David Van Nuys: Welcome to Wise Counsel, a podcast interview series sponsored by CenterSite, LLC, covering topics on mental health, wellness and psychotherapy. My name is Dr. David Van Nuys. I'm a clinical psychologist and your host.
David: On today's show, we'll be talking about Bipolar Disorder with my guest, Lorna Hyde Graev. Lorna Hyde Graev is a successful public relations businesswoman who also suffer from Bipolar Disorder. As a result of her own experiences with mental illness and her high profile business background, she's been active on the board of Fountain House, a pioneer in the field of community mental wellness and psychiatric rehabilitation services in New York City.
Now, here is the interview...
Lorna Hyde Graev, welcome to Wise Counsel!
Lorna Hyde Graev: Thank you David. I'm very pleased to be able to talk to you today.
David: Well, me too. Now, I'm under the impression that you've been diagnosed with Bipolar Disorder and that as a result of that, plus your extensive business background, you've become a mental illness activist. Or, maybe I should say mental health activist. Do I have that right?
Lorna: I think that's right. I actually call myself an "advocate" rather than an activist, but that's correct. I speak publicly on the issues of mental illness. In particular, I talk about my own Bipolar Disorder. And I have become involved with a wonderful organization in New York City, Fountain House, that rehabilitates people with major mental illness.
And I have created a symposium and luncheon in New York City that is an annual event in April and we now have over 600 people who attend. Each year, we have a panelist of three people, two doctors and a layman who has lived with the illness that we are addressing in that particular year.
So, I've not only raised awareness, but I've also been able to raise a fair amount of money for Fountain House. Last year, it was over a million dollars.
David: Wow! Well, that's really wonderful. And I think before we get into Fountain House, I'd really like to explore your own experiences as someone who's diagnosed with Bipolar Disorder because the people who will listen to this, I think many of them are people who are either dealing with various kinds of mental health issues or have family members who are dealing with mental health issues.
And so, a lot of the interviews that I've conducted have been with therapists and with researchers. But every now and then, we like to get the voice of somebody from the other side of the couch, so to speak, somebody who's been in that role of patient. So, how old were you when you were first diagnosed with Bipolar Disorder, if I may be so bold as to ask about age?
Lorna: I guess I was 40 or 41 years old.
David: OK. Tell us a little bit about what led to that diagnosis.
Lorna: Well, I think maybe I should start with the fact that my mother was bipolar.
David: Yes, I think there is evidence of a certain amount of heritability with this. Is that right?
Lorna: Well, that's what I'm told. And in our family, both my mother and one of her two sisters had Bipolar Disorder and in my family, there are other members of my generation who have the illness as well.
David: And of course, in their time it wouldn't have been called bipolar, it probably would've been called "Manic Depressive."
Lorna: Yes. When my mother was diagnosed at the age of 31 -- and actually, she became ill in post-partum depression after the birth of my younger sister. It was referred to as "Manic Depression" and there was really no medication for it then, which was in the late 1940's. My mother suffered terribly with chronic mood swings until she was asked to be a part of a study for lithium application for people with Manic Depression/Bipolar Disorder that was being run up at Columbia Presbyterian Hospital in New York City by Dr. Ronald Fieve.
She was one of 12 people on whom Dr. Fieve tested the lithium application and it was very, very successful, it changed her life.
David: Well, that's wonderful. So, coming back to your life, what was going on in your life that led to that diagnosis for you?
Lorna: Well, I was in the middle of a divorce. I had decided to go back to school. Actually, I was studying Art History in London. I was doing the Christie's course, as in Christie's Auction House. I had a lot of pressure on me, a tremendous amount of pressure and one morning, out of the blue, I just couldn't move. I was totally unable to move my legs. I became, very quickly, extremely agitated.
Lorna: Having almost an outer body experience. I was cycling, which I didn't know what cycling meant at the time.
David: Yeah, I'm not sure I know what you mean by "cycling." Tell us what you mean by that.
Lorna: Well, it means that your cycles, your high, high manic is as high as you can go.
