Saturday, April 2, 2011

Here's a Life Story ...(WARNING: this is long and on a subject many don't want to acknowledge)

On September 21, 2008, my daughter attempted suicide.  She was 16 years old, and a junior in high school. 

When The Daughter was about 12, she started having migraines a LOT.  She was so moody and irritable.  ALL the time.  She hated everything and everyone.  Her grades were slipping, and she spent most of her time in her bedroom.

During her Freshman year, she was missing a lot of school due to migraines. I had gotten her in with a neurologist for her headaches, and he was awesome.  He really talked to The Daughter a lot and was trying to get to the source of the headaches.  As part of his assessment, he asked her if she ever thought about suicide.  She bluntly said yes.  I was shocked.  I also was in denial.  The thought that ran through my mind was, “well, suicidal people don’t tell you they’re going to do it, so she must not really mean it.”
He tried some mild antidepressants but wasn’t really convinced that she had depression, so if it didn’t make any difference for her, he would just take her off instead of increasing her dosage.  She also had severe insomnia, but nothing really worked to treat that. His assessment of her was that she just had a more melancholy personality and that she is a deep thinker so he just wanted to make sure she had good support and since she and I were close, we were supposed to do something together at least once a week.

The Daughter was always well liked by her teachers and peers.  She never got into trouble.  She never did drugs or smoked or drank alcohol.  She was always the one that brought the “lost” kids home and we took care of them.  She excelled in Student Council and was easily elected for class president of her Sophomore class too.  In fact, no one even ran against her. 

A few months later, she confided to me that she had been cutting herself.  I flipped out (in my mind anyway).  I called her neurologist and he said she needs counseling so I got her into counseling. 

By this time, The Daughter was pretty shut down and the counseling wasn’t really going anywhere.  There was just an emptiness and darkness in her that I could not figure out. 
When I spoke to family about it, I got a lot of judgment.  I was clearly sucking as a parent.  I didn’t discipline her enough, I didn’t set high enough expectations, I wasn’t there enough…the list goes on.

In April, 2008, The Daughter told me that she was at the end of her rope and she wanted to kill herself.  I got an emergency meeting with her counselor.  During that meeting, The Daughter would not agree to not harm herself, so I had no choice but to have her hospitalized.

I took her to the University Neuro-Psychiatric Institute.  They diagnosed her with Major Depressive Disorder and suicidal ideation.  They put her on Prozac.  The Daughter met all of the behavioral requirements and excelled there.  That was fine, but I wasn’t seeing any difference in her demeanor.  I’d go see her every couple days and talk to her psychiatrist.  The Daughter was pretty stuck on the fact that it was her step-dad that was the problem.  I kept telling them that wasn’t it, that something else was going on and they needed to dig deeper with her.  Unfortunately, that particular establishment was more concerned with the fact that they were an “acute-care” facility so their goal was to get her to say she wouldn’t kill herself and they’d release her.  Which is exactly what they did after 10 days.  So, home she came.  Nothing had really changed, other than she wasn’t threatening suicide anymore.  She continued with counseling, but since the Prozac wasn’t helping, she quit taking it.  I asked the Dr. about it, and he gave me a big long spiel about how Prozac is the best and most trusted treatment for youths, there’s 30 years of research, blah, blah, blah…Since I still had no understanding of depression as a medical illness and I was extremely skeptical about medication, I didn’t push the issue.   I also still had my family basically telling me this was a parenting problem, that The Daughter was just being a spoiled little brat and that I was playing into her bad behavior.

So, we cruised along on auto-pilot for about 5 months.  Nothing was changing and The Daughter had pretty much stopped going to counseling because she wasn’t participating and it was a waste of $150 an hour. 

When I say The Daughter is depressed, people want to know what she is depressed ABOUT.  I myself wanted to know that for a long time.  The Daughter has everything a girl could want materially.  She is physically beautiful.  She is an EXTREMELY talented artist and is amazing at everything she puts her hand or eye to.  She is intelligent and compassionate.  She is a leader and a great friend.  Everybody loves The Daughter, kids and adults alike.  In that regard, it was really difficult not to just assume she was being a spoiled brat.  Which is what most people were telling me.  I got a lot of parenting advice, as if I could parent the depression out of her.  Depression is a difficult illness to grasp.  The Daughter has written about her depression for a long time and though my eyes read the words, I just missed it all together….but reading her poetry now, well, she is quite articulate in describing how it feels to have depression.  Unfortunately I never knew the depth of her depression until she tried to end her life on September 21, 2008.  She appeared to be very functional so it was easy to dismiss what she would say as being dramatic, typical for a teenager, whatever….I just didn’t get it… until I was sitting in the emergency room with her unconscious.  At that moment, my heart broke for my daughter.  To get a glimpse of the pain she has been living in, pain that has no face, no real cause, it isn’t ABOUT anything, it just lives in her always…..and to understand she’s been carrying that pain for as far back as she can remember….it was a devastating revelation.

