That Kind of Breaking

The guidance counselor was kind and calm. Anyone who can maintain those two qualities while in the confines of a public middle school all day has my immediate respect. I sat and listened as he began to speak.

“Your daughter tells me things have been rough at home, that your family has had some pretty big challenges.”

“Yes. That’s true. We certainly have.”

It had been about two years since my husband’s traumatic and failed fight for his life, and though he was a stepfather to my children they loved and missed him deeply. I had returned to the workforce, my son had moved to his dad’s and his sisters didn’t often see him, we had made the transition from homeschooling to public school, and my older daughter had recently been released from a five-day stay at the psych ward.

Yup, I’d say those were some pretty big challenges.

“Well, she’s been having a tough time dealing with it all, as you can imagine.”

Teenage Problems, Social Issues and Bullying

This was the coming-to-life of some of my deepest held fears at the time. In all fairness, I had quite a few fears, pretty much all of which included my kids. I knew that my older daughter’s struggles and rages were traumatizing our family. I knew that her continuing self harm and relentless thoughts of suicide were more than taking their toll.

I knew that I tried so hard to protect my younger daughter from her sister’s struggles, even as I didn’t know how to define or predict what those struggles might be. I knew how frightened I was, and I could only imagine how terrifying it must feel to a 13-year-old girl whose world had been shattered long before her sister’s mental balance had.

I knew that my youngest was getting lost in the shuffle of psychiatric appointments. I knew she felt invisible and dispensable as so much of my time was spent talking her sister ‘off the ledge’, cleaning and bandaging her self-inflicted wounds, walking on eggshells, trying to find an answer, a balance, a cure.

I knew that the older often goaded the younger, then immediately wanted her sympathy and compassion. She showed us all macabre, dark drawings she’d made, somehow expecting us to praise the depictions of death and blood she produced.

I could make no sense of it as an adult. I certainly could never expect my youngest teen to have the ability to process and make peace with all that was going on. And yet I felt powerless to guide her. How can you teach someone to do what you are unable to do yourself?

And so here we were, in the school guidance counselor’s office. I was waiting for what I didn’t want to hear, but what I needed to know.

 Worried

My daughter had ended up there after having had a particularly rough day, and she’d thankfully confided in her counselor about the unfathomable mess that was our family. She’s always been one to think she can tough her way out of anything (I have vivid memories of a three-year-old determined to swim in the deep end of the pool, working hard to hide the panic on her face) and I was so glad to see that she’d taken the chance to share her confusion and pain with a trusted adult.

The counselor continued, gently breaking the news to me that my daughter – the one here with me, not the one (hopefully) waiting in the car – had been cutting herself as a way to deal with her distress and pain.

My stomach dropped then just as quickly threatened to jump up out of my throat. I was facing my daughter, whose eyes were filled with many things, including fear. I knew she’d seen me deal with her sister and that she’d seen me be both gentle and brusque in trying to stop the ongoing and escalating self harm. Of course she had to be nervous about what my reaction to this news would be.

Outwardly I pretty much held it together, meaning I didn’t curl up in the corner in a fetal position. I fought the sudden nausea I felt.

But inwardly I was breaking, as if there was a  tire screeching, metal crushing, glass shattering  75 car pileup, the kind where you know things are so out of control you are clueless as to where or how to start administering any kind of aid. The kind where you are the lone witness and all you have are Band-Aids and the phone lines are down so try as you might you can’t call for the 50-plus ambulances that you need.

That kind of breaking.

 Car pileup

Tears sprang to my eyes.

“Oh, sweetie.”

It was all I could say.

© Monica Simpson and Help To Hope, 2014
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A Tough Task

“Yes. I’m her mother. Can I help you?”

I got the call while I was sitting in the car outside my younger daughter’s middle school. I’d left work, picked my older daughter up at her high school, and driven to the middle school to park and wait for the day’s final bell. The interaction with my daughter sitting next to me was stilted and unnatural, as it so often was at the time.

 girl in car

Source

Her behavior after release from her first hospitalization for a mental health hold had been shaky. We’d had high hopes and bundles of nerves, and we were trying hard to make right something that we weren’t even able to completely identify.

In addition to obvious depression and unmanageable rages, she’d become involved with a boy at school who shared some of her struggles. He was a nice enough kid, but the dysfunctions they shared caused them worrisome co-dependence, especially when it came to their self harm behaviors.

teen couple

 Source

And while being together could be uncomfortable for both of us, I had serious concerns about leaving her unattended. She had alluded to running away on a number of occasions,  even trying to run off on that weekend before I’d had to call the ambulance. I knew that her thought processes were off-kilter enough that she could make some dangerous decisions.

My youngest daughter’s guidance counselor had called while we waited. “I have her here in the office with me. Is there any way you can meet with us before the school day is over?”

“I’m actually parked right outside. I can be right there,” I replied. The evasive, non-committal tone of the conversation made it clear to me that no good news was waiting inside.

