The signs that he was spiraling downward were everywhere. They appeared in his scribbles in red marker all over his apartment walls. They materialized when he stripped down to his skivvies at a happy hour, after winning a court case while sporting a new mohawk.
And they screamed out as he raced around New York City for 12 hours, darting through traffic, bounding through a dog park on all fours, assuming strangers were actors in his very own reality TV show.
By the time police handcuffed Zack McDermott — then crying, shoeless and shirtless on a subway platform — it was clear he’d had a psychotic break.
The 26-year-old Brooklyn public defender was in the midst of a severe manic episode. He was taken to Bellevue Hospital, where he spent 10 days in the psychiatric ward. He was diagnosed with bipolar disorder, a manic-depressive illness that afflicts more than 6 million American adults, according to the National Alliance on Mental Illness. Like most mental illnesses, it is often misunderstood, stigmatized and spoken about in whispers, if it’s spoken about at all.
McDermott, now 34, who traded in the practice of law for full-time writing in 2015, is on a mission to change that.
With brutal honesty, sharp humor and an accessible tone, he’s laid his journey bare in his book “Gorilla and the Bird: A Memoir of Madness and a Mother’s Love,” which was released September 26 and has been optioned for a TV series.
McDermott has offered glimpses of his story in various publications, introducing audiences to the tale of him and his mother, the constant supporter whom he calls “the Bird.”
“The ‘madman’ had raided my checking account, and there was no overdraft protection for ‘Sorry, I had a manic episode and rang up $800 worth of novelty T-shirts at Urban Outfitters,’ ” he wrote recently in the New York Times. “I’d taken to calling the Bird in the middle of the night, every night, to hear her voice. … She couldn’t tell me that everything was going to be O.K. because the truth was, she wasn’t sure. All she could do was make sure she kept answering the phone.”
He’s put himself out there for others struggling with mental illnesses, including the countless clients public defenders stand up for in courts, men and women who don’t have the support networks and privileges — including easy access to health care — that he’s had. Already, he’s seeing a payoff in opened conversations.
“It’s no longer surprising to me how many people have stories of their own or a loved one’s struggle with mental health that they are dying to share but embarrassed to talk about,” said McDermott, who says he’s been flooded with responses. “I hope we can give folks a little permission to talk about these things, because it’s important, and it’s everywhere.”
One among millions
Nearly 44 million American adults, or 18%, experience some sort of mental illness in any given year, according to the National Institute of Mental Health. Of those, about 10 million, or one in 25, live with a serious mental illness.
And adults in homeless shelters and prisons or jail are more likely to have a mental illness than those in the general population. More than 26% of adults in American homeless shelters have a serious mental illness, according to a 2010 report by the US Department of Housing and Urban Development, and a US Department of Justice special report released in June shows 14% of state and federal prisoners and 26% of jail inmates have “reported experiences that met the threshold for serious psychological distress.” Even more inmates, 37% of those in prison and 44% of those in jail,” had been told in the past by a mental health professional that they had a mental disorder.”
Too many adults with mental illness go untreated. Nearly 60% went without mental health services in 2014, according to the Substance Abuse and Mental Health Services Administration, and odds of getting treatment often fall along racial lines. For example, African-Americans and Hispanic Americans accessed mental health services at half the rate of whites, the administration found in 2015.
In a number of ways, one might say, McDermott was lucky — not least of all because of the mother who raised him.
Hours before McDermott was born, his Uncle Eddie — diagnosed with paranoid schizophrenia — was taken away by ambulance and institutionalized.
The reality that mental illness ran in the family shaped how Cindy Cisneros-McGilvrey, the Bird, watched her son. She tried to stay positive and not worry, but there was no denying that Zack, her middle child, concerned her, McGilvrey says. Early on, he was difficult, volatile, prone to pounding his fists and holding his breath till he turned blue. He trusted few, and McGilvrey says she lost babysitters because of him.
By the time he went off to elementary school, though, he’d adjusted socially. Her son was highly intelligent and funny, but he was also a smartass who “suffered no fools,” she said. Boredom drove him to torment others, and he liked to make people uncomfortable. He’d do striptease acts, which was ironic given what transpired as he unraveled in New York years later.
When he was in law school at the University of Virginia, McGilvrey worried about his excessive partying. Given her brother Eddie’s history, which included abuse of drugs, her own struggles with depression and her father’s alcoholism, she says she issued warnings.
