Monday Morning

It’s 8:32 in the morning and I send a text message to both of my boys about the Thanksgiving holiday, which is over a month away. I have to make airplane reservations and I want to check on their schedules. I expect I’ll hear from Michael; it’s three hours later where he is and he already had a class this morning. Blake I don’t expect to hear from until at least late afternoon or evening with his sleep issues. He has a 10 am class, but he’s missed attending nearly every week.

To my surprise, it’s Blake I hear back from first at 8:39 am. He confirms his schedule for me. 

Me: Whatcha doing?

Blake: Waking up.

Me: You heading out to class?

Blake: Yeah 

Me: Out of bed yet?

Blake: Showered.

Me: Wow. Just wow.

Blake: I appreciate your amazement at my basic levels of human functioning. 😛

Me: It’s a mom thing.

Blake: Are turnovers a breakfast pastry or dessert?

Me: They are whatever you like them to be. Love you.

Blake: Love you too!

It’s a brief moment in time, but it’s a victory nonetheless. Blake is awake. He got himself showered at a time that allows him to participate in the day. Whether he will leave his apartment and head to school or head back to bed is uncertain. It is just this – a moment.

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Another Bump in the Road

Friday Evening…

8:35 pm:

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?

Blake: Yeah

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.

Saturday Evening

8:25 pm:

Text from me to Blake: Hello

Blake: Hi

Me: How you doin’?

Blake: Rough

Me: Can you talk for a min?

Blake: Yeah

“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…

A New Definition of Success

Blake is in his fifth week of college classes. It’s been a trying time for everyone, not the least for me. I’ve realized over the last month that I’ve spent a great amount of time over the past fourteen years involved in Blake’s well-being – in helping him to be successful. Whether it was running him to neurologists to answer to his teachers’ concerns that he was having seizures (he wasn’t; he was experiencing intrusive thoughts), meeting with occupational therapists to ensure he could find his way around the school, or teaching school personnel how to manage anxiety, OCD, and depression, much of my time was running interference so that Blake could do his job of being a student.

Listening to my son’s feelings of overwhelm these past several weeks and hearing about the days he has missed school entirely and succumbed to depression has sparked that old impulse in me to jump in, to make it better, to pave the path for success. Yet, at the same time, I am learning a new way to interact with Blake and his schooling. And I am learning to define success in a different way.

In the past, helping Blake to be successful meant teaching others to understand the way he learned, and to recognize when mental health issues were interfering or needed to be attended to. It also meant pushing Blake forward when he didn’t believe in himself and helping him to find the tools he did not know he had. It sometimes meant forcing him to get out of bed and to follow a schedule for the day – or even for the hour.

But Blake is not six-years-old anymore. He’s not even seventeen. He is a young adult man – one who has had help and labels poured on him for most of his life. And those things probably continued to come even when he did not want them. In some ways, sometimes, they likely made him feel like a failure, because he struggled, at times, to even do the basic things people do to get along in this world.

My beautiful nineteen-year-old son is living in an apartment nearly 1,000 miles away with three other young men. He is struggling to get along in school, having chosen a major that, as his adviser has pointed out, plays more to his weaknesses than to his strengths. He struggles to get out of bed some days or to find what motivates him. He has dropped all but two of his classes and is teetering on dropping out of school altogether.

BUT…

He is feeding himself every day and getting to the grocery store weekly. He visits his adviser at school and is working on a plan with the disability office. He figured out how to transfer his prescription from our pharmacy at home to one near his apartment in the new state. He gets out of bed MOST days. He got his hair cut (he doesn’t know I know this) which means he figured out where there was a salon, got a ride over and back, and paid for it all himself. 

My husband and I were worry warts in college. We were scheduled; we were efficient with our time. We were not our sons. They have their own way, and Blake’s way is to pave his own path. It is not the path I would have taken or that his dad or his brother would take, but that does not make it any less valid a path. My son is brave and I believe in him. His road is his own. I am here to assist and support if he needs me, but right now what he needs is for his dad and I to believe in him. 

