Mental illness ran in Meg's family. Suicide forced them to talk about it.

Sana Qadar: Take two alcoholics, one with bipolar, the other with crippling anxiety, and let them have eight kids in 12 years. What could possibly go wrong? That is one hell of a line. One hell of a question from a memoir written by Meg Kissinger. Meg has spent 25 years covering mental health in America as a journalist. It's a job she spent her whole life training for.

Meg Kissinger: I was born in 1957, and so the 1950s and 60s, this was a topic that we just didn't have the language for. So I watched as the people that I loved the most became quite disabled by their illness, but we didn't have a way to talk about it, and a way that I found to understand it was to go out and report on it. So to talk to people out in the world, strangers that were struggling. And I found that I could learn from them what I couldn't from the people that I lived with and loved.

Sana Qadar: This is All in the Mind. I'm Sana Qadar. Meg is turning her reporting inwards this time. Her memoir is titled While You Were Out: An Intimate Family Portrait of Mental Illness in an era of Silence.

Meg Kissinger: I knew that I was going to be unearthing some very painful archives. I was going to be getting the medical records for my family, so I knew it was going to be, you know, a scary chore.

Sana Qadar: But for her, this work is necessary, a way to end the silence that leads to stigma, that leads to shame, that leads back to silence. And there's hope bound up in her story, too. It illustrates how far we've come in many ways in our discussions around mental illness and suicide.

Meg Kissinger: It's so much better now, better in many ways, and not better at all in others, but better in the way that we talk about mental illness.

Sana Qadar: Today, how Meg's family shaped her award winning reporting, and how to talk about suicide from someone who knows what it's like to lose loved ones to it. This episode is a heavy one, so please take care while listening.

Meg Kissinger: So my mom and dad were lovely people. They were hilarious. They were bright, they were warm and loving and caring, but they were also very ill.

Sana Qadar: Meg Kissinger grew up in the suburbs of Chicago in the 1960s. She was the fourth eldest child in her large Irish Catholic family.

Meg Kissinger: My mom was 25. My dad was 24 when they were married. And then bada bing, bada boom, you know, in 12 years they had these eight kids. And that was not unusual in the area that I grew up in. You know, I grew up in this enclave of Irish Catholic families and the baby boom. And that was a pretty typical kind of size of a family. So lots of chaos, lots of shenanigans, lots of fun, lots of dysfunction, though, and we didn't always get our needs met.

Sana Qadar: And do you remember when you first sensed that something was wrong with your parents?

Meg Kissinger: Yeah, I do, I was five years old. We had moved back to Chicago. My dad was a successful advertising executive and he had started his own magazine. So we moved out to New York. But things went bad quickly. He got into a fight with his business partner and they yanked us back to Chicago. So with seven kids in tow, off we moved back to to Chicago. This was before my youngest sister, Molly was born, but I came down to breakfast one morning and went to look for my mother, and she was not there. And I looked everywhere for her. And again, because we had just moved, I thought, well, maybe she's in one of these boxes that has all the winter clothes. I just didn't know. And maybe she's in the attic, or maybe she's in the basement. And I looked all over for her, but she wasn't there, and nobody was telling me where she was or why she was gone. I would come to learn many years later that my mother was being hospitalised for depression, but I wasn't told that. I was just told that she was gone. And I then imagined, well, did I do something to make her leave? Did I cause something? Did I do something bad? So. So your imagination reels when you're five years old and you don't know where your mother is.

Sana Qadar: And so no one said to you like, don't worry, mommy, we'll be back. They just said she's gone.

Meg Kissinger: Right. And then I remember pressing my grandmother and all my grandmother would tell me is that. Just say she's got pneumonia. So it was very. It was very confusing.

Sana Qadar: Meg's mother did eventually return, although she's not sure after how long. Her memory is fuzzy from this time. And while her mom continued to struggle with depression and anxiety, her problems were soon eclipsed by another member of the family. Can you tell me a bit about your older sister, Nancy?

