A diary of depression

girl on beachThis time last year, Nora’s illness was only beginning. We had no idea how bad things would become. We never could have imagined that our eleven-year-old daughter would reach a point where she was so ill she wanted to die.

For some time, I’ve wanted to write about how Nora’s illness progressed, but I’ve never been able to get the words down. It’s always been too painful.

But…I want other parents – who are going through something similar – to know that they’re not alone.

So, I’ve finally written something. I hope it helps.

Month one

Nora’s anxiety has become unmanageable. The only way I can get her into school if we go for long walks beforehand. This means getting up early and walking for up to two hours before school.

I know that Nora’s already in a dark place, and she needs help. Through our GP, we’ve got a referral for a private consultation with a psychiatrist. Apparently, Nora isn’t ill enough for a CAMHS referral.

Month two

The psychiatrist thinks Nora may be suffering from depression, although this condition is – apparently – extremely rare with children as young as Nora (she is eleven).

Because of Nora’s age, the psychiatrist rules out anti-depressants, and recommends a ten-week course of CBT counselling. My husband and I are relieved. It seems inconceivable to medicate our eleven-year-old daughter with anti-depressants.

Month three

The CBT sessions aren’t helping. Nora continues to deteriorate and I suspect the counsellor doesn’t really know how best to treat her.

Nora’s school have suggested that trying – and failing – to keep Nora in school is counter-productive. The counsellor disagrees and thinks we should keep sending her in.

We take the school’s advice, because it feels like the right thing to do. Nora stops going to school.

By now, Nora is self-harming and suicidal. More than once, we’ve ended up in hospital, where we spend nights on ‘suicide watch’. Nora undergoes several psychiatric evaluations. These confirm what we now know: Nora is suffering a severe depressive episode.

Nora’s psychiatrist prescribes anti-depressants. We are relieved. It’s clear Nora needs more than weekly counselling sessions to get her better.

girlMonth four

Nora has stopped speaking. Completely. The only time I hear her voice is during her terrible meltdowns, when the weight of what she is enduring simply becomes too much.  These happen several times a day.

Following one particularly bad episode, we end up back in hospital. We are given a private room, because Nora’s meltdowns are so upsetting to the other children on the ward.

For the third time, Nora is assessed by CAMHS, who tell us they can’t treat Nora while she’s being seen privately.

We have to make a choice. The psychiatrist’s secretary calls me and tells me Nora will get much better treatment under CAMHS. I take her advice and we end the private treatment.

Month five

We are now under the care of CAMHS. We now have a team of people looking after us. There are people I can phone at any time of the day and night. Mental health professionals visit us at home several times a week. We have a new psychiatrist and a brilliant counsellor.

Time and again, these professionals tell me they have never encountered a child with symptoms as severe as Nora’s. This is frightening, but also oddly reassuring because I know she is – indeed – very, very ill.

This month is Nora’s birthday. Her friends come to visit with presents. She can’t speak to them, but they all give her hugs and I’m glad they’ve come. They cry, because they haven’t seen her since she fell ill.

She is pale, gaunt and silent. She has lost so much weight, her friends look like giants beside her.

Month six

Nora’s CAMHS team tell me they are ‘flummoxed’ and simply don’t know how to treat her. If they cannot come up with a plan soon, the next step will be to admit her to a psychiatric unit. This is a specialised unit for teenagers with severe mental health problems. Typically, children in this unit are aged from fourteen to eighteen. Nora is twelve.

We are told Nora will have to be fed through a tube if we cannot get her to eat.

Month seven

We have a care plan! It’s pretty basic but it feels like a huge step forward. It involves Nora doing things like getting out of bed by herself, eating regularly, getting dressed and getting fresh air each day.

Nora doesn’t think she will be able to do any of these things. She locks herself in the bathroom and tries to cut her wrists. Luckily, with the help of a neighbour, I’m able to knock the door down before she cuts herself too badly.

Although this is awful, it’s also a turning point. Gradually, we see tiny signs of improvement. And then something wonderful happens. Nora starts speaking again. Whispers at first, just a few words every now and then.

But every single word is precious. Over the course of her illness, I’d forgotten what her voice sounded like; I would watch videos I’d recorded before she fell ill, simply so I could hear her speaking.

Today (one year since the beginning of Nora’s illness)

Nora is speaking, eating, exercising and engaging with life. She sees her friends. She goes to the gym and goes for long runs most days. She writes poetry, and takes acting classes. She is rehearsing for the lead role in a play.