Blake, Dad and I believe in you and whatever your path may be. Thank you for teaching us that success comes in many different hues. When those big feelings you have seem too overwhelming to manage, we will be here to remind you that feelings pass, and that you have what it takes to hang on through them and then to forge onward.

His Own Initiative

Our oldest, Michael, left the country one week ago today with excitement over studying and living in another country and a passion to become more fluent in another language. The hubby cried as he hugged our son goodbye, then cried more as we drove home, and once again as he searched birthday card after birthday card in pursuit of a suitable one for our younger son, Blake’s, nineteenth birthday. The hubby’s tears reflected many things: the sadness at watching Michael leave after several weeks in which they spent many close moments together, the bittersweet realization that we will be empty-nesters in a few short weeks, the juxtaposition of the personalities of our two young men – one who craves new experiences in the world and one for whom his bed and our sofa seem experience enough.

Michael’s parting recommendation to his brother had been that he begin to venture out into the world, that he practice the skills he will need when he moves to college in another state next month. He’d worried lovingly about his brother and whether he’d have the skills to live in his new environment. He’d proposed a plan to his brother in which Blake would go out of the house, perhaps a couple of times each week, so that he might gain experience and confidence, and perhaps a little momentum. Blake initially embraced the idea, but it quickly seemed to fall flat as I wrote about in my previous post (“A Plan That Lost Steam“). Depression and anxiety seemed to win out.

A Flash of Hope

I had resigned myself that Blake was not going to follow the plan he and his brother had plotted out. I expected to see him step back from life even more. The hubby and I were true to what we had promised and did not bring the plan back up. To be honest, I even stepped back on our therapy-planned morning routine of waking Blake up. Sure, I still saw that he got up and out of his room, but with much less rigidity and urgency. I felt deflated and spent time searching my mind as to how I would live as meaningfully as possible regardless of what would come with either of my sons in the months ahead.

Still, there were things to be done before Blake can leave for college. There were apartment supplies to be ordered and bank accounts to be transferred (Blake still only had a custodial account in my name). So, I continued to go through the motions of preparing for the move. On Monday morning, Blake and I prepared to go to the bank to get things in order so that he might obtain the all-important debit card.

“Do you want to go grab a coffee afterward?” I asked him just before we left.

“Oh, I was planning to go there myself as a way to get out today. You know, like we talked about with Michael. Is that okay?”

I was a bit startled, a little excited, but tried not to show it.

“Of course,” I said. “Do you want to take separate cars and meet me at the mall, then? We can walk over to the bank, then grab a coffee, and I then I can leave so you can have your time.”

So, we did. Blake navigated his way to the mall parking lot and we met up and walked to the bank and completed the business of transferring his account into his name. Then we walked back to the coffee shop, where I grabbed an iced coffee and quickly made myself scarce. Blake set up his computer at a table.

“I wish I’d brought a chess board,” he noted. “I’d ask someone here to play with me.”

When I got home, I dashed off an email to the hubby at work: “Thought you’d want to know…

And Then Another

On Thursday, he did it again.

“Mom, since we need to go out on another college planning errand today, can I use it as a way to launch into going out on my own again? It kind of helps ease me into it. I mean, since we are going out already, I can just go off on my own when we’re done. I’d like to go to the board game store.”

“Sure, honey. Let’s meet up at the store. We’ll pick out supplies and then you can head on your way,” I’d suggested.

About a half hour later, Blake showed up to meet me.

“Twenty-five minutes to find my way here!” Blake shook his head.

“Hey, you found it and you did it safely,” I replied.

Then we proceeded to giggle our way through the store, Blake being more frugal than I, me reasoning that the slow cooker he was choosing was going to be too small. As we finished, I bid him fun on his adventure. A couple of hours later, he was back home. He’d completed his mission, and had even observed a group at the store playing a Dungeons and Dragons game.

“I tried to join in,” he said, “but they were already too far in. They have a board game night there every other Thursday.”

