me. I’m a good
example of someone who’s in recovery.”
RT: The workplace brings you self-esteem and income, but can’t
the workplace also bring you frustrations and stress?
Bob: My job is really kind of tedious and not the most interesting.
I’d like to get a new job. But when I send out my resume, I’m not
getting any response.
Jack: Everybody has that problem.
Lina: Yeah, it’s the economy.
Bob: There are more consumers now who want jobs, and there
aren’t that many jobs open. I’d love to change jobs, something
closer to home that is better paying. Part of my frustration with my
current employer is that they have their Christmas party for staff
only [laughs]. The consumers who we’re supposed to be helping
are not included.
Lina: Some workplaces literally have separate bathrooms for
consumers and staff. It’s as if we have cooties.
(continued on page 18)
16 FALL 2004
REINTEGRATION SHOWCASE
MI
CASA
ES
SU
CASA
(MY HOME IS YOUR HOME)
HISPANIC CONSUMERS FIND A SPECIAL PLACE
AT CASITA UNIDA
VITAL STATISTICS:
Weston United Community Renewal Inc.
Casita Unida Clubhouse
320-A East 105th St.
New York, NY 10029
212-996-1990
DIRECTOR:
Adrian Benitez
FOUNDED:
May 2000
COMMUNITIES SERVED:
New York City and Environs
We felt the warmth and welcoming spirit the moment we entered.
A member saw us come in and quickly approached: “Hablan
Español?” she asked enthusiastically. My colleague and I shook
our heads, but she was undeterred. “Would you like something to
drink?” she asked in an easily detectable Spanish accent. We
shook our heads again and thanked her for her kindness. In the
background the chatter in Spanish from other members busy at
work could be heard. This tidy, well-organized clubhouse was
beginning another day, but it was already clear to us that Casita
Unida was something different — something special.
Located in the heart of Spanish Harlem in New York City, Casita
Unida is the only clubhouse in existence that caters predominantly to
the Latino community. And it has become a haven for its nearly 100
active members — 60 percent of whom speak little or no English.
Casita Unida was founded just four years ago (May, 2000) as an
initiative of the Weston United Community Renewal program and
it is an internationally (ICCD) certified clubhouse. Casita Unida’s
director, Adrian Benitez, was quick to point out the importance of
having this facility specifically for the Hispanic community:
“Many Latinos with mental illnesses face unique problems,” he
states. “Not only is the language barrier a huge issue, but also many
of our members are immigrants with rural backgrounds trying to
make a new life in the big city. Many lack basic education, making
job training and job placement formidable prospects. As a result,
they may also lack the financial stability to seek the treatment
they need.”
FOCUS ON EDUCATION
As a result, the work-ordered day at Casita Unida is slightly
different from many other clubhouses. While they do offer other
programs, special emphasis is placed on literacy, ESL (English as a
Second Language), and GED (high school equivalency) training.
“We may not be like other clubhouses who have members attending
or preparing for college,” said Adrian, “But we are encouraged by
our accomplishments just the same. We have members, for example,
who when they first come to us have to ask someone else to read
private letters they receive from home, and it is such a pleasure to see
them reach the stage of being able to read and write on their own.”
HISPANIC TRADITION
Apart from remedial education, members of Casita Unida have a
variety of other activities to occupy their day. From 8:00 am to noon,
members can help in the Intake and Membership unit, the Clerical unit or the Café unit. Members usually gather for a communal
lunch, then spend the rest of the day in recreational activities.
Because clubhouse members come from diverse countries in the
Caribbean, Central and South America, and Europe, there is no
end to celebrating their strong Hispanic heritage where family
and food often take center stage. Judit Dieguez, Casita’s Intake and
Membership Coordinator explains:
“The one thing I see at Casita is that strong sense of family,
belonging, and unity. We greet each other with a kiss in the morning — and there is no division between staff and members. We
also love to celebrate, and our celebrations always involve a lot of
food, singing, and dancing the merengue and salsa.”