I did the quick mental gymnastics: If I leave her here in the car while I go inside, will she be safe? Will she run? Will she be here when I get back? Should I make her go inside with me, feeding her insistence that I never trust or understand her?

I swallowed hard as I told her that I needed to go inside and speak with someone, and that I’d see her when I was done. She sat with her earphones on, black eyeliner encircling her downcast eyes, too cool and too annoyed to acknowledge much of anything. I put my car keys in my purse and walked to the school entrance.

Photo: D Sharon Pruitt

I signed in and was directed to the counselor’s office where my younger daughter peered up at me nervously from her seat. She was dressed like a typical middle-schooler, sporting a bulging backpack, carefully styled hair, colorful braces, and inches of plastic bracelets halfway to her elbows.

I tried to smile, to remain calm, to not read into the situation anything that wasn’t specifically presented. After all we’d been through as a family in the past years, that was a tough task to handle.

© Monica Simpson and Help To Hope, 2014
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On Thin Ice

The weeks following my daughter’s release from her first mental health hold were a tenuous mix of hope and dread. I was hopeful the change of medication would help stabilize her, and at the same time I was terrified that the change of medication would not help stabilize her. Worse yet, I was afraid the change of medication would aggravate her already fragile demeanor.

It felt as if we were walking on thin ice, fearing a web of cracks with each step.

Walking_On_Thin_Ice_by_X_ample

(Photo Source)

My daughter returned to school, and it’s hard to say whose nerves were more frayed. Returning to classes and trying to explain to her peer group all that had happened could not have been easy for her.

I still had daily worries about her younger sister and the volatility within which we were all living. It was clear that, although the five days in the psych ward had helped to temporarily steady the crisis we were facing, our predicament was by no means resolved.

Soon enough the unpredictable and explosive episodes returned. The fragile and subdued girl who left the behavioral center after a psych eval was gone. In her place once again was a struggling teen unable to manage the emotional eruptions that plagued her.

There were necessary boundaries I was continuing to implement for her safety and my sanity, but I tried to allow my daughter time for friends. Though the dynamics of those friendships were not what I would have chosen (for any of them), I wanted to honor her need for her own identity and self-discovery. It seemed to be an integral part of the solution for her, but only if done in a healthy way.

I offered to drive them to the local ice skating rink or make our home available for their gatherings. All offers were declined, sometimes with a dismissive or angry attitude, sometimes with what seemed like abject hopelessness.

I tried to arrange my work schedule so that I could pick her up at school not too long after classes ended for the day. Getting in enough work hours could be difficult, and there were days she would call me filled with rage, demanding I pick her up right away.

on the phone

(Photo Source)

I wasn’t often able to leave early, though if I felt she was not emotionally safe, I would try to head out as soon as possible for the half hour drive. Memories and thoughts of her self inflicted wounds were never far from my mind.

It could be tough to know the right thing to do: Was she trying to manipulate me with her anger, expecting me to respond to her every whim? Or was she truly incapable of regulating her emotions, succumbing to the darkness that enveloped her like a cloud?

The answer to both questions was a resounding yes.

I was often confused by the seesaw of emotions I witnessed. She would insist that she wanted to stay after school to be with her friends, dramatically declaring that they were the only reason she went to school or kept herself alive. But her insistence about the importance of being with her peers was equally matched by her absolute loathing of them at times.

Life remained utterly unpredictable.

One thing that was relatively unsurprising was my daughter’s therapy sessions. As per the discharge paperwork from her hospitalization, she started seeing a new counselor. Unlike the previous therapist, this one was not located near our home. In all fairness, it wasn’t too terribly far; it just felt that way. The drives there and back were filled with heavy silence or forced, uncomfortable conversation.

What was not a surprise was the refusal from my daughter to fully engage in the help that was available to her. While she would talk on a superficial level with her counselor, she had in truth done nothing but reinforce the brick wall that surrounded her, the wall that she mistakenly felt would protect her from pain and struggle. At times she would even agree with insights her therapist offered, but by her own admission, she simply didn’t care.

Sometimes near the end of her sessions, I was brought into the office and the conversation. It was not unusual for me to watch my daughter sit in stony silence, her arms crossed tightly, her breathing heavy with anger. Her eyes would be filled with rage while she stared at a distant point, as if to will her bodily out of this universe and into one of her own making, one that would soothe her despair and anguish.

Sadly, she was unable to see that she was surrounded by people who truly wanted to help her reach a place of calm and peace. Her depression had convinced her that this was not a possibility for her.

Our lives continued to be lived in the shadow of her illness.

© Monica Simpson and Help To Hope, 2013
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Work

My daughter’s stay in the psych ward (her first stay, at least) was five days. Yet it seemed interminable and exhausting to me. I can only imagine how it must have felt to her.

While my daughter was hospitalized, I worked. I worked to find the new therapist she needed. I worked to prepare my younger daughter for her sister’s return. I worked to prepare myself for her return as well. I worked at calming my nerves in anticipation of the unknown that lay ahead for us.

