This episode is sponsored by Blue Apron. To get your first 3 meals free with free delivery go to www.BlueApron.com/mental

Rarely do we talk about the spouse of someone battling a serious mental illness. Mark and Giulia had never heard of Bipolar I with psychosis until she broke from reality well into their marriage. Taped in front of an audience in Oakland, they bare their souls about the pain and confusion of her treatment and Mark realizing how much help spouses also need.

Episode notes:



Check out Mark's new book My Lovely Wife in the Psych Ward

Visit his website www.MarkLukach.com

This episode is sponsored by Blue Apron. To get your first 3 meals free with free delivery go to www.BlueApron.com/mental

This episode is sponsored by BetterHelp online counseling. To experience a free week go to www.BetterHelp.com/mental

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Episode Transcript:



Transcription services donated by Accurate Secretarial LLC. You can find them at www.AccurateSecretarial.com.

Welcome to Episode 329 with my guests Mark and Giulia Lukach. I'm Paul Gilmartin. This is the Mental Illness Happy Hour, a place for honesty about all the battles in our heads, from medically diagnosed conditions, past traumas and sexual dysfunction to everyday compulsive negative thinking. The show's not meant to be a substitute for professional mental counseling. I'm not a therapist. It's not a doctor's office. It's more like a waiting room that doesn't suck.

The Web site for the show is Mentalpod.com. Go there, check it out, fill out a survey. Maybe we'll read your survey on the air. There's also ways that you can support the podcast because we depend on your donations. Yeah, and any link that I mention on this podcast will be available there as well.

I want to give a special, special thanks to Jody Colley and the East Bay Express for putting this event on, where we recorded Mark and Giulia. Jody made it all happen, and I'm very, very grateful to have her be such a great supporter of the show. And the East Bay Express is a great newspaper. They won a Polk Award, which is a national editorial award. So, go check out their work. They do some great work.

I've mentioned before BetterHelp.com is a sponsor of this show. I love them. I've been using one of their counselors for the last six months, and I am sold. I love doing video, video-to-video counseling. I don't have to get in my car [chuckles]. I can make myself a cup of tea if I want one halfway through. Sometimes she watches me stuff turkey into my mouth halfway through a session.

But it, to me, it has all the intimacy of a face-to-face in-person session. So, I recommend it, and if you're interested, go to BetterHelp.com/mental, and fill out a questionnaire. They'll match you with a BetterHelp.com counselor and then you get to check out a free week of counseling and see if it's right for you. You've got to be over 18, and again, it's BetterHelp.com/mental.

All right, this is an Awfulsome Moment filled out by Everything Is Awful, and she writes, or he writes, I think my anxiety is passing because I think I can go to the gym and cancel my membership.

[Show intro]

PAUL: I'm so excited to bring up my two guests. I read about their story in the Pacific Standard magazine, and I thought, I've got to have them as guests. They have a book coming out in May, is it, called My Lovely Wife in the Psych Ward. Please welcome Mark and Giulia Lukach.

[Applause & cheering]

PAUL: Come on down.

MARK: Now we hug. We hug here.

PAUL: And Giulia is nervous, and I told her she has nothing to be worried about. There is no hostility in the room except for me. And where would be a good place to start? Well, I guess let me give an overview of what I read in this piece. It was about Giulia's battle with bipolar, is it bipolar I or II?

MARK: One.

GIULIA: One.

PAUL: Bipolar I. And how it affects their relationship, how they view mental illness, and a variety of other things. So, where would be a good place to start?

You guys have been together for 16 years?

MARK: Yep. I'll start with when I first, I didn't even see Giulia yet. I heard about her.

PAUL: Mm-hmm.

MARK: This is already emotional, not a good thing yet, but--

PAUL: We welcome that here.

MARK: We had just started college, and we started the same year, and I heard about this Italian girl who was from Italy and was apparently blowing everybody away through her radiance, and I didn't even know who she was. I just was like, I hope I get to meet her someday.

And when I saw her, I was incredibly nervous. I basically had this expectation that I was never going to have the courage to actually talk to her. And I just thought it would be like this from-afar kind of infatuation.

And instead, there was like a reggae festival for this new freshman orientation thing, and we were sort of milling about and the crowd just kind of like morphed and then I was there, and Giulia was there, and I tried to play the tough guy, like, hey, how are you, and not give away like how I was already like completely infatuated with her.

Yeah, and then I think it was a few weeks later, we were at a party and I had come with a girl and Giulia had come with a guy, but we saw each other at the party and almost immediately--

GIULIA: Said, let's get out of here, let's go.

MARK: --abandoned the people that we were with--

[Chuckling]

MARK: --to talk to each other and then just spent the whole night talking, yeah.

PAUL: Those two are my guests tomorrow night.

[Laughter]

PAUL: They were both deeply traumatized, and we're going to get to the bottom of that.

Giulia, what do you remember about the first time you guys met?

GIULIA: I actually remember because he lived upstairs from me and I remember him bringing down, like he was taking down his boxes in the stairway, and I look up and I see this tall, tanned, shaggy blond hair, surfer dude, and I was like, oh, my God, I'm in trouble, because going into college, I was like, I'm going to play it cool, I'm not going to get tied down right away, I'm not going to have a boyfriend, and then I see him and I'm like, I'm so screwed.

[Chuckling]

GIULIA: So, I remember seeing him before the reggae party. And then when I saw him at the reggae party, he played too cool and he was like, oh, hey, what's up? And I was like, oh, you know, I was like [chuckles], I was not into that he was not paying attention to me. So, but at the same time--

PAUL: And that's what intrigued you.

GIULIA: Yeah, exactly. So, yeah.

PAUL: Let's rewind, then, and just talk about what childhood was like, kind of the environment you guys were raised, where were you raised, how many kids in your family, what was your parents' relationship like, what was kind of the emotional temperature in your house and inside yourself. Let's start with you, Mark. And if you could just hold the mic a little bit closer to your mouth.

MARK: Sure thing. Sorry, everybody.

PAUL: No worries.

MARK: I'm from Delaware. Yeah.

[Chuckling]

MARK: My favorite shirt was Dela-dot-dot-dot-where, question mark, and I would actually say, the real question is Dela-why--

[Laughter]

MARK: But, yeah, I'm from Wilmington, Delaware, and I'm one of four. My sister's here tonight with her husband. And always super close. There's four of us amongst only six years. I have to say, I feel like I got the golden ticket with my family life. My siblings and I are best friends, have been from the beginning and stayed that way.

My parents I think modeled what a healthy relationship looks like to us. They always did a good job of presenting a unified front, where we didn't try to play them against each other. They actually had like the control that sometimes we lack to like talk to each other in private first before you react in front of the children.

My dad worked hard. My mom is a teacher and just like loved us, and I have to say, it was like really good. Now, when I was, in 1989, so seven, we moved to Tokyo, Japan, and we ended up living there for seven years, or six years, and the interesting coincidence is that Giulia, who I will let obviously talk about her childhood, that's the same year that her family moved abroad as well. So, when we started to talk to each other, we had our family upbringing but also this like kind of international experience as something that we really bonded over.

PAUL: And we were talking a little bit about this backstage, and, you know, they expressed a little concern that maybe their childhoods weren't bad enough to sound like a valid Mental Illness Happy Hour [chuckles] episode, and I said, no, these are great episodes because there are so many listeners who didn't have trauma to point to and say, why am I struggling so much? And I think stories like these are really important because the why isn't as important as the how do I cope.

Giulia, tell us about your childhood.

GIULIA: I was born in Rome, in Italy. And I was there till about seven, and then, because of my dad's job, we moved to New York, and I was fortunate enough to live all over in the States and then moved to London, and I was fortunate to see the world with my family.

I have a younger brother, five years younger. He lives in New York with his wife. And my, I feel like I had a very fortunate upbringing. We didn't have to worry about finances, and I got to go to the best private schools all over the world, and I definitely felt loved, yeah.

PAUL: So, it'd be fair to say, then, that the, kind of the emotional temperature in your house was, I mean, clearly not volatile. Would you say that emotions were allowed to be expressed if someone was sad, you know, they weren't tried, a lot of times you'll talk to people who are like, oh, yeah, my childhood, you know, was awesome, and then you find out that, you know, their parents would really have a problem with that child expressing sadness, which to me is like that's [chuckles], that's not a stable home.

And I'm not saying that was the case with you. I just want to find out, was there, you know, was there emotional support and a freedom to express emotions and have them validated?

GIULIA: Yeah. I definitely feel that way. It was more on me. I was very much like a type-A personality and I put the pressure on myself to excel in everything, you know, and all straight A's. If I got a B, I would, you know, be really upset with myself, but my parents were always supportive and like, Giulia, it's no big deal.

MARK: I just want to point out, her first B ever was in her sophomore year of college, okay.

[Chuckling]

PAUL: Seriously?

GIULIA: That's true, yes.

MARK: Seriously.

PAUL: Well, no wonder you lost your shit.

