September should be a wonderful month….the beginning of school, the beginning of fall, the return to routines at home and school and sports. I watched through the big panoramic windows of my office as the day progressed from a partly cloudy day with the occasional peeks of sunshine to the light rain of the evening. The weather is less predictable, dressing for the day more challenging and the inevitable signs of fall begin to appear. Why is it that in this month with novelty of new classrooms and teachers and the beauty of greener grass and cooler nights that so much sadness exists?
Today I saw a very sad teenager. A wonderful kid whom I have known for a while and today she came into the office and was clearly depressed. She was a bit disheveled, her mood flat, and she was wary of me for the first time. She came in because she was having stomach upset and had spent the last week or so running away from things (figuratively mostly). She has a hobby that she is passionate about and for the last two months has not been able to participate due to anxiety. She has a mother who is a great source of support and with whom she has been able to talk openly and share things for a long time and yet she has withdrawn from her mother as well. Lucky for her, this afternoon a friend received a text message from her that threatened suicide and that friend acted. He got a message to her mother who was able to go to school and get her. Her mother and I spent time today on the phone with the therapist she has been seeing and even with these extreme worrisome signs, she was unable to get an appointment with psychiatry until October 4th! That is lunacy! Unfortunately for this young woman, she had to go to the ER to have a total stranger in a very threatening and anxiety producing setting assess her to determine if she needed to be hospitalized to protect herself or if she could seek more therapy as an outpatient. Having to bear your soul to a complete stranger in that sort of setting would be traumatic enough but to go there feeling so badly that you weren’t sure you wanted to even be alive would be downright petrifying.
I bring this up not only to point out the fact that as parents we cannot always read our children completely, especially as they grow into adolescence but also to point out that the mental health support community is broken. Few people go through life without facing some very challenging emotional stresses and some people will experience these stresses to the extreme. We as a community of people need to recognize that mental health and physical health are connected…that this girl’s stomach aches were not only physical but emotional too…that her depression has effects on her physical health and even if she were not suicidal would be a huge burden to bear.
We all get sad or blue at times. We all at some time or another will have to deal with the loss of a parent or a job or a spouse and many times dealing with these stresses requires help….from family and friends and clergy and doctors and therapists. Why is it that when a person is having a heart attack, there is a rapid response team that will swoop in and work tirelessly to save her but when that same person is so depressed that she wants to kill herself that I can’t even get anyone to see her? It is a frustrating double standard that actually has much larger implications for society than does heart disease. Mental illness effects not only the person but her family, her friends, her children, her colleagues in a way physical illness does not. Sure you can feel bad for someone having to deal with medical challenges and sure you may even have to pick up the slack for that person at home or work as they recover but mental illness is insidious and insinuates itself in everyone’s life that touches that person. Personality is at the core of who we are and when your personality is affected by mental illness it is unnerving for everyone around you. Babies of depressed moms or dads have colic, toddlers and preschoolers of depressed parents have huge behavior problems including aggression and defiance, school aged children of anxious or depressed parents will often become so anxious about leaving their parent that they refuse to go to school in the hope that their presence will help the parent feel better, teenagers who are depressed or have depressed parents or friends drink, use drugs, have sex as ways to ‘self-medicate’. This is a huge problem.
I don’t have any platitudes or suggestions but I encourage us all to be aware of each other’s mental well being and do what we can to encourage each other to get help when needed. I encourage you to talk to your children about not only their feelings but yours too. Don’t burden your child but share occasionally your feelings of sadness or anxiety and talk to them about how you can overcome them. Allow them to ‘help’ you by suggesting things or just entertaining you. Of course the goal is not to have the children feel responsible for your mental well being but rather give them the tools to recognize and talk about their own feelings, and if needed, tell someone else if they see a friend or family member who is profoundly sad.
Talk to your kids, cry with them, hug them and heal and each day will be your best.
Molly O’Shea, MD Birmingham Pediatrics + Wellness Center 248 816 2558