How do you deal with your suicidal kid?
April 5, 2018 6:22 PM Subscribe
My 13yo has been verbalizing suicidal ideation. I admitted her to a psychiatric hospital Monday night; things are not going well. Wall of text inside.
My daughter has been exhibiting signs of depression for the better part of 18mo but refused to see a therapist. Once we got to the point where she was willing, my husband lost his job. After two months of COBRA, we established new insurance coverage, found an in-network therapist and started CBT two weeks ago. This practice requires you to become an established CBT patient prior to seeing a psychiatrist for meds.
Easter Sunday morning, my daughter told me that she wanted to kill herself the night before. I told her that we needed to go to a hospital, she pushed back,saying maybe later that night, that she wanted to eat Easter dinner. Her mood was significantly better and she promised she would not harm herself overnight. I spoke at length with her Pediatrician, we agreed that I would watch her overnight. We were able to see her psych Monday morning for an emergency meeting. He put her on 10mg Prozac; he felt she was walking the fine line between in-patient and intensive out-patient care, saying that because she was so guarded and closed off, it was difficult to tell.
My daughter willingly took the first dose of 10mg Prozac that night, but then complained of palpitations and chest tightness about three hours later. I told her it was more likely due to anxiety. She seemed to accept that explanation, was in a good mood, stayed downstairs, watched two movies, joked with her sister, ate food and was fine. The next day she compiled a list of goals and saw her therapist without issue. Later that afternoon, she suddenly spiraled down. She told me that she wanted to harm herself, refusing to take her next dose of Prozac, saying it didn't work and made things worse. I told her that she needed to go to the hospital, without exception. She fought me for almost an but ultimately went.
She was admitted late Monday night and is still there. Prior to the intake interview, she would not talk to me about her intentions, other than saying she had a plan and method. She finally said that she had been planning since November or December. She admitted that she had been starving herself and binging. She also said that she intentionally burned herself in February because she 'deserved to feel the pain'. Further, her current plans included either stabbing herself or laying in the road.
We saw her this afternoon (Thursday) and she is now saying that she feels worse, doesn't feel safe, she wants to harm herself even more and wants to come home. She said that she's been clawing at her wrists (I couldn't see any injury but she was angry and wouldn't really let me look), and nobody noticed or checks. The hospital intake physician and I agreed that she should be started at 5mg and titrated up to 10mg Prozac over the weekend. She also has a PRN of Vistaril available for anxiety or insomnia. As of this afternoon, she is still saying that she wants to harm herself. She still hasn't been moved up to 10mg.
The initial plan was to let her come home on Monday and transition to her a full time intensive out patient program for 4-6wks, then wean down to a 3-4 day part time after school program. My daughter is dead set against any group therapy, full stop. She feels that there's no use for it and will not participate no matter how we broach the subject. I just don't know how we can move past this to the point where she will be able to accept (and receive) the help she so desperately needs. I told the Social Worker today that there is no way she can come home the way in the mental state she is currently exhibiting. She agreed with me and said she will be speaking with her doctor (I wasn't able to reach the doctor, myself).
I can lock up medications, knives, put a lock on the basement door and the cabinet under the sink, lock the garage door. But what do I do about dog leashes, when she wants to take a shower, when she wants to throw herself over the stairs, the fireplace, run out in to the street?
Have other MeFite parents been in this situation? How have you dealt with your kids? I completely understand that this is the safest place for her to be right now and that she isn't in the right frame of mind to understand this. I also fully expect that she will be furious with me for a very long time.
She is very, very intelligent and researches *everything*. My fear is that the meds will start to work enough where she will begin to realize that she can work the system enough to play along and act as though she's mentally fit enough to come home.
I know that NAMI is usually the MeFi answer in situations like this, but for MeFi members that have been in situations where they have contemplated suicide, how often has it been an impulsive decision? My daughter has these fits of rage and acts very rashly -- that's what I'm most worried about. She is roughly the same size as me and she is hard to physically control. I am home during the day and am an RN. Still, this is a parent's worst nightmare. I never thought I'd be fighting to keep my 13yo alive.
I truly thank you for any and all advice. Especially those MeFites that may share their own firsthand experiences. I understand this may be a difficult thing.
My daughter has been exhibiting signs of depression for the better part of 18mo but refused to see a therapist. Once we got to the point where she was willing, my husband lost his job. After two months of COBRA, we established new insurance coverage, found an in-network therapist and started CBT two weeks ago. This practice requires you to become an established CBT patient prior to seeing a psychiatrist for meds.
Easter Sunday morning, my daughter told me that she wanted to kill herself the night before. I told her that we needed to go to a hospital, she pushed back,saying maybe later that night, that she wanted to eat Easter dinner. Her mood was significantly better and she promised she would not harm herself overnight. I spoke at length with her Pediatrician, we agreed that I would watch her overnight. We were able to see her psych Monday morning for an emergency meeting. He put her on 10mg Prozac; he felt she was walking the fine line between in-patient and intensive out-patient care, saying that because she was so guarded and closed off, it was difficult to tell.
My daughter willingly took the first dose of 10mg Prozac that night, but then complained of palpitations and chest tightness about three hours later. I told her it was more likely due to anxiety. She seemed to accept that explanation, was in a good mood, stayed downstairs, watched two movies, joked with her sister, ate food and was fine. The next day she compiled a list of goals and saw her therapist without issue. Later that afternoon, she suddenly spiraled down. She told me that she wanted to harm herself, refusing to take her next dose of Prozac, saying it didn't work and made things worse. I told her that she needed to go to the hospital, without exception. She fought me for almost an but ultimately went.
She was admitted late Monday night and is still there. Prior to the intake interview, she would not talk to me about her intentions, other than saying she had a plan and method. She finally said that she had been planning since November or December. She admitted that she had been starving herself and binging. She also said that she intentionally burned herself in February because she 'deserved to feel the pain'. Further, her current plans included either stabbing herself or laying in the road.
We saw her this afternoon (Thursday) and she is now saying that she feels worse, doesn't feel safe, she wants to harm herself even more and wants to come home. She said that she's been clawing at her wrists (I couldn't see any injury but she was angry and wouldn't really let me look), and nobody noticed or checks. The hospital intake physician and I agreed that she should be started at 5mg and titrated up to 10mg Prozac over the weekend. She also has a PRN of Vistaril available for anxiety or insomnia. As of this afternoon, she is still saying that she wants to harm herself. She still hasn't been moved up to 10mg.
The initial plan was to let her come home on Monday and transition to her a full time intensive out patient program for 4-6wks, then wean down to a 3-4 day part time after school program. My daughter is dead set against any group therapy, full stop. She feels that there's no use for it and will not participate no matter how we broach the subject. I just don't know how we can move past this to the point where she will be able to accept (and receive) the help she so desperately needs. I told the Social Worker today that there is no way she can come home the way in the mental state she is currently exhibiting. She agreed with me and said she will be speaking with her doctor (I wasn't able to reach the doctor, myself).
I can lock up medications, knives, put a lock on the basement door and the cabinet under the sink, lock the garage door. But what do I do about dog leashes, when she wants to take a shower, when she wants to throw herself over the stairs, the fireplace, run out in to the street?
Have other MeFite parents been in this situation? How have you dealt with your kids? I completely understand that this is the safest place for her to be right now and that she isn't in the right frame of mind to understand this. I also fully expect that she will be furious with me for a very long time.
She is very, very intelligent and researches *everything*. My fear is that the meds will start to work enough where she will begin to realize that she can work the system enough to play along and act as though she's mentally fit enough to come home.
