My Lovely Wife In the Psych Ward: A Love Story

A fairy tale marriage faces dramatic challenges as a psychotic breakdown interrupts a beautiful love story

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An interview with Mark Lukach

by Kristen Noel

Listen to the audio interview

Kristen:           Once upon a time, a beautiful fairytale romance was born. It was love at first sight for Mark and Giulia Lukach who met on the campus of Georgetown University when they were only 18 years old. Madly in love, they graduated, married, secured dream jobs, and rode off into the sunset, moving across the country to live in San Francisco, one of the most desirable cities in the world. Life was full of promise and they dreamed, plotted, planned, and saved for the bright future ahead. They had it all mapped out until the ‘in sickness and in health, through good times and in bad’ part of their vows was put to the test… and put to the test and put to the test.

In 2009, when Giulia plummeted into the abyss of mental illness after a psychotic break, the map of their life rerouted and nothing would ever be the same. In his recently released memoir, My Lovely Wife in the Psych Ward, Mark Lukach, a teacher and freelance writer, depicts the side of mental illness often overlooked from the partners, the family, and the bystanders — a journey to healing in all of its guts and glory. This inspiring memoir is a brave account of what really happens when a family is ravaged by mental illness. Candid and gut wrenching at times, there is no glossing over what it really took to find their way back to each other.

I’m Kristen Noel, Editor-In-Chief of Best Self Magazine, and I’m honored to sit down today with Mark Lukach to delve further into this amazing story. It is a book I couldn’t put down. While I was rooting for their love story, I didn’t know how it would end. It made me question myself, it made me think about our capacity to love one another, and it made me revere the power of love because at the end of the day, we all want love to win. Welcome, Mark.

Mark:  Kristen, that was the most beautiful introduction, thank you. What a way to get things started. It’s great to be talking to you.

Kristen:           I want to commend both you and Giulia for sharing this story. Why share this  very personal and at times, excruciatingly painful journey?

Mark:  I think the answer to that is two-fold. The first answer is actually personal. I’m not a trained writer; I’m a high school history teacher and I never really envisioned writing a book. But after Giulia had been hospitalized a few times we had a really hard time reconnecting as a couple because our experiences of her psychosis and then depression were different. And if we tried to talk about it, it got tense and brought up a lot of tough feelings and resentment and difficult memories — even though we went to couple’s therapy and everything.

On a whim, I tried writing about it for Giulia like it was an audience of one. I thought if I can sit here and sort through my thoughts in a way where I’m not just blurting them out or not wrapped up with emotion, but rather I’m trying to take the time to groom and make them accessible for her — maybe she’ll be able to hear them and we can process and move forward together. That began the journey of writing about this so that Giulia and I could simply reconnect as a couple. And I have to say, on that front, it felt like this book has been a really big success. There’s no question that the writing and Giulia reading and us talking about it subsequently helped us to process as a couple what it all means for us.

And then for the public answer — when Giulia was hospitalized, I remember sitting in the waiting room and being on my phone and trying to Google my way to understanding what was happening. I was trying to comprehend some of the terms the doctors were using, but I found pretty much nothing that helped me understand what I was about to go through. What was the journey going to look like for me? What were some of the choices that I was going to have to face?

I don’t know if I’ve ever felt more alone than I did that day in the waiting room with Giulia locked away on one side and this gigantic unknown, and no one that I could find on the internet or anywhere that had gone through something similar. Thus the motivation for writing was that Giulia and I together could be a voice, and hopefully other families could find our book and feel less alone as they go through their own journeys.

Kristen:           That’s a beautiful reason. It’s really hard to believe that in this day and age, you would have such a hard time finding other stories.

Mark:  I know. I was shocked by it, too. Now granted, this was 2009. IPhones are only a few years old. Social media is still just catching on, but I’m a reader and a historian so I go looking for answers. I was looking for the book that could tell me what was going to happen to me. I found a lot of books about what Giulia was going through — and I read every single one of them — but I just couldn’t believe that no one was telling this story.

