health

Mark and Giulia fell in love young and married in their 20s. Then Giulia suffered a psychotic break.

Content warning: This post deals with issues surrounding suicide, and may be triggering for some readers.

Mark and Giulia fell for each other in their teens, married in their 20’s, and didn’t realize what their love would demand of them until Giulia suffered a terrifying and unexpected psychotic break at the age of twenty-seven. Mark, struggling to support Giulia, was torn between the demands of keeping her safe and following doctor’s orders…

The first time Giulia’s doctor said the word ‘schizophrenia’, I thought I must have misheard him.

His assessment felt like a death sentence. Schizophrenia meant the psychosis would come back to haunt her for the rest of her life. She would never again be able to trust her own mind. She’d probably never be able to return to her high-powered job or our dream of having three kids.

Even though this initial diagnosis was eventually changed to bipolar, in that instant I lost my wife and gained a lifelong patient. I put my head down and sobbed.

After the meeting, I went to San Francisco’s four-mile stretch of beach. A friend told me that I had to do as they tell you on an aeroplane: put on my oxygen mask and take care of myself before I could put on Giulia’s.

The first three days of her hospitalisation I barely slept or ate and when I did it was to binge on junk food. I tried to tell myself that I had to be rested and clear to be her protector. If I didn’t put on my mask first I would pass out and then I’d be no good to anybody.

The waves looked fun enough so I went home and got my wetsuit and board. I threw myself into the ocean, grappling with the implications of Giulia’s psychosis. I paddled out past the breaking waves into what felt like the open ocean. I faced its enormity and dived in. I couldn’t control what happened, or how long it would take her to get better, but I didn’t feel afraid. I felt relief.

Photos courtesy of Mark Lukach.
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I heard a soft pull of air and glanced to my right to see two dolphins swimming together. They swam right under me and then popped up again on my left side. I watched them swim away and thought of how vast and terrifying the ocean is and I resolved that if they could stay together, then so could we.

‘Honey, you’re coming home!’ I beamed as I saw her.

‘Mark,’ she whispered, as she leaned in close, looking wildly over her shoulder to see if anyone might be listening. ‘This is a big mistake. I am the devil and need to be locked away.’

My buoyant optimism skipped a beat. The doctor had been so convincing last night on the phone that Giulia was more stable, yet here she was, still psychotic and coming home with only me to take care of her. What was I getting into?

I brushed off her hesitations and said, ‘You’re doing great, Giulia.’ We packed up the last of her things. After only a few moments together she had returned to a sense of stability and talked about how she couldn’t wait to see our bulldog Goose and take him to the beach.

With the paperwork signed and a bag full of medication, a nurse led us to the glass doorway that had divided my world from Giulia’s for the past 23 days. I held on to her hand as we walked out into the waiting room. She was weak from the weeks of inactivity and lack of sleep.

At first, she was cautious of everything, desperate to feel comfortable and settled at home but trapped in uncertainty.

Photos courtesy of Mark Lukach.
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Like a bad fever, the psychosis came and went at whim and Giulia slipped in and out of it several times a day. Sometimes the psychosis had her fixated on religion, sometimes it was intense paranoia, or it might be delusions. Her body language was the sign of its return with the rocking side to side, the puckering lips.

For me, the transition from being with her 90 minutes a day at the hospital to all day, every day, was abrupt and demanding. I rarely left her side. The first time I did, to step into the bathroom on the first afternoon she was home, she walked out of the front door and was halfway down the road by the time I got to her.

The medication knocked her out early, by 7pm. Her sleep was motionless and dreamless, the collapse of a hurting mind that wanted to be rid of itself. When she finally woke, 12, 13 or sometimes 15 hours later, she had barely moved.

After she fell asleep my nights were filled with a thick loneliness. I spent all day with her, our lives stripped back to the barest essence of survival, but at night, the rest of the world crashed back. I paid bills, emailed our parents; I sat uneasily with guilt over leaving my work as a teacher, my worries about where her illness was going to take us, my frustrations with no companionship, no sex, no job, no life. I couldn’t go anywhere or have anyone over.

After about a month I couldn’t handle these nights any more so I started running. I tiptoed down the street barefoot, crossed the dunes and ran from one end of Ocean Beach to the other and back again, music blaring in my headphones. I begged and pleaded as I ran: please get us through this mess.

