Mental Illnesses Travel in Packs

Who would think that a person with one serious illness could have two or more? It seems cruel, unconscionable that God would allow that. And yet, like other inexplicably painful phenomena, it happens more often than we think. 

The condition of having multiple illness goes by several names: dual diagnosis, co-existing disorder, co-occurring disorder, or co-morbidity. People can have co-occurring mental disorders, mental and intellectual disabilities, or mental and substance use disorders. No matter how you mix or match these, it relates to someone having several illnesses at once. Rachel hit the jackpot: she had co-occurring physical, mental, and substance use disorders. 

Co-occurring disorders are not uncommon. People can receive a medical diagnosis for a physical problem, like cancer, and then develop a mental disorder, such as anxiety or major depression. Or they can receive one mental diagnosis followed by another;[1] for example, major depression co-occurs with anxiety disorders in 50 percent of cases; and with eating disorders, namely anorexia and bulimia, in a whopping 92 percent of cases. [2] Not surprisingly, people with a mental health condition are twice as likely as the general population to acquire a substance use disorder.[3]

Please don’t gloss over these facts. Co-occurring disorders are painful and dangerous. To appreciate a victim’s plight, you’d have to understand how daunting it is to cope with just one serious illness. Diabetes alone requires a person to maintain a constant balancing act between food, exercise, and insulin for healthy blood sugars. Sickness or stress throws everything off. Highs and lows respectively induce searing stomach pains and dizziness. Future health problems constantly loom. You’d have to witness the wild mood swings of someone with bipolar disorder to comprehend how much that one disorder tortures him/her. People with bulimia grapple with chronic freight-train urges to binge and purge; guilt and despair; massive food bills; and frightening physical symptoms. Individuals with substance use disorders, who have struggled for decades with alcoholic or drugs, have their own horror stories to tell. Each disorder comes with its own set of distressing symptoms and risks. Any single major illness is so fierce, so all-consuming that it can overtake a person’s life. And even with treatment, certain disorders require lifelong maintenance. 

Now, if you can imagine how difficult it is to live with one serious illness, multiply that by two or three to get an inkling of the hell people with co-existing disorders live in. It’s no wonder they tend to be less responsive to treatment, have poorer prognoses, and exert a greater demand on health care services than patients with a single illness. People battling multiple illnesses also have more brutal symptoms and poorer quality of life, not to mention suicidal thoughts and higher rates of suicide.[2]

In Reckless Grace, I’ve tried to bring these truths to light. My deepest hope is that my book makes it to the nightstands of people in high positions--doctors and nurses and CEOs of health insurance companies, hospitals, and eating disorder (ED) facilities--moving them to review and improve practices and policies that would give young people with co-existing disorders a fighting chance to improve their health and live long, full lives. 

Carolyn DiPasquale grew up in Franksville, Wisconsin, graduating from UW-Milwaukee with a double major in English and French. In 1983, she moved to Rhode Island where she raised three children while pursuing her Master’s in English at the University of Rhode Island. Over her career, she taught literature and composition at various New England colleges; worked as a technical writer at the Naval Underseas Warfare Center in Newport; and wrote winning grants as a volunteer for Turning Around Ministries, a Newport aftercare program for ex-offenders. She has been an active member of the Newport Round Table, a professional writing group (founded in 1995), since 2013. 

[1] https://www.verywellmind.com/what-is-comorbidity-3024480

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4392551/

[3] National Institute of Mental Health

The Child of Ukraine: Weaving the Threads

Time seems to travel in a circle. Or at least, I remember thinking that when I saw that my book was being bought and read by people after the war in Ukraine started, in February 2022. It’s as if the thread I pulled in 2016, when I began writing this book, was the thread that brought it all together now. Time is funny that way, you only understand how it connects events by looking backwards. "You can't connect the dots looking forward," Steve Jobs famously said. "You can only connect them looking backward.” 

My family is full of threads that are stories woven into a tapestry of who we are: most cultures are like that, but Ukrainians in particular; we are now seen in the world as a country full of storytellers, and fervently stubborn survivors. It was one of these stories, about my maternal grandmother, that catapulted me into finally pursuing a writing career, and I wrote it really for myself, and my own family, but I knew that it would resonate with families the world over. You see, survival and grief and hope are universal themes that we all live with, and the more we talk about them with our parents and grandparents, the more empowered we will be to be transparent in navigating our life on this planet. Or at least, not be ashamed to share that for the most part, we’re figuring it out as we go along. None of us have the answers. 