Subsequently, I’ve come across a few more communities and a great support group for families called the National Alliance on Mental Illness, also known as NAMI. But the logistics of actually getting to that support group turned out to be difficult for me and so I never really was able to take advantage of that.

I wrote an article back in 2015 in Pacific Standard magazine and it became the template and the basis of the book. It’s what got me a book deal in the first place. That article talked about the caregiving side of mental illness and the struggle and difficult choices I had to make, and some of the internal struggle around guilt and responsibility. That article blew up on the Internet. I think that really demonstrated to me just how many people out there are desperate to have their experience validated and feel like there’s someone else out there who’s gone through it.

I’ve had a lot of really amazing interactions with the readers and it brings me to tears when I hear from people who say, “Thank you. I’m in something similar and it’s just so nice to know that I’m not alone.”

Kristen:           This is the human story. This is the story of all that unfolds around it. It’s complicated and it’s messy and it’s painful and it’s glorious and it’s beautiful and it’s all those things. That’s not what you’re going to find on Google.

Mark:  I agree with you. The book, too, is obviously about mental illness, but I think it’s also about how every relationship is tested at some point by crisis — so how do you try to work together to get through that crisis. You’re right. You’re not going to find that answer on Wikipedia or the web.

Kristen:           Let’s go back to 2009 and paint us a picture of this love story and what happened.

Mark:  It was like a charmed fairy tale romance. As you said, we met super young. We moved out to California and felt like we were living our dreams. We were so happy and made a nice friend group. Giulia was thriving in her career. She’s always been really ambitious and successful and so it was no surprise that she was doing well in work. I was teaching high school and loving that. I remember my dad came out and visited us in the fall and we were on a walk. He put his arm around me and said, “You done good,” like, “You found a pretty good life for yourself,” and I couldn’t have agreed more.

Then when we were 27, Giulia transitioned to a new job at a new company and almost immediately, things took on a different tone. This confident, successful woman that I had known for nine years was all of a sudden really uncertain at work. She didn’t know what to do. She was getting emails and not sure how to respond to them so she’d send the draft that she was working on to me. And these were like one or two-sentence replies that Giulia was apparently working on for hours. I was wondering, “What’s going on here? You’re so good at your job. You’ve always been so good, even back when I knew you in college.” She had an almost perfect GPA and great internships over the summer, so I just couldn’t understand what was happening. To be honest, I was impatient and frustrated. “Don’t you see how great things are? What are you so worried about? Why are you so preoccupied and concerned about not doing well? You’ve always done well.”

Giulia lost her appetite and would just pick at her food rather than eat it, so of course she lost a lot of weight. She began to have trouble sleeping because she was so preoccupied with what she wasn’t doing in work and what was happening; she just couldn’t let those thoughts go at the end of the day. It would take hours to fall asleep and then, unfortunately, that transitioned to not sleeping at all.

All those combinations led to her starting to experience delusions where she was basically hearing things that weren’t real and believing things that weren’t real. And then the delusions became really dark. To give you a sense of the timeline, she started her job in mid-July and I took her to the ER over Labor Day weekend. This is only about six weeks for her to go from no previous signs of mental illness, no mental illness in her family history, and then six weeks later, I’m sitting there in the emergency room with the doctor saying, “Your wife’s having a psychotic break and we need to take her to the psych ward for inpatient treatment.”

There’s that Talking Head song lyric, “And you may ask yourself — well… How did I get here? “ I think I had that deer in the headlights look. How was it that it was all so good and suddenly 6 weeks later, I simply couldn’t understand what was happening?

Kristen:           Describe the decision to take Guilia to the emergency room, because that also opened up a whole other can of worms.

Mark:  Her father had flown in. Giulia’s from Europe and so her dad had come out because we thought this was connected to work and Giulia and her dad really connected on work. I woke up one morning and Giulia was pacing around the house and she said, “The devil’s here and he says I’m never going to get better. There’s no point in trying, so we should just give up.” I woke up my father-in-law and said, “Look, Giulia had seen a therapist once or twice, but we are in over our heads. We don’t know what to do. We can’t help. We need to take her to the doctor.” He totally agreed.

