Text message from Blake: Hey Mom. I slept through another disability meeting. Even with only two classes, I’m completely unable to function. As much as we’ve tried with everything and even switching programs, I feel like we might need to call it quits on college. At least for this year…
Me: Hi baby. I’m right in the middle of something. Can I call you when I’m done?
I call Blake as I drive home for the evening. He’s down on himself for missing yet another scheduled meeting with the disability office at school. He’s unhappy with life, doesn’t know what he wants, can’t find a reason to even exist.
I try to be a good listener, but I get caught in my old trap. I sink down into the well of despair with Blake and I try to fix the situation. I point out how much better he does with more structure. Perhaps he needs a job, I suggest. At one point I even ask if he needs to be in a hospital. He hates when I do this and I hate it even as I say it. He wants to get off the phone with me and I ask him to call me tomorrow after he wakes up to check in. He agrees.
Text from me to Blake: Hello
Me: How you doin’?
Me: Can you talk for a min?
“I want to apologize to you,” I say. “Last night when we talked I just wanted to be a good listener – and I wasn’t. When you’re in a really bad place I sometimes get caught up in wanting to help. And that’s not what you needed last night.”
“Thanks, Mom. I kind of do need help because I don’t know what to do.”
“Maybe the first thing to do is to know that this feeling will pass and when you feel clearer that’ll be the time to decide what you’re going to do.”
Then I remind him of all the ways that he IS functioning.
“You’ve got successes, honey. You made it to your English class both days this week. You’re grocery shopping; you’re eating; you’re going to chess club; you’re taking your medication…”
“About that, Mom,” he begins, “I’m not doing so well with the medication. I’ve been waking up too late to take it so I’ve been missing it.”
My worry starts to set in. Blake is on an SRI – a serotonin reuptake inhibitor. He’s on the highest dose a doctor might recommend and has been for quite some time. I know it’s not good to miss taking it.
“Honey, how often are you missing taking it?” I ask.
“Probably 75% of the time,” is the answer.
“Blake,” I say, “you cannot not take your medication. Even if you wake up late, it should still be taken. Maybe you should switch to taking it at night since you are awake then.When is the last time you took it?”
“Maybe…Thursday?” It’s more a question than an answer. He’s really not sure when he took it last.
Abrupt cessation of SRI’s can lead to a withdrawal or discontinuation syndrome. Two of my patients in just the past week ran out of their SRI medication and missed a day or two. The effects were swift – one had a quick return of strong intrusive thoughts of harming others; the other experienced a significant uptick in her depression symptoms and found herself unable to do even the smallest exposure practice for therapy.
I know how Blake has reacted in the past when he’s even been a few hours late to take his medication. He starts to feel like he’s having electrical shocks in his head. He starts to feel dizzy. He claims he hasn’t felt any of that, but the problem is he hasn’t been awake. He’s been sleeping very late. He slept til almost 8 pm tonight. He’s feeling very down and depressed and not sure of his path. I give him a quick rundown of SRI withdrawal and have him take his medication right away.
When I explain to the Hubby what I’ve learned, he is concerned. Could it be that our 19-year-old son is not able to take care of himself on his own? How could he not have realized that it was not okay to miss his medication? Why didn’t he say anything until now if it’s been going on for a while? I tell him that we need to wait and see if he makes the correction and if it sinks in.
In the meantime, Blake has now taken his medication two days in a row and I’ve been checking in with him regularly to make sure there haven’t been issues with that. Since he didn’t wake up until nearly 8 pm last night, he’s been up for over twenty-four hours. It’s a familiar cycle for him – one I’ve lectured him on many times before, but resist doing now. He’s still down today, but he’s been in better spirits, texting me funny photos and fun facts about goofy things. Another episode in this journey…