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Late-Onset Mental Illness Unravels a Family's Life
A daughter supports mental health research to ensure other families don’t have to live through what hers did.
Among Janet Larsen’s family mementos, carefully preserved and passed down by her mother, is a letter addressed to Janet’s father, Victor Lottmann, on the occasion of his high school graduation in 1928. Written by the school’s principal, the letter extended to the young man “heartfelt congratulations on graduating with honors.” Janet gets a particular kick out of the part that says “my hope is that you keep on ascending the ladder of success until, eventually, you sit in the chair of the chief executive of this great United States.” Framed with the letter is a photo of a handsome teenager, tall and slender, the world clearly his oyster.
Although he did not become president of the United States, and despite the advent of the Great Depression, Victor Lottmann did, as hoped, climb the ladder. After earning a business degree at Washington University in his hometown of St. Louis, he went to work for what was then Ralston Purina, hired by one of the company’s founders, who was impressed by his intelligence and drive. Shortly after, in 1935, he married Edith, his childhood sweetheart. A scant dozen years later, following a stint with a management consulting firm in Chicago, he landed a senior executive post with the Ford Motor Company.
Janet, born in 1937, was followed by two younger brothers. With the move to Ford, Victor built a house for his family in Bloomfield Hills, in suburban Detroit, that seemed to his little girl “like a palace.” She recounts: “He was really moving up. He traveled a lot for the company. He gave speeches all around the country. He was smart and he was charismatic.” Most of all, as far as his adoring daughter was concerned, “he was a wonderful father.” She remembers him, in those days, “always smiling and doing fun things.” One such thing she especially remembers. “One day, out in the country, he decided it was time to teach me to drive. There I was, age 11, driving a brand new Ford.”
In those prosperous postwar days, the Lottmanns were, says Janet, the quintessential “Beaver Cleaver” clan, with an English setter named Skippy, a mother who dressed up to greet her husband each evening and a father who fixed post-movie ice cream floats for his brood, and sang with such audible enthusiasm in church that his mortified daughter “wanted to hide under the pew.”
Then, seemingly out of the blue, the loving father, dashing husband and rising young executive, age 37, stopped smiling. Janet remembers him up all night prowling the house, unable to sleep. When his performance at work began to slip, the company urged him to seek psychiatric help. He refused, insisting that there was nothing wrong with him. His symptoms worsened and he lost his job. Finally hospitalized, he was diagnosed with schizophrenia.
The beautiful home was sold and the distraught family moved back to St. Louis. For a time, the children were scattered, living with various relatives, until Edith was able to buy a small house, using the money Victor had so carefully been putting away for his children’s college education. She went to work selling real estate to support the family.
At the hospital, Victor was given electroconvulsive therapy (ECT) and eventually released. One of the few forms of treatment then available for the mentally ill, ECT technology was considerably cruder than it is now, and could have devastating effects on memory. He returned home calmed, but unable to hold a job. “He tried working as a bookkeeper for a local company,” Janet recalls. “He lasted about a month.” The man with university training in statistics “had made too many mistakes.” Gone forever was the glamorous figure in “suit and tie, always spruced up.”
Over the next few years, except for some brief periods in a sanatorium, Victor remained, as Janet remembers him, a quiet figure sitting in front of the television set—until he “went really awry.” Following a series of violent episodes, including one in which he trashed the kitchen, Edith was advised that his condition had become too dangerous for him to remain at home. He was committed to the state psychiatric hospital in 1956, where he remained for the rest of his life, and died, in 1976, from a kidney infection at the age of 64.
With the passing of time and the advance of psychiatric research, which she tries to keep abreast of, Janet Larsen has come to believe that her father was misdiagnosed. “It seemed as if at that time everyone who had mental illness was diagnosed with schizophrenia. But he didn’t have any of the symptoms of schizophrenia.” The alternating bouts of depression and mania he experienced were, she later learned, more typical of bipolar disorder. “In those days,” she says, “most people had never even heard the term bipolar disorder.”
And in those days, people kept mum. Throughout their childhood, Janet and her brothers were told almost nothing about their father’s illness. “You weren’t supposed to talk about it. There was all this pressure to keep it secret because it was so shameful.” And throughout the many years of his confinement, the family rarely visited him. The authorities at the hospital told Edith that after their visits he became extremely agitated, and it was in his best interest if they didn’t come.
In the years since, sadness at her father’s fate and at the lack of knowledge that kept him improperly treated and confined, as well as her own remorse at not having spent more time with him, have spurred Janet to become as informed and as open and forthcoming as possible with her own children about her father’s illness. She is heartened that the stigma of mental illness has lessened, that information can now be more freely exchanged, and that improvements in treatment have allowed more people like her father to live a near-normal life. As a mother of four and grandmother of 14, she is also keenly aware that mental illnesses can be passed down.
Her family’s experience, plus an acquaintance with the late Sidney R. Baer, Jr., led Janet to support the work of the Brain & Behavior Research Foundation. During several years when she was a bank trust officer, Baer was one of her clients. The scion of founders of a department store chain, whose own life was constrained by schizophrenia, he established an organization to support mental health efforts. In 2004, the Sidney R. Baer, Jr. Foundation entered into a partnership with the Brain & Behavior Research Foundation, then called NARSAD, to help fund NARSAD Grantees. As part of that support, each year the Baer Prize, carrying a stipend of $40,000, is awarded to a NARSAD Young Investigator Grantee who has initiated innovative and promising research in schizophrenia.
Sidney Baer’s knowledge and experience of mental illness also helped to reinforce Janet’s conviction that her father’s symptoms were those of bipolar disorder, not schizophrenia. The state hospital where Victor was kept is long closed, but as a project in her retirement, Janet is hoping to track down her father’s records to learn more about the course of his illness.
Today, scores of investigators, many working with NARSAD Grants made possible by donors like Janet Larsen, are exploring the biological underpinnings of bipolar disorder, tracing its course and developing and testing new forms of treatment. Among them, Brent Forester, M.D., director of the Mood Disorders Division of the Geriatric Psychiatry Research Program at Harvard’s McLean Hospital, is one of the NARSAD Young Investigator Grantees whose work on late-life mental illness is highlighted on page 18.
Dr. Forester explains that with bipolar disorder, untreated symptoms tend to worsen with age, as may have been the case with Victor Lottmann. “Focusing on an older population with bipolar disorder is particularly important,” he says, “given the aging of the population,” which, beyond the personal heartache to families like Janet’s, imposes an enormous socio-economic burden.
Janet Larsen believes we’ve “come a long way” from the days of her father’s illness. Her hope is that with more research, once-vibrant lives will not have to end so sadly.