We don’t know what the future will hold but, then again, none of us know that.

girls danding

Five things I’ve learned

lonely boyI’ve been slightly overwhelmed recently by the number of people I’ve met – online and in person – caring for someone with mental health problems.

These conversations have made me realise that I know quite a bit more about anxiety and depression than I did nine months ago, when Nora first became ill.

So, today’s blog looks at five important things I’ve learned about supporting a child with anxiety or depression.

Don’t wait to get help

This may seem obvious, but it’s not always. As parents, our first instinct  is to protect our children. We don’t want them to be ill.

Sometimes, when they start self-harming, stop eating or tell you they want to die, we don’t take this seriously. We tell them to stop self-harming. We sanction them for not eating properly. We tell them they don’t really want to die.

We try to address the problem with logic. But mental health problems aren’t logical.

Self-harming, suicidal thoughts, refusing to go to school, problems eating and sleeping… these are all signs your child needs help.

Educate yourself

This is important. No matter what support you’re getting from CAMHS or other mental health services, you – and you alone – will be the person spending most time with your sick child.

When Nora first fell ill, I believed I could ‘fix’ her through the sheer strength of my love and my determination that she would be well again. I approached her illness with the logical, problem-solving approach I use to tackle most of life’s problems.

Of course, unconditional love is hugely important. Your child needs to know you love them, no matter what. But they also need to know that you understand enough about their illness to help them get them through this dark and difficult time.

The more you learn about your child’s condition, the better placed you’ll be to give them the help they need.

If you’re unsure where to start, take a look at the website for mental health charity Young Minds. They have a wealth of resources, as well as a Parents Helpline you can call for help and advice.

You can also check out the resources section of this blog  for books and online material I’ve found most useful.

tabletsAnti-depressants aren’t always ‘a bad thing’

Nora has been taking Fluoxetine for six months now. She’ll need to continue taking the medication for a further six months, at least. Anti-depressants saved Nora’s life. We wouldn’t be where we are today without it.

I know that anti-depressants aren’t right for everyone. Finding the right medication, at the right dosage, takes time. And all the time you’re playing around with different levels and types of medication, you are acutely aware that you’re giving your child a drug that has horrific side effects.

In our case, persistence paid off. Once we got the medication right, Nora’s recovery was nothing short of miraculous.

Of course, medication alone isn’t enough. In Nora’s case, her recovery is down to a combination of medication, a counsellor who understands her complex issues, and a loving, supportive family.

If a psychiatrist prescribes anti-depressants for your child, that’s because they believe medication is your child’s best hope of recovery right now. You should listen to what the psychiatrist is telling you. It may be, that you try medication and find it doesn’t work. On the other hand, it might just save your child’s life.

Recovery takes time

Nora had been taking anti-depressants for about eight weeks before we saw the first early signs of improvement. At first, the changes were tiny. She started responding when I hugged her, putting her arms on mine for a moment before dropping them again. She started sleeping again. And then, one morning, a miracle happened – she got out of bed and came downstairs without anyone helping her.

Of course, the next morning – and others after that – she needed help again. But there were also many more mornings when she was able to do it alone. And since then, things have continued to improve.

But…

It’s taken nine months to get this far, and she’s still not ‘better’. She hasn’t gone back to school, she still has terrible meltdowns on a regular basis, and she struggles to do many of the day to day tasks she used to take for granted.

The key thing, however, is this: she’s getting better. Your child will too. Just don’t expect it to happen overnight.

It’s no one’s ‘fault’ your child is ill

We all know that mental illness can be triggered by traumatic events in a person’s life. But often people fall ill and there’s no obvious reason why.

If you’ve been a relatively okay parent, if your child’s life up to this point has been pretty uneventful, then the chances are this illness would have happened to them sooner or later.

It’s hard not to blame yourself when your child’s behaviour suddenly changes. Sometimes, it’s also hard not to blame your child.

The line between ‘bad behaviour’ and ‘behaviour caused by anxiety or depression’ is blurred, at best. How can parents know a child’s bad behaviour is deliberate and when it’s not? The simple answer is, we can’t.

But, we should remember this: when a child has anxiety or depression, they’re often unable to help the way they’re behaving.

