The Fog

I’ve experienced four major depressive episodes in my life (if you don’t count the postpartum depression after I had each boy). One was when I was a teenager – maybe 15 or 16 years old. The second was when I was 30 and my aunt (a close confidante) and uncle were killed in a freak accident. The third was when I was 38 and struggling through some major life issues. The fourth is happening now.

Mental health issues are abundant in my family. My siblings and parents struggle with various forms of anxiety and depression. One of my aunts died by suicide – one of many cries for help that had a permanent outcome. Another aunt in my grandparents’ generation was hospitalized multiple times for her depression and went through several rounds of electroconvulsive therapy. I remember stories of my grandfather locking himself in his room for days. I could go on. Suffice it to say, it’s no surprise that the hubby and I have passed on anxiety, OCD, and depression to our own offspring.

My last major depressive experience was before Blake was diagnosed with OCD. I almost forgot what it feels like…but I recognized it as soon as it started settling in. There’s the thick, thick fog in my head that makes me want to lie down with its weight, and the lack of enjoyment in just about everything I do. I feel myself going through the motions, but I’m distant, falling deeper into an abyss as I see this shell of myself move through the days. And then there’s the vacillating from just not giving a crap to being seized by moments of rage – to hearing myself pop off at those I love the most.

I Know What Prompted This

I can pinpoint the catalyst for each major depression I’ve experienced, and I know what it is for this one. Yes, there’s the fact that I just lost a friend to cancer. I promised I’d go see her – and then I didn’t follow up to that last text message that she didn’t answer…and she died. And there’s Michael. Sweet, competent Michael, who is on the other side of this country so stressed out by what he’s taken on that he can barely see straight. But I can handle either of these – alone or together. I can be the rock. There’s this one thing I can’t be the rock for anymore.

Basically, I’m watching my almost-adult son fall apart – at least in my eyes. This bright, funny, sensitive young man who the hubby and I have invested so much love, time, and attention in cannot seem to manage the basic skills of living day to day. Blake’s sleep/wake cycle, which we have worked so hard with him to regulate, is more messed up than ever. He sleeps until six in the evening and is up all night. When he does wake up, he is down on himself and upset. Then, of course, the schoolwork doesn’t get done. Two months shy of graduation and I’m not sure if he will finish his coursework.

Just this past week, we were supposed to take a trip to the school that is his first choice for next year – and where he was accepted. The place where he will train in the skills that are supposed to launch into the career he’s imagined most of his life. We told him this trip was a “must” in the final decision-making process. The hubby and I woke for our plane flight. Blake had already woken, turned off his alarm and gone back to sleep. The hubby went in to wake him again and let him know he had to be downstairs by the appointed time – a time that came and went and ended in the hubby cancelling our flight, our hotel, and our rental car. Moreover, it made us recognize that our son is not ready for this next step in life. I think I’m okay with that, and yet, I still grieve.

Time to Step Back

I look back over the years and I wonder how we got here. Perhaps I’ve propped Blake up too many times. One of the things that happens when you have a child who struggles with OCD is that you become fiercely protective. You make sure that people around him understand what is going on. You make sure that accommodations are in place where necessary. You push him forward when he cannot find the strength to do it himself. But the most painful realization of late is that, perhaps, I’ve done more of the pushing than Blake has. I may have prevented him from developing the skills he needed to be ready for this next step in life. I haven’t allowed him to fail and pick himself up.

You see, while Blake has been struggling with his sleep this past year, it’s really been me who has done all the work. I’m the one who has set up all the protocols. I’ve been the cheerleader. I’ve been the one who has emphasized how important it is to learn this skill. I’ve been the one who has gotten him out of bed and prevented him from missing the really important things. And I can see the future if we keep propping him up and then send him off to college next year – in an apartment out of state, no less.

It is all but destroying me watching him go through this. It’s like watching some suspenseful series, constantly rooting for the hero, seeing him fail over and over, and not knowing where this story is going to end up. Even as I pull away, I sink more into my own depression. To make matters more stressful, Blake is watching my every move, as he always has. He is sensitive to my mood, wanting to know what is wrong. His OCD tells him he must take extra care of me. If I scream out the things I really think and feel, I will only set him off and send him spiraling.

