Being of sound mind means being free of illness

To me, having a mental health issue means something more than dealing with a diagnosable illness.

It's all about maintaining the right quality of life, protecting yourself from disease and not having to fear that death is at your door.

If we were to expand the definition of mental illness in such a way, then the continent of Africa is suffering yet another epidemic - only this one is of the mind.

It's mental disease brought on by the scourge of AIDS that, despite medical advancements, is still killing hundreds of thousands of people each year.

At the same time, it's turning hundreds of thousands of children into orphans, as well as many others motherless and fatherless every day because of the deadly disease.

In the wake of their dead loved ones, many are suffering from witnessing the spectacle of people who once led robust lives only to be destroyed by a disease that took their life away long before they were dead.

Perhaps no book captures that struggle more - as well as the hope offered by those fighting to save Africa from the disaster - than There Is No Me Without You: One Woman's Odyssey to Rescue Africa's Children by Melissa Fay Greene.

The story revolves around Haregewoin Teferra, an Ethiopian woman who has welcomed people of all types - particularly youthful victims of AIDS, many of them orphaned - into her house to talk, eat and, usually, stay for a while until they seek stability, care and love.

In the opening scene, Haregewoin got a call about an abandoned child. She was inundated with children already. But the mother had AIDS and the dad, TB.

No, she said initially. But Haregewoin quickly changed her mind. Over and over again, Haregewoin's objections almost always disappear after some reflection. To Haregewoin, humanity always triumphs over convenience.

This is what happens in Ethiopia, where disease has forced a population that once lived in civility to lean on others - even if they're sick, too - for support. It was under colonial rule but broke free from the Italians in the 19th Century, largely because people felt proud about their country and their leadership.

Dictators took over and selfishly raped the landscape for their own benefit, Greene noted. The rest of the hard-working country suffered as hunger, poverty and lack of education all soared. Places that were once lush with forests and other resources were suddenly deprived of water and oxygen.

Greene, who lived the life of a soccer mom, read about this situation in The New York Times and wanted to do something about it. She eventually found herself with a book contract, and then flying to Ethiopia to watch Haregewoin do her work and see the sides of her that were truly heroic yet deeply human.

Haregewoin didn't even like talking about herself. She was too distracted by the children she had to save.

One boy, named Misty, was removed from his dad after he was constantly promised that he would be able to bring biscuits to him later on, but there was no follow through. He had to stay with Haregewoin and the taxi driver who brought him to Haregewoin's compound, and he did his best to calm him down despite the boy's cries of panic.

Haregewoin had lived the middle class life, too, only to see it disappear because of the epidemic.

She married a man named Worku and they had two children - not 20, like the family she came from. Haregewoin worked for a computer company and Worku was a high school principal, so they were educated, and they didn't want to go down the same path of living with a too-large family in a too-small house.

Then Worku surprisingly died of a heart attack - even though he appeared to be healthy. Soon after, one of Haregewoin's two daughters rebelled, got together with a security guard who acted thug-like, but still ultimately married her.

Haregewoin had a sudden back problem that she thought was cancer, so she went to Cairo to get it checked out. It turned out to be no big deal, but she liked Cairo and stayed - despite being far away from her family while it was falling apart.

Haregewoin started to worry when her daughter, in telephone conversations, complained about feeling tired. It turned out she was pregnant, but her complaints persisted. Hargewoin finally went to visit and found her somewhat emaciated, but she just thought it was because of the pregnancy.

Her daughter had the baby, and everybody celebrated. But the daughter became more of a recluse, and her husband put up a barrier between Haregewoin and her daughter that prevented Haregewoin from knowing too much.

Frustrated with the situation, Haregewoin eventually went to visit again, and found her daughter suffering from what appeared to be AIDS.

Haregewoin's son-in-law, Ashibr, took the baby away; Haregewoin cared for her daughter at a hospital and, later, at home, where she died in 1998.

Haregewoin was devastated. She went into seclusion, shunned people and thought about becoming a full-time mourner.

Only a religious group stood in her way, and asked her to take care of two teenage children. Haregewoin intially didn't think she could do it, but she did it - much to her friend's dismay - because she couldn't say no.

The children were rebellious - especially Abel, who was a drug addict. Those children were eventually taken away. But Haregewoin's willingness to take them in inspired religious groups to seek her help again. Other smaller children were dropped off, and the emptiness Haregewoin felt after losing her daughter quickly disappeared.

