One family's story

MAT-SU -- Freshmen in Philosophy 101 wrestle with the eternal question of knowledge vs. reality for only one semester, accepting, at least for the sake of argument and three credit hours, that there is no knowledge in the absolute sense.

For the mentally ill, however, that fight can go on for a lifetime, with no resolution.

The recent film, "A Beautiful Mind," tells the story of John Nash, a brilliant mathematician who struggled for most of his adult life to separate reality from the delusions that are a common symptom of the disease of schizophrenia. His disease placed him in an alternate reality in which he believed he was the target of government conspiracy.

At the end of the dramatized version of his life, Nash still saw and heard the government agents he believed were threatening him, but had accepted on an intellectual level that they were not part of the real world. With that acceptance, he was able to go on with his life and eventually won a Nobel Prize for his work.

For one Valley family, Nash's story comes much too close to home. In order to protect their privacy, we will call them Jane and John Doe.

The Does married 17 years ago. They had enjoyed several years of family life and were happily rearing their several children when John's job began to be a problem for them.

Problems at work are not uncommon in families. Changes in management or work conditions and requirements can result in stress that, if not resolved, goes home with the employee to be shared with the family.

And so it was with the Does. Jane listened sympathetically to her husband's complaints and offered suggestions when he explained what "they" were doing.

Jane came gradually to realize that John's problems, however, went beyond the job.

In the movie about his life, John Nash found evidence of the conspiracies against him in newspaper articles that he clipped and fastened to a wall. In real life, Jane Doe said that her husband also began to collect newspaper articles that proved in his mind that he was a target of conspiracy.

But when he began one day to talk about "the Russians" who were after him, she understood finally that although her husband had no history of mental illness, he was now experiencing mental delusions.

The Doe's story past that point becomes a cycle of spiraling erratic behavior, paranoia, arrest and even FBI investigations.

At one point John was arrested for terrorist activities as a result of his making repeated harassing telephone calls to public officials who he firmly believed were behind the conspiracy against him.

Sporadic hospitalizations followed, on at least one occasion in the psychiatric facility within the Anchorage jail.

With a formal diagnosis of mental illness, treatable with medications, the family's life would return to something resembling normalcy for periods as long as five years. John met with a counselor, attended group therapy programs, and took the medications that helped him to live a normal life.

Medication presented its own set of problems, however. According to Jane, John did not like taking them and would cease taking them once he felt the disease was under control, or once his treatment was no longer under the jurisdiction of the court as a condition of probation.

Although Jane says her husband never became suicidal or depressed, he would inevitably begin again to experience the manic highs and paranoid delusions that she had come to recognize as symptoms of his disease. When she tried to convince him to resume the medications, he would tell her he did not need the medications any longer to control the disease, and would refuse to take them.

With small children in the house, Jane, in desperation, would ask her husband to stay away from the family home when he was in the manic phases of his disease. She did this not because of any abusive actions, but because she was unable to cope with John's paranoid behaviors and accusations. He would return home only to shower and change clothes. He would lose as many as 15 to 20 pounds during these times.

She remembers on one miserable day receiving a telephone call from an FBI agent who was aware of John's case and concerned about the family. The agent said that John had made 20 harassing phone calls to officials in a single day.

The final cycle came to a crushing climax in the fall of 2002. Jane recognized that John was more out of control than he had been in recent years yet he refused to resume treatment, take his medications, or to acknowledge the disease.

She reached out for help. She went to the Palmer Court House and filed the forms to petition the court for an ex partŽ order for emergency evaluation and involuntary commitment.

Jane waited for a period of time, but because of her job and the necessity to pick up one of her children, she could wait no longer for the judge's ruling. She said that the clerk advised her that the judge did want to meet with her on the record, and an appointment was arranged for the next day.

Later that day she called the Alaska State Troopers and asked them to find her husband and take him into protective custody, but could not tell them where to look for him. She was discouraged when she was told that they would look for him, but would not be able to take him into custody unless he clearly presented imminent and immediate danger to himself or others.

"I know him better than anyone else," she said, pain and frustration in her voice as she recalled the events.

Later that evening she received the call that her husband had been critically injured in an accident as a result of delusional behavior, and had been taken to a hospital. He would later be transferred to an out-of-state hospital for months of treatment of his serious physical injuries and his mental illness. He remains there as this newspaper goes to press, leaving his wife alone in Alaska to care for the couple's children.

Although she hopes for the best when her husband is able to return to Alaska and his family, Jane is concerned that the disastrous cycle could resume once John is out from under medical or court supervision of his treatment.

How would she like to see the mental health system be more responsive to the needs of families with problems such as theirs?

"I would want the system to provide for continued supervision and monitoring of treatment and medication," she answered. Her husband's history has taught her that only outside supervision can help him to remain on an even keel.

For the Does, and for other Alaskan families facing this cycle of despair, however, the system as it stands today provides only voluntary services once a patient who has not committed a crime has been discharged from residential treatment.