Whether Blake will continue his missions out into the world we shall see. This week, my son, the one who prefers his bed and the family room couch, went out twice – for no reason other than to practice doing it. No one cajoled him or made suggestions. He just did it himself. While we cannot show great excitement because we know, from experience, that this will just send him back into hiding, this weekend the hubby and I are doing happy dances when no one is looking.

A Plan That Lost Steam

Michael, our 21-year-old, is getting ready to leave to study abroad for the remainder of this summer. He sat the hubby and I down the other day and told us he was worried about Blake’s emotional state and his upcoming move out of state to begin college.

“He’s really not ready to go,” Michael observed. “He feels like a disappointment to you guys, especially when it seems that everything is based on whether he gets up in the morning or not. And he doesn’t respond well to tough love. It just makes him shut down more.”

“So what are you thinking?” I asked him, as the three of us sat on our back patio.

“I think he needs a mission, a purpose. You know, little tasks to get him out of the house. Things he needs to practice to live away from home. He can go buy his groceries so you can get an idea now what he’ll need to spend on them and so that he’ll get used to buying what he needs. And he can go to the library or the coffee shop and set up his computer and practice writing from there. You could give him a small stipend each week so he could practice. I think it would make him feel accomplished. But,” Michael continued, “I don’t think it should come from you guys.”

“What do you propose?” asked the hubby.

“I’ll talk with him tonight,” Michael noted. “I’ll see what he thinks and help him to make it his. If it’s his idea, he might be willing.”

So, we parted leaving this between the boys.

Michael Makes Inroads

The next morning, Blake stopped me early.

“Mom,” he said, “Michael and I were talking last night about ways for me to get ready to leave for school. Can we talk with you and Dad tonight about it? I think it’s a good plan.”

“Sure,” I answered. I tried to sound calmly enthusiastic, but inside I was kind of excited. Was my son who regularly chooses bed and the sofa to leaving the home actually wanting to launch a little bit?

The four of us met last night and Michael and Blake led the talk. Michael shared how doing these kinds of things would have helped him make the transition a little easier when he left for college. He thought it would give Blake more confidence to live in the world

And Then I Watched it Happen…

Blake went from mildly enthusiastic to questioning to looking downright terrified. He started finding reasons it wasn’t a good idea. He started worrying he’d be judged and held to this standard. He worried he’d fail. It didn’t matter what anyone said. The hubby and I noted we wouldn’t hold him to anything. It was his plan, and if he followed it, we would cheer him on. If he did not, we wouldn’t comment. Michael stayed positive and light and shared how beneficial it could be. I was proud of how he held his own and supported his brother. In the end, we left it that Blake could decide whether he did it or not.

And then, as I got ready for bed, he called me into his room.

“It’s just so hard to get out of bed,” he said, staring off into space. “Bed is the only place that feels good. It’s like having a hug and having to leave it. Nothing in the day feels good and I just distract myself with YouTube or games all day. And then it’s even hard to go back to bed knowing I’ll have to do the same thing again tomorrow. Living is hard and I’m too scared to die – so I’m just in that in between space.”

And there was little more I knew to do for my son than listen, acknowledge, and snuggle him with a tight squeeze until he dismissed me with a, “Good night, Mom.” For all my professional training and experience, I do not know how to move my own son from here to there. And right now, I don’t know that there is anyone else who knows how to either.

We Have to Want It Less Than They Do

Image courtesy of Nanhatai8 at FreeDigitalPhotos.net

This week I attended a daylong community OCD event. The venue was completely full, there were terrific speakers, and there were lots of opportunities to connect. At the end of the day, there was a gathering to re-cap and ask questions. One parent stood up to ask a question that grabbed my heart and my attention.

The parent asked about a topic that is near to many of us who have young adult (or almost-adult) children struggling with OCD (or other mental health issues). That is, the parent wanted to know how to motivate one’s older teen or young adult to get serious and use the treatment being offered to them. I immediately felt a kinship to this parent. I wanted to reach across the crowded room and say, “Yes, I want to know that, too. You are not alone.” Yet my heart already knew the answer that was about to come.

