This piece has nothing to do with a book which i read once,  “Love in the Time of Cholera” written  by Nobel Prize wining Colombian Author Garbriel Garcia Marquez.

This poignant novel had nothing to do with cholera though in the words of novelist himself  the lovesickness of key protagonists that was so pronounced in the novel was nothing but a disease comparable to cholera. But in the literal sense, if cholera had  such destructive power on the humanity  that its outbreak it killed millions  and wiped out whole cities in no time and there was hardly  any time left to love during the outbreak of cholera. During the time of cholera, it was not the love, but the sudden grief was pronounced as those inflicted with cholera died swiftly leaving in its wake painful memories.

But this  piece has something to do with a book I  have just finished reading, “No one Told Me: Love in the time of Dementia”  by S. R. Karfelt.

The book has had profound impact on me, “dementia” is a mind-malady whose nuts and bolts we have not been able to decipher so far nor are we likely to do so any time soon. It is a terrible situation where “memory loss changes, more than the person who can not remember. It changes those who can not forget” (taken straight from the inner cover of the book)

Loving those in the grip of dementia, is indeed tough, more so when one in the throes of dementia neither knows nor cares how much he/ she is being loved by those who love her/ him.

This piece has all to do with- “Love in the Time of Madness”.

And before I begin I ask for pardon if my choice of the word “Madness” (instead of more secular or more palatable word like “mental illness or mental disorders”) is considered insensitive by some/all readers. But I have stayed put with the madness for last two decades simply because “madness” is one composite word by which for last two millennium those suffering with all sorts of mental illnesses across nations, cultures, races and religions have been described with.

Madness is an impossible condition to live with.  And loving some one afflicted with madness has often been more difficult than living with madness itself.

And make no mistake. Both the incidence and severity of madness  has been on uptick in society and with all the advances in the science, the treatment of severe forms of madness at the best remains palliative and symptomatic.

The etiology of various forms of madness remain elusive.

In last century and half the only form of “madness” which doctors have been able to cure is the “General Paralysis of Insane (GPI) which was first treated by the Malarial Fever therapy  by Wagner-Jauregg and then more authoritatively by the Pencilin after its discovery.

In last seventy years or so, the great awakening of psychopharmacology will make us believe that it has all the solutions of madness. I wish it was the case. I am one of the classic cases where “psychotropic medicines” have helped me mostly retain my sanity even in insane times. Also agreed these medicines have helped millions remain productive and millions more have been saved from being institutionalized in hospitals or homes. But sad truth remains, with all the advances, the numbers of mad have only gone on increasing.  If you look from one side it is “madness visible” from other side it is “Madness Invisible” .

But it has been madness, madness every where you go.

Living with madness in is crippling. But living with mad is excruciatingly tough. And loving a Mad requires summoning all the internal reservoir of energy from the one who make it their duty to love the mad.

If the “mad” person is your parent or your “off-spring”  love or not in most cases you are forced to stay put with them in Indian conditions. I say so with informed knowledge because in a country of 135 crore population, the mad in asylums of all types (mental hospitals run by government, private sector and NGOs taken together) do-not exceed 25,000. Even if we assume that another couple of lakh  have found place in other institutions (like jails beggar homes etc), most of the severely mentally ill, i.e. four crore of them (3% percent of population) remain at home and are looked after there.

It is a big question whether those declared “mad” are also loved at home or just tolerated as hobsons choice?.

Let me say so from personal experience of having befriended madness for better part of six decades of life, that even my family which has shown extreme empathy and has loved me unconditionally always, has found it excruciatingly difficult not the get baffled at times. Time and again their coping strategy has been tested beyond the human power of endurance. And I have been one of the luckiest person who has been loved unconditionally despite extremity of the lightning rod of mania or the deafening and decadent flame-out of depression.

The contour of love at the time of madness is changing fast at least in urban areas of the country.

With more and more marriages becoming love-marriages (unlike traditional arranged marriage), the meaning of love in the time of madness too is changing fast. If the mad person is a boy friend or a girl friend, there is an easy exit route available. Even short term price of staying put with the partner in the throes of madness is so overwhelming that the early exit route is becoming the preferred choice. But more complicated are the young cases, where one spouse gets mad or seriously mentally ill. Well the Hindu Marriage Act (rather all the variants of marriage laws in India) again provide a very liberal exit route.  The party who is well can exercise the choice, and get out of the wedlock almost instantaneously.

Except that, a little love, having stayed put for a while would have made the so called mad person well again. There is no nostrum better than love in the time of madness for those in asking questions in life when the madness strikes.

What if madness strikes one spouse after a decade or more of marriage. Well life gets more complicated if there is only one earning member in the family and he/she turns mad. Complication does not lessen even where both are earning members. Getting internal resolve to take care of the mad spouse even if all the love is in place often becomes impossible. More complications arise with now family getting turned into one parent family for the “children” ? Love or not. Staying or moving out of such a marriage becomes all the more difficult

What if Madness strikes in fifth or sixth decade of life

By fifth or sixth decade of life, marriage has run its course of time. Old love either withers out or the golden love of having lived together for decades in harmony turns into bliss. Madness is known for striking early in life. But what if madness changes its trajectory and arrives late in life. Particularly if it arrives late in fifth decade or early in sixth it is a period when with children having ventured out of your life, it is only spouses who are left to take care of each other. With all the love in their heart, they may not have much energy left.

What if one spouse is gone, other gets mad

In the definition of madness here, apart from all the classic forms of madness i also include dementia of all hues.  With the love of the life gone, how does one get love in this stage of the madness. I have seen recent examples in close quarters- in one case solution found was institutionalizing in mental hospital, in the second case, I found the surviving partner taken to old age home and in the third case I found the person taken in by the children.

In all the three cases, I found love was what was missing.  And the love was needed most.

So where do we go from here