Meg Kissinger: So Nancy was the second oldest. I'm number four in line. Nancy was the second oldest, so she was four years older than I and always a bit of a rascal. She was beautiful. She was quite bright, a lot of fun. But it was clear by the time she was about 12 years old that something wasn't quite right. She was. She had ants in her pants. She was getting into trouble at school. She was acting out. She was always quite emotional. And my mom and dad had a hard time kind of getting her to toe the line.

Sana Qadar: Meg would later come to find out that her sister Nancy, was attempting suicide from the age of 12, and as she got older into her teen years, Nancy was getting into trouble, shoplifting and drinking, and her mental health just kept getting worse.

Meg Kissinger: Any kind of resources that my mom and dad had squirrelled away for our college funds were really ultimately going to provide Nancy with mental health care.

Sana Qadar: Nancy had been diagnosed with various conditions depending on the doctor. Depressive neurosis, schizophrenia, mania with depression. That last one is basically what they called bipolar disorder before they called it bipolar. And that's what Nancy and Meg's father would eventually be diagnosed with. But not for another few decades. For now, whatever Nancy had, she wasn't getting better.

Meg Kissinger: She just got sicker and sicker. But in my teenage brain, I wasn't as empathetic as I might be today. So I was really looking at it her as really a problem. I was really more annoyed and bothered by her.

Sana Qadar: Nancy's first serious suicide attempt was when she was 19 years old.

Meg Kissinger: And that was kind of the point of no return. It was a very public attempt and the fire department was called. All the neighbours knew, and I didn't really know anybody else who'd ever had that situation in their family. I'm sure that there were I'm sure that there were many people that I knew, but it was just not talked about. So it became that's what I really, really remember, the first kind of strong feeling of shame. And so having this sense of instead of really feeling worried for my sister, really feeling embarrassed by her, which I'm so sad to admit that. But that's the truth.

Sana Qadar: When Nancy was 24 and Meg just 20, Nancy died by suicide.

Meg Kissinger: This is sounds crazy to say, but I remember the night that she died. First of all, my dad called us all into the living room and sat us down, and he knew that the house would be filling up fast. That word was going to get around that Nancy had died. The neighbours were going to come with their bottles of Scotch and their plates of store bought cookies and all the attendant, you know, creature comforts to kind of get us through that night, which was lovely, but a lot of pressure, too. And my dad was scared, you know, he was afraid that if word got out that Nancy had taken her own life, that that is in the eyes of the Catholic Church, a mortal sin. And she would be denied a funeral and burial in the family cemetery plot. And so he told us, you know, in no uncertain terms, if anybody asks, this was an accident. And those were scary words to hear. We knew that that was a lie. We just thought it was a stupid idea. Nobody was going to buy it. For starters, everybody knew that Nancy had tried to kill herself so many times. So this was just a dumb idea of my dad's. But again, looking back on it now, I see why he was saying that. You know, I could see that this was just a desperate act to save face on his part. But it also underscored for me the the shame associated with suicide. And but what it also did was really minimise the suffering that Nancy went through. And to say that this wasn't a purposeful act on her part and something that we should be ashamed of, that wasn't helpful. I think that really set the stage for troubles that would follow.

Sana Qadar: Two decades later, Meg's family would have the serious misfortune of having this happen again to another sibling.

Meg Kissinger: So Danny was also a rascal. He was the second youngest and Danny was a darling little guy. He was just had these big chocolate brown eyes and these dimples. But Danny, as he grew older, I think he was he was quieter and less kind of able to showcase his own wonderful qualities. And when Nancy died, Danny was 15 years old, and he was quite embarrassed and he was quite angry. And I think a lot of the unresolved grief of Nancy's death really landed with Danny.

Sana Qadar: At the age of 30. Danny was diagnosed with bipolar disorder with some paranoia and delusions.

