Thursday, October 04, 2012

Dealing With My Child's Suicidal Thoughts

I saw one of my former Boy Scouts a few months ago at an event that involved our kids. He is an engineer and a fine family man. It's difficult to describe how good it made me feel to see him doing well.

Back when this man was one of my scouts, I knew that he took medication for bipolar disorder, a problem that was common to several members of his family. His case was somewhat mild, but he admitted that his medication helped him cope. He could get by OK if he missed his meds for a day or two. Another member of his family, however, became utterly dysfunctional if she missed a single dose.

A couple of my children have been notoriously moody. They probably come by it honestly, because I was a moody child. Just ask my Mom. (For that matter, my wife might tell you that I've been a moody adult.) The older of my moody children eventually seemed to even out, gaining some mastery of his emotions. (Or at least their public display.)

I have been long aware that the other child of which I speak has had mood swings. But I really didn't think the problem was too far out of the ordinary until the day told me that he wasn't sure that he could bear to continue living.

My son had been having a pretty good day, I thought. He had been playing with friends and seemed happy. After a lot of jumping and running around, he came in the house and lay on the couch to relax. After a while he made some kind of expression that made me think he was tired. He explained that it was more than that. He just didn't feel like living any longer. No, it had nothing to do with his friends. He said that he just sometimes felt that way.

I sat down and tried to do the calm dad thing on the outside while freaking out on the inside. I gently tried to get my son to tell me when he first noticed such a feeling and how often he felt that way. His answers gave me to understand that it was a relatively recent development.

Before long my son met with a psychologist and then a psychiatrist. (No, they're not the same thing. The former focuses on counseling, while the latter diagnoses and treats mental conditions.) The consensus was that my son had bipolar disorder that required both counseling and drug therapy.

Bipolar disorder seems to have genetic, physiological, and environmental roots, impacts, and/or effects. The drugs that help are aimed at controlling the physiological aspects of the condition, which can help mitigate the impact of social and emotional triggers. Counseling is designed to help patients develop coping mechanisms for dealing with a permanent condition.

I was initially quite opposed to drug therapy. We have too many kids doped up on drugs in an effort to force them to fit well within our increasingly sit-down-shut-up-memorize-and-regurgitate school system. (Don't be too surprised when this methodology fails to turn out the next generation of highly skilled engineers and innovators—or even capable clerks, for that matter.)

Despite my reluctance, my son began taking the prescribed medication. It took several weeks, but it clearly helped. After a while, however, he experienced stomach problems, which are a common side effect of the drug he was taking. He had to be weaned from the drug and then remain unmedicated for several weeks. Those were tough weeks. He eventually started on another drug. It has some side effects too, but it seems to work to a degree.

It's difficult to effectively regulate drug dosages for growing youngsters. They can have growth spurts seemingly overnight that can leave them undermedicated. Vigilance is required.

Even with drug treatment, my son's case presents challenges. Since a significant portion of the underlying cause appears to be structural, the condition can only be managed, not cured. Thus, my son will face challenges throughout life.

My son can actually be quite entertaining during manic episodes. During recovery following a recent surgery he had my wife and the recovery nurse in stitches. The nurse, who sees many recovering patients daily, said she'd never seen anyone talk that humorously in recovery. Unfortunately, my son can also be obnoxious during manic episodes. Sometimes he becomes chatty and just won't shut up. This causes problems at home and at school.

My wonderful wife has done the lion's share of dealing with my son's condition. It's not uncommon for our son to slide back and forth between mania and depression several times each day. To me, the depressive episodes seem worse than the manic episodes. "Feelings of sadness, anxiety, guilt, anger, isolation, or hopelessness" as well as "problems concentrating; loneliness, self-loathing, apathy or indifference; depersonalization" are common during these times.

Dealing with my son's bipolar condition is challenging for us as parents. When he is belligerent about doing his homework, for example, where does the malady end and his controllable will kick in? To complicate matters, this line of demarcation differs from episode to episode.

I recently accompanied my son on a two-mile hike with his scout troop. I went along because my son was being belligerent about hiking. He dislikes hiking, probably even more than I did when I was a kid. But I felt it was important for him to support the troop. Besides, I know from my current perspective that hiking builds character and helps youth develop resilience.

During the hike my son's bellicosity crossed the boundaries of the tolerable. I let him know in very clear terms that he had crossed that line. He took off and soon surpassed the foremost hikers. But after we rounded a bend in the trail, he was nowhere to be seen. I discovered him behind a stand of scrub oak after a few minutes of panic and searching by the four adults on the hike. By then he realized that he had done a very dangerous and foolish thing. He was surprisingly cooperative the rest of the evening.

I wondered before and during the hike whether making my so go on the hike was the right thing to do. Was I helping him develop useful skills or was I being a tyrannical parent? In hindsight, I still think my wife and I were right when we insisted that my son go on the hike. But exactly what the correct approach is in any given situation with my son is far from clear. Do we have to continually walk on eggshells? With how much do we let him get away?

Going back to the initial symptom that started us on the path to diagnosis, it is chilling to note that one-third of those diagnosed with bipolar disorder attempt (or complete) suicide. I occasionally had suicidal thoughts in my youth. But I never got to the point that I could have actually done something about it. Some people that deal with depressive disorders clearly can get to that point. Family members are left wondering what they could have done differently that might have prevented such an outcome.

Seeing my former scout as an adult that has thus far successfully dealt with his bipolar condition gives me hope for my son's future. At present it's just really hard for us as parents, as I'm sure it is for my son. It's very challenging to help him progress in positive ways while swimming in a sea of negative emotions and behaviors that impact the whole family. It will take a lot of years before we know how well we have done.


Michaela Stephens said...

That's a big difficulty you have. It probably feels like you are getting PTSD from it. Can you find any books for parenting manic depressive children? They might have specific techniques you can use. You have deal with both teenage boy and psychological condition.

Scott Hinrichs said...

We have access to books and professional services that are helping our family through this issue. But that doesn't mean that it's not challenging.