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Saying Goodbye

Updated: May 26, 2021

It seems strange to start with the one end result of teenage depression that we all try to avoid - suicide. It wasn't my intent to start with this, but things changed for us overnight.

For nearly 8 weeks, my daughter has been in some form of hospitalization for depression, self harm, suicidal thoughts and anorexia. She has been treated for the eating disorder since August of last year. In June, after several months of lockdown and her first month without online school, I noticed that she took a nosedive. Everything in our town was closed - no parks, no hiking trails, no stores, restaurants or movie theaters. In other words, all the things kids normally flock to during the summer. Add to this, she got her first period and changes started happening in her body. She became withdrawn and spent hours in her room by herself either reading, or spending as much time as I would allow on my iPad. I tried to get her to interact with us, but every time I stepped foot into her room, she got angry. I mentioned several times that this behavior wasn't like her and asked her what was wrong. At the time, she refused to own up to anything. Then, our dishes and silverware began disappearing. For weeks, she had been squirreling her lunch away up to her room so she could eat while she read. The dishes never reappeared. I knew they were in her room, but when I asked about it, she said she didn't have them. Finally, after weeks of this, I entered her room to try and hunt down dirty laundry so she could have clean clothes. I found the dishes - along with weeks-worth of moldy food. I also found multiple empty snack and cookie wrappers. Having dealt with this myself when I was younger, I knew this meant she had an eating disorder. I talked with her about what I found and she seemed relieved to be able to tell me. I kept the conversation calm, but told her I would be looking for a therapist to help her. I finally found a nutritionist and a therapist - both of whom were recommended by a friend who treats eating disorders, but who specializes in kids older than my daughter. At the time, she wasn't yet 13.

For a while, the therapy seemed to help - at least it did with her attitude and willingness to open up to us. I attended most of the sessions with her nutritionist so I could learn how to help her. After several weeks, her nutritionist noticed that her behavior had escalated. My daughter reported in a therapy session that she had started refusing breakfast, too. That meant the only meal she was eating during the day was dinner with our family. We decided that she needed more therapy intervention than she was getting, so we switched therapists to one who focused on coping skills for kids with eating disorders. My daughter loved the new therapist, and for months, her behavior improved and she seemed to be interacting more with people at school. It wasn't as much as her interactions in the past, but I put it down to her natural introversion, and the fact that she was in online school through December and had missed out on in-person school in the fall. I continued to encourage her to talk and connect with her friends and she said she would try.

By January, the eating disorder had escalated again, and she reported not eating at all during school for the past several weeks. I worked with her therapist to arrange a 504 with the school so that she could eat lunch in the nurse's office to make sure she completed everything. It took several weeks and some push-back from school officials before we got them on board with what she needed. For weeks, the 504 seemed to be working. She was eating lunch, even if it was difficult, and her anxiety seemed a little better. She went out for the soccer team.

Weeks later, she nosedived again. She had found a way to get around the school nurse's observation and told us that she was throwing her lunch away again. We spoke to the nurse and asked that she be moved to a more open area in the school clinic where she could be easily observed. She also lost quite a bit of weight. We talked with her nutritionist about this and we told my daughter that if she didn't eat more, we couldn't allow her to stay on the soccer team due to the risks to her health. She agreed to try, but after several more weeks, she lost weight again and we pulled her off the soccer team. She was upset by this, but she understood the reason. She worked hard and gained some of the weight back. Because she worked so hard, we allowed her to go out for the track team.

At this point, things had, at least on the surface, been going well. Her grades were excellent and she had all A's, even though she was carrying a heavy load of AP classes. She also sat 2nd chair and led the 2nd violin section in her school's chamber orchestra. This orchestra is usually made up of 8th grade students, but she was only in 7th grade. We told her how proud we were of all her progress.

Just before spring break in March, I picked her up from school and she told me she had a little trouble at school that day. She showed me her arm, which had several scratches on it. They weren't deep, but they had to have hurt her. I was alarmed and asked her what caused her to do something like that and she said she was just anxious. She had a scheduled therapy session after school that day, so I encouraged her to talk with her therapist about it. Her therapist called me after the session to discuss what happened. She asked how I was doing, and honestly, I had been so focused on my daughter, the question surprised me. At the time, I was just doing what I could to support my daughter, but I hadn't slowed down to figure out how I was processing everything. With a little reflection, I found that I was very anxious about my daughter and I was fearful that she appeared to be getting worse, not better. We discussed that the self harm was serious, but it was the first time she had done it and the wounds weren't serious. We agreed to watch her closely to make sure it didn't happen again.

Added to this, I was experiencing my own depression. I had recently started seeing the pastor at our church. I have a lot of trauma in my background that I have tried, somewhat unsuccessfully, to deal with. The stress of loosing a job I loved during the pandemic, the loss of income and the identity that came with it, had brought up old feelings that I hadn't quite put to rest. Since my layoff date, I started working with my husband on one of his companies. The salary wasn't what I had made previously, and the job didn't fulfill my need for independence and an area to succeed in my life that was all my own, but I knew that I was luckier than most. I had something worthwhile to do and employees that I could coach to be better at their jobs. In talking with my pastor, however, I admitted that I had been having suicidal thoughts and that they were more frequent that I wanted them to be - not that any amount of frequency was ok. I was really struggling with the idea of working from home when I had been so fulfilled working and traveling with large team just a few months prior. My pastor recommended a professional therapist and suggested that I go to my doctor and ask for anti-depressants to help me. Everything - the job and income loss, not seeing friends or co-workers on a regular basis, and the issues with my daughter - were getting to me. I scheduled time with the new therapist and got a prescription for anti-depressants through my doctor. The combination helped me to think more clearly about all the stresses I was facing and to deal with them in a more thoughtful, logical way, rather than the emotional reaction I had been having previously.

