mental health hold | Help To Hope

I tried hard to be a voice of reason to my daughter. But how does one reason where there is no willingness to receive it? It didn’t work for Alice after she fell down the rabbit’s hole, and it wasn’t working for me. Still, it seemed all I could do.

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Tuesday night had seen a change to my daughter’s medication. The two SSRI anti-depressants she’d tried in the previous weeks had served only to take her deeper into rage, depression, and thoughts of suicide.

She was switched to a medication initially developed to treat seizures but used off-label to treat mood disorders. As those with mental health issues often find, medication is not an exact science. Not at all. But the aim at this point was to stabilize her, which (ironically) meant taking her off anti-depressants.

She soon found out that the term “72 hour hold” was a misnomer, more a guideline than a declaration. This was first a rumor she heard from other adolescents in the unit, and then she found out it was to be her reality.

I tried to explain the reasoning behind the need for her to stay in the psych ward longer. “They’ve switched your meds. The old ones obviously didn’t work well for you. They need to make sure you don’t have a bad reaction to this new medication. It’s a safety issue.”

Predictably, she was not receptive. For the record, I’m not so sure I would have been either if I’d been in her shoes. Also predictably, her anger flared. She was not allowed contact with any friends while she was hospitalized, and even if the support system she’d built for herself was terribly dysfunctional and harmful, all she knew was that it had been taken from her. And she was mad.

There were some curious things I realized about myself in those few days, difficult things that made me sad and confused.

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I knew that I was afraid for my daughter to be released from the psych ward and sent home. I was fearful that she would quickly return to her previous behaviors and that I was just too worn down to be an effective parent anymore. I was scared that there would be no lasting changes resulting from this awful ordeal. And I was so out of ideas.

I knew that my goal was not to keep my daughter from getting angry nor was it to have her like me. My goal was to keep her safe, even if she came to hate me in the process.

I knew that I wanted to put up all kinds of roadblocks so that her choices were limited and she couldn’t make decisions that would be harmful. But I knew that would be a disservice to her, that it would mistakenly teach her that she could not be responsible for herself.

I knew that, in the bigger picture, I couldn’t and really didn’t want to control my daughter; I wanted her to learn to control herself.

I knew that for that to happen there had to be boundaries and consequences in place, and that she had to choose her actions and thus her own outcomes. This was a source of great pain for me, because I knew some of the choices she would make and that their results would be very hard for all of us.

But I had to let that go. Even though I could see that she was not yet willing (or able?) to face some of her bigger issues, I had to let her choose for herself.

I will once more refer to an email I wrote to my small and trusted circle of support. This was yet another middle of the night message, a bit disjointed and bearing witness to my fears and frustrations. This was written on day three of my daughter’s stay at the behavioral center, the day she had mistakenly decided she was going to be released and sent home.

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I had a meeting today with C and her dad and caseworker. There was a chance for C to have her say and a chance for us to, then time for us parents to meet alone with the caseworker. We were told early in the meeting that C would not be released until Saturday (day five of her “72 hour” hold). We really lost her at that point. She wants to come home NOW.

She was not forthcoming about some stuff she’s been lying about lately, nor about what might have been bothering her that led up her hospitalization. She’s been telling me for weeks about some things that are just driving her crazy, but she never even mentioned them in today’s meeting. I told her that I’d learned about some of her deceptions but she would not acknowledge anything, just said she had no idea what I was talking about.

I tried to prepare her for the fact that things will be very different when she gets back home, that boundaries will be tighter, and privileges will need to be earned back. I don’t think she has any idea what that means or thinks it will really happen anyway.

I am feeling extremely overwhelmed at the thought of her return home. The caseworker had all kinds of thoughts and ideas, and while some of them may be helpful, the work of it all feels like it will bury me.

When her dad and I walked out of our meeting with the caseworker, C came straight over and asked me why she couldn’t be released sooner. She was very angry and confrontational and kept demanding answers that I couldn’t give her. I gave her the only answer there was to give, but she wanted more and I told her that was all I had, I couldn’t make anything up to satisfy her.

She directed all her anger and frustration towards me. I don’t think she even made eye contact with her dad for that 5 to 10 minute conversation. She made vague threats about not eating (that’s her choice if she wants to make it) and swore she was better and ready to come home. It was really pretty awful.

She chose me to be the one to pick her up when she is released on Saturday. She told me she wants me there at 6 in the morning. I told her I’d be there between 9 and 10.

I know there are many strategies to deal with her in the days ahead; I just honestly feel like there is nothing left in me to do it – to learn what I need to learn as a parent, to find her a new psychologist (her request and the caseworker’s recommendation), to drive her across town how many times a week for those appointments, to find extra-curricular activities & get her enrolled & to the activities, to meet with her school counselor and teachers and try to help her not fail her freshman year.

I am just spent, which may be exactly where I need to be but it doesn’t make any sense to me and I can’t see how it’s all supposed to get done.

I did tell her dad that with these added commitments I cannot logistically do all that needs to be done for both girls during the week (always on ongoing battle for me), and he said he’d be available but the truth is that he works during the hours these things are going on. I will have to continue to change and arrange my work schedule to take care of things.

