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

It's My Party and I'll Cry if I Want To!

                
Birthday parties! Nothing elicits more excitement, anticipation and squeals of delight from a child, with the exception of Christmas, but birthday parties are a very close second. Kids begin planning and daydreaming about their big day months and months in advance, usually long before your wallet and nerves have recovered from the last birthday party. They plan out their invite list, which is typically extraordinarily long and they plan the theme and activities. When the big day gets close they start doing a countdown, and by close I mean 8 months away! This is exactly how it unfolded in my home for both of my daughters but the end result was very different for my youngest child. 

She would send out numerous invitations to children in the neighborhood, children at school, children from after school care and children she barely knew. As the day approached she would become so excited with the biggest smile on her face, and any mention of her party or purchase of anything for the party, no matter how small it was, would send her into an excited little happy dance, with little squeals of excitement.

When the big day finally arrived, the house was decorated with bright, colorful streamers and balloons and there were bowls of various candies, chips, dips and various goodies set out on the table along with theme table cloth, napkins, cups and plates – all ready for all the little party-goers. Sitting on the couch, wearing the cutest outfit she could find and a party hat with cascades of long brown curls flowing from beneath it, she waited. I would look out the window every so often to see if I saw anyone driving aimlessly passed the house and then look at my watch. As time went on, her big grin was replaced with a look of concern and she would finally ask, “What time is it, mommy?”

When it became evident nobody was coming she was beside herself; still wearing her party hat, surrounded by festive streamers and balloons, her mood was in stark contrast to her surroundings-she sobbed uncontrollably. It was so heartbreaking! I scrambled and called anybody I knew that had children. I called friends and neighbors that I knew had children, no matter their age and sent my oldest daughter and two teenage stepsons out to round up their friends quickly. So, about an hour and a half later than planned, and with no presents other than what her dad and I bought her, she was surrounded by children, laughing, playing and having a wonderful time.

This happened a couple years in a row until her dad and I finally began inviting our friends to come over and bring their children, still allowing our little girl to invite whomever she wanted, but making sure we had ‘backup kids’ just in case. It’s a good thing we did this because we would have run into the same situation again and again or have only one child show up.

Friendships have always been difficult for her.  She became aggressive towards her friends or just ‘mean’ and they didn’t want to play with her again and the
child’s parent didn’t want their child around her. They used her as an example of how not to act and labeled her a bad kid.

Anytime she made a new friend she would get so excited and latch on immediately, skipping  the getting to know them part and ask if they could spend the night, proclaiming they are best friends within minutes of meeting. It never lasted long and many times would dissolve within an hour, leading to tears and my child upset that she doesn’t have friends.  I also lost friendships and had bad blood between neighbors over her moods/behavior because I got angry when people would say rude things or assume she did something because “you know it’s something she would do”…well, that doesn’t mean she did it! I actually had one neighbor tell me she was going to have her son beat my kindergarten aged daughter up because “she’s a bad kid…you know she is”!  Her son was 4 years older, much heavier and about 8 - 10 inches taller than her! I informed her that as soon as he laid a hand on my daughter my step son would beat him up – my step son who was 3 years older than him and had about the same height and weight advantage on her kid that he had on my daughter. Not the best way to handle it but I prevented her from getting pummeled by the bigger, older neighbor kid.

As a teenager, friendships and relationships are still hard for her to maintain. She absolutely adores someone one minute and hates them with a vengeance the next. She says mean, hurtful things and very quickly regrets it and apologizes but after doing this so many times, eventually the friendships dissolve on pretty bad terms, leaving her depressed, sometimes spiraling into suicidal thoughts and almost always cutting to ‘feel better’. It’s a never ending cycle she goes through with friendships, and with boyfriends and the dissolution of these relationships is always very hard on her, leaving her feeling overwhelmed with guilt because she knows she said or did things to bring it about.

She desperately wants good, close, long-lasting friendships and a long-term boyfriend and I desperately want it for her. I’m really hoping that with some good talk-therapy and behavior modification as well as her medications that this will become a reality. She deserves to love and be loved in return. I want her to be madly in love with someone who loves her in return, get married and have her own little girl who squeals with delight and does a happy dance at the thought of her own birthday party.

Wishing you balance.
~Melissa