We basically ended up having to corner her. We told her we needed to go to the hospital, but she wouldn’t have any part of it. She was physically resisting and calling out and literally grabbing onto doorknobs and doorways to try to stop us. My father-in-law and I were literally carrying her to the car when I realized that he was crying, and I was crying uncontrollably.

We took her down into our garage and got in the car and drove her to the hospital and on the way there, as we were driving through Golden Gate Park, Giulia tried to open the door and jump out of the car. She opened the door and was taking off her seatbelt so I pulled over and slammed the door. We then got her into the back of the car to sit with my father-in-law. It’s the stuff out of nightmares to have to do that to someone you love and care for and suddenly don’t recognize anymore.

Kristen:           And once you bring someone to the hospital, don’t they commit them to stay for a certain period of time?

Mark:  Yes, and they tell you, “Okay, so this is an involuntary hold. It’s a minimum 72-hour hold and we’re going to basically observe and see what’s going on and offer her medication.” But Giulia was legally allowed to refuse the medication. This is the way it is in California; I don’t know how it is in other states. After the 72 hours, the doctor who had been observing Giulia made a recommendation to a judge about whether they can now legally require that she be there for longer and also if she can be forced to take medication — even if she doesn’t want to take it by choice — which is the equivalent of people pinning her down and giving her injections.

When I took Giulia to the ER, I knew she needed help, but I didn’t know what that help was going to look like. When we actually got to the psych ward, it looked right out of the movies with bars on the windows and fluorescent lighting and not a lot of fresh natural light or fresh air or anything. I remember thinking, “She’s not supposed to be here. This is a terrible place. What did I just sign us up for?”

Kristen:           And how is she going to get better here?

Mark:  Yes. So I panicked when we got there, but she was already in. We had crossed the point of no return.

One of the points of this book is to demystify the psych ward. The authentic experience of our first hospitalization was horrifying, really jarring and unsettling. But with prolonged exposure — which unfortunately we’ve had since she’s been in different hospitals three times — each time it becomes less scary. We are more accepting of it and I’m less terrified and less distrusting.

I’ve grown to put the psych ward in its proper place. It’s not like the horror film-setting so often depicted in movies. It’s a place where people actually do get better, so it’s important to at least acknowledge that.

Kristen:           At that point in 2009, Giulia was ultimately given a diagnosis, which was schizophrenia. You wrote in your book, “With one word, I had lost my wife and gained a lifelong patient.” You also said, “I was learning that psychiatry and the prescribing of medications is more art and guessing game than science because in fact, Giulia wasn’t schizophrenic.”

Mark:  Exactly. What I learned about psychiatry is that a diagnosis is like, “If you’ve got 7 of these 10 symptoms, then you might have this.” But there’s also another diagnosis that has many of those same symptoms on its list. What if you have 7 of one list but 6 of another? What does that mean?

It’s basically a lot of experimentation. I didn’t know that about this field of medicine when I was first introduced to it. If you break your arm, you know exactly what to do and you know how long it’s going to take to heal and you just move on. The irony of these medications is that the symptoms that they’re trying to address can actually get significantly worse if it’s the wrong pill. That’s why they keep them in the hospital, because they need to be able to immediately observe the impacts of these pills.

When Giulia was out of the hospital, she entered an outpatient program three days a week.

Kristen:           Which I assume helps patients assimilate back into their lives.

Mark:  That was critical to have some time rather than just jumping right from being in the hospital to trying to resume a full-time working mode. Their outpatient program was intended as a stepping stone back to normal life.

Kristen:           Also, you said that it afforded you some time to get back to your life as well and to take care of yourself. Here you were, running around frenetically, trying to manage all of this, and you have either your running shoes or your surf equipment in the back of the car so that you could drop her off and then run to the beach and try to squeeze in some self-care.