I’m Getting Help

I tell him that I am struggling with a big episode of depression, as he’s heard me talk about having experienced in the past. I tell him that it is not anybody’s fault; it’s how my body works. I tell him I am getting help. I have an appointment with a therapist next week. I hope that I am being a role model by getting help when I am struggling. What’s more, I really need the help right now. I need a place to put all that I’m feeling somewhere besides on my hubby’s shoulders. I need a neutral party to look at this situation and guide me. And I need someone to hold me back before I say something stupid or jump in and try to “save” my boy yet again.

Tenth Anniversary – Part I

Image courtesy of Chaiwat at FreeDigitalPhotos.net

Image courtesy of Chaiwat at FreeDigitalPhotos.net

This weekend commemorates an anniversary in our family. It is ten years since we recognized that our son, Blake, had Obsessive-Compulsive Disorder (OCD). I remember the weekend well. One event in particular prompted us to reach out for help and plunged us into new, unfamiliar territory.

Our family went boating that weekend. We weren’t very experienced with motor boating, and we excitedly packed up both boys, my parents, and one giant inflatable raft and made our way to a local lake. Goal: encourage Grandma and Grandpa to take a turn on the raft as it was towed by the boat. We were sure they’d love it.

We were successful in getting both my parents to give the raft a try. I remember the gigantic smile on my mom’s face and the “thumbs up” sign she threw us as she requested that the boat go faster. We had a ball swimming, picnicking, and taking in the beautiful day.

I don’t recall if Blake, then seven, got in the water or on the raft that day. I do recall, though, that at one point he became aware that people sometimes relieve themselves in the water. The recognition horrified him and, from that point on, he wanted nothing to do with the water. Exhausted from the activities and the sun, he fell deeply asleep on the boat bench. The hubby had to lift him from the boat and into his seat in the car, where Blake awoke as he was being buckled in.

A Child Possessed

Suddenly, it dawned on Blake how he had gotten into the car…and he began to scream. Gut-wrenching, blood-curdling, ear-piercing screams began to emerge from my seven-year-old’s mouth, causing the other five of us in the car to wheel around to look at what was going on. Blake looked like a child possessed. His face was contorted and bright red. He struggled in his seat as those screams kept coming.

Wash! Wash! Wash! Need to wash! Wash! Wash!….”

My parents looked dumbfounded and helpless in the back seat. Michael looked confused. My husband and I tried to talk to Blake, to calm him down. Our attempts fell on deaf ears. Blake just kept right on screaming. I didn’t know what to do. I felt something primal well up deep inside of me.

KNOCK IT OFF!!!!!” I heard myself bellow.

Can’t You See He’s Terrified?

Blake looked at me through tear-filled eyes. I’d frightened him (and probably everyone else in the car).

“Can’t you see he’s terrified?” my hubby said to me. He went to comfort Blake, but Blake wanted nothing to do with him, for it was his father, who had been in that urine filled lake and then carried him into this car, who was the source of the contamination that now tormented him. He didn’t want his father, or any of us who had been in the lake, near him. We were all a source of fear. My hubby and I could not offer comfort to our own child.

We drove home in near silence.

“We need to get help,” my hubby said to me.

“They’re going to say it’s my fault, but you’re right. We can’t go on like this.”

Today’s outburst hadn’t been the first. It was the scariest, though. It was the latest in a summer full of incidents that told me our younger son had OCD. I’d just kept hoping I was wrong. Everything I’d learned about OCD in my psychology graduate program pointed to the mother as the source of the problem, and I was terribly afraid and embarrassed. I was scared of what OCD would mean for my son’s quality of life, and ashamed that I, as a child clinical psychologist, did not know what to do for my son. It was time to surrender to the fact that we needed help. I silently prayed that there was something that would help. I would reach out to colleagues in the upcoming week.

Too Many Anxieties

Image courtesy of stockimages at FreeDigitalPhotos.net

Image courtesy of stockimages at FreeDigitalPhotos.net

The hubby and I have just returned from a two week trip to South America. We are celebrating 25 years of marriage and it is the longest we have gone away from our boys. They’ve just held down the fort for two weeks, Michael exercising his young adult wings and grandparents checking in on them.

