Author’s note: This story was originally published in Ami Magazine. It has been edited from its original form. It was originally published under a pseudonym.

My story isn’t easy. It’s an uncomfortable subject for many people, for many reasons. I hope that in sharing it I can help not only myself, but others going through a similar situation.

Mental illness has always been a touchy subject. Society as a whole has done a decent job of addressing it, but as Orthodox Jews, we’re taking our time. We fear the stigma, the implications for shidduchim (Jewish matchmaking prospects) and reputation. While I’ll admit that mental illness is something to take into account when considering a prospective spouse, it must be understood that the culture built around the fear of mental illness and the stigma not only hurts countless people, but magnifies the problem. The damage stigma causes to people who suffer from mental illness, and the culture of denial and concealment, perpetuate the problem by ensuring that the people who need it will be too scared to seek treatment. My and my family’s suffering may have been avoided had this stigma not existed.

My birth was not a highlight in my family’s history. My mother was on the back end of an awful marriage, which ended shortly after I was born. That’s when her bipolar disorder decided to manifest. Various mental illnesses can lie dormant for years until some kind of inciting trigger sets it off. Bipolar is one of them. You’re born with a genetic predisposition toward the disorder, not unlike the genetic predispositions toward heart disease or cancer, but it generally takes some environmental force to trigger it. In my mother it was triggered by her divorce, and she suffered a breakdown. She was hospitalized for two months in the psych ward of a local hospital and placed on meds.

Psychiatric treatment is not a perfect science, and devising an effective regimen can be tricky. Often, drugs are not enough, and studies show that treatment is much more effective with accompanying psychological treatment as well as meds. Even when an effective regimen is devised, it can become less effective over time. People on meds need constant monitoring to ensure that their drug levels in their blood don’t get too high or too low, and the drugs’ effectiveness can eventually wear off. It’s difficult, which means that one of the most important factors in psychiatric treatment is how compliant and willing the patient is.

My mother wasn’t very compliant. She had grown up believing that mental illness was either a contrivance on the part of doctors (and what do they know anyway, right?) or that you were a gibbering loon who regularly converses loudly with people no one else can see as he stumbles down the street. The idea that most people have of functional people with a legitimate but manageable illness was foreign to her, her family, and her community. She would comply with the doctors and their regimen for as long as she needed to, but inevitably, she would declare herself “cured” and stop taking her meds.

This happened pretty regularly for 16 years in three year cycles. She would stop taking her meds, and for two months she would rapidly decompensate. She would become angry, snappish, moody, manic. She’d subject me to some kind of mistreatment, sometimes it was as small as just snapping at me if I spoke, sometimes it was a new starvation diet she decided was a good idea for herself which I for some reason had to adopt as well. My family would let her progress until she did something violent to someone and even then they were hesitant to have her committed. They didn’t like having to admit that there was enough of a problem. They downplayed it, pretended as if it could be managed at home, and no amount of experience ever wised them up. “What would the neighbors say.” “Shidduchim.”

So she would be committed, stay there an average of two months, during which she would go from angry, to “if I’m going to be here I’m going to run the place” to grudgingly compliant. I’d come visit her often. It wasn’t half bad, actually. The food was surprisingly good, and I was young enough to appreciate the activities they had for the patients. When she’d be released we would make her a welcome home party of sorts. I’d decorate banners to hang in the house, heralding her return. She’d mellow out, stabilize, and the good times would return. We’d go to restaurants during the week, touring different cities, and just sit around and talk on shabbos (sabbath) afternoons. Life was pretty good when she was stable. The two months of instability and subsequent two months of her being committed seemed a price worth paying for my mother.

Bipolar disorder, as the name suggests, is a cycling between highs and lows, or more accurately, mania and depression. In my mother, mania would make her a thousand times herself. She wouldn’t sleep. She would become very outgoing, energetic, very friendly with everyone but me, but with a very short temper. She became the life of everyone’s party. But she also became angrier, sarcastic, mean. After a few weeks of that she would crash. Her world would become grey, muted. She’d lie in bed all day, sleeping or watching TV, barely capable of walking to the fridge to get food.

