Losing My Brother to the Two-Headed Monster of Mental Illness and Addiction

I had some trouble sleeping and didn’t know why. I’m not a superstitious person, but it was a strange coincidence to have something keeping me up. My sister Alecia sent a text early on the morning: “Call me.” I did. I heard her say through sobs that our brother Russell had died. That radical thought plowed through my consciousness like a Pittsburgh Steeler.

I wanted to recall the very last time we talked. It must have been a few days before his 56th birthday. I asked him what he wanted. Underwear. He wanted boxers this time, he was done with the “tighty whities” and needed a slightly larger size. We laughed. That’s all he wanted. Socks and underwear were all he ever wanted for the past 10 years or so. He didn’t ask for much. He didn’t like feeling that he owed people.

He had many troubles in his life. He was proud he had survived a full 30 years after his first psychiatric hospitalization for a psychotic episode and planned to celebrate. But I think it was a bit of a let down, a hollow victory. He had already written a thorough account of his childhood memories and the later hallucinations, paranoid racing thoughts and delusional thinking. Writing seemed to help. Like with me, his handwriting never really matured. The words always appeared to be scrawled by an elementary student just learning cursive. He had the autobiography typed-up professionally a decade ago.

I think the early years were some of his happiest, when Dad was still alive and working. They were best friends. My father would never admit it, but he had a very special relationship with Russ. I think he knew Russ was vulnerable in some way from day one, and Russ never stopped idolizing him. He was “Daddy’s boy all the way!” Russ later admitted that he tried too hard to take care of him, as Dad was aging, and should have found him a nursing home sooner, but Russ felt that deep obligation, that strain of caring and perhaps a little denial.

When Dad died in 2001 at age 96, Russ slowly went into another deep depression, drank heavily and ended up in jail and the hospital again within a year or so. Losing a father and best friend at the same time must have been soul-crushing. I had over a decade of therapy and 12-step work under my belt by that time. Losing Dad was completely devastating for me, but double for Russ. I managed to write and give Dad’s eulogy, while the rest of the family could barely speak. I did the same for Mom who had died five years earlier. She had psychiatric and substance issues as well.

Russ had some good professional help along the way here in Pittsburgh. But he had a devastatingly horrific initial experience with the mental health system in general when he was physically restrained and given powerful sedatives against his will. Several psychiatrists, therapists and other mental health professionals helped when he could accept it. His last psychiatric hospitalization was in 2003 (15 years from the time of this writing). But he consistently turned to alcohol and nicotine to cope, and denied that dependency for the longest time, as substance issues were secondary, though he had attended dual-diagnosis groups in the past.

The alcohol and tobacco were part of his coping strategy since adolescence and never really ceased. We tend to do what we know. Though the past two months of his life he reluctantly began to attend a few alcohol-anonymous meetings and took some pleasure in hearing the stories. He had even asked his friend to get him to detox the day before he died. Four months earlier, Christmas 2017, he had been hospitalized for life-threatening withdrawal symptoms after a hard bout with the flu when he wasn’t eating or drinking. The drug Atavan saved his life then, though he appeared to minimize that experience at first and then agreed to go to some AA meetings at Alecia’s urging.

Unfortunately, sometimes the disease wins. The schizoaffective symptoms were actually managed rather well, but the substance abuse had not been adequately addressed. He used his “chew” (tobacco) and alcohol on a daily basis. I spent about 30 years attending 12-step meetings myself, after Mom’s medical issues in her 50s. She went to rehab back in the late 1980’s where I attended a family visitation day. I decided that I was going to quit smoking after that, eventually stopping on Russell’s birthday in 1992. Life was unmanageable and I wasn’t living up to my potential. Nicotine withdrawal was the most difficult challenge I had faced at the time.

Alecia dragged me to my first meetings on Saturday mornings. Doughnuts and coffee helped me to keep coming back and I eventually attended consistently on my own, what with Mom and then Russ being hospitalized multiple times. I seemed to find much of what I needed through decades of therapy and Al-Anon that likely saved my life. Though Russ, like many others with addiction, was never really convinced to pursue any of the 12-step programs.

Russ was his own person and made his own decisions. I disagreed with him mostly, but also came to understand that he deserved the dignity of his own choices, so I tolerated his behavior while setting boundaries with him. We actually had lived together for a time after mom died, until he had another psychotic episode and ended up drinking, jailed and involuntarily hospitalized for his dangerously erratic behavior in 2003. Having a severe mental illness compounded by substance abuse is quite the two-headed monster. Herculean efforts are required.

He bravely fought his demons and rode his dragons for 30 years and had had enough of playing the hero. We talked a few weeks before the end. He had just spent a week housesitting for me and my wife, and caring for our dogs. He had use of my car and during that time, he had visited Dad’s grave. He said it felt a little too much for him. Maybe not a full week next time. He shared with me that he basically had retired and already had one foot in the grave. I did not like what I was hearing and suggested he had a few more years left in him. I certainly was not ready to go anytime soon and I directly told him so. I wished so much more for my brother.

But I have learned through my own recovery process that placing expectations on another’s behavior is a premeditated resentment. It took several years of living with him and feeling betrayed, time and again, that I could never presume to get him to control his behavior. I came to understand that I was going to the hardware store to get a loaf of bread. I had to let him go. That didn’t mean I loved him any less. I had to let him be who he was, whether I liked it or not. I was learning to respect him as an individual, as we all deserve. We were both learning to play the cards as they had been dealt. But I didn’t want him folding too soon.

He was proud to have been an active body builder, earned a college degree and worked very hard to perform at a high-pressure job. It didn’t take long for his mental health issues to take their toll. But he kept trying and had some good days. In the end, we all have our limits and the body can take only so much. His spark was never completely extinguished and that light lives on in those of us he managed to touch during his brief time on the planet. I take great inspiration from my brother. That was his gift. His story is a lesson for the rest of us.

As our high school principal would say, “A word to the wise is sufficient.”