M.I.A.



photo by mkorchia/edited by me 



My daughter had been dealing with the depressive side of her Bipolar Disorder for a while. Although she has mixed episodes and cycles rapidly, the depression was the most prevalent mood. She would cry every night and almost always fell asleep crying. There was never any culprit that allowed me to give her a pep talk or ‘fix’ the problem for her – the sadness wasn’t situational, it was chemical.

 Because this was the prevalent mood for some time, her previous psychiatrist put her on an antidepressant and essentially opened the flood gates of hell. Every visit to her doctor we were complaining about something new and suffered serious issues at home. It never dawned on me that the antidepressant caused her to become manic. The initial phases of mania were pleasant to both of us. Although she was bouncing off the walls hyper and talking fast and jumping from topic to topic, unable to stay focused on anything, it was a welcome change to have her smiling at me, to hear her laughter again and see her loving life. Because of that I never realized she was manic, I just thought, ‘YES, she’s happy again and it’s been so long since I’ve seen her happy or since she has been happy that she’s really excited’!  Well that initial phase of mania went away and she escalated into the next phase of mania, an even higher phase that was aggressive, violent, risk taking, all-knowing and defiant. If she didn’t want to do something, she was not doing it, from doing the dishes to doing schoolwork. She didn’t care about consequences and would openly defy me. I would threaten to ground her and she would cuss at me and say she didn’t care. How can you protect a child who doesn’t care about consequences and will just pick up and walk out the door and go wherever she damned well pleased?

Well, all this led to her being hospitalized for her protection. During that hospitalization we ran into her old psychiatrist, one I was happy with and she liked and who saw her since the very beginning of her illness (or at least when it became very evident something was very wrong) but he had to shuffle some of his patients to another doctor due to a cut back in his schedule. He would stop me in the hallway as I was coming or going from visitations on a daily basis to discuss how she was doing. After filling him in on what was going on and what meds she was taking he said “Doctor ___ has her on an antidepressant?! That’s what’s wrong, Melissa!".

 I didn’t realize that was what caused the months of being in and out of the hospital, aggressive behavior, smashing things in the house, running away, suicide attempts, cutting, drug use and all the other behavior and mood disturbances. Luckily I was so angry that we had gotten nowhere with her doctor that when she became inpatient that time I specifically asked that her doctor not be assigned to her while she was there so the staff psychiatrist saw her instead. The staff psychiatrist told me the same thing, a Bipolar child should not be put on antidepressants because instead of making the child happy they become manic. He took her off the antidepressant and added a mood stabilizer to the anti psychotic medication she was already taking. She improved and was stepped down from inpatient to outpatient. 

After her second day as outpatient she overdosed on her new mood stabilizer! Thankfully I got a call from her sister telling me to watch her closely because she was saying goodbyes and told her sister she wanted to die. As I was talking to her sister I realized she had gotten up from the computer, where moments before she was crying and angrily typing away (and became enraged when I inquired about what was wrong) and I saw the light coming from under my bathroom door. I hung up and ran to my bathroom and tried to open the door - it was locked! She never locks the door, it's a rule we set up under the advisement of an old therapist to be sure she is safe. When she heard me try the door she said "It's too late mom, I already overdosed, I'm dying". Panic set in!

She was forced to ingest charcoal to absorb the pills in her stomach. I say forced because she became so delusional, psychotic and hallucinated terribly in the hospital and couldn't drink the charcoal so a tube was inserted into her nose that went down to her stomach and charcoal was put in the tube - of course the experience caused her to have severe panic attacks but she was alive!

She spent the night in the "suicide watch" room of the E.R. and I watched her closely, putting my ear to her chest every so often to be sure her heart was still beating(not trusting the monitors). I didn't sleep at all that night and the following morning she was escorted in a security vehicle back to the psychiatric hospital as inpatient.

Following her release she began doing better but soon became depressed and was hospitalized again for her safety. This time she had been seeing her old psychiatrist outpatient (the one we liked so well and I chatted with in the hallway of the psychiatric hospital). He phoned me while she was inpatient and said he wanted to go up on her Tegretol (mood stabilizer) and I reminded him that at higher doses she had hallucinations on it when she was first put on it in the psychiatric hospital, so he said he was very hesitant to do this, but how about if we try a very low dose antidepressant. I agreed. Why did I agree?!



Well, you can see where this going. During my visitation I noticed she was happy and smiling and it was so nice to have my little girl back! She stayed in the hospital for 8 days. Upon her release her mood began to shift some. Her boyfriend broke up with her, which is devastating to any teenage girl but for her it was just enough to set off a chain reaction. She began getting angry, yelling and cussing at me, refusing to listen to anything I said. One evening she just walked out of her room and said "I'm leaving" and had a book bag on her back. She was not stabilized at all - it was a day to day balancing act - and I was monitoring her closely until her doctor could see her. Aside from the dangers lurking for any teenage runaway, I knew with her mental state it could very well be the last time I saw her alive. I called 911 and ran out of the house after her.  She ran into the woods and I couldn't catch her. I saw the police pulling up so I went back to the house and told the officer everything. As he was taking notes, she walked up in tears, sat down next to me on the porch and apologized. I thanked the officer and he stayed while I called the doctor's office and gave my baby her medicine that calms her down and also sedates her. I was making her go to sleep so I knew she was safe until I could speak to her doctor in the morning, since I was unable to get anyone on the emergency line.