Lorna: And you are basically out of control and you can't sit down, you can't stay still. I kept throwing myself in a bath of cold water because that was what I thought would get me some relief from this agitation, but it didn't. I landed up going into the streets of London in a bathrobe, walking around with no shoes on and thinking that this walk would help me. I was unable to function, I couldn't eat, I couldn't sleep.
David: This is moving a little quickly for me here. So, at first, you were in bed and you couldn't move at all?
David: But then, at some point, you became very agitated and that's when you...
Lorna: That's right. That's just right. It started first with being unable to move. My legs felt like they were pillars of marble, they were so heavy.
Lorna: And then, I started to get agitated. I was still in bed at this point. And the agitation got worse and worse. And then, within a question of hours, I was absolutely out of control. Quite honestly, I was foaming at the mouth. I was in a very bad state. And it went on for days like that. So, you can imagine how that impacts the body, not just your mind.
David: In your mind, did you have any sense of what was going on? What did you think was happening to you?
Lorna: Well, when my mother died in 1983, I'd had a little bit of depression. I mean, I felt depressed. And so, therefore, I had a sense of what depression was, but I had never had anything happen to me that was like the 1991 cycling episode. Obviously, I knew that mental illness was in the family.
Lorna: And I kept saying, "Oh, I hope I'm not going to be like my mother. I hope I'm not going to be like my mother." That was what I kept thinking as I was taken over by the mania. And finally, two friends came to see me, both girl friends. One flew in from New York and then another friend of mine who lived in London. They got together and they decided that I had to go back to New York as soon as possible.
David: Yeah, sometimes when people have a manic episode, they do things like run up large amounts of money on credit cards and things like that. Did you have any behavior like that of spending?
Lorna: I was so sick. I think that before my Bipolar Disorder declared itself in 1991, I had had during my adult life up until that point, the tendency to spend too much money. I'd had the tendency to drink too much. I was a party girl. I wasn't drinking so much during the day, although I would definitely have my two cups of wine at lunch. But I thought that was all right because I was half French and after all, the French love wine. So, I sort of passed it off, I could rationalize everything.
Lorna: But at night, I would start drinking solidly. At about 5:30 or a quarter to six, I might be getting myself together to go out. I would have a drink already right at my right hand as I was putting makeup on and then I would drink wine at dinner and then I would drink stingers or alcoholic drinks of that type afterwards. So, I was really, I think, self-medicating?
Lorna: And I really didn't know it.
David: Yes. So, there were signs there earlier, but that you weren't recognizing?
Lorna: That's right.
Lorna: I just thought that was me, that that was just part of who I was and I didn't really know that it was probably the illness that I was keeping at bay, or at least I thought, by drinking.
Lorna: But as the years went on, it became very clear to me that the next morning, the morning after the night before, I felt sad. I felt kind of like, "Oh, maybe alcohol isn't my best friend because I feel kind of blue the next day when I've been out the night before, drinking." But I didn't do anything about it. I only did something about the drinking, which is a different issue, after I was diagnosed in '91.
David: Yes, so...
Lorna: We can talk about that later.
David: OK. So, friends persuaded you to go back to New York?
Lorna: Yes, they did.
David: Because why? They thought treatment would be better?
Lorna: Because they felt that I had a doctor there, I had been doing talk therapy in New York. And so, therefore, they felt it was better to get me back to the doctor in New York with whom I'd had a relationship. And they also felt that I was alone in London, I didn't have any family. They knew that I had my father in New York City at that time, he was still alive and I had a sister in Washington D.C. who could come up. And I had a network of friends in New York City that I didn't have in London. I was very much alone there.
David: Yes. So, when you returned to New York, how did this episode get resolved?
Lorna: Well, to be honest, it was a big struggle. I should say that I was in such bad state, I was so weakened by the cycling that by the time I got myself to the plane at Heathrow Airport in London to come to New York City, I was in a wheelchair. I mean, that was the condition that I was in.
Lorna: Within about 10 days of struggling with cycling episodes.
Lorna: One after another. So, when I came to New York City and arrived there, my doctor was waiting for me. It was a Saturday and he was in his office. He came in to see me and he saw right away the state I was in. And he thought, probably, that it might have been... I think he said to me, in fact, it would be maybe good to hospitalize you. But I'm strong-willed and I didn't want to go to a hospital. I felt that I could tough it out on my own, but with his help.
