The Past is the Prelude

My experience of mental illness begins with my father, who suffered recurrent psychosis and depression for decades following World War II.

Near the end of WW2, he saw a doctor at the American Hospital in Paris, and reported that voices in his head had convinced him he was guilty of terrible crimes in the past. He also reported vivid somatic symptoms and sensations, telling the doctor that his brain and body had become so diseased that he felt the urge to gouge his eyes out. The doctor told him that he must never tell anyone about this, or he would be seen as a disgrace to his country.

When the War ended, he returned to his home in Ohio, where he again contemplated gouging his eyes out or ending his own life. He self-medicated with alcohol, together with narcotics and other drugs he took from his brother-in-law’s doctor’s bag.

Over time, my father received a range of treatments during the late 1940s and early ‘50s, including hypnosis, major tranquilizers, ECT, and decades of psychoanalysis. He initially recovered sufficiently to be able to marry our mother, but continued to have relapses throughout our childhood and adolescence, and had multiple extensive inpatient stays at a local unit for treatment of mental illness, which were considered cutting edge at that time.

“The weather of depression is unmodulated, its light a brownout.” - William Styron

Neither medication nor mental illness stopped my parents from creating and raising a large family. My mother believed that the pleasures and connectedness of a large family to raise would provide my father with stability and meaning after his own childhood had been repeatedly disrupted by trauma, tragedy, and loss. This proved to be more challenging than they originally intended.

The unpredictable currents of parental mental illness

“About 61% of the children of parents with major depression develop a mental illness over the course of childhood and adolescence. The probability of mental illness in childhood and adolescence is elevated more than fourfold over that of the normal population” ¹

As children, our father’s recurrent bouts of psychosis were unfailingly terrifying, confusing, and disruptive to our daily lives. I feel guilty saying it now, but the sound of the ambulance arriving at our house to take him away, sometimes for months, often came as a profound relief.

_{My father looking at a toy truck at Christmas, soon after he was discharged from one of his hospital psychiatry inpatient stays.}

During his inpatient stays, our mother demonstrated an unmatched ability to keep the rhythm of our daily routines going, providing us with a lively but stable social and family setting. Her plucky “can do” attitude served us all well, even in the throes of our father’s depressive spells, her steady resilience gave us something to hold onto when we felt most at sea.

His multiple medications included sedatives, tranquillisers, and powerful opioids which were prescribed for his orthopaedic pain from bone atrophy that had been neglected during his army years. These drugs often came with erratic and unpredictable behaviour which, amid the dread of further psychotic episodes, left us apprehensive and confused.

During his periods of recovery, our father was the most engaging, amusing, and empathic person in our wide orbit. His physical disability meant that he was around much more than our friends’ parents, who always seemed to be off playing golf or going to the country club. Our father’s wit and warmth drew people to our house which was a hive of lively gatherings of family and friends.

The formation of psychological distress in my early years

On starting school, I experienced separation anxiety, developed gripping stomach pains, dizziness, fainting spells, and profound loss of appetite.

At night, I saw strange, surreal beings lurking in the corners of my room, outside the windows, or hovering over my bed. I lay paralysed with fear, terrified that any movement would alert them. Often, I could hear my father moving about in my parents’ bathroom, taking pills to help him sleep or ease his pain. The sound reassured me that I wasn’t alone.

I began to see patterns, signs, and hidden meanings everywhere. I was convinced that if a toy or doll was damaged, someone in my family would suffer. One time, the leg of my toy horse cracked and made me believe that my father’s hip complications would recur. I frantically tried to repair it with tape.

These fears gradually expanded. After accidentally knocking the pendulum off our grandfather clock, I became convinced that if it ever stopped, someone in our family would die. By adolescence, I was finding sinister meanings in ordinary words and events. My father’s “secretary” became someone keeping dangerous secrets, while his role as a chief executive fed elaborate fantasies that a deadly plot was unfolding around us, one that only I could solve. I kept these fears to myself, not wanting to burden my mother with yet another worry.

The most harrowing year of my life

When I was aged thirteen or so, my older siblings were all away from home much of the time, at college or prep school. While this allowed me to have a great deal of my mother’s attention and company, my father’s condition worsened. His delusions and paranoia became a constant presence, disrupting nearly every day.

At dinner he would accuse my mother of trying to poison him; his suicide attempts became more frequent and dramatic; he would lock himself in a room, refusing to come out for fear that he might injure us. It felt like his death was just always just around the corner.

One Thanksgiving, when everyone was together at home, he lunged at one of my siblings during a political argument, grabbing them by the throat. We watched in horror. The inevitable call for an ambulance followed, relieving us of his haunting presence, but left us shaken by how powerless we were to influence his behaviour.

At school, my grades plummeted. I felt sick every day, plagued by stomach pains and exhaustion from lack of sleep. Visits to the family doctor found nothing wrong – I was instead encouraged to eat more.

A fresh start

“This leaden and poisonous mood the colour of verdigris, so incongruous in the midst of the lush New England summer.” - William Styron

After many discussions, I was offered the chance to attend prep school near Boston, which provided me with a fresh start at school and an opportunity to distance myself from the storms of my father’s mental illness.

