Mania Cymbalta 13/07/2009 Montana Musician Develops Mania On Cymbalta Summary:

Paragraphs 48 & 49 read:   "'I was depressed because I was going nowhere with my daughter, and the doctor put me on Cymbalta. That turned me manic,'  Caruso said."

"His cousin drove to Oklahoma, gathered Caruso’s belongings, and brought him home. The move didn’t work out very well initially, which both men attribute to the Cymbalta."

Manic man in the promised land’

By EVE BYRON - Independent Record - 07/12/09

 Eliza Wiley Independent Record - Mike Caruso stops abruptly while telling a story during an Independent Record interview in May. Mike Caruso’s psych report says he has delusions of grandeur and is bipolar.

Mike Caruso says he’s played harmonica with Lynyrd Skynyrd, and his band Dream West performed at a party for the Rolling Stones, at their request.

He says renowned rock musician Allen Collins gave him a 1964 Gibson Reverse Firebird III guitar that Collins picked up in St. Paul especially for Caruso.

He says he’s a friend of Sonny Barger, a founding member of the Hell’s Angels outlaw motorcycle group, and performed at a party when Barger was released from federal prison in 1993.

His psych report says Caruso has delusions of grandeur and is bipolar.

Caruso grabs an electric guitar and slips a slide bar on his pinky finger. He taps his foot and plays a few tunes. Make up your own mind, he challenges.

He’s clearly a brilliant musician. He’s also clearly a little hyper, a little over the top, a lot intense. He’s open, honest, defiant yet fragile.

“It’s a fine line between being insane and eccentric,” he says with a sly smile.

Sitting on a well-worn couch in Caruso’s sparsely-furnished duplex in Helena, his cousin Steve Caruso laughingly, sometimes ruefully, vouches for Mike’s stories. He recalls how his cousin used to call him from the road, talking about the famous people he’d met and the places he’d been.

“Everybody knows him as ‘String.’ Everybody from Eric Clapton to the Rolling Stones,” said Steve Caruso, a former bank examiner for the state of Montana. “He was a rock ’n’ roller.”

Mike Caruso is a man who has lived with a mental illness for 42 of his 52 years. He’s a man who has survived rock ’n’ roll and rejection, the law and losses, 26 institutions in three states. He’s a man who embraces redemption and recovery, with a deep faith in Jesus Christ.

“Call me the manic man in the promised land,” he says with a mischievous grin. It fits.

While Caruso’s life story is unique, his experiences with mental illness are similar to those of many Montanans. Caruso is incredibly creative when he’s manic, so he doesn’t like to take medications that “dumb him down.” He’s estranged from many of his relatives, who he scares when he’s on a rant. He’s been taken down by Helena police, handcuffed and sent to Warm Springs.

What sets Caruso apart, though, is the range of treatments he’s gone through here and elsewhere, giving him a broad perspective of how people with mental illness are treated. In addition, he’s been an ardent advocate for the past 20 years throughout the United States, and knows the pitfalls, loopholes and safety nets in the mental health arena.

Caruso is as contrary as his bipolar illness, an eternal optimist who literally was born into the blues. His mother grew up in Helena and his father in Livingston. They moved to California on their honeymoon, which is where Caruso was born in 1956.

“My mama sang the blues and jazz like you never heard … and she was singing the blues as loud as she could when I was born, and shooting craps,” Caruso says, swinging his left hand in the air as though he is throwing dice. “My mother was a devout Catholic and a recovered alcoholic when she died. I was an alter boy growing up.”

His life story comes out in bits and pieces today because he’s in manic mode, prompted by a glitch in the Social Security disability payment system that happens twice a year, when people receive three paychecks in a month rather than two.

While the extra check may be a welcome relief to some, it jeopardizes Caruso’s disability payments if he makes more than $980 a month from his part-time job at the Hannaford House, a transitional home in Helena for people living with mental illnesses.

His life is a high-wire balancing act. When he falls, he falls far and hard.

“I just live in fear I’ll get sick again and lose everything again,” he says a few days later, a little more mellow but no less intense, with a raspy voice from the cigarettes that help pass the time. “I fear that Social Security will find some way to cut me off and I’ll become homeless. I’m lucky to have a place to work that understands me.”

