Why the Sanity Papers?
Every woman’s experience of menopause is within a range and yet unique. The fact that half the population endures it does not undermine this. The symptoms are legion and the permutations seem to multiply all the time.
Menopause is filled with awkward moments, mistaken assumptions, and self-consciousness. It’s a lot like puberty, only with the added burden that the menopausal woman is expected to behave like an adult, demonstrating responsibility and self-control.
Like many women, my friends and I joked that there is no handbook on menopause. In fact there are innumerable books on the subject, ranging from clinical to chatty self-help. They tend to focus on the physiological and psychological symptoms that provide common denominators. They do not address individual experiences, the life-changing decisions that get made solo, or the wisdom that comes from surviving roiling hormonal changes for a second time.
The story of one woman got me really thinking about the subject. While I was the director of the Frazier History Museum in Kentucky we were able to purchase the so-called Mary Todd Lincoln “Insanity Papers.”
Mary Lincoln had a difficult time, to say the least. She was known to be eccentric and a lavish spender before the President died. The strain of being First Lady in time of civil war was exacerbated by finding her husband leading the Union while her family aligned with the Confederacy; of having three of her four sons die very young; and, most dramatically, of having her husband assassinated—shot while she sat beside him at the theater.
After the President’s death, she ran into money troubles and, in 1871, her son Tad died. Like many women of the time, she became addicted to the opiate laudanum, which was commonly prescribed for everything from menstrual cramps to nervous distress. Increased dosages gave her opium dreams which, combined with her severe anxiety, occasionally led her into paranoia.
Her surviving son, Robert Lincoln, went to court to have her declared insane. He complained that his mother wept incessantly. He wanted her confined because he couldn’t take her distress, its symptoms, and the effects of the patent medicine cures. The court agreed that she was mad and so, in 1875, she was sent against her will to Bellevue Place, an Illinois sanitarium catering to wealthy women. She was 56.
She had suffered mood swings, migraines, and anxiety all her adult life. Her rages and possible bipolarity have all been examined at length. My question was, why now at 56? What finally tipped her over the edge?
When I held the ledger of the sanitarium in my hands I had to search for her name. As I did so, one fact shone out at me: here were many names of women confined to the asylum at roughly the same age. I realized that what I was looking at was not just a historical factoid but a data set. So many women were between the ages of 45 and 55. Then as now, the average age for menopause was 51. At 56, she may have been coming down from the high point of her menopausal symtoms, but for Robert, they had probably just gone on too long. Why I think she was coming down is because of her age and the fact that she got out of the sanitarium quickly. She was able to focus on her problem; she wrote letters and persuaded the sanitarium to let her go in less than six months. She simply wasn’t crazy.
There’s no proof on my side. I claim no evidence that connects Mary Lincoln’s extreme symptoms to menopause per se—such things were barely discussed in the nineteenth century and often misguidedly linked to cancer and “lesions”—but looking at the ages of the women in the ledger one can make an educated guess.
A hiatus from living in the world was not an uncommon respite among menopausal women even in the twentieth century. In Louisville the local sanitarium, Central State Hospital, was filled well into the 1970s with women taking just such a break
What treatment did these women receive? Probably about the same as mothers and wives during the Trojan War, I would imagine–although the latter might have included a few murders of women by their menfolk or by women of the men who made them see red. Just as my generation turns to drugs like Lexapro or Zoloft, Mary Lincoln’s resorted to patent medicines and the Trojan women probably used other poppy-based concoctions to elevate their darkest moods. Neither we nor Mary Lincoln were the first women to find chemical solace—the pattern goes all the way back into the depths of history. Menopause!
Prescription drugs help many—something they take the abrasive edge off reality. When these remedies fail or women prefer to let nature take its course, there is a whole spectrum of behaviors and experiences. Some of us have been overcome by weeping, like Mary Lincoln. Some are filled with unstoppable anger. Some take lovers for a last fling or series of flings with sex and romance.
There is a very high divorce rate in this age group and apparently it is usually because the woman wants a change, or better, a fresh start. These women have made great efforts to succeed at whatever had to be done in their marriage. They’ve worked to support young and college-aged children. They may have entertained lavishly to sustain their husband’s ambitions. They may have put up with difficult spouses or demanding offspring for too long.
Often it’s nothing dramatic. Children are grown, husbands are dull, or just ceaselessly abrasive. For these women, the comforting myths that got them to seek life partners and produce families in the first place have failed. At the end of the day the results, even if they are good, are just not enough. Despite the social cost and the loss of a support group, these women divorce to seek new adventures alone.
Reading about Mary Lincoln, I wanted to know more about other women. What about those who were not famous? Their lives were an unsolvable puzzle, but what about my peers? Perhaps I have a historian’s need to know personal stories and seek out first-hand accounts but, being a woman of Mary Lincoln’s age, I related to her from a specific moment in time: menopause.
I found my experience of menopause to be outside the lore that had been passed to me. Not for me was there a lack of sexual interest—very much the reverse. Something I did not know to be hormonally related was the escalation of my sex drive. I was consumed by the thought of sex. I left my best long-term relationship to scour my acquaintance for a new bed partner. Everyone looked good to me and I made inappropriate advances to all sorts of people. Luckily nothing came of my efforts. Instead a new lover found me before I made a complete spectacle of myself!
On the bright side, I was not much bothered by hot flashes as a physical symptom. I was not depressed.
But I was easily irritated. The follies of the world and its people seemed to be spot-lit by my gaze everywhere I looked. Carelessness, casual discourtesy, indifference, sloppiness: these drove me to the borders of rage.
And I became restless. I wanted to seize one last chance to develop my career. I got a new job in a part of the country that was new to me. Having lived with self-imposed inertia for several years before, I felt driven to act.
As I responded to these and other changes I did not always behave well or kindly. It was like being one of the Dionysian women, or Kali, the Destroyer, intoxicated and ready to rip everything apart.
Recently, I spoke to a friend about the wealth of medical information on menopause but the lack of personal insights. Looking back she said, “There was no one to talk to.” This rang in my head. For all the great women I know, none seemed to be sharing my experiences as I went through them. There was no place for me to start a conversation. My gynecologist was a decade younger than I; my regular doctor was a man. They had all the facts but they didn’t have a clue.
I wanted to know personal stories that would overlay the medical information in a way that would be meaningful. I wanted to know that I wasn’t crazy. I wanted some assurance that there was something worthwhile at the end of this hormonal rage.
Chuck out the tampons—what’s next?