They treated her with mood stabilizers, antipsychotics, anti-depressants, which worked great when she was depressed because they gave her some semblance of a life, but when she’d cycle back to manic (a muted sort of manic when she was on her meds, more like just high enough to function) the meds would make her feel limited, like her mind was hitting a glass ceiling teasing her with possibility but never allowing her to reach it. Kind of like that mashal (parable) people use to describe gehinnom (hell), where God is compared to the sun, and gehinnom is an eyepatch. She’d put up with it for about three years and then decide that she had enough. It would usually even out, though. She would crash hard and, albeit grudgingly, in some way acknowledge the fact that she needed treatment. She would never say those words, but she understood it.

For some reason, after years of being on Haldol, she suddenly developed a severe allergy to it. Her face swelled up and she had to go to the ER where they gave her IV antihistamines and immediately took her off the medication. Her doctor was supposed to replace it with another antipsychotic, but he never got around to it. To my mother it was like a convicted lifer getting a furlough. It wasn’t complete freedom, but enough to give her hope. Also enough to finally start functioning the way she felt she should. For two weeks she became more energetic, but not overly energetic. More alert, but not hyper-aware. Better but not crazy. Her doctor seemed impressed, and not only officially discontinued her antipsychotic, but lowered her other dosages. This kept happening, slowly over the course of about two months, until she was on such a low dose that she declared herself cured and stopped taking her medicine altogether.

That’s when she really started declining. She quickly started becoming manic. She became slightly less coherent, spouting ideas that only made sense to her. Her memories were distorted. Her difficult childhood rose to the surface, reawakening old vendettas ad grudges that she’d buried. She turned against everyone she believed wronged her. Her parents for not being there for her, her friends for not being supportive enough, her relatives for things they’d done to her as children, and I became the reminder of her failed marriage and ruined life.

One Friday night, when I was about sixteen years old, things came to a head. Because my mother was divorced and suffering with bipolar disorder, we lived by my grandparents. The household consisted of me, my mother, my grandparents, and my uncle, who was disabled and required constant care. He suffered from schizophrenia which went undiagnosed and subsequently untreated long enough for him to stab himself in the kitchen one night. Something went wrong during the surgery to repair his heart, and he spent the next fourteen months in a coma. He woke up, but since then he’s required constant care. We were an odd family, but my grandparents made it work.

Shabbos was always nice. My grandfather sitting at the head of the table, leading us through the meal, softly singing his zemiros (traditional songs sung on the Sabbath) in tunes from his childhood, telling us stories about “der alter heim (the old country).” He died when I was eleven, and my grandmother tried to take his place, but it wasn’t the same. Shabbos was never the same after he died. There was no substitute for him. Gradually shabbos became less about us eating together as a family, and more about getting the meal over with. We would all bring books to the table and do our thing as we made our way through the courses, hurrying to finish so we could each go nap, or in my case play. There wasn’t much ceremony to it, even less feeling. No more zemiros, no more stories. No more conversation.

Over the years, my mother’s approach to religion has moved toward the “I need something from God, let’s see what he’ll give me” approach. She wasn’t overtly religious, and didn’t really do anything particularly religious, unless she wanted something from God. Then she would go overboard, hoping for some immediate divine reward in return for her sudden piety. These “episodes” would usually coincide with her manic episodes. If she started to pray every day, or cover her hair, or do anything particularly religious, it was almost a harbinger of trouble to come.

That Friday night she had her hair covered and was singing shalom aleichem (traditional song welcoming the Sabbath). I came to the table with my book, feeling a little apprehensive. She saw the book and got angry. I was messing up her perfect shabbos. God wouldn’t give her what she wanted if I read at the table. She demanded that I take it away. I didn’t understand why I should. I mean, it wasn’t like this week was any different from any other; it wasn’t like we were suddenly going to be a regular family; what else was I supposed to do at the table if not read?

She lost it. She started insulting me, cursing me, telling me she wished I had been aborted, telling me that it was my fault her boyfriend wasn’t marrying her, and that if I weren’t around she would be able to be with him every night. I ran from the kitchen where we’d been sitting into the living room and barricaded the recliner against it. That didn’t stop her, though. She kept yelling and cursing at me to the air, to the walls, to my grandmother who was trying to calm her down. I couldn’t take it anymore. I kept the recliner barricaded against the door and slipped out of the house through the living room door.

I ran crying to my friend’s house, where I cried some more. They were incredible. His mother took me to a side room and asked me what happened, and then she and my friend sat with me for a few hours. She offered to have me over for the night, but I said no. I wanted to go home, see if things had calmed down. Maybe she would apologize. Maybe it would be ok when I got back.

