If you’re the parent of a child with severe depression, you quickly learn that you will spend time in and out of hospital. There will be occasions when either you or your child know that hospital is the only safe place to be right now.
Nights spent in hospital with your sick child are no fun. If you’re lucky, you’ll get a bed to sleep in. Otherwise it’s a chair beside your child’s bed. If your child is a suicide risk, you have to spend the night sleeping by the nurse’s station. Sorry, did I say sleeping? I meant ‘trying to get some sleep, despite the bright lights and the constant noise’.
After one of these nights, Nora and I were waiting to be seen by CAMHS (Child and Adolescent Mental Health Services). We were exhausted. By now, Nora was very sick indeed. She was extremely suicidal, withdrawn and desperately in need of help.
Midway through the morning, a woman approached Nora’s bed and introduced herself as the ‘community paediatrician’. I had never met this woman before. Neither had Nora.
Here’s what happened next
Community Paediatrician (CP) shouts at Nora: ‘Hello, how are you this morning?’
When Nora doesn’t respond, CP looks at me: ‘Have you considered…?’ Her voice trails off as she whispers the final part of her question.
Assuming she’s going to suggest something helpful, I ask her to repeat her question.
She raises her voice, shouting again to make sure I hear this time: ‘Autism,’ she roars. ‘Have you considered your daughter might be autistic?’
Me: ‘Um… no actually. She’s under the care of a psychiatrist and her diagnosis is anxiety and depression.’
CP, holding her hand up to prevent me saying anything else: ‘It’s autism. I see this in young girls all the time. They do okay in primary school by pretending. But then they start secondary school and their strategies don’t work. Their autism becomes apparent. You need to get her screened for autism. I will speak to CAMHS about this.’
Me: ‘She’s been seeing a psychiatrist for two months. Wouldn’t her psychiatrist have mentioned it if she thought Nora was autistic?’
CP: ‘They always miss it. Me? I see this all the time. You need to get her screened for autism.’
I glance at Nora, and see she’s listening intently to this conversation. I want to say something. I want to tell her not to worry, I’m sure she isn’t autistic. But I can’t because, in my befuddled state, I think this person – who is a doctor, after all – must know what she’s talking about.
When I look up, the doctor has already left. Nora and I are alone. Only we’re not. Because the nurses in this children’s ward are incredible. Without me realising it, one of the nurses – Sandy – has appeared. She takes one look at my face and calls for another nurse – Joyce – to come in.
Sandy: ‘Nora’s mum, you come with me. Joyce will stay here with Nora.’
Sandy takes me outside. We walk around the hospital grounds.
I am not making much sense. I keep saying things like: ‘I don’t understand. Can someone suddenly become autistic? That’s not how it works, is it? If she was autistic, wouldn’t I have realised it before now?’
All the while I’m muttering like this, my mind is going back over the last eleven years of Nora’s life, looking for signs my daughter is on the spectrum. I can’t find anything specific, but then I think maybe – to a greater or lesser degree – we’re all somewhere on the spectrum.
When I say this to Sandy, she smiles and says: ‘You’re absolutely right.’
‘But she has lots of friends,’ I say. ‘And she’s really socially aware. Too socially aware. That’s what got her into this mess in the first place. I mean, surely I would have guessed something was wrong?’
Sandy gives me a sympathetic hug and asks: ‘When was she first diagnosed with autism?’
Me: ‘Oh just now. Well, not diagnosed but the doctor thinks that’s what’s wrong with her.’
As I say this, for the first time I start to wonder how someone who has never met my daughter before could reach such a conclusion so quickly.
Meanwhile, Sandy takes one of my hands in hers, squeezes it and says: ‘Ah. I probably shouldn’t say this, but I’d take what that doctor tells you with a pinch of salt. You see, she doesn’t believe in mental illness.’
She doesn’t believe in mental illness
I replay these words inside my head, looking for the joke. Then I realise, Sandy isn’t joking. The paediatrician – a medically trained doctor whose job it is to take care of sick children like my daughter – doesn’t believe in mental illness.
That doctor wasn’t speaking to me as a medical expert. Instead, she was choosing to share her uninformed, and unforgivably ignorant opinion on why some adolescent girls ‘appear’ to have mental health problems.
Now, you might be reading this and wondering why I’m sharing this story with you? Well, I’m NOT sharing it with you because I think a diagnosis of autism is ‘worse’ than one of severe depression. I don’t know what it’s like to have an autistic child, so I cannot make that comparison.
Nor do I think the doctor was wrong for wanting to explore autism as a possible cause of my daughter’s symptoms.
This doctor had never met me or my daughter before. She had no right – none, whatsoever – to assume it was okay to discuss Nora’s health in front of her the way she did. One of the key things you learn when your child is depressed is the importance of creating a safe environment which reduces your child’s anxiety levels.
Telling a depressed child she quite likely has other health problems is not a very clever way of reducing her anxiety.
Whether they like it or not, doctors are part of a profession which treats all aspects of people’s health – mental, as well as physical. It is simply unforgivable to ‘choose’ not to believe in some illnesses.
Would we trust a doctor who ‘didn’t believe in cancer’? I don’t think so.