Not long enough ago I sat in the ER while a psychiatric resident checked the IV attached to my sixteen year old daughter’s arm and asked, ‘Why do you want to kill yourself, honey?”
The words are forever tattooed on the wall of my heart.
After endless worrying about her anxiety and self-destructive impulses, of watching her oscillate between the usual trials of adolescence and erratic emotional distress, my daughter was diagnosed last year with Borderline Personality Disorder, a psychological illness marked by unstable and turbulent emotions and impulsivity. On a personal level the diagnosis felt like an indictment of my parenting. Where did I go wrong? What did I do to raise this anxious child? At the same time it was a weight lifted; this thing she had battled for years was real. We finally had a name and a course for healing.
In the year since that night I have learned that developing a treatment plan for a psychological disorder is a complex endeavor, one that becomes thornier when the sufferer is a teenager. The rapidly changing bodies and hormones of any teenager can result in maddening behavior on occasion. Add to that a malfunction of a neuronal connection in the brain and the result is an emotional boomerang that can make the act of establishing a treatment plan feel like trying to hit a moving target while wearing a blindfold.
Like it or not – ready or not – parents quickly realize that the responsibility of getting all the pieces working together depends on us. Someone has to be the manager and organizer, appointment setter, records keeper, advocate, cheerleader, disciplinarian, and comforter. There is no training, no certificate of competency; one day we are the anxious parent of a deeply troubled teen and the next day we are a bold pioneer forging a path towards a family-focused mental health treatment plan.
Most days I feel ready for it, whatever the new it of the day may be. Occasionally I feel like pulling the comforter over my head and refusing to surface until the Jacksonville Jaguars win a Super Bowl.
In my quest to be the best caregiver to my daughter that I can be I have read articles and books that caution parents of psychologically distressed teenagers to “Take care of yourself!” and “Make sure your needs are being met!” But what does that even mean? Where are the how-to’s for that? The literature does not provide a lot in terms of specifics.
So, to parents like me who are living the complex reality of caring for a mentally ill teenager: let me share four things I have learned that have helped me keep my wits about me:
- Get Connected. It Changes Everything.
During the most difficult episodes of my daughter’s depression my instinct was to keep our painful family crisis a secret. Protecting her from cultural stigma was paramount. I felt guilty about pursuing anything that ‘distracted’ me from my primary responsibility: getting her well and keeping her safe. How could I even think about imbibing in a girl’s night out or writing on my goofy chicken blog at a time like this?
The side effect, of course, was that in the throes of crisis I felt very alone.
According to the National Institute of Mental Health, 26% of Americans have experienced a mental health crisis of some form. That translates to a vast number of families who understand exactly what we are going through even while we subsist in silence. The fact is, sharing with those who have lived a similar experience can change the trajectory of our lives.
When I finally shared my situation with a select few, not only was I overwhelmed by the number of people who have gone through a similar crisis with their own child, or whose family has rallied around a niece or godson, I was unprepared for their intuitive guidance and eagerness to share professional referrals that set my family’s treatment plans on an accelerated path.
Success is all about who you know. Get connected. Get into a support community to help you crack the complex world of psychological treatment services. Seek out those who will applaud your successes and commiserate your setbacks.
As a parent, being reminded regularly that you are not alone is key to your own emotional health.
- Forgive Those Who Talk Stupid.
Recently an acquaintance visiting my home declared she had no clue how my daughter could feel depressed when she had everything a kid could ask for and if we stopped indulging her she might snap out of it.
Just as the outpouring of support from unexpected sources will leave you feeling awestruck, so may you feel defensive and raw from insensitive comments some people feel obligated to make. The truth is, sometimes even very caring people say really stupid things (err…myself included). In a social climate where myths about mental illness run rampant we must recognize that not everyone is prepared to bring well-drafted opinions and proper vocabulary to the table.
It is often the best policy to simply overlook stupidity and be on our way. On the other hand, we are not obligated to succumb to flawed cultural stigma. If someone makes a comment that is clearly infused with vice we can advocate for our teenager by calmly stating the facts and establishing ground rules. Knowing in advance what to say is helpful. I have a set response for these rare occasions. It goes something like this:
“Asking a person with a psychological illness to snap out of the chemical imbalance in her brain is like expecting a Type 1 Diabetic to snap out of her defective pancreas. We have a team of brain experts developing a plan for our family and we are not really in the market for an uninformed prognosis.”
This approach nearly always results in one of two outcomes – a profuse apology or an abrupt change of subject. Both are fine by me. My home is my sacred place and there are ground rules to follow.
