Don’t Other People Do That?

I haven’t written much lately about Blake’s OCD. Though it’s been in a “waxing” period for some time now, there are still “rules” Blake follows all day every day. This was a moment we had last week.

Our cat presents a challenge for OCD’s contamination rules

Blake is helping me make my bed and we are chatting as we work. The only problem is, our cat isn’t cooperating. He insists on walking all over the blankets and sheets, making it nearly impossible to move or straighten anything without difficulty.

Impatient with our furry companion, Blake picks up a pillow and starts swatting at the cat. He’s not actually hitting him, just trying to encourage him to move off the bed. He swats repeatedly, but it’s a fruitless maneuver. The cat only moves a few feet so that Blake has to move to another part of the king size bed to reach him.

I watch this scene with interest. It’s a pretty ineffective technique for moving a cat who is determined to stay put, yet Blake continues to try to use it.

“How about if you actually give him a little nudge with your hand, honey? Or maybe pick him up and put him on the floor?” I finally ask.

“Then I’d have to go wash my hands and I’m trying to wash my hands less,” he answers.

I don’t say anything. My silence obviously speaks to Blake who asks me, “That’s not unusual, is it? People wash their hands when they touch their pets, right? Right?”

“Um…that’s not what most people do. I mean, most people don’t run to wash their hands immediately after they touch their pets.”

“They don’t?”

“No. They don’t.”

“Ew. I don’t think that would be very uncomfortable.”

“Okay,” I say.

“Do you think I’m wrong?”

“Blake, you asked if other people wash their hands when they touch their pets. I answered you that most people don’t.”

“But am I wrong?” he asks.

“Only you can decide that, honey.”

“I don’t like to feel uncomfortable,” he answers.

“I know,” I say kindly. “Maybe, if you wanted to, you could expand the limits of what makes you uncomfortable by just waiting a tiny bit longer to wash after you touch our pets.”

“Thank you, mom,” he says.

That’s my signal that the message is received and he’s done with the conversation. Yet, this is the first time I can ever recall that Blake is questioning his behavior. He’s always just asserted that he is the way he is and that he thinks he is right. Today he is questioning whether his rules about what’s contaminated are in keeping with what others do. I don’t know that it means anything…but maybe it does.

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Back Home

Blake has been home now for just over two months. It’s been nice having him home. He’s been more self-reflective and more open to sharing. It’s also been a relief to know he’s eating and taking his medication more regularly. The hubby and I have been able to be calmer with him than before and less impatient with him in many ways. Yet, at the same time, things are still so uncertain with him and it’s tough to know what ways things will go.

He wants to be a writer and he spends his days working on a book he’d love to publish. Some days he write a lot. Other days – not so much. The topic of his book is a secret. I only know that it is a work of fiction, maybe even sci-fi. He ponders whether he should return to school at some point. And sometimes he’s very sad and lonely.

Recently, when he was feeling very sad, he shared that the only things he really looks forward to are eating and sitting in front of his space heater. I reminded him of how, a month ago, he enjoyed playing video games with his brother and a friend.

“I think that you’re actually a social guy and that it’s important for you to get out of the house and be with people on a regular basis.”

“But what would I do?” he asked.

“Maybe apply for a volunteer position where you’re required to show up at the same time every week?”

With a little more talk, he agreed to try. He reached out, with my help, to several organizations in our community and started a weekly position with our local food pantry. For the past three weekends, he’s ridden in the big truck with the driver, picking up donations from local grocery stores. It’s heavy lifting work and is probably good for his mood. He and his driver sound like an odd pair, yet Blake has taken to this young man (who is about 10 years older than him). Blake has even learned to appreciate a new music genre: Hick Hop! He actually looks forward to going each time.

In addition, Blake has started a blog. Again, it was at my urging, but he joyfully wrote his first post. It’s a humor blog and that first post was pretty hysterical to all of us. We’ll see where it goes. The hubby and I hope that, little by little, Blake will build up momentum to living in the world and taking more steps on his own.

The Food Thief

A sandwich I ate on our drive home. Blake happily ate a similar one, plus many of my French fries.

I pull into the Trader Joe’s parking lot and circle around a time or two. The lot is crowded with folks shopping for their evening meals and the rain is beginning to fall. As we walk through the lot, the water and dark sky mask the red blotches that have bloomed on Blake’s face from the tears he’s cried the entire short distance from his apartment. He feels like a failure – having left home four months ago to begin a new college career in a new city and dropping out after one semester.

