Surrounded by Madness: A Memoir of Mental Illness and Family Secrets

by Rachel Pruchno

"What was the likelihood my adopted daughter would have my father's hazel eyes and my mother's mental illness?" 

In this fiercely candid memoir, Dr. Pruchno, a scientist widely acclaimed for her research on mental illness and families, shows how mental illness threatened to destroy her own family. Not once, but twice. 

As a child, she didn't understand her mother's episodes of crippling sadness or whirlwind activity. As a mother, she feared her daughter Sophie would follow in the footsteps of the grandmother Sophie never knew. 

Unraveling the mysteries of her mother's and daughter's illnesses, Pruchno fought to preserve her marriage and protect her son. But it was not until she came to terms with her own secrets that she truly understood the destructive and pervasive effects mental illness has on families. 

Surrounded By Madness  is transforming. It will empower families to stop hiding and start talking when mental illness strikes.

Genres: Mental Health, Psychology, Nonfiction, Memoir, Neuroscience, Contemporary, American

328 pages, Paperback

First published March 24, 2014

Reviews

[Sarah Lumos · Rating 5 out of 5]

I am surprised this book does not have more reviews. It was heart wrenching to read - that is the only way I can describe it. This book is about Dr. Pruchno’s family. It is about the broken mental healthcare system, and the devastating affect mental illness can have on both patients and their families. 

Dr. Rachel Pruchno has a PhD in Human Development and Family Studies. After struggling to convince naturally, she adopts a child. Choosing the latter option also helped Pruchno feel more secure. She was afraid of having biological children. Her mother suffered from, and lost her life to, a severe mental illness. She was afraid of passing down the mental illness gene to her child. But mental illness has a complicated pathogenesis. There is no way to determine if your child will be born with a mental illness or not. But adopting a child put her mind at ease. There was no way could pass down her mother's mental illness now.

However, often life has a strange way of coming full-circle.

From a young age, her adopted daughter, Sophie, showed prodigious intellectual abilities. She could understand complex and abstract information most adults could not. Since both of her parents had PhDs, they encouraged Sophie's natural curiosity. They wanted her to love learning as much as they did.

However, as Sophie grew older, her behaviour became more and more erratic. She refused to follow the rules, defied authority, caused classroom disruptions, created elaborate lies, refused to finish her homework, and got distracted easily. Her parents tried to discipline her, but it did little to change her behaviour. 

This became exhausting for her parents. They were doing everything they could, yet their daughter’s behaviour continued to worsen. Over the years, they sought the help of many specialists. Sophie would receive multiple diagnosis over the years - ADHD, depression - but none of them were correct. Sophie would be an adult by the time they received a clear diagnosis.

Reading this book was harrowing because Pruchno did everything she could to help her daughter. She was a kind, loving, and understanding parent. She was not overbearing. Her disciplinary methods were well-researched. She also spent thousands of dollars on therapy, psychiatry, and summer programs. 

How can someone with access to some of the best mental health treatment in the world continue to get sick? Why does it take so long to achieve a diagnosis? What does this mean for families who cannot afford mental health treatment for their loved ones? How do other parents help a child who has a mental illness? Is mental illness determined by nature or nurture? 

Although this book focused on Sophie’s medical journey, her mother made sure she portrayed her daughter as being more than her illness. I learned Sophie was a great artist, inquisitive, bright, enjoyed learning about her faith and helping others.

However, reading this book was heart breaking. Despite being more aware of mental illness, there is still so much stigma attached to having one. It is okay to have a bout of mental health issues as long as you become functioning again. But people often lose their empathy and patience when you have a chronic mental illness that impairs your life indefinitely.

I cannot recommend this book enough. If you have a loved one with a mental illness, then please read this book. It will provide you with new insight and let you know that you are not alone.  

[Rave Reviews Book Club · Rating 5 out of 5]

Where do I begin? SURROUNDED BY MADNESS was one of the best written books I’ve ever had the pleasure of reading and I, in my long life, have read LOTS of books!