Lorna: So, I stayed at home. I had somebody with me all the time because I had some suicidal tendencies and feelings. It was the only time in my life that I ever entertained that thought, but I did have them during that episode. So, a friend moved in with me and I went to therapy everyday. And the doctor decided to put me on... Well, first of all, he didn't know exactly what he was going to do, whether or not he'd take me off medication completely just to see what would happen when I bottomed out. But then, he said, "No, I think what we'll do is we'll try Prozac."
David: Now, had you been on lithium at all?
Lorna: Nothing. I had nothing like that, but when I was anxious or nervous or I wasn't sleeping well, he'd given me a little Valium in those days or something.
David: Oh, OK.
Lorna: But I wasn't on any medication for Bipolar Disorder.
David: Oh, OK.
Lorna: So, he said, "Look, we're going to start from scratch and we'll try Prozac." And, of course, it was the worst thing for me because it just agitated me more. There, I was in even greater pain, both physical and mental, from Prozac. Then, he decided to stop that after about two months and we go cold turkey again. And at that point, I started again with more feelings of cycling, more of the same and he said, "You know Lorna? I think we've got to put you on lithium." And I said, "Oh, I don't want to go on lithium, Doctor. This is what my mother was on." I mean, I can't believe that I'm really bipolar. I sort of fought it, but not for very long.
David: What was your resistance to lithium? Are there side effects that made you feel resistant? I mean, you saw that it had been such a big help for your mother. I'm curious as to why you felt resistant.
Lorna: Well, I think primarily because there can be weight gain with lithium.
Lorna: And I had seen my mother who was very slim and very beautiful put on a great deal of weight with lithium. So, I was resisting that...
Lorna: More than almost anything else. But, resisting not for very long. I decided I was in such terrible shape, I said, "Listen, I'll go with it. I'll go with the program." And I have to say that within a matter of days, I started to come back to being my own self. It was very, very quick. I can remember thinking, "My gosh! My body must be craving this medication because it responded so quickly." And, of course, it had been very, very successful for my mother and my doctor said if a medication works for one member of the family, it often works for other members of the same family.
And indeed, it did. I really started to function again very quickly after I began taking lithium.
David: So, it really was like a miracle drug for you?
Lorna: It really was and it's been very successful also for my mother's sister who took it until a year or two ago. She is now 91, so she made the decision that she didn't need to continue to take her lithium. She decided, for whatever reason, not to, because she's also very old at the time. So, I think, the family also agreed that perhaps it wasn't necessary.
But my mother took it till the day she died and I had taken it, except recently in the last two years, I'm taking a little less and I'm boosting up the lithium levels by taking Lamictal. I don't know if you know Lamictal, but it's an...
David: I don't.
Lorna: Well, it's an anti-seizure drug. It's sort of in the same school as Depacoat. It does not create weight gain and it's, again, a drug that has worked for me and for other members of my family in the United States. So, I have not had any mood swings whatsoever since I've been taking both low dose of lithium and Lamictal.
David: And I was wondering about the weight gain. Did the weight gain happen for you too with the lithium?
Lorna: It did, but not in the same way that it did for my mother. I gained probably five, six or seven pounds with lithium and basically, I would go to the gym and try to exercise as much as possible because that's very good too for your endorphins. And so, I was able to keep it down to five or six pounds.
David: Yeah, that's not so bad.
Lorna: No. And people in my mother's generation, my mother would be in her 90's day. I mean, when she was 30 or 35, women weren't really exercising then.
David: Yes, that's right.
Lorna: But today, you can control some of that weight gain by eating properly...
Lorna: Vishnus who can help you know how to do that and exercise.
David: Yes. You've been out there in the world, very visible as an advocate. But I'm wondering, did you at any time experience any sense of stigma around your diagnosis?
Lorna: I never discussed my illness in the workplace.
