Loving Someone Who is Chronically Suicidal

Note: This is a reflection on living with a loved one who chronically wishes to die. There are no graphic details.

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It has been so very hard to write these past months since my son, Blake, was released from his second hospitalization. I’m pretty sure I’ve been on autopilot. I don’t experience joy in the same way I used to. I find myself drifting off when I’m with a group (the few occasions that I am now). I am delighted to hear what is going on with my friends’ children: the upcoming weddings, the new jobs, starting a new education, traveling. Yet there is just this sadness in me that lingers. It touches everything, leaving its residue. I don’t take new patients into my OCD and anxiety psychology practice. I’m sure many people think that I just have a long waitlist. The truth is, it would be unethical for me to take on more when I’m struggling myself.

Yes, I am depressed. I know it. Yes. I’m in treatment myself. Have been for a long time. Thank goodness for therapy. It sustains me through the ups and downs. It keeps me moving on through the unknown.

I’m struggling whether to tell you today about the sense of abandonment or what I’ve finally come to that is providing me a measure of peace. Probably the latter today. With the abandonment part comes a lot of anger and I can’t find it in me today. No. I’ll tell you instead about the peace.

A couple months ago we ventured away for a family overnight. In the bathroom as I prepared for bed, I wondered to myself how one actually copes with having a chronically suicidal loved one. What is one to do when their loved one is chronically in emotional pain, shares about it frequently, and could leave this world at any moment? 

“How do I keep going? How does one come to terms with this?”

My therapist hadn’t been able to answer that question when I’d asked her about it the previous week. It felt to me like an unending grief – like I was watching my 22-year-old son die from a life threatening illness and I could do nothing to save him. Part of me wanted him to “snap out of it,” though I knew that was unrealistic, even unfair to suggest.

Just then, in the hotel bathroom, it washed over me that, indeed, my son did have a potentially life threatening illness – it just wasn’t a physical one. 

“So how do people manage when someone they love dearly has an illness that may end their life at any time?” I wondered, thinking of a particular colleague whose spouse was painfully terminally ill. 

I rolled into bed, considering this. It occurred to me that, when you love someone who is seriously ill, you stay with them through their pain. You empathize with it as much as you can; you don’t discount it or disregard it or blame them for it. You accept that it is part of their illness. And while you desperately do not want to lose them, you accept that death may be part of the equation at any time. If that’s the case, you appreciate each and every positive moment together that you can, knowing that it may be brief. And while you don’t want to lose them, you respect their right to choose what interventions are acceptable to them.

When I awoke the next morning, I recognized that I had a new perspective on living with my son. It is what guides me and helps me to keep moving through the unknown. My son’s illness is potentially life threatening. In fact, somehow I have fully and radically accepted that I may lose him at any time. I don’t want that, but I have no control over it. My job is to accept and hear his pain, no matter how difficult that is. I can hold hope for the best, while helping him pursue the treatments he is willing to accept. And, maybe most important of all, I can cherish the moments of joy that we have – and we do have them sometimes. 

Somehow they are all the more precious.

*If you or someone you know is considering suicide, please consider reaching out to the National Suicide Prevention Lifeline at 800-273-8255, or the equivalent in your country.

Eight Years

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WordPress informed me that in July I hit eight years blogging here at “OCD in the Family.” Unreal. It gave me pause to think back a bit (oh, and also to update my “About” page). I remember where I was when this blog was born. Blake had just turned 14. Michael was 16. And I was in a place where I felt powerless to help my treatment-refusing son, to be a good mother to both of my teens, and to have a healthy marriage and family life. Now my boy are both young adults, trying to find their way in this world.

Over these years, the blog has evolved. It has shown our ups and downs, it’s grown to cover the topics of depression, suicidality, hospitalization, treatment, and life as a therapist who specializes in Obsessive-Compulsive Disorder and anxiety disorders. I’ve learned much – and my learning continues.