Upon discovering The Daughter in the bathroom, my first reaction  was  ANGER! I still had no real understanding of what was happening.  (The depths of denial are truly confounding.) I called 911.  I had no idea what she had taken and was having flashes of her going into cardiac arrest and wasn’t going to risk that.  The ambulance came and I followed in my car with the bag of pills I’d found.

Anger was really my strongest emotion at the time.  My daughter was lying in a hospital bed, hooked up to IVs and monitors and she was really out of it.  She’d wake up from time to time, but was pretty unresponsive if we’d ask her things, though she consistently said she wanted to die.  She asked me why I didn’t just let her die.

It was pretty much at that point that I feel like God delivered into me some divine understanding of what was happening.  My daughter, my only beloved, cherished daughter INTENDED to DIE.  She was trying to KILL HERSELF.  This was not a cry for help.  This was not an act of a spoiled child.  This was not a call for attention.  This was an attempt to end her life. 

All at once I got a glimpse of the fact that my daughter was living in TREMENDOUS emotional pain.  She was hurting, relentlessly, every single day of her life and I didn’t know WHY… and I couldn’t hug it or love it away.

The Daughter spent 48 hours at our county hospital while we waited for a bed to open at WBI in Casper.  They had a bed open at UNI where she previously was, but I INSISTED that was not an option.  I told the head nurse what happened before, and she went to bat for me with the Dr.’s to keep her here until we could get her to WBI.

The Daughter spent 37 days at WBI in Casper.  It was one of the most difficult experiences of our lives, but it was also really good.  While my daughter was in treatment, we learned alot.  I learned that she had told at least 5 students of her plans and had been telling them regularly.  I learned that she was on the phone with someone while she actually was attempting, and told them, and they did nothing.  I knew that was because so many people do not know what to do, they don't take it seriously and they are not educated about suicide and mental illness. Again, they diagnosed her with Major Depressive Disorder with suicide ideation, but they also diagnosed her with Post Traumatic Stress Disorder.  The Daughter had been the victim of sexual abuse when she was younger but had never told anyone. That was a huge blow, too.

I started reading everything I could get my hands on about Depression and PTSD.  I found out that untreated depression causes atrophy of the brain.  Wait, what? The brain actually starts to die?

It was then that I figured out and reconciled in my own head and heart that depression is a MEDICAL condition. 

I also found out that PTSD affects the brain the same way that Depression does.

They put The Daughter on Prozac again.  They also wanted to give her Klonopin however, I remembered watching a TV interview with Stevie Nicks a while back and she said if a doctor ever offers that, run away.  So, we declined that treatment (thankfully). 

This time, The Daughter was really participating in her treatment.  Every Thursday I’d drive to Casper and spend all weekend there.  An old high school friend works at an area hotel and secured me a great rate and made sure my room was ready every single weekend.  The Daughter and I really strengthened our bond and I could see a change in her eyes.  She was doing really well.  I was determined that this time, she wasn’t coming home until she was fixed.

After about 3 weeks, The Daughter was feeling ready to come home, but I was skeptical.  She was really tired of being there though.  She was on meal-watch all the time because she was so tiny (93lbs) and it took a lot of convincing on our part that she wasn’t anorexic and just lying about it… She was getting irritated with that big-time, and she was tired of the other patients there because they seemed to be doing everything they could to stay sick and she really wanted to get well, so even in treatment, she felt alone.  She would call me and just cry… Finally, after 37 days, The Daughter came home.  

I’d like to be able to say that we all lived happily ever after at this point, unfortunately that is not true.

Things were pretty good for  about 2 weeks.  I got The Daughter in for her follow up appointments and got her set up with someone to manage her medication.  Unfortunately, because of our rural location, psychiatrists are hard to come by and the only access we have locally is to the same Dr. that oversaw her care at UNI and released her from the first hospital.  Needless to say, there was no way I wanted that guy.  I decided to give The Doc a try.  The Doc is a Psychiatric Nurse Practitioner with prescribing authority.  I also got The Daughter set up with a great counselor that she actually connected with and things were moving right along. 

About a month after she got home, The Daughter was slipping back into her isolating patterns, staying in her room, acting defensive and grouchy ALL the time again. She wasn’t eating or sleeping much and she was still having suicidal thoughts. She seemed to be diving further and further into the darkness again.

I was heartsick.  I’d felt so hopeful that things were going to be better.  She’d just been hospitalized and received therapy for 37 days…. What the hell was I going to do now?  I was so frustrated too.  I prayed all the time for her.  I prayed that for just for one minute she would be able to feel differently.  She had lost all hope.  Again.  She told me that she was having impulsive thoughts to kill herself which was different for her because before, she always thought about suicide, but it was more like long-term planning, not impulsive. 

