Mental Illness and Parenthood

In an April 4th article entitled “Should I?” on Boston.com, Marya Hornbacher describes how her mental illness has affected her decision to have children.  She explains how she and her husband were in the middle of the adoption process when she had a massive depressive episode and lost her confidence in her ability to raise a child.  Her story provides excellent insight into the ways that mental illness affects women, although I am by no means suggesting that her experience is something that men would never have.

Hornbacher describes her feelings as she lay in the psych ward during a major depressive episode:

I was so sure, at that moment, that I was making the right decision. I believed, for that one life-changing instant, that I truly wasn’t capable of raising a child, that any child would be better off without me as its mother. Lying there in a hospital bed, the idea of taking care of something so fragile as a child, when I couldn’t even take care of myself, made my head spin. So I said no.

It was obvious: I wasn’t up for that kind of responsibility. Wasn’t reliable enough, was maybe too volatile to be trusted. Yes, maybe I had wanted it, but what about the best interest of the child? That day, I, like a whole lot of people, believed that mental illness really did disqualify me as a parent.

Now, I’m not so sure.

Hornbacher relates one of the major concerns of most expectent parents, or those people thinking about becoming parents: Will I be good enough to raise a child?  In this case, it’s clear that Hornbacher’s insecurities about her abilities to parent stem, as far as she can tell, from her bipolar disorder.

She describes how she first coped with the disorder:

Like a great many people with mental illness, I resisted my diagnosis – who wants to believe they’re mentally ill? – and with it resisted the medication that would make it manageable. And like about half of people with bipolar, I struggled with substance abuse for years. For someone with a mental illness, drinking and doing drugs is like pouring gas on an already smoldering fire.

Here, she also reveals a connection between mental illness and drug abuse; when you’re mentally ill, sometimes drugs can seem like good ways to cope with mental illness.  It’s also important to remember that there’s no such thing as a “bad” coping mechanism; there are unhealthy ones, to be sure, and substance abuse is one of them.  But Hornbacher’s resistance to the diagnosis also speaks to the stigma that comes with mental illness; she tried to manage her illness in an effort to convince herself and others that she was fine.

She explains what it’s like to be mentally ill in a society where mental illness is an invisible marker:

This means that, in most ways, I’ve left behind the chaos of my earlier life and joined the ranks of “normal.” People who manage their mental illness are all around you, and you probably don’t know it, because they look and act just like you. They go to work, buy groceries, drink lattes, and have kids. That’s what’s funny – I imagine a whole lot of people would think I’d make a great mom, right up till the moment they learned I have a mental illness.

Her use of quotation marks around the word “normal” is extremely revealing; her description places mental illness very clearly among other forms of identity that aren’t considered normal.  Mental illness, like queer sexuality, it something that tends to be invisible until someone discloses it; then, opinions may change.  As Hornbacher said above, people might think she’d make a fantastic parent so long as they weren’t aware of her mental illness.  She has to hide behind the “normal” facade in order to be considered acceptable as a member of society and as a parent.  This is not to suggest that she and others with mental illness shouldn’t receive treatment and find coping mechanisms that help them lead happy lives.  Instead, the perceptions of mental illness and the social ostracization are what become problematic. Hornbacher could be the best parent to ever exist on the face of the planet, but as long as people know she is mentally ill, she won’t be recognized as a capable parent.

While signing books after a lecture on her memoir, Hornbacher recalls a woman who was surprised to find that she (Hornbacher) was married, and practically relieved to learn that there were no kids in the picture:

Apparently I hadn’t quite made my point. Because after 45 minutes of going on about the facts that mental illness is highly treatable, that one can live and live well when one has it, and that my life as a mentally ill person is really quite average, she’d come away with: mentally ill people are so warped that it’s a miracle anyone can stand being married to them, let alone allow them to inflict themselves on a baby.

While it is disconcerting and disappointing that this woman completely missed the point of the lecture, it’s certainly a very clear description of perceptions of the mentally ill.  It also demonstrates how social attitudes continue to plague people with mental illness, even if they themselves might have been working very hard to cope with both their illnesses and their perceptions about their personal illnesses.

Hornbacher also examines how reproductive rights factor into the issue:

When people with uncontrolled mental illness have kids, those kids do feel the effects, and it’s a serious struggle for both parent and child. But unless we want to skate dangerously close to the suggestion that those people should not be “allowed” to have children – a suggestion that leads ultimately to an argument for eugenics – “we” are not in a position to say that they can’t have kids.

I would venture to say that many people start having children without deeply thinking it through, and without being particularly well-prepared. Who allows them to do this? Well, that’s not really the question. We sigh and say, God, there should really be a test. But we’re joking.

Her sentiments are not only very clearly expressed, but also reflected in the experiences of many other women and would-be parents affected by eugenics, or at least eugenicist attitudes.  Who is to determine whether or not someone who is mentally ill, black, mentally retarded, or poor should have kids?  After all, there are plenty of white, upper-class people with no mental illness or retardation who make terrible parents.  Hornbacher also describes her experience growing up with a parents with mental illness, and while she acknowledges that it was sometimes difficult to be a child of a person with mental illness, her father was a great parent, and that what she takes away from the relationship is positive.

Hornbacher ends her piece with her own uncertainty:

I sometimes have this dream where I am holding a thing, and then it floats away, and I get this weird weightless ache in my arms. Then I wake up and listen to the silence. It is the noisy silence of the ghost of the 5-year-old I chose not to raise. Is anyone raising her?

You often hear people with mental illness who have children described as “selfish.” There’s the perception that someone like me would have kids only to serve my own needs. But maybe the decision I made was the selfish one. My arms are empty. And my burden is very light.

I find her final paragraph incredibly moving and disquieting at the same time.  How are people with mental illness “selfish” for having children, while those without illness aren’t?  Hornbacher wasn’t planning to have biological childen; she and her husband were adopting.  If she’s not passing on her genes, is she still a bad parent?  Are parents free of mental illness necessarily better parents?  What does this reflection say about how mentally ill people are treated in a culture where the “other” is marginalized?

For more insight, check out the article, and especially check out the comments.