It has been a long day; it’s nearly 8 p.m. here and the hubby and I have been up and traveling since the equivalent of 2 a.m. It’s hot and we are hungry, yet all we want is to spend time with our young men. We pick up food and take it out onto the patio. It’s cooler here than inside the kitchen. Michael and the hubby start to swap stories. Michael shares what he learned about how difficult it is to run a house. The hubby talks about traffic in a country south of the equator. I notice that our table is not complete. Blake, who was preparing his own meal, has not materialized outside. I peek inside the kitchen and see him sitting by himself at the table.

“Blake?” He is quiet. “Blake, are you going to join us outside?”

Blake’s head is down and he is somberly eating away, appearing more like he is forcing himself to eat than enjoying any of it.

“We’d love you to join us.”

“I…I can’t. Bugs…”

“There aren’t any bugs that I can see tonight.”

“It’s just. I have so many anxieties. Eating outside brings up too many. I don’t want to stand up to them tonight.” He places his head in his hands.

“You don’t need to. Thank you for telling me. I’ll miss you. See you after dinner.”

I go back outside to join Michael and the hubby, who are still engrossed in conversation. Blake finishes his meal alone at the kitchen table. I ache just a bit for the piece of our family that is not here and for how I can see that Blake is struggling. Yet I’m glad he could put it into words, without screaming, without melting down as he might have in the past. He is learning to put his struggles into words. He is learning to share that he is anxious and that he doesn’t have the strength to challenge his fears right now. That is growth. Perhaps another day his strength will win out.

“I’m In an Exposure”

Image courtesy Stuart Miles at freedigitalphotos.net

Image courtesy Stuart Miles at freedigitalphotos.net

“Hey Mom, I’m in an exposure right now,” Blake informs me. He sounds just the slightest bit excited.

“Really?” I ask. “What are you in an exposure for?”

I’m curious about this statement. Blake hasn’t talked about “exposures” in years. Certainly I haven’t heard anything of the sort from him since he refused treatment for his OCD just over three years ago. Exposures are an integral part of evidence-based treatment for Obsessive-Compulsive Disorder. The person with OCD places themselves, often with the support of a therapist, in situations that would normally provoke compulsions/rituals, but chooses not to pacify the OCD by performing those compulsions. Gradually, the OCD sufferer adjusts and learns to cope with what might have previously felt intolerable.

“Today is a special day, religiously,” Blake tells me. “I don’t know if there are any special observances I should be doing beyond what I’ve already done. I’m feeling pretty anxious, but I’m not giving in to it. I’m allowing myself to tell myself that I’m doing the best I know how and that has to be good enough.”

I know this is tough for him. We’ve been held captive in the house, at times, with Blake paralyzed over not knowing how to handle some religious observance (he is more religious than the rest of our family, having embraced religion about five years ago. OCD loves to mess with that and his obsessions and compulsions often revolve around religion). I tell him that I recognize this must be tough and that I’m glad he’s happy he’s made the choice not to give in to his OCD this time.

Blake is still struggling with depression and having difficulty with motivation. His OCD lingers mostly in the background, rearing its head from time to time. Yet, at moments lately, I see mini breakthroughs. He is more willing to talk about feeling anxious – something he would have become furious about in the past if I would have mentioned it. Just yesterday I heard him repeating a prayer as I sat next to him.

“Are you supposed to repeat that prayer at certain times?” I inquire. “I notice you just said it a second ago.”

“No,” he says.

“Oh, it’s an anxiety thing?”

“Yep, it is,” he replies – with no defensiveness.

That little exchange would have been unthinkable even six months ago. Perhaps he’s a little more mature. Perhaps I’ve learned to be less intrusive, to have less of that accusatory tone in my voice. Whatever it is, this little window of openness is nice.

As for the exposure he self-imposed, we never spoke of it again, but I’m pretty sure it went well. He went off to babysit our friends’ children, came home later and proceeded with his day. There was no frantic calling of religious authorities or begging me to text someone who is in the know. Maybe that is how Blake’s war with OCD will be won, with little hand-selected battles he feels ready for. If so, I’ll cheer him on quietly each time he takes one on.