A therapist at the front of the room took the question and tenderly noted, “I notice that many times parents want desperately for their child to get better. Yet that seems to keep the child or young adult from wanting it for themselves. They have to want to get better more than their parents want them to get better.”

And there it was. A simple truth. We parents can want what we want for our children. We can lead them to treatment. We can urge, press, plead, make deals…but we can’t be doing more work than they are. We cannot be more invested than they are. We have to want their recovery LESS than they do.

My heart feels heavy for just a bit as I hear what I already know. And my heart aches for the parent on the other side of the room. How do we do this? How do we care less when they don’t seem to care much at all (at least on the surface)? I think the answer is that we have to find a meaningful life for ourselves in spite of their mental health struggles. I think that we have to back off on the pressure and put faith in their ability to decide when enough is enough. And we have to have the courage to not pick up the pieces and make the consequences of their struggle easier – they have to be doing much of the hard work.

This is simple, in theory, but difficult in practice. As parents, we are programmed to respond to our child when we see them suffering. We are oriented toward providing comfort and to removing obstacles. With OCD, anyway, doing our job as parent may be presenting them with the difficult path toward healing, and waiting nearby allowing them the struggle of coming to the decision that there is a better life to be lived.

I Matter, Too

Image courtesy of digidreamgrafix at FreeDigitalPhotos.net

“More importantly, how are you doing?”

This question from Blake’s therapist takes me by surprise and throws me off balance for a moment. Blake has just walked out of the room, shutting the door behind him. Nature calling. I’m just finishing paying for the session, thinking I’m about to walk out the door, too. The therapist isn’t quite done yet.

“What do you think?” he asks, and then he points out, “He’s talking about serious stuff now.”

He’s correct. Blake only started coming to therapy when he wanted to take some control of the interventions his therapist, his dad, and I were implementing. He was angry. He came to bargain. In recent sessions, he’s talked about depression, his dislike for himself – just the mere concept of “Blake,” about his disconnection from the world. Today was no exception and, as has begun to be our routine, I sat like a fly on the wall watching the interaction between Blake and The Doc, wondering what I was doing in there. Although the therapist in me is fascinated by observing what’s going on.

It’s Not About Me, Right?

We’ve been seeing this therapist in hopes that our 18-year-old can overcome his OCD and severe depression and ready himself to live in the world.  So I just didn’t expect it when the therapist asked about me.

“I have good days and not so good days,” I answer.

“Well that’s a pretty non-specific answer,” the therapist says with a smile.

“I worry about him,” I say, “but I’m learning patience.”

The truth is, I’m kind of disconnected about how I am. I’ve been so mesmerized by the therapy session, I lost myself a bit. It’s only later in the day, as I ponder the question, “More importantly, how are you doing?” that I think over my frustration at watching my son climb back into bed multiple times each morning. It’s later that I recall the heartbreak at hearing my son talk about how life isn’t worth the good moments when he considers how awful the bad moments are. It’s later that I remember part of me sinking inside as I watch my son wash his hands immediately after handling money or tiptoeing around areas that the dogs might have contaminated.

At the same time, I’m touched by The Doc’s inquiry. As much as my son is suffering, family members are, themselves, affected when their loved one has OCD, depression, or other mental illnesses. If we aren’t directly involved in rituals, or trying to get them out of bed, we are worrying about them. So I’m appreciative of this simple act of kindness and caring. It resonates in me. It reminds me that we family members have to remember to care for ourselves in the face of our loved ones’ struggles. We have to be mindful of our own well-being. If we aren’t, we can become impatient, bitter, angry – basically of little use in this war called mental illness.

So, thank you, kind therapist, for reminding me that I matter, too. It opened something up inside of me and I feel just a little more alive and grounded. I feel less stuck in the mess with my son, and more like myself. And this morning, when I allowed myself to take a long hike in the nearby mountains, I was just a little more open to taking in the scenery and appreciating it, instead of having the specter of depression and OCD hanging over me. Yes, I matter, too.