I don’t expect him to make any sizable contribution to handling those details because he hasn’t before. It would be helpful if he actually had some input or action of his own; I feel like it’s up to me to take the lead on these things because he simply will not and we are at a critical juncture where action must be taken. He does not seem to accept the seriousness of the situation. (Caution: ex-wife frustrations are surfacing!)

Again, the ideas for help and change sound really good in theory but the reality of it feels nearly impossible to me. There just isn’t enough of me to go around.

The diagnosis the caseworker gave for C today was General Anxiety Disorder and Depressive Disorder. I don’t know if a new therapist will reach a separate conclusion. C says she hasn’t been suicidal for about a day and a half. She says cutting is stupid and disgusting and she’ll never do it again (which she’s said before), and she swears that she has learned all she needs to know and will be fine.

She also says she wants to “help” her friends who cut to stop cutting, which basically translates to her taking responsibility for their actions – which scares me especially when she cannot take responsibility for her own.

After today, I cannot imagine a conversation with her that is not angry and confrontational and manipulative.

I do get that her choices are her own and that my job, after assuring her safety, is to allow her to deal with the consequences of her choices. I know very well what some of those consequences could end up being, and I can honestly say I hate that.

Maybe that is where so much of my anxiety is coming from and I need to work towards what is acceptable and adequate, not what is perfect and guaranteed (those two options really don’t even exist). But I selfishly look at those consequences, should they come – and I know some of them will – and I know that they will result in even more being put on my plate and I feel frustrated and angry about that.

Well so there it all is. I am too tired to make this (or me) sound nice. I have no neat or tidy wrap up for this message; I’m just continuing to ask for and appreciate your prayers and hoping that my ranting and venting haven’t been too offensive.

In a few hours I start a very busy day, not only working on my taxes, etc., but also working out C’s discharge, contacting her school, trying to track down and interview therapists and stuff like that. I appreciate your prayers and support.

“Bring me his sweatshirt, mom. Please.”

“Of course, sweetie. Of course I will.”

My daughter was limited in the personal items she was allowed to have during her mental health hold. Hoodies – the staple of teen fashion – were okay, but drawstrings had to be removed. Favorite (imitation) Converse shoes? Fine, but no shoestrings allowed. The safety pins my daughter loved to use as fashion statements were absolutely forbidden. I was forced to look at clothing, and much of life, in a whole new way.

But the thing my daughter wanted most was “his sweatshirt”, and there was no reason to deny her request.

When my husband had died almost two years earlier, I’d invited all three of his adult kids to go through his clothes, to pick out some favorite items they might want to keep for themselves or their own children.

I tried to also give them each special items, perhaps tokens of affection they or their children had given their dad that would now make their way back to the original gift givers. Or maybe an item that they had seen growing up in their childhood home that held special memories for them. It seemed only fitting to do this.

(Admittedly, there were a few things it took me time to be able to part with. Thankfully, my step kids are gracious and patient.)

I had also asked my own three adolescent children what they would like to have of their stepdad’s as special mementos. My older daughter had chosen an old sweatshirt that my husband used to wear often. He was great at coming home from a day of work and changing into comfy clothes, a signal that work was left behind and he was now present and available at home.

But this particular sweatshirt was one he often threw on early on a Saturday morning as he brewed coffee, read the paper, and prepared his favorite bagel for breakfast. It was a treasure on many levels and had become something of a security blanket to my daughter

(Photo Source: Google Images)

In both the best and worst of times she slept nightly with the worn shirt close by. So often she had cried to me after his death about missing him and wanting him back. I understood at a deep level how she felt (and then some), and was not at all surprised that she wanted “his sweatshirt” now that she had been placed on a psychiatric hold for suicidal ideations.

It made perfect sense to me. To a frightened and unstable fifteen-year-old it was portable comfort, raveled and worn, in a place where comfort was difficult to find. I was happy to grant her request.

Visiting hours included Tuesdays, so I was returning less than 24 hours after I’d followed the ambulance across town and had her admitted. I took some approved clothes, the needed sweatshirt, my younger daughter, and an anxious heart, and drove us all through afternoon traffic for our first visit.

To call it uncomfortable would be an understatement. And incomplete. How else might I describe it? It was bewildering, sad, strange, surreal, terrifying, and with a few tendrils of hope that I tried to believe weren’t just taunting me.

There was one room where all visits took place simultaneously. All of the adolescents hospitalized there and all of the visitors who had come to see them were confined to this one very plain not-terribly-large space. Each group had their little gathering of chairs as segregated as possible from the others, with some people having to share their seat with another.

(Photo Source: Google Images)

Some groups sat close together, speaking in hushed tones. Some seemed less eager to sit closely, or to even talk with one another. Some were loud and frustrated, others subdued and resigned.

I tried to (or not to?) catch glimpses of the others in the room while simultaneously trying to figure out how our family had ended up here, how my daughter was faring in the psych ward, and just exactly what the next step might be.

Add “disconcerting” to the list of adjectives.

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