I made sure all firearms were secured from her and I called The Doc.  They did an emergency assessment and were able to get The Daughter to agree not to harm herself.  Every day I would make The Daughter give me her word that she wouldn’t kill herself.  Everyday she would begrudgingly agree. 

By December, things were so much worse than they had been even before The Daughter attempted.  I was beside myself.  There were times that I was so engrossed in her pain that I felt like telling her to just do it.  I NEVER did tell her that, but it was certainly a thought in my mind, just a reaction and a desire to end her pain.

In January, 2009, we went in for a check up with The Doc.  The Daughter still wasn’t feeling better and The Doc had already been weaning her off of Prozac and had started her on Wellbutrin. Having to take medicine every day for someone who recently swallowed 250 pills is not the easiest task either, so that was another challenge unto itself.

During the appointment, we told The Doc some of the things that The Daughter had revealed to me during the previous couple of weeks.  One of those things was that The Daughter had been experiencing hallucinations for several years that she had never told me about. 

The Daughter had a cast of characters that played a role in her life that were unseen to the rest of us.  One was a big black dog.  There was a little girl, an old woman that she was afraid of and some others…  When we shared that information with The Doc, she said “Ok that’s it.  I have been suspicious that The Daughter is Bipolar, but that is the last straw.”

She told The Daughter to stop taking the Prozac all together, to keep taking the Wellbutrin and to start taking Lamectal, which is used to treat Bipolar disorder.

Within about 1 week, things were a little better, but not by much.  At our next appointment, The Doc added Abilify to the regime.  That was it.  Within 2 weeks The Daughter was so much better and within a month she was completely transformed.

We finally have the correct diagnosis and the correct treatment. It is amazing to see the difference.  She was finally stable.  She is finally “normal” in the sense that she can enjoy life.  She can see a future, she actually WANTS a future. 

One memorable milestone for me was a couple of months after The Daughter got stable.  A friend of ours reported that he was driving home from work and the car in front of him pulled off the road.  A woman got out of the driver’s seat, walked to the other side of the car and shot and killed herself right there on the side of the road.  It was all over the news.  I talked to The Daughter about it and she said she couldn’t imagine doing that.  I was like, are you serious? Like 2 months ago that could’ve BEEN you?  She didn’t even really remember what it was like to feel that way.  That’s because before she was stable, she was basically in psychosis.

The Daughter’s biological father is Bipolar. The Daughter’s paternal grandmother has been diagnosed with Major Depressive Disorder.  I’m sure I have other members of family that have undiagnosed mood disorders and/or depression.  All of these factors contribute immensely to one’s chance of developing depression or in The Daughter’s case, Bipolar Disorder.

Not all Bipolar looks alike.  The Daughter has Bipolar II, which means the mania she experiences is nothing like they depict on TV, where the person acts so happy and full of life and bakes for everyone and is “high” on life, they go off their meds, then they plummet into darkness and suicide attempts. That’s more like Bipolar I. 

For The Daughter, it took a long time to diagnose her because she didn’t display any type of mania like that.  She experiences more depression and those types of symptoms.  Her mania comes out in extreme insomnia, low appetite, and hallucinations, but none of those symptoms were something we could really SEE. 

The Daughter’s dad is still struggling with his Bipolar Disorder.  He is 40 years old, and is in pretty bad shape.  He’s never really gotten stable.  Bipolar Disorder, unlike some types of Depression is chronic and life long.  The Daughter will have to be on medication for the rest of her life.  She realizes this and also realizes that if she doesn’t take her medicine, she will die.  Fortunately, because The Daughter was still young when we got the correct diagnosis, her prognosis is good, provided she stays with the program.

If a person with Bipolar receives treatment, becomes stable, then goes off their medication (a common occurrence because they start to feel better therefore, they think they’re cured and don’t need their medicine anymore) it takes 50% longer to get stable again, EVERYTIME they go off.  This makes it even more difficult because then they feel like treatment isn’t helping so they won’t take the medicine.  Also, if they go off their medicine, usually, the medication that worked before to stabilize them will no longer work.  Sometimes, medication that is working will stop working so it is a continual process of treatment for life.

The Doc also told us that Bipolar is a mental illness that the professionals know the LEAST about because it affects the entire brain instead of certain areas like other illnesses. 

The Daughter is still a work in progress.  She is much better now.  I have had to let go of a lot because she is 19 now, fully an adult (legally) so I have no say in her treatment anymore.  Of course I'm slightly fearful of that fact, however she has stepped up to the plate and taken charge of her treatment better than I ever imagined and I am very proud of her.

My hope is that in our story, other’s will find hope; that like me, the facts I have come across will sink in and help give an understanding of mental illness as a medical condition; that some of you won’t live in denial as long as I did; that the guilt we feel as parents and mothers, can be relieved and that it isn’t that we are terrible parents.

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