While You Were Out: An Intimate Family Portrait of Mental Illness in an Era of Silence

by Meg Kissinger

Growing up with so many unexplained and unexplored traumas

I’d learned how to block out what I didn’t want to think or hear or see. When you put on blinders, it becomes easy to create your own reality, to blur fact with fiction. You sharpen the focus to only a few pixels so that you can’t see the whole picture. You start to wonder if something really happened or if you were making it up. After a while, I couldn’t trust myself to know the difference.

Trauma does that to you. It steals your memory.

People are always assuming that having a mental illness makes someone dangerous, though that is rarely true.

Life and death and the urgent need to keep each other safe. We help protect one another because we are family, and that’s what good families do.

why it is so difficult to determine whether a person with severe mental illness is an imminent danger and how can you get them help before something tragic happens.

Despite the way they are often portrayed in popular culture, people with severe mental illness are rarely dangerous.

some people who are too sick to realize that they are ill can be a danger to themselves or others and need someplace safe to stay until they are better. As uncomfortable as it is to acknowledge that, it’s equally irresponsible to ignore.

when should a person’s right to autonomy yield to their safety or the safety of others? These are not easy questions to answer, if there are any answers at all.

pouring most of its resources into emergency psychiatric care with little regard for preventive care or long-term treatment, the equivalent of putting a Band-Aid on a broken leg when the real problem is bone cancer.

Police are not mental health care providers, nor do they want to be. Some underestimate the danger; others are too quick to reach for the handcuffs and taser guns.

Without adequate treatment options in the community, patients cycle in and out of the emergency room at alarming rates.

Only love and understanding.

Comfort the afflicted. Afflict the comfortable!

Only love and understanding can conquer this disease.

Find a way to make people care. Get to know the subjects of your stories, beyond the labels of their particular illness. Spend time with them. Sit down, shut up, and let them talk. Find out what they like to eat, what frightens them, what makes them laugh, what they wanted to do with their lives before their illness grabbed them by the throat. Go where the people are.

Knowing the warning signs for suicide and how to talk to those who are considering it will save lives.

If we’d been taught about the warning signs of mental illness or even just the language to talk about it, we would have been better equipped to care for one another, or at the very least, to offer comfort.

We break down the sequence of events leading up to them and look for cracks in the system, inflection points where one decision could have averted the tragedies. We try to identify the flaws in the system, hoping that they will be corrected so something so terrible won’t happen again. This is what I wanted to do with my family’s story, go back over the events of the days that Nancy and Danny died—and the months and years leading up to them—to see if there was anything more we could have done to change the outcome.

I wanted to show as unflinchingly as possible what the long-term consequences are when you are shamed into silence. Not to browbeat but to bear witness.

Had we done enough to help each other? Do you ever worry that we might be doomed by our genetics? What trauma or mental illnesses might we have passed along to the next generation?

it’s never too late to reckon with your past. But, brace yourself: it is going to be painful.

make sense of what happened and put it into perspective. We worked to understand what has changed and what has not.

you can’t fast-forward through grief or read a CliffsNotes version of your life and expect to make peace with it. As I revisited old memories, I allowed my new feelings to surface and hang around long enough to acknowledge and try to reconcile. Almost immediately, I could see that so much of my family narrative as I had understood it was either woefully incomplete or just flat-out wrong.

People are at the highest risk of suicide just after they have made an attempt.

The power of shame can get between even the closest of sisters.

how vulnerable we each had been and how important it is to wrestle with your past so you can learn to let go.

a study that found that nearly half of all people who survived a suicide attempt made their decision within the previous ten minutes, and most were glad that their attempt had failed.

They never had the chance to get old. When someone dies suddenly, especially if it’s by suicide, you don’t get to grieve them in the same way that you do for someone who’s lived a full life or battled a long illness. You might strain to recall an amusing anecdote or two, but to assuage the guilt or dull the shock, you constantly remind yourself how sick they were and that they are much better off now that they are dead. That

You can’t find peace without properly grieving,

clung to whatever earthly possessions might keep us linked,

Why do some people recover but others don’t?

We are very protective of this next generation and, knowing our family history, we have good reason to be. We aren’t silent any longer, sharing tips and resources.

trauma passed down from one generation to the next and environmental factors like stress and drug and alcohol abuse can trigger symptoms.

When family gets involved in the treatment, the patient is more likely to have a better mood, a richer quality of life, enhanced work performance, and reduced substance use.

The suicide rate in the United States is up more than 35 percent since 1997, the year that Danny died. That’s not a typo. Thirty-five percent.

we have become a more isolated society, paradoxically even as social media makes us better able to connect with one another.

several factors that add to the risk of suicide: violence in the home, financial insecurity, access to lethal means, lack of coping skills, isolation, previous attempts.

Suicide is preventable, the experts say. It starts by...