[Laughter]

PAUL: That's a big build-up.

GIULIA: Yes, yes. I was very wound up--

PAUL: You almost made it to the finish line and you fucked it up.

GIULIA: Yes, yes, I did.

[Chuckling]

PAUL: Oh, you have disappointed me deeply.

Wow, where do you think, when you're raised in an environment where that's not modeled and that's not expected of you, it's got to be genetic, wouldn't you think? What, do you remember consciously, was there anything driving you with that perfectionism?

GIULIA: I mean, I feel like, I mean, my family, especially my dad, I mean, he's a water polo Olympian so he needs that drive, right, so I definitely come from a family that wants, is expected to work hard and then excel all the time.

PAUL: And was that communicated to you, or was that just kind of--

GIULIA: Lived, yeah--

PAUL: --intuitively by his example, you thought--

GIULIA: Yeah, by their example.

PAUL: --if I want to be happy and stable and successful, this must be how I--

GIULIA: Mm-hmm, yeah. He built his success from the ground up, you know.

PAUL: Was he, did he find a balance between getting his work done and being successful and being able to find time to spend with the family and be present while he was spending time with the family?

GIULIA: He was present, yeah.

PAUL: That's success, in my mind.

GIULIA: Yeah, yeah.

PAUL: I mean, that's like amazing. That's--

MARK: In fact, I remember in college, Giulia took a speech class and had to write about, speak about someone she really admired and she chose her dad for that exact reason, like the fact that he was a world champion in water polo and yet still she felt so supported by him. Yeah, I distinctly remember that.

PAUL: So, then let's fast forward unless there's something I’m skipping over, where, was there any trauma or life-changing events until your bipolar began to express itself?

MARK: I mean, the fast forward is like it got even a little bit more fairy tale, right?

GIULIA: [Chuckles]

MARK: Like--

PAUL: That's just going to bum us out--

MARK: I know--

[Laughter]

PAUL: --because we all had fucking miserable high schools and . . .

MARK: So, we were like, I guess, officially together within the first month of college, stayed together all of college, knew we wanted to plan the future together. Giulia got a job in New York. I was in Baltimore. We were commuting on the weekends to see each other.

We got engaged. When we, we packed up our houses, like our apartments, to move and we put them on a truck and we sent them to San Francisco but didn't have a place yet, and got married and the next day we were on a plane to come out here, to give us a little bit of time to find a house before the moving truck got there.

And I had a job lined up as a teacher. I teach high school history. Giulia didn't yet have a job but had these like stellar recommendations and like letters of support from her previous employers, so she was able to get a job really quickly, and it was just like the most ridiculous smooth sailing you can imagine, right?

GIULIA: Then it comes crashing down.

MARK: Yeah. And then it was like just this, you know, the terrible, ehrr, you might be wondering how I got in this situation [chuckles]. That's basically what happened, right.

PAUL: So, take us there, from its beginnings.

[Mark and Giulia deciding who should go first]

MARK: Well, I guess for me, Giulia got a new job, right. She was doing well at her job but she saw limitations to growth, so she tried a different workplace, and they really wanted to hire her but it wasn't for the position that she had applied for, so they created a position for her.

And I think in that, Giulia, who has these perfectionist talent-, tendencies, who really wants to excel, she wanted to do it perfectly but they didn't actually know what they wanted from her yet. And she certainly didn't know what they wanted from her.

And so, like this was a job she was so excited about, and I remember it was summer and I was teaching so I had the summer off, and I'd like send her off to the day and be like, have a great day, honey, and then she--

PAUL: Did you have a pipe and a cardigan?

[Chuckling]

MARK: Yeah, wrapped in a plaid blanket--

PAUL: Because that's what I'm picturing, yes.

MARK: But then, she called and she's like, hey, honey, I'm having this tough day, I got to write this e-mail to my boss, I'm not really sure what to say, can you help. And I was like, yeah, sure, just send me the e-mail, no problem. She's like, I've been working on it for a while, I really want it to sound right.

And she sent it to me and it was literally like a very bland two-sentence e-mail, no big deal, something you would write at any point. And I called her back and I was like, it looks fine, like. She was like, I've been working on it for like the last hour. Are you sure it's okay? I was like, yeah, it's okay, you should just send it, don't worry about it.

And I think that's when I got my first sense of like, this feels a little weird, you know, that feels more obsessive than maybe some of the perfectionism I had seen in college, and it just ramped up really fast from there, where then it was like every task, every e-mail, she's calling me, she's forwarding me, she's asking for advice, she's overthinking absolutely every step of her job, which was like this total spiral because then she's afraid she's not living up to the expectations because she's not actually doing anything at work. She's just obsessing about what she's not doing and if she's doing it right, and so then the pressure feels even higher.

Yeah, that's really how it all started.

PAUL: Man, that cycle of perfectionism and being frozen because you're afraid of doing the wrong thing is a hell unto itself, its own? I don't know what the word is. Let me find out the perfect way to say that.

So, Giulia, take it, for you, did it start before then? Do you remember something happening before this two-sentence thing that you were agonizing over?

GIULIA: So, I turned 27 on July 9th, at the time. I'm not 27 [chuckles]. And--

PAUL: By the way, how many years ago did this happen?

MARK: This was seven years ago.

GIULIA: Seven and a half, yeah.

PAUL: I just wanted to find out your age. Go ahead.

[Chuckling]

GIULIA: And I remember flying back, we had gone to Mark's sister's wedding, and I flew back to start this job. And I was there like a week, and I started already, like starting to get overwhelmed and like panicked that I wasn't going to succeed. And I remember stepping in and out of my desk like 10, 15, 20 times a day to call my brother or call Mark or call someone to just check in with them because I was terrified that, you know, it was over my head and I couldn't excel at this and what the hell did I just get into.

And I remember just coming home and laying in bed and not being able to sleep. I don't know if anyone has experienced not sleeping for endless nights, over and over and over again, and they were spiraling--

PAUL: By applause, by applause?

GIULIA: Yeah, thank you.

[Applause]

GIULIA: So, it's a very scary feeling because nothing is working. You're listening to the meditation tapes over and over again, and you look over at your partner who is sound asleep and you are there, alone, and it just kept building up, the endless no sleep, sleepless nights, and I was just not able to function during the day.

For the first time ever, I was like calling in, you know, sick and playing hooky, because I just couldn't get myself dressed and in to work. So, I literally, at 27, I didn't even know what depression was. I had no idea of that diagnosis. I had no idea about medication.

I remember at one point we considered going to talk to a therapist, and I'm like, a therapist, what? And I felt like, at the time, it was a weakness to take medicine, and I was like, I'm not taking this. And at the same time, I remember it spiraled so quickly that within that first month, when the, when I went to my psychiatrist for the first time and I got these medications and I came home, I was already thinking about killing myself. That's how quick it was.

And it was like a feeling that just took over me, and I remember calling my mom on Skype, who was in Italy at the time, and being on Skype for seven hours with her, because she was terrified to hang up, because now I had these pills with me and she didn't know what I was going to do with them, because in my mind I was already ready to give up. And I didn't understand these feelings. Like, they just came so quickly. You know, the darkness came so quickly.

PAUL: Was the darkness exacerbated by your shame at having to take meds, or was it there before the meds came into the picture? Or is it hard to remember?

GIULIA: I don't know.

MARK: I think that, Giulia, if you don't mind me trying, because like, I, the book that we're publishing I wrote and I've been, so I've dug through a lot of this stuff many, many times, and so sometimes I have more of the factual stuff and Giulia has more of her emotional memories.

I don’t know if the medicine made, the presence of the medicine made things worse. I think the fact that she now had a means for suicidal ideation certainly made it feel a lot scarier to me, where it was no longer, and she's like not being able to sleep. I'm literally laying with her and I'm like, honey, just go to bed. Why can't you just relax? Take a deep breath, calm down--

GIULIA: Yeah, he didn't get it.

MARK: --it's going to be okay, you know. And of course, I've subsequently realized like the worst thing you can do to like help someone calm down is say calm down, you know.

[Chuckling]

MARK: It's like, yeah, I don't know why I didn't realize that then, but I was just like, it's going to be okay, a lot of like backrubs and that sort of stuff, and then just eventually, at my point, at some point, like passing out and not really knowing why she couldn't just snap out of this. But I think when the meds were there and Giulia had that long Skype call with her mom, we realized like, this is really, really serious.

PAUL: Giulia, if you can recall, what do you remember feeling in your body and/or thinking when this first wave of feeling overwhelmed and depressed came to you?

GIULIA: Well, my delusions and my first episode were very spiritual. It came on pretty quick to me, the feeling that I was the root of all evil and needed to ultimately end my life for the good of the people. So, those were my delusions.

So, I thought I was the devil.

PAUL: That's heartbreaking, thinking what that kind of self-hatred must have felt like.

GIULIA: Yeah. Yeah.