I know that NAMI is usually the MeFi answer in situations like this, but for MeFi members that have been in situations where they have contemplated suicide, how often has it been an impulsive decision? My daughter has these fits of rage and acts very rashly -- that's what I'm most worried about. She is roughly the same size as me and she is hard to physically control. I am home during the day and am an RN. Still, this is a parent's worst nightmare. I never thought I'd be fighting to keep my 13yo alive.
I truly thank you for any and all advice. Especially those MeFites that may share their own firsthand experiences. I understand this may be a difficult thing.
I'm very sorry you're going through this. From past experience, when she does come home, make sure she has a good support system so she doesn't have a relapse. If you see her getting worse, don't be afraid to take her straight back to the hospital. Memail me if you want to. I have first hand experience, although not on this exact situation.
posted by starlybri at 6:32 PM on April 5, 2018 [2 favorites]
posted by starlybri at 6:32 PM on April 5, 2018 [2 favorites]
Check your MeMail
posted by The Almighty Mommy Goddess at 7:12 PM on April 5, 2018
posted by The Almighty Mommy Goddess at 7:12 PM on April 5, 2018
if your daughter is refusing to hold up her end of a safety contract or is refusing outpatient treatment then you are absolutely right, she should be in a locked unit. She is in the safest place she can be. I know Monday-Thursday seems like a long time for her to be away from home, as an ER nurse we regularly hold minors for a week to a month at a time until a plan materializes. In the meantime she is getting her medication and psychiatric attention.
I am so, so sorry that you are going through this. I really, really think that when she gets a few weeks of Prozac under her belt she will be in a better spot - at least not in crisis mode.
posted by pintapicasso at 7:27 PM on April 5, 2018 [18 favorites]
I am so, so sorry that you are going through this. I really, really think that when she gets a few weeks of Prozac under her belt she will be in a better spot - at least not in crisis mode.
posted by pintapicasso at 7:27 PM on April 5, 2018 [18 favorites]
I’m on my phone right now so I’ll write more later but it is absolutely an impulsive act and she should be watched extremely closely. I have been in that state a number of times and I was hospitalized twice as a teen. Search her room before she comes home for drugs or alcohol.
posted by AFABulous at 7:35 PM on April 5, 2018 [5 favorites]
posted by AFABulous at 7:35 PM on April 5, 2018 [5 favorites]
Best answer: I'm sorry that this is happening to your family! I wish you all the best. As a survivor of a suicide attempt myself (I was in college at the time), I can share some things that my parents could have done to be more supportive:
--build communication: do everything you can to establish communication with your daughter. limit judgment, restrain the desire to fix the problem, and just start talking. about anything. open the space for dialogue and dont insist what needs to go there. if she can't talk about how she's feeling, then talk about something else. when I am depressed, thinking about how I feel is terrible -- I feel terrible, and I don't believe it will get better, and I don't want to talk about it. If I can manage a conversation with someone about anything, and just feel slightly more normal for even a few moments, then it starts to feel more possible and slightly easier to maybe face part of the problem.
--be present: this is part of building communication i guess. you can do so much for her by just being there. At the hospital all the doctors are there to fix her. her own brain is probably doing laps between recognizing the huge problem, thinking that the solution to the huge problem should really be quite simple, and feeling incredible guilt or anxiety that the simple solution is somehow impossible. when I'm in that trap I desperately need someone to just be there, be present, not be part of my brain's own self-doubt, and to just help me feel like this is OK as it is and that we're gonna get through it. so in the moment of crisis now, you need her to be in a totally safe hospital zone, where people are judging her mental state and taking extraordinary steps to prevent harm. but you can visit her, or call her, and be a different kind of presence.
--take care of yourself: loving someone with depression is really taxing. you need your own support system so you can have a big well of strength when you need it. also be open and transparent with your daughter about what you can and can't do -- when I'm depressed I always assume that I am a terrible burden on everyone and I just go silent and stop asking for help, so when someone is honest with me about being able to help in XYZ ways but not in ABC ways then I can trust them and ignore my lying depression brain so that I get the help I need
--build understanding of depression: for yourself and maybe for your daughter, though hopefully her doctors and therapists will be helping on this too. you both need a mindset about this disease that feels adequate and hopeful. I fretted a lot early on and felt that no one could understand what was happening to me, so I was really distrustful of their efforts to help. It helps when you can trust that another person at least gets it to some degree. My experience of depression is this: its a near perfect trap, with walls of fear and pain, and it feels like there are no possible actions that will get me out, and so eventually it seems like there is only one way out. I didn't actually want to die - I just wanted the fear and pain gone. So the hard part is to remember that the trap isn't perfect, that there are some ways out, and the only way I can do that when things are really bad is to have someone to talk to who can just be there with me and remind me that things can be OK (hence advice above).
--be patient with the medication: here's the thing -- when its really really bad, even knowing how to spring out of the trap is useless. right now, your daughter might already be aware of that stuff. maybe it has even worked for her before. but right now its not working, so this trap feels even worse than what's happened before. here's where medication comes in -- it can make it possible to climb out of the deeper holes and then do the work that depressives need to do to stay out of them. but it can take a while to find the right meds -- multiple weeks to phase in effects, and then longer if dosage needs to change or a new medication is needed to find the right balance of side effects and benefits. you both need to stay aware of that process so you can try to be patient with it. talk with her about side effects. laugh with her about side effects if you can manage it. help her remember that she doesn't have to live with side effects that feel awful, but that it can take time for side effects to change or go away.
There's probably more but that's a start. happy to share more from my experience or answer additional questions as they come up.
posted by cubby at 7:35 PM on April 5, 2018 [45 favorites]
--build communication: do everything you can to establish communication with your daughter. limit judgment, restrain the desire to fix the problem, and just start talking. about anything. open the space for dialogue and dont insist what needs to go there. if she can't talk about how she's feeling, then talk about something else. when I am depressed, thinking about how I feel is terrible -- I feel terrible, and I don't believe it will get better, and I don't want to talk about it. If I can manage a conversation with someone about anything, and just feel slightly more normal for even a few moments, then it starts to feel more possible and slightly easier to maybe face part of the problem.
--be present: this is part of building communication i guess. you can do so much for her by just being there. At the hospital all the doctors are there to fix her. her own brain is probably doing laps between recognizing the huge problem, thinking that the solution to the huge problem should really be quite simple, and feeling incredible guilt or anxiety that the simple solution is somehow impossible. when I'm in that trap I desperately need someone to just be there, be present, not be part of my brain's own self-doubt, and to just help me feel like this is OK as it is and that we're gonna get through it. so in the moment of crisis now, you need her to be in a totally safe hospital zone, where people are judging her mental state and taking extraordinary steps to prevent harm. but you can visit her, or call her, and be a different kind of presence.
--take care of yourself: loving someone with depression is really taxing. you need your own support system so you can have a big well of strength when you need it. also be open and transparent with your daughter about what you can and can't do -- when I'm depressed I always assume that I am a terrible burden on everyone and I just go silent and stop asking for help, so when someone is honest with me about being able to help in XYZ ways but not in ABC ways then I can trust them and ignore my lying depression brain so that I get the help I need
--build understanding of depression: for yourself and maybe for your daughter, though hopefully her doctors and therapists will be helping on this too. you both need a mindset about this disease that feels adequate and hopeful. I fretted a lot early on and felt that no one could understand what was happening to me, so I was really distrustful of their efforts to help. It helps when you can trust that another person at least gets it to some degree. My experience of depression is this: its a near perfect trap, with walls of fear and pain, and it feels like there are no possible actions that will get me out, and so eventually it seems like there is only one way out. I didn't actually want to die - I just wanted the fear and pain gone. So the hard part is to remember that the trap isn't perfect, that there are some ways out, and the only way I can do that when things are really bad is to have someone to talk to who can just be there with me and remind me that things can be OK (hence advice above).