Mark:  I’ve been a very happy-go-lucky guy for my life. Until Giulia got sick, I didn’t realize how much work it takes to be happy and how much you have to make deliberate choices and schedule times to nurture yourself, because it’s just in my DNA and it had just previously come easily. But when Giulia was not doing well, those three hours that she was in that outpatient program were literally my only 9 hours in the entire week when I wasn’t the primary person responsible for Giulia, who at that point was actively suicidal.

Basically, she had been in the hospital, psychotic for 23 days. They pumped her with a lot of antipsychotic drugs. With psychosis, your thinking is going so fast; the primary purpose of the antipsychotics is to slow down your thinking, to mute the psychosis. They were effective in that regard. The psychosis faded, which is great. But on those meds, Giulia was really slow, physically and mentally. It was hard to engage in conversations. She was also in the wake of the trauma of being hospitalized.

Giulia was deeply suicidal and hopelessly depressed. It was an effort to get her out of bed in the morning. I basically felt like I had to plan our days so that she wouldn’t just sit around and think about killing herself.

Kristen:           Tell us about hiding the medicine.

Mark:  She hated the medicine prescribed, because she was gaining weight on it and it made her slow, but she also saw the medication as a way to overdose and commit suicide. I basically hid her pills throughout the house and would change up the hiding place every two days. Each night, when it was medicine time, I’d lead Giulia into our bedroom, sit her on the bed, close the door and pretend to search through the house so that she couldn’t get auditory clues of what room I was in. I’d look through every closet and look through every drawer and eventually, of course, find the pills because I knew where they were, and then take out the dose and then come back in the room and watch her as she took them, opening her mouth to make sure she took them.

You can imagine how after she got better, it was really hard for us to reconnect.

Kristen:           This became a 24-hour job for you, so you had to take a leave from work.

Mark:  I was off work for almost an entire semester and I never let her out of my sight. On Day 2, I literally stepped into the bathroom and in those 2 minutes, Giulia had left the house. She had opened the front door and was just walking away with no sense of where she was going. So I was full-on in caregiving mode.

Again, to get back to where we all started with this, three hours a day on Monday, Wednesday, Friday, I dropped her off in an outpatient program and that was my narrow window of time to take care of myself.

Kristen:           Well, thank God you had the presence of mind to do that because someone else might just crawl up on the sofa and start eating bonbons.

Mark:  The medications she took knocked her out early and deeply, so she’d be asleep by 7 or 8pm. I began running at night on the beach at 10 or 11pm. After I was certain she was down and not going to wake back up, I’d go out on these runs by myself in the dark as my way to give myself a breather.

I’m a physical person. I process my world through my physicality, so to be moving through life at this slower pace with Giulia was really hard. I needed to have those moments of release where I could just go and get it all out, whether it was in the water, surfing, or running on the beach or whatever it was.

Kristen:           My grandmother used to tell me that God never gives you more than you can handle and I certainly have questioned that notion many times. How do you feel about that? Where was God in all of this for you? Did you pray or meditate or scream? What was your spiritual grounding and foundation that got you through this and did it morph?

Mark:  That’s a great question. Giulia and I were both raised Catholic. Of the two of us, I historically have been more connected to spirituality than she has. In fact, there was a time in high school where I considered the priesthood. But I recognized that my truest vocation was actually to have a family and to be a dad. I didn’t spend too much time dwelling on that, but definitely, religion has always been big for me.

But the problem was that Giulia’s delusions were religious. They were all about purgatory and heaven and hell, and that left a bitter after taste for me around religion. I would say that during this time, my spirituality really morphed to more like a polytheistic animist kind of thing where I would feel the presence of a higher being in a lot of different places — in the ocean, in particular.

I share this moment in the book where I literally had two dolphins swim underneath me while I was sitting in the water contemplating if I had the strength to carry through with this. Here come these two dolphins that I interpreted as Giulia and me on our journey together. I thought, “All right, there’s my sign. As long as we can do this together, we can make it.”

To be honest with you, I got groovy around spirituality during this time because I definitely needed something to feel connected to.

Kristen:           I was amazed at how much family support you had given that Giulia’s parents were in Italy at the time. Both of your families just hopped on planes. They were so supportive that you had to eventually start scheduling them — you can come for this week, you can come for that week. But thank God, you had this beautiful family support around you.