“I’m completely unable to function,” Blake has told me on more than one occasion.

What I see differs from what he sees. I see success in having navigated the basics of day to day living. I see a future full of possibility. I see growth and more lessons that still can be mastered. But I also see something that concerns me – something I’m not sure my 19-year-old son is even aware of. I see his weight – or lack of it, that is.

Back at the Apartment

Before we leave Blake’s apartment, he phones his academic advisor.

“Um, hi. This is Blake Roberts. Is there anything else you need from me before I leave?”

As I stand behind him, waiting as he makes his call, my son’s almost-six-foot-tall frame comes into focus. And for a moment, it startles me. He is shockingly thin. His clothing hangs on him, making the weight loss look even more obvious. Did anyone at school notice that the clothes he arrived in at the beginning of the semester had become exceedingly large? He’d lost a good amount of weight before he’d come home for Thanksgiving. Has he lost more? It appears that way.

When Blake finishes his phone call, I focus back on our task of moving out. I file my observation away for later. How would I bring this up in a sensitive way? Would I even bring it up at all?

At the Store

Blake wipes his face and follows me into the grocery store. We’re here for food for the three days ahead of us. Because of food restrictions, eating in most restaurants is not an option for Blake. I want him to choose things he’d like to eat, but he seems uninterested when I point things out.

“Food just doesn’t seem interesting now,” he notes.

I know from experience that trying to force him to make some choices won’t work. Instead, I begin to pick things off the shelf and put them into my cart. I give Blake space and he wanders close by. After a time, something catches his interest. He picks it up, reads the label, and then adds it to the cart. Little by little in this manner our cart fills up. Blake pauses at an item – chocolate mint caramel popcorn (or something like that). He ponders it. I know he’s questioning whether to treat himself (something he rarely does).

“Can you add that to the cart?” I ask.

“Why?”

“It looks interesting. I’d like to try it.”

Blake seems reluctantly happy to comply. He puts it in the cart. We pay. We pack up the car, drive to our hotel for the evening, and unload what we need for the night. Before I’ve even shut the door, Blake has gotten into a bag of food. He eats with abandon. And I silently and gratefully take notice.

Are You Aware…?

Blake continues to eat this way over the next couple of days. He even treats himself to snacks at convenience stores we stop in along the way. Nearing the end of our second driving day, a day in which we’ve marveled at views and checked out historic downtowns, I decide to ask.

“Hey honey? I was wondering – are you aware that you’ve lost quite a bit of weight?”

“Yes,” is the answer.

“Was it intentional?”

“No,” – which is said in a tone that indicates he’s not offended, so I dare to dig slightly deeper.

“Was it because of mood, or was it because of having slept so much and missing meals?” I try to ask gently.

“It was a mix of those. Sometimes I was so depressed food just didn’t sound good. I just didn’t feel like eating. Some days, bed was the only thing that sounded good. It was like a warm hug and I couldn’t think of a reason to leave it – and I slept through mealtimes,” he answers.

“Thank you for sharing with me,” I say tenderly, and we continue on with some other topic.

Silently, though, I’m thinking what a thief and a liar both depression and OCD can be.

“Bed is the best thing in your life. Stay here! Feel safe and comforted. You don’t need to bother with such trivialities as eating. Ah, there. See?”

I imagine Blake sleeping through a day, tricked into believing that bed is best. When he can finally lie there no more and the cobwebs begin to clear, the depression takes the opportunity to dig in more and remind him what a failure he is. It steals his appetite, he mindlessly plays video games to numb the sting of the words his brain tells him about himself, and then it steals the next day of living by convincing him once again that bed is the only place worth being.

For now, Blake seems to be eating with regularity. Occasionally, he forgets a meal. I’m observing and trying to give him room to work this out. One thing I have noticed is that, like me, he seems to derive joy out of feeding others.

“Mom,” he says to me, “may I cook a lasagna for the whole family one night? I’d like to share one with you all.”

“I love that idea,” I say – and I do, much more than he will ever know.

