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Thank you Cary for printing this letter and for your well reasoned response. I found your quoting of Terkelsen's 10 phases of coping with mental illness to have been especially valuable. Looking back at how my own mother's mental illness unfolded over the last 25+ years, it was downright eerie to see how closely it parallels the Terkelsen model.
As for the LW, "Hoping Against Hope", thank YOU for your story... your pen name describes my attitude for many years. Hoping that someone, somewhere, would find a way to help my mother out of her long dark journey into psychosis. And while many advancements have been made over the last 25 years they're all a bit too late to make much difference for my mother, who was like yours in that she didn't much care to take anything in the first place. (The fights between her and my father over her meds were epic and terrifying. My siblings and I lived in fear that the cops, when they arrived, would suspect our father was an abusive spouse and would haul him off to jail leaving us alone with Mom.)
All I can say is that gradually, over time, I came to accept that my mother was not going to get better. I can't pinpoint a particular moment... maybe it was a book I read, or another advice column like this one, or maybe even that statistics course in college that finally let me understand what the doctors were REALLY talking about when they said "long odds of recovery".
But if that moment never arrives for you like it did for me, and you find yourself still hoping against hope 10, 20 years from now, always remember that you are not living your mother's life (genetic similarities notwithstanding) but your own. I'm not a very spiritual person anymore but what little I have left is summed up nicely by the Serenity Prayer - accepting the things you cannot change and changing the things you can. Mental illness is one of those things you cannot change - so accept it and try to find your serenity any way you can... and when you do take every day's worth of it that's out there as a blessing from the deity of your choice.
One last thing: Don't let the haters (like "Ben Dover" or "you're welcome" here in the Letters, just for starters) get you down. We're stuck with living in a time where we're simultaneously learning to treat mental illness and trying to liberate ourselves from our old medieval superstitious attitudes about it. It's going to take a couple more generations for those troglodytes among us to "weed themselves out" the old fashioned way so in the meantime don't give them the satisfaction of seeing you get angry!
Here's hoping things get better for you -
Adam in Philly