Rachel Pruchno put together a compelling story about her mother’s mental illness; how she opted to adopt just in case that illness had trickled down to her (and not wanting to risk passing that on to her own child), unbeknownst to her and her husband, adopted a child with severe mental illness issues. What are the odds?

I completed this read in record time and that’s saying a lot because I’M EXTREMELY BUSY! I was so touched and moved by the author’s candor, I began reading parts of the story out loud to my husband and my youngest daughter. There were so many times, while sitting in my teenager’s room, reading aloud to her (surprised that she was even interested in what I was reading), that we all would let out collective sounds of "awwwwww", and phrases like "how sad".

This book moved me to no end and I will forever be touched by the anguish this mother felt, which she made me feel, and the helplessness to have the professional background she did, yet being unable to "fix" her child.

Rachel Pruchno is a FANTASTIC writer! Let me repeat that, louder this time… RACHEL PRUCHNO IS A FANTASTIC WRITER! If you haven’t read this book, I believe the world should stop spinning until you do! I can’t limit this book to just 5 stars, but, in Amazon’s world, I’m forced to!

[Pat · Rating 5 out of 5]

I approached this book both eagerly and cautiously, because the author is a colleague and a friend. She had, over the years, shared her adopted daughter's problems in broad strokes, so I thought I knew what I was getting into when I picked up the book. But I was not prepared for Rachel's revelations of how her life has been shaped by her mother's emotional disorder, the depth of her angst over her daughter Sophie's descent into mental illness, nor the honesty with which she portrayed both.

This is a heartfelt telling of a painful story. It is unfolded slowly and skillfully, in a voice that is always clear and straightforward. The structure of short chapters sets the memoir up almost as a mystery; I quickly became absorbed and really did have trouble putting the book down. The author expertly recreates her and her husband’s fear and exasperation as they tried to manage their young daughter’s increasingly erratic behavior. Overlaid on this is the ghost of her mother’s mental illness and death, highlighting the author’s vulnerability and shaping her reactions to her own daughter’s illness. The line between weakness and strength is finely and candidly drawn here in mother, daughter and child.

This book is, ultimately, about the intransigence of mental illness, and of a mother’s love. The forthright, matter-of-fact voice makes the story even more powerful. The book offers no happy ending, but it exhorts us to action, to help others coping with a beloved family member’s mental illness. A touching and thought-provoking memoir.

[Stevie Turner · Rating 4 out of 5]

Dr Rachel Pruchno writes from the heart as she relates her mother's decline into mental illness and eventual suicide when Rachel was 12 years old. Compounding her grief many years later, Rachel seeks help for her adopted daughter Sophie's increasingly erratic behaviour, realising eventually that Sophie also suffers from an incurable, debilitating mental illness.

Rachel's grief at both her mother and her daughter's conditions make her question whether she did everything she could have done to help them. In my opinion there is nothing else that she could have done; there is no reasoning with somebody in the throes of mental illness. A health system skewed in favour of the adult patient being in charge of taking their own medications does not aid recovery either.

My heart goes out to this lady.

[Michele · Rating 4 out of 5]

This was a pretty fine true story of mental illness, misdiagnosed, carefully treated, and yet still heartbreakingly impossible to cure. The mother is notable to me for her ability to cling with everything she had to parenting routines, and to employ generally effective child-rearing formulas again and again despite all evidence that her daughter was not responding. She was very rule-bound, but the tragic outcome wasn't her fault. I wanted to shake her from time to time, but in fact, she could not have made the situation better or worse, because it wasn't in her power.

