The Long Middle Ground

Finding Purpose in Persistence

Linda A. Kurzawa Community Center, DCHD

In my previous post, I recounted a devastating series of events—a treacherous psychotic episode, a humiliating arrest, a cancer diagnosis, and the loss of my father—all of which were followed by an unexpected lifeline: quiet and ordinary work at the DuPage County Health Department in Illinois. This post is the other side of those crises—the long stretch of daily effort, the quiet perseverance, and the rare moments of connection that sustained me for over a decade at DCHD. This is the story of that long middle ground.

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After my father passed away, I no longer had his financial support. I was unemployed, struggling to pay rent, and shouldering the steep monthly cost of COBRA health insurance. (COBRA is a federal health insurance program where, when leaving a job with medical benefits, a person can retain health benefits for eighteen months by paying their entire cost.) Financially, I was in dire straits.

In my emotional pain, I reached out to the executive director of the local NAMI chapter, whom I knew, and shared my streak of bad luck and growing desperation. In what felt like a stroke of incredible fortune, NAMI DuPage was looking for a manager for their resale shop, the Encore Shop, a small business they had started to provide jobs for people with mental illness. I was hired. The position came with no benefits, but it reconnected me to a routine and a source of income. Given all the stress and upheaval I’d been through, I felt profoundly lucky to be working again.

In the coming months, I was to face a new setback. I was now back on a mix of medications that supported me, and while I managed The Encore Shop with some competence, I had also come under the care of a new psychiatrist. After running a full panel of blood tests, standard protocol for anyone on lithium, he was alarmed to find that my kidney function was impaired. This, unfortunately, is a common side effect of long-term lithium use. He immediately gave me a rapid tapering down schedule to free myself of the drug, but I had been taking lithium for more than 25 years. My recovery was deeply dependent on it. I tried to follow his regimen, but I soon fell into a depression, plagued by relentless suicidal ideation. Each day became a battle against those dark thoughts.

After weeks of this, I returned to my previous psychiatrist at the University of Illinois. He prescribed lithium once again, despite the damage it had done to my kidneys. However, in choosing to return to lithium, I knew the risks, but stability was more urgent than longevity. I needed to function, to earn, to survive. I remained on lithium for another decade or more. My depression, suicidal ideation, and mood swings stabilized, but today, I live with serious kidney disease as a lasting consequence.

Financially unstable due to paying hundreds of dollars a month for medical insurance and living on a relatively meager income from The Encore Shop, I knew I had to find employment in an organization that offered medical benefits. I turned to Thresholds' psychosocial agency in Chicago, where I knew the executive director, and applied there for their Assertive Community Treatment (ACT) team. I was hired and relieved to have medical benefits again, though I was unprepared for the toll that ACT work would take on me emotionally. (I described this in my post “Surviving Thresholds: Reflections on Humanity’s Edge.”)

When the pressures of Thresholds began to wear me down, a friend and former colleague, Irene, told me about an opening on the ACT team at the DuPage County Health Department. It was a lifeline. The work was similar—still ACT, still severely impaired clients—but the job was much closer to home, and the threat level was much lower. In Chicago, I had often feared for my safety.

At DCHD, I worried more about burnout. I delivered medication and money from clients’ disability checks, a task that sometimes required bending the rules. Technically, we weren’t supposed to transport clients in our cars. But when the checks I delivered needed to be cashed and there was no other way to get to the bank, I drove them. It wasn’t rebellion—it was realism. Over time, the grind of ACT wore on me, and again, Irene stepped in. She tipped me off to a position teaching Life Skills classes at the Health Department, and I applied. The stress didn’t completely disappear, but the focus shifted. I was much relieved.

Life Skills sounded simple enough in theory—teach clients of the health department fifty-minute classes once a week on topics like stress management, anger control, social skills, and symptoms of bipolar disorder, schizophrenia, OCD, and anxiety. Compared to ACT, it was both a relief and heartening. While the clients were sometimes disinterested, distracted, or disruptive, my colleagues—fellow instructors—were supportive and caring.

Still, holding the clients’ attention for even ten minutes could be a challenge, let alone filling an entire class period with meaningful content for ten weeks at a stretch. I spent hours preparing material, usually arriving early in the morning, often apprehensive about how I’d stretch it to cover the time. Every ten weeks, clients re-enrolled, and I would silently dread seeing if only a handful signed up for my classes. The fewer the students, the more intense the pressure. Productivity was measured by the number of classes taught, which depended on the number of clients served. If my class numbers dropped too low, my performance was questioned. To increase my numbers, I did my best to bring humor and creativity into the room, but it felt like I was just hanging on some days. One class, though, was different.