One very special thing over the years has been the connections I’ve made with readers. Some are fellow bloggers who I’ve actually gotten to meet in real life, others are regular commenters who I’ve grown so fond of over the years, some comment from time-to-time or only once, and others leave a “like” or just their imprint in my daily stats. However you’ve been here, reader, I am so grateful that you chose to stop for a moment and visit with me.

I plan to continue to share our family journey, wherever it goes. I’m honored if you come along.

Are Things Better?

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This – or a variation of this – is the question I keep getting asked in the almost month since my young adult son, Blake, came home from his second hospitalization. Blake was hospitalized with severe depression after a recent spike in his Obsessive-Compulsive Disorder (OCD) and related intrusive thoughts. He made a plan to end his life, and he’d planned to carry it out. Yet, that is not where the story begins, nor is his release from the hospital where it ends. They are pieces in a long journey.

I can’t speak for my son and what it is like to be him. I can, however, speak as a mom who has watched her child suffer for a very long time. There have been twists and turns on this road over time and lots of things have contributed to where we are now as a family. The bottom line is that my son came to the point a while back where he decided that this world was not for him. He’s been clear about that with us. He lost hope somewhere along the line that he would ever feel better. And we have been living with this as a family for some time. His hospitalizations did not represent a sudden departure from the life we lived with him. They were just the most obvious signs to the outside world. To many, I guess it appeared we had a sudden crisis along the road and that the hospitalizations were about addressing that. Maybe they were. But they didn’t “fix” a problem; they just kept my son safe for a period of time. Maybe they even reinforced his view of himself as a failure.

So now people ask me, “Are things better?” or “Is he feeling better?” I understand that they care and that they are being kind. And I feel like I disappoint with my answer. Bluntly, the answer is, “No.” That’s not what I answer, though.

“It’s going to be a journey,” is what I say. That’s the truth. Simple. Pure. I don’t know what direction my son is going to go in. It kinda kills me as a mom to move through life knowing that my child, who I love dearly, believes that each day he is here is torture. But, this is not the end of the journey. Not now. I don’t know where it leads, only that it is.

The New Normal

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Welcome to the surreal world of post-hospitalization for a mental health issue. Glad you could come. Suspend all disbelief at the door.

Seriously, this is a bizarre journey. Come along if you like. Today Blake had his first real appointment since he was released from the hospital. He met with a psychiatric service that was meant to help him continue with his medications until he connected with a new psychiatrist. I checked on him just after the video appointment was to begin. Hearing no sound coming from behind the door, I knocked to check in. No one had contacted him yet. He was sitting and waiting, almost willing someone to email him a Zoom link for his appointment which was supposed to have begun five minutes before. I coached him to call and he was given a way to connect and I left the room once more.

When he finished, several minutes later, he was more confused than ever. The wrong medication was prescribed and he had been told to go back to his previous psychiatrist and outpatient therapists. This is NOT what the hospital had told him to do. And, all importantly, there was no blood test ordered to check his Lithium levels (one of his new medications is Lithium, and he must have regular blood tests. In fact this was the most important reason for his appointment).

I recognized, after hearing of his experience, that I need to step in and advocate for my young adult son. He is scared and confused.

”In the hospital, they do everything but spoon feed you,” he noted. “Now I’m supposed to know how to manage everything and I don’t. It’s all my fault.”

“No. You’re not. And it’s not helpful to pile blame onto yourself,” I told him, gently. “This is confusing for Dad and I, too. We’ll figure this out together.”

I helped him call his psychiatrist, a man he’s seen only once before he was first hospitalized a month and a half ago, and helped him book an appointment. Thank goodness he had something within a couple days. I hung around while Blake completed a mass of online documentation and I provided moral support and assistance as he needed it. He got through it all.

Later, the pharmacy left a message. I’m pretty sure they refilled medications he is no longer taking. I haven’t even told him yet. He doesn’t need more confusion for the day.

