When teenager Mona Starr finds herself spiraling into a depression, her best friend persuades her to begin seeing a therapist. Mona does more than see a therapist. She takes an active role in her own healing journey by meditating, journaling about her thoughts and feelings, and analyzing how her mind works with the help of a therapist. Young Mona’s visceral struggles are translated into images so deftly that people who have experienced mental illness will take comfort in the knowledge that they are not alone. Those who have not experienced mental illness will find this book a rare window into the inner world of people who have.
The visual language in The Dark Matter of Mona Starr avails itself of the most common school supplies found in students’ backpacks (i.e., graphite pencil, black pen, graph paper, and yellow highlighter). This palette will be recognizable to high-school-notebook-doodlers past and present. Such pedestrian materials might be overlooked by many artists, but when deployed with the level of imagination and skill possessed by Laura Lee Gulledge, they result in mind-blowing images. Beautiful graphite illustrations, lovingly blended to create soft textures, are meticulously inked in black for sharp detail. Juxtaposed with cover-to-cover depressive grayscale, highlighter-yellow is used sparingly throughout the book to convey the magical healing powers of love, friendship, creativity, and self-compassion.
I especially love how this book is both a moving story and a practical guide! In the back of the book Gulledge’s personal Self-Care Plan is laid out in detail, and beside it, a companion note-catcher in which readers can figure out a self-care plan of their own.
Depression affects millions of people each year, and the National Alliance on Mental Illness (NAMI) is here to help. Founded in 1979, NAMI is the country’s largest grassroots organization dedicated to improving the lives of people and families affected by depression and other mental illnesses through support, education, advocacy, and research. On Wednesday, February 8th at 7 pm, their affiliate NAMI Cook County North Suburban brings Mark Litzsinger to EPL to share his recent book Out of the Shadows: A Journey of Recovery from Depression. In anticipation of this important program, we recently spoke to Mr. Litzsinger about his years struggling with depression, the treatments that aided his recovery, and his motivation for writing Out of the Shadows and to NAMI’s Judy Graff about the NAMI Reads author series and other NAMI programs.
Evanston Public Library: To begin with, Judy, can you tell us a little about NAMI Cook County North Suburban’s history and mission?
Judy Graff: NAMI CCNS is an affiliate of the national organization that was started in the early 1990’s by a group of families all dealing with the challenges of having loved ones with mental illness. In the beginning, they offered a single family class, and now we’ve grown to serve more than 17 communities. Today we offer free classes for families and parents along with peer groups and family support groups. We host bimonthly education meetings and advocate for individuals with depression and other mental illnesses. People who have taken our classes and attended our support groups constantly comment about their positive experiences and how NAMI has helped them put their lives back together again.
EPL: Mark, can you tell us about your experiences with depression? When did you first begin to suffer from it, and what were its causes?
Mark Litzsinger: My first experience with depression was just after I graduated from Texas Christian University. I was 23 years old and had started working for my family’s company Follett Corporation as a management trainee in the college bookstore division. I was living in Mission Viejo, California where I was learning to run the bookstore at Saddleback Community College. I had been working there for about 4 months when I had my first episode with depression. One morning I woke up and didn’t feel right. It wasn’t the flu or a cold, but something much different. I felt down. At first, I thought I was homesick. I signed up for a class at the college so I could see the psychologist on campus. I saw the psychologist twice, but the sessions didn’t help. Still thinking I was homesick, I eventually called the Follett Regional Manager and asked to be transferred back to the Midwest. I ended up at our bookstore at the University of Illinois in Champaign, IL.
Interesting enough, once I was in Champaign for several months, my negative feelings went away. I attributed my better outlook to being closer to home. I did not know that three years later the same feelings of being down would come back.
EPL: Can you describe the symptoms of depression with which you struggled?
Mark Litzsinger: There are approximately ten symptoms of depression that are listed in Out of the Shadows. If you have seven out of ten of these symptoms for more than three weeks, you should see your internist.