Caruso believes his mental illness first manifested itself when he was 10 years old, but he wasn’t diagnosed until he was 17.

“They said I was schizophrenic, but they misdiagnosed me. I’m bipolar with psychotic features,” he says bluntly. That means when he’s manic or deeply depressed, he may have delusions or hallucinations. It’s thought to be caused by electrical and chemical elements in the brain not functioning properly, and seems to be hereditary.

Caruso said his mother, who recently died, and a brother, who is homeless somewhere in Idaho, also are bipolar, as are an estimated 3 million other Americans.

Caruso’s initial diagnosis came around 1974, after he left California with a couple of surfers to visit a music man they knew in Memphis. The surfers had heard him playing guitar ­ his mother gave him his first when he was 10 ­ and thought he had talent.

Caruso says he hooked up with the legendary country blues guitarist Furry Lewis and met members of Lynyrd Skynyrd, the southern rock group who had recently released the hit single “Free Bird.” But a bout with a broken heart prompted his first break with reality.

“I wandered Memphis for seven days. It was spectacular, terrifying, fearful, and culminated with cops picking me up in a railroad yard, where I had stopped an engine. Good thing it wasn’t going too fast,” Caruso recalled. “I was so far gone I didn’t know my name. I was manic. Lucky for me, they called my dad.”

He was institutionalized for the first time, until he was 18 and the insurance ran out. Caruso said he wandered the streets of Los Angeles for three weeks. With every breath, he wanted to die.

Caruso eventually moved back into his father’s home and got a degree in wastewater technology. He worked for Los Angeles County, but hid his illness, afraid that he’d be fired.

One day, a pipe fell on his back and injured him. Caruso spiraled downward and ended up in the Sutter County mental hospital.

Once discharged, he moved to San Diego with his mother, and reconnected with Lynyrd Skynyrd. Eventually he became best friends with Skynyrd guitarist Allen Collins, and partied with rock stars.

“Ronnie Van Zant (Skynyrd’s lead singer) sat me down once and told me there are only three things you need to know,” Caruso noted. “The only thing you take out of this world is how you love other people. The only thing you know is you never know when you’re gonna go. The last thing is there are no problems, only solutions. You need to ask God to give you the wisdom to solve the problems at hand.”

Van Zant died, and Lynyrd Skynyrd dissolved, after the group’s plane crashed in 1977.

Caruso eventually moved to Idaho with his mother, but again was in and out of mental institutions as he tried to hold down a job, stay on his meds and hide his illness. He married Anita Wayment, and their family moved to Oregon. But while he had what he refers to as “periods of normalcy” that would last for years, his mania and depression continued.

“I was 18 years old when we married and didn’t have a clue about his mental illness,” Wayment said recently from her home in Idaho. “He was full of life and energy, but after five months together he had his first episode.

“He would get so wound up to where he couldn’t calm himself down, and then ideas would come into his head, where he would make millions of dollars or change the world or the world was ending. He could stay up for three days without any sleep.”

Caruso ended up being charged with attempted murder for “rearranging the outside” of his landlord’s house with a shotgun; he says the man tried to molest Caruso’s daughter. He served time in the Oregon state hospital’s forensic unit.

In 1984, Caruso got involved in the mental health consumer’s movement. But after seven years of relative peace, he started getting manic again. He was overmedicated and fighting for his Social Security disability benefits. Wayment divorced him, saying she couldn’t handle his mental illness.

“He’s kind and he’s smart, but living with someone who is manic depressive is a challenge,” said Wayment, who remains friends with Caruso. “When he’s feeling good, he’s full of energy, so why would he want to take pills that make him sedated? Then he slips into depression and ends up in the fetal position.”

His downward spiral escalated after Collins, who had continued playing music after the demise of Lynyrd Skynyrd, died from complications of injuries he suffered in a drunk-driving automobile accident. Caruso was a pallbearer at Collins’ funeral in 1990. He dropped his meds, turning instead to marijuana and selling it to support himself.