PAUL: Did you share that with anybody when it was--

GIULIA: Yeah. I mean, I shared it with Mark. Like, it got to the point where my family was really worried, so my dad at the time was working in Vienna, he came and flew in to assess the situation [chuckles], and he came in thinking, oh, you know, she's stressed at work and we need to get her back on track and go to work and, you know, everything is going to be okay.

And then my mom flew out, and I remember sleeping near, next to my mom one night because I wanted to be near her and, again, not sleeping all night because I felt like I had to protect her and I had to protect her from the devil, and the devil was becoming, like coming to me and becoming me.

PAUL: So, the devil was going to pass through you and you'd be the instrument to hurt the people that you loved.

GIULIA: Yeah, yeah. So, I was up all night, and so when she woke up and she's like, honey, did you sleep tonight? It's like, no, I was up all night. She's like, what do you mean? I was, I was up all night, protecting you, you know, and that's when it just, people were freaked out, like alarm, siren in everyone's mind, you know, like she needs help, you know, something bigger than what we can handle here at home.

PAUL: I can't imagine how, A, terrifying it was for you and Mark, but also for your family to be, have somebody you love be dealing with something that's so confusing, so misunderstood and not talked about in our society, at least in enough detail that we have even the slightest grasp on it--

GIULIA: Yeah. There was a lot of Googling going around.

[Chuckling]

PAUL: Well, at least it wasn't so long ago that it was Ask Jeeves, because you talk about emotionally ignorant.

[Laughter]

PAUL: I think it was also just that British arrogance that nothing's ever wrong.

So, what happened next?

MARK: Well, if I can chime in, I just want to make sure everyone understands, that was six weeks after the job started, to give you a sense of how quick. I mean, that is unbelievably rapid, for there to be no hints anywhere, no family history anywhere, just it was like a night-and-day experience.

And we were kids, right? We were 27, living in California, on the other side of the world from our families. My parents were in Japan at the time. Giulia's were in Tok-, I mean in Italy. And just feeling like, we have no idea what the hell is going on.

PAUL: And it must have been terrifying.

So, what happened next?

MARK: Well, when she woke up and said she's the devil, we realized, like--

PAUL: That's a great sentence, too, by the way, isn't it?

[Chuckling]

MARK: Giulia woke up and said, I'm the devil, yeah.

PAUL: The best stories start with, when she woke up and decided she was the devil. Nobody tunes you out at that point.

MARK: So we, Giulia had been kind of seeing this psychiatrist but very halfheartedly, keeping them at arm's length, wanting the medication just as a potential overdose but not to actually take it. And so, we--

PAUL: Because of the shame and viewing it as a weakness or a crutch?

MARK: Yeah.

PAUL: Okay.

MARK: And so that's when we realized we needed to take her to the actual hospital, right. And so, this is always a hard thing to talk about, but we, my father-in-law and I had to actually pick her up because she was so resistant. She was flailing and screaming and like trying to hold onto doors so we couldn't, I like literally viscerally remember prying her fingers off a doorknob to take her down into the car, drive her across the city.

Halfway there, driving through Golden Gate Park, she opened the door, popped off her seatbelt, I was like, holy shit, grabbed her, pulled her over. Just like, what happened to her? And us, you know. And I just, I got into the ER and I was like, help, my wife's losing it [crying], I don't know what to do.

And the ER staff was, unfortunately, like really emotionally unavailable, you know. Like, sign on the line, what do you need. I'm like, what do you mean, what do I need? Like, this is so fucked up, right? Like, you've got to help me out here.

And I think it was like literally from minute one, my realization that like, and this is where our stories diverge a lot, that if you're the one who's not sick, that you're not sick. You're fine. We don't need to deal with you. We're going to get your paperwork. We're going to get your background info. But the assumption is that all is peachy and dandy with you because you're not having delusions about the devil.

And that was a feeling that I got over and over by like the support team for Giulia, because I'm supposed to be fine, you know. And so they put her in a triage room, hooked her up to like an anti-anxiety to calm her down, and then she just went real low, right?

And that's when I heard words I had never heard before, like psychosis. You know, I didn't even know what that was. I just thought of like psychopath, so I thought they thought maybe she was like a dangerous, violent person.

PAUL: That must have been scary.

MARK: Yeah. Yeah. And we were in the ER forever, and we're just waiting and, you know, I kind of dozed in and out. And then finally they, the doctor was just like, we found a bed for her, let's go. Because the ER we were at doesn't actually have a psychiatric facility. They contract out to another hospital that does, so we just had to wait until they were able to process all that. I don't even know how long it was. I think it was like at least six or eight hours.

And then all of a sudden, they put her on a, they wheeled the bed out. Her mom got in the ambulance with her. Me and her dad chased behind in the car. We had to find our own parking and like ran in. And I have no idea what's happening. I just know Giulia is heavily medicated. I don't know what the hospital is going to be like. I have like a gazillion questions.

I get to the hospital and I'm all disheveled, I'm like, my wife just got admitted to the psych ward, what's going on? And the guy's like, oh, you have go to, there's only one elevator that goes to that floor, you have to go to the special elevator over there. And I'm like, this is, like what is this? Only one elevator stopped on the third floor.

So, I get out--

PAUL: And was it operated by a guy that shames you all the way up?

MARK: Yeah, seriously, right? So, I get on the elevator, go upstairs. Me and her dad are like in stunned, just horror. Like we're, we've cried, where there's no tears. There's no words. It's just, he's Italian. He's like--

GIULIA: He's six-seven--

MARK: --got this thick accent. Giulia's mom is similar, thick accent. They're like in the States, yes, they lived in the States, but like a foreign country. So none of us, like we don't even know how to help each other. We just like feel so alone and lost, even though I'm literally in the, like in the elevator with my father-in-law, right.

Get into the waiting room. The waiting room is this like, if I can kind of visually lay out the facility. The waiting room is like this glass nucleus, and the entire ward revolves around it. It's really in the middle, and almost all the blinds were pulled and there's just a couple of really underused, gross chairs sitting there. And we just sat there, you know.

And I didn't know where Giulia was. Her mom was--

GIULIA: I was inside.

MARK: Yeah, exactly, but I didn't know what that meant, right? Like, what did it mean to be on the other side? There's one door, I go banging on the door. They kind of look at me like, hey, we're busy here. And I'm like banging on the door, so someone comes out and they're like, what do you want? What do you want from us?

I'm like, my wife just got checked in here, what do you mean, what do I want? Like, help me out here. Help me get my bearings down. And the woman's like, well, she's obviously psychotic, we need to process her, it's better done away from the family, you need to go home. And I'm like, I, how am I supposed to go home right now? What does home look like, you know?

And so, I was really pissed off at that nurse, but I needed, I needed her to like me, because I needed her, I needed her to be an ally, right? I needed to know that like I could call her and maybe she'd help me and I could give her some info, and so I was like so hurt by how she treated me, but I was so desperate to please her, because I thought she was the ticket to helping Giulia and so, if I could convince her that Giulia was different than everybody else in there, and it was just, ugh, it was terrible.

PAUL: You know, as you describe this, it's like you were pleading to say, please, we're human beings, we're not a chart.

MARK: Yeah. I mean, exactly. She kept just saying, it's not visiting hours, the visiting hours are posted, it's not visiting hours, you know. I'm like, okay, but I'm here now, right? And so she said, and this is where I also had some, like I understand that people who are mentally unstable need protection, right, because not everyone had, like a lot of that is brought on by trauma or whatever, but I didn't think Giulia needed protection from me, but she still had these rights that entitled her to protection from me.

And so, I wanted to go talk to her. I wanted to tell her, like, it's okay, don't be scared, we're going to figure this out. And I was like, can I please go talk to her? And the woman's like, you're not allowed to, she didn't sign off for you. And she had signed off for her mother who was in the ambulance but not for me because I was in the car behind and I don't know what Giulia was processing, but she just didn't sign off for me or her dad.

And so I said, please, just go ask her if I can talk to her, and, you know, I finally was sort of like able to look in and Giulia is at the nurses' station, and she's like, it's [sighs], it's such a heart-aching image to see. She was so still and like, like, just like an immovable object just sitting there.

And I went up, like I said, can I please talk to her? And the woman went up and like, you could see them talking, and Giulia like slowly looked at me and then shook her head, and then the woman said, she doesn't want to talk to you, and closed the door, and that was it. And then Giulia is in the hospital and I'm not.

PAUL: My God. Wow.

MARK: Do you have a joke to lighten the mood now?

[Chuckling]

PAUL: I don't.

MARK: No, and that's where like, then it became for 90 minutes a day we were, we had the same story, and for every other minute, like it was, we were in completely different worlds, right, where I was like on the phone. The first day, I think I was on the phone the entire day, calling people, calling different hospitals. I didn’t know what I expected. I think I expected that they were going to give her this like pill and it was going to go away in like an hour, like a headache, you know.