Besides being down, my major symptoms were ruminations and obsessive/compulsive behaviors. Ruminations involve little things you felt bad about as a child that get blown up in your mind into big issues. You feel terrible about them, and you can’t stop thinking about them.
Most people have heard about obsessive/compulsive behavior like washing your hands excessively or checking that you have locked your door five or six times. My obsessive/compulsive thoughts mostly dealt with driving. I would drive awhile and then worry that maybe I had hit someone a mile or so back. I would go back and retrace my tracks and it became a cycle I would eventually have to break by force of will.
EPL: What was the impact of your depression on your professional and personal life?
Mark Litzsinger: Of course you don’t tell any of your friends that you have the illness for fear they won’t understand or think of you as a crazy person. I had a number of bouts of depression from the ages of 23 to 47. In every case its treatment took time and experimentation with various medications that were evolving over the decades, and I believe that I lost years of my adult life from this illness. I have never been married, and it’s possible the illness got in the way. The worst episode I had was when I was 47. I had been dating a woman for two years when depression hit me. I needed to focus on healing myself, and the relationship ended.
I can’t say for sure, but I think people probably noticed my depression early in my career. They definitely noticed when I had my worst episode at the age of 47. I had been appointed Chairman of Follett Corporation, but my productivity was not good. I showed up every day but was not functioning at 100 percent. I was sick for 2 ½ years, and though I wasn’t hospitalized and my brother and my cousin protected me, after that long period of time my illness was negatively affecting my career.
EPL: Can you tell us about when you decided to seek help?
Mark Litzsinger: The first time I sought help was from the campus psychologist at Saddleback Community College. The second was three years later at the University of Illinois. I didn’t know who to turn to when my depression came back in Champaign. The only resource I had was a Maywood internist and psychiatrist named Dr. Norman Bengtsen. He and his wife were best friends with my grandparents, and during WWII, Norman had been a psychiatrist in the Navy where he helped the submariners deal with psychological issues. After the war, he started his own practice out of his house.
I called Uncle Norman from Champaign and told him that I wasn’t feeling well and didn’t know what was going on. I asked if I could come up to meet with him and drove up to Maywood that same day. Within 15 minutes of seeing me, he diagnosed me with depression. He explained that it ran in the Follett side of my family and that he had treated my grandfather, his three brothers, and my mother. He had me call my dad at his office in Chicago, and when I talked to him he was surprised I was in town and not at work. He came to Uncle Norman’s office and listened to what he had to say. Uncle Norman gave my dad some suggestions about the best treatment options in Chicago, and I ended up at RUSH Medical Center’s Psychiatric Department. They were known as one of the leaders in treating mental illness with medication at the time.
When I suffered my worst episode of depression at age 47, my brother and father went to my psycho-pharmacologist Dr. Bill Scheftner and inquired about electroconvulsive therapy (ECT). Since my medications weren’t working, we decided to try it. ECT – or shock therapy – has been depicted in Hollywood films as almost a torture. In today’s world, the technique is very safe and does not hurt the patient. I had five out-patient sessions over a three week period.
EPL: What treatments were most effective for you?
Mark Litzsinger: All the medications I’ve taken during treatment have eventually lessened my depression. In the beginning the medications I used had side effects like dry mouth, constipation, and dizziness, and I remember having to have my blood checked frequently to see how much of the meds were in my system. Later the drugs became better with fewer side effects. I’ve even had several two- or three-year periods following remission when I haven’t needed any medication at all.
As for ECT, I came out of those treatments smarter than I had ever been. In my career, I was asking all the right questions, and I was able to analyze business situations very quickly. I couldn’t make a wrong decision. My world opened up, and I was interested in a broad spectrum of new things I hadn’t been prior to ECT. My brain was functioning on all cylinders at a 1000 mikes per hour. I was on fire!
EPL: Judy, what types of programs does NAMI offer for the families of those struggling with depression?