“It was a nightmare, an absolute nightmare,” Caruso said.

He moved to Arkansas and met another woman, whom he married, divorced, and remarried. They had a daughter together and moved to Missouri, where Caruso once again got involved in mental health advocacy. He says his wife couldn’t handle his going public with his illness, and they divorced again.

“She didn’t want to go around town with everyone thinking I was a nut case,” Caruso said.

The divorce wasn’t amicable, and Caruso fell apart again. He was hospitalized several times and ended up in Oklahoma during a full-blown manic episode. Once he finally got the mental health care he needed, he again turned to advocacy, this time as a member of the Oklahoma Mental Health Planning Council. He was honored numerous times for his work there.

“He wanted to be sure people got access to services and there weren’t rules or procedures that slowed that down or denied them access,” said John Hudgens, the Oklahoma director of provider certification. “Mike is very energetic, a very bright person, and he has lots of ideas. In terms of credibility, some of the things he says might raise some questions, but I’ve never found anything that he told me to be untrue.

“I’ve been doing this work for 30 years, and I love people like Mike because they make what we do real. Mike takes up a lot of space, figuratively, but it’s good stuff that he brings to the table. We’ve learned from him to be more responsive and open, less rigid.”

While serving on the board, Caruso was busted for selling marijuana, but was referred to a newly created drug court. He successfully completed the program, graduated at the top of his class, and ended up working for the drug court. The conviction was expunged, so he has no criminal record.

Caruso visited Montana often as a child, playing with his cousin Steve in Missoula, and it was always Caruso’s dream to someday move here to climb mountains and play his guitar. The opportunity arose in 2006, after Caruso realized that the relationship he hoped to develop with his daughter wasn’t going to happen any time in the near future.

“I was depressed because I was going nowhere with my daughter, and the doctor put me on Cymbalta. That turned me manic,” Caruso said.

His cousin drove to Oklahoma, gathered Caruso’s belongings, and brought him home. The move didn’t work out very well initially, which both men attribute to the Cymbalta.

He wound up in Warm Springs ­ twice ­ but eventually got on some new meds that have stabilized him. Mike Caruso said Warm Springs was “a Hotel Hilton” compared to some of the places he’s been committed.

Steve Caruso said he’ll never send his cousin there again because of the trauma surrounding the involuntary commitment. In addition, even through Mike Caruso was stabilized within three days of getting off Cymbalta, he wasn’t released from Warm Springs for a month. By that time, an injury he suffered to his heel during his arrest that went untreated had partially crippled his cousin for life.

Steve Caruso said it’s not always easy, but his cousin is his best friend.

“I don’t worry about him. I used to, many years ago because of his lifestyle,” Steve Caruso said. “But I’ve learned that somebody with bipolar affective disorder has to have a very orderly life, that the daily stuff that we would never bother with makes Mike crazy.

“If he can work two or three days a week, the same hours, on the same days, wake up at the same time and go to sleep at the same time, it’s really important.”

The Carusos say Mike doesn’t have much to do with other family members who live in Montana, because of mental illness’ stigma, and he scares them at times.

“I act oddly when I’m symptomatic, delusional, psychotic, manic. I have to admit I’m probably not somebody anybody wants to be around,” Mike Caruso said. “But it’s not a mental health issue to me. It’s a physical disorder.”

These days, he’s engaged to a wonderful woman who expects to move to Montana soon. He’s also trying to get his arms around his newest diagnosis of Post-Traumatic Stress disorder, brought on by his troubling ride through the mental health system in the U.S.

And Caruso is putting that lifetime of experiences to use at the Hannaford House, helping others transition from Warm Springs or other care facilities back into the community. He’s learned that you have to be an advocate for yourself, but if the meds are dragging you down or the system is confusing you, then having someone like himself there, who can empathize yet also make the necessary phone calls, can be lifesaving.

“To work here is really an honor,” he said recently, looking around the clean, Spartan group home. “We can give them a safe and healthy environment to develop the skills they need to live in the community.

“We are in the business of hope.”

To view the complete series on mental health care services in Montana, click here.

Eve Byron: 447-4076 or