And I called all these facilities and all these friends who were recommending professionals, and I still didn't have any sense of what was going on. And I was gearing up to go see her that night, right, knowing that from 7:00 to 8:30 I was allowed to be there. And my mother-in-law is like losing her shit, and we're in the same house together and she doesn't know anyone in the entire state of California except me. And so, like we're kind of taking care of each other but not really, because we're just so disoriented.

And then I went and visited, and then you have your 90 minutes together, right, where I'm like, I kept, so like the first episode I thought I could help unlock whatever was going on, right, that like I knew Giulia well enough, I had known her since she was, we were just 18, we had lived together for so long, that like I could somehow give the right clue to the doctor where he'd be like, a-ha, and this is what's going on now, thank you for your helpful information, we figured it out, she's going to be okay, right.

And so I would like obsess all day, what may be part of this, what's going on. And then I get there and I'd want to talk to her, but like the first visit didn't exactly go that well, you know.

PAUL: What happened at the first visit?

MARK: So, she had spent the entire day on her bed, just staring at the wall, basically, like not engaging with anybody. And when me and her mom came, she just started screaming, like stay out of here, the devil's going to get you, you've got to stay out, you can't come near me.

PAUL: She's referring to the nurse?

[Chuckling]

MARK: She's referring to us, right--

PAUL: No, I mean, she's talking about the nurse being the devil.

MARK: Yeah. And so--

PAUL: I like when you have to explain a joke. That usually means it needs a little punch-up. Go ahead.

[Chuckling]

MARK: And so, I'm like, okay, 24 hours just passed, she's in the exact same situation she was a day ago. What happened here, you know? And then I'm thinking of all the things I want to ask the nurse, like what'd you guys do to her? Like, she's been in the hospital for a day, away from us, I'm assuming you're doing something.

PAUL: How do we let our society grapple with this on their own without, I know that we can't solve the chemical issue overnight, but for God's sakes, can't we at least provide some basic ideas of how to form a community to talk about it or support each other or here's what to expect.

MARK: Right. You know, and I know I'm doing a lot of talking here. I want to let Giulia chime in. But like, I think one of the big reasons ultimately that I ended up writing a book is because I went, I'm a researcher, right, I'm a history teacher. I go looking for answers, and I was looking for someone who could tell me what I was feeling and what was going to happen and what I could do.

And the community of support for caregivers is pretty darn thin, right. It's, I'm so grateful for the many brave people who have spoken about their experience of having mental illness or whatever you want to call the experiences that they have, and that was super helpful and I was reading those books, but I was learning about Giulia and I wasn't learning about me, and I wasn't learning about what life was going to be like for me and how I was going to have to navigate this.

And I felt so alone in that, just so completely disoriented. I had my in-laws telling me one thing. They're getting super protective because it's their little girl. I've got my parents telling me something else. I've got my siblings, I've got friends, but deep, like in the end, like this is my partner for life, right, this is who I chose to be with for life. I want to be there to make these choices to help her and to take care of her and to show her I love her, and I have no idea what that's supposed to look like, you know.

PAUL: Giulia, do you want to talk about what it was like for you?

GIULIA: Yeah.

PAUL: What are you thinking or feeling right now after hearing Mark share that stuff? She's rubbing his shoulder.

GIULIA: That I love my husband. He stuck with me through all that. You know, a lot of darkness and the psych ward, and when I got admitted I didn't know where the hell I was. I thought I was in hell, actually. I thought, oh, my God, something happened and I just ended up in hell.

Like, that was my experience of the psych ward, because again, remember my upbringing, you know. I'd been protected my whole life from any hardship, and then here I was, taken away from Mark and my family and finding myself so alone with complete strangers and people, if I was crazy, everyone in there was crazy, you know. And not understanding how I ended up there and how this was my life, this was my reality, this was my new reality, and I was locked up in a psych ward and I couldn't leave.

PAUL: So, in your mind it was forever.

GIULIA: Yeah. Like I just remember it was, it was 33 days, which is a very long time for my first hospitalization, and I just thought I was even in purgatory, that never-ending just day after day of like the same activities, just being alone with your own mind and not trusting your own mind.

It's like it was telling you things because you're delusional and you basically have to then train yourself and tell yourself, those are not true, those feelings are not true. Mark is safe, right? Mark is safe. But that's not what I believed.

PAUL: So, you were emotionally feeling something that you, that was different than what you were intellectually telling yourself.

GIULIA: Yeah.

PAUL: Like, your body had one story and your intellect had another story.

GIULIA: Yeah. A big delusion for me with me, in the hospital my first time, was this belief that, it was kind of like the Truman Show. I was the main act, and everyone was actors and they were all playing their role, and Mark was also a main actor. And I was like, you fucking assholes, I'm not falling for this shit, you know.

And I was like, I can't believe I'm in like a scene of a movie, you know, like I can't believe you guys are all in this and you guys are all against me and you guys put me here, this is not funny, get me the fuck out of here.

PAUL: Wow. Now, when you say that it was like you had wound up in hell, do you mean a figurative hell or like a literal hell to you? I mean, was there, also were there visual hallucinations, or was it more hallucinations about the intent of people around you?

GIULIA: I think both. Like definitely there were some visual cues and things going on that you're like, what the fuck is going on here?

PAUL: Any that you can recall?

GIULIA: [Chuckles]

PAUL: Because for some of us who have not experienced psychosis, I think it would be helpful for us to try to imagine specifically what that is like. I had a very, very brief period at the end of my drinking where I heard voices at night when I was trying to sleep. I heard people calling my name, which I, in hindsight, later realized, oh, there were people in my backyard who wanted to talk to me.

But it seemed so real, and that was like, oh, I need to buy a gun, you know, and so then I applied for a gun license and fortunately got sober before I bought a gun, which I thought I needed for protection, but I was convinced that this was all real.

So, paint that picture for us, if you can, in as much detail when you talk about the unreality of it.

GIULIA: It's so hard, you know, because it's been, you know, a few years since my last episode. It's just this feeling, it's like you're in two worlds, you know, where your mind is telling you things and like, but yet you've lived your whole life believing certain things in a certain way, so you're telling your own mind, this is not true, this is not true, but your mind is still processing these feelings.

And they take over all of you and your whole being, and they evolve. Like, my three hospitalizations and the psychosis tied to each of my hospitalizations has been completely different, and they're rooted in different things. Like the first one being I'm the devil, the second one was all about heaven is a place on Earth, it's actually a beautiful thing I discovered, that heaven is a place on Earth. Like, that's amazing. I just solved like the key to life and I'm only, you know, at the time I was, what, 32, and I'm only 32 years old and I figured it all out, you know.

So, it's like, I don't know. I don't know what else to say.

PAUL: Was there a, again, I'm not a mental health professional. I'm a jackass that tells dick jokes. But it almost sounds to me like the first one was depression-driven and the second one was mania-driven.

GIULIA: Yes, yes.

PAUL: I am a mental health professional, ladies and gentlemen--

[Laughter]

GIULIA: And that's why after the second episode I was diagnosed with bipolar, and that's my current diagnosis.

PAUL: They should have come to me.

[Chuckling]

PAUL: Should have come to me.

MARK: You know, if I can say something, my observation is that psychosis for Giulia was deeply traumatizing. It was a real wound to experience that distrust.

PAUL: To her or to you or--

MARK: To her. I mean, definitely--

[Simultaneous discussion]

MARK: --to both, but after she got out of the hospital and was really heavily medicated, one of the biggest sources of her suicidal depression was, I can't believe that happened to me, I can't believe I went, I thought those things. You know, it was like the psychosis itself became the trauma, right.

And I would say that was very much the case for the first episode. As Giulia said, she's been hospitalized with psychosis three times. For I don't know why, but the sense of trauma I think is lessening and I think that the nature of the delusions is becoming, oddly enough, a little more positive, too.

GIULIA: Well, it's about also acceptance, right? It's like at first you're like, what just happened to my life? And like the belief that you have to rebuild your life and re-create your life and you are this new person. I will never be the same person that I was before the psych ward. Like, the psych ward changes you. Like, it changes your soul.

You know, that innocent girl before going into the psych ward is no longer here, because the stuff that I've experienced and seen, the darkness that I've lived with changes you, you know. And so this whole, these last seven and a half years, it's been about acceptance and acceptance of who I was and who I am today, and those are two different people.

PAUL: You know, I can't help but think, and thank you for sharing that, I can't help but think, as you're sharing that, how similar that is to a person who experienced sexual trauma and how it then affects their sexuality and then that person usually winds up thinking that, well, this weird thing turns me on now, that must be a moral statement, a statement about who I am morally.

And so then that adds to the depression, the anxiety, the difficulty getting close to people, etc., etc., until they get help and find out, oh, no, this is a thing, this is just like if you're in the sun too long you get a freckle, and you shouldn't be ashamed to say, hey, here's a freckle I got, you know, if your freckle's not hurting anybody or, you know, whatever, you're not crossing anybody's boundaries.