[Ruth Ann · Rating 3 out of 5]

This book hurt to read. Unlike other readers, I had to put it down and take breaks because it was so raw, honest, painful, and true. I cried, I wanted to scream, and I wanted to give Rachel and her family a hug. Diagnosing a mental illness is difficult, especially in young children and adolescents. There are no medical tests and the mental health system is so splintered that continuity of care almost never happens. Finding a doctor, locating a therapist, working with the school, repeated trips to the ER and behavioral hospitals, are all exhausting for parents and sadly, support for the family is virtually nonexistent. In addition, a mental illness in the family drains financial resources and strains family relationships. It is tragic for everyone close to the one with mental illness, and it often ends badly. Rachel knows. Her mother did not survive. No wonder it breaks her heart to watch her daughter be so beyond her reach.
The one positive thing about the memoir is that it is a brave sharing that is breaking the silence and it calls attention to the fact that the mental health system is indeed mad. How can a mentally ill person, who lacks insight and rational decision-making skills, be expected to ask for help? It takes someone being hurt or imprisoned before the law can mandate that medication be given against the will of the patient. Humane or Insane? Everyone should join the conversation and more money should be allocated to attack the devastation of mental illness.

[MerryMeerkat · Rating 4 out of 5]

Surrounded by Madness So as most people know, I’ve basically stopped reading for a long time due to a bad relapse of my depression. I tried once to get back to it but the books didn’t do it for me so I stopped. Maybe I just wasn’t ready yet. Now I’m trying to get back to it again, this time trying for a book that I can relate to right now which is mental illness (written before i really got deep into the book).
I like how there is no long drawn out wait for the big horrific moment the book is about. I like how the chapters are short which is good for trying to get back into reading. What amazes me about this author is how long it takes her to get her child into therapy. I'm not trying to be judgmental but seriously, the child needed help. I understand the money issues all too well because of my own mental health issues but I don't think that is what that kept the mother from seeking help earlier.
overall this is a good book. There's a bit too much psychobabble and history of the mother. The ending is a bit of a let down because there is no ending. I'm dying to know what happens to Sophie but I guess there is no ending yet. A good book on mental illness. Makes me want to go back and reread Prozac Nation and others and review them.

[Ashley Elliott Shaw · Rating 5 out of 5]

I was not sure what to expect when I started this book but I was immediately sucked in. I am extremely interested in the study of mental illness and how this can impact families and this book puts you directly in the experience that one family has. I appreciated the author's honesty regarding her daughter. I cannot imagine how difficult this book was to write but I hope that anyone struggling with this in their own life finds something useful in reading this.

[Irene · Rating 5 out of 5]

A heartbreaking account of one woman’s journey to save her daughter and ultimately her family from the grips of mental illness. An eye-opening education into the current state of mental health care in this country. A must-read book that does good work.

[Ginny · Rating 5 out of 5]

Hey memoir addicts this book is the best memoir I have ever read. Better than Stryon's Darkness Visible. It's a page turner and will transform your understanding of mental illness and how we treat it.

[Victoria Iadisernia · Rating 5 out of 5]

I was assigned this book for my Clinical Practicum class and am so glad I was! This memoir sucked me in. There were moments I wanted to stop as Rachel Pruchno's pain became my own. This book was devastating, fascinating, and all too real.

[Sneha Kher · Rating 4 out of 5]

A book that I'd recommend all families struggling and dealing with mental illness read. It will shine light on the complex mysteries of disease and show you the way. I'd definitely want my family to read this.

[Nicole]

I don’t give stars to school books. I read this for class, but it is a good, but sad book. It is hard to watch someone’s life fall apart, and it is apparent that society does not support people with severe mental health problems.

[Ashley · Rating 5 out of 5]

This is an excellent book. It's raw and emotional but also informative. I commend Rachel Pruchno for sharing her story. This is something thousands of families live through everyday.