The Child of Ukraine was one of those stories that flowed out of me like an imperfect fever dream: I saw it play out in my head cinematically, and I wrote it with pure instinct. Was it perfect, even after the 8th draft? No, but no life is, really, and no story is. And once I’d published it, I saw a wave of interest with people not just because it was a story about a mother making impossible choices in her life, but because it prompted people to start asking questions of their own family history, to know where they came from, and to see their living history as full of people that are humans, not just parents and grandparents and aunts and uncles. 

Having published the story in 2020, I noticed that the ebbs and flows of people wanting to read the book was one of those things that I had to accept: people weren’t really aware of Ukraine and Ukrainian stories even as recently as two years ago. Ukraine had always stayed within Russia’s shadow and had always been seen as a poor country full of farmers and cleaners and rent-a-brides. Sadly, this media portrayal was pretty pervasive for a long time. It was only since the war began and Ukraine was front and center in the news on a daily basis, fighting for hope and survival, did the attention on my book (and other Ukrainian translators and authors) kick in. Albeit the circumstances were unfortunate, but the passion for this story was immense. I started seeing a huge investment in not only the media but from readers and agents and activists around the world, reaching out to me and others on how we all feel about writing and creating art during a time of such unrest and grief.

How do I feel? How do we all feel, collectively? Tired, is the first word we can all agree on. But I suspect that every single Ukrainian around the world feels heard, supported, and validated. We have been waiting in the wings for so much of our art and for all of our voices to be amplified, and now we have a moment to extend the narrative past war, past death, and destruction. I feel it is our time now to create a lasting legacy of hope, of creativity, of modernism, of architecture and industry. We are a country with a modern leader who is using social media platforms to create an awareness of Ukrainian culture, our heritage, and our history. And within that history, I’m so pleased that my book, and future books, will connect people not only to Ukraine and its people, but also Ukraine and the countries around it: Poland, Hungary, and even Austria and Germany. 

When my grandmother was dying and I told her about the book that I wrote based on the epic story of her life, she said to me, “little mouse, surely my life isn’t that interesting. So many of us went through much of the same during that time.” Which made me realise that these incredible stories of love, loss, betrayal, and hope is now more important than ever, in an age where time and news stories move so quickly. We, the artists, the voices, are the creators of a new legacy of hope and empathy and change; we are the dreamers, we are the future. Stories like this will create lessons of determination and pride when so much of the world feels like it’s not listening. It is, and we are the ones who will encourage it to, we will connect those threads and create more circles.

Tetyana Denford grew up in a small town in New York, and is a Ukrainian-American author, translator, and freelance writer. She grew up with her Ukrainian heritage at the forefront of her childhood, and it led to her being fascinated with how storytellers in various cultures passed down their lives to future generations; life stories are where we learn about ourselves, each other, and are the things that matter most, in a world where things move so quickly.

A Conversation with Dwyer Murphy, author of An Honest Living

After leaving behind the comforts and the shackles of a prestigious law firm, a restless attorney makes ends meet in mid-2000s Brooklyn by picking up odd jobs from a colorful assortment of clients. When a mysterious woman named Anna Reddick turns up at his apartment with ten thousand dollars in cash and asks him to track down her missing husband Newton, an antiquarian bookseller who she believes has been pilfering rare true crime volumes from her collection, he trusts it will be a quick and easy case. But when the real Anna Reddick—a magnetic but unpredictable literary prodigy—lands on his doorstep with a few bones to pick, he finds himself out of his depth, drawn into a series of deceptions involving Joseph Conrad novels, unscrupulous booksellers, aspiring flâneurs, and seedy real estate developers.

Your novel is a love letter to New York City during the aughts of this century . . . from Williamsburg to the Village to the Upper West Side, the bridges, subways, and architecture that make up the city. NYC is a character in many ways. How did you develop such a clear love and respect for the city, and how did you communicate that on the page?

I’ve spent most of my adult life in New York. Even if I hadn’t, I probably would have felt that way about it from books and movies. We all have an idea of it as a character, right, for better or worse, hero or villain? I moved here while I was in law school. I knew some people with an open bedroom in a duplex near the Brooklyn Museum. The rent broke down to four hundred a month so long as we provided upkeep on a two-story organ built into the apartment. How can you beat a thing like that? It was a couple hundred blocks from campus and I got in the habit of jumping off the subway and wandering the streets when I should have been in class. In my mind, the city was mapped out as a series of bookstores, movie theaters, good food, and erratic subway connections.