 

“I’ll Try”

Image courtesy Gualberto107 at freedigitalphotos.net

Image courtesy Gualberto107 at freedigitalphotos.net

“Why haven’t you posted on your blog in a while?”

My hubby poses this question as we sit at dinner with Michael. I stop for a moment and ponder his query. The truth begins to make its way out; I’ve held it deeply inside for these past months.

“I haven’t been able to write since Collin died,” I say. The three of us sit in silence for a moment. Michael’s friend and classmate since kindergarten was killed in a tragic auto accident in February (see “The Phone Rings in the Dead of Night“). Although the young men mostly moved in different circles, and though our contact with the family had dwindled to meeting up at Open Houses and Back-to-School nights with agreements that we needed to get together, in the aftermath of the accident our community suddenly seemed much smaller and intricately interconnected. The air felt heavier. Little things mattered less…and my own personal struggles felt insignificant.

“I have my sons,” I say. “So Blake has OCD. So he struggles with depression. It just seems insignificant to write about that when Wendy and Jay would probably give anything to have Collin there, even if it was to have an argument. Maybe I was just wallowing in my own stuff. We have a good life.”

“Yes, we have a good life,” the hubby acknowledges. “We also have this very real thing going on in our life. It’s not insignificant. OCD and depression are not insignificant. If you don’t write about it, you don’t acknowledge the realities of the people who read your blog to connect and to have hope. You also don’t acknowledge our reality. Your writing isn’t wallowing.”

“You need to write, Mom,” Michael encourages me.

“I’ll try,” I promise.

So, it would seem, I am trying. Let’s see where it goes…

 

The Phone Rings in the Dead of Night


IMG_1971[1]Saturday morning, February 27, 2:31 AM

  • I am woken from my slumber by our home telephone announcing that Michael is calling us.  I quickly do the calculation in my head.  It’s 5:30 AM where he is. Michael is not an early riser.  Something must be wrong.  I race to the phone and no one is there.
  • My hubby and I call Michael back from each of our cell phones.  Voice mail. We text. No reply.
  • I start to hyperventilate. I picture an awful accident. How can I go back to sleep? The hubby pulls me into a tight hold in our bed.
  • I remember I have a “Find My iPhone” feature on my phone.  I’ve promised to only use it in emergencies.  I think this qualifies.  I locate the phone in his dorm.
  • I fall asleep around 4 AM with vague images of campus shooters in my brain.

Saturday morning, February 27, 6:38 AM

  • A text from Michael.  “Sorry my phone has been having trouble with voice control. It must have called you while I was asleep. I love you!”

Michael and I talk once I’m fully awake.  He tells me that, while he was sleeping, his phone randomly dialed our house phone, a girl from junior high, and a friend from our religious congregation.

“You know what’s weird, though, Mom?  At the same time I managed to call everyone, I was feeling overwhelming panic.  The last time I felt that was when Kat died.  So, I thought maybe Uncle L had passed away.”

What Michael is referring to is that he had a premonition a few years ago at nearly the same moment a close family friend died.  And, right now, the hubby’s beloved uncle is gravely ill.

“Uncle L is at home with family,” I say. “No one died.  Maybe you just felt my panic at receiving your call and not being able to reach you.”

“Maybe.”

We are both wrong.

Sunday morning, February 28, 1:33 AM

  • In my dream, there is a chime. Then another. I wake to see light shining from under Blake’s bedroom door.  Maybe that’s what woke me.  I wander in the dark to the restroom.  I have a vague memory of a chime in my dream.  Maybe it wasn’t a dream.
  • I check my phone.  There’s a text from Michael: “I found out that Collin X* died yesterday in a car crash.” “Do you want to talk?” I reply.  “Sure.  I’m just confused right now.”
  • Michael calls me from the hall outside his dorm room.  It’s just after 4:30 AM where he is.  Everyone is asleep. Michael has known Collin since kindergarten. Collin was killed shortly before Michael began sleep dialing last night. Michael is dazed and in shock.  Suddenly, he begins to sob.  He can’t believe this is happening, and he is so far away.  I tell him it’s okay to let it out.
  • Alone and sobbing in the hallway, Michael develops a gushing nose bleed. He takes me with him into the restroom and I wait silently for the bleeding to stop.  Finally, it does.
  • Michael talks until he is ready to try to sleep.  I promise to contact him when I know more facts.
  • I lay awake looking for news that can tell me if, indeed, this is true.  The facts I can find all point in a bad direction.