Meg Kissinger: And then when his mental illness began to burgeon and he was scared and ashamed and didn't have a way to really process that. So this was something we could see it coming a mile wide. And by now, having had the experience of losing Nancy, one would think that we would be better equipped to sit him down and have these very candid conversations. But we didn't. We still were really wrapped up in that shame and guilt. I'm being a little hard on myself because we ultimately did have conversations with Danny, urging him to get help and to go see a doctor, get on medication, get therapy, work it through. So it wasn't like we ignored it all together. But we didn't have very many sustaining conversations because it does take courage. You really do have to kind of empty yourself out and, and, and really dig out what's going on with the other person and have them trust you and tell you what's what's the matter with them. You would think we would have figured that out. Alas, we did not.

Sana Qadar: In the book, Meg paraphrases an Oscar Wilde quote and writes, to lose one sibling is a tragedy. To lose two looks like carelessness. And so when Danny died by suicide, Meg says, it felt like an explosion.

Meg Kissinger: I mean, it was it wasn't like twice the grief. It was like 2000 times the grief. Yeah. And and I think it was beyond cumulative. It was. It was crushing. It was. How could this happen again? And if it could happen again, if it could happen two times, why couldn't it happen three or 4 or 5? You know, are we do we all have a big sign on our backs? Are we are we just sitting ducks? And this is going to happen time and time and time again. That sounds so irrational right now as I'm saying this to you. But it it felt like that. It felt it felt like a curse. If we couldn't stop this, what could we do?

Sana Qadar: From her own family's experiences, and over her years of reporting on mental health, Meg has learned a few things about how to talk about suicide.

Meg Kissinger: Well, I've learned first and foremost that you should talk about it. So I. For so many years did not we would reference it ultimately. How could you not? You know, there's a Christmas card with ten people and all of a sudden there's a Christmas card with eight people. So you can't avoid the fact that there are people missing in your family and how they came to be missing. So we would talk about the the result, but not really what was leading up to that. And what I learned is that there are no shortcuts to grief, that you can't kind of just do this Reader's Digest version of your life. You really need to sit with things and consider them. We need to be present. We be more present to one another and take good care of one another.

Sana Qadar: And so for anyone who listens to this, who might have someone in their family or their friendship circle who has struggled with suicidal thoughts or maybe even made an attempt and they don't know how to talk about it. Do you have any specific words of advice for what they could do?

Meg Kissinger: What I've learned is that it's very important to ask somebody if they're feeling like harming themselves. I used to think that that was a scary question that you should not ask, because it's going to plant a bad idea in somebody's head, right? What I've come to know is that that idea is already in their head. And so it's important to ask that. And it's important to say, what is that plan? And I will sit with you and help you. I will talk to you about it. I will help you find a medical professional to talk to about it. I want to keep you safe.

Sana Qadar: These suggestions from Meg are grounded in research. The Beyondblue website also suggests asking someone directly about their suicidal feelings. It notes, research shows asking about it won't put the idea in their head. Instead, they'll likely feel relieved someone is there to listen and support them.

Meg Kissinger: That takes a lot of courage. It takes a lot of courage in yourself to be able to sit with that and let somebody tell you that. I've learned that that's that's a very important skill that we all need to master.

Sana Qadar: I want to talk now about how and when mental health started to become the subject of your reporting. In your book, you write about a pretty formative experience where you were on mat leave. This is back in the 80s and you were already a reporter at this point, but you came across something surprising of Nancy's. Can you tell me about that story?