Judy Graff: NAMI teaches that when a person struggles with a mental health condition it affects everyone around them including family, friends, classmates, and coworkers. Our programming for depression includes support groups and classes such as the Family-to-Family Education Program and Basics for Parents.
Family-to-Family is a free 12-week course for families and close friends of adults with mental illness. This course is taught by trained teachers who are also family members and know what it is like to have a loved one living with major depression and other mental disorders. Many family members describe this experience as life-changing.
Basics for Parents is a free six-week course for the parents or caregivers of school-age children and adolescents with mental health issues. It’s taught by parents with the lived experience of having a child who has struggled with mental illness. I’ve been a teacher in this program since 2008, and it is such a gratifying experience to see parents get a clear understanding of the biology, treatments, and school-related issues of having a child with a mental health condition. Many times it is the first opportunity for parents to meet other parents who have “walked the same walk” and share their trials, tribulations, and successes.
EPL: Mark, is your struggle with depression an ongoing battle, or do you consider yourself fully recovered?
Mark Litzsinger: I still believe that one of the secrets to my dealing with the illness was to trust my doctor and never give up. Perseverance plays a big roll in overcoming depression, and my experiences as a championship tennis player at Hinsdale Central High School and playing on the team at Texas Christian University really helped me learn to never give up. When you are down a set in singles tennis, you have to change your strategy and figure out what you need to do to come back and win. You don’t tank the match. You fight and never give up.
Since the ECT, I haven’t had a depressive episode in 14 years. I’ve taken a small maintenance dose of Cymbalta every day during those years and have never had another bout of depression. Am I unique? Probably. According to Dr. Scheftner, most patients will have depressive episodes even after shock therapy. Sometimes I think the ECT totally rewired my brain and that maybe it is permanent.
EPL: On Wednesday, February 8 at 7 pm, Mark visits EPL to share Out of the Shadows as part of the NAMI Reads author series. Judy, can you tell us about the program?
Judy Graff:NAMI Reads is a new program that brings authors to local libraries in the 17 communities we serve in the north and northwest suburbs. Evanston Public Library will host our fourth presentation. Thus far we have offered books by authors who have a compelling story to tell about mental illness and a positive message to share of their road to recovery. NAMI wants to change the misconceptions about mental health issues and the people and families who are affected by mental illness. As we plan future programs, we’ll adapt our author choices to the needs and requests of the community we serve.
EPL: Mark, what motivated you to write Out of the Shadows? What was the process like?
Mark Litzsinger: I was speaking at a seminar at a country club on the North Shore that was moderated by Mark Pollack – the Chairman of the Psychiatry Department at RUSH. I basically told the story of my battle with depression. My brother and a good friend were in the audience, and after I spoke, my brother told me that all 165 people in the crowd were glued to every word I said. He said I had to write a book.
The writing process was an adventure and an education at the same time. I had never written a book and didn’t know where to start. My friend Adrienne Fawcett was the online editor for the Lake Bluff newspaper, and I asked if she knew anyone who was a ghost writer. I knew James Patterson didn’t write a book a month without help.
I was eventually referred to Sarah Hamaker, a ghost writer from Fairfax, Virginia, and the process of writing with Sarah was wonderful, fun, and a learning experience. She is a true professional and knowledgeable about everything from writing and editing to book design, publishing, and sales.
EPL: What would you like readers to take away from your book and the NAMI Reads program?
Mark Litzsinger: I want people to know how important it is to get the right help quickly when fighting a bout of depression. Skip the psychologist or psychiatrist. Go straight to a teaching or research hospital with a top psychiatry department like RUSH Medical Center and get an appointment with a top psycho-pharmacologist. These doctors are the top of the food chain in dealing with mental illness. They focus on treating mental illness with medication and are familiar with the latest research from around the world. Perseverance is key. Never give up, and trust your doctor. He or she is the expert. You are not. Also, great support from family and friends is critical. They too have to be educated to understand depression so they can be the most supportive and helpful. By the way, all proceeds from the sale of Out of the Shadows go to RUSH Medical Center’s Psychiatry Department.