About a month after the first self-harm incident, I got a call from the school nurse that my daughter had engaged in more self harm while she was at school. This particular wound required disinfection and dressing. The nurse was very worried about her. I thanked her and immediately called both her therapist and her pediatrician. Both recommended that we have her evaluated at the local children's mental health facility. I naively thought we would be assessed and receive a recommendation for anti-depressants, which she had been on since the first incident of self harm, or we would receive a recommendation for more intense out-patient therapy. We waited for hours in the waiting area before being seen. Because of COVID, when we were finally called back, only one parent was allowed to go with her. When the psychologist met with us, my daughter admitted to multiple instances of suicidal thoughts, several had occurred for her that day at school, precipitating the self harm. I tried my best not to fall apart while I listened to her. It is extraordinarily painful as a parent to hear, in detail, how your child thinks about ending her life. The psychologist stood up after my daughter was finished talking and announced that he had enough information to admit her to the center. Again, I was shocked. This was our first go-around with all this and I was not expecting her to be admitted. He explained that with the suicidal ideation, the safest place would be for her to be admitted so she could be watched until she became more stable.

After he left, I apologized to my daughter and explained that I hadn't expected this when I drove her there after school. If I had known, I would have prepared her for this possibility. I prayed with her and I asked that she view this as a chance to work on herself away from school, friends, and other stressors. We called her dad, who was waiting outside and told him the news. Nurses and aids came into our room, one after the other, with mountains of paperwork for us to sign. They explained what was going to happen, explained visiting hours, and told me what I could bring back for her in the way of clothing and other essentials while she was an in-patient. I was then handed a parent folder with more information and allowed to tell my daughter goodbye before I had to leave.

I was numb. My brain, at the time, couldn't fully comprehend what happened. I would have to provide an excuse to the school, what would I tell my other kids, etc. It was very late at this point and the center was 30-45 minutes from our home. It would take a while to run home, tell the other kids what was going on, and drive back to the center with clothing and other things she needed.

I didn't realize it then, but this was the first of several hospitalizations or partial hospitalizations over the next few months. She was released from the center after about a week and entered a partial-hospitalization care program. After a week there, the suicidal thoughts returned and she needed to be fully hospitalized again. This time, the center didn't have room, so we had to take her to the county facility. I hope no other parent has to experience what we did during admissions at this facility, and leaving her there was agony. I will detail more about this experience in a later post. After leaving this facility, we got her into the Eating Recovery Center. She responded well to treatment and for the first time in a while, she was completing meals on her own without direct intervention. The suicidal thoughts returned, however, and this time, the escalated into what her therapists call a suicidal gesture, which is a suicidal act without the full intent of going through with it. It is enough of a crisis, though, that she was referred to yet another in-patient facility. In speaking with her psychologist and therapist, we decided that full hospitalization would not help her, but a residential program that focused on coping skills would be more beneficial. The problem is that these centers are few and far between. The only one available in our state was several hours away and they had no capacity to deal with her eating disorder. The only other facility that could help her with coping skills and could offer at least some support for the eating disorder was located three states away.

My daughter has been at this center now for a week. I will discuss more of her journey in a later post. For now, I will leave this entry on a very sad and upsetting note regarding something that happened in my family last night. My cousin's 14-year-old committed suicide. If you've never had this happen to someone close to you, I can't begin to describe the physical ache that comes with loosing a child, even if it isn't your own. My heart hurts for my cousin. I would give anything in the world to take this pain away from her. I know that any pain we feel from her son's loss is magnified 1,000-fold for her, her husband and her other children.

I mention this as a part of our journey not to co-opt the experience as our own, but to highlight that extreme situations, like a suicide, do not happen in a vacuum. They happen to everyone around that person. It happens most acutely to the family involved, who has likely been dealing with active depression in the victim for months and feeling the helplessness of trying to get their loved-one the help they need. They happen to the extended family who loved that person. All of us in our family are grieving deeply for the loss of this sweet, wonderful boy. We also have to figure out how to tell my daughter, who is undergoing her own treatment and does not have the extra emotional resources to deal with this right now. We have a plan to tell her in therapy so that she gets the support she needs to process her feelings - particularly since she's dealing with her own suicidal thoughts. Preventing her own loss is exactly why we made the difficult decision to send her to another state for treatment. For now, she is getting the help she needs. We were just lucky enough to catch it before things got worse. My cousin, and other families like her, was not so lucky.

This disease - and it is a disease - is stubborn and it likes to hide from others who can help. At the very time the person experiencing these feelings needs the most help is when their brains are telling them to disconnect from those around them. It is this disconnection, and the social and mental reasons why it exists, that is the reason for this blog. In the area of mental health, silence truly kills, but connection builds awareness and hope. My hope is that in sharing our story, others would find space to share theirs with at least one other person, and maybe, in the process of breaking down these barriers, we can start to get rid of the social stigma and really reach out to those in need.

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