1. Schmidt, Joan MS-MPH, RN, ACRN

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It all started after a colleague jumped to her death from a 15th-floor balcony. Rumors spread that she leapt in uniform, clutching her agency-issued pen-based computer and paperwork. But questions posed by the staff about the incident were dismissed by the leaders of the home agency as "morbid curiosity."


I was an HIV-AIDS specialist with a dual master's degree; for 23 years my career flourished. But I became increasingly troubled by the silence surrounding my colleague's death, and for three days I called around looking for answers. My anxiety escalated. Soon, painful memories came flooding back.


My mother, a World War II Army nurse, first attempted suicide one month after my 11th birthday. It was Thanksgiving week; she slashed her throat with a razor blade. From that day on she veered between the vibrant, nurturing mother she had once been and a paranoid "crazy lady" who conversed with God, angels, and saints in our dish cabinets. Eventually, she left the house only to go to church, spending most of her time wandering like specter, a haunted look in her eyes. Psychiatrists have since told me that she must have been either paranoid schizophrenic or schizo-affective-either way, psychiatry in the 1950s and 1960s couldn't restore her mental health. When she died in 1985 of liver cirrhosis and addiction to barbiturates, narcotics, and sedatives, I'd lied to friends and associates. Fearful of exposing a family history of mental disease, I told them she'd died of a stroke.


Within days of my colleague's suicide, I began telling colleagues, friends, and loved ones about my mother's illness and my fears that "vampire mommy" would rise from the grave to harm my family. I talked about her for three days straight and slept just two hours a night. I became hoarse from talking so much.


My husband listened quietly at first, then became increasingly alarmed. I wouldn't stop talking and I couldn't sleep-a deprivation that was impairing my judgment. My friends also listened patiently, but when the Neurontin my therapist prescribed failed to stop the escalating mania, two of my friends-one a nurse, the other a psychiatric social worker-convinced me to admit myself to a psychiatric ward. Otherwise, they warned, I could be admitted involuntarily. They worried I might become a danger to myself.


I was 49 years old when I was diagnosed with bipolar disorder and hospitalized for mania.


It was only after my second hospitalization one and a half years later (this time for depression) that I began to talk with colleagues about my diagnosis. Earlier that year I'd been out with a herniated disc, and when I returned to work many asked if my disc was acting up again. "No, it's not the disc," was my reply. "I'm bipolar and I was out with depression." At the time, my job involved consulting with nurses about difficult patients. After learning that I was bipolar, a few nurses stopped approaching me to discuss cases.


Examples like this make "coming out" as mentally ill an ongoing battle; I'm always afraid my career will be hurt by stereotypes and misconceptions. Bipolar disorder is a mood disorder; my intellect is not impaired. My days are not filled with dramatic highs and lows. In fact, my symptoms are well-controlled by medication and I work hard in therapy to avoid relapses. My husband attends therapy with me, and he can identify warning signs. For example, we both know that when I suddenly begin to sleep four instead of eight hours a night, it's time to visit my psychiatrist to have my medication adjusted.


Upon my first hospitalization I was handed a hospital gown and slippers and told to put all my clothing into a paper shopping bag. My purse and clothing were searched, and my husband was handed my nail clippers, file, and tweezers. He also took my wallet with my identification: I had become just a number on a wristband. But diligent attention to the requirements of my disorder has given me back my life. It's an opportunity that my mother and my colleague who committed suicide never had. I think my mother would be proud of what I've made of this chance.