Mark:  It was really fortunate to have family who were so willing and also had the resources to be able to help. My mom could just drop everything and come and live with us and my mother-in-law could do the same. But that abundance of family help did come with some anxiety for me.

It’s just how I’m wired, but I felt responsible for managing their experience of Giulia, so at times it actually felt like work. Even though my mother-in-law was cooking and cleaning and doing all the grocery shopping, I also felt like I wanted to try and see how she was doing emotionally and manage her experience of it a little bit and then the same for my mom. But it felt like there were too many cooks in the kitchen at times and I actually just needed to say no to the offers of help.

That’s actually a part of the story that I’m still learning more about. A major thing that happened through this illness is that my worldview, which had been so big, became so narrow. It was so focused on one person for so long; now it is interesting to hear stories from our families about what it was like for them. These are stories that they’ve been sitting on for years because I hadn’t really asked them that much at the time. I just made assumptions on their behalf around how they might be feeling it and made decisions based on those assumptions, without actually letting them have the fullness of their experience. I’ve been learning more about the full picture.

Kristen:           Giulia went on to have two additional psychotic episodes, so you were really living in this crisis management mode. All else had to be put on hold, and that included your own feelings and your own resentments.

You wrote, “I ran through all the amazing things that my friends had done over the last year. Our siblings all took big steps forward in their careers. It seemed that the last 11 months had been good to everyone but us.”

Mark:  Absolutely. I had to sit there and grin through it and pretend I wasn’t frustrated and feeling stuck, because the last thing I wanted to do was be a burden on Giulia. This illness she was encountering was already such a burden that I didn’t feel like I could further weigh her down with my experience. That was tough. In that year, 4 or 5 friends started companies. It seemed like they were all thriving and here I am thinking, “God, what happened? We’re just stuck. We are stuck in quicksand.”

When Giulia got better, what should’ve been a time for celebration actually became a time where I felt like I could finally let my guard down and let my real feelings come out. That was at the heart of why it was so hard for Giulia and me to relate because she was wondering, “Why are you so cranky? I’m better. Isn’t that awesome? This has been such a hard year,” and I’m like, “Yeah, it is awesome that you’re better, but it was such a hard year and I had to pretend that it wasn’t, and now I can’t pretend anymore.”

I think I was seeking validation. I was seeking acknowledgement. This feels like a selfish thing to say, but I was trying to give as much as I could and I needed to know that Giulia saw it. The way she came out of her illness, I just didn’t think she actually appreciated the real scope of what the caregiving was like for me.

Kristen:           Let’s not forget that at one time, you were getting those needs met, so when you lost Giulia to this, you lost that as well.

Mark:  Exactly.

Kristen:           Luckily, you said you had a great therapist who finally gave you validation by declaring, “Mark, you’ve been through a tsunami. Of course, you feel like shit.”

Let’s talk about how you two found each other. When you made your way to couple’s therapy, you were looking for your ‘Thank you’ and instead, Giulia’s rage was coming out. She called you the ‘medicine Nazi’.

Mark:  All of this caregiving was very well intentioned, but I had taken some missteps. Giulia felt micromanaged and suffocated at times. I’m like, “What? That’s not the thank you I was hoping for.” It felt so tragic because we had gotten through this prolonged crisis and now here we are and the marriage feels the most fragile and the most uncertain. Rationally, I couldn’t make sense of it. Looking back, it makes a lot of sense, but at the time, I was thinking, “How are we not at the best point ever?”

Kristen:           You had to catch up on feeling your feelings.

Mark:  As I said earlier, the amazing medium to bridge that gap turned out to be my writing. It was incredibly helpful for me to sort out my feelings and then for Giulia to be able to read about it. She definitely had a very limited sense of my experience before I wrote about it. I also acknowledge that I had a limited sense of what it was like for her. We were both so consumed with our own experience of things.