Meg Kissinger: Sure. This was a winter night. I had gone down to Chicago with my then fat little baby son, Charlie, who was struggling with some kind of little fever. So he was he awakened in the middle of the night, and he was fussing, and I was trying to keep him quiet, to not wake up the whole house. And I was in my childhood bedroom, and I reached for any kind of book that I could read to him, just to soothe him. But the only thing I could find was my high school yearbook. And as I opened up the pages, I saw something that I'd never seen before. And they were little scratches, little notes in the margins and where my picture was, the teeth were blackened out. There were devil's horns on my head, and it looked like the little impish marks of none other than my sister Nancy, who at that point had been dead for nine years. And it was this very tender moment. In the middle of the night, I felt like Nancy had kind of come back from the grave, and we were sharing a little joke. She was she was pulling a fast one on me and making fun of me and teasing me. And so I was laughing, but also crying. And it was so moving to me and I. And as I was holding my little fat baby and I thought, you know, you never knew this sister of mine.

Meg Kissinger: And she was so funny and she was so naughty, and I loved her so much. But when she died, I was so traumatised that I really put her out of my mind. So I didn't talk about her and I wanted him to know about her. So I sat down and wrote about her, and I wrote this essay just about how meaningful she was to me, and that I was so sorry she was gone and I missed her so much. And I don't know, I just was all full of mother's milk and, you know, hormones and unresolved grief. And I poured it all into this essay, and I submitted it to the editor at the newspaper where I was working. And he loved it. And he put it on the cover of the Sunday magazine. And my father was so angry. He was fit to be tied. He just thought this was awful. Like, why would I write about something so personal and something so embarrassing as the fact that my sister had taken her own life and my mother, bless her heart, turned to my dad and said, Bill, she needs to write about this. This is how she processes her grief. This is how she understands by writing. And that really made all the difference to me. And when that story came out, it really put me on the map.

Meg Kissinger: You know, it kind of marked me as the person in the newsroom who had known this kind of tragedy. This was long before nowadays you read all these stories about somebody's family member who died by suicide or whatever. This was so rare back then. This was really unheard of. So it was really remarkable. And I heard from all kinds of readers, people really pouring their hearts out to me about people in their family. And I really came to understand that there's so much suffering out there that we whisper about that is just not addressed at all. So I started writing about it. I was lucky enough to have an editor who felt that this was an untapped vein and gave me all the rope that I needed, gave me so many resources, let me travel around to go out and tell these stories. And really, that's what I did for decades was just writing about the grief of mental illness, not properly cared for, and what that sorrow means both to the people who are struggling with mental illness and their families and then ultimately society. You know how when we ignore people who are struggling or suffering because of psychiatric illness, we are really laying a foundation of of chaos. As I said, I never ran out of stories to tell.

Sana Qadar: Meg is obviously based in the States, so the issues around access to care there are different to Australia, but access to care is an issue in both places regardless. Here's where things stand in the US.

Meg Kissinger: Here in the United States. More than half of the counties don't have a psychiatrist.

Sana Qadar: Wow.

Meg Kissinger: That's such a shocking statistic. But it's it's quite true. We also have great discrimination. So some people talk about stigma of mental illness, but I talk about it in terms of discrimination. And this is the distinction. So the word stigma you know comes from stigmata. So meaning like a marking. And when we talk about stigma, the suggestion is that the people with mental illness are marked by their illness in a way that's something that that is on them. Whereas the problem is how we treat people with mental illness, which is really discriminatory. So we don't provide them the same kind of health care. Here in the United States, in order to get clearance for a psychiatric visit, you call a different telephone number to get clearance from your insurance company so the services aren't as readily available, and the threshold to get those services approved for insurance is higher. We also tend not to hire people with psychiatric illness. There's all kinds of ways that we hold people with mental illness at a long arms length and don't really let them participate in society the way that we do, somebody who might be struggling with cancer or heart disease.

Sana Qadar: What is it like for you to cover these stories, to cover this beat, given your personal experience? Because like, in some sense, you know, it's not turning away from your trauma. It's facing it and reliving versions of it through the stories you cover. That must be really hard. Or do you feel like you have a mission here?