Virtually all the children had parents with AIDS or had died of AIDS. There were twins; there were even children with AIDS. One mother dropped off her baby, fell down and died just outside Haregewoin's door as she left. Even the police dropped off unnamed, abandoned children.

Haregewoin saw this as her calling - and even hung a picture in her house of her deceased daughter holding her newborn child with an inscription from a pop song: "There is no me without you."

The children, meanwhile, played in the yard and with each other, and then went to school and played soccer. One man dropped off his sick daughter just so she could socialize.

A group dropped off a young girl who hated being there, and wanted to prove it so badly that she repeatedly slammed Haregewoin's steel door, trying to get out. People on the other side of the door - the people who dropped her off - were crying. The author, who witnessed this scene, thought of offering the group money, but decided against it.

There were other troubles, too, that had nothing to do with disease.

An uncle Oscar who was involved in the life of a pair of twins came around, and Haregewoin blocked the door. Before this encounter, Oscar once pulled down the pants of one girl, and tried to rape her. He was caught, and he took off the hills. But he tried to re-enter their lives, and Haregewoin wouldn't allow it.

Overall, Haregewoin enjoyed the experience. But eventually, it took its toll. People in the area shunned Haregewoin and her children. They didn't want to come into contact with people who have had some association - even remotely - with AIDS.

Money was tight, and Haregewoin began taking donations. She told people she couldn't take any more children, but she did anyway, because she couldn't say no.

Children like Minty held out hope their parents were still alive. Minty, for instance, was hording rolls that he wanted to give to his father - even as they grew moldy and disgusting. He still wanted to give them to his dad, Eskender.

But Eskender, Haregewoin soon found out, died.

Haregewoin eventually grew weary. She saw her numbers grow from two dozen to three dozen children. She told people, "No more," but they came anyway.

Suddenly and hopefully, adoption groups approached Haregewoin. It was just the right time, because Haregewoin couldn't be the mother she was when she had fewer children.

She also needed a doctor - and she found one, an American who gave up his life for this cause. He examined a baby who was literally "dropped" at Haregewoin's house, and whom everybody thought had AIDS. The doctor discovered he actually had a milk allergy. He was given soy milk and became a normal, everyday child.

Adoption agencies eventually came out of nowhere, taking away babies left and right. Haregewoin grew attached to some of the children and didn't want to give them up. But she relented, realizing that others could provide a better life.

Haregewoin found a place for the older kids, too - the Americans, who had set up a local agency that found parents for the children.

A rich woman had a birthday party at Haregewoin's compound. She wanted her pampered child to see poverty. For a day, everybody - including Haregewoin - felt like they were in the middle of a fairy tale.

Haregewoin eventually developed something of a celebrity status in Ethiopia. She won an award that earned her a trip to the United States, the same country that provided shelter to companies who refused to allow generic anti-AIDSs drugs to be developed and cheaply sold and used in Africa, Greene noted

For Haregewoin, however, success didn't come without new struggles.

People started to resent her, and believed that she was getting rich off her good work. They started to snipe at her. An agency was upset with the way she handled the adoption of a girl who was presented by a 17-year-old mother. When the 17-year-old took the child back after much wrangling, the government investigated Haregewoin for child trafficking.

An investigation into a possible rape at Haregewoin's compound lingered for months as rumors began to spread about mistreatment and child-trafficking. Donations and adoptions stopped coming. The children were getting smaller meals.

Ultimately, Haregewoin was arrested and locked away, like she was a political prisoner. Her surviving daughter and friends tried to spring her loose, but Haregewoin viewed her time away as an opportunity. It gave her some moments to reflect, as though God led her here.

In early 2006, Haregowein was back home. The Ministry of Justice took over control of her orphanage, and also cleared Haregewoin of any wrongdoing.

She also reacquainted herself with her grandson, then 7. Ashibr relented after prodding from Haregewoin's surviving daughter. They developed a regular relationship, all while Haregewoin continued taking kids in.

But it was her time in jail that gave her the moment to realize her work was her gift to life.

Faced with loss, Michelle Williams can find hope

If Heath Ledger's ex-girlfriend, Michelle Williams, is looking for inspiration in the face of her loss, she can look no farther than Mary Jo Codey.

Williams (left), an actress, has been out of public view since "The Brokeback Mountain" star's death last week. But she is believed to be very distraught over the loss of the father of her 2-year-old daughter.