So that was huge; equally huge for us was going on a trip around the world. We needed to just get out of our scene and get out of our physical space to try to find our new rhythms, so we took a four-month trip around the world. We volunteered in Indonesia for a while and in Kenya, which was similar to when we were newly married and had just moved out to California. We had to depend on each other and not assume the roles of caregiver and sick person.

That was actually a great healing process for us. Our final day was in Dublin, Ireland. We walked out to this lighthouse that I had found on the map. It was this beautiful, foggy, cold day. It felt beautiful to us because that’s what our neighborhood in San Francisco was like. It just felt like home. On the walk back, Giulia started playing around with her phone and I was fuming thinking, “How is she ruining this moment?” It turns out that she was writing me a letter. It was what I needed to hear: Thank you for staying with me and helping me and even keeping me alive. It was the most beautiful and perfect end to that trip that you could ask for.

Kristen:           I was not going to let you gloss over that because that is the most beautiful blog post I have ever read. That truly was the moment of your homecoming.

You said in the book that this was never meant to be just a fun trip to get away and explore the world. This was a healing journey for the two of you.

Mark:  I have to give Giulia the credit for writing that amazing letter. And it was a healing journey because when we returned to the US, we got back on path with life. Giulia got back into work. In fact, towards the end of the trip, she was applying for jobs. She already had interviews lined up by the time we returned.

Kristen:           Because that’s what Giulia does.

Mark:  Exactly. She’s an amazing career woman and best of all, what we were able to do is re-approach the prospect of becoming parents. Giulia had gone off birth control in July of 2009 and started that job two weeks later and then was in the hospital six weeks after that. We worried initially that maybe the door to parenthood had been closed. But after this trip and getting home, we talked to our doctors and said, “Hey, we really want to be parents. Is it a good idea to go for it?” They were totally onboard. At this point, her diagnosis was major depression with psychotic features, so the hope was it was a ‘one and done’ kind of deal. The truest homecoming was thinking we were getting to go and embark on this new journey together of having a child.

To fast forward, pregnancy for Giulia was awesome! Some of the happiest times I’ve ever seen her. We were smitten and totally in love immediately with Jonas, our son. The plan was that I was going to be the stay-at-home dad, and Giulia was going to get back to work after an extended maternity leave. When he was 5-months-old, she went back to work and 3 weeks later, she had a 2nd relapse — or a 2nd psychotic episode — and was back in the hospital.

Kristen:           You said, “When I was with Jonas, I was worried about Giulia. When I was in the hospital, I worried about Jonas. I didn’t know who I was anymore, a husband or a father. The two roles pulled me in separate directions and I didn’t know how to go in both places without being torn in half.”

Mark:  I still get emotional about this part of it because, as I said earlier, I really think that my biggest calling in life is to be a father. It’s just the most instinctive, natural thing I do and I was so excited for it and wanted to be so immersed in it. I know for a 5-month-old, you want to be upbeat and cheery and use your baby voice and all this fun stuff — and then on the other hand, my spouse was back in the psych ward, psychotic and needing to be convinced to get back on her medication. And then afterwards, of course, she was once again deeply depressed.

The two roles demanded such different things of me. How can I do both when those two people I love are literally in the same room? I defaulted to Jonas’s energy.

I think it was during the second episode, and certainly during the third episode, that I stepped back from Giulia’s recovery. Like you said earlier, God only gives you what you can handle. I had to realize that I couldn’t be the captain of the ship of Giulia’s recovery like I had tried to be the first time. Instead, I needed to be a father first and foremost.

The interesting thing is that I did that out of necessity, but I actually think that was a good thing in the long run because Giulia felt less micromanaged and less suffocated.

Kristen:           You describe having to make peace with the reality that there could be relapses. You said, “I had already grieved a life’s worth of mourning for her. I wanted her to just survive her bipolar, but I knew that something some day was going to take her away, but that didn’t unhinge me anymore.”

Mark:  To be honest, I do feel like I learned to accept the finality of life through Giulia’s constant obsession with wanting to kill herself.

