There is nothing harder to get through than adolescent depression. Not only are you dealing with the darkness that is a depressive episode, you are stuck in an environment where drama is amplified and your hormones are raging and you are trying to figure out where you belong in the world as you transition to adulthood. It’s really fucking hard.
Yesterday, my aunt texted to tell me that she was back in the ER with my 15-year-old cousin, I’ll call her Jen. I just visited Jen last week in a special group home for youth with various mental illness. I visited her twice in the 10 days she was in the home after previously giving her school counselor a note saying she had a plan to kill herself. The first visit went relatively well, but was short because I got there after work and they have an early curfew.
I felt like we connected a bit as I told her that I also struggled in high school and that I know how hard it is. She even said, after I told her a little of my story, “wow, I didn’t realize that we’re so much alike.” I thought maybe that’s a good thing – if I can be a positive role model for her… I never had that when I was going through my own shit in high school… maybe that could help.
We discussed my coming back on Sunday to visit so when I did I was a little surprised that she wanted me to leave after 20 minutes or so. I wanted to be respectful of her needs and wants at that point, and I didn’t know what to say anyway, so I left. Maybe I should have stayed or told her I could come back in an hour or something. She had to go to an art therapy session that was optional but really I could tell she just didn’t want company, though was grateful for the M&Ms and root beer I brought her. She gave me a quick tour of the campus and the gardens and then we talked about hanging out for a weekend she she got out and back to the real world. She said she’d tell me more about what’s going on with her when we do.
The first night, I asked her if she still feels like she wants to kill herself and she told me that she does. She made me promise not to tell anyone and I told her I wouldn’t (mostly because she didn’t tell me about a specific plan and she was already in this safe place for feeling that way, which is where they would put you if you told someone you wanted to kill yourself.) I also wanted her to feel she can trust me for sharing what’s really going on – even if we couldn’t discuss this until after she left her treatment center and spent a weekend with me hanging out. I wanted to find out what was really going on with her, and that started by building trust. You can tell me how you really feel, what’s really going on. I also honestly thought it was so obvious she was not healthy enough to leave, but apparently she convinced the psychologist on staff that she was in good spirits and looking forward to returning to school. She’s really good at acting and manipulating people to get what she wants. In this case, she wanted to get out so she could actually enact her plan. I don’t understand why the professionals didn’t see this or at least let her parents know about how high risk she is. They weren’t even told they have to lock up sharp objects or pills, this was optional if they wanted to.
My aunt is divorced, which makes the whole situation much more difficult as she doesn’t always see eye to eye with her ex. Her ex, who I know well as he was my uncle for many years, is very much in the mindset that things aren’t that serious. He doesn’t want them to be, so they aren’t. He thinks, like many fathers would, that she’s just acting out like a normal teen. Many teens threaten suicide, few actually proceed to attempt it. Even so, he says he locked up most of his medicine and left only a few pills out if needed. I’m not sure about the knives. It really didn’t ultimately matter because she tried to overdose with tylenol PM.
She went to school on Friday morning and even texted me back when I asked her “how does freedom feel” that morning with the response “amazing!” I could sense that wasn’t anywhere near the truth, unless by amazing she meant “I’m free to go ahead with my plan to kill myself.” Deep down, I knew she was going to make an attempt. I didn’t think it would be so soon.
That day, apparently at lunch, she swallowed 9 tylenol PM pills. She may have got them from her father’s house or she may have walked across the street at lunch to the supermarket to buy them – they have an open campus so there really isn’t anything that can be done to prevent her from buying basic over-the-counter pain killers. Luckily, her teachers who are on high alert about her mental state noticed she was acting strange and had her go to the counselors office, where she admitted what she had done and was rushed to the ER. She’s “fine” and locked up again… and the whole situation is an absolute mess… and I feel guilty because I KNEW she was going to do this… but what could I do? Why aren’t the doctors understanding the risk and acting on it appropriately?
But then again, what should they do? Mental health treatment is largely based on what you tell the doctor. If they ask how you’re feeling or what you’re thinking and you tell them what they want to hear, you’ll never be helped. The home she went to was good for a place to stay for a while that is safe, but I don’t think their group therapy sessions about coping skills and DBT to address controlling emotions are useful when you’re just so far gone with who knows what personality disorders waking up in partnership with mood disorders. They let her leave and go back to school as if nothing happened. She was to return for outpatient family therapy, but she had other plans.