Tomorrow, we celebrate his birthday. It can wait until after that. His birthday had been planned as his death day. Our plan is to help him avoid fulfilling that plan. He seems on board with that and has given us permission to commandeer the day with special surprises. Thank goodness for that. Perhaps we can have one day of delight – one day where the weirdness waits. It’ll be back on Friday, I’m sure.

Just an Update

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Hello Dear Readers,

It’s been a little while since I’ve written and someone just reached out to me to ask how things have been since Blake’s hospitalization. I’m guessing this person is not the only one who has wanted to know so I’d like to share a little update. This style is uncharacteristic for me on this blog, but I’m so very tired lately, and it’s the easiest way for me to share with you what has been going on.

Not long after my last post Blake returned home and started in a partial hospitalization program (for OCD, anxiety, and depression). That means he went five days a week for six hours each day. Without sharing too many details, I can say that it did not go well for him and he was admitted back to the hospital within a couple weeks of being released. This second hospitalization was longer and he is now home again. We are working as a family to put together the pieces of what aftercare will look like.

I can share my own personal experience of this as being scary, confusing, and an emotional roller coaster. When your young adult is admitted to a psychiatric ward and held, they (and you) lose control over exactly what happens and when they get to leave. There are twists and turns on a daily basis – he’s going to be trying this procedure. No, wait, he’s not. He’s on this medication. No, we changed that two days ago. We’re recommending this program. No, we’re not. We think it’s this diagnosis. No, we changed our mind – it’s this. Oh, can you pick him up in two hours? He’s coming home.

My head has been spinning and it’s not been easy to regain my balance. I’m decreasing my workload as much as I can to attend to my family. As many of you know, I’m a psychologist who specializes in treating anxiety and Obsessive-Compulsive Disorder. I can tell you that none of my education, training, or experience has prepared me to face this situation more than anybody else. I don’t like that. Sometimes it feels like Blake has been moved from professional to professional and there’s no one staying involved long enough to keep things moving forward in a logical direction. It feels like we, as a family, have been tossed around – and now it is our job to sort out what’s next with the leads we have been given.

I’ll keep you posted on our progress. We are diving into uncharted waters. I hope that, someday, I can use this experience to help make is less scary and confusing for others.

All my best,

Angie

There’s Nowhere Else…

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Please be aware, short reference to suicidal ideation below:

I can see her waiting patiently out of the corner of my eye, as I listen to the social worker’s voice on the other end of the line. She can’t see or hear me; my camera is off and my mic is, too. I can see the fuzzy blackness covering the square that would be me in this telehealth call. She looks uncertain about what to do as she waits. The social worker on the phone talks on, giving me updates and directions. I dutifully take notes, painfully aware of the time that has lapsed since I darkened my screen and left this mom, mother of one of my young patients, waiting. I hang up the phone. Six minutes have gone by. I turn my camera and mic back on and she looks at me with concern and with what I imagine is a question that hangs between us.

“Is everything okay?”

It is not like me to abruptly leave a therapy session, and the call came in so early during our meeting I hadn’t yet been able to tell her. This has been a week unlike any other. I’ve told each and every patient or parent that I might be interrupted. I’ve mastered the drill by this point – a family member is having a health crisis; everyone is safe; doctors call me unexpectedly and I have little control over when that happens; if it happens, I’ll turn off my camera and microphone, take the call and return as quickly as I can; please forgive me if it happens. But this time, I had no opportunity to share, the call came so close to the beginning of our session. Then I tell her more than I’ve told any other person I’ve met with this week, pausing only for a millisecond in my head to debate whether it is appropriate.

“My son is in the hospital,” I say. Now it is out there. “I deeply apologize that I didn’t have the chance to tell you that I might get a call.”

“Was it planned?” she asks.