--be patient with the medication: here's the thing -- when its really really bad, even knowing how to spring out of the trap is useless. right now, your daughter might already be aware of that stuff. maybe it has even worked for her before. but right now its not working, so this trap feels even worse than what's happened before. here's where medication comes in -- it can make it possible to climb out of the deeper holes and then do the work that depressives need to do to stay out of them. but it can take a while to find the right meds -- multiple weeks to phase in effects, and then longer if dosage needs to change or a new medication is needed to find the right balance of side effects and benefits. you both need to stay aware of that process so you can try to be patient with it. talk with her about side effects. laugh with her about side effects if you can manage it. help her remember that she doesn't have to live with side effects that feel awful, but that it can take time for side effects to change or go away.
There's probably more but that's a start. happy to share more from my experience or answer additional questions as they come up.
posted by cubby at 7:35 PM on April 5, 2018 [45 favorites]
If she has friends visit her in your house, make sure they don’t sneak her anything.
posted by AFABulous at 7:39 PM on April 5, 2018 [3 favorites]
posted by AFABulous at 7:39 PM on April 5, 2018 [3 favorites]
I'm so sorry to hear this. I have no psych training whatsoever but as a 13 year old who was suicidal with no support at all, what ended up helping me was finding something, anything, that I would look forward to. I wished so much I was dead until I it struck me that actually, I really wanted to see the next episode of my favourite show (her comment about easter dinner really hit me). Being like, actually, that's the only thing I want to live for right now but it's actually something worth living for, for me, really helped.
It also really helped to have something to hold on to physically, a big pillow, a bear, something that reminded me I was alive.
Wishing you both all the best.
posted by kitten magic at 7:43 PM on April 5, 2018 [26 favorites]
It also really helped to have something to hold on to physically, a big pillow, a bear, something that reminded me I was alive.
Wishing you both all the best.
posted by kitten magic at 7:43 PM on April 5, 2018 [26 favorites]
There is some really exceptional research coming out about using ketamine for immediate and profound, though perhaps short-term, relief from acute adolescent depression and suicidal impulses. It might be worth discussing with the treatment team.
posted by thebrokedown at 7:45 PM on April 5, 2018 [6 favorites]
posted by thebrokedown at 7:45 PM on April 5, 2018 [6 favorites]
Best answer: Huge sympathies from a parent who lived that. My kids are now doing so so much better as young adults, there is hope. We basically shadowed the kid 24 hours, sleeping beside them on the floor in their room, hanging out with them all day and accompanying them everywhere. I homeschooled for a while also. There were spot checks on phones and social media. I root installed an app to monitor their access to the internet that triggered for key words like suicide and kill etc. A bedroom door lock helps if you're sleeping in that room. All this was discussed with the counsellors and social workers.
The kids went from clingy to furious to childish to shut down to calm - a rollercoaster. It was exhausting to parent. If you have other children, make sure to carve out time for them and help them with the tumult going on.
The other thing i wish I'd done but don't was not be quiet about how hard this was. I was socially isolated for other reasons and had very little support. I did try asking for help from a relative but it was a disaster that ended up involving the police etc due to that relative being a hidden nightmare. It's a weird support area to be in because people are very very judgemental in a way they aren't with physical illnesses. So choose support that's practical, guard your daughter's privacy with judgemental people, and with people you do trust? Open your heart and cry. The people who did get it and helped would have done more happily if I'd asked, I see in hindsight and it would have helped me be a better less exhausted parent.
That's my other advice. This is your next 6-12 months, dealing with immediate recovery and diagnosis. Drop any activities you can spare, ask for support from friends and family, get household help or lower your cleaning standards, and schedule specific date and exercise time for yourselves so you stay healthy and sane. Prepare for a medium long haul of this. That also skied your daughter that you are serious about being there for her to get better.
And at 13, this is likely to be brain chemistry. It's brutal to see your kid in so much pain, but she is ill. This is not something you can fix alone, or prevent by - don't waste too much time on guilt, although it comes with the territory. Try journaling, that helped me a lot.
My thoughts are with your family.
posted by dorothyisunderwood at 8:01 PM on April 5, 2018 [16 favorites]
The kids went from clingy to furious to childish to shut down to calm - a rollercoaster. It was exhausting to parent. If you have other children, make sure to carve out time for them and help them with the tumult going on.
The other thing i wish I'd done but don't was not be quiet about how hard this was. I was socially isolated for other reasons and had very little support. I did try asking for help from a relative but it was a disaster that ended up involving the police etc due to that relative being a hidden nightmare. It's a weird support area to be in because people are very very judgemental in a way they aren't with physical illnesses. So choose support that's practical, guard your daughter's privacy with judgemental people, and with people you do trust? Open your heart and cry. The people who did get it and helped would have done more happily if I'd asked, I see in hindsight and it would have helped me be a better less exhausted parent.
That's my other advice. This is your next 6-12 months, dealing with immediate recovery and diagnosis. Drop any activities you can spare, ask for support from friends and family, get household help or lower your cleaning standards, and schedule specific date and exercise time for yourselves so you stay healthy and sane. Prepare for a medium long haul of this. That also skied your daughter that you are serious about being there for her to get better.
And at 13, this is likely to be brain chemistry. It's brutal to see your kid in so much pain, but she is ill. This is not something you can fix alone, or prevent by - don't waste too much time on guilt, although it comes with the territory. Try journaling, that helped me a lot.
My thoughts are with your family.
posted by dorothyisunderwood at 8:01 PM on April 5, 2018 [16 favorites]
Response by poster: but as a 13 year old who was suicidal with no support at all, what ended up helping me was finding something, anything, that I would look forward to
My daughter really wanted an acoustic guitar (she told her pediatrician it was one of the only things she was interested in), so we went and bought one a couple weeks ago. She's been diligently practicing every day. Music is a huge passion of hers. Of course, no phone or computer allowed on the unit, so that's one more thing to be incensed about right now. There is music therapy, but I couldn't get an answer about anything right now.
If she has friends visit her in your house, make sure they don’t sneak her anything.
There are no meatspace friends to speak of; they are all online. There are no guns in the house. I do have prescription meds, but they will be locked up, along with OTC stuff. I plan on locking what small amount of liquor we have in the house in the basement.
posted by dancinglamb at 8:07 PM on April 5, 2018 [3 favorites]
My daughter really wanted an acoustic guitar (she told her pediatrician it was one of the only things she was interested in), so we went and bought one a couple weeks ago. She's been diligently practicing every day. Music is a huge passion of hers. Of course, no phone or computer allowed on the unit, so that's one more thing to be incensed about right now. There is music therapy, but I couldn't get an answer about anything right now.
If she has friends visit her in your house, make sure they don’t sneak her anything.
There are no meatspace friends to speak of; they are all online. There are no guns in the house. I do have prescription meds, but they will be locked up, along with OTC stuff. I plan on locking what small amount of liquor we have in the house in the basement.
posted by dancinglamb at 8:07 PM on April 5, 2018 [3 favorites]
Sending you all the strength in this incredibly difficult situation. In addition to everything else, is it possible that she is having an adverse reaction to Prozac or the generic version of Prozac she’s been given? It seems like she’s having a very severe spike in her symptoms, as well as some alarming somatic side effects, as a result of going on this particular medication. I’ve seen and experienced mental health symptoms spiraling dramatically and immediately out of control as a result of a new medication many times and it is terrifying, and while common wisdom is to “push through” the increased suicidality that does sometimes comes with taking certain SSRIs, this is not a side effect that all people experience with all meds, and ime it is safer to discontinue a medication that is causing this reaction than to keep taking it in the hopes that it will start to have the intended effect. You may want to consult with her psychiatrist to put her on a different kind of antidepressant. Best to both of you, rooting for you and for her.
posted by moonlight on vermont at 8:27 PM on April 5, 2018 [9 favorites]
posted by moonlight on vermont at 8:27 PM on April 5, 2018 [9 favorites]
Other things to check are shoelaces, drawstrings, belts. She should have no bedroom door until she has demonstrated the ability to communicate in the moment when she is having self-harm thoughts and to use coping skills to manage those thoughts appropriately and safely. Also--pencil sharpeners, along with pencils and pens and any other writing utensils should be removed from her access, and given to her PRN. Also-razors for shaving (if she or anyone else in the family shaves) should also be kept under lock and key and given to her for use during a timed shower or bath. I don't know if you work, but caring for her at home while she is still in a near crisis state (and I realize she's still inpatient, and I hope that she will be able to remain there until she is truly stabilized and ready to step down to a lower level of care) will be a full time job. Please make sure you are getting the support you and the rest of the family need as well.