Giulia’s psychosis faded gradually. The first time I left her alone and awake was almost two months after her discharge from hospital. Two months of always keeping her in sight. But at some point we needed to let the space return into our relationship, to detach each other from our intense co-dependency.

Photos courtesy of Mark Lukach.
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That morning we had a lovely bike ride and Giulia was drained when we got home. She needed a nap, so when my friend Austin texted me about going surfing I figured I would give it a shot. She had been in good spirits and it had been a pretty good week. I’d have to leave her alone at some point, so today was the day.

When I returned home Giulia was sitting at the dining room table. ‘Don’t worry about my medicines tonight, I already took them,’ she said.

At first I was more confused than panicked. ‘What do you mean? You don’t even know where the pills are.’ I was still changing the hiding spot every few days so that she wouldn’t find them.

‘I found them,’ she said quietly. ‘I took more than I need, I put a big fistful of them in my mouth.’
I gasped. ‘Did you swallow any of them?’

‘No, I spat them out into the bin.’ Giulia appeared calm and matter-of-fact.

I raced into the kitchen and there they were, as promised, about 20 pills, dissolving at the bottom of the rubbish bin.

‘Don’t worry, Mark, I didn’t swallow any. Not the first time, or the second time.’

‘The second time?’ I felt I couldn’t breathe.

‘Don’t worry, I spat those out into the bathroom bin.’

Once again she was telling the truth. I went to the bedroom and started to pack a bag for her, not thinking, just acting.

Giulia appeared in the doorway, glaring and accusatory.

‘Please don’t, Mark, I can’t go back to the hospital. I didn’t take any pills. I spat them all out.’

‘But you tried to overdose Giulia. Twice! I wasn’t here to stop you. I left you and you found the pills and almost took them.’

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I asked her over and over again to tell me the truth, to promise me that she hadn’t swallowed any of the pills and she never wavered in her response. I finally relented and put away her clothes. I nervously checked her heart rate every 20 minutes or so, both of us hating the other for having to do this.

Her medications took weeks to reach full effect. I felt like she was the subject of a science experiment. This drug didn’t work? Let’s increase it or decrease it, or replace it, or add something else to supplement it. Sorry you’re suffering through depression, psychosis and miserable side effects while waiting to see if it works.

But I refused to lose hope. Gradually, Giulia became more spontaneous in conversation. It had been two months since she had exhibited any sign of psychosis. Progress. Finally.

‘Mark, if I kill myself, will you promise me that you will find a new wife so that you can still be happy?’

I sighed but I didn’t have an answer for her. I was tired from worry, tired from spending so much time trying to convince Giulia that it was worth staying alive. I couldn’t handle another conversation about suicide. There had been so many over the eight months since she had been hospitalised.

Slowly, Giulia began to say more. ‘I can’t ever come back from what I went through in the hospital,’ she said nervously, a mantra I had heard and rebutted hundreds of times. But this time I didn’t say anything. I merely listened.

Photos courtesy of Mark Lukach.

In the gaps between her sentences I realised how I rarely let her speak about how she was feeling. I treated her depression like a fire I had to extinguish. I had to act quickly every time the feelings surfaced, to stop them from growing into a destructive inferno. My instinct was to love her psychosis and depression away, to talk her out of her suicidal tendencies. Finally, exhaustion shut me up.

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‘I hate myself and want to die.’

I said nothing; her despair hung heavily in the room.

‘I wish I had never been born.’

More silence. And then she left me stunned.

‘Thank you for listening to me,’ she said, grabbing my hands, pulling them up to her lips to kiss. ‘It’s so nice to talk to you.'

I realised then why people call suicide hotlines. The person on the other end of the line is there to listen without judgment or fear.

Then she surprised me further by leaning in to kiss my lips, our first kiss since she had left the hospital.

‘Thank you Mark, I feel a lot better. Let’s make some dinner.’

If you or anyone you know is struggling please call Lifeline Australia on 13 11 14.

This is an edited extract from My Lovely Wife: A Memoir of Madness and Hope by Mark Lukach, Bluebird, RRP $32.99. Available now in all good bookstores and online.