RealMental

It’s that time of year again- time to get ready for a new school year. Princess is still in the special school, with small classes and lots of counseling support. Also lots of troubled kids, but in a way I feel as though being surrounded by everyone else’s issues may force her to cope with her own. She made a good friend last year, another girl who loves Harry Potter and Invader Zim and writing role plays on Gaia. Oh, and who is also fighting some mood disorders. There is something very comforting about arrangement a sleepover when you know the other parent totally understands the medication drill and all that. We are in the midst of changing the mood stabilizers, but so far we have not had any problem with the transition. I remain cautiously optimistic, and continue to take things slowly. There is something to be said for keeping her in the special school for the remainder of the year, and waiting until she starts ninth grade to transition back into the comprehensive school.

Hoss is working really hard at being in control, even dropping his afternoon ADHD dose on days when he is just hanging out. His meds have been steady for some time, his appointments are now spaced out more than before, and we are not dreading the return to school. The administration stacked the cards in our favor this year- the fifth grade had a vacancy, so Hoss’ fourth grade teacher rose to fill it. And, in a totally unexpected move (and by “unexpected” I mean “totally expected,” a la Professor Doofenschmirtz), Hoss was assigned to Mr. G’s class again this year. Hmmm, a teacher who my boy totally connects with and loves more than anything, and a special educator who gets his humor. What more can a mom ask for?

This, I think, is the year of Little Joe.  The quirks and routines are starting to become more noticable.   I forsee testing, and am going on record with a prediction of PDD/mild Aspergers with a touch of OCD. I hope that any issues can be dealt with by behavioral measures, since the possibility of Little Joe swallowing even the tiniest of pills or anything liquid that is not milk is…let’s just say it would be a challenge.

My goal for the school year? No hospital stays. It’s not so much to ask.

More from Joshua Walters.

We left home for the ER around 7:45 Tuesday evening. I packed a bag for Princess- a few changes of clothes (no drawstrings, hoods, scarves, belts or jewelry), a few books, some toiletries (not her hair pick, no bar soap). I brought my knitting and a magazine to read.

By now I know the answers the nurses and doctors need to hear. I rattled off the history of the previous visits and hospitalizations. I identified her current and previous medications, by name and dosage and treatment schedule. The terminology is almost second nature now- she is not in active crisis, but is unable to ensure that she is fully capable of maintaining her own safety at home. The bipolar tendencies were first diagnosed in September, and her brother’s mood disorder (the ever popular “NOS,” which in layman’s terms means “your kid’s brand of crazy doesn’t fit the current DSM definition”) was diagnosed about 20 months ago. There is no diagnosed history from parents or previous generations. Note that I don’t say there is no mental illness in the parents or previous generations; I firmly believe that there has to be something on both sides that we just don’t have on paper. I can’t accept that I ended up with two children with such significant mood disorders just by the luck of the draw.

The transport to the psychiatric hospital came at 7:30 on Wednesday. We were ready to leave. 24 hours of hospital food and sleeping on a the chair that pulls out to a cot took its toll. I survived the the 35 minute drive, as I followed the ambulance, without significant incident. The blowout I got during that same drive in September remained in the back of my mind.

We got her checked in without a snag. A couple of the nurses recognized her name when the paperwork was handed to them. They checked her bag, noting that everything was acceptable (I learn from experience). She hugged me goodbye and asked if I was coming to visit every day. I promised that we would try to visit, and would call if we could not be there in person. No one cried.

I feel numb and empty. The experts tell me what to do, I do those things, and yet we are not being able to help her. I have come to believe that she needs a specialized school situation, one which provided the cognitive behavioral therapy that she needs to combat the irrational thoughts before they become emotional actions. The medication is not enough. But the specialized school will require many, many hoops to be jumped through. I am in the process of the educational evaluation that has the potential to put her in this type of school without me needing to go bankrupt. But I am scared to admit to my husband or my parents or my friends or the current school that the special school is what I really want for Princess. They fear a stigma, or an inability to re-assimilate to the life we’d planned for her (e.g., attendance at the private school at which her dad is the band director). I fear that the adjustment to a new group of students and a new school will be more anxiety-provoking than returning to her current situation, although she reverts to the harmful behaviors when she is back at school for more than a few weeks.

The more I research and the more I learn, the less I really know about any of this.

(Cross posted on Band Back Together)

Princess was released today. Her medication has been adjusted, thanks to a doctor who was willing to listen to my speculation about bipolar tendencies. We meet tomorrow with the practice that will take care of the transitional care when she returns to school next week (either a partial hospitalization program or an intensive outpatient, both of which will take place after school).

Tonight was back to school night at Princess’s school. It was not an easy night, since I didn’t know what to expect from other parents or from the teachers regarding Princess. Many of the parents seem not to know that anything has gone wrong. The only parents with whom I talked about her recent hospitalization were the parents of one of the girls who reported to the counselor that she was talking of stabbing herself. I thanked them, and their daughter, for starting the process to getting better. I tried to hold back the tears, but…well, that isn’t so much an option for me sometimes. I apologized for putting their twelve-year-old daughter in such a tough spot.

My tears brought some tears from this girl’s mom. She and her husband admonished me for apologizing, and said they are keeping Princess in their prayers. They wanted to pass along to their daughter our appreciation for having done the right thing. She told me that her sister had struggled with depression and talked of suicide, and that her husband lost a friend to suicide.

I still feel like a shell of myself. I’m sleeping more than typical yet not feeling rested. I eat because I know I must, not because I have a taste for it. Our priest, the school staff, Princess’s therapist, the executive assistant for my department are keeping a close eye on me, I think, not sure if I may shatter at any moment. But for Princess I am holding it together, I take deep breaths and I focus on how to move forward. One small step at a time.