But it, it just seems to be a theme through people's emotional struggles that acceptance is so vital in the beginning and so fucking hard, again, because we're not prepared for it. We're told, well, you just need to have a better attitude, you need to be grateful for the life you have, and they should make a special boxing glove to hit people that tell you be grateful for all you have.

MARK: You know, last night we were kind of preparing for this. I have to be honest, Giulia, I'm surprised you talked about the devil, because last night Giulia is like, I don't want to get into the specifics of the devil because I think, while Giulia has accepted so much of her journey, that detail is something that you've been really hung up on for a while, because there's something just about that association that's really been, still I think really traumatizing.

GIULIA: And then we talked to Paul and he said just put it all out there, so--

[Chuckling]

PAUL: I always tell people, I will edit anything out afterwards, you know, and I do. I edit stuff out sometimes. But I think I can speak for all of us when I say I just feel really privileged to have somebody be so vulnerable about something so personal. It's really, I'm really, really grateful that you could get so specific about those things.

And having read thousands and thousands of people's surveys, I can tell you, those are the most common things that I hear when people describe bipolar psychosis, schizoaffective or whatever it happens to be, it so often, religiosity or something else comes into it, and it kind of breaks my heart to see that people then judge themselves for that, as if it's, has something to do with their character.

So, when I had asked you to describe in as much detail as you could, do you feel like you were able to describe it as much detail as you could recall, what the psychosis looked like?

GIULIA: It's just, it's so dark, you know.

PAUL: We can handle it. Unless you're uncomfortable talking about it--

GIULIA: No, no.

PAUL: --in which case, totally fine.

GIULIA: No. It's just, it's just crazy to have experienced your mind go to these places, you know. Yeah.

PAUL: I don't want to push.

What's the next phase?

MARK: I'll do the sort of narration, then, of what happened from there. Giulia was in the hospital for a long time. She finally came home and was still intermittently psychotic but was on medication.

PAUL: Okay, taking as prescribed?

MARK: Yeah. Giulia has been, with only two exceptions, a very tolerant patient of the medication. And the medications were really numbing and really slowed down her processing and her thinking.

So, I took off a semester from school through the Family Medical Leave Act so that Giulia wouldn't be home alone. I mean, I don't know if she could have like driven a car, but certainly I didn't feel like she could be home alone. And we just kind of like just took it, I don't even want to say day by day, but like minute by minute.

GIULIA: Yeah. It's like we lived and didn't live, you know. It was kind of these days that were the same kind of days.

MARK: Yeah, get up, walk the dog, maybe go to yoga if we could like sort of rally for that.

GIULIA: It was just existing.

MARK: Yeah.

GIULIA: You know, it wasn't living.

PAUL: As you look back now at that stretch of time, do you feel differently about that time? Do you have any different feelings attached to it?

GIULIA: I mean, I think it was a very important time, you know, because it was slowly trying to heal from such a traumatic experience about, oh, my God, what the fuck just happened to my life, you know? So it's like baby steps going to, I went to, it's called IOP, intensive outpatient care. Most patients go for six weeks. I was there nine months. I think I was the longest-standing patient, you know, in this program.

PAUL: Did you get an A?

GIULIA: Yeah. Yeah, I think so.

[Laughter]

PAUL: Well, you know, maybe I should just speak for myself, but as you were sharing about that stretch of time, I got this feeling like, while the struggle sucked, there's something beautiful about you taking that time off and you taking it minute by minute and being present with each other and accepting that this is our new reality. And instead of just, you know, shutting down and ignoring it, you got into the solution and faced it together.

MARK: I think that's absolutely right. The first thing I ever wrote about our experience was a column in the Modern Love, the Modern Love column for the New York Times, and it was exactly about that, how in all of this like horror there was a tenderness because we were so minute to minute. And I honestly don't think we fought for nine months. We didn't disagree about anything. We were just like two fragile to do that. We were just so supportive.

But it was so unrealistic because we weren't doing, like neither of us were working, right. I was, Giulia was passing out, heavily medicated, at like 7:00, and then I was like paying bills and e-mailing updates to the parents and just trying to like deal with all the logistics of life from 7:00 until whenever I fell asleep. We hardly saw people. People were certainly offering to come see us, but it was really hard for me to, for people to see Giulia like that, because it was so different than who I believed Giulia to be, I guess, you know.

But if I can go back to your first question about do you see it differently. I see it really differently, because at first I thought what was happening, the reason it took so long, was because of like the mania was a psychotic mania and then it was the depression, right. But now I have much stronger suspicions that it may have been prolonged by how long she took antipsychotic medication, the doses at which she took it.

These are doses that I gave her. These are doses that I, at the time, was like this is, this is the right thing, let's do it, here, let's go in the bathroom, I know you don't want to take these, I'm going to watch you take these, open your mouth, show me that you took them, but--

GIULIA: Yeah, these were the meds where I gained 70 pounds and I was so adamant and like, I am not taking this medication, and yet I had to take it.

PAUL: But the dosage was as prescribed--

MARK: It was all as prescribed, right.

PAUL: Okay, I was going to say, because it almost sounded like you were saying you decided what the amount should be--

[Chuckling]

PAUL: --and I was like, well, this might be worth talking about in some detail.

MARK: I think, yeah [chuckles], but you know what, that's funny because I did feel like, I'm in the driver's seat of this. Like, I’m telling these, I'm consulting with these doc-, I still had that like, it wasn't a delusion in that it was like voices, but it was clearly not realistic that I was going to be the one dictating Giulia's care, you know. And so--

PAUL: Almost as if by default. If you're not going to, who else is?

MARK: Yeah, that's a good point, too. But I think when I look back, like Giulia has been in the hospital three times, and after each hospital she's had a prolonged depression, and I, the first one lasted almost nine months, right, which is such a long time for someone to be suicidally depressed. I mean, can you just imagine that, right? Waking up and wanting to die, that's the first thought you have, for nine months.

And so like, they've gotten shorter, which is great, and I, we've gotten different about how we talk about medication, and the benefits that medication plays in certain contexts, certain types work in certain contexts, but that doesn't mean she needs to be on antipsychotics for as long as she was. Like, maybe we can taper off a little earlier and see if she's actually out of the psychosis.

You know, I think because of her first hospitalization, it was so abrupt and so deep, they were putting like, playing it super conservative. We're like, we're going to mute this thing until we know it's completely gone and drag out that heavy dosage for as long as it takes. But I didn't really think about that at the time, you know. I just thought this was what depression looks like, this is what it looks like to be suicidal.

GIULIA: Yeah, I feel like Mark has very much evolved as a caregiver, you know, like especially in my last episode, where [chuckles] we were more a team. Like, when I started getting psychotic, you know, he would come with me to the psychiatrist and we had a plan and we worked together on that plan. He didn't just like pack up my bags, brought me to the psych ward.

Now, looking back, right, we have a son now, so our son, you know, at the time being two and a half--

MARK: Was two and a half, yeah.

GIULIA: --you know, had a delusional mom walking around in the backyard, in the grass with her bare feet because she loved that feeling of the grass and she felt connected to the Earth, so was that the best decision? I don't know about that, right.

PAUL: Wait, hold on. I do that.

[Laughter]

PAUL: I fucking love the feeling of grass on my bare feet.

GIULIA: Yeah, I was definitely delusional.

PAUL: Until I hit dog shit.

[Laughter]

GIULIA: So, we just came together, to an agreement that we were going to try to postpone me going back into the hospital as much as possible.

And then, obviously, it lasted two weeks and then we both decided actually, basically, the best decision was to go back to the hospital, but I really feel like, from the first, you know, the first episode when I was basically calling Mark the medicine Nazi, you know, to the last episode, I think he's definitely evolved as a caregiver, you know, really listening to me and my needs, even when I am delusional.

Like he listens to me even in my delusional state, what I'm comfortable with, and ideally it is to not end up in the hospital. But at the same time, we have a kid now so things are different because it's all about just doing what's best ultimately for Jonas, and sometimes that might mean going to the hospital.

PAUL: Before we, I have like three different questions I want to ask you.

[Chuckling]

GIULIA: Sorry, I fast forwarded.

PAUL: No, no, no, no, no. The first one is, Mark, you talked about people saying, you know, if you need anything, let us know. I know sometimes people say that and there's just a vibe to it that you know they're just saying that. What ideally would you have liked people to have said or done in your circle of support?

MARK: I don't want to disparage the circle of support that I had. And some of those people are here, I mean, like lifesaving friends and family members, who, you know, Giulia said listen, right, like that's what you can do, whether it's me listening to her, whether it's someone who knows that I just need to get this all off my chest, I don't need a problem to be solved because it's way too big to solve, but I just need to talk about it.

You know, I think there's a really strong instinct to, when someone is struggling, you're like, okay, we're going to fix this together, let's figure this out. At least that's certainly what I do, right? And it took a while for me to learn that like I can't fix it, but if I can maybe hear you just talk through it, that in itself, like paradoxically, becomes a little bit of a fix, right, at least for that moment.