I loved my school in Massachusetts. In the late ‘60s, Boston was vibrant with change and the years of the counter-culture had taken hold, and I fully immersed myself in all it had to offer. My classmates and I cared passionately about civil rights, women’s rights, the Vietnam War, and avidly read the works of Ken Kesey, Marshal McLuhan, Laing, and other great thinkers of the time who brought new ideas into our minds and hope into our hearts.

On weekends we would go into Boston city center, hang around Harvard Square, wear peace symbols around our necks, smoke dope and drop acid in the Common. We listened with fervor to the music of the age that gave us a real sense of breaking free from all the traditions of the previous decades.

The music of that time embraced the positive social changes we were witnessing, but also leaned into the angst and disillusionment about the political social structures that remained unchanged. This helplessness - combined with the drugs - led many of us into a deep depression, with me included – especially considering I was experiencing the aftershocks from the tectonic ruptures caused by our father’s mental illness. It seemed a mental health crisis was imminent for me.

“Hello darkness, my old friend, I’ve come to talk with you again”

I gradually became encased by a carapace of depression. Although it provided me with a kind of emotional armour protecting me from feeling too much, it also caused my mind to be so profoundly numbed that I was cut off from the emotional connections that were such an inherent part of my friendships. I felt adrift, like an external observer of my own life rather than a sensate participant – quite the opposite from the child I used to be, one who was overwhelmed by love and fear.

“Lost in a Roman wilderness of pain / And all the children are insane.” - The Doors

In my Medium essay, My Year of Being and Nothingness, I described how the emotional numbness gradually gave way to terrifying physical sensations and the return of my childhood fears – early signs of my emerging psychosis.

“The psychosis initially introduced itself through bizarre physical sensations and perceptions about my body…” I became convinced I had hidden illnesses and parasites beneath my skin, leading to repeated visits to the school infirmary. At night, I lay away convinced my clothes had caught fire from static electricity, waiting for that first hint of smoke.

Those fears soon expanded into full-blown delusions of persecution. As I later wrote in My Psychosis:

“Once I returned to my dorm room... I would often lie awake all night in order to remain vigilant…Shadowy presences hover[ed] by my bedside, murmuring sotto voce, phantasms slipping through the closed door, voices behind the skirting board, malevolently cackling and snickering about me as they plotted and orchestrated my thoughts and actions.”

Looking back, I am struck by how closely my psychotic experiences mirrored my childhood fears and lifelong tendency to find meaning and danger in ordinary events.

Finding My Way Back

My chronic state of anguish eventually caught the attention of the dormitory house mother. I was fortunate to be referred to a psychiatrist in Boston, who quickly recognized how seriously my mental health had deteriorated, and arranged for me to return home without delay. There, I began seeing a child and adolescent psychiatrist who had been recommended by the parents of a close friend.

I received thoughtful, comprehensive care that matched the severity of my distress. As the relentless fear and internal chatter gradually subsided, I became able to engage in therapy and, little by little, return to my studies, friendships, and ordinary adolescent life. My parents and extended family provided not only a place of safety, but also the patience and encouragement I needed as I slowly found my footing again.

_{Me at the Assembly Ball (a major society event for debutantes) a year after my own psychotic breakdown}

The Shape of Recovery

Years later, after my father had also recovered from the illness that had dominated so much of our family life, he reflected on one of his own hospitalizations:

“One time in ‘49 I locked myself in the bathroom, broke the knob off so I couldn’t get out to hurt anyone, and chopped my arm with the broken knob to be weak and harmless when the police came. In the following three months on the psychiatric ward, I learned to receive kindness, and I worked my way out by realising what my wife and children meant to me, and what I meant to them.”

Reading his words now, more than fifty years later, I see my own story differently.

The only enduring trauma of my childhood was my father’s recurrent severe mental illness and the uncertainty it brought into our home. Yet that same experience also made him uniquely able to guide me through my own illness. He understood, in a way few others could, what psychosis felt like from the inside. Despite the suffering he had endured—and despite his own difficult experiences with treatment—he never allowed me to lose hope. He believed recovery was possible, encouraged me to trust the care I was receiving, and reminded me that modern treatments offered possibilities that had not existed when he first became ill.

I am neither glad that I experienced mental illness, nor sorry that I did.

I believe that every part of our lives carries meaning and helps shape who we become. I am still uncovering what the psychoanalyst Christopher Bollas called the “unthought knowns”—those deeply embedded experiences that quietly influence us long before we recognize them. Understanding how my father’s illness became woven into my own story has become part of my life’s work.

Dr. Annie Hickox is a consultant clinical psychologist and clinical neuropsychologist with more than 35 years of experience in the UK’s National Health Service and independent practice. She trained in clinical psychology at the University of Edinburgh, where she also earned a PhD in clinical neuroscience. Drawing on her experiences as a clinician, patient, and family member, Annie writes about mental illness, shame, stigma, self-disclosure, and the complicated terrain of speaking publicly about lived experience. Her writing has appeared in The Psychologist, The Guardian, and on Medium.