Meg Kissinger: A little of both. I do feel it's a bit of a mission. The week before Danny died, he wrote me a letter and he talked about what it was like living with mental illness. Now, Danny, you know, never had really acknowledged his own mental illness before. He was always quite embarrassed of of having mental illness. But in this letter that he sent me, he really bared his soul. And he talked about how awful it is to live with the disease that causes you to say and and act awkwardly and do things that you're later embarrassed about. And as I was reading it, I thought, wow, this is this is such a confession. You know, this this was very worrisome. I thought, this is this a suicide note? As it turned out, it was. But when he ended his letter to me, he said that. Only love and understanding can conquer this disease. And at the time, I thought that was such a cheesy thing to say. It was just he didn't talk like that. It just it just sounded such like such a, I don't know, like a greeting card or something. But after he died, I had I had great occasion, of course, to think about that. And I thought, you know what? He's exactly right.

Meg Kissinger: This is like the perfect algorithm. Like, if you love somebody, you'll try and understand them. And if you'll understand them, you'll understand how they are suffering, and you will work to help them and make them try and do what you can to make them feel better. So I wrote those words down on an index card, and I taped them to the side of my computer and I in the newsroom, and that became my battle cry. I really used that as my kind of go forth and tell the world and let people know what Danny was saying, that we need to love and understand people with mental illness. So that gave me a lot of fuel that that really I was really incentivised by that. That said, it was hard. It was hard writing about the struggles of people. And I would lie in bed at night and think about, you know, my mom pacing the halls, worrying about Nancy and my dad, you know, in the days after after Danny died, you know, just being so sorrowful and I and I had flashbacks, you know, in a sense. And I thought, you know, gee, it's it's important to bear witness, but it's very hard to bear witness.

Sana Qadar: Meg is in her 60s now, so it's been decades since the loss of her sister and her brother, but she only sought therapy for the first time in the last few years when she sat down to write her memoir. Now, she says, the guilt and the shame she felt around the mental illness and suicides that plagued her family are gone.

Meg Kissinger: I see now that we we did the best that we could with what we had at the time. It's not going to get you anywhere. It's what my dad used to call stinking thinking. You know, it's not going to change. It's not going to change anything. So the fact of the matter is, and this is a really important message, sometimes, despite your best efforts, despite all the love, all the care, all the opportunities that you give for somebody to unburden themselves or however present you are, some people are just catastrophically mentally ill. And they're going to they're going to take their own life. They're going to die. And just as the same is true with cancer or heart disease. It's just going to overtake them. And we can't spend our lives feeling guilty about that. If you've done everything you could and they die anyway, just know that you did your best. And that's there's got to be some peace that comes from that. I organised this book around a very beautiful poem by Mary Oliver, and this poem, called In Blackwater Woods, is about a forest fire and really the beauty that comes after. And it spoke to me about my own family and kind of the beauty that we have found in one another in the wake of the devastation of our family. And the final stanza of her poem goes like this. She says, in order to live in this world, you must do three things love what is mortal. Hold it against your bones. Knowing your whole life depends on it. And when the time comes to let it go, to let it go. And that's what this book has done for me. It's allowed me to let go, and I'm so grateful for that.

Sana Qadar: Oh my goodness, that actually made me tear up a little bit. That's really that's really beautiful and really affecting. Wow. I did not expect her cry.

Meg Kissinger: That's wonderful.

Sana Qadar: That's wonderful. That's really lovely. Thank you so much. That is such a beautiful spot to end this. I really appreciate you sharing that. That's really lovely. That was Meg Kissinger, journalist, Pulitzer Prize finalist and author of While You Were Out, An Intimate family Portrait of Mental Illness in an era of Silence. If this episode raised any issues for you, you can call lifeline on 13 11 14 or beyondblue on one 1300 22 4636. And that's it for all in the mind this week. Thanks to producer Fiona Pepper and sound engineer Roi Huberman. I'm Sana Qardar. Thank you for listening. I'll catch you next time.