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“And that’s really not funny, Matt,” his mother snapped.
Matt avoided her eyes and reached in the refrigerator. He came out with a bottle of Newcastle Nut Brown Ale.
“It’s a little early for that, isn’t it?” Amy said.
He held the bottle so that the lip of the cap was on the edge of the stainless steel counter. He then bumped the cap with the heel of his hand, catching it as it flew up off the neck.
“For medicinal purposes, Doc,” Matt said, smiled, then raised it toward her in a mock toast before taking a big swallow.
“Amy said she saw you on the early-morning news,” Patricia Payne said. “What was that all about?”
“Nothing good. But it’s why I needed to see Amy.”
“So, let’s hear it,” Amy said.
“Okay. I’ll try to keep this brief. Yesterday, as I was pulling into The Rittenhouse to see about leasing a unit that just came on the market . . .”
—
When he had finished five minutes later, Patricia Payne said, softly, “How absolutely horrible! Such a beautiful woman. And, from what I’ve heard, I mean that inside and out.”
“Well,” Matt said, “I cannot disagree with that. Everyone seems to say she meant well. Even her brother concedes it. But, apparently, the inside of her head had some real problems. Her brother said she fought mental demons forever. All the trips to rehab turned out to be little more than Band-Aids.”
He looked at Amy. She was refilling her coffee mug.
“So, Sigmund, what do you make of it?”
“Interesting that you bring up Freud,” Amy then said. “Erik Erikson, a well-regarded psychoanalyst, credits Freud for having said that for a person to have a healthy mental being, to be happy, there must be lieben und arbeiten—to love and to work.”
“I seem to recall he also said, ‘Sometimes a cigar is just a cigar.’”
“Bipolar is very real,” Amy, ignoring that crack, went on. “And, tragically, it is quite common. How much do you want to hear?”
“Whatever you got, Doc,” he said, rolling his hand in a gesture for her to go on.
She sipped her coffee, clearly in thought, then nodded.
“What’s known as mania,” she began, “defines the disorder, and the mildest level is hypomania. Those with it tend to have lots of energy. They excite easily. Yet it can also make them highly productive. As the level of mental illness gets worse, the behavior becomes impulsive. Bad decisions are made. They’re erratic. They don’t sleep. When it gets really bad, they can become psychotic—their world is distorted.”
“Jesus,” Matt said, then took a swig of his beer.
“It’s not pretty,” Amy said. “There is no consensus on how many types exist, but there are three main subtypes, and another one that is a catchall for everyone not fitting the first three. Then there are other mental components that can complicate a bipolar description, from schizophrenia to borderline personality disorder.”
“I heard Morgan say that the lithium helped—when Camilla Rose actually took her meds.”
“A mood stabilizer is needed, and lithium has been found to be most effective. Depending on the severity of the symptoms, an antipsychotic drug can be used—for example, to help severe behavior problems.”
She paused to sip her coffee, then went on. “The real problem is that despite how effectively we can diagnose the condition and create a treatment using a combination of psychotherapy and medication, the patient often chooses not to follow through.”
“Like Camilla Rose,” Matt said. “They stop taking their meds and skip their support group meetings. And self-medicate?”
“Yeah,” she said, nodding. “And what’s referred to as the true mania, a step worse than hypomania, can run for about a week, or even months. It simply varies from person to person. It’s a kind of euphoria, during which they’re prone to substance abuse. They speak quickly, their thoughts race, they focus really heavily on goals, and they engage in hypersexuality and other types of high-risk behavior . . .”
Payne, sipping his beer, felt his throat close involuntarily. He coughed, and a small amount of beer sprayed from his lips.
I’ll be damned! Is that why she was trying to seduce me?
Amy stopped and shook her head.