Lorna: My friends knew, my close friends knew that I had Bipolar Disorder. But I was very frightened that my employers could feel uncomfortable having a person with a mental illness working for them. So, I hid it, which I'm afraid is what happens a lot in corporate America.
David: Yes. Now, the friends who you told, did any of them seem to treat you differently or behave in a way that would suggest stigma?
Lorna: I don't believe they did. I mean, once in a while, somebody will say to me, "Well, Lorna, you can be hyper but that's very bipolar" or something like that. Sure, there are people who trivialize everything, but I've never had anybody make fun of me or make me feel uncomfortable.
David: Well, good.
Lorna: It's just sometimes they don't realize... I think the biggest issue that I've had is that even the people that I talk to about my illness because they want to hear about it, they can't quantify it. They can't understand it because they can't see it. I often say to people, "If I fell on the street and I opened up my leg and I had a big wound on my leg somewhere, everybody would cook chicken soup and send me flowers and constant emails."
David: Yes, right.
Lorna: But when you have pain that people can't see, they don't know what to do. They don't know how to express their concern, they don't know what to do and they can't really understand it.
Lorna: That's what's very difficult about having, I feel, a mental illness, is because you isolate. You find it hard to talk to people about what you're feeling.
David: Yes. I'm wondering, is talk therapy still part of the picture for you?
Lorna: Absolutely. I believe in talk therapy and psychopharmacology, the two. I personally wouldn't do one without the other. Talk therapy is very important.
Lorna: After all, we're human. We all have issues. We have things we want to deal with.
Lorna: We want somebody to talk to about them and they're often confidential.
Lorna: So, I'm very open about my illness, but sometimes, I'm not that open about myself as a person.
David: OK. Well, you've been pretty open here and I really appreciate that. Now, you've had a pretty high profile career, I gather. Is it the fashion industry?
Lorna: Yes, it is. I work for Christian Dior, both in Europe and in the United States for over 17 years. I was the spokesperson in the United States. I did all of the traveling with the Christian Dior collection across the United States. And I did the in house fashion show. Each city has one or two major department stores or specialty stores and I did the in house fashion shows.
And then, I would do the early morning talk show at any given city where I was doing a fashion show. And I was gone for the fall and the spring seasons, I'd say 30 to 35 days for each season. I was on the road a city a day. I really got to know America.
David: Yeah. Did all of that take place before 1991 or some before and some after?
Lorna: All of that was before 1991.
Lorna: I worked for Dior throughout the 1970's and into the very early 1980's. And then, I became spokesperson for Jones New York, which is a division of the Jones Apparel Group. And I went on the road again for Jones New York, doing the same things that I'd done for Christian Dior.
Lorna: But I did a lot of print work as well, a lot of covers in magazines, lots of interviews with fashion magazines and newspapers throughout the country.
David: So, this is a piece of cake for you then, being interviewed?
Lorna: I don't know about that. It's always harder to talk about yourself than it is about something that isn't personal. But yes, it is.
David: Yeah. So, how did you come to be involved in mental health activism?
Lorna: Well, I think that more than anything, is that I felt very fortunate to have access to very good doctors, that I was in a position to be able to do that financial and otherwise. And many years into my illness, I discussed with my psycho pharmacologist here in New York the idea of going to work for an organization and help people who are perhaps less fortunate than I. She suggested one or two organizations that she held in high regard and one of them was Fountain House.
David: OK, and you're on the board of directors and as you've mentioned, you've raised a million dollars for them. I have not heard of Fountain House. What is Fountain House?
Lorna: Fountain House is a rehabilitation organization that was founded in 1948 in New York City. The family of members, three members of the early Fountain House organization, they were the ones that bought these buildings and created the clubhouse at 425 West 47th Street. We are an organization that has served since its inception over 16, 000 people in the New York City area.
It's a five-story mansion-like complex of over 57, 000 square feet. The idea was that it should feel like a home and not like an institution because many of the early members of Fountain House had come out of these large psychiatric institutions, state institutions. That was so inhumane in many ways.
David: Yes. Let me remind you to move the phone away a little bit.
Lorna: Can you hear me now?
David: Yeah, I can hear you. It's just starting to get that scratchy sound.