“Zack, you know the odds aren’t in your favor,” she remembered saying to him. “Let’s not play Russian roulette with the gene pool.”
McGilvrey, an educator in Wichita, Kansas, who helps adults of all ages earn high school diplomas, was vigilant. She read up on mental illnesses. She attended counseling with her children after her divorces, first from McDermott’s biological father and then from his stepfather. The Bird watched out for her boy like a hawk.
McDermott doesn’t dispute that he was a handful.
“I was an awful kid,” he said, ticking off his offenses. “I’d been arrested five or six times, got into a lot of fights, totaled a couple cars and partied way too much from 14 on.”
There were some bouts of clinical depression in high school, college and law school, he says, but that didn’t faze him.
“I felt a little crazy,” he said, “but good old-fashioned crazy.”
The Bird swoops in
The night he was hauled off to Bellevue by police, McDermott’s roommates called his mother to tell her what had happened. She’d never been to the East Coast, let alone the Big City. But by the next morning, the Bird took flight to be with him.
She’d didn’t know how to hail a cab and arrived with five $100 bills, she said: “one in my bra, one in each shoe and one in each back pocket.”
At the hospital, McGilvrey stood on her tiptoes to peer through a window and see her son. The mohawk and “Fu Manchu mustache” threw her, she said, as did the 35 pounds he’d lost.
“I knew it was Zack, but he didn’t look like Zack,” she said. “He didn’t talk like Zack. Even his gait was different. He was not aware of his surroundings or what was going on.”
She entered the room and stood behind the yellow line she wasn’t allowed to cross. When she announced who she was, he didn’t believe her. Then he leaned into her, allowed her to hug him, and she called him “Gorilla,” the nickname she uses for her dark-haired, barrel-chested boy. That’s when he knew it was her.
During his 90-day leave of absence from work, she would take him home first to Wichita, where he remained for more than a month. But for the 10 days he was institutionalized, her days revolved around her visits to him, during which she stayed strong.
“I did not cry in front of him,” she said. “I cried all the time when I wasn’t with him. … I could not shake the image of my brother,” who died at 42 after 15 years of being institutionalized.
Every second of every visiting hour, she was at McDermott’s side. She hated to leave. Even in his compromised state, he remained his funny and thoughtful self.
“Bird, you better leave, because they’re going to lock you up too, and then what are we going to do?” she remembers him saying to her, allowing them both to laugh.
Fulfilling a purpose
The average onset age for bipolar disorder is 25, and McDermott presented as a textbook Bipolar I Disorder case, his longtime psychiatrist said. Bipolar I is assigned to those who have severe episodes of mania and, usually, depression.
Dr. Prameet Singh, the New York City psychiatrist who’s treated McDermott since 2010, says the diagnosis is sometimes tossed around too easily when people are really moody. The crippling protracted effect of Bipolar I, when not treated, far exceeds any kind of mood swing, he says.
It’s hard to say what set off McDermott, but Singh says his alcohol and drug use — he smoked a lot of marijuana — didn’t help. Nor did his high-stress job and lack of sleep.
In the years since that first episode, there have been a few others.
McDermott, though, has been “inordinately lucky,” Singh said, because the psychiatric medication that works for him was identified quickly and results in no side effects. He takes his meds like clockwork, stopped smoking marijuana, cut back on his alcohol intake and has “a really good internal barometer,” a level of self-awareness that allows him to recognize when an episode is coming on, which helps him ward it off.
“I believe that my son is fulfilling his purpose,” she says. “He took something that was horrible and devastating and turned it into this book. Not only has it received critical acclaim already, I think it’s going to give people permission to talk more openly about mental illness.”
Her son is reminded that he is not alone by the stories that have poured in since he published his own.
A mother wrote to tell him of her son’s suicide. A guy wrote to say how he’d been arrested four times in a year, coinciding with four manic episodes. A man in his late 60s said he, too, was in his 20s when he had his psychotic break — but pharmacology then wasn’t where it is now.
“It’s cool, because no one will usually cough this stuff up, but when you do, they want to share,” McDermott said.
And even for those who are lucky enough to not be touched personally by mental illness, Gorilla and the Bird hope their experiences increase empathy and force much-needed conversations.
“Everyone is hurt, and everyone is wounded,” McGilvrey says. “It’s not always obvious.”