I worked at contacting personnel in my daughter’s high school to let them know why she’d missed school and was failing her core classes. I worked to advocate to her teachers on her behalf as depression, anxiety, and panic had interrupted class tests, make-up tests, and all manner of school work and homework in the preceding weeks.

I worked to make it clear to her teachers that I was not trying to excuse any behavior; I simply wanted my daughter to know she could walk into a classroom, take a test, and not let anxiety continue to drag her into a dark abyss leading to self harm and despair.

I worked to prepare the way to help my daughter find even a tiny but necessary victory.

I worked to release the frustration of not hearing back from several of her teachers. I worked to let go of the fear that they would judge me as “that mom”, the one who let her kid get away with anything, then made excuses.

mean-teacher

Source

 

I worked to remember that my goal was not to get my adolescent daughter to pass English, sing in choir, or even pass her freshman year. I worked to stay focused on helping her reach a place of mental wellness, health, and personal safety.

I worked, literally, to keep my daughter alive, to help her want to stay alive.

I worked to respond to the teachers who had kindly and compassionately replied after I contacted them to inform them of my daughter’s deep struggles. I worked to contain my tears, to thank these good people for seeing the inherent value in my 15-year-old, even though she could not see it in herself.

I worked to remind myself that they were bearing witness to the good in my daughter, and helping me hold onto hope, whether they realized it or not.

I worked at letting go of the frustration that I was the one having to do everything, with no help from my children’s father. I worked to not allow wasteful bitterness about that overtake me.

I worked to arrange my schedule so I could be where I had to be when I had to be there, whether taking my youngest to cheer practice, or visiting my older daughter in the psych ward.

I worked at pushing aside the grief I felt as a widow, the utter sorrow I felt at not having my husband to talk with at the end of an exhausting day. I worked at trying to think of the encouraging words I knew he would say to me.

I worked to recall the feel of his arms around me, the safest place I’d ever known. I worked to remember that, no matter how distant it now seemed, I hadn’t imagined him in the first place.

I worked at staying awake and focused despite little sleep. I worked at the dailies of life: carpool, laundry, dishes. And, of course, I worked at work.

I was tired.

 

(One of my favorite bands/songs/videos. Best when played at a loud volume.)

 

Saturday finally arrived. Though two days earlier my daughter had angrily demanded I pick her up “Saturday morning at 6!” I kept my word and arrived around 9:30 a.m. The requisite paperwork took a little while. And there were new friends she’d made to whom she wanted to say goodbye.

We left with a prescription and a plan, and I was hopeful they would work at the same time I was terrified they would fail.

One of the perks of a psych ward stay (who knew there was such a thing?) was that my daughter was able to continue as the patient of the psychiatrist who saw her during her days there.

While that may not seem like such a big deal, the truth is that finding a qualified psychiatrist can take more time than one might imagine. And after finally tracking someone down, it’s not unusual to have to wait up to two months (yes, TWO MONTHS – or more) for an available appointment.

This one not-so-small detail had now been taken care of. It’s not like the appointments would be close to home, but just to HAVE appointments for someone who could manage medication was a major hurdle crossed. I was very grateful.

sunny day

 (Source: Google Images) 

 

My daughter and I stepped out into a bright, sunny February morning in Colorado. She hadn’t had the freedom to be outside for several days. She seemed small and fragile, a combination of embarrassment, nervousness, and relief. I felt much the same as she.

I didn’t know the rules for what a parent is supposed to do when they pick their kid up from the psych ward. So we went to Jamba Juice. It seemed like a good idea. And it was.

© Monica Simpson and Help To Hope, 2013
https://www.facebook.com/HelpToHope
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Curiouser and Curiouser

I tried hard to be a voice of reason to my daughter. But how does one reason where there is no willingness to receive it? It didn’t work for Alice after she fell down the rabbit’s hole, and it wasn’t working for me. Still, it seemed all I could do.

alice in wonderland confusing

(Source)

Tuesday night had seen a change to my daughter’s medication. The two SSRI anti-depressants she’d tried in the previous weeks had served only to take her deeper into rage, depression, and thoughts of suicide.

She was switched to a medication initially developed to treat seizures but used off-label to treat mood disorders. As those with mental health issues often find, medication is not an exact science. Not at all. But the aim at this point was to stabilize her, which (ironically) meant taking her off anti-depressants.

She soon found out that the term “72 hour hold” was a misnomer, more a guideline than a declaration. This was first a rumor she heard from other adolescents in the unit, and then she found out it was to be her reality.

I tried to explain the reasoning behind the need for her to stay in the psych ward longer. “They’ve switched your meds. The old ones obviously didn’t work well for you. They need to make sure you don’t have a bad reaction to this new medication. It’s a safety issue.”

Predictably, she was not receptive. For the record, I’m not so sure I would have been either if I’d been in her shoes. Also predictably, her anger flared. She was not allowed contact with any friends while she was hospitalized, and even if the support system she’d built for herself was terribly dysfunctional and harmful, all she knew was that it had been taken from her. And she was mad.