Lorna: That's OK.
David: I went on to the Fountain House website and I noticed that they said it's an approach that has really spread into other parts of the world and they describe it as a "clubhouse approach." So, what's meant by that phrase, "clubhouse"?
Lorna: It is a clubhouse approach and I know the idea behind that was this, that the members... They're patients but they're called "members." The members of the clubhouse or any of the clubhouses, which we will discuss in a moment because the clubhouse model has been replicated all over the world. And the idea is that no decisions are made at Fountain House in New York City, unless they are made in tandem with members.
And members are fully active in all aspects of the management of the clubhouse in New York. There are 1300 members, there are about 850 of them that are active. Meaning that, the other, let's say, 700 members or whatever are feeling better so they're not coming in everyday, they go to work because we organize for our members to have access to jobs, housing, education. The clubhouse provides over 350 meals a day and we nurture our members, we give them support. We have 85 of our members who are actually getting either high school or college degrees.
As we speak, they'll be graduating in May. Not young people alone, people of all ages. And we have an enormous education department which supports them with tutoring and books and scholarships and so forth.
David: Well, that's wonderful. I gather there is a wide range of diagnostic categories of the people who belong to the clubhouse?
Lorna: Oh yes, that's true. I'd say the large majority, however, are bipolar and schizophrenic.
Lorna: But yes, that's correct.
David: OK. Now, I wonder if you have any particular view or opinion of current national mental health policies and resources?
Lorna: Well, we're going to be holding this year the fifth annual Fountain House Luncheon. Two luncheons ago, we honored Patrick Kennedy, Congressman Kennedy, the son of Senator Ted Kennedy. And I don't know if you remember that two days... Well, I know that two days after the luncheon, he had an accident in Washington and it became widely known that he was a sufferer.
And he and I, as a result of the fact that he spoke at my Fountain House luncheon days before his accident or his outing, if you wish, had become very good friends because we're both suffers, we share that bond. He and I saw each other this week and he informed me that he has been able to get a parody bill through the House of Representatives. It has not been ratified, but it's a very important move.
David: Parody with what?
Lorna: Parody bill, which means that if it were to be ratified, that insurance companies would have to cover mental illness in the same way that they cover physical illness.
Lorna: And that is groundbreaking. If this goes through Congress, this will be a very important piece of legislature for the mental health world.
Lorna: And for sufferers, particularly, throughout the United States.
Lorna: So, we're waiting to see what will happen. There's a good chance that President Bush would like to be part of an important domestic piece of legislature before he is not longer in office. And so, we're hoping that this will be the piece of legislature that he will embrace.
David: OK. Well, Lorna, as we begin to wind down here, I wonder if you have any advice to those suffering from bipolar specifically or mental illness generally?
Lorna: I think if I could say one thing and that is that the more you can talk about your illness, the better you get. And that as long as you hide your illness, the illness owns you. So, I always encourage people to talk about their illnesses and not to feel awkward about it and to feel that we're all human. We're not responsible for these illnesses and many instances, more than not, they're unfortunately hereditary or the tendency is. And that we oftentimes, bipolar people are very talented. Bipolar Disorder loves artists, actors, writers and so forth and so on.
So, I specifically try to encourage the young who have just been diagnosed to realize that there is good in some of these illnesses. It's not just a hard road, that there's some very good things, being sensitive, being creative, being artistic isn't all bad at the end of the day. So, I look at the positive.
David: That's a great point and a great place for us to close. So, Lorna Hyde Graev, thanks so much for being my guest today on Wise Counsel.
Lorna: Well, thank you, David. It was a great pleasure to talk to you.
David: I hope you enjoyed this interview with Lorna Hyde Graev. I also hope you were inspired by her courage and her success as a mental health advocate through her work on the board of directors at Fountain House in New York City.
As you heard, their work has led to many similar clubhouses in other parts of the US and around the world. You can find out more about this fine organization by visiting their website at www.fountainhouse.org.
You've been listening to Wise Counsel, a podcast interview series sponsored by CenterSite, LLC. Until next time, this is Dr. David Van Nuys and you've been listening to Wise Counsel.