The Journey Home Begins

Blake was fast asleep when I arrived at his apartment. A roommate answered the door and went to wake him. Blake, now awake, led me to his bedroom where a quick glance revealed that the young man he shared a room with was also fast asleep. Almost two in the afternoon. Seemed about right for college students…

What took me by surprise (though it probably shouldn’t have) was that Blake hadn’t packed up his room at all, except for his clothes, which were all in his duffel bag. I’d asked him to pack up everything he could before I’d arrived and he’d done very little. I was frustrated, but kept that to myself. I recognized that getting upset would most likely only delay completing the task at hand. Instead, I suggested we get to work. Blake suggested he take a shower. Sigh.

“Sure,” I said. “I’ll go make some work phone calls in the car. Come get me when you’re ready to pack.”

Twenty minutes later, Blake was knocking on the car window. He didn’t seem to know where to start. I’m not sure if it was depression, being nineteen, or just plain old lack of experience that paralyzed him. Whatever it was, I began directing.

We folded bedding; we packed kitchen supplies; we sorted through his remaining food. Hygiene items had to be sorted – those worthy of the journey home and those to be relegated to the trash. I directed Blake to suitcases, to giant trash bags I’d brought with me, and to grocery bags. At some point his roommate had gotten out of bed and we had the room to ourselves. I directed swiftly staying focused on the task.

There was a quarter dollar coin on the carpet. Blake walked carelessly back and forth over it.

“Who does this belong to?” I asked.

“It’s been there a long time,” Blake answered, “ probably most of the semester.”

We loaded all his belongings into the car, two floors below. Up and down the stairs, over and over again. Finally, we’d finished and it was time to say goodbye.

“Hey, Josh,” Blake called to his roommate, who was now at the dining table, “Do you know whose quarter is on our floor?”

“Oh yeah. That’s mine. I dropped it a while back.”

Blake handed the quarter to him and then they shook hands.

“I wish you all the best, man,” Blake said as they parted.

“Yeah, you too.”

We climbed into the car.

“Ready to go?” I asked. Blake nodded. As we pulled out of the apartment complex, I saw Blake wipe a tear from his face. Then another. And another. They were flowing freely now.

“You gonna miss it here?”

“It just feels like another failure – another failed opportunity in my life,” he said.

“Hey,” I said, “there were successes here, too. A lot of them. You’re allowed to feel what you feel and I won’t take away from that. You certainly have more growing and learning to do. At the same time, please remember that there were some things you dealt with very well.”

“Thanks, Mom.” My cue to be quiet. And we drove out of the complex I silence. Onward toward the future.

The Semester Winds Down

One of the successes: A lasagna Blake made for himself. He likes to photograph his meals.

Blake has been at college for an entire semester – or one week shy of it anyway. It began unceremoniously, with Blake declaring that this would be the shortest college experience of anyone in our family and dreading the start of classes. I flew back home fearful of the unknown and how my youngest might fare.

It’s been a semester of ups and downs. The downs include Blake not making it to class many days, him sleeping way into the evening on days when depression made bed the only option that felt viable, MANY assignments never turned in or even attempted. It included many phone calls from Blake saying he just couldn’t do this, that he needed to drop out. And there were the tears Blake cried over not feeling adequate, losing hope, and no longer knowing what his passion is.

The ups included Blake cooking for himself, grocery shopping, keeping up on haircuts – and being the only one in the apartment to actually clean the bathroom (though that may have been prompted by OCD fears – I digress). They include Blake joining clubs on campus and even attending murder mystery special events (something he rarely did while at home, and then only with much prompting). In short, my 19-year-old moved to a new city, lived in an apartment with three others, shared a room, and took care of the basic things he needed to in order to survive. I’d venture to say that joining clubs is a step beyond the basics.

Still, college itself definitely did not go well. I don’t know how well Blake performed in any class; I don’t know if he even knows. He has decided that this is just not the right time for school for him and he is coming home. He’s not happy about that. In fact, he feels like a failure and fears he’ll only continue to fail and to suffer emotionally. He hates the idea of being an adult in his parents’ home (and cannot seem to recognize that he is certainly not alone in that status).

Late next week, I will fly to meet him. We will pack up his apartment and come home. But we won’t be flying. The hubby and I felt that being back home in a matter of hours was too abrupt a shift from what we think was a growing experience for our boy. So Blake and I will take a road trip home. We have no planned route, no place we must stop – only an ending destination of home in a time span of three days. There will be a lot of open road and empty expanses on our way. My plan is to remind my boy of the successes he had and hope that he can find a way to hold onto those, even for a brief moment.

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.

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…