As far as getting it onto the page, it wasn’t too hard to conceive, I’ve always loved flâneur novels. Get the characters walking, breathing air, talking to people, wearing out shoes. That melds perfectly with the tradition of private eye fiction, which this turned out to be, an accidental detective novel in the middle of a city full of arcane laws and a million people ignoring them in their own distinctive ways. That’s the town of my dreams—a city of well-read scofflaws.

Your semi-anonymous protagonist is an attorney. You were a lawyer before becoming editor-in-chief at CrimeReads. Why did you give up the law for writing and crime fiction?

Giving up the law always seemed to me the only decent thing to do with it. I practiced at a corporate firm in New York. I was a litigator. For a while it appeared to me a pretty genteel if inherently cruel profession and I always knew that I would quit it as soon as I could, before it worked its way too far under my skin. I did meet a lot of interesting people during that time. Strange clients with midnight crises, judges, prosecutors, opponents. A lot of gruff litigators schooled in the old New York lingo of chits and power brokering. It wasn’t a bad way to spend your formative years, but at some point you had to get the hell out. For me, books were the way out. I didn’t have any intention of writing about lawyers or the bizarre mysteries they sometimes get mixed up in, but when the time came that was the kind of story I wanted to read and to tell.

How has reading and reviewing hundreds of mysteries and thrillers as an editor at CrimeReads. informed you on writing a crime fiction novel?

It’s given me a deep appreciation for mystery fiction as a means of telling vivid, passionate, provocative stories of human striving and misunderstanding, a form passed down through the centuries, built around the dark art of suspense, entertainment and respect for your readers. The crime fiction world today is full of new voices telling timeless stories. I wanted to be a part of it.

An Honest Living is set in the early 2000s, at the tail end of the analog era and before Internet culture fully took over. Why did you want to write about this time period?

There was a mystery to everyday life during that time, some of which was snuffed out by the full onset of the digital era. I used to sit around bars and living rooms forever debating questions that could be answered by a google search. My pockets were lined with calling cards and I spent a good portion of every evening trying to get ahold of people I knew to find out where we were going or what time a movie was playing. Your roommates disappeared. Your bodega shuttered without explanation. The 2 train ran on the 4 line and it was up to you resolve all these little puzzles. That was the kind of mystery I wanted: full of odd, bewildering, lonely moments.

An Honest Living is a tip of the hat to noir mysteries and mentions “worlds colliding” 1950s films like Touch of Evil, Roman Holiday, Rear Window and, especially, from a later era, Chinatown. In what ways do the plot, atmosphere, and characters mirror Chinatown?

I can’t be the only one who thinks of Touch of Evil and Roman Holiday as a nice double feature, right? Or Rear Window as a guide to life? Chinatown was a movie I got obsessed with while my wife was first pregnant. I would fall asleep watching it, and in the morning we’d talk through various vindictive lawsuits the characters might have brought against one another. Lawyers get up to strange activities left to their own devices with a major life event looming on the horizon.

So, Chinatown worked its way into my life. I started seeing it everywhere, which I think is a little how Robert Towne might have felt when he was writing the thing, and certainly how Jake Gittes felt living through it. The fiction seeped into my New York existence and colored the way I saw friends and neighbors, new building developments and old bastards who mispronounced my name. I started writing a novel where Chinatown, the movie, has an outsize influence and Chinatown, the ambiguous unknown metaphor, prevails over ordinary logic.

What was your process for developing the noir feel the novel has? Did any crime fiction books from another era influence you? If so, which ones?

Ross Macdonald and the restrained, bighearted poetry of the Lew Archer novels were my touchstones. I was reading a lot of Margaret Millar at the time, too. Nobody writes a perplexing, insidious phone call like Margaret Millar. (She happened to be married to Ross Macdonald, aka Kenneth Millar, and imagining what that marriage might have been like no doubt influenced the direction of the ruthless literary relationships I was writing about, too.) God, I love classic noir. And from later eras, Donald Westlake, Lawrence Block, Elmore Leonard, with all those schemers and operators talking a mile a minute, mixed up in one another’s lives. Then returning again to Walter Mosley, Megan Abbott, Roberto Bolaño, Santiago Gamboa, Idra Novey, Laura van den Berg, all these writers capturing an uncanny, unmoored feeling at the heart of great noir.

Is there a second crime fiction novel in your future? If so, what can you tell us about it?

I’m at work on a sequel to An Honest Living . It’s another off-kilter murder mystery in the world of arts and letters, similarly obsessed with classic movies and noir atmospherics, but this time the characters go to Miami. It must be my homage to Elmore Leonard and another beloved lost city.