[Lara Girdler · Rating 5 out of 5]

A secret can be either one’s doing or undoing, a secret can bring someone to the forefront, make them famous, or even keep them in the limelight once there – sometimes that very secret can also be their undoing. We’ve seen it a hundred times over in Hollywood where addiction has become the very undoing of the fabric of a stars’ success – then again sometimes they take that struggle and addiction and turn it around to become more than they once were. However, the one secret we rarely hear about floating around Hollywood is Mental Illness. Why is it the one thing that more people suffer from is the one thing we as a society are either ill-fit or unwilling to discuss? Our mental health system used to include locking up those with some form of mental illness for something as seemingly minor as clinical depression or something as severe as schizophrenia. Now a days though in order for someone with mental illness to get the very treatment they need they have to be cognizant enough to ask for the help – however, sometimes they do not possess this level of cognizance to ask or seek out the help they need – so they are left to their own devices, especially if that person is an adult. In minor children it’s easier to get them the help they need – sometimes – let me add and addendum here stating that sometimes it’s near impossible to get the medical community to admit a child might, just might, have some sort of mental illness outside of the autism spectrum.
As a parent Rachel found that the road to figuring out what was ‘wrong’ with her otherwise free-spirited child was a road wrought with peril, ups and downs and many many downfalls on Sophie’s part before someone finally admitted she might need help outside of just ADHD Medications. Sometimes mental illness can be mis-diagnosed and in Sophie’s case Rachel found that to be true. It was discovered that what they thought was ADHD was more along the lines of Bi-Polar and Personality disorders…a scary thought for a parent of a teenager. She and her husband made the decision to adopt after their attempts to conceive were futile, in the end she thought that decision would help them avoid some of the demons she witnessed her own mother battle with and ultimately lose the battle.
This memoir was well written, the reader is taken on the journey with Rachel and her family, in the end the reader feels for Rachel and her family. They just want to wrap them up in a protective cocoon and prevent anymore struggle and trouble from befalling them. As a parent myself of two children with ADHD, one of which is exhibiting signs similar to what we read about in Sophie I can only image the level of struggle we may encounter in the future with my child – I can only pray they don’t come under that umbrella of severe mental illness. This book took us on the journey of struggle, endearment, and ultimate separation of family and left us hoping beyond hope that Sophie finds her way in the world and is ok. I believe like Rachel has stated its time to break the silence about mental illness, bring it to the forefront and face it head on…otherwise others like Sophie will fall through the cracks.
**I received a copy of this book from the author’s publisher in exchange for an honest review**

[Jonathan Brill · Rating 5 out of 5]

How do you communicate that a book is a page-turner while maintaining credibility? How do you tell others that a memoir presents a poignant story with a compelling message about a topic of huge public policy importance without sounding overly zealous? These objectives may be tough to accomplish, but if you buy Surrounded By Madness and read it, I promise you will not be disappointed.

Well-written and highly readable thanks to a style that features short chapters presenting self-contained vignettes, Surrounded By Madness is a winner as a memoir. The narrative presents a story that is often sad, occasionally amusing, and at times disturbing, thus taking the reading on a roller coaster ride of emotion. A great strength of the book is the frequent appearance of musings by the author, providing unusual insight into the issues and allowing the reader to share the author's feelings of frustration, anguish, and despair.

But, perhaps most importantly, Surrounded By Madness offers a lifeline to the estimated 100 million Americans whose daily life is disrupted and, sometimes, turned completely upside-down by serious mental illness suffered by a close member of the family (parent, sibling, spouse, or child). Even though diagnosable mental illness is the most prevalent chronic disease in the United States – suffered by an estimated 78.4 million adults and children and far outpacing cancer (13.0 million), diabetes (18.8 million), and heart disease (26.6 million) combined – it is something we tend to hide and be reticent to discuss because of the associated social stigma. That’s why this book is so important. Through a truly gripping story, the book demonstrates why mental illness and secrecy are a toxic combination and why open discussion about mental illness is empowering to the individual and family and healthy for our society. It provides others with a blueprint for resilience and healing - even when, as in author's experience, there is no happy ending - if and when mental illness strikes the family.

Surrounded By Madness is a must read about a hugely important topic. It also presents a compelling story that will suck you in completely. Once you start reading it, you will have difficulty in putting it down until you turn the final page. Guaranteed.