(I am an outpatient therapist working in community mental health and I was previously a clinical therapist working in a residential treatment center with boys, ages 12-17). For children who are particularly enterprising, anything can be a weapon used in self-harm. You are doing a great job of advocating for your daughter! I'm thankful she has a mom like you to fight for her when she can't fight for herself.
posted by heathergirl at 8:42 PM on April 5, 2018 [12 favorites]
(I am an outpatient therapist working in community mental health and I was previously a clinical therapist working in a residential treatment center with boys, ages 12-17). For children who are particularly enterprising, anything can be a weapon used in self-harm. You are doing a great job of advocating for your daughter! I'm thankful she has a mom like you to fight for her when she can't fight for herself.
posted by heathergirl at 8:42 PM on April 5, 2018 [12 favorites]
Seconding moonlight in vermont to say that side effects from SSRIs like Prozac can be NASTY, especially when starting meds or increasing the dosage (and they take several weeks for the positive effects to kick in, so there can be a really rough let-down of "These are making me feel like crap and I'm not even getting the smallest bit of good from them.") I had to discontinue Zoloft because of the heart palpitations and twitchiness and feeling that I was crawling out of my skin, but when I was switched to another SSRI I didn't have the same side effects with it. It's definitely worth trying out different meds with her psychiatrist to find something with fewer or more tolerable side effects, if the Prozac continues to be a problem.
posted by Jeanne at 9:17 PM on April 5, 2018 [2 favorites]
posted by Jeanne at 9:17 PM on April 5, 2018 [2 favorites]
If she has friends visit her in your house, make sure they don’t sneak her anything.
There are no meatspace friends to speak of; they are all online.
This is a miserable, miserable situation for a 13 year old to be in. All they care about is socializing at this age. Thank god for the internet, but long term--once you get past this crisis situation--I'd focus on positive ways to connect her to other people her age who share her interests. Maybe look into enrolling her in a Girls Rock Camp?
posted by PhoBWanKenobi at 10:37 PM on April 5, 2018 [10 favorites]
There are no meatspace friends to speak of; they are all online.
This is a miserable, miserable situation for a 13 year old to be in. All they care about is socializing at this age. Thank god for the internet, but long term--once you get past this crisis situation--I'd focus on positive ways to connect her to other people her age who share her interests. Maybe look into enrolling her in a Girls Rock Camp?
posted by PhoBWanKenobi at 10:37 PM on April 5, 2018 [10 favorites]
My situation was a little different - my kiddo was hearing voices telling to hurt herself (and me!) but she didn't want to listen so she was pretty cooperative. That said, she was in the hospital 2-3 weeks until things had stabilized. If they keep her until the meds start to work, things should be a little easier when she comes home.
The main thing I want to say is to try to get some personal, individual counseling for yourself - and your partner if they are willing. This is very scary, high pressure situation and you will be expected to be perfectly calm, perfectly adult at all time for weeks and months in a row. Not humanly possible! But getting your own counseling can give you a sliver of time when you can get a chance to step back, catch your breath, say all those things you can't say out loud to your family and then regroup and get some perspective.
And adding to dollyisunderwood - if you give a hint of what is going to on to your friends and family , you may be very surprised to learn about other people's challenges that they just don't talk about with those who aren't in the same club.
posted by metahawk at 11:26 PM on April 5, 2018 [6 favorites]
The main thing I want to say is to try to get some personal, individual counseling for yourself - and your partner if they are willing. This is very scary, high pressure situation and you will be expected to be perfectly calm, perfectly adult at all time for weeks and months in a row. Not humanly possible! But getting your own counseling can give you a sliver of time when you can get a chance to step back, catch your breath, say all those things you can't say out loud to your family and then regroup and get some perspective.
And adding to dollyisunderwood - if you give a hint of what is going to on to your friends and family , you may be very surprised to learn about other people's challenges that they just don't talk about with those who aren't in the same club.
posted by metahawk at 11:26 PM on April 5, 2018 [6 favorites]
This might sound a bit crazy, but please bear with me.
What you wrote about your daughter wanting to play the guitar, and practicing every day... well, Jeez. I'm sitting here with tears streaming down my face. I really think that inside those words you have your answer, because here is someone with creativity, and a passion, and the ability to contribute something beautiful to the world. At the moment this beautiful soul is experiencing only pain, and probably feels that all she does is hurt the people around her. That is obviously and demonstrably untrue, but it doesn't feel that way to her. The message she is giving herself about herself is overwhelmingly negative, but there are also positives in there (looking forward to Easter dinner), they just need room to shine.
I've been on a long and painful journey with depression myself, and just over a year ago I kicked the habit once and for all, mainly through becoming addicted to Tony Robbins. He's not for everyone, just as not every cancer treatment works on every kind of cancer. But I'd like to break down some of what I've learned from him, because it might just help you and your daughter.
We have four basic emotional needs, and two advanced emotional needs. The basic ones are:
1. Certainty - "I know where I will be next week, next month. I can predict the future."
2. Variety - "I don't know EXACTLY what will happen - there will be surprises and exciting twists along the way."
3. Love and connection - "I am connected to other people, I am a part of the group, I am loved"
4. Significance - "I matter, I am important, I am unique"
The two greatest needs - the ones that make us fulfilled - are CONTRIBUTION (I make others' lives better) and GROWTH (I am becoming better and better every day).
The idea that blew my depression apart once and for all is that we will make sure these emotional needs are met EVEN IF IT HARMS US. If you think about it, a suicidal person can tick a lot of those boxes - they are connected because everybody is talking to them and relating to them constantly; they can be certain that next week, next month they will be so depressed that they will be receiving treatment, or will be in hospital; but there is also variety, because who knows how sick they will be, or whether they will be on medication or in therapy? There is enormous significance - "I am the problem that everyone is focussed on, I am the most important issue in everyone's lives." What a depressed person needs to do is to get those same needs met in a way that isn't harmful - they need to swap the negative ways of feeling connection, significance etc for positive, constructive ways.
So here's what I think you should do. This is what I wish someone had done for me when I was at my lowest ebb.
Write a letter to your daughter about her guitar playing. Don't mention the depression, the suicidal thoughts, the therapy AT ALL, because what you're trying to do is draw attention to a world where these things no longer exist. But in your letter, show her, in as vivid a way as possible, how her emotional needs will be met through her guitar playing. Make the scene as real as possible - engage all five senses, make it vivid, make it personal to her (I get a feeling from your question that you can write well enough to make this pretty damn good).
Something like this:
Dear Daughter
I've been thinking a lot lately about your guitar playing. When we bought that guitar for you, I wasn't sure if you would stick with it, or just toss it aside like a lot of kids do. But you've practiced every day, without fail, and you've shown me how disciplined and dedicated you can be. I've started wondering where you will end up if you keep investing in it, day after day. Every minute you practice, you get a little bit better. It's so exciting - where will your practicing take you?