There were some curious things I realized about myself in those few days, difficult things that made me sad and confused.

 alice in wonderland sad

(Source)

I knew that I was afraid for my daughter to be released from the psych ward and sent home. I was fearful that she would quickly return to her previous behaviors and that I was just too worn down to be an effective parent anymore. I was scared that there would be no lasting changes resulting from this awful ordeal. And I was so out of ideas.

I knew that my goal was not to keep my daughter from getting angry nor was it to have her like me. My goal was to keep her safe, even if she came to hate me in the process.

I knew that I wanted to put up all kinds of roadblocks so that her choices were limited and she couldn’t make decisions that would be harmful. But I knew that would be a disservice to her, that it would mistakenly teach her that she could not be responsible for herself.

I knew that, in the bigger picture, I couldn’t and really didn’t want to control my daughter; I wanted her to learn to control herself.

I knew that  for that to happen there had to be boundaries and consequences in place, and that she had to choose her actions and thus her own outcomes. This was a source of great pain for me, because I knew some of the choices she would make and that their results would be very hard for all of us.

But I had to let that go. Even though I could see that she was not yet willing (or able?) to face some of her bigger issues, I had to let her choose for herself.

I will once more refer to an email I wrote to my small and trusted circle of support. This was yet another middle of the night message, a bit disjointed and bearing witness to my fears and frustrations. This was written on day three of my daughter’s stay at the behavioral center, the day she had mistakenly decided she was going to be released and sent home.

* * *

I had a meeting today with C and her dad and caseworker.  There was a chance for C to have her say and a chance for us to, then time for us parents to meet alone with the caseworker.  We were told early in the meeting that C would not be released until Saturday (day five of her “72 hour” hold). We really lost her at that point. She wants to come home NOW.

She was not forthcoming about some stuff she’s been lying about lately, nor about what might have been bothering her that led up her hospitalization. She’s been telling me for weeks about some things that are just driving her crazy, but she never even mentioned them in today’s meeting. I told her that I’d learned about some of her deceptions but she would not acknowledge anything, just said she had no idea what I was talking about.

I tried to prepare her for the fact that things will be very different when she gets back home, that boundaries will be tighter, and privileges will need to be earned back.  I don’t think she has any idea what that means or thinks it will really happen anyway.

I am feeling extremely overwhelmed at the thought of her return home.  The caseworker had all kinds of thoughts and ideas, and while some of them may be helpful, the work of it all feels like it will bury me.

When her dad and I walked out of our meeting with the caseworker, C came straight over and asked me why she couldn’t be released sooner.  She was very angry and confrontational and kept demanding answers that I couldn’t give her.  I gave her the only answer there was to give, but she wanted more and I told her that was all I had, I couldn’t make anything up to satisfy her.

She directed all her anger and frustration towards me. I don’t think she even made eye contact with her dad for that 5 to 10 minute conversation.  She made vague threats about not eating (that’s her choice if she wants to make it) and swore she was better and ready to come home.  It was really pretty awful.

She chose me to be the one to pick her up when she is released on Saturday. She told me she wants me there at 6 in the morning. I told her I’d be there between 9 and 10.

I know there are many strategies to deal with her in the days ahead; I just honestly feel like there is nothing left in me to do it – to learn what I need to learn as a parent, to find her a new psychologist (her request and the caseworker’s recommendation), to drive her across town how many times a week for those appointments, to find extra-curricular activities & get her enrolled & to the activities, to meet with her school counselor and teachers and try to help her not fail her freshman year.

I am just spent, which may be exactly where I need to be but it doesn’t make any sense to me and I can’t see how it’s all supposed to get done.

I did tell her dad that with these added commitments I cannot logistically do all that needs to be done for both girls during the week (always on ongoing battle for me), and he said he’d be available but the truth is that he works during the hours these things are going on. I will have to continue to change and arrange my work schedule to take care of things.

I don’t expect him to make any sizable contribution to handling those details because he hasn’t before. It would be helpful if he actually had some input or action of his own; I feel like it’s up to me to take the lead on these things because he simply will not and we are at a critical juncture where action must be taken.  He does not seem to accept the seriousness of the situation. (Caution: ex-wife frustrations are surfacing!)

Again, the ideas for help and change sound really good in theory but the reality of it feels nearly impossible to me. There just isn’t enough of me to go around.

The diagnosis the caseworker gave for C today was General Anxiety Disorder and Depressive Disorder.  I don’t know if a new therapist will reach a separate conclusion.  C says she hasn’t been suicidal for about a day and a half.  She says cutting is stupid and disgusting and she’ll never do it again (which she’s said before), and she swears that she has learned all she needs to know and will be fine.

She also says she wants to “help” her friends who cut to stop cutting, which basically translates to her taking responsibility for their actions – which scares me especially when she cannot take responsibility for her own.

After today, I cannot imagine a conversation with her that is not angry and confrontational and manipulative.

I do get that her choices are her own and that my job, after assuring her safety, is to allow her to deal with the consequences of her choices.  I know very well what some of those consequences could end up being, and I can honestly say I hate that.