It’s not your fault your child is ill. It’s not your fault their behaviour is worrying and disruptive. And it’s not their fault, either.

lonliness

 

 

My child is depressed – is it my fault?

tabletsAs the parent of a severely depressed child, I applaud the growing awareness of mental health problems in young people. Knowledge is power, after all. The more parents know about mental health problems, the better equipped we are to intervene early.

Understanding the causes and symptoms of mental illness could – potentially – help us prevent problems happening in the first place.

I say ‘potentially’ because, of course, sometimes children get ill no matter what we do.

In today’s world of never-ending parenting advice, this is a hard message to swallow. We are constantly being bombarded with information on how to raise healthy, happy, well-adjusted children. There are books, websites, radio and TV programmes devoted to this topic.

Everyone has an opinion

Everyone from politicians and celebrities to members of the Royal Family has an opinion on the state of young people’s mental health, the reasons for the increase in mental illnesses amongst children and adolescents, and the measures that can be taken to prevent this.

Researching this article, I did an internet search for ‘How to prevent childhood depression’. This yielded 121,000,000 results. I’ve looked through the top 5 results and you know what? There’s nothing that tells me how I could have stopped my daughter being diagnosed with severe depression.

Yes, there’s a lot of information on ‘signs to watch out for’. And yes, this is helpful; in the early days of Nora’s illness I found this sort of thing very helpful indeed.

But when I read the tips for ‘preventing’ childhood depression, without wanting to come across all defensive, I’m pretty sure we were already doing all the right things.

The top 2 websites on my internet search both inform me that ‘childhood depression can be prevented’. I’m sure, in some cases, that’s true.

But sometimes people get sick; no matter how desperately we try to stop that happening.

According to all the websites I checked out, the things you should do to ‘prevent’ your child from getting depressed are the things most sensible parents try to do anyway:

  • Minimise conflict in the home
  • Have a good relationship with your child
  • Be open and encourage your child to talk openly about their feelings
  • Help your child set realistic goals
  • Foster independence
  • Etc

Now, all of this is very good advice. I’m not for one moment suggesting we shouldn’t all try to be the best parents we can be.

I’m very aware of the damaging effects on children when they are raised in environments that are not conducive to their mental health and general wellbeing. Children need to feel loved. They need to feel that home is a safe place, where they can be themselves and talk about any problems or worries they have.

But ‘good parenting’ lists and ‘how to stop your child getting depressed’ lists haven’t helped me understand why my daughter became severely depressed. They certainly haven’t helped me identify how I could have prevented this happening.

So what could I have done?

The logical part of me knows I probably couldn’t have prevented Nora’s illness; that, sometimes, bad things just happen. But the emotional parent in me can’t help picking away at what happened, looking for reasons to blame myself.

I think about Nora’s rapid descent from a happy, confident, well-adjusted child to the very ill person she is today, and I know I made mistakes.

Of course, I got some things right. Mostly, the stuff that’s already on those ‘good parenting’ and ‘how to prevent your child getting depressed’ lists.

If you’re reading this, chances are – like me – you’re worrying about other stuff; the stuff that doesn’t appear on any generic list and is specific to your child, and your situation.

So, for you, here are  the top 3 mistakes I made during the early days of my daughter’s illness. I’m not saying you’ll make the same mistakes. I’m certainly not saying that if you avoid these mistakes, your child won’t get sick.

I’m sharing this because reading other parents’ experiences has helped me enormously. I’d like to be able to do the same.

Mistakes I made

The wrong counsellor

guiltyNora’s early symptoms were extreme anxiety. This manifested itself in severe meltdowns, panic attacks, problems sleeping and strong resistance to going to school.

A few years earlier, Nora had suffered mild anxiety, which was treated with a course of CBT counselling. After 6 sessions, the anxiety was under control and life continued as normal.

As soon as I realised the anxiety was starting up again, I took Nora to her GP, who referred her for more counselling.

The counsellor we’d had before wasn’t available this time. At first, I didn’t think this was a problem. I was wrong.

There was a complete disconnect between the counsellor and my child. She never ‘got’ Nora, or really understand the causes of Nora’s anxiety. She seemed completely unaware that, week by week, my daughter’s illness was getting worse.

Most worryingly of all, Nora’s counsellor seemed to forget things Nora had told her in earlier sessions.

In their first session together, Nora and her counsellor spoke at length about Nora’s self-harming. Midway through our fourth session, misunderstanding something Nora told her, the counsellor looked at me, smiled and said: ‘So she’s never self-harmed, then. That’s good.’

We never went