PAUL: It certainly lightens their emotional load for a moment.

MARK: Yeah. So, like I had, you know, I had like a lot of people who wanted to help and I kind of would have to do this dance between saying like, I need you, give me space, I need you, give me space, you know, which was probably incredibly disorienting for them, right? Like, when would I call my mom and need a two-hour just like sob on the phone, and when would I be like, Mom, I just need like, I can't talk right now, you know? So, how hard that must have been for her to navigate, right.

You know, like we get really, I think one of the bigger things that happened in this is how my life became such a tunnel vision, how much blinders I put up and, to what it was like for other people, right, what it was like for my friends to see this happening to their friend, what it was like for Giulia's friends, what it was like for her parents.

At the time, I had no capacity to think about any of that. And I really tried to think about what it must have been like for them, but it's something that we hear about over the years, right, like we might, one little story might come up and then we'd actually hear, because we're with my parents, what it was like for them when that was going on, or for her parents.

And that's been really important for the both of us, because I think, Giulia talked about how we have a plan, like we want our family to know like we love them and that they help us, but we, I also can't worry about them while I’m trying to deal with these crises, you know.

PAUL: And I think they probably would be okay with that. If they truly love you, they would understand, he's got a pretty big fire to try to contain right now, and . . .

MARK: Yeah. I don't know. It was, after Giulia's first episode, I took a long, solitary bike ride down the California coast, where I literally took a vow of silence, and I'd bike like 100 miles a day and, it's because I just felt like I was at the control center, and I needed to not communicate for a little while.

And all I was doing is once a day telling her where I was [chuckles], that's pretty much it, like where I slept that night, because I just felt so responsible for so many things, and it was just, I just couldn't handle it all, you know, and I realized, I need to do the exact opposite. I need to be only responsible for me for a little bit.

PAUL: It seems like a really great, intuitive way to recharge your battery.

MARK: Yeah, well, guess what happened [chuckles]?

PAUL: What?

MARK: On my, what should have been my last day, I guess I was like over-fatigued and I kind of fell asleep on my bike and crashed and broke my collarbone. I had landed in a patch of poison oak while doing so.

[Reactions & chuckling]

MARK: So, it was like, how's that for your recovery bike ride? Yeah. Yeah, but regardless of how it turned out, for the like four and a half days before I crashed into a turnout on Highway 1, it was this really amazing, and it taught me so much about how important it is for me to step away and not feel responsible.

Look, I’m a high school teacher, right, like I got all my students I'm responsible for. I'm a parent. We have all of our friendships. We just feel responsible for the people we love and want to take care of, but you have to, at least I've found, is I have to get away where I don't have to worry about that for an hour or even like half an hour. It's so important for me.

PAUL: And I love that you, with your crash, you managed to combine pathetic and scenic both at the same time.

MARK: Yeah. It was in a beautiful state park, Salt Point State Park, yeah.

[Chuckling]

PAUL: Let's talk about medication for a little bit. What has the arc of the medication been, not only what the medication specifically is, but your attitude towards it and how it has affected you, if you're comfortable. You don't have to share anything you don't want to talk about.

GIULIA: Well, I was put on a lot of medication [chuckles] from the first episode, and I kind of zoned it out, so Mark would know all the names of the medications. I tried to zone everything out. I just saw the white pill and I would take it because I was forced to take the medication or else they would hold me down and inject me with the medication, so I tried to avoid that.

So, what has worked for me and what I've been on for probably the last, what, five years, yeah, five years, is lithium. I'm on lithium.

PAUL: And as needed or continually?

GIULIA: Oh, continually. Every day I'm on lithium. I'm on 900 milligrams of lithium, and I just added 150 to have a better baseline, so I'm on 1050 a day.

PAUL: And how do you feel it affects you in terms of side effects and--

GIULIA: Lithium, I feel, has been good. It was actually the Zyprexa that I had gained the 70 pounds that I asked to please not put me on that again. The lithium has been good in the sense that on the lithium I haven't had those sleepless nights recurring.

They're, like I said, I did have them at the onset of my second and third hospitalization, and a lot of that is also tied to stress, whenever I feel extra stress, and time of year, for whatever reason. I've had all my hospitalizations in the fall, September, October, November. So, the fall, I'm very sensitive.

PAUL: I think a lot of us experience that.

GIULIA: Yeah.

PAUL: Yeah. Not necessarily what you went through, but in terms of the fall, I always feel my depression--

GIULIA: The fall is really tough for me, and so, so I feel like the lithium is something that I take every day and I take it for me and I take it, I take it for Mark, and I take it for my son [crying].

PAUL: That's, I mean, to me, like that's what marriage vows are all about.

MARK: Right. You know, and I haven't had to observe her medication in a long time. After the first episode, there was a point where she was so sick of one of the antipsychotics, Risperdal, that she did just stop it immediately and went into a really bad downward spiral.

After the second hospitalization, she tapered herself off, once again, Risperdal without telling her doctors. Ironically, the doctors ended up agreeing that she was ready for it, even though I was like, how dare you do that--

GIULIA: Ready to kill me.

MARK: --how dare you do that to us, you know? But it's been, thankfully it's been a really long time. You know, I try to be sensitive to that, like the uniqueness of our story, that like we haven't, yes, for a while I certainly had to supervise Giulia, and I was hiding the medication for fear that she might overdose on the medication, but there are a lot of people who take themselves on and off of medication. And I just know that like through the difficulty of this, I've been really fortunate that Giulia has been really like obliging for this, you know.

PAUL: I was sharing with them backstage that I have a friend who has bipolar with psychosis and they refuse to take medicine. They've been involuntarily hospitalized and evaluated, and this person believes that the FBI is conspiring against them, etc., etc., and they have burned pretty much every bridge in their life, but when this person is in their mania, I think it feels so good to them and I think they feel so morally and spiritually superior that it is the thought of giving that up, that high, no matter how damaging it may be, the thought is off the table for this friend of mine.

And I had to say to her, I can't be around you until you get help because it's too painful, it's just too painful. I can't, the person that I know and love is not there when I'm hanging around you.

From your perspective, can you, Giulia, can you share what it is like when you're in that place of mania that feels omnipotent and energized and visual clarity, what do you feel and think when you're in that place and everybody else is telling you, hey, I don't think you're in a good place right now? I'm assuming that you experience that.

GIULIA: Well, the funny thing is, my mania, for me, has just been my psychotic episodes. Like those have been my peaks. And I hate them. Like, I hate feeling like delusional, even when I did feel on top of the world when I was the devil. I would walk down the halls being like, you know, like in charge and everyone, like I would just like point to them and everyone would just like, you know, fall, you know, in my mind, I had that power.

But I never, I never loved it, you know. Like, I never loved it. I was always afraid, you know, of those episodes and that darkness. So, that's why I take the medicine, like I don't want to go there. Like, I just don't. I don't want to go there.

PAUL: Well, how about when the heaven-is-a-place-on-Earth stuff, that wasn't pleasurable?

GIULIA: That was more like a realization at the time. Obviously, you know, believing that like felt good, but when I ended up in the hospital because of that, like that feels horrible, right?

Like, I don't want to have these crazy thoughts because that's going to mean I'm going to end up in the hospital, which means I have to leave my son for another 30 days, or I have to stop breastfeeding because, you know, he's five months old and I got put back on the antipsychotics and I'm in the psych ward and can no longer take care of my son, you know. So, for me, it's always been a negative connotation.

So, unlike, you know, I have amazing friends that I've met through, you know, the hospital, and they have taken themselves off the medication. They're artists, so they love that creativity that comes with their manic episodes, so they have taken themselves off the medication and have ended up in the hospital dozens of times.

PAUL: In the mania or when the depressive episodes follow after it?

GIULIA: In the mania, yeah.

PAUL: What would you like to share, if anything, that somebody who's never been hospitalized might not know? Myths about it, things, details about it that you didn't know existed or you think are worth sharing, because I think for a lot of us, all we can think of is One Flew Over the Cuckoo's Nest, and I know--

GIULIA: And it feels like that sometimes, you know. Definitely my first episode, it was surreal. But at the same time, I feel like all of these in the end were experiences that made me who I am today, right.

And like, I like wouldn't change that, because that perspective I have, when I look at someone and they're struggling for whatever reason, like put aside the mental illness, for whatever reason they're struggling, I look in their eyes and I feel their pain, and I feel like the psych ward gave me that.

PAUL: So, there's a spiritual, and by spiritual I don't mean religious, but a soul connectivity aspect that it--

GIULIA: Yeah. I feel like I wrote this beautiful poem when I was psychotic, in my third episode, and it starts with, we are all interconnected human beings attached together by a string to our souls. And I wrote that in the hospital, and I remember bringing it around to everyone to like show them, like, oh, my God, like this is so beautiful, isn't it, it's just so beautiful, and like even like sending it to my whole family after I got out of the hospital [chuckles]. And it still speaks to me.