George, a Peruvian immigrant, is one of the few members with
a college education. He compares Casita Unida to other programs
he’s been involved in.
“I like this program because there is so much to do,” George says.
“It’s good to be able to help people, so I cook, and I tutor other
REINTEGRATION TODAY 17
MEETING THE NEEDS OF MEMBERS
members in Math and English. At the same time, I can feel comfortable here because of the strong Hispanic tradition.”
Linda, another Casita member agrees, with the importance of
having such a strong Hispanic tradition in the clubhouse, but
adds, “This clubhouse has great training and employment
programs too, because ultimately, it’s not just about fitting in
here, but also about being able to function effectively outside of
the clubhouse.”
(continued from page 16)
Lawrence: I worked at one [mental health] agency where we
weren’t allowed to share anything that was even mildly personal.
Everybody at Fountain House knows their case worker’s birthday,
the name of their husbands, how many children they have.
There’s no delineation or hierarchy between case workers and
members. Fountain House is exceptional in that case workers and
members are treated equally.
Lina: I don’t think work and stress is something that every consumer can handle. Everybody recovers at different levels, and I
think you have to make your own assessment.
Bob: I work with people who’ve been in the state hospital wards
and are still severely ill. Some of them are not ready to handle the
stress of working. So I help them to dream. I tell them, “You know,
maybe you could work,” even though they are clearly not yet interested nor ready.
RT: Do other consumers view you as role models?
Bob: A lot of people at Fountain House [clubhouse in New York]
look up to me. They know I’m working full time. They know I
travel to Staten Island to work, so they know I’m making a lot of effort.
Jack: People [at the clubhouse] know that we’re their peers, that we
have mental illnesses, and yet we’re working. We are role models.
18 FALL 2004
Casita Unida has a small staff of five individuals who work very
hard to ensure that members are well cared for.
“Since so many of our members are struggling financially, we
try to ensure that they receive at least one balanced meal here,”
Adrian points out. “We enlist local hospitals to come in and
administer free blood tests and diabetes/high blood pressure
screenings. We also try to ensure that our members take their
medications. We have created a healthy environment where our
members can learn, work, socialize, and become empowered
enough to be able to function effectively outside the clubhouse.”
For the staff, the programs available at Casita Unida serve to
instill in the minds of the members that they are more than their
illnesses, that as human beings they have value, and can accomplish
anything they set their minds to doing. Thus, the credo of the clubhouse: “Turning disability into ability and dreams into reality.”
Weston United Community Renewal Inc. has been providing
residential and vocational rehabilitation services to the Harlem
community since 1985, under the leadership of Jean Newburg,
Chief Executive Officer. In 2002, Weston United was the recipient
of a Lilly Reintegration Award for most innovative and
artistic organization. RT
RT: What advice do you have for other consumers?
Peter: People who are returning to work for the first time and want
to grow should seek a transitional employment (TE) position.
Jack: TE is good because there’s nothing like working and receiving pay.
Lawrence: The advice I would give to a person with a mental illness who’s thinking about starting work is to start with a
volunteer kind of job. It builds up your confidence to take the next
steps and maybe do a part-time job.
Lina: The main advice I would give is to hold the dream. It is
doable. It takes a lot of discipline, but you can go back to work. You
can feel good about yourself. And, you can do it, as I’m proving, in
uncommon areas like acting.
Lawrence: The other thing to keep in mind is that even if you have
to change the field that you’re used to earning your living in, it
doesn’t mean that you can’t keep hobbies that make you happy.
It’s important to have outlets that are for your soul, not just for
your pocket.
Jack: I would add this: trust the professionals helping in your
recovery and you’ll see the results. RT
FURTHER INFORMATION
The Source
A SEAHORSE YEAR: A NOVEL
SOMETIMES MADNESS IS WISDOM
By Stacey D’Erasmo
By Kendall Taylor
[Houghton Mifflin, July 12, 2004]
[Ballantine Books, July 1, 2003]
ISBN 0618439234
ISBN 0345447166
In a follow-up to her first novel Tea, Stacey
D’Erasmo writes a sincere second novel about
a family living in San Francisco coping with
their son, Christopher, and his mental illness.