Forgiveness is an essential skill for parents caring for teenagers with mental illness. It burns up less energy than harboring a grudge and I have learned to apply it liberally. However, relationships involving humans who are persistently insensitive about my daughter’s mental health are ones I permit to fade. For the wellbeing of our family it is essential to forgive stupidity and, when necessary, know when to move on.
- Intentionally Seek Laughter.
Listen, fellow parent who is caring for a teenager with psychological illness, I totally get it: you probably have never felt less like laughing than you do at this moment. But I promise you this: you have never needed laughter more than you do right now.
Laughter can boost our mood, strengthen our immune system, and shift our perspective. Best of all, laughter is contagious. Right now you probably do not feel like introducing your family to new activities that feel frivolous but, dear parent, here is the thing: if you embrace these activities with gusto, eventually your teenager will follow suit. This is the nature of laughter.
Over the past year laughter has served as a marker of significant progress in our daughter’s treatment. My husband and I knew we had found the right therapist for her the moment we heard them erupt into laughter in the next room. And during a particularly dark period of adjustment we attended Alton Brown’s cooking show with her reluctantly in tow, and when the show opened with sock puppets singing fart jokes I snuck a peek at her out of the corner of my eye expecting the worst. I caught her guffawing with her head thrown back and looking for all the world like a happy, carefree teenager. Her joy took my breath away and I spent the next two hours clandestinely wiping happy tears – and the corresponding snot – on my shirtsleeve. It was a cooking show for peat’s sake; I had not thought to bring Kleenex.
And once in a family therapy session the counselor asked the teenagers in the room what their parents did when they got stressed out. My daughter’s hand shot into the air and I searched frantically for a place to hide. “I always know when my mom is stressed because I find her in the hen yard talking to our chickens.” The room erupted into laughter and the discussion was hopelessly sidetracked. At the end of the session I apologized to our counselor for the disruption but she assured me that laughter was an excellent use of therapy time.
Laughter is a powerful antidote to stress and pain. It unites us and creates a joyful memory map that can be revisited during times of distress. Pursue laughter as relentlessly as you seek talk therapy and psychiatric medications. Let it bring your family together and ease the sting of darker times. Intentionally introduce moments into your family’s day that are infused with buoyancy and levity and see what happens.
Laughter is potent medicine. Even in the form of farting sock puppets.
- Reclaim Your Routine.
After my daughter was released from the hospital there was a period of weeks when my husband and I roamed the house like strangers in a foreign land. We adjusted awkwardly to new therapy strategies and tag-teamed our way through daily medical appointments. Hobbies were pushed into dark corners to gather dust.
But my husband faithfully stuck to a routine he developed when our daughter started high school: he had a strong conviction that it should be him who cooked a homemade breakfast for her every morning. Providing his child with delicious and nourishing food was a privilege and responsibility he refused to relinquish to anyone, and certainly not to the public school system. So when she returned from the hospital he picked back up right where he left off. Morning after morning he cooked her breakfast. Even on days when she was too anxious to move. Even when the plate on the stand by her bed was repeatedly left untouched. He never complained. And he never gave up.
One morning she lifted herself up out of bed on her own accord and wandered into the kitchen. “Mmmm,” she said, “it smells good out here. Like breakfast.”
He just smiled. And kept right on cooking.
Routines are a powerful counter-force against the chaos and unpredictability of this disease. Adjusting as a family following a mental health crisis is a confusing undertaking. It is easy to let routines slide. Household chores, Friday pizza night, and yoga on Tuesdays, all of that is important. Predictable family rhythms give our teenager a sense of security. They allow her to feel in control. She knows what comes next and what is expected of her.
This stands true for parents. Routines provide us with a sense of comfort and of purpose. So reclaim your routines. And don’t skip the ones that bring you joy.
Not long ago my daughter asked me why I do not write on my blog anymore. I told her I had other important things going on. She said, “But it made you happy.”
So, dear friends, this is me practicing the healing power of routine. I have dug the camera out of the closet and revived my Saturday morning ritual of documenting the sassy centerfolds in my hen yard. I have dusted off this blog and started a list of topics on which to opine.
Getting back into the swing of things feels very, very good.
Living with our teenager’s mental illness can be daunting. Equally important as developing a treatment plan for our child is the need to take care of ourselves. This means being surrounded by people who understand our struggle and forgiving those who say insensitive things. It means seeking joyful experiences even in the darkest times and recognizing the power of our routines. Given the choice we would never have picked this path for our child or ourselves, but as parents we are fine-tuned for having walked it. We see the tiny steps forward that might otherwise go unnoticed. Even in the face of this persistent foe we have become parents capable of believing life is good and the future is bright.