The doctor told me to stop the antidepressant immediately, which I did. This is when I realized the early stages of mania, which I usually find so pleasant, is just that, mania, and it progresses to this awful, dark and dangerous place.

She had more issues with self harming and depression, requiring an overnight hospital stay after which the doctor raised her Abilify, which is her anti psychotic medication. Soon after the dosage increase she became angry and threw her drink at me and went off somewhere without telling me and when her sister and I finally found her after an hour of driving around, she punched her sister in the face! I had to call police to force her to come home with me but the following day was the most frightening and alarming yet.

She came in to my room and was being so sweet, laying her head on me and giggling. I was getting up to make us breakfast and I reached in my purse to give her her morning medication and she refused to take it. She stormed out of my room and said she wasn't taking her medicine. I in turn told her she would be grounded until she took her medication. I tried to take her phone that she was texting on and she pulled it away and cussed at me so I grabbed her laptop and took it to my room and she yelled out that she didn't care because she could still get online with her phone. I could not allow her to refuse medication and still get to do whatever she wanted without any consequences so I went back to her room and snatched the phone out of her hand and told her she could have it all back as soon as she took her medication. When I turned my back to walk back to my room I was barraged with a series of punches to the back. As a side note, my daughter is fifteen and the same height and weight as me. She's a strong kid and it was like being hit by a grown man. When I turned around she slapped me across the face. I pushed her down on the couch she was standing next to, turned and proceeded to walk to my room. She ran behind me and punched me some more and when I turned to yell at her she threw a glass at me filled with water and then hit me in the head. I realized this was getting way out of hand and I was trying my best to retreat to my room hoping she would calm down but instead she followed me into my bedroom and began hitting me over and over in the face yelling "GIVE ME MY PHONE YOU F***ING B**CH!!" - emphasising each word with a hard blow. I couldn't hit her back. Although she was trying to beat me unconscious, she was still just a child.  She hit me over and over until I saw flashes of light and thought I would pass out. I was on my bed and I thought to myself, if I pass out she's going to kill me!! I yelled throughout the ordeal "GET OFF OF ME!" "GO TO YOUR ROOM!" "CALM DOWN!" and "STOP IT!" I used my legs to push her off of me and before I could attempt to retreat or protect my face she was right back on me  - I pushed her off again and she'd scramble back as I was pushing her - over and over and over, I couldn't get her off of me! I needed to get her away but also be sure I didn't hurt her. She was cussing at me, her face contorted into an expression of pure hate. I began having chest pains, my heart was pounding so hard and I couldn't catch my breath. In short bursts of words with a huge gasp of air between each syllable I said "I- THINK- I'M- HAV-ING-A-HEART-A-TTACK-PLEASE-STOP!". But she wouldn't.



photo by mkorchia/edited by me 

  When I laid back on the bed to call 911 to get help for her and be sure I wasn't having a heart attack,  she grabbed the phone from my hand, thinking she finally got her phone away from me. She got off the bed, stood at the foot of the bed and laughed holding the phone up. When she realized it was my phone she got mad and snapped it in two. She stormed off to her bedroom and I called 911 on her phone.

I was not having a heart attack, thankfully. The physical wounds will heal. When the police saw the cuts and bruises on me they wanted to charge her with domestic violence and I would not allow it. I'm glad they didn't push the issue because they very well could have and I think that would have made matters worse. I told them she needs psychiatric help, not to be locked up with criminals.

We learned the increase in her Abilify caused the violent behavior. She was very remorseful and in tears anytime she thought about it or saw the bruises on me. We are still waiting to get in to see the doctor about the initial mood problems that she was given an antidepressant and then an increase in her anti psychotic medicine to treat. Her doctors' scaled back schedule was the reason she was shifted to a new doctor previously and until she is stabilized, going a month between medication changes, and waiting another month to try a new one when the first one isn't working is not cutting it! I can't continue to watch her suffer and just wait around doing absolutely nothing about it because her doctor is only in two days a month!

This is, believe it or not, the short version of why I've been M.I.A.. I hope all of you and your babies have had, and continue to have, balance.

I will keep everyone updated more frequently so you won't have a novel of a post next time :)

~Melissa

Current Meds:

• Tegretol (mood stabilizer)    twice daily
• Abilify    (anti psychotic)      @ night
• Ativan    (high potency benzo for anxiety - calming/sedating effect)    as needed