Maybe that is where so much of my anxiety is coming from and I need to work towards what is acceptable and adequate, not what is perfect and guaranteed (those two options really don’t even exist).  But I selfishly look at those consequences, should they come – and I know some of them will – and I know that they will result in even more being put on my plate and I feel frustrated and angry about that.

Well so there it all is.  I am too tired to make this (or me) sound nice. I have no neat or tidy wrap up for this message; I’m just continuing to ask for and appreciate your prayers and hoping that my ranting and venting haven’t been too offensive.

In a few hours I start a very busy day, not only working on my taxes, etc., but also working out C’s discharge, contacting her school, trying to track down and interview therapists and stuff like that.  I appreciate your prayers and support.

© Monica Simpson and Help To Hope, 2013
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His Sweatshirt

“Bring me his sweatshirt, mom. Please.”

“Of course, sweetie. Of course I will.”

My daughter was limited in the personal items she was allowed to have during her mental health hold. Hoodies – the staple of teen fashion – were okay, but drawstrings had to be removed. Favorite (imitation) Converse shoes? Fine, but no shoestrings allowed. The safety pins my daughter loved to use as fashion statements were absolutely forbidden.  I was forced to look at clothing, and much of life, in a whole new way.

But the thing my daughter wanted most was “his sweatshirt”, and there was no reason to deny her request.

When my husband had died almost two years earlier, I’d invited all three of his adult kids to go through his clothes, to pick out some favorite items they might want to keep for themselves or their own children.

I tried to also give them each special items, perhaps tokens of affection they or their children had given their dad that would now make their way back to the original gift givers. Or maybe an item that they had seen growing up in their childhood home that held special memories for them. It seemed only fitting to do this.

(Admittedly, there were a few things it took me time to be able to part with. Thankfully, my step kids are gracious and patient.)

I had also asked my own three adolescent children what they would like to have of their stepdad’s as special mementos. My older daughter had chosen an old sweatshirt that my husband used to wear often. He was great at coming home from a day of work and changing into comfy clothes, a signal that work was left behind and he was now present and available at home.

But this particular sweatshirt was one he often threw on early on a Saturday morning as he brewed coffee, read the paper, and prepared his favorite bagel for breakfast. It was a treasure on many levels and had become something of a security blanket to my daughter

 red sweatshirt

(Photo Source: Google Images)

In both the best and worst of times she slept nightly with the worn shirt close by. So often she had cried to me after his death about missing him and wanting him back. I understood at a deep level how she felt (and then some), and was not at all surprised that she wanted “his sweatshirt” now that she had been placed on a psychiatric hold for suicidal ideations.

It made perfect sense to me. To a frightened and unstable fifteen-year-old it was portable comfort, raveled and worn, in a place where comfort was difficult to find. I was happy to grant her request.

Visiting hours included Tuesdays, so I was returning less than 24 hours after I’d followed the ambulance across town and had her admitted. I took some approved clothes, the needed sweatshirt, my younger daughter, and an anxious heart, and drove us all through afternoon traffic for our first visit.

To call it uncomfortable would be an understatement. And incomplete. How else might I describe it? It was bewildering, sad, strange, surreal, terrifying, and with a few tendrils of hope that I tried to believe weren’t just taunting me.

There was one room where all visits took place simultaneously. All of the adolescents hospitalized there and all of the visitors who had come to see them were confined to this one very plain not-terribly-large space. Each group had their little gathering of chairs as segregated as possible from the others, with some people having to share their seat with another.

visiting room

(Photo Source: Google Images)

Some groups sat close together, speaking in hushed tones. Some seemed less eager to sit closely, or to even talk with one another. Some were loud and frustrated, others subdued and resigned.

I tried to (or not to?) catch glimpses of the others in the room while simultaneously trying to figure out how our family had ended up here, how my daughter was faring in the psych ward, and just exactly what the next step might be.

Add “disconcerting” to the list of adjectives.

© Monica Simpson and Help To Hope, 2013
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I Left Her There

The moment had come. They psych ward doors had opened, swallowing us into the unknown, shutting tightly and unnervingly behind us.

Once again, my daughter was given scrubs and non-skid socks to wear until I could return with “approved” clothes for her. I was grieved that she had no personal items to comfort her in this most frightening of places. (Shoestrings, drawstrings, belts, and other such items were strictly forbidden in the locked ward populated by adolescents who might use anything they could find to harm themselves or others.)

black hightops

(Photo Source: Google Images)

It was around midnight after a very long day.  I honestly don’t remember much except being in a small, dark room where the clothes of the adolescent residents were kept folded and stacked on shelves.

As I look back on that time, I’m surprised at the details I simply cannot recall. The emotion of the moment … that returns to me in a heartbeat, and even now I weep as my body responds to the memory of all that I felt in those difficult hours. I can feel it in an instant.

I left my daughter. I left her there. I left her in a psych ward on lockdown. I left her there because she was suicidal. I left her there because I could not keep her safe. I left her there because I loved her. I left her there with a trail of my tears and much of my heart.