In a style typical of D’Erasmo, the family is not just a conventional
family: Nan Ashby is a lesbian mom with a longtime girlfriend,
Marina, and Hal is a gay accountant sperm donor father.
Its interesting “family” dynamics give way to a poignant
account of a family trying to help its son deal with his mental illness. D’Erasmo takes her readers through the rocky ride of drugs
and institutions and also a family and son in denial. But the rocky
ride stops when Christopher runs away from home to Northern
California and everyone is left to come to grips with his illness and
their family bond.
Stacey D’Erasmo in A Seahorse Year paints a picture of a troubled young man and his not-so-normal family. D’Erasmo asks
difficult questions and pens harsh realities. But the work sheds
insight on how families cope with mental illness and how illness
and families both grow and change.
In Sometimes Madness Is Wisdom, Kendall
Taylor, a cultural historian and former
university professor, pens a thorough chronicle
of the marriage between Scott and Zelda
Fitzgerald. Using materials previously undiscovered, Taylor
sheds new light on the familiar story of “Manhattan’s most
sought-after couple” who were plagued by mental illness and
drinking problems.
Taylor’s account pays particular attention to the mental illness
of Zelda. From the documentation of Zelda’s experimental treatments to the discussion of Zelda’s mental collapse, Taylor gives his
readers a profound sense of the serious mental illness Zelda dealt
with throughout her marriage and her life. Yet, at the same time,
Taylor continually enriches the tragic story with anecdotes of
Zelda’s brilliance and ambition.
Sometimes Madness Is Wisdom is a poignant account of the
tumultuous life of the famous duo, Scott and Zelda Fitzgerald.
Although the story has been told many times, Kendall Taylor
brings new research and a fresh life to his account.
Upcoming Events
On The Web
INSTITUTE FOR COMMUNITY INCLUSION
http://www.communityinclusion.org
The Institute for Community Inclusion supports
the rights of children and adults with disabilities
to participate in all aspects of the community.
Forming partnerships with individuals, families,
and communities, ICI works as an advocate for
personal choice, self-determination, and social
and economic justice. Some of ICI’s key interest
areas include the employment of people with disabilities in community settings, the expansion of
local recreation and school activities to include
people with disabilities and the examination of the
impact of national and state policies on people
with disabilities along with their families.
The ICI Web site contains information on ICI’s
different educational and community outreach
programs. It also contains a link to information on
ICI’s employment services that focus on enhancing
employment opportunities for people with disabilities. The site also has links to ICI publications on
various topics. Finally, on the ICI site, there is a
guide to online disability resources; for example,
the guide contains a tremendous amount of information on disability-related issues on the
Internet.
NATIONAL CENTER ON WORKFORCE
AND DISABILITY
http://www.onestops.info
The National Center on Workforce and
Disability/Adult (NCWD) provides training, technical assistance, policy analysis, and information to
improve access for all in the workforce development system.
The NWCD Web site features links to the following: resources about policy issues that affect
services for people with disabilities, promising
practices and information on NWCD’s customized
Employment Projects, and WorkFORCE Action
Grants and its training and consultation services.
The site also contains a link to NWCD publications containing briefs and reports on workforce,
employment and disability from the Institute for
Community Inclusion and other NCWD partners.
18TH ANNUAL
RESEARCH CONFERENCE
Theme: A System of Care for
Children's Mental Health:
Expanding the Research Base
March 6-9, 2005
Tampa Marriott Waterside
Tampa, Florida
http://rtckids.fmhi.usf.edu/rtcconference
2005 FINDING BETTER WAYS
CONFERENCE
Theme: Addressing the Mental Health
Needs of Children, Youth, and Families
May 2-4, 2005
JW Marriott, New Orleans, Louisiana
http://www.cwla.org/conferences/2005fbw
rfp.htm
REINTEGRATION TODAY 19
Reintegration Today
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Park Ridge, IL 60068-3251
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