[Betty Windom Kirsch · Rating 5 out of 5]

I love reading fiction, but for the past three years I have focused primarily on reading non-fiction. My goal has been to continue to research the mental health " system " which was my final topic and paper when I received my Master of Science in Nursing in 2002 at the University of Minnesota. My research at that time covered 30 years of policies and programs recommended at the federal, state, and county levels. Recommendations for sweeping changes were made consistently over a 30 year period. Ironically, excellent recommendations were never made But no changes were made. But in the 1980's a national movement began to transition long-term mentally ill clients from state hospitals that held several thousand individuals. The hospitals were closed and the goal was for human services to find appropriate placements in the community. Many ended up in small group homes, but over time the majority ended up in horrendous housing conditions, and over time statistics showed that 50% of incarcerated individuals had a serious mental illness, plus the mentally ill homeless population burgeoned. The insanity of the mental health system is described poignantly in this memoir. Page after page made me think "oh my God, the individual experiences are exactly what I have needed to hear". I have seen so many heartbreaking outcomes for families who attempted to maneuver the "system." And I want to add my story to this list. This story could have been mine.

[Roberta Havel · Rating 5 out of 5]

Everyone has a story to tell and “Surrounded by Madness” is a narrative too many families know. The author tells the story of her family’s journey with her mentally ill daughter. Unlike so many books on mental illness, it is not academic but written as a heart-wrenching page turner. The short chapters give the reader the opportunity to take a deep breath and keep going or contemplate the enormity of this ever so sad journey. If you want the real story on mental illness or you want to know you are not alone in your personal family journey with mental illness, “Surrounded by Madness “ is the book.

[Brenda · Rating 5 out of 5]

This book displays the ups and downs of living with a person with mental illness. I feel that Dr. Rachel Pruchno is a strong women who always managed to keep her family together no matter what she had to sacrifice. Although she did not have child of her own she cared and loved them as if they were hers which is what a good mother does. This book will make you laugh and cry.

[Marilyn J. Martin · Rating 4 out of 5]

The author is absolutely right about the mental health system being broken in the USA. She is one of many of us suffering the anguish of having children with these illnesses, many of whom disappear for long periods of time. Those of us who know where our children are must realize how fortunate we are even though we don't know how our kids will survive after we are gone.

[Ruth · Rating 5 out of 5]

Raises Much Needed Awareness

Couldn’t put it down. Everyone in America should be required to read this book in an effort to change the stigma of mental illness and how it’s treated.

[Payton · Rating 4 out of 5]

As someone who has personal experience with someone close to me having ODD and other compounding mental illnesses this book helped me recognize patterns and witness how other families have dealt with these things.

[Patricia J. Cipolla · Rating 4 out of 5]

O

[ELVIA P. · Rating 5 out of 5]

Surrounded by Madness is a deeply moving and candid memoir that explores the intersections of mental illness, family dynamics, and personal resilience. Rachel Pruchno writes with clarity, insight, and unflinching honesty, making the reader feel both the weight of her experiences and the hope she finds in understanding them.

What stood out most to me is the way Dr. Pruchno balances scientific observation with deeply personal narrative. She captures the devastating effects of mental illness on families without losing sight of love, courage, and perseverance. The memoir is both a guide and a companion for families navigating mental health struggles, offering empowerment and insight in equal measure.

This book is essential reading for anyone affected by mental illness—whether as a family member, caregiver, or researcher—and for readers who appreciate memoirs that illuminate the complexities of human relationships and the resilience of the human spirit.

[D · Rating 5 out of 5]

I loved this book. I thought it was so well written and narrated. I found it very suspenseful and couldn’t wait to get back to it to see what would happen next. How awful for Chloe (the adopted daughter) and everyone in the family. It really gave a firsthand account of all the emotions and trials that a family goes through in discover and handling a family member with mental illness. It was overwhelming and I agreed with the choices that the family made to keep their own sanity and protect their family. It’s such a shame that mental illness is not handled better buy institutions and society. It is obviously a very complicated issue and this book shows you all the struggles involved.

[Sydney · Rating 5 out of 5]

really really good