Upon returning home, I sent an email out to my trusted group of friends, those I’d been sharing the journey with on many a late night when I was unable to sleep or bring any order to my world or mind.

I so missed the strong support of my husband. It had been less than two years since we’d watched him be removed from life support and take his last breath. How desperately I ached for his wisdom and comfort.

And so, my small but trusted band of friends had ‘listened’ faithfully as I’d regularly poured my heart out to them via email, lamenting my daughter’s depression, self harm, truancy, constant talk of blood and death, and all the other dark details that had been filling our lives for a number of months.

sad emailer

(Photo Source: Google Images)

There had been a few quick calls and texts to them during the daylight hours as we’d moved through the mental health crisis that had landed us in the emergency room. The following is part of the update message I sent to My Group after admitting my daughter to the psych ward for the first time. It’s a bit disjointed, though I tried to edit it to make it easier to follow.

It was sent on February 19, 2008 at 1:31 a.m.

* * * * *

Hello, friends.

I am just home from a very long night during which C was hospitalized for her own safety.  C’s dad came over to talk with her. He was very reluctant to admit her, but I am quite convinced it was the only safe option.

I did call 911 because C made it very clear that she would fight us if we tried to take her to the hospital.  So between the two squad cars, paramedics and ambulance, she went rather peacefully if not tearfully.  My heart just aches for her.

I had asked C earlier in the afternoon to rate her likelihood of suicide on a scale of 10 and she nearly yelled “10!” at me; I asked if she thought she actually would act on it and she said of course if everyone would just leave her alone (she used much more colorful language).  That was when it became glaringly apparent that she really needed to be admitted.

She had threatened to run away over the weekend and she and I even had a tussle in the driveway as she fell into a heap yelling about how much she hated me, much to the confusion of the man watching us from across the street.

We went to Children’s Hospital emergency room by ambulance about 6 p.m. Monday, and they had no empty beds so she was transported to [a freestanding behavioral center].

The supervisor I spoke with tonight said there is a decent likelihood she will be there more than 72 hours as there will likely be med changes they will have to monitor, but they don’t generally keep someone longer than 5 days.  He did tell me that last week they had 3 adolescents and in the past 24 – 36 hours they have admitted 15.  Wow.

Poor C may just be getting to sleep now (if she is lucky) and their days start at 6:15 and go until 9 or 10 at night.  When I said goodbye to her tonight she actually let me give her a kiss on the cheek and a good, long hug (which felt so good; I’ve really missed that).

I cannot describe to you her state of mind earlier today and over the past 4 days.  It’s been as if another person is living in her body, and this week I have been the trigger that has really set her off.  She told me, among many disturbing things, that she’s sick of people saying they love her and care about her and it just makes her want to kill herself when she hears it.

But she told me she loved me tonight so I felt free to return the favor.  I did tell her as I was leaving that she was going to be okay there and she agreed and said, “I know”, but in her real voice, not the unknown person she has been.  I think maybe, at least tonight, she might have even felt safer there than she did at home.

I spent about a half hour talking with the supervisor before I left and I feel like they are on top of things with the kids in their care; he even addressed issues before I had a chance to voice my concern about them.

This will, of course, take C way out of her comfort zone; that’s not a bad thing but I sure would appreciate your prayers for her.  I just want to scoop her up and cradle her in my arms and bring her home ~ which would defeat the purpose of everything we went out on a limb for today, but it just really hurt to see her like that.

Perhaps now that she is there the fear and anxiety of the unknown, and the threat of hospitalization (vs. the reality) will melt away and she can actually get to a safe place.  I know this may not be the last time we have to do this; I hope so, but I won’t be surprised if it isn’t.  There are so very many things going on concerning her treatment and the more people involved the more “options” are offered or brought up.

I feel very helpless to protect her, but I felt even more helpless when she was at home.  Now I believe she is in a safe place where she cannot hurt herself, and she can get some ongoing help, even if only for a few days.  I know it’s a long road ahead.  But I think I can get a few good nights worth of sleep, and I look forward to that.

K (sister, age 14) and J (brother, age 18) are both very upset.  I communicated with J several times by phone tonight and he was in tears.  K was here when all the uniforms and official vehicles arrived and that was very scary for her.  She was able to go to the hospital and see C before they moved her to another facility. I think that was good for both of them.

(My stepdaughter) went in to see her also and of course C apologized for the colorful tirade she let fly against her this afternoon.  As usual probably more details than you wanted, but as always I appreciate your prayers and concern.

C has not been able to tolerate any concern from others lately, and I don’t know if/how long that will continue.  But thanks for loving her with your prayers, even if it is from afar.

Monica

 

© Monica Simpson and Help To Hope, 2013

Waiting For The Unknown

We waited at the Emergency Room. That’s what Emergency Rooms are for, it seems.

We waited for a mental health evaluation for my middle child who a short while earlier had threatened suicide to anyone who would listen. We waited with knotted stomachs and interminably slow clocks.