That’s actually one of the notes the book ends on — that it’s been two and a half years since Giulia’s latest episode and things feel like they’re going amazing. But we can’t have that naiveté that this is no longer a part of our lives. There’s still the possibility that Giulia can have another relapse, so we need to develop the tools to prioritize her health and ensure that we do the best we can to keep a relapse at bay.

Despite what we do, it still might happen. It still might be something we have to confront, so we have to figure out how can we go about that without being so scared and having our lives be so permanently disrupted by it.

Kristen:           For the family and the partners and the bystanders of someone that’s suffering with mental illness, it’s really important to put the tools in place to take care of yourself because if you don’t take care of yourself, you can’t take care of anybody else.

Mark:  I felt guilty at the beginning, but now I realize I don’t feel guilty about it anymore. I know how crucial it is and how without it, I really can’t be the best father or husband or teacher or writer if I’m not making sure that I get that time in each day to just be alone and process in the way that I need to process.

Kristen:           That’s the whole societal conversation that has to be rescripted, because we’ve got that all backwards.

Mark:  I agree with you, Kristen. There is a ton of pressure on parents to literally sacrifice themselves at the altar of martyrdom on behalf of their children. I think that’s so wrong because we have a bunch of burned out, anxiety-plagued parents who are so worried about everything. And you know what? If you just give yourself an hour and let someone else watch your kid, you’re going to be a better parent as a result, not a worse parent.

Kristen:           If you could reach back to yourself, that 2009 version of you who had no idea what lay ahead of him and probably would never have been able to handle someone saying there are going to be multiple episodes ahead of you, what advice would you give him?

Mark:  That’s a tough question. Before I answer it, I have to say Giulia and I have both definitively concluded that while we would not wish our experience on anyone, we also would not take it away from ourselves because we learned so much and grew so much as individuals and as a couple through this process.

I think what I would tell myself in retrospect is that I’d try to give myself permission to take care of myself sooner. That was a lesson that took a little bit of time to get to. I think I would have probably resented things less and been less burned out by the time Giulia eventually did get better if I was able to prioritize self-care earlier. That was 7 years ago, so it obviously took me a while to figure some of these lessons out.

I’d also say that love is the greatest force that there is. I would remind myself, “Hey, if you love someone and they love you, you guys can make it through whatever might lie ahead. Don’t lose sight of that foundation — everything’s going to be manageable together.” I think that’s something that I believed in the abstract, but if I could have heard it definitively, then that would have really taken away some of that uncertainty.

Kristen:           How old is Jonas now and how aware of Giulia’s condition is he?

Mark:  He’s five, so it’s been two and a half years since her hospitalizations. He was two and half at the last one. I’m almost certain he doesn’t remember anything from when he was five months old. I’m not so certain about the second one. We haven’t really asked that much because I don’t necessarily want to implant memories for him. I think it’s fortunate if he doesn’t remember too much of it.

That being said, we’re really open about Giulia and that she can get sick. He knows that I wrote this book. He knows it’s about our family and about how mommy can get sick sometimes and needs to take care of herself, and that we love each other and that’s what the book is really about. We plan absolutely as he grows to let him know more. But since his current understanding is that he doesn’t really remember or hasn’t had to confront this in his consciousness, we’re not going to say, “Yup, mom’s got bipolar and she gets these hallucinations and it’s pretty scary.” If we do have a fourth episode — which we’re hoping doesn’t happen — he’ll already know that mom gets sick. It’ll just be about trying to help him process what that sickness looks like.

That’s something that I think about a lot, and I hope we’ll never have to cross that bridge. I hope he’ll never actually have to see his mom have another psychotic break, but if he does, depending on how old he is, I’m certainly going to want to protect his sense of security and comfort. I would remind you of just how scary it was the first time for me. I’m not scared of it anymore, but that doesn’t mean it wouldn’t be really scary for a little kid to see it happen to his mom.

Kristen:           Do you have a sense that you’re waiting for the shoe to drop?

Mark:  Currently, no, because it’s June. When we get to September, October, November, those months tend to be a little more anxiety-producing for us, because all three of her hospitalizations have happened during these months.

Kristen:           What is the correlation between the months and the time of the year and Giulia’s breakdowns?