I am going to visit her tomorrow. I called the hospital today and didn’t expect to talk to her but they put her on the line. I told her I loved her and that i’m so happy she’s alive and then I nearly burst out crying. I have a hard time with emotions and such and my family doesn’t really do emotions, and I don’t know how helpful hey are anyway. They might be very helpful in that I think a big part of the problem is that we both grew up in families that don’t really feel anything other than anxiety. I wanted to help her know it’s ok to feel sad and scared and upset, and that’s normal and healthy and our families are so messed up in that they don’t know how to do feelings. But, I just felt like everything coming out of my mouth was the wrong thing to say. I can’t help but feel guilty, like maybe I said something or pushed her along in her thought process by accident. What if she had actually successfully killed herself and she told me that she still wanted to die, and I didn’t tell anyone? That would be horrible, but I promised her I wouldn’t tell anyone and I figured that the counselors there would know this. I figured as mental health professionals they’d know the signs and how to see past her saying that things are all rosy. Apparently, I was wrong.
Now my aunt and uncle are trying to figure out what to do next. Options are very limited and they really don’t know what to do. Who are you supposed to ask about this? You can always hire super expensive help — psychiatrists and such who charge $300+ an hour and specialize in adolescent psychiatric issues. You can just keep going on like you’ve been doing, put her back in school and hope she doesn’t try again. Or they can invest in a $10k a month therapeutic boarding high school for troubled teens that may or may not have long term benefits other than keeping her alive another two years until she graduates.
She is on a basic SSRI now which also concerns me as there are studies showing it has the potential to make teens MORE suicidal. Did being on a low dose SSRI cause her suicidal thoughts to turn into action? Who knows. I’m sure she feels hopeless and over the world right now. I completely know the feeling, even if her reasoning is different from what I’ve felt in the past. I just want to help her get through this. It’s hard when I’m still depressed and struggle with these issues on a daily basis — I can’t count the number of times I’ve thought about killing myself because the world is just too much and I when it comes down t it I hate myself and feel alien from the world around me. I haven’t attempted it since high school, and even then I only took 6 tylenol and nothing came of it other than an awkward night-long stay in the hospital with my father by my side being overly emotional suddenly after being such an asshole to me for so many years (of course as soon as I get out of the hospital he goes back to being an asshole.)
These days teen suicide is taken so much more seriously and that’s a good thing but even with all the awareness and prevention and everything that was done by the school and her family, she still managed to get a bottle of pills and take them during school hours clearly with the hope to epically die in the middle of class, the same place where she is most tormented. Most suicidal people want to commit suicide in private, so this was clearly an attempt not only to die but to make a big statement. Or, she wanted to be rescued, because nine tylenol in a school setting when the second you pass out, if you even do, you’re going to get medical attention and it is not likely to kill you. But who knows what she was thinking. If anything, she was thinking that everyone is not taking her seriously, and she has to show them now that she isn’t just faking it for attention, that she’s serious about ending her life.
And she almost did.
Her parents are a mess, they don’t know what to do, and they can’t agree with each other on anything. Now her dad wants to send her off to a high-priced therapeutic boarding school and her mother wants her to see a better neurologist first to understand what’s going on chemically and get her on the right medication combo before sending her away. It’s really tough when they can’t agree on anything for her treatment, and I’m sure that tension just adds to her depression even more.
There is no right answer here, only the open question of what should her parents do right now? They can’t lock her up forever, and hopefully she can get on the right combination of drugs to bring her back to a healthier mental state so she can feel something good again. That will take time and over that time how do you keep her safe? What can they do?
I wonder what I would do if I was her parent. I don’t know how I would handle the situation. I’d be just as confused and scared as my aunt is. I don’t want to look back on this post a year from now wishing I had said or did something more to help.
I talked to my sister today – she’s seven years younger than me and also went through a period of severe depression. I feel horrible that I wasn’t there for her enough during the time, but I didn’t know how to be. She did get treatment. I told her she should go to see a therapist and she eventually did. The medicine worked for her. I didn’t know that in college she had thoughts about jumping in front of the train, but didn’t because she was concerned it wouldn’t work and she would end up severely injured. I didn’t know how depressed she was then. I asked her today if she’s still depressed and she said kind of but it’s different because now she can see her future and she looks forward to it. Back then, she didn’t see a future at all.
I didn’t know she felt that way then. I would have been devastated had she ever attempted suicide. I’m not very close to her, or anyone for that matter, but I hope she knows I’m here for her, and I home my cousin can survive this time in her life so we can look back on it later in a positive light. I wish we all could just break free of the cloud of hopelessness and emptiness that sometimes becomes so suffocating. Depression means that survival must be the goal above all else – even if that means missing a year of school or leaving the workforce to take care of yourself and your mind. We must know ourselves and our limits. We must not be ashamed of our illness, or hide it, or think it’s nothing because it happens to not be a physical cancer or disease. We need to survive.