And I personally waited with the audacity to hope that things could change, that she could ‘get better’ and stop skipping school, stop wearing torn black clothes, stop wearing her hair covering three quarters of her face, stop believing that she was a doomed failure, stop reading and writing and drawing about nothing but blood and death, and stop carving her body to help relieve the anguish she was feeling.

My daughter was understandably distraught and confused. And of course, how else might a teenage girl initially feel when armed police officers walk into her bedroom and announce that she will be going in for an emergency psychiatric evaluation? She alternated between tears of remorse and bursts of frustration, then her anger began to flare as the realities of the situation became apparent.

girl on bed

(Photo Source: Google Images)

Her cell phone had been taken upon arrival, along with her clothes and shoes. She wore oversized maroon-colored scrubs as she endured the aggravation of not being able to communicate with her friends beyond the few messages she had frantically texted before the phone confiscation.

I had known that her peers were firmly intertwined in her self-destructive and dysfunctional behaviors, and her inability to communicate with them during this crisis annoyed her greatly. (Okay, that’s a major understatement.) When her younger sister came to the ER after a while, she secretly asked her to contact certain people for her, to give them specific messages.

After several hours of waiting and evaluation, of tears and apologies mixed with empty promises and accusatory adolescent eyes, I was only partly taken aback at the announced possibility that my daughter might simply be released from the ER and sent home. She’d said that she no longer wanted to be alive and wasn’t at all averse to ending her own life. But she had not formulated a specific plan.

In an emergency room that’s apparently a pretty big distinction.

I wanted my daughter be admitted on a mental health hold. I had watched her descend into darkness over the previous months. I had been the recipient of so many of her rages. I had cleaned and bandaged her self-inflicted wounds. I had seen the black emptiness in her eyes as she spoke of the hopelessness she could not crawl out of, the blackness she’d seemed to learn to surrender to and eventually embrace.

I knew that if she went home nothing would be different. She would still carve through her skin, she would still rage and make threats that included suicide, she would still be failing school, living in the dark despair that had become her reality. Our home would still be held hostage in turmoil, and I would still fear for her life. Every single day.

I could not help her to stabilize. We needed someone else to facilitate that. So at my insistence, the decision was made to admit her. I believed without a doubt that, as backwards as it might have seemed or felt, it was the only chance for her overall long-term safety and wellbeing.

medical chart

(Photo Source: Google Images)

There was no room available in the mental health section of the hospital we were at, so calls were made to “find a bed” for her. A freestanding behavioral center with available space was located halfway across town, and we began another wait for her second ambulance ride of the day.

It was nearing midnight when my daughter was once more loaded into an ambulance. By this time my car had been brought to the hospital, so I got directions to the facility where I was to connect with them after transport and sign the consent for a 72-hour mental health hold.

My ex-husband had left and I traveled a couple of interstates alone to a multi-story building I’d seen many times off the highway. I parked my car and hurried to meet the ambulance as my daughter was once more offloaded and taken inside.

This facility was secure, meaning that no one could get in or out the glass front door without the lock being ‘buzzed’. I learned that no bags or purses were allowed inside, so I returned mine to my car. Again, the emergency personnel were sympathetic and considerate. They conversed easily with my daughter and offered their best wishes as they departed.

We were led to some elevators and up to another floor. We approached an area with yet another set of secure doors. These were large, locked, wooden doors. No going in or out without an electronic passkey, which only the employees were permitted.

locked hospital doors

(Photo Source: http://keyeslifesafety.com/)

And this was it. This was the unknown that I had both feared and longed for, the place where I trusted my daughter would not be able to self-harm or act on her suicidal thoughts. This was the place I hoped she could start to find safety and stability.

This was the psych ward.

 

© Monica Simpson and Help To Hope, 2013

At The E.R.

The ambulance driver and I made small talk as he transported us to the Emergency Room. Lights and sirens were not used on our drive, and I was thankful. He told me that, in his experience, drivers did strange things when they saw an ambulance on the road.

Most notably, he said, when a situation is emergent (using lights and sirens) people tend to not see him or just don’t move out of the way as the law dictates. Ironically, he noted that when there are no loud sirens or flashing lights, other drivers tend to give him a wide berth.

I tried hard to stay engaged in the conversation. It helped to fight the rising nausea in my stomach, the indistinguishable thoughts in my head, and the constant threat that my heart kept making: that all of this was simply and ridiculously too much, and it would soon just give up and shut down.

My daughter was a few feet behind me in the ambulance, separated by the cab wall, but strapped safely to a gurney and attended to by competent emergency personnel. I could only imagine what she was experiencing, how scared she must be, if she – like me – was wondering just how all of this had happened and where things went from here. Did she too feel a sharp mixture of fear, dread, relief, and hope?

I wanted to be with her, to reassure her that she was not alone among strangers, to promise that I would not leave her to fend for herself. After all this time, I still wanted desperately to know that I could hold her and make everything okay again. I couldn’t. I couldn’t hold her, and I couldn’t make everything okay. But I so wanted to.