Sunday, February 28, 9:06 AM

  • Can you talk? Just heard some news.” reads the text. “Collin?” I reply, hoping the sender doesn’t know what I’m talking about.  If she doesn’t, then maybe it wasn’t him. “Yes,” is the reply.
  • Joanna is crying on the other end of the line. She’s in a social group with Collin’s mom. The worst is confirmed. Collin was riding home with friends when illegal street racers on the highway caused a horrific accident.  A big rig was sent careening into the car Collin was riding in.  The big rig driver and two teens, including Collin, died at the scene.
  • When I hang up the phone, it’s my turn to cry.  I’ve known this family for years.  I cannot begin to imagine their pain.

The hubby and I have an event to attend. In my numbness, I dress myself, try to go through the routine. I give Blake some instructions about what he is to accomplish today.  A couple things to catch him up in school.

“Great.” he moans. “Now I have nothing to look forward to.”

Blake doesn’t know about Collin yet. I don’t want to share this news on the way out the door, however, his words strike me.  I want to shout at him.  You think life is awful because you have a couple of assignments for school?! Collin won’t ever get to go to school again! 

I keep my mouth shut.  Blake is still struggling with depression, still not wanting help for that or for any mental health issue.  I’ll talk with him later.

Sunday, February 28, 10:40 AM

  • As we drive to our event, the hubby’s phone rings. It’s one of the dads from the group of kids who’ve grown up with Michael.  He’s known the hubby since childhood.  He and his wife want to visit with Collin’s family later today.  Will we go with them?  Of course we will.
  • We arrive at our event and a friend innocently sits down next to me.  “How are you?” he wonders. I burst into tears in front of him.

When we get home, we tell Blake about what has happened.  We offer to answer any questions he might have.  He doesn’t have any.  We ask how he is doing.  He says he is fine. We tell him Michael is having a tough time and would probably love to hear from him. He says he has nothing to say. We mention his comment about having nothing to look forward to and we talk about how there are blessings for us to find in each day that we are here.

“This doesn’t make me feel any better,” says Blake.

Sunday, February 28, 6:40 PM

  • We meet at Joanna’s house – the hubby and myself, Joanna, and the other couple. We walk over together, looking for emotional strength in our numbers. Will they even be wanting visitors. We will respect what they want. We each bear gifts. I’ve baked. It’s all I know how to do when there’s a loss – bake, cook.
  • As we approach the door, we slow down. Who will go first? Do we knock? Ring? Our friend’s wife is the brave one. She rings. The woman who answers the door motions for us to come in. Collin’s parents come up front to see who it is. Our connected lives instantly plug in. Their tears start to flow when they see us. We all hug and cry for what seems endless moments.
  • I wander into the kitchen and set down my baked good. As I make my way back to the front, I see Collin’s dad, our friend, and my hubby locked in one big man embrace – three manly men crying in each other’s arms.

When we return home, I ask Blake if he will please come walk the dogs with us. It’s been a long, difficult day and I’d like to walk together as a family, even for just this little bit. He argues with me about not wanting to come, but I ask him to please join us. As we walk, he stays about a half block ahead. I wonder with the hubby if Blake is struggling, angry, or simply detached. I never know lately. When we get arrive home, Blake is waiting to get into the house. I have the key.

“Thank you for coming, Blake,” I say.

“I hope it made you feel better,” he says and he walks inside and places his headphones into his ears. I try to hug him and he shakes me away, telling me he doesn’t want to be coddled. There’s really nothing for me to say. I’ve been reminded today that, no matter what is going on in their lives, we parents must cherish the moments we have with our kids. Yes, we will have struggles and difficult emotions, but each is a blessing in their own way. I try to remember that as my son demonstrates he wants nothing of this.

