Mark Vonnegut, son of Kurt Vonnegut, Jr., first wrote about his struggle with mental illness in The Eden Express. His newest book has an updated focus, written from a seasoned perspective, with doses of humor which make the book very engaging. To get a fuller perspective about how the newer volume fits into Mark's life, I'd strongly suggest reading The Eden Express first. No, it isn't necessary, but does add perspective and a historical comparison between views about mental health in the 70s and now. It also makes it easier to grasp Vonnegut's changed views of mental health diagnosis and treatment.
By Mark Vonnegut's own admission, "craziness" ran in his family and manic depression affected at least four generations of the Vonneguts - and maybe even more. Alcoholism also seemed to be a common theme, with his great-grandfather drinking when he needed to escape from the voices he heard in his head. His maternal grandmother went through periods of psychiatric hospitalization.
When he wrote The Eden Express, Mark believed he had schizophrenia and was even formally diagnosed as schizophrenic. But he later decided that he actually had a form of bipolar illness, characterized by periods of mania as well as depression. Perhaps that is the prime reason his new book has more of an emphasis on bipolar illness. Vonnegut now questions the vitamin therapy which he credited in The Eden Express for much of his recovery. He has revisited that treatment option, noting it didn't work for many others.
Having read The Eden Express, I was eager to find out what had happened to Mark Vonnegut in the years since its publication. As it turns out, he'd not only gone to Harvard Medical School but became a practicing physician, all described in detail in his latest work. He also had to deal with the loss of his famous father and other blows. He eventually had a relapse (his fourth), complete with hallucinations, hearing voices and delusions that led to potentially lethal acts.
For those who are familiar with some of the biographical information about the Vonnegut family, it is relevant to keep in mind how the family history of depression may have made Mark particularly vulnerable. Mark's father (Kurt Vonnegut,Jr) had spells of depression so severe that he couldn't write for long periods of time. Mark's grandmother (Kurt's mother) committed suicide. So there is a case to be made that a tendency towards depression, bipolar illness, and alcoholism was inherited and may have played no small part in Mark Vonnegut's psychotic breaks.
Adding to the complexities, Vonnegut came of age in the 70s, a time when there was some support for the belief that there was no such thing as "mental illness" and that it was society which was "crazy" or out of whack. This was the time period and social construct when The Eden Express was written - but not the same time frame for his newest book. Finally, like so many in the late 60s and early to mid 70s, Mark took drugs and this complicated things even further. He joined a commune and was seen as a mystical figure, helping to obscure his increasingly disjointed thinking and delusions.
When Just Like Someone Without Mental Illness..etc...was written, drugs were still a factor but consisted primarily of Xanax and alcohol (never a good combination, potentially fatal). After Mark recovered from his first breakdown, the one chronicled in The Eden Express, and became a physician he also became a fairly heavy drinker, although he was careful not to drink at work. He'd sometimes add a bit of Xanax to the mix. Then he stopped drinking, quit the Xanax and everything went haywire again. He started to hear voices, something which hadn't happened to him in 14 years. Then he spiraled downward, began listening to the voices and ended up leaping through a glass window as an act of faith. In short order, he was back in a mental hospital and put on a daily dose of Xanax which seemed to be the bright spot in his day. At one point, he was also put on Haldol. All of this is chronicled very well by Vonnegut.
Maybe all this seems too grim for the average reader. But this isn't just a memoir about very bad periods in Vonnegut's life but also serves as an inspiring and truthful look at getting on with life, in spite of the possibility of regression. It took some bumpy years for Vonnegut to find some sort of equilibrium. After taking a close look at his past, Vonnegut began going to AA meetings and worked hard on his marriage. Although he was out of the psychiatric unit of a hospital, he still had to face a wealth of continuing problems - that turbulent marriage, a dying mother, uncertain funds, and more. And yet he persevered and became a practicing physician again. His success came in bits and pieces and this book chronicles his journey, from the lowest moments to the decisions he made to find some normalcy again.
Whether potential readers of Vonnegut's book have experienced mental illness or known someone who has, this memoir is worth reading. I hope it dispels some of the stigma about bipolar illness and other forms of mental illness. It is a courageous and open account. Vonnegut's memoir also lends credence to the fact that mental illness is a condition which can affect anyone, including those who are highly creative and famous as well as the poor and homeless. Vonnegut is proof that even a respected physician, someone named a leading physician by Boston Magazine, could be seriously impacted by bipolar illness. Vonnegut also doesn't take the stance that there is such a thing as complete mental wellness.
But he does find a way to schedule his life in hopes of staying well enough to be happy, function in the world and (hopefully) avoid any recurrence of severe episodes. He attends AA meetings and adds creative activities, including remodeling homes, to his life. All of this seems to help. I found the tone of the book to be best described as one of cautious optimism, of learning to be "comfortable with being uncomfortable" (as Vonnegut puts it). In his own way, he seems to have come to terms with his family's history of psychiatric problems and found his unique methods for maintaining some balance.
Perhaps Vonnegut expresses it best when he writes: "None of us are entirely well, and none of us are irrevocably sick. At my best I have islands of being sick entirely. At my worst I had islands of being well. Except for a reluctance to give up on myself there isn't anything I can claim credit for that helped me recover from my breaks. Even that doesn't count. You either have or don't have a reluctance to give up on yourself. It helps a lot if others don't give up on you."