I had this idea that maybe on your eighteenth birthday we will all gather in the back yard to hear you play. By that time you will have been practicing for five whole years, and your fingers will be nimble and quick, and the music will have seeped into your bones so that you probably won't even have to think about the song, it will just flow out of you as if it is a part of you.
I imagine you sitting in that old chair of grampa's from the corner of the living room. We will put it under the tree in the far corner, and there will be rows of chairs in front of it. Your friends will all be there - Julie, Jessica, Mike - and they've all blossomed into beautiful young adults. Julie's braces are off, and Mike is wearing a ridiculous bow tie! Your cousins are there, and Kelly's baby is a five-year-old, running around causing havoc! None of them have seen you practicing, so none of them will know what is about to happen. But I will know, because I have seen the work you have put in to get to this moment.
Your hair is longer now; you are wearing a beautiful dress. I can hardly believe you are my daughter, because you look so grown-up, and so beautiful, and I feel at that moment like I might just be the proudest mama in the whole wide world.
And then you start to play.
The people gathered in the garden are stunned into silence. Each of them feels an incredible connection to you, through the music that you are creating. Every person is touched, but every single one of them in a different way. Their jaws drop; they exchange glances with each other, because they never knew you were this good. Each chord is a surprise, each note lifts them a little bit higher. The way your fingers dance is so unexpected, so surprising; and yet there is so much certainty that however they move will be beautiful and seamless. All eyes are on you, all attention is yours: they know that only you could create music so wild and yet so controlled, so exciting and so extraordinary.
None of them will know how much patience and hard work it took to get to this moment, but I will know. I will remember the time spent locked away in your room, hearing the muffled notes coming through your bedroom door as you refined, and adjusted, and polished your music. I will know about, the callouses your slowly developed so that you could play without pain, the time spent learning to read music, watching tutorials. I will remember the times you were late for dinner because you just needed five more minutes, or when you didn't want to go out in the sunshine because you were too busy enjoying the light of a song. I will know every step you took - and that will make your music more beautiful to me than to anyone else in the world.
I'd love to talk to you about your concert next time I see you. Maybe I have some of the details wrong - maybe you'd like to play in some beautiful concert hall, or - I don't know - have a garland of flowers in your hair or something! Have a think about it, I'd love to hear how you imagine it being.
I can't wait to see where your music takes you.
All my love,
Mom x
***
Tony Robbins taught me that the best way to get through depression is by building a compelling future. It's so easy to get caught up in the struggle when you're depressed, but you also need to have a clear idea of what life will be like AFTER depression. Otherwise, getting over depression is scary - who will I be when I am not a sick person?
I know this idea may be counter-intuitive, because what I'm actually saying is to take your eye off the depression and the suicidal ideation, at least part of the time. I mention it only because it worked for me.
Good luck. Your question has really touched me and I truly believe that you have the love, the intelligence and the empathy to get your daughter through this. I'll be thinking of you.
posted by matthew.alexander at 2:20 AM on April 6, 2018 [43 favorites]
What you wrote about your daughter wanting to play the guitar, and practicing every day... well, Jeez. I'm sitting here with tears streaming down my face. I really think that inside those words you have your answer, because here is someone with creativity, and a passion, and the ability to contribute something beautiful to the world. At the moment this beautiful soul is experiencing only pain, and probably feels that all she does is hurt the people around her. That is obviously and demonstrably untrue, but it doesn't feel that way to her. The message she is giving herself about herself is overwhelmingly negative, but there are also positives in there (looking forward to Easter dinner), they just need room to shine.
I've been on a long and painful journey with depression myself, and just over a year ago I kicked the habit once and for all, mainly through becoming addicted to Tony Robbins. He's not for everyone, just as not every cancer treatment works on every kind of cancer. But I'd like to break down some of what I've learned from him, because it might just help you and your daughter.
We have four basic emotional needs, and two advanced emotional needs. The basic ones are:
1. Certainty - "I know where I will be next week, next month. I can predict the future."
2. Variety - "I don't know EXACTLY what will happen - there will be surprises and exciting twists along the way."
3. Love and connection - "I am connected to other people, I am a part of the group, I am loved"
4. Significance - "I matter, I am important, I am unique"
The two greatest needs - the ones that make us fulfilled - are CONTRIBUTION (I make others' lives better) and GROWTH (I am becoming better and better every day).
The idea that blew my depression apart once and for all is that we will make sure these emotional needs are met EVEN IF IT HARMS US. If you think about it, a suicidal person can tick a lot of those boxes - they are connected because everybody is talking to them and relating to them constantly; they can be certain that next week, next month they will be so depressed that they will be receiving treatment, or will be in hospital; but there is also variety, because who knows how sick they will be, or whether they will be on medication or in therapy? There is enormous significance - "I am the problem that everyone is focussed on, I am the most important issue in everyone's lives." What a depressed person needs to do is to get those same needs met in a way that isn't harmful - they need to swap the negative ways of feeling connection, significance etc for positive, constructive ways.
So here's what I think you should do. This is what I wish someone had done for me when I was at my lowest ebb.
Write a letter to your daughter about her guitar playing. Don't mention the depression, the suicidal thoughts, the therapy AT ALL, because what you're trying to do is draw attention to a world where these things no longer exist. But in your letter, show her, in as vivid a way as possible, how her emotional needs will be met through her guitar playing. Make the scene as real as possible - engage all five senses, make it vivid, make it personal to her (I get a feeling from your question that you can write well enough to make this pretty damn good).
Something like this:
Dear Daughter
I've been thinking a lot lately about your guitar playing. When we bought that guitar for you, I wasn't sure if you would stick with it, or just toss it aside like a lot of kids do. But you've practiced every day, without fail, and you've shown me how disciplined and dedicated you can be. I've started wondering where you will end up if you keep investing in it, day after day. Every minute you practice, you get a little bit better. It's so exciting - where will your practicing take you?
I had this idea that maybe on your eighteenth birthday we will all gather in the back yard to hear you play. By that time you will have been practicing for five whole years, and your fingers will be nimble and quick, and the music will have seeped into your bones so that you probably won't even have to think about the song, it will just flow out of you as if it is a part of you.
I imagine you sitting in that old chair of grampa's from the corner of the living room. We will put it under the tree in the far corner, and there will be rows of chairs in front of it. Your friends will all be there - Julie, Jessica, Mike - and they've all blossomed into beautiful young adults. Julie's braces are off, and Mike is wearing a ridiculous bow tie! Your cousins are there, and Kelly's baby is a five-year-old, running around causing havoc! None of them have seen you practicing, so none of them will know what is about to happen. But I will know, because I have seen the work you have put in to get to this moment.
Your hair is longer now; you are wearing a beautiful dress. I can hardly believe you are my daughter, because you look so grown-up, and so beautiful, and I feel at that moment like I might just be the proudest mama in the whole wide world.
And then you start to play.
The people gathered in the garden are stunned into silence. Each of them feels an incredible connection to you, through the music that you are creating. Every person is touched, but every single one of them in a different way. Their jaws drop; they exchange glances with each other, because they never knew you were this good. Each chord is a surprise, each note lifts them a little bit higher. The way your fingers dance is so unexpected, so surprising; and yet there is so much certainty that however they move will be beautiful and seamless. All eyes are on you, all attention is yours: they know that only you could create music so wild and yet so controlled, so exciting and so extraordinary.
None of them will know how much patience and hard work it took to get to this moment, but I will know. I will remember the time spent locked away in your room, hearing the muffled notes coming through your bedroom door as you refined, and adjusted, and polished your music. I will know about, the callouses your slowly developed so that you could play without pain, the time spent learning to read music, watching tutorials. I will remember the times you were late for dinner because you just needed five more minutes, or when you didn't want to go out in the sunshine because you were too busy enjoying the light of a song. I will know every step you took - and that will make your music more beautiful to me than to anyone else in the world.