ER Ambulance Bay

(Photo Source: Google Images)

We reached the bay doors of the ER and I watched my daughter, on her gurney, come out of the back of the ambulance. She was wheeled in through the automatic doors and I followed closely behind, gratefully noting the kind interactions and well-wishes of the EMTs as they spoke with her and shared their goodbyes.

She was taken back to an evaluation area set up for situations just like ours. There were a few patient rooms with large windows for easy observation. Mini-blinds were sandwiched inaccessibly between two panes of  (presumably unbreakable) glass and doors were double hinged to prevent tampering and escape.

The rooms were Spartan in their appearance, leaving nothing to chance when it came to patients who were making physical threats or experiencing suicidal ideations or other mental health crises.

There was a small central area which the rooms surrounded, a place where nurses and guards could keep a watchful eye on those who were unstable, who were a very possible threat to themselves or others.

It was sobering to realize this was a necessity at our local Children’s Hospital.

I remember walking out to a large, public waiting room to call my daughter’s therapist. I needed to let her know what was happening, and to cancel the next afternoon’s appointment.

Hospital Waiting Room

(Photo Source: Google Images)

I dared to wish for understanding and empathy from another adult who grasped the intensity, depth, and true severity of my daughter’s plight.

How grateful I was when she offered words of sympathy and encouragement. I was comforted by the fact that she wasn’t surprised by our current turn of events.

It helped me understand that I had not failed, that I was not incompetent and thus unable to keep my daughter safe at home. I was reassured to know that the professional who knew my daughter best agreed with my assessment and decision to call 911 and take her to the Emergency Room for a mental health evaluation.

My ex-husband had arrived and we began a long wait. I think we likely both felt a natural though unrealistic hope that now that we were here in the ER, now that she knew this wasn’t a joke and when you threaten suicide, adults take it seriously … now she would just come to her senses and stop with the crazy talk already. Unrealistic indeed.

 

© Monica Simpson and Help To Hope, 2013

“That Family”

My daughter was given a choice by the policemen who had climbed the stairs to where she was waiting in her room: she could go with them and willingly enter the ambulance waiting in our driveway, or they could “help” her down and into the ambulance if she preferred. From there she would be transported to the Emergency Room for an evaluation due to her threats of suicide.

As an officer came downstairs and relayed this to me, I was beyond relieved and somewhat surprised when he told me that she had agreed to go of her own volition. I didn’t ask what kind of “help” she would have received had she resisted. At that point I didn’t really care.

I only knew that for her own safety she was going to the Emergency Room whether she wanted to or not, and I welcomed any help or means to get her there.

ambulance

(Photo Source: Google Images)

I must clarify that the policemen in our home that day were kind and empathetic. I did not feel in any way that my daughter or I were being threatened, bullied, or coerced. (Trust me, if I had thought any of those tactics would have worked up to that point, I would likely have used them myself!) These gentle men were respectful and compassionate, and I will always be thankful for the calm and reassuring assistance they gave us.

I watched as my middle child came meekly down the stairs with her escorts in blue. By this time a few of the initial seven had dispersed (even though some had only waited in the hallway outside her bedroom), but I was struck by the timidity of her gait and demeanor.

I imagined what fear I would have felt had I been in her position, hearing and seeing a line of uniformed policemen who had come directly in response to her threats and anger. This made me both thankful and heartbroken for the passive end to her tumultuous fury.

As I’ve said before, I believe that although my daughter’s rage and wrath had escalated sharply over the past months, part of her was aching desperately for help. The larger part of her was loud, threatening, accusatory, and fond of obscenities and self harm. But undoubtedly she was still crying out to be rescued from the darkness engulfing her.

 help (google)

(Photo Source: Google Images)

Despite the trauma of a 911 call and the police officers gathered in our living room, as I watched my daughter quietly make her way to the front door I felt a glimmer of hope that maybe, just maybe, we could finally get the help she needed. I allowed myself to wonder if perhaps soon she would be safe.

I quickly gathered my purse and a jacket and followed the line of all those going outside. The ambulance personnel carefully strapped my now submissive teen’s small frame to a gurney and lifted her into their medical room on wheels. I was directed to the front of the ambulance, where I was to ride next to the driver.

I was dazed and shaken as I climbed helplessly into the ambulance’s cab, heartbroken to leave my youngest daughter behind. She was in the good care of her step-sister, but it all felt so wrong and inconceivable to me.

Why could I not be in two places at one time? How could I choose between which of my children needed me most? I couldn’t. The choice was made for me, and had been building to this moment for so many long weeks, even months.

This couldn’t be real. We couldn’t be “that family”, the one that all the neighbors would now be talking about, recounting how many police cars had been parked in front of our house next to the ambulance, wondering and whispering about why they’d been summoned there in the first place.

 gossip

(Photo Source: Google Images)

I knew I was as helpless to quell any neighborhood gossip as I had been to help my daughter rise to the surface of her depression. It was another in a long line of things I simply had to let go of in order to concentrate on whatever was ahead.

None of us knew what would happen next, but it was more than clear that something had to change.

 

© Monica Simpson and Help To Hope, 2013