Mark:  Giulia works in online marketing in the fashion and retail world, so those are the months when they’re planning for the big holiday extravaganzas. Maybe that’s connected, but we’re not sure. All I know is that there’s no question about it that during those times of the year, we tend to be a little more nervous. We don’t really want to talk about it because that can make the nerves bigger and more real. We want to just give it some space.

This fall will be 3 years since her last episode. The pattern has been Fall 2009, Fall 2012 — so that’s 3 years later. Then Fall 2014 — so that’s 2 years later. Last fall we were definitely nervous because it was 2 years, and we were wondering if that is her pattern. If we get through this fall, which we’re super hopeful about, then I think we might put our guard down a little more than it already is because we’ll feel like we’ve broken the pattern.

But again, we can’t take it for granted. This could come in May, for all we know, 15 years from now. So now in the fall we are a little bit gentler with each other because we know we’ve both got this in the back of our mind, but don’t want to talk about it because if we do talk about it, we get each other worked up.

Kristen:           So maybe you just ramp up the self-care with a double dose of love during the fall.

Mark:  Giulia is more pro-active; she usually takes more of her lithium during that time of year. She increases her dosage and then tapers back off once we get through the holidays. We are both more in tune to taking care of ourselves and realize that having more self-awareness is super important.

Kristen:           There’s a lot of controversy these days about pharmacology and the use of antidepressants and antipsychotics, and how big pharma turns patients into lifetime customers, and how the medical practice often uses a ‘one size fits all’ approach. I would feel remiss if I didn’t ask you if you’ve ever considered alternatives to Giulia’s treatments?

Mark:  That’s a great question. At first, I was 100% taking the marching orders from the doctors, no questions asked. I’d do my research, but then give the medicine as prescribed. Since then, my feelings about the medications have evolved. Now I think that the anti-psychotics are important for her when she’s psychotic, but I think when she’s out of the psychosis, the muting effect that they have on her can actually make her feel more depressed. In fact, I feel like sometimes what looks like depression might actually just be the side effect of anti-psychotics.

What I’ve really grown to appreciate is that I can’t speak for everybody. I can only say that each person has to find their own relationship to these types of medications. For Giulia, she’s found a pill that works for her and it helps her stay stable. That means she can be thriving in her career the way she is, she can be a present mom and a present wife, and all those really wonderful things. But it’s not just about medication. She needs to also put that in the context of therapy and self-care. I’ll make sure she gets to bed, stays active, and eats healthily. For her, it’s really that the medicine is a piece of the puzzle, but it’s certainly not the only puzzle.

I think there are many people who have found pathways where the medicine is not part of the puzzle. Just the fact that she’s had these relapses makes us more accepting that she’s probably going to take these pills for the rest of her life. Even though we both would prefer in an ideal world that she not, but the bummer of taking pills is much more manageable than the huge concerns around relapses and having another psychotic episode.

I get tons of emails from readers who recommend alternative methods. I always research them and look into them, but because we feel we found the path that is working for us right now, I’m not that keen to go experimenting — because if it doesn’t go well, it could bring on another episode and we certainly want to avoid that if we can.

Kristen:           Well Mark, thank you for sharing your story with Best Self Magazine. Despite it all and because of it all, yours is truly a love story, a journey of traveling to the depths of fear and darkness, yet holding steadfastly.

One thing it really made me think about was that in a world of quick fixes, where things are often disposable and marriages regularly disintegrate, the story of your journey and holding on to each other, is really a testament to what is possible when we don’t give up, when we don’t let go of our love and of our best selves. We are certainly rooting for your love story.

Mark:  Oh Kristen, thank you so much. I cannot tell you how much this means to hear these beautiful and validating words. Thank you for wanting to share our story with your readers and your interest in the book.

Kristen:           My Lovely Wife in the Psych Ward is a fabulous book about a beautiful human love story. It’s my belief that we hear most through the sharing of authentic story and that is what you have done. I thank you, but I also thank Giulia for giving her permission to open this journey of her life and her healing. I really wish you all the best.

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