I came back into my house through the living room door, hoping that they hadn’t figured out I had left and had left the room barricaded. I wanted to be alone. When I opened the door I saw my aunt and uncle sitting there with my mother and grandmother. They were all laughing at something my mother had just said. It was like nothing had happened that night, like she hadn’t told me that she’d have gladly traded my life for more sex, like she hadn’t told me that my existence was such a nuisance that she’d have been better off aborting me. She turned to me, the vestiges of laughter still on her lips, and said “hi.” No “I’m so sorry,” no “I will do anything you need me to do to get your forgiveness,” no “can we please talk about it?” Hi.

“YOU WANT TO FUCK HIM SO BADLY? WHY DON’T YOU GO FUCK HIM THEN?!”

Those were the last words I ever spoke to my mother. I ran to my room, crying, flopped into bed and vowed, as my tears soaked my pillows, that on my life I would never speak another word to her. It’s been five years and I’ve kept that vow.

She’s never once apologized, or even tried to. She still talks at me, but I don’t react. I still live in that house with her and my grandmother, but I haven’t so much as looked at my mother’s face, let alone spoken to her in five years.

That Friday night was the beginning of the end of my family and my connection with it. My mother continued to decompensate. She became increasingly angry, more violent. She shouted, cursed, and threatened, both me and my grandmother. I can’t count how many times I begged my grandmother to have her committed. I’d plead, beg, scream, hoping that she would come to her senses and have my mother committed, of not for my sake then for my mother’s. She needed treatment and we needed a break from her. My grandmother kept clinging to the hope that this was all part of a process which would eventually level itself out and result with my mother cured and able to function independent of medication. I’d point out all the times in the past when she and my family were wrong and ask why this time was any different. It always came down to the neighbors and shidduchim.  I tried to convince some of my family to circumvent my grandmother, have my mother committed against both of their wills. None of them wanted to cross my grandmother, and all of them shared her concern for our family’s appearance and reputation. Neighbors. Shidduchim. As if either of those have MDs.

Finally things got bad enough for shidduchim and neighbors to not matter as much. That’s when my mother played the guilt card. Over the years my mother has built up quite the arsenal of guilt trips, things she accuses my grandparents and her siblings of having done to her over the years which contributed to the shambles her life was. In between fits of violence she would play victim just long enough to make them appeal to their guilt and empathy. Whatever kept her out of the psych ward was fair game. As soon as they would acquiesce, she would go back to angry and violent. Much of that violence and anger was targeted at me.

I have a brother who was taken from her when he was an infant. My whole life I’ve been hearing about him. For years she had been going to family court, trying to win first visitation, and then full custody. Every time she seemed to get close, she’d stop taking her meds and wind up in the hospital. She never did manage to get him back. As long as she had me, though, it didn’t matter as much. At least she had one of her sons. But now I wasn’t talking to her, and she couldn’t bear to lose another son. I knew that was the worst possible thing I could do to her, which is why I stopped talking to her. She didn’t deserve children and I wanted her to be childless.

Rather than trying to repair her relationship with me, she tried controlling and beating me into submission. If she couldn’t have a son who loved her, then by God she would have one who feared her. Chosech shivto soneh b’no. Ish imo v’aviv tirau. (He who withholds the rod hates his child. A man should fear his mother and father.)Those were her mantras. I heard them often, usually right before I felt them.

Unfortunately, this left my grandmother in the middle trying to play peacekeeper. For my part I tried to make it as easy as I could for her, never instigating the fights my mother picked with me. My mother, though, occupied every waking moment of her day, and a few of her sleeping moments, too. My mother would keep her up until very late and then wake her up very early in the morning. Eventually my grandmother lost the ability to sleep altogether. She saw a psychiatrist, a friend of hers, who prescribed Zoloft, an anti-depressant, to help her mood and help her sleep. I remember the exact moment she called and told me she had decided to go on meds. I wanted my mother dead. I could handle what she was doing to me, but I hated that my grandmother was becoming collateral damage. Again I begged her to have my mother committed. Again she refused. The Zoloft would help her cope.

