At age 31, President Abraham Lincoln described himself as the “most miserable man living.”

The misery would continue for another 25 years until his assassination in April 1865.

It wasn’t the effects of politics or even a raging Civil War that left the American icon in such emotional turmoil.

The 16th president of the United States battled severe depression.

There were days Lincoln could barely get out of bed, let alone last hour-to-hour to serve as commander in chief and free the nation of slavery.

“… Whether I shall ever be better I can not tell; I awfully forebode I shall not; To remain as I am is impossible; I must die or be better,” Lincoln is quoted as saying in Joshua Shenk’s 2005 book, “Lincoln’s Melancholy: How Depression Challenged a President and Fueled His Greatness.”

Die or get better

For most suffering from mental illness, those seem like the only two options: die or get better.

Sixty-three-year-old Barbara Franklin decided to get better – but not before clawing her way through hell and back into recovery.

Times-Mirror Staff Photo/Beverly Denny From left, Barbie Franklin, Amina Muhammad and Jean Campbell, all of Sterling, participate in a yoga class designed for those with Parkinson’s disease at the Loudoun County Senior Center July 12. Instructor Bonnie Elliott has been teaching yoga for three years. “It’s not easy for the mind to process trauma so the movement of the body allows you to release tensions of the body, mind and soul,” Elliott said.

Since 1972, the Sterling resident was hospitalized time and time again for substance abuse and mental health issues. Between 1982 and 1994, Franklin attempted suicide three times, including one episode in 1987 where she swallowed an entire bottle of barbiturates and chased it with alcohol.

“I’m lucky to be alive,” Franklin said. “… But by the grace of God, during that hospitalization, the doctor made sure I got to the drug and alcohol support that I needed.”

But for other Loudoun County residents, recovery never came.

This year the Loudoun County Sheriff’s Office already has 14 confirmed suicides. Last year, there were 28 –  a 75 percent increase since 2010 when 16 people took their own lives. In 2009, there were 19 confirmed suicides.

The numbers point to a disturbing trend, according to Loudoun County officials, who worry there are not enough resources available to treat the area’s residents in need of critical mental health services.

Times-Mirror Staff Photo/Beverly Denny Barbie Franklin holds her hands in a comfortable position at the start of a yoga class at the Loudoun County Senior Center July 12. Franklin has been practicing yoga for decades and also knows hand formations called mudras common in yoga.

Nationally, an estimated 45.1 million adults age 18 and older suffered from a mental illness in 2009, the latest statistic available, according to the Alliance for Health Reform.

For Franklin, it would take 28 years to get the right treatment to lead a healthy, productive life. The Sterling resident was first hospitalized for abusing “mind drugs” – everything from marijuana to LSD to mescaline.

Seven years later, in 1979, after the birth of her son, she found herself in a Fairfax hospital, this time for what doctors said was postpartum depression.

“Buck up”

Decades ago, mental health was a taboo topic. Many suffering from an illness were cast away, shunned or sent to asylums to live, according to Mental Health America, a national advocacy organization.

In 1946 the National Mental Health Act was passed, establishing mental health treatment institutes across the country.

From 1955 to 1980, the focus shifted to moving patients from treatment facilities to community integration, such as housing and jobs. During that time period, the population at institutions fell from 559,000 to 154,000, according to the National Alliance on Mental Illness.

By the 1990’s, whole institutions began to close and more state-controlled funding was allocated to community care.

Times-Mirror Staff Photo/Beverly Denny Barbie Franklin of Sterling, left, participates in a yoga class designed for those with Parkinson’s disease at the Loudoun County Senior Center, along with Amina Muhammad and Jean Campbell, right, both of Sterling, July 12. Instructor Bonnie Elliott has been teaching yoga for three years. “It’s not easy for the mind to process trauma so the movement of the body allows you to release tensions of the body, mind and soul,” Elliott said.

Still, during those decades, doctors didn’t properly know how to treat mental illness. There wasn’t a plethora of drugs available to treat various diagnosis and most patients were lacking family support systems. Patients were usually told by their loved ones to “buck up” and “learn to pull yourself up by your bootstraps.”

It’s a stigma that still exists today, according to Joe Wilson, director of the Loudoun County Department of Mental Health, who worked for two years at Walter Reed Army Medical Hospital, helping to treat soldiers suffering from post-traumatic stress disorder.

“People don’t really have a great understanding of what mental health challenges look like and how do we define those in a way that leads us to then get to resources,” Wilson said.

Plagued with depression

Franklin left the hospital in 1979 without treatment.

“They didn’t really haul me in and go over my case with me,” she said.

She came home still plagued with depression so debilitating she was unable to take care of her son and then-husband, a struggle that lasted for years.

“I really was in too much pain physically and emotionally to take care of them by myself,” Franklin said.

Franklin was not only fighting depression but mild schizophrenia – a diagnosis she wouldn’t learn about until years later.

Unable to function, Franklin lost custody of her son to her now ex-husband, who took their child to Denmark. The loss of her son was too much for Franklin and she was again hospitalized, released and then spiraled deeper into her depression, again attempting suicide in 1982.