“No,” I answer, “though things are stable. I just get calls from doctors and I don’t have any say when they do that. I’m so sorry that this took from our time. I will make that time up.”

“Are you sure you’re up for being here? We can reschedule.” I see the caring and concern on her face.

“Honestly, there’s really not anything else for me to be doing right now. If I wasn’t working, I’d be sitting around waiting for time to pass,” I tell her. Then I lean in to the monitor, “Right now I’d like to be here with you, if you’d like to be here with me, too.”

She decides to continue and this honestly is exactly where I want to be.

Blake has been in the hospital for eleven days as I write this. For those of you who’ve followed this blog, you’re aware he’s struggled with depression and OCD. At times, it has been confusing which is more pressing. He’s been open, for the first time in a long time, to participating in treatment. He’s been working with a couple therapists and a psychiatrist. While he’s been the driver of his treatment, he’s also felt little hope or joy. He’s found nothing he wants in life. Depression is a thief that way; it robs us of seeing any possibility life might hold for us. Still, he continued on, trying a new antidepressant. Then, OCD’s intrusive thoughts took hold, constantly locking him in a fight against the torment. Simultaneously, his muscles started twitching uncontrollably, making him that much more uncomfortable. It took a while to realize that the twitching was a likely a side effect of his medication. The entire experience led him to hatch a plan to end his life – a plan he luckily shared with my husband and I, and later with his therapist.

Now our journey will take a new direction. Blake is scheduled to begin a Partial Hospitalization Program for OCD and anxiety shortly. He has never had treatment this intense ever in his life, and he is understandably scared. I have never had such brain fog in my life as I have this week, nor have I ever recognized so starkly the incredible beauty and supportiveness of those around me. I’ve had little energy to interact with others beyond what I “must” do, but those interactions have made me appreciate the power that exists in supporting one another.

And so, dear reader, thank you for coming to visit with me today. There’s nowhere else I’d rather be than here with you, if you’d like to be here with me, too.

Three Things I’ve Learned in Suicide Prevention Therapy

*This is not meant to be advice; it is simply something I’m learning as our family navigates having a family member with suicidal ideation. If you are thinking about suicide or have a loved one who is struggling with thoughts of suicide, please call the National Suicide Prevention Lifeline at 1-800-273-8255 (In the United States. In other countries, please reach out to a similar service in your country).

Image by Mabel Amber from Pixabay

The hubby and I began participating in therapy with a specialist from a suicide prevention center just a few weeks ago. Our son, Blake, had been sharing a good deal of suicidal thoughts with us and, since he was not interested in any ongoing treatment, we recognized we needed support ourselves. So far, we’ve done an intake meeting and two sessions. Although I’m a psychologist who specializes in treating anxiety and OCD, it’s a completely different story being a patient. I am learning, for sure, so I thought I’d share three nuggets I’ve gotten so far:

1. It’s not necessarily a bad thing that someone is talking about suicide.

Emphasis here is on “talking.” It was terrifying to me when Blake shared the thoughts that go through his mind, how much he suffers, how much he thinks of dying. I became alarmed at the very presence of these thoughts. However, our therapist (and others) have told me that it is actually a positive thing that Blake is talking about his thoughts. Talking and sharing are attempts to reach out and connect with others. This is a better thing than keeping these thoughts all to oneself – and not connecting with others.

2. It’s important to listen, not try to problem solve.

Many times when Blake has shared his pain with us, the hubby and I have worked to problem solve with him about ways to cope. We’ve also tried to shine a light on the bright side of things that he may be overlooking. What I’ve learned is that the most important thing I can do when my son shares his thoughts and feelings – even though they contain very dark and frightening content – is to listen and accept them as his. It is not my job to problem solve. That’s not where he’s at; he’s in sharing mode and he simply wants to be heard. As far as pointing out the bright side, our therapist noted that, for someone who is not ready for that, it’s kind of like shining a light in the eyes of someone who has been sitting in the dark. It’s going to be jarring and unappreciated. So, I’ve been working on listening and simply hearing.