I'd love to talk to you about your concert next time I see you. Maybe I have some of the details wrong - maybe you'd like to play in some beautiful concert hall, or - I don't know - have a garland of flowers in your hair or something! Have a think about it, I'd love to hear how you imagine it being.
I can't wait to see where your music takes you.
All my love,
Mom x
***
Tony Robbins taught me that the best way to get through depression is by building a compelling future. It's so easy to get caught up in the struggle when you're depressed, but you also need to have a clear idea of what life will be like AFTER depression. Otherwise, getting over depression is scary - who will I be when I am not a sick person?
I know this idea may be counter-intuitive, because what I'm actually saying is to take your eye off the depression and the suicidal ideation, at least part of the time. I mention it only because it worked for me.
Good luck. Your question has really touched me and I truly believe that you have the love, the intelligence and the empathy to get your daughter through this. I'll be thinking of you.
posted by matthew.alexander at 2:20 AM on April 6, 2018 [43 favorites]
Take a deep breath. This is the most terrifying thing parents can go through and you're doing fine, but you need help. I appreciate people giving you advice here about how to make your home safer and ideas about medication but for the love of all that is good and holy, do not let her come home until she's safe and you have a day program in place.
I cannot overstate this enough: adolescent suicidal ideation is not something parents can fix. Your daughter has a lot of hard work ahead of her, and she needs to do it with the help of people who do this for a living. You really need to understand that this is NOT SOMETHING you can do.*
My daughter is dead set against any group therapy, full stop. She feels that there's no use for it and will not participate no matter how we broach the subject. I just don't know how we can move past this to the point where she will be able to accept (and receive) the help she so desperately needs.
She doesn't have a choice. Once kids become suicidal, they don't get to make critical decisions. She has a serious disease right now. Imagine if this were a bacterial infection. She wouldn't get to decide to stop taking medication because she had no use for it. SHE'S 13--this is not something she gets to decide. I know it sucks and I'm sorry, but you gotta believe me, you cannot let her come home until she's safe and ready. A BIG part of that process is her accepting and using all the prescribed therapeutic interventions. She doesn't get to choose because right now, her wiring is off. Her wiring was telling her to kill herself, so her thought processes don't get a vote about treatment right now (having said that, there may be a different inpatient unit you can send her to).
I've lived through this with my own kids twice, and my kids are better but this type of help is a secret society and nobody tells you anything. What I've learned:
1. The lack of pediatric/adolescent mental health care is fucking shocking. It's either very short term acute hospitalization or months of waiting to get into day treatment. Prepare yourself for very little options and start planning, researching and asking everyone NOW.
2. For insurance reasons, inpatient pediatric units are for kids in crisis only. Once the kid is stable and saying they're no longer actively suicidal, they're released, often without any real followup plan other than checking in with a psychiatrist. They generally will not refer you to day programs. VERY often kids up right back in acute care because there was no plan put into place.
3. That means you need to start finding outpatient programs NOW, making calls, and trying to get your daughter on a waiting list. Again, ask everyone you know.
4. Even though I'm a teacher, I had no idea how much the school system could help my kid. Your special ed department will have resources. They will want to help and can make calls on your behalf and undoubtedly, they have in-district resources for kids. So call the school.
5. You will eventually get to your new normal. Right now you are in crisis mode and you need to stay healthy. Try to eat well, hydrate, sleep, get outside for walks, and write as much of this down as you can. You WILL forget who said what.
*And now I'm going to reiterate something which is scary and true: **DO NOT TRY TO FIX THIS YOURSELF**. I have worked with families whose kids were inpatient, but then the kid didn't want to engage and the parents let them come home, and once home, those kids hurt/killed themselves. Your daughter has something fixable, but this will not be easy and you cannot let her run the show.
posted by yes I said yes I will Yes at 2:53 AM on April 6, 2018 [19 favorites]
I cannot overstate this enough: adolescent suicidal ideation is not something parents can fix. Your daughter has a lot of hard work ahead of her, and she needs to do it with the help of people who do this for a living. You really need to understand that this is NOT SOMETHING you can do.*
My daughter is dead set against any group therapy, full stop. She feels that there's no use for it and will not participate no matter how we broach the subject. I just don't know how we can move past this to the point where she will be able to accept (and receive) the help she so desperately needs.
She doesn't have a choice. Once kids become suicidal, they don't get to make critical decisions. She has a serious disease right now. Imagine if this were a bacterial infection. She wouldn't get to decide to stop taking medication because she had no use for it. SHE'S 13--this is not something she gets to decide. I know it sucks and I'm sorry, but you gotta believe me, you cannot let her come home until she's safe and ready. A BIG part of that process is her accepting and using all the prescribed therapeutic interventions. She doesn't get to choose because right now, her wiring is off. Her wiring was telling her to kill herself, so her thought processes don't get a vote about treatment right now (having said that, there may be a different inpatient unit you can send her to).
I've lived through this with my own kids twice, and my kids are better but this type of help is a secret society and nobody tells you anything. What I've learned:
1. The lack of pediatric/adolescent mental health care is fucking shocking. It's either very short term acute hospitalization or months of waiting to get into day treatment. Prepare yourself for very little options and start planning, researching and asking everyone NOW.
2. For insurance reasons, inpatient pediatric units are for kids in crisis only. Once the kid is stable and saying they're no longer actively suicidal, they're released, often without any real followup plan other than checking in with a psychiatrist. They generally will not refer you to day programs. VERY often kids up right back in acute care because there was no plan put into place.
3. That means you need to start finding outpatient programs NOW, making calls, and trying to get your daughter on a waiting list. Again, ask everyone you know.
4. Even though I'm a teacher, I had no idea how much the school system could help my kid. Your special ed department will have resources. They will want to help and can make calls on your behalf and undoubtedly, they have in-district resources for kids. So call the school.
5. You will eventually get to your new normal. Right now you are in crisis mode and you need to stay healthy. Try to eat well, hydrate, sleep, get outside for walks, and write as much of this down as you can. You WILL forget who said what.
*And now I'm going to reiterate something which is scary and true: **DO NOT TRY TO FIX THIS YOURSELF**. I have worked with families whose kids were inpatient, but then the kid didn't want to engage and the parents let them come home, and once home, those kids hurt/killed themselves. Your daughter has something fixable, but this will not be easy and you cannot let her run the show.
posted by yes I said yes I will Yes at 2:53 AM on April 6, 2018 [19 favorites]
Could the problem with group therapy be social anxiety or fear of looking bad in front of others? Is individual therapy an option? I know I would feel very anxious about talking about my problems in a group setting, and I’m not a teenager any more. Looking bad in front of others can be a REALLY scary thing for a teenager.
posted by Anne Neville at 3:22 AM on April 6, 2018 [2 favorites]
posted by Anne Neville at 3:22 AM on April 6, 2018 [2 favorites]
Keep her in the inpatient facility until she has stabilized and habituated to the reality that she has to follow the care plan given to her by medical professionals.
When I was 17 that process took me 6 weeks in an inpatient facility.
By the time I was ready to leave inpatient I just needed to be shown respect and compassion and I was stable enough to show the same back. I had made a promise to follow “the agreed plan” and I finally cared enough to do that.
I went outpatient for another 12 weeks, I continued training against the demon in my head until I was finally well enough to manage it and be mostly functional without danger of being a harm to myself.
Basically she needs to stay in inpatient until she is ready to commit to taking care of herself and doing the actual necessary steps to recover and not bargaining with you about what she will or won’t do. Half measures will not keep her safe nor will they keep her alive.