Princess is back in the hospital. School started on August 25, and I have been monitoring her homework (checking her agenda book and comparing it to the completed work in her binder) and asking her about her school day and doing my best to keep the line of communication open. She met with her therapist on the Saturday before school started and again this past Saturday so she could first prepare herself to return to school and then process the first (partial) week of school to assess its success. Everything seemed fine.

When I picked Princess up from her aftercare program on Tuesday, I had a message that the school counselor wanted to see me. Princess and I gathered her things and sat down in the counselor’s office to talk. The counselor relayed that another student came to her to say that Princess had indicated that she was planning to bring a knife to school for the purpose of stabbing herself or cutting her throat. She’s never articulated a plan before, and never expressed thoughts so boldly violent. The counselor advised me that she would need written confirmation from some mental health professional regarding Princess’ abililty to return to class.

We made an appointment with the therapist, and Princess was vehement in saying she did not want to go back to the hospital. She later had an outburst that culminated in her locking herself in the bathroom, refusing to speak to me, and I told her through the door that if I could not get the key to work, I would call 911 and have them break the door down and take her to the ER in an ambulance. She came out, and finally admitted that her thoughts were too overwhelming to handle alone, and she thought she needed to go back to the hospital.

We arrived at the pediatric ER around 2:00. We met with the intake nurses and pediatrician and social worker. We waited for word about which hospital had a bed and would accept her into the program. I called and texted my husband (who was home with the boys) and my parents and my siblings with updates through the night. The food service people delivered Princess’ dinner to the adult ER, so it was cold by the time we hunted it down, but she ate it anyway. They fixed another dinner for her, so I ended up getting to eat something, too. The ambulance transport came just before midnight. I took my car and agreed to meet them at the hospital.

About halfway to the hospital, my car blew a tire. I sat at the side of the highway, sobbing so hard I thought I would vomit. My  husband called the pediatric ER staff, who called the transport company, who contacted the ambulance driver to  have him come back to get me. Another bus from the same transport company arrived a few minutes after we did, so the drivers kept me distracted with their chatter. I barely remember filling out the paperwork for the intake. The coordinator on the unit asked me if I had a ride home, and I asked her to help me call a cab. She did one better- she arranged for a transport voucher for me, since I wasn’t sure I had enough cash on me to pay for the 40 minute ride home.

I got about 3 hours of sleep before taking the boys to school and coming into the office. My boss is wonderfully understanding and supportive, and is allowing me to make my schedule day by day depending on what I feel I need. I don’t know what it is I need, though.

I am still standing, and I know that Princess is getting the help she needs. This is a different hospital than the one she was in during May. That program seemed to work then, but the doctor’s willingness to dismiss my suspicions of a biploar disorder bothered me. This hospital seems more open to the possibility that there is more going on than her anxiety/depression. And we will once again find our light at the end of the tunnel

The thing about slipping away, slipping under, the light getting smaller and smaller, is that you don’t realize it’s happening until it’s too late.

You’re going along, not thinking about how things are getting incrementally harder because you’ve always had days that are harder. And then get better. And then harder again and then better again ad nauseum until you are pretty much used to the ride. You don’t consider it remarkable anymore because it’s your “normal” life.

But the black hole is sneakier. The days get harder and harder. You’re waiting it out. You know if you just get through another day, things will get better again. So another day passes where you’re holding on with both hands. Then one hand. Then a few fingers. Then you notice your fingernails are torn and bloody stumps and finally, FINALLY, you realize you’re not going to be able to get back up. You are losing your grip completely and it’s too late to take precautionary measures. Way to late for that.

It becomes a life of lying under the water, looking at the world through goggles and trying not to think about all the ways you could die. Accidentally, of course.

And then it becomes a life of trying not to think of how to die on purpose. And you can’t even see out of the water anymore. Someone turned out the lights. You can’t hear or see or feel anything but extreme sad and bad and guilt.

“I’m trapped!” I yelled at the psychiatrist yesterday, “I can’t stay here and worry everyone while my mother-in-law has stage4 cancer and I should be taking care of her! I can’t go see family because they would worry the whole time I’m there! I can’t stay alive because this is how things will be the rest of my life – up, down, up, down – I can’t do it anymore! And I can’t kill myself because my kids would never get over it!”

It feels like I’m trapped in hell.

A med change is underway. I don’t feel better, I feel weird. Even more distant from my surroundings and I care even less.

I can write this because I’m a writer and this is what I do. I can’t change anything in my brain because this is how I am. I haven’t stopped crying for over 2 weeks and I shake all the time. I don’t want food. I only want to drink and fall asleep. But I don’t. I just think about it. Because maybe I won’t wake up. That would be nice.

My husband says, “There are lots of people who want you around, and alive. I love you Leah. You are valuable and precious.” I hear it but I can’t hear it because it feels like a lie. I didn’t think I would get married again after my divorce in 2002. I figured no one should be married to the mess that is me. But, I did marry. And he’s wonderful. And I fill his life with stress and drama and worry. In loving him I’ve ruined his life. If I really loved him, I would leave him.

This is the black hole talking. In this flash of sanity, I know it. But, sometimes the black hole just takes over everything and reason and sanity are nowhere.

Originally posted on Leahpeah

From the Vancouver Sun –

A new antidepressant being tested in Canada appears to do what no other drug can — increase connections between brain cells within hours to swiftly improve symptoms.

The finding by Yale University researchers may explain how one dose of ketamine can reduce symptoms of depression within 40 minutes among the hardest-to-treat cases, and could help spur development of quick-acting antidepressants.