The hubby and I finally climb into bed. He holds me more tightly than normal. We hope for a night without phone calls or text messages. We think of Collin’s mom, trying to call and text Collin, much as we tried to call Michael when he accidentally dialed us in his sleep the other night. We imagine locating his phone and finding it, instead of in a dorm, at the scene of an accident. Nauseated and numb, I finally fall asleep.

* As always, all names have been changed for privacy.

When Psychiatrists Disagree

Image courtesy blackzheep at FreeDigitalPhotos.net

Image courtesy blackzheep at FreeDigitalPhotos.net

I’m sitting in my car.  I check my e-mail, then I check the clock. Eleven-thirty a.m. Finally. I dial Dr. X’s number on my cell phone, not really expecting him to pick up. He’s told me to call at this time, but he must still be finishing up with a patient.  I’m just anxious to hear what he thinks and take the next steps.  The phone rings.  Dr. X picks up.

“I have just a few minutes,” he tells me.  “I haven’t heard back from Dr. Z yet.  Tell me what he had to say.”

Dr. Z is the psychiatrist we met just the other week.  He’s the head of adolescent psychiatry at a major university, a close colleague of Dr. X, and someone we consulted with to see if there is something different we can be doing to help Blake.

“He said that he sees Blake as being affected by dysthymic disorder – a constant low level depression.”

“What about his OCD?  Does he disagree with that?”

“He agrees that he has OCD.  He just doesn’t see the OCD as the cause for the depressed mood right now.  He thinks we should change to the other medication I mentioned.  Try a trial for a time-limited period.”

“Here’s the issue,” Dr. X says.  “Dr. Z has always liked that other medication better.  The down side of it is that it can cause greater amounts of anxiety in kids like Blake who already have high anxiety.  The other problem is Blake.  How does he feel about it?”

“He’s willing to give it a try for a time-limited period.  He is doubtful that it will be helpful, but he’s willing to do it.”

“Look, I know Blake’s history and we have to take that into consideration.  Blake has a negative view of the world and he doesn’t have much motivation to change things right now. I’m concerned about putting all our eggs in one basket, putting everything on the hopes that this medication will change things.  If Blake isn’t really on board, and if this medication is a failure – which it is likely to be if he doesn’t want it to work or believe that it can work – then it just becomes more proof that the world isn’t worth it and that he’s right to have the world view he does. He really needs to want to get better.”

My stomach is sinking at this point. This is an issue that’s come up over and over in the past four years. Blake has to want to get better. It doesn’t matter what anyone else wants; it matters what he wants. The truth is that it is still me who cares more than Blake about how his life is going. It’s me who wants to jolt my son into giving a damn about the world.

“I understand what you’re saying,” I  say, as my heart turns into a knot in my throat. “It’s just that I’m the one who has to wake him up every morning – over and over. I’m the one who doesn’t get to work out in the morning, or schedule patients before the afternoon. If I leave the house, he sleeps until three pm.”

Dr. X continues, “I really think that Blake has not experienced the full consequences of his refusal to get better and to join the world. It’s a tough time for this, but it’s important that he feel the consequences of not getting out of bed. I had another patient where the mom finally had to tell the son that she’d changed her life enough for him and she had to go back to work. We call it ‘family accommodation’ when family members change their behavior so that the one who is ill does not have to suffer as much…”

“Dr. X, you know that I know what you’re talking about. I work with this with my own patients and their families all the time. It’s just so hard to know what to do when it’s your own child. You’re telling me that I have to let him experience the consequences of his not getting up and not getting involved in the world.”

“Look, Angie, if Blake is on board and wants to, I’ll order a test to see how he metabolizes medication. That will help us know what medications are or aren’t likely to help him. However, Blake has to really want it. I’ll wait to hear from you about when you’d like to meet. I’ve got to go; that’s my next call.”

I sit in the car, alone in thought, for some time. I had been so hopeful. I’d wanted to put faith in the idea that a medication change could make my son see more that is positive in the world, maybe help him find a little motivation. Now I’ve been brought back down to Earth. I am reminded once again that a key ingredient is Blake. I’m also reminded that I probably make life a little too easy. Do I have the guts to stop waking him up and let him face the consequences? Will he even care? There are definitely no easy answers for me.