After a four-month stay in an institution in Northern Virginia she went to a group home in Philadelphia.

Throughout her two-year stay in Philadelphia, Franklin was getting help, but still was determined to get her son back. A trip to Denmark in 1984 left her in another mental hospital in Paris. 

“I think I really was just in the wrong place at the wrong time. It can happen when you don’t know what you’re doing and you’re lost,” Franklin said.

Once released from Paris, Franklin found Friendship House, a Loudoun County-based mental health rehabilitation program. But it wasn’t enough. Her final – and worst – suicide attempt came in 1987, but Franklin believes it was then she finally got the right help she needed.

She was given a diagnosis of severe depression and mild schizophrenia. She was sober and her prescribed medication finally got a chance to work.

Hard, cold steel

In 1996, Franklin would relapse. It’s a common occurrence for those suffering from mental illness and substance abuse.

A 2009 study by The Alliance for Health Reform found that 26.9 percent of people with mental illness also used illicit drugs, more than double the 11.6 percent of people using drugs who did not have mental illness.

This time, Franklin’s relapse would cost her more than a hospital stay.

Franklin was caught trying to buy cocaine and was sentenced to a year in prison.

“If you like hard, cold steel go out and get some drugs and get some undercover cop to find you. It’s not pleasant,” she said.

During her time at the then Loudoun County Jail, Franklin said she received decent mental health treatment.

Times-Mirror Staff Photo/Beverly Denny From left, Barbie Franklin, Amina Muhammad and Jean Campbell, all of Sterling, participate in a yoga class at the Loudoun County Senior Center in Sterling July 12. Instructor Bonnie Elliott has been teaching yoga for three years. “It’s not easy for the mind to process trauma so the movement of the body allows you to release tensions of the body, mind and soul,” Elliott said.

Today, at least 16 percent of the population at the Loudoun County Adult Detention Center suffers from some type of mental health disorder, according to Maj. Rick Frye, division commander.

Adding substance abuse into the equation, the number skyrockets to 80 percent, Frye said. These statistics mirror numbers in jails statewide, he said.
On a national level, more than half of all inmates, including 56 percent of state prisoners, 45 percent of federal prisoners and 64 percent of local jail inmates were found to have a mental health disorder, according to the most recently released study in 2006 by the Justice Department’s Bureau of Justice Statistics.

The mental health disorders treated at the Loudoun Adult Detention Center run the gamut from depression to personality disorders, such as bipolar or schizophrenia.

“A lot of it comes from post conviction depression, those who’ve never been in jail before,” Frye said. “For others, incarceration just puts a capital letter on their diagnosis, so to speak.”

Many, he said, were caught using illegal drugs as a coping mechanism for their mental illness. When that crutch is taken away, reality sets in.

“They’re left with coping with reality. What they used to cope is taken from them and that’s when they reach out to the therapists,” Frye said.

The major admits in the past correctional institutions haven’t given mental illness the attention it deserves. But that’s changing.

Once released, prisoners with mental illnesses are made appointments with doctors on the outside. Prior to release, therapists work to make sure the prisoners have the life skills they need to stay on their medications and keep their doctors’ appointments.

Times-Mirror Staff Photo/Beverly Denny From left, Amina Muhammad, Barbie Franklin and Jean Campbell, all of Sterling, participate in a yoga class at the Loudoun County Senior Center in Sterling July 12. Instructor Bonnie Elliott has been teaching yoga for three years. “It’s not easy for the mind to process trauma so the movement of the body allows you to release tensions of the body, mind and soul,” Elliott said.

But Frye said his staff knows there’s only so much they can do, especially since mental health services in Loudoun County are outnumbered in comparison to the individuals that need them.

Many times, the prisoners will see Frye again.

“I know a lot of people that go in and out of jail and that’s the only medical help they’ve ever received was in jail,” he said.

Correctional officers try and give prisoners the best help they can when they leave the facility, but Frye understands they “can’t go out and walk them by the hand to their appointments.”

Peace at last

Ironically for Franklin, a stint in prison led her to finally find peace in her life.

She stayed sober and on her medication. She began living in a rehabilitation home in Sterling in 2007 and has learned coping skills. She’s now retired and has regained a relationship with her son, who she speaks with at least once a week via Skype.

“… He wouldn’t have even known who I was had I continued drinking and drugging and trying to kill myself,” Franklin said.

She has a boyfriend. She walks every morning, practices yoga and is active at the Sterling Senior Center and Community Lutheran Church.

“I regained my totally lost sense of self esteem …” she said.

Franklin’s even shared her story several times during the National Alliance on Mental Illness’ “In Our Own Voice” presentations, where people in recovery attempt to educate others on their illness.

“I find it interesting to share in the sense that it could lead someone to choose treatment for a problem,” she said. “It’s hard to diagnose yourself, but you know if you’re depressed.”

This is the first of a series of articles on mental health in Loudoun County. Next week, a mother shares what life is like with a schizophrenic son and a lack of available services.
For help in treating mental illness, crisis intervention services are available 24 hours a day in Loudoun County. For an appointment, call 703-771-5100. For emergencies, call 703-777-0320.