Regarding group therapy:
I stayed in weekly group therapy for two years after.
Across that time frame about 35 other teenagers from the same facility followed a similar timeline to mine. We all helped each other, it was powerful to have one evening a week where for two hours “I was known” and recognized by my peers as opposed to all the other days where no “got it” not even my parents.
When I realized after two years that I didn’t need group therapy anymore I sat in my car afterwards and cried and cried because it was scary to let go of the safety and comfort of the rings of care I had come up through, but I was finally okay.
That two year care plan from inpatient, to outpatient and to group therapy literally saved my life. Give the same gift to your daughter please.
posted by Annika Cicada at 4:38 AM on April 6, 2018 [11 favorites]
When I was 17 that process took me 6 weeks in an inpatient facility.
By the time I was ready to leave inpatient I just needed to be shown respect and compassion and I was stable enough to show the same back. I had made a promise to follow “the agreed plan” and I finally cared enough to do that.
I went outpatient for another 12 weeks, I continued training against the demon in my head until I was finally well enough to manage it and be mostly functional without danger of being a harm to myself.
Basically she needs to stay in inpatient until she is ready to commit to taking care of herself and doing the actual necessary steps to recover and not bargaining with you about what she will or won’t do. Half measures will not keep her safe nor will they keep her alive.
Regarding group therapy:
I stayed in weekly group therapy for two years after.
Across that time frame about 35 other teenagers from the same facility followed a similar timeline to mine. We all helped each other, it was powerful to have one evening a week where for two hours “I was known” and recognized by my peers as opposed to all the other days where no “got it” not even my parents.
When I realized after two years that I didn’t need group therapy anymore I sat in my car afterwards and cried and cried because it was scary to let go of the safety and comfort of the rings of care I had come up through, but I was finally okay.
That two year care plan from inpatient, to outpatient and to group therapy literally saved my life. Give the same gift to your daughter please.
posted by Annika Cicada at 4:38 AM on April 6, 2018 [11 favorites]
Make sure the eating disorder is getting addressed. That in and of itself is extremely disregulating and it's a negative coping mechanism that is very, very hard to escape from. An active eating disorder makes treatment of the underlying depression difficult.
posted by drlith at 5:00 AM on April 6, 2018 [9 favorites]
posted by drlith at 5:00 AM on April 6, 2018 [9 favorites]
First of all, all my best to you, your daughter, and your family.
As someone who had to deal with a depressed spouse in the past, I can only quote cubby here from above, because I can't say it any better:
--take care of yourself: loving someone with depression is really taxing. you need your own support system so you can have a big well of strength when you need it.
Keeping your daughter safe minute to minute will be overwhelming, but even more so if you don't take the time for self care. Consider a therapist for yourself, if only as a safe space to express the complaints and frustration you don't feel you can express at home.
Always remember that this is a disease, not a shortcoming or mental weakness. I was a week in the hospital when first diagnosed with my Type I diabetes--not because I failed or my parents failed, but because a medical issue arose and medical professionals helped keep me alive and put me on the path to managing it. This is no different. And give no quarter to those who would cluck their tongue and tell you otherwise.
posted by stevis23 at 7:03 AM on April 6, 2018 [4 favorites]
As someone who had to deal with a depressed spouse in the past, I can only quote cubby here from above, because I can't say it any better:
--take care of yourself: loving someone with depression is really taxing. you need your own support system so you can have a big well of strength when you need it.
Keeping your daughter safe minute to minute will be overwhelming, but even more so if you don't take the time for self care. Consider a therapist for yourself, if only as a safe space to express the complaints and frustration you don't feel you can express at home.
Always remember that this is a disease, not a shortcoming or mental weakness. I was a week in the hospital when first diagnosed with my Type I diabetes--not because I failed or my parents failed, but because a medical issue arose and medical professionals helped keep me alive and put me on the path to managing it. This is no different. And give no quarter to those who would cluck their tongue and tell you otherwise.
posted by stevis23 at 7:03 AM on April 6, 2018 [4 favorites]
I’m sorry that you and your daughter are going through this. I was a little older (15?) when I first experienced major depression. I wouldn’t say I wanted to die but I was in a lot of pain and wanted to stop hurting.
One thing I’ve taught myself since then is that feelings are temporary so if you feel like your daughter is in a rational place sometime soon, maybe see if that’s an idea she’s open to. It’s been helpful for me because even now when I feel like I am in The Dark Place, I can say to myself, this will be different a few days from now - not necessarily better but different, so I just need to hang in there until it’s different (related - I think I read here that parenting is basically trying to keep your kid alive until they’re less likely to hurt themselves doing something stupid).
Also, again, if/when you feel like your daughter is in a rational place, I’d see if you can come up with a safety plan together. There are templates out there but an easy way to think about it is a list of things you will do if you feel unsafe - call a friend, tell a parent, write in a journal, listen to some positive music, pet a dog, etc.
Again, I’m sorry you’re dealing with this but I’m proof it can work out. I do think the point above about how a future that looks promising is a good way to treat depression. Having things to look forward to is imperative so maybe you two can write a list of things you look forward to broadly - graduating high school and going to college, a TV show coming back, an upcoming concert, the summer, etc. I’m glad your daughter has you and I hope you find a way to take care of yourself during this difficult time.
posted by kat518 at 9:38 PM on April 6, 2018
One thing I’ve taught myself since then is that feelings are temporary so if you feel like your daughter is in a rational place sometime soon, maybe see if that’s an idea she’s open to. It’s been helpful for me because even now when I feel like I am in The Dark Place, I can say to myself, this will be different a few days from now - not necessarily better but different, so I just need to hang in there until it’s different (related - I think I read here that parenting is basically trying to keep your kid alive until they’re less likely to hurt themselves doing something stupid).
Also, again, if/when you feel like your daughter is in a rational place, I’d see if you can come up with a safety plan together. There are templates out there but an easy way to think about it is a list of things you will do if you feel unsafe - call a friend, tell a parent, write in a journal, listen to some positive music, pet a dog, etc.
Again, I’m sorry you’re dealing with this but I’m proof it can work out. I do think the point above about how a future that looks promising is a good way to treat depression. Having things to look forward to is imperative so maybe you two can write a list of things you look forward to broadly - graduating high school and going to college, a TV show coming back, an upcoming concert, the summer, etc. I’m glad your daughter has you and I hope you find a way to take care of yourself during this difficult time.
posted by kat518 at 9:38 PM on April 6, 2018
I am an intake nurse at a psychiatric facility.
My fear is that the meds will start to work enough where she will begin to realize that she can work the system enough to play along and act as though she's mentally fit enough to come home.
This is a very reasonable fear of yours. It’s something to look out for! Specifically, it’s somthing for the hospital staff to look out for, as they do for so many patients.
Keep talking with the social worker, keep voicing your concerns, but keep some faith in the idea that this is medical treatment that your daughter needs and that they are assessing and evaluating her responses to the treatment. Absolutely be her advocate, don’t feel like you have to defer to them, but you’re working with them to keep her safe.
posted by RainyJay at 6:39 AM on April 7, 2018 [1 favorite]
My fear is that the meds will start to work enough where she will begin to realize that she can work the system enough to play along and act as though she's mentally fit enough to come home.
This is a very reasonable fear of yours. It’s something to look out for! Specifically, it’s somthing for the hospital staff to look out for, as they do for so many patients.