3. An increasing number of conversations about suicidal ideation does not necessarily mean the person is about to act.

In our last session, I noted to our therapist that the freqency of conversations seemed to be going up. Our son was having more conversations with us about his pain and his thoughts of death. He wasn’t sharing intent to act, he was just sharing more often. It was emotionally exhausting, at times, and I was concerned what it meant. The therapist reminded me that we’ve shifted our conversations from problem-solving and pointing out the bright side to actually just listening and accepting. She noted that the increased frequency may simply mean it’s become more safe to share and that, when a person feels like they will be heard, they’ll take the opportunity to talk more often about what may be going on in their head. So, although it feels scary to me to be hearing my son’s thoughts more, it may just be that he feels more accepted in voicing them now than he did in the past.

We still have a way to go on this journey, and we have to listen to our son to ensure we are not missing signs of intent to harm himself. On the way, I am learning, and I hope our experience can help others.

Fear Itself

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This blog will be seven years old in July of this year. When I began writing it, Blake was a 14-year-old who was tortured by his own thoughts, but refused treament for his Obsessive-Compulsive Disorder (OCD). I was a terrified mom, one who struggled to stay out of her son’s compulsions, despite being a psychologist who specialized in treating OCD, and who should have known better. In three months, Blake will be a 21-year-old man – one who has grown tremendously over the years. As for me, I hope I’ve grown as well. Now, as the world struggles with fear and uncertainty and our family practices physical distancing to do our part during a pandemic, I am reflecting on where we are.

My blog began with a post titled, “We Are Here.” I was in despair and fear when I wrote it. I didn’t know where our journey would take us, but I did always have hope (though sometimes it was barely holding on). Over the years, there have been ups and downs. At first, Blake’s OCD was a constant in our lives. There were arguments with his brother, tears for each of us, and family events lost. There were also small triumphs. Then, the rituals went mostly underground and depression took center stage. Though Blake went off to college at 19, he came home at the conclusion of his first semester after spending much of it in bed and losing so much weight I barely recognized him. Through it all, Blake did not want to talk about OCD.

Lately, though, something is changing. Blake has been sharing his inner world more and more. He’s been spending his time writing. He’s been working on a fiction novel (it’s at just over 200 pages as I write this post), and he has been writing for an online gaming news site. The writing has been incredibly challenging – the novel in particular.

“My mind,” he told me one day the other week, “it never stops. I keep thinking ‘what if this’ and ‘what if that.’ It loops into so many things. I think about why I’m not a good person, or what if I’d been born into a different family – whatever it is, I just can’t stop it. It can go on the whole day. It’s why I like to sleep. It’s the only time I get a break from my thoughts.” He shares that even his movements are dictated by OCD – they are subtle, but even walking must be done according to rules.

“Thank you for sharing that with me, honey. You’ve given me a window into what it’s like to be you,” I answered, realizing that my son’s OCD never really took a vacation. It morphed into mental rituals – tricks and contortions he must do in his head until his brain finally feels satisfied for just a brief moment. I realize it is a true feat that he’s written so much of his novel thus far. And it is GOOD STUFF – really good.

Earlier today, there was another “a-ha moment.” Blake finished a volunteer shift at the local food pantry, came home and wrote a quick gaming article, and then disappeared. I found him a couple hours later fast asleep in his room. I coaxed him out of bed and into the family room.

As he became less groggy, he shared that he’d gone to sleep because of thoughts that he wouldn’t hit his writing goal for the day in the time he had. “I was afraid and I couldn’t get out of my head,” he said.

“Well,” I said, “maybe it’s time to face that fear and start writing.” A short time later he did and soon thereafter he called to me.

“You know what, Mom? Earlier, I didn’t write because I was afraid. Now, at the rate that it’s actually going, I realize I would have written even more than I expected in the time that I had. Ironically, it’s my fear that got in my way – giving in to my fear may have prevented me from reaching my goal.”