PAUL: I was going to say, that's awesome. I think it's a great poem.

[Chuckling]

GIULIA: Yeah. It still speaks to me, and Mark got it plastered, like he got a local artist and it's now like in our entryway to our house, and I look at it every day, and I see it and I'm like, you know, that wouldn't be there if I hadn't had my experiences, you know. Everything shapes you. It shapes who you are. And--

PAUL: And it's so based on how do you react to it.

GIULIA: Right.

PAUL: How do you react to it, you know, and I'm, I wouldn't have had you guys as guests if I didn't think that the way that you've reacted and grown from it wasn't beautiful and inspiring.

MARK: Thank you. You know, I'm a little self-conscious about that, though, because I just want, like not, I don't, I don't want it to be like, if your marriage doesn't survive it, it means you failed, or if you, or if it results in someone taking their own life, you failed, right, like there's so much guilt with crisis and trauma.

And I worry sometimes that because we're still together, because we have a child together, because we, it feels like we, quote, unquote, made it, I don't want it to make anyone feel like--

GIULIA: Like isolated, yeah.

MARK: Yeah, that like we're somehow saying, like, well, this is how--

GIULIA: We're better or whatever--

MARK: --yeah, you've got to get through this.

PAUL: We got an A.

MARK: Yeah, exactly.

[Laughter]

MARK: Exactly, you know. And I do, I think a lot of that is because of our situation, our upbringings, the fact that, like I said, Giulia was compliant around her medicine, for the most sake. The fact that her mania is so shitty is like really convenient, because she doesn't want to go manic again, so she's going to take her meds to keep that away, as compared to if mania was awesome, she'd be like, you're taking away one of my best feelings that I get, you know.

PAUL: Thank you for saying that. That's a really, really important thing to mention because I think so often, when we're facing something that's difficult, we automatically just go to, well, how are other people handling it, and based on that, I'm going to grade myself and decide how much of a piece of shit I am today.

And we're just always looking for something to justify that mean voice in our head instead of giving ourselves the compassion at the time we need it the most and surrendering to what is, and then saying, okay, the things I do have a little bit of influence or control over, how can I do this in a way that is principled and realistic and adult. But it's so hard in that moment because you just want to put your fist through a wall.

We've got about five minutes. Let's share some loves.

MARK: You go first or you want me to?

PAUL: We're just going to do these off the top of our heads.

MARK: I would say this, I, I started working on writing about this almost immediately when Giulia was hospitalized, because I was e-mailing my parents, and I've turned to writing as a way of processing. And we're on the cusp, we're on the brink of publishing a book, and this is kind of our first event to be talking about this really knowing that a book is coming and that it's right around the corner, and I just feel so much gratitude that you all are here, like you wanted to spend the night hearing from us.

The people who I know so well and love so much, all that you've done for me, the strangers who I'm just seeing your faces for the first time, the people who have e-mailed me over the years about stuff that I've written, I just, it's like so overwhelming, and I think it's because this kind of stuff happens and we make it worse because we feel like we can't count on each other, you know. And I just want, like I love that we can count on each other.

PAUL: Wow, that's, that's beautiful.

[Applause]

PAUL: That's beautiful.

MARK: Thank you.

PAUL: And fuck you for making us have to follow that one.

[Chuckling]

PAUL: I was going to say, I like vanilla sundaes.

[Chuckling]

PAUL: Actually, I don't. You know what I love? I love actually, on a Sunday, when there is almost, but not, too much hot fudge and marshmallow, just you know it's at the most that it could be without it turning bad and you're not getting shorted. Have you ever had a sundae and they short you on hot fudge?

MARK: Oh, it's the worst. It's terrible.

[Chuckling]

PAUL: That is some first-world horseshit.

[Laughter]

PAUL: Do you have a love, Giulia?

GIULIA: Yes. I love going to sleep at night and having our eight-year-old bulldog snoring at our feet and at 4:00 a.m. hearing the tiptoes of our five-year-old son, Jonas, and his huge whale coming to bed with us, and then ending up all together every day.

PAUL: Oh, that's sweet. Mark?

MARK: Another love?

PAUL: Yeah. Let's do one more each.

MARK: Okay. I love that you brought up ice cream, because I don't drink, I don't do drugs. I've never like sipped alcohol or even coffee, and so, but I fucking love ice cream, man. That's like my biggest indulgence of them all, milkshakes, ice cream, load it up. So, the fact that you brought that up like feels really good.

[Chuckling]

PAUL: Do you go milkshake or malt?

MARK: Oh, no, definitely milkshake. Malt is just--

PAUL: Ugh, ugh, ugh, yeah--

MARK: In fact, you inspired me, we were too nervous to eat dinner and I'm going to go home and make a giant milkshake tonight.

PAUL: Are you?

[Laughter]

MARK: Yeah, because you brought it up, so thank you.

PAUL: Well, if you really cared about me, you'd make it a malt.

[Laughter]

PAUL: Yeah, I [chuckles], I have three different pints of Ben & Jerry's, and I will pretend that I'm just going to sample one of them, and so I get the big spoon and I pull it out and I stand at the sink, just actually one more, just one more, just one more, until that's about, a third of it's gone, and then I put it away and I say, oh, I'm just going to have one bite of the other one.

[Chuckling]

PAUL: And I've been playing that charade now for about a week, and I can't wait to go pants shopping for the next size up shortly.

Oh, what do I love? This is kind of a simple one, but you know, as some people know, I'm living on my own for the first time ever, and I have had to learn self-care in a way that I've never had to learn it before. And I love the pleasure of the feeling I get after I've done all of the cleaning and laundry and I feel exhausted and responsible. That's a good feeling, the combination of responsible and exhausted, yeah.

Giulia, do you have another one?

GIULIA: Yeah. I love all these faces [chuckles]. My close friends who are here, and my family [crying] and all my new friends. So, yeah, so thank you so much for coming out on a Wednesday night, a night that's a workweek night, and spending it with us. So, really, like we love you guys. Thank you.

PAUL: And thank you to East Bay Express and Jody Colley, and once again, Giulia and Mark Lukach.

[Applause]

PAUL: Thank you, guys, thank you for coming out.

[Applause]

PAUL: Many, many thanks to Mark and Giulia, and Mark's book is, it's out now. It's called My Lovely Wife in the Psych Ward. We'll put a link to that on this episode under the show notes. Check it out because there's a lot more to his and her story than you could squeeze into our interview.

This episode that you just listened to, or are still listening to, it's soon going to be transcribed and available on our Web site, and many thanks to Accurate Secretarial for donating their time and helping out with the show.

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I want to read a couple, let's see, where is this? Sorry, I'm a little, this is an Awfulsome Moment that was filled out by Anxious About Creating a Name, and they're gender-fluid and they write, when going through the application process for therapy, I had to have an interview over the phone for what my current issues were to be matched to the appropriate services.

As the call was rounding up, she said, so why haven't you killed yourself yet? I wasn't expecting this, and I'm quite bad on the phone, so I replied, I'm not sure. How about you? There was a silence, and then she changed the topic. I still cringe and smile at the same time at this painful interaction.

First of all [chuckles], I don't know whether that woman should have been fired or given a Snickers. Maybe she should have been fired as she was given a Snickers. Here, take a bite out of this, and clear out your desk. That is like, so why haven't you killed yourself yet, that is, like if there was a list of a hundred things you say to somebody while they are in crisis, that would be number 101, beyond fucked up, beyond fuck-ed up-ed.

This is a survey, it's a Shame and Secrets Survey, and this was filled out by a guy who calls himself Unshackled and Seeing the Light, and he is gay, he's in his 60s, he was raised in a pretty dysfunctional environment. He was the victim of sexual abuse and never reported it.

And he writes, for years I've been battling depression, self-medicating and wondering what life would have been like without an alcoholic bipolar mother who on a good day would say she loved me to pieces, only to hear the next day that men were no good, that my dad, brothers and I were the cause of all her problems.

I didn't know this was abnormal behavior until I grew up and mentioned to friends some of the horrendous things my mom would say and do. I'd get the response, your mom said what? She did that to you? Wow. She was some screwed-up chick. Only then did I realize just how dysfunctional my upbringing was. It was embarrassing to hear those comments.

Although our physical needs were met, I saw my mom as somewhat evil for all the mental pain she brought on our household, as well as physical pain when she decided to hurl something at us during one of her diatribes.

I felt she intentionally abused us emotionally this way, not realizing how very sick she really was. My passive dad had his own problems and was unable to speak up on our behalf. After her death, it took me 10 years to get over my anger. I was especially upset at her response to the following story.

I recently saw the movie Spotlight on TV, where it highlighted the sexual abuse by Catholic priests in Boston. I was anxious to see it since I, too, was a survivor of priestly sexual abuse 50 years ago, when too many people looked the other way. When I gaze upon my innocent nine-year-old grandson, I say to myself, my God, that's how old I was when I was molested by the priest, how did he justify his behavior?