Keep talking with the social worker, keep voicing your concerns, but keep some faith in the idea that this is medical treatment that your daughter needs and that they are assessing and evaluating her responses to the treatment. Absolutely be her advocate, don’t feel like you have to defer to them, but you’re working with them to keep her safe.
posted by RainyJay at 6:39 AM on April 7, 2018 [1 favorite]
Check your MeMail.
posted by colorblock sock at 10:10 AM on April 7, 2018
posted by colorblock sock at 10:10 AM on April 7, 2018
You have all of my sympathy and encouragement. We went through this with my step daughter, including an almost successful attempt in our house (saved by EMS and emergency detox). She spent some time as inpatient in various wards around Southern Ontario. Played all the "i'm fine now" head-games with the doctors. Snuck her phone onto a no-outside-communications ward -- twice.
There were a lot of contributing factors that helped her get through the acute and chronic parts of her illness. Probably the best thing to rekindle her interest in living was being placed in a youth group home where she made new friends, including people her age who really cared about her, had direct, recent experience with what she was going through, and accepted her as she was. Also, finding the right meds and the right dosages was a big deal.
It was also extremely hard on her mother and I. At several points one or another of us had to just say, "nope, can't handle this right now" and step back for a little while in order to get out of crisis mode. It really sucked to not be able to provide care because we had nothing left to give.
Look out for her, but also pace yourselves. Make sure she's safe is the most important thing, but after that you have to make sure you're not digging yourself a hole. Use whatever resources YOU have to make sure you have the energy to help her, don't just try and tough it out.
She's just moved back in with us a month ago after some not-great living arrangements went sour and it's nice to have her. The apartment is too small, really, but I am just glad we have another chance to be with her until she finds her feet again.
posted by seanmpuckett at 1:41 PM on April 7, 2018 [4 favorites]
There were a lot of contributing factors that helped her get through the acute and chronic parts of her illness. Probably the best thing to rekindle her interest in living was being placed in a youth group home where she made new friends, including people her age who really cared about her, had direct, recent experience with what she was going through, and accepted her as she was. Also, finding the right meds and the right dosages was a big deal.
It was also extremely hard on her mother and I. At several points one or another of us had to just say, "nope, can't handle this right now" and step back for a little while in order to get out of crisis mode. It really sucked to not be able to provide care because we had nothing left to give.
Look out for her, but also pace yourselves. Make sure she's safe is the most important thing, but after that you have to make sure you're not digging yourself a hole. Use whatever resources YOU have to make sure you have the energy to help her, don't just try and tough it out.
She's just moved back in with us a month ago after some not-great living arrangements went sour and it's nice to have her. The apartment is too small, really, but I am just glad we have another chance to be with her until she finds her feet again.
posted by seanmpuckett at 1:41 PM on April 7, 2018 [4 favorites]
Hope there has been some sign of improvement. Re: impulsivity, very, very much so - part of the theory with SSRIs is they work *just* enough to elevate a person's energy levels and enable them to figure out and act on it. And once you've done it once, the threshold for committing it gets lower each time. The upside of that is also that impulsivity has an inverse correlation to lethality. That said, if she starts not just acting well enough to stay at home, but well in general, she may be making a serious plan for suicide and is trying to give you a last few good days.
Agree that eating disorder symptoms should be addressed at the same time. I don't know if you have seen any significant weight loss, but being at too low a weight for your body, self-starvation, etc can be pretty crazymaking.
I didn't see a mention of an individual therapist and I wonder if that would be an answer. Your comment about not having IRL friends makes me think that group therapy would genuinely not be a good fit for her and that she may find one-on-one therapy a safer space. I don't know if that would be an option. But having that personal connection, and the trust in that *specific* person, is what saved my life. This may mean that you are going to find out heartbreaking things not through her but through her therapist, and that doesn't reflect in any way on how you are dealing with the situation; it's just the perverse nature of suicidality that doesn't let us turn to the person we love most.
In the long term: this may be a single depressive episode that resolves itself (fingers crossed). But this may be more than your next 6-12 months; it may be much of her adolescence, and there may be a new normal to which you will have adjust, and the loss and grief that comes with it. In my limited experience, psychiatrists will only prescribe (I think) fluoxetine & escitalopram to minors, and it can also be hard to get approval for ECT in the US if that's where you are. Some of the options that may be game changing for her may also therefore be unavailable for a long time.
Thinking of you.
posted by ahundredjarsofsky at 6:24 AM on April 10, 2018
Agree that eating disorder symptoms should be addressed at the same time. I don't know if you have seen any significant weight loss, but being at too low a weight for your body, self-starvation, etc can be pretty crazymaking.
I didn't see a mention of an individual therapist and I wonder if that would be an answer. Your comment about not having IRL friends makes me think that group therapy would genuinely not be a good fit for her and that she may find one-on-one therapy a safer space. I don't know if that would be an option. But having that personal connection, and the trust in that *specific* person, is what saved my life. This may mean that you are going to find out heartbreaking things not through her but through her therapist, and that doesn't reflect in any way on how you are dealing with the situation; it's just the perverse nature of suicidality that doesn't let us turn to the person we love most.
In the long term: this may be a single depressive episode that resolves itself (fingers crossed). But this may be more than your next 6-12 months; it may be much of her adolescence, and there may be a new normal to which you will have adjust, and the loss and grief that comes with it. In my limited experience, psychiatrists will only prescribe (I think) fluoxetine & escitalopram to minors, and it can also be hard to get approval for ECT in the US if that's where you are. Some of the options that may be game changing for her may also therefore be unavailable for a long time.
Thinking of you.
posted by ahundredjarsofsky at 6:24 AM on April 10, 2018
Response by poster: Thank you for all of your replies, including the DMs. I apologize for not replying, as this has been unbelievably overwhelming. It's been a long and very stressful month. After a week in the hospital, my daughter was discharged home on Prozac and Vistaril. We had a disastrous experience at one full time out patient facility after a half day. The staff was awful -- my daughter had an anxiety attack, she was not appropriately cared for, and it went south from there. She was then home with me for over a week. The meds ultimately didn't work, as they were causing akathisia.
She was switched to Klonopin and Zoloft and we started a new outpatient program at a different facility that is much better. The meds aren't working and she is now self harming and the suicidal ideation continues (although my daughter admits they're thoughts with no intent). The binging and intermittent starvation is also continuing. I've taken her off the Zoloft and we are waiting for DNA testing to come back within the next couple days to help determine what meds will biologically work best.
This is, without a doubt, one of the most heartbreaking and difficult experiences I've ever dealt with. It's also the loneliest. I have daily conversations with her; some lighter than others. A few of them have been nothing short of torturous and heart wrenching. To complicate matters, it came to light that her 15yo sister has also been self harming and had been dealing with intrusive thoughts and suicidal ideation. She, too, had a trip to the hospital but wasn't admitted. She is also now in therapy.
posted by dancinglamb at 5:38 AM on May 10, 2018
She was switched to Klonopin and Zoloft and we started a new outpatient program at a different facility that is much better. The meds aren't working and she is now self harming and the suicidal ideation continues (although my daughter admits they're thoughts with no intent). The binging and intermittent starvation is also continuing. I've taken her off the Zoloft and we are waiting for DNA testing to come back within the next couple days to help determine what meds will biologically work best.
This is, without a doubt, one of the most heartbreaking and difficult experiences I've ever dealt with. It's also the loneliest. I have daily conversations with her; some lighter than others. A few of them have been nothing short of torturous and heart wrenching. To complicate matters, it came to light that her 15yo sister has also been self harming and had been dealing with intrusive thoughts and suicidal ideation. She, too, had a trip to the hospital but wasn't admitted. She is also now in therapy.
posted by dancinglamb at 5:38 AM on May 10, 2018
I can’t favourite that, but I hear you and sympathize with all my heart.
posted by seanmpuckett at 4:20 PM on May 10, 2018 [3 favorites]
posted by seanmpuckett at 4:20 PM on May 10, 2018 [3 favorites]
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