Codey, meanwhile, is the wife of Richard Codey, who served as New Jersey's acting governor from 2004 to 2006. But she is known mainly for her public disclosure that she suffered from postpartum depression.

The illness has dominated much of the last 25 years of Codey's life. But her story has inspired many - and now it's culminated with her winning the Eli Lilly Welcome Back Lifetime Achievement Award.

Ten years ago, Eli Lilly and Company, a pharmaceutical promotion company, says it launched the "Welcome Back Awards" to fight the stigma associated with depression and promote the understanding that depression is treatable.

Codey is "an amazing woman who has lent her life, public forum and passion to the cause of perinatal mental health," said Susan Dowd Stone, president of Postpartum Support International. "For years, Mary Jo has been a national spokesperson and crusader for maternal mental health, sharing her story to help other women reach out for help."

Knight-Ridder newspapers recently provided an in-depth and stirring account of how Codey recovered from the depths of postpartum depression to become a national symbol:

After giving birth to a son in 1984, Codey said she didn't feel the joy she saw on her husband's face. Her indifference became irritability, and then she began having thoughts that scared her -- urges to drown Kevin, or put him in the microwave.

Horrified by those images, Codey placed 6-week-old Kevin in her husband's arms and demanded to go to a mental institution.

"I didn't realize that once you were depressed, you could get over it. I just thought I was crazy. I gave the baby to my husband, and I said, 'Find yourself a new wife, Richie, someone who will be good to the baby,'" Codey recounted. "Suicide looked good to me. If you're having thoughts about harming your baby, wouldn't you rather kill yourself?"

At the Carrier Clinic in Belle Mead, N.J., Codey's condition stabilized with antidepressants. She returned home, but hid her experience from her family and friends. "I was afraid that maybe God would think I was ungrateful for the baby, and I wasn't. I went to a fertility doctor for three years to have him."

She stopped taking the medication when she became pregnant with her second son, Christopher, in 1988. By her eighth month, she was severely depressed, and her doctor told her that electric-shock therapy was her only option. She had one 11-week treatment that resulted in some memory loss, but no pain.

"I felt like such a waste of a human being, because there I was, eight months pregnant with a gift, and I was going for shock therapy," she said. "I didn't understand depression was biological and not my fault."

After Christopher's birth, Codey went back on her medication, and this time there were no baby blues.

"I could do and feel the things other mothers did," she said.

She told Kevin, now 20 and a sophomore at Drew University, and Christopher, 16 and a junior at Montclair Academy, about her illness "almost as soon as they could understand English."

"I never wanted them to hear, 'When you were born, your mother was so depressed she went to a psychiatric hospital,"' Codey (right) said. "If I wasn't secure in my relationship with them, I'd be afraid to tell them."

But her battle with depression wasn't over.

Early in 2002, shortly after her husband became copresident of the state Senate, Codey's antidepressants stopped working. Her doctor changed her medicine, but the dosage was too high.
Codey said she recalled opening her refrigerator on St. Patrick's Day, asking Christopher what he wanted for lunch, and then collapsing.

At the hospital, the family was told that doctors had induced a coma to stop seizures caused by the new medication. But then they couldn't bring her out of the coma.

"What do you say to your two teenage sons who ask if Mom is going to live?" her husband said, recalling the days he spent at the hospital.

Codey emerged from the coma after seven days, but struggled without medication for her depression.

Two weeks later, a routine mammogram showed she had breast cancer, the disease that had killed her mother. "I was a mess anyway, so the news didn't frighten me," Codey said. "My family was upset, but I was already as low as I could go."

She had a double mastectomy, fighting the cancer with chemotherapy and the depression with more shock therapy. As her cancer entered remission, a doctor put her on new depression medication that she said had worked well.

Codey said she was struck by the contrast between the care and concern breast-cancer patients receive and the stigmas associated with people suffering from mental illness.

She formed a postpartum-depression group at her local hospital, St. Barnabas, and listened to new mothers recount the same sort of thoughts she'd had. Her husband said he had often come home to find a new mother crying to his wife on the couch.

After Jim McGreevey resigned as governor in November 2004 and her husband became the state's chief executive, Codey resolved to use the opportunity. She speaks to mental-illness and women's groups two or three times a week, she said.

"When we're out on the weekends, women will grab Mary Jo by the arm and say, 'Thank you,'" Richard Codey said. "It helps when you have a survivor who can make people reach out and feel what you're talking about.