During the movie, the first time my eyes welled up with tears was when one of the abused survivors said, do you know what it does to your mind when a priest, who we were taught was the next best thing to God, molests you? As I write this now, it brings tears to my eyes.

I came from a very large Catholic parish, around 10,000 people. It was the late '50s. I was a boomer child. There were typically 65 children in each of the three classrooms for each grade at school. They had an upstairs church and a downstairs church to handle all the parishioners going to mass on Sundays.

During the week, they only used the upstairs church, where we put on our cassock and surplice outfit, I think I'm pronouncing those right, to serve mass. The newest altar boys were given the 6:00 a.m. masses to serve because of the very early hour.

The local Catholic high school supplied extra priests to say mass at ours and other local churches in order to handle the crowds. At 6:00 a.m. mass, there was only one altar boy instead of the typical two for every other mass. I think, quote, Chester chose to say mass at 6:00 a.m. in order to have a continual flow of fresh young boys. How sick.

He would see me descend the stairs at 5:45 to change and he'd follow me down. He would gently take my hand and say, come with me. He took me through the door, into the shadows of the dark downstairs church, where the only light was what came through the leaded-glass church windows. He would unbuckle my pants and slide them to the floor. I would be standing there naked, as the priest admired my little-boy body.

He would stoop down and bear-hug my thighs, then lift me into the air, where my butt and genitals were right at eye level for him. He would stroke me front and back for a while, and with a strong French-Belgian accent he would ask, you like? Well, of course I would say, yes, Father. What else was I going to say to the next best thing to God?

Each time it happened, my mind and soul would freeze in horror. I knew it was wrong, but I was too afraid to tell anyone. I knew little about sex and wondered what the heck he was doing to me.

The same scenario was repeated three times. When it was about to happen the fourth time, I was finally able to say no to him. The only reason I said no was because Jimmy, another altar boy, had mistakenly come early to serve mass one morning. He saw the priest and I emerge from the dark lower church with my head lowered in shame.

When the priest went upstairs, the other altar boy whispered to me, I see he got you, too. If it wasn't for Jimmy speaking up, who knows how long I would have had to put up with the abuse. That boy will never know what solace he brought me over the years as I think back.

I feel validated that it was wrong what that creepy man did to me. Jimmy was the only person who knew about what happened to me until I told my mom about it 12 years later, when I turned 21. It was the mid '70s, when stories of sexual abuse by priests started coming to light in the newspaper.

My Irish mom was a dyed-in-the-wool Catholic. I poured my heart out to her with all the details and told her how it so screwed with my mind and my entire concept of God. I told her that as a teenager I had to see that priest every day in high school. I really wanted to take French class, but he was the only French teacher in the school and it literally made me feel sick to my stomach just thinking about having him as a teacher. I settled for Spanish class and really liked my teacher.

I told my mom I wanted to report that priest as a child molester. Her response was to minimize my trauma. Well, he didn't actually have sex with you. How traumatic could it have been, she said? I agreed he was wrong to do it, but that, she said, I agree he was wrong to do that but just remember, he sacrificed his entire life for the Lord. He'll only end up in prison if you report him. What good would that do? No, please don't report him. That would be the wrong thing to do.

Yeah, what I think your mom really should have added is, I'll feel embarrassed and it's all about me.

Continuing. I listened to my mother and never reported him. I regret that decision to this day. How many kids would have escaped the hands of a molester had my instincts not been invalidated by the second best person next to God, my own mother?

I did eventually call the rectory where the priest was living and reported him. It was 10 years ago. They said he had passed away in the mid '90s and that there were no other reports of molestation by him. It was [coughs], excuse me.

It was an agonizing call. I was literally shaking as I spoke. The priest on the phone offered me free counseling, and I thought to myself, it would probably be with another priest, so I declined. But soon I will be in counseling. I've been talking about writing this story for 20 years and sharing it in some way for others that might also be in pain. Thank you for this opportunity. My head is spinning with thoughts of hope and recovery.

One last note, upon my mother's death, it was revealed that over the years she was repeatedly molested by a relative who was a doctor when she was growing up and her mother would do nothing either. Go figure. And I want to apologize for judging your mother. That's just sometimes my, my anger comes up when parents don't stick up for their kids.

Any positive experiences with the abusers? No positive feelings towards the abuser, only negative. Darkest thoughts. My abuser should have gone to jail. Sexual fantasies. I really have no sexual fantasies. I've had a normal and healthy sex life with no complaints in spite of the past.

What, if anything, do you wish for? I wish that I had never gone to Catholic school. Maybe then I never would have been molested. Have you shared these things with others? I was embarrassed to share all the details with my family or friends.

How do you feel after writing these things down? I feel relieved to have written it down and have just shared my story with my family members.

I want to give you a high-five, because that is some hard, hard shit to go back and relive. And a high-five for getting into counseling and giving yourself that love and that compassion that that little boy never got.

This is an Awfulsome Moment filled out by Dying for Doughnuts, and she writes, a couple months ago I had an awful mental breakdown. I stopped showering, slept all day, watched TV all night. I stopped talking to my husband for a week. My mind was in a very dark place.

The only thing that made me smile was watching Twin Peaks on Netflix. If you haven't watched that show, the characters have a thing for doughnuts, so I decided I also had to have a doughnut to feel some sense of normalcy. I dragged myself to go grocery shopping with my husband and spent much of the trip drooling over the giant pastry selection.

After a while, I carefully selected a simple glazed one and we made our way home. I'd been planning on taking my doughnut and crawling back into bed in a locked, dark room to watch more of my beloved show. I looked everywhere for that damn doughnut for 10 minutes, until I realized the cashier misplaced it.

I turned from a zombie to the Hulk. I started crying and then screaming to my husband about how all I wanted was a fucking doughnut, and it was taken from me, how that was the story of my life. I could never get what I wanted, no matter how small, because the universe hated me and I was a piece of shit that didn't deserve joy.

I tore through our place like a tornado, decided I was done living like this and ran to grab my husband's gun, only to see he had disassembled it. Of fucking course, I thought. I can't even kill myself if I wanted to.

He came to check on me and then asked, in a truly confused tone, did you really just try to shoot yourself over a doughnut? I felt foolish when he put it that way and slowly snapped out of it. I'm ashamed I put him through that. It took a while, but we're okay again. We started therapy recently.

But this was one of those moments where having bad luck kind of paid off. I'm finally getting the help I need. I realized I don't want to die, and reconnected with my husband when I thought I was losing him. P.S. I did eventually get my doughnuts. I hesitate to say worth it, but they were pretty damn good.

Thank you for that [chuckles]. That was fucking beautiful, beautiful and horrible and awfulsome.

And then finally, this is an e-mail that I got from a mother who calls herself C. And she writes, after wracking my brain for three sleepless nights on how to convey to a 10-year-old boy the fact that everyone has struggles and that everyone is fucked up in some way but that we are capable of working on those struggles and moving forward in our lives, that he is not alone, I finally came up with what I believe to be the perfect analogy.

Everyone in this world is walking around with a big, nasty, festering scab on their leg. It hurts and it's gross, and we don't even want to look at it most days. My scab is made up of a bunch of different things, my complicated relationship with my mom, my anxiety, my struggles with depression, etc.

If I ignore that nasty, infected scab, it's only going to get worse and worse until it gets infected and starts growing and affecting other parts of my body. It is my job to figure out the appropriate medicine to put on that scab and to look at it closely and clean it and keep it dry and help it to heal. Everyone has one.

If I let someone else's nasty scab rub up against my scab, it's going to be a real nasty situation. They need to treat their scab and I need to treat mine. It doesn't mean we can't talk about them with one another, but it's important to make sure the germs in my scab doesn't get into theirs and vice versa.

As his mom, it's my job to teach him how to look at that scab, clean it, put some Neosporin on it and keep moving, every day making sure that it's getting a little bit better. When that scab heals, it's going to leave a scar that can be seen forever. It'll always be there, even once it's healed, but you can look at that scar and remember how badly the scab hurt when it was raw and infected and how much time and care you put into helping it heal, molding you into who you are now.

The other day I asked him how he was feeling and if there was anything he wanted to talk about. He started off our 45-minute conversation with, well, I started looking at my scab and I realized, dot, dot, dot.

That is so cool. That is so cool. Man, giving your kid tools to cope emotionally and normalizing their feelings is, I don't know why we don't talk about that more. I don't know why there isn't more education about it. I suppose because we're in the dark ages of, we're moving forward, but we've got a long way to go.

But anyway, if you're out there and you're afraid to get help, don't be. Don't be. Don't be. Even if your first experience isn't so good, even if your first, second and third experience isn't so good, keep doing it, because you will find people that can help you, people who will change your life, people who will reconfirm that there is goodness in the world and that we can get better. I know it because I've experienced it, and it's worth it. It's so worth it. And no matter what you're feeling--

[Closing music swells]

--you're not alone. You're not alone. And thanks for listening.

[Closing music]

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