Even a Mother Can’t Body-Block Mental Illness

ZIG-ZAG BOY: A Memoir of Madness and Motherhood, by Tanya Frank

When Tanya Frank’s otherwise healthy 19-year-old son, Zach, experienced his first psychotic break in 2009, he thought his friends had become members of the Russian Mafia, that his cellphone was bugged, and that his college was a network set up to spy on him, along with the whirring helicopters that seemed to hover over the family’s Hollywood Hills home.

Frank wondered initially if Zach, an agile surfer and chess standout, had gotten hold of a bad batch of psychedelics. She checked him for signs of a fever, then rushed him to the E.R., praying that the whole episode was a one-off, something doctors could quickly fix and put behind them.

Over the next several years, Zach would boomerang between hospitalizations and homelessness with periodic moments of wellness. His antipsychotic meds helped quell the voices in his head but also made him “numb inside” and gave him blurry vision and muscle spasms. When he wasn’t on the meds, things went downhill quickly, and he sometimes did dangerous things or fell into catatonia. Further complicating his condition was his inability to understand the reality of it.

Zach was eventually diagnosed with schizoaffective disorder, a topic his mother poignantly plumbs in her memoir, “Zig-Zag Boy,” which grew out of a 2017 essay she wrote for The New York Times. A freelance writer and former college lecturer originally from England, Frank has lived with her son’s illness in the United Kingdom as well as in California, finding the mental health care systems in both places woefully rigid and inept.

“Zig-Zag Boy,” titled both for Zach’s childhood nickname (Zigs) and for the perpetual back-and-forth of his illness, is by turns an eloquent meditation on the power of nature and a terrifying exposé on the hellscape of parenting a mentally ill child into young adulthood: the arrogant doctors who accuse Frank of mollycoddling, the trial-and-error guesswork of finding medications to quell the voices, and the byzantine bureaucracy that continually puts up barriers to care, from privacy laws that prevent her from discussing teenage Zach’s care with his treatment team, to untrained police officers who too often are de facto emergency medical workers, to conflicting theories on pharmacology.

Zach’s diagnoses are “as changeable as his mood, or as illustrative of the mutability in the field of psychiatry,” Frank writes. “It is guesswork, trial and error, more like a game of spin the bottle than science.”

Frank ultimately — and controversially, if you take mainstream medicine’s view that antipsychotic medications are crucial — comes down on the side of not forcing medications, noting that “many of the people who manage to live a life without drugs do not stay within the system and so are not a part of the statistical record.” Zach’s condition is so unusual — fewer than 1 percent of Americans will develop schizoaffective disorder — that it hasn’t been widely studied.

As the artist Jasper Johns once famously said of the creative process: “It’s simple. You just take something and do something to it, and then do something else to it.” The something else Frank hangs her intense, readable journey on is the healing power of nature and community.

When we first meet her, she’s training to be a docent for an elephant seal sanctuary in Northern California while her son is curled up inside a sleeping bag, hands over his ears to shut out the voices. It’s the sanctuary of marine life Frank turns to most for inspiration and healing. Watching as a mother seal finally leaves her crying adolescent pup, Frank wonders if she will ever “become a woman who isn’t solely consumed by looking after her son, trying to put him together again.”

Throughout her family’s ordeal, Frank finds solace in the mountaintop retreat she shares with her wife — which stands in as both therapeutic treatment for the author as well as for readers who may find Zach’s story too painful to process.

Frank also realizes that she must reach out for help, finding mentors in the struggle, including those successfully navigating life with schizophrenia disorders, parent support groups organized by the National Alliance for the Mentally Ill, and British-based groups like Safely Held Spaces, which push for supportive housing rather than hospitalization, without forcing medication protocols.

This book will be a balm for relatives of people with mental illness, particularly those who haven’t yet sought support. But if you’re looking for in-depth analyses of conflicting treatment modalities or scientific theories, “Zig-Zag Boy” is nowhere near as thoroughly researched as Kay Redfield Jamison’s work on bipolar disease or Leslie Jamison’s and Carl Erik Fisher’s addiction memoirs. While Frank name-checks some of the best-known advocates calling for mental-illness treatment reform — from Will Hall to Ellyn Saks — her mentions of their work are brief, mining little more than overviews available on TED Talks and in podcasts.

Does today’s uber-strong cannabis play a role in increasing psychosis among young people? Is Big Psychiatry over-medicalizing mental illness treatment because its greedy overlords know that it can be more lucrative to give someone a pill than to address the critical lack of supportive housing and psychosocial therapies?

At one point, Frank wonders why conventional medicine mostly views functional medicine as quackery, with the latter’s emphasis on natural protocols and vitamins and gut health. But we don’t learn enough about those modalities to make a call.

Frank is better at describing her journey than being prescriptive or placing it in historical context. There are crucial moments in her narrative, such as when Zach is kicked out of her home, where we’re not privy to the precipitating factors. It reads as if she had committed to telling her story, but she still wasn’t comfortable probing the hardest parts, possibly because of her fear of being stigmatized and judged — and possibly to protect Zach’s privacy. We also don’t know whether Zach participated in or approved the writing of this book.

Still, much of Frank’s writing is fresh with keenly observed details: There’s the umpteenth doctor “with the very white teeth,” the seal skin that “shimmers like silver foil” and elegantly woven biographical details: “The elephant seals conserve their energy in the same way my mum used to save electricity: vigilantly.”

What “Zig-Zag Boy” does best is put you inside the dark recesses of living with a mentally ill adult child, an experience that is on the rise and exacerbated by Covid-19. The same week I was learning from Frank’s book that half of people with schizoaffective disorder attempt suicide, and 15 percent succeed, I learned about a dear friend of a dear friend who also heard voices: 48-year-old Casey Clabough, a tenured creative writing professor who had written about his journey with schizophrenia, was pursued by park rangers and the police for driving on the beach after dark while searching for his dog. The misunderstanding escalated into a chase that ended with the officers’ guns drawn and Casey being tasered, according to his brother Seth Clabough.

“Denied what few remaining things brought him some measure of peace — his dog, seeing his family, walks in nature, his books and the ocean he loved to swim in — Casey hanged himself alone in his cell on New Year’s Day,” his brother wrote.

“Zig-Zag Boy” may not have many answers to this growing problem, but hopefully it will inspire the most important quality of all among providers, police officers and the public: empathy.

Beth Macy is a Virginia-based journalist and the author of “Dopesick” and “Raising Lazarus: Hope, Justice, and the Future of America’s Overdose Crisis.”

ZIG-ZAG BOY: A Memoir of Madness and Motherhood, by Tanya Frank | 224 pp. | W.W. Norton & Company | $28.95