Two weeks later she collapsed on the kitchen floor, delirious and semi-conscious. My mother wanted to just put her in bed and let her rest. She tried stopping me from calling an ambulance. It’s a good thing I did; my grandmother, as a result of the Zoloft and poor diet, had developed a severe sodium deficiency. I rushed with her to the hospital, sitting in the passenger seat of the ambulance as she lay in the back, the EMTs trying to wake her up. We got to the hospital and my grandmother was taken to radiology to rule out stroke. I paced the ER, frantically calling my relatives, letting them know what was happening. They dropped everything and came running.

My mother came too, right as we were talking to my grandmother’s doctor. I was hoping she wouldn’t but there was nothing I could do about it. She wanted to be alone with my grandmother, and my uncle motioned me to come outside. I went with him, but stayed close; I wanted to keep an eye on my mother.

“RACHEL! NO!” My uncle dove at my mother as my mother tried to remove the central line from my grandmother’s neck. “But she wants to go home! She said so!” A passing nurse called security, and they escorted my mother out. She could have severely injured my grandmother, but my family still wouldn’t have her committed. The sodium deficiency was so bad that they admitted her to the ICU to keep her levels closely monitored. I stayed with her late into the night, and then came back the next day, but purim (holiday celebrating the Jews’ salvation from extermination at the hands of the ancient Persian king and his viceroy) was the next day and I had to prepare.

I spent that purim in the hospital with my grandmother. They had a very nice megillah (story of purim) reading for patients and family in the hospital atrium. I enjoyed the parts I didn’t sleep through. The food they had afterward was pretty good for hospital fare, but what I loved most was the effort the volunteers put into trying to make it as real and as festive a purim as was possible in a hospital, surrounded by the sick and dying. I think that night was one of the most beautiful purim experiences I’ve ever had. The singing was more real and heartfelt than anything I’d ever heard at home, and the feeling of togetherness of a roomful of people, each mired in their own personal tragedies, coming together to celebrate the salvation of our people, and the hope that must always exist even when death seems certain, brought me to tears. I went home late that night, and woke up early to get back to the hospital.

I spent as much time with my grandmother as I could, but even the most devoted seventeen year old can only stand so much hospital time. I made my excuses and left. I was supposed to be going to my yeshiva (religious school) seudah (festive meal), but I just went back to my room and sat on my computer. I just needed some alone time, some time away from the world and its problems. I had brought food with me from the hospital and ate my seudah alone while my cousins, uncles, and aunts celebrated together with my mother in the living room.

Some families get a little loose with alcohol and weird things happen by their purim seudos. Never ours, though. My family never drank. Our seudos were always tame. In sharp contrast to the sounds of a struggle and shouting I was hearing. I forced myself out of bed and out into the hallway and found my mother running through the house, in full view and earshot of all of my younger cousins, loudly accusing my disabled uncle’s home health aide of killing him. I found them grappling in my uncle’s room, my mother trying to push her to the floor. One of my uncles came running and pulled my mother away; the home health aide ran out of the house, yelling behind her that she quit. I ran after her and stopped her outside. My disabled uncle remained in the living room, watching the scene with a bemused smile on his face.

“Either she goes, or I quit. I can’t work like this anymore.” It was this, not everything my mother had done prior, not the beatings she had given me, not the way she used to physically push my grandmother around, not trying to rip out my grandmother’s central line, that final got my mother committed. Good home health aides are very hard to find, especially good ones who work a twelve hour shift. While my uncle kept my mother busy, I ran to the hospital. I still needed my grandmother’s permission before I could have my mother committed. I raced into her room and explained what was happening. It took ten minutes of convincing before I got the green light. I called my uncle at home and told him to have her committed. She was gone by the time I came home.

My grandmother came out of the hospital a shell, depressed to the point of catatonia. She’s gotten a bit better, but is still too depressed to function. My mother has turned her into a slave. I still don’t talk to my mother. My family still refuses to acknowledge their mistakes; they still refuse to do anything about my mother. I eventually learned to fight back when she beat me, and now she’s scared of me, but she keeps my grandmother under her thumb, uses her like a slave, and my family does nothing.

This article was originally meant to be published under my real name, but my grandmother adamantly forbade it. Ironically, that argument was the most lucid she had been since she came home from the hospital, and the most lucid she’s been since. Again the reasons for not printing my name with the article were neighbors and shidduchim. My cousins were becoming of marriageable age. Some people never learn.