Current Events, a class about the news headlines of the day, was the exception. It was the one class I genuinely looked forward to. I had the idea to turn the news into a trivia game, with questions about recent headlines, pop culture, and major events. It wasn’t just informative—it was fun. The clients were engaged, alert, and even driven. Some followed the news more closely than I expected, and others simply enjoyed the game-like format. There was laughter. There was discussion. And for a while, each week, there was energy in the room. The class developed a following. It was the only time I felt, unequivocally, like I was doing something that worked, something the clients appreciated and remembered. It reminded me of what I loved about teaching and performing: the shared moment, the spark of connection. In a job defined by obligation, this class was a small source of pride.

Not all parts of the job were so rewarding. In the early days of my Life Skills position, I was also assigned case management duties—a role I found particularly difficult and thankless. Managing a caseload meant dealing with constant crises, extensive paperwork, and complicated client needs that often went unmet. It drained me. Fortunately, about halfway through my tenure, the department moved to a modern facility, our case management duties were suspended, and things improved. The classroom was better equipped, with an overhead projector and computer access that I used extensively to enhance lessons. I leaned on visuals and humor wherever I could, trying to create an environment that at least looked engaging. But that momentum didn’t last.

After the worst of the COVID-19 pandemic, everything changed. Our in-person classes were no longer held at the agency headquarters but at scattered group homes across the county. Without tech support or visual aids, teaching became significantly harder. The routines I had built, however imperfect, were upended. Once again, I found myself driving long distances, often to rooms that were poorly suited for instruction. The spark I’d felt in the Current Events class was impossible to replicate. I grew fond of a few clients, but for the most part, the work became more draining than sustaining. When I became eligible for retirement, I didn’t hesitate.

Looking back, my years at the DuPage County Health Department didn’t come with prestige or passion, but they came with perseverance. I showed up. I fulfilled my duties. I worked through stress, limitations, and ambivalence. It wasn’t my most inspired chapter, but perhaps it was one of my most grounded. I found ways to contribute, to connect, even briefly, and to endure. In a career marked by both collapse and creativity, these years were a quiet stretch of stability. Maintaining steady and routine employment paralleled resilience and the maintenance of solid psychiatric health. And if there was one class, one moment each week where the room lit up with laughter and learning—that was enough. I did the job. And when it was time to go, I left with my head held high, knowing I had done a good job.

When I first retired, I found myself adrift. Days stretched endlessly before me, empty hours demanding to be filled, yet I had no clear vision of how to structure this new chapter of my life. That's when someone introduced me to Meetup—a discovery that would transform my retirement experience. Meetup opened up a world I hadn't known existed. This social networking platform connected me to an incredible variety of activities: thoughtful discussion groups, live concerts, game nights, communal dinners, and bowling leagues. I threw myself into this new network enthusiastically, attending event after event, gradually weaving together a social fabric that had been missing from my days. Through Meetup, I not only found friendship but also discovered the rhythm and structure my retirement had been lacking.

As time passed, however, my path began to shift. New interests emerged, and my circle of connections expanded beyond the Meetup community. I became deeply engrossed in editing The Awakenings Review, writing for Substack, religious and spiritual activities, freelance editorial work, and contributing to the Awakenings Project—work that consumed my attention and passion entirely. Gradually, I found myself stepping back from most of my Meetup commitments, though not without some reluctance.

Today, I maintain just one connection to that original community: a small walking group that gathers every Monday, Wednesday, and Friday. These regular meetings provide something invaluable—consistent exercise paired with genuine friendships that have deepened over time. It's a perfect complement to my current focus on editorial work.

In my next reflection, I'll share how I've structured my daily routine around managing a severe mental illness while maintaining this balance of meaningful work, physical activity, and social connection.

What strikes me most about this journey—from the depths of crisis through years of quiet persistence at DCHD to the purposeful structure of retirement—is how recovery isn't a destination but a daily practice of showing up. The work at the Health Department taught me that meaning doesn't always announce itself with fanfare; sometimes it arrives in the form of a Current Events trivia question that makes someone laugh, or the simple act of delivering medication to someone who needs it. Those years weren't glamorous, but they were essential; they gave me the stability to discover that I could endure, contribute, and even find moments of joy in the most ordinary circumstances. Now, as I walk with friends three times a week and immerse myself in editorial work that truly engages me, I carry forward that hard-won understanding: that a life lived with mental illness can still be a life lived with purpose, connection, and quiet triumph. The path from survival to flourishing is rarely straight, but it is always possible.