In my mind, that was a wise observation. It wasn’t ability or creativity that held Blake back – only his own fear. By listening to his fear instead of to what was important to him, he was held back from his goal. It made me think of a quote I’d heard long ago by Franklin D. Roosevelt. It turns out it was from his inagural address in 1933, at a time when the United States – and the world, for that matter – was in the depths of a depression and faced much uncertainty. I’ll conclude this post with that quote. I think it rings true for Blake’s recognition today and, perhaps, for all of us as we face our own challenges in the form of COVID-19.

“...the only thing we have to fear is fear itself—nameless, unreasoning, unjustified terror which paralyzes needed efforts to convert retreat into advance.

Be well,

Angie

Everyone is Me!

Like just about everybody else, our family is staying at home as much as possible right now. I’ve completely moved my OCD and anxiety psychotherapy practice to telehealth, so I’m home almost all the time now (exceptions being to get groceries, and to walk around the neighborhood after sitting all day and forgetting to even go to the bathroom between patients). The hubby works in an essential industry so he still has to go in to work. Michael has seen all his plans, including work, go bust. He and Blake have a commitment to volunteering at the local food pantry, which seems to need them more than ever at this time.

The hubby and I are taking advantage of this unprecedented time with our young adult kids by watching family movies, playing games, and taking turns making meals for one another. We’ve always eaten dinner together as a family. It’s just different knowing they’ll be here for dinner every night.

Last evening, as we sat around the kitchen table, considering the news of the day, Blake suddenly became bright and animated.

Image by jacqueline macou from Pixabay

“I’ve been a germaphobe my whole life. I wash my hands all the time and worry if they’re clean enough. I walk around feeling anxious every day. I almost never leave the house. Now, everyone is me!” and then he smiled a very satisfied smile.

We pondered this together as a family. Blake has struggled with contamination fears since he was very young. His anxiety can be debilitating. He self-isolates often (much to our chagrin, but apparently adaptive in the present circumstances), though he’s gradually improving on this. Now, it seems as though the whole world is living the way he is. For the first time in a long time, his world is the norm…and it feels good to him to belong. It’s not that he wishes this situation on anyone; it’s just good to feel like he knows how to live in the world the rest of us now find ourselves in.

Blake summed it up to us, as he shared his perspective, “Welcome to my world!” he said.

The OCD in the Family Family Takes the OCD Conference…Well, Sort Of

Austin, Texas. I’m writing tonight from Austin and the 26th Annual OCD Conference. And, Blake is here! The guy who wants nothing to do with anything OCD is here of his own free will. How’d that happen?

Gorgeous view on my Thursday morning walk.

Truthfully, it was a strange turn of events. Michael was on a month long trip around the country with a friend from college. He was supposed to meet me in Austin and join me at the conference. Late the night before I was going to leave, his friend abruptly needed to cut the trip short for himself, leaving Michael stranded without a plan in the southeast. The hubby and I hurriedly helped him to identify a flight to get to the conference (he has some commitments here). I assumed he would fly back home with me, but the hubby had other ideas.

“What do you think about Blake joining you for the last two weeks of your trip?” he’d asked Michael.

“I’d love that!” was Michael’s reply.

The beautiful Driskill Hotel

Blake, surprisingly, was eager to join his brother. He even opted to come out earlier than necessary to see his brother present at the conference. Now, I must admit, I had ideas of grandeur that he’d attend all sorts of events here and enjoy the conference. I was wrong. I think attending Michael’s presentation filled his quota of OCD-themed material. So, he’s enjoying just hanging out, but, hey, he’s here! And he’s going on a spur of the moment trip to who-knows-where with his big brother.

Not bad for a young man who, six months ago, frequently slept til 10 pm and almost never left the house. I’m content.

We are here, Austin!