'I thought my mind would never be mine again': Author explores mental illness in new memoir
Irish playwright and author Arnold Thomas Fanning's new book Mind on Fire: A Memoir of Madness and Recovery recounts in harrowing detail the decade he spent grappling with depression, bipolar disorder and mania.
Fanning was shortlisted for the Irish Book Awards Newcomer of the Year in 2018 and the Wellcome Book Prize in 2019.
Fanning spoke with White Coat, Black Art host Dr. Brian Goldman at the dotMD conference in Galway, Ireland, about the book and what it can teach health-care professionals about treating people with mental illness.
The book begins with a first-person, real-time description of one of his manic episodes, which found him charging through Heathrow airport. Dr. Goldman began by asking him about that night.
One moment you are trying to board a plane bound for Israel to join the Israeli Defense Force. The next moment you're a detective trying to crack a case. You enter a restaurant demanding and expecting to be served a meal for free. Was that a typical episode of mania or the worst?
That was the worst. That was the kind of rock bottom. Fortunately for me it was also the point of a helping intervention and the beginning of recovery. I am quite aware having researched a lot about bipolar in the years since living it, but [at the time] you're not aware and you don't comprehend why other people don't comprehend your world.
I felt for example I could fly, and it was more than a sensation. It was an actual event that took place. I would stand at one side of the street and fly to the other side of the street. Now that is clearly empirically provable as not having happened, but I can tell you, I flew — I was Superman.
You actually talk about patient-centred care in the book. Part of that is incorporating the patient's story into what we do so that we [health-care workers] have more of an appreciation. It's better for us to know what impact it has on patients.
Another origin of the book is that there's a very, very good psychiatrist in the last outpatient service I was going to several years ago. She was the one who listened to me, and got my medication so I could write again.
She [was] very aware I was a writer and she said: "... We're looking for a writer to volunteer to teach creative writing to other patients experiencing mental distress." A peer-to-peer group, you know? And [she asked], "Would you do it?"
I went into that group, and I said we're not patients here, we're writers. The basis of that pilot project was that they wanted the psychiatric service-users to get more coherent at telling their own stories to the doctors ... and to learn storytelling techniques — and creative writing would help that. And that got me into life-writing for the first time. This was 2016 and that's how I wrote the essay which the book grew from.
Why would you be ashamed of a diagnosis that's not your fault?
[Editor's note: Fanning was diagnosed with depression as a teenager after his mother died. After going on antidepressants in his 20s, he experienced his first episode of mania. He believed the mania was brought on by the medication, not bipolar disorder, because he was ashamed of having the condition.]
Well, this was in 1998 and in Ireland at least, people weren't talking about mental illness. I subsequently discovered for example my father, when he heard I was bipolar, he thought it was a death sentence. People accept and can talk about depression and can talk about anxiety, but when it comes to saying I have schizophrenia, I have bipolar disorder, I have borderline personality disorder … people become uncomfortable. You wouldn't tell your employer, your insurer, your mortgage lender those things.
I believe that stigma is still there. In 1998 it was really there. I thought bipolar was the end of my life. I was terrified of what it would mean. ... No one wants to lose their mind, you know.... I thought my mind would never be mine again. I thought I'd never write again, never have relationships, again never hold down a job again.
One of the arcs of the book is that eventually, in the end you accept, "Yeah. I have bipolar."
I had an intervention by some very, very good, kindly doctors in the National Health System in England and they got me to hear the diagnosis, and I listened for once. Of course, a huge number of factors tie into that, like taking the medications that they gave me, going to the therapies they did. They did art therapy and cookery therapy.
There was a very strange moment where I discovered a leaflet walking around the hospital and it was the information leaflet about bipolar and I read all the symptoms and thought: "That's me."
Do you think that people who work in the health-care system reach for the prescription pad a little too quickly when it comes to people who have mental health complaints?
Well, that first experience I had where I asked explicitly for therapy and was given medication, I think was really detrimental. If the person had spent more time listening to me, and recognized the patterns — that I had these ups and downs I described in my 20s, and explored it more deeply, maybe they would have figured it out a bit quicker.
I do believe in the power of medication, but not alone. So I need therapy, exercise, sleep, self-care … but I also really depend on the medication. And I think when someone's in a lot of stress, on the verge of death, I think they need intervention. I do think medication is appropriate … so it depends on the individual.
Do you have a message for health-care professionals as to what people like me should learn from this book from your experience?
What I really needed immediately when I presented as distressed and depressed all those years ago, was someone just to take some time with me. I feel it's taken, you know, 20 years for my story to be told. If that [doctor] I talked to just listened back then, I could have received better help. And it took six years to receive any help, really.
You know, just listening — the power of listening, and that takes more than empathy — it takes a bit of time, and we're also damn rushed these days, not giving time to things.
This interview has been edited for length and clarity.
The music heard at the end of the program is by Irish singer Anna Mieke. The song Keep it Whole is on her 2019 album Idle Mind.