Fisher au­topsy sheds light on life­long demons

Los Angeles Times - - FRONT PAGE - By Joe Mozingo, Soumya Kar­la­mangla and Richard Win­ton

Car­rie Fisher never said she had con­quered her prob­lems. The quin­tes­sen­tial child of Tin­sel­town never ex­pected a Hol­ly­wood end­ing. She talked openly and often about her 45-year-long fight with bipo­lar dis­or­der, al­co­holism and drug ad­dic­tion, ex­plain­ing how opi­oids in par­tic­u­lar “di­aled down” her manic episodes.

She shared, in her dis­tinc­tive brand of gal­lows hu­mor, such episodes as Dan Aykroyd per­form­ing the Heim­lich ma­neu­ver on her af­ter she got so wasted she choked on a Brus­sels sprout. She wrote about get­ting her stom­ach pumped and re­ceiv­ing elec­tro­con­vul­sive ther­apy.

While many young stars who have died from drug abuse be­came mythol­o­gized, stuck in an im­mor­tal fast lane, Fisher laid out the much more ragged and te­dious re­al­ity of a con­stant strug­gle that mil­lions of Amer­i­cans fight.

A coro­ner’s re­port re­leased Mon­day about her death in De­cem­ber said al­co­hol, co­caine, heroin and ec­stasy were found in her sys­tem. Al­though the pathol­o­gists could not con­clude how toxic the drug lev­els were or how they af­fected her death, their use af­ter so much med­i­cal in­ter­ven­tion and ther­apy tes­ti­fies to the sheer re­lent­less­ness of Fisher’s bat­tle.

“Un­for­tu­nately there are so many Amer­i­cans and peo­ple across the world who are suf­fer­ing from ad­dic­tion and men­tal health prob­lems, and her life truly high­lights how dev­as­tat­ing ad­dic­tion and men­tal health prob­lems can be as a dis­ease,” said Adam Leven­thal, di­rec­tor of USC’s Health, Emo­tion, and Ad­dic­tion Lab­o­ra­tory.

Car­rie Fisher lived in rar­efied cir­cles — the daugh­ter of Deb­bie Reynolds and Ed-

die Fisher, the ac­tress best known as Princess Leia in the block­buster “Star Wars” fran­chise.

Fisher’s will­ing­ness to talk about her men­tal ill­ness helped des­tig­ma­tize it for many or­di­nary Amer­i­cans, and prob­a­bly led to more peo­ple talk­ing to their friends and fam­ily about their feel­ings, and even­tu­ally seek­ing treat­ment, Leven­thal said.

He said the prob­lem is that many mind-al­ter­ing sub­stances — al­co­hol, metham­phetamine, ec­stasy, co­caine, heroin — “trick the hu­man brain into be­liev­ing” they’re needed to feel right.

“Drugs made me feel more nor­mal,” Fisher told Psy­chol­ogy To­day in 2001. “They con­tained me.”

Her drug of choice was Per­co­dan, an opi­oid med­i­ca­tion that be­came avail­able in the 1970s. At her low­est point, she was pop­ping 30 Per­co­dan a day, she told the mag­a­zine. “You don’t even get high. It’s like a job, you punch in,” she re­called. “I was ly­ing to doc­tors and look­ing through peo­ple’s draw­ers and medicine cab­i­nets for drugs.”

By 28, she landed in the hospi­tal with a tube down her throat to pump her stom­ach, be­cause she was not con­scious enough to tell doc­tors what she was on.

Fight­ing a dis­ease, look­ing for re­lief

In re­cov­ery, she was di­ag­nosed with bipo­lar dis­or­der. It was the sec­ond time in four years. The first time, she ig­nored it, feel­ing the di­ag­no­sis just gave her an ex­cuse for her moral fail­ings as a priv­i­leged child turned drug abuser. This time, she ac­cepted it and got treat­ment for it and her ad­dic­tions.

She went on to write about the re­hab ex­pe­ri­ence in her best­selling, semi­au­to­bi­o­graph­i­cal novel, “Post­cards From the Edge.”

An es­ti­mated 6 mil­lion Amer­i­cans have bipo­lar dis­or­der.

At least half of those “have a life­time al­co­hol use dis­or­der and about onethird have a life­time drug use dis­or­der,” said Sa­muel A. Ball, the pres­i­dent and chief ex­ec­u­tive of the Na­tional Cen­ter on Ad­dic­tion and Sub­stance Abuse. “Med­i­ca­tions for pain, anx­i­ety, and sleep can be often mis­used in an at­tempt to self-med­i­cate the emo­tional pain, ag­i­ta­tion, or sleep prob­lems that ac­com­pany ei­ther the manic phase or the de­pres­sive phase of bipo­lar ill­ness.”

With treat­ment, Fisher took nearly two dozen pills a day, some­times re­luc­tantly for fear of sti­fling a bout of cre­ativ­ity that came with the ma­nia. She also told in­ter­view­ers that writ­ing gave her a way to chan­nel her hy­per­ac­tive mind.

She be­came a pro­lific au­thor and script doc­tor, and her comic, self-flag­el­lat­ing tales of ex­cess seemed to be rooted in the past.

“There is treat­ment and a va­ri­ety of med­i­ca­tions that can al­le­vi­ate your symp­toms if you are manic de­pres­sive or de­pres­sive,” Fisher told USA To­day in 2002. “You can lead a nor­mal life, what­ever that is. I have got­ten to the point where I can live a nor­mal life, where my daugh­ter can rely on me for pre­dictable be­hav­ior, and that’s very im­por­tant to me.”

‘I’m not alone when times are tough’

Many were in­spired by her mes­sage. Char­lotte Hor­ton, a 20-year-old stu­dent at the Uni­ver­sity of Cincin­nati, said she felt iso­lated as a teenager af­ter she was di­ag­nosed with bipo­lar dis­or­der, anx­i­ety and de­pres­sion.

She didn’t have any friends to talk to about her ill­ness and felt as though she would never achieve any­thing in life.

Then she found articles about Fisher and Demi Lo­vato, a singer and ac­tress who has also spo­ken out about liv­ing with bipo­lar dis­or­der.

“Look­ing at peo­ple who had it gave me a sense of I’m not alone when times are tough,” Hor­ton said. “I can be­come suc­cess­ful. I can make my own story rather than just let my men­tal ill­ness con­trol my life.”

Fisher was in a highly pro­duc­tive pe­riod of her life be­fore she died. She just fin­ished film­ing the “Star Wars” se­quel “The Last Jedi.” HBO re­leased a doc­u­men­tary about her re­la­tion­ship with her mother, “Bright Lights: Star­ring Car­rie Fisher and Deb­bie Reynolds.” And she was tour­ing to pro­mote her lat­est best­seller, “The Princess Diarist.”

Fisher stopped breath­ing Dec. 23 on a flight from Lon­don to Los An­ge­les. Her as­sis­tant told au­thor­i­ties that Fisher slept most of the f light and had a few episodes of sleep ap­nea dur­ing the jour­ney, which was usual, the coro­ner’s re­port said. To­ward the end of the flight, Fisher could not be stirred awake, the re­port said. A few min­utes later, she be­gan vom­it­ing pro­fusely and slumped over, the re­port said.

She was taken to Ron­ald Rea­gan UCLA Med­i­cal Cen­ter, where she was placed on a ven­ti­la­tor and died four days later.

Steve Suss­man, pro­fes­sor of pre­ven­tive medicine, psy­chol­ogy and so­cial work at USC, said it’s hard to know what pushed Fisher to­ward drug use in the days be­fore her death, but the de­ci­sion to use is often a re­sponse to stress. The mind as­so­ci­ates pos­i­tive feel­ings with a drug, and then seeks that drug to self-med­i­cate.

“Ev­ery­thing is mo­ment by mo­ment with ad­dicts,” he said.

Natasha Tracy, who blogs about men­tal ill­ness and wrote the book “Lost Mar­bles: In­sights Into My Life With De­pres­sion & Bipo­lar,” called Fisher “a bright light” for peo­ple who strug­gle with men­tal ill­ness.

More than just open­ing up about it, Fisher showed that she could have a fam­ily and a ca­reer, and write books and do stand-up com­edy.

“I think it makes it eas­ier to come out with your own strug­gles. Look, peo­ple with men­tal ill­ness aren’t just crazy peo­ple .... Peo­ple with men­tal ill­nesses have lives and can in fact achieve great things,” she said.

Tracy said that since she was di­ag­nosed with bipo­lar dis­or­der nearly two decades ago, she’s found com­fort in oth­ers speak­ing out about their ill­nesses. She re­called read­ing about Fisher hav­ing a manic episode while per­form­ing stand-up on a cruise.

“That mo­ment alone is such a teach­able mo­ment be­cause it says that no mat­ter how badly your men­tal ill­ness screws up your life and it can be very, very, very, bad you can come back from it and you can con­tinue on with the life that you want.”

Tracy said the fact that Fisher died with drugs in her sys­tem doesn’t tar­nish her legacy of re­silience and tenac­ity.

“You can fight and fight and fight and fight and fight and some­times you lose,” she said. “If any­thing it shows how much pain and how much strug­gle she had that she had over­come for such a long time.… The end is re­ally un­for­tu­nate but all of the in be­tween is amaz­ing.”

Al Seib Los An­ge­les Times

CAR­RIE FISHER was al­ways can­did about her strug­gle with bipo­lar dis­or­der and ad­dic­tions.

Willy San­juan Invision/As­so­ci­ated Press

THE GAY MEN’S CHO­RUS of L.A. sings at the me­mo­rial for Car­rie Fisher and Deb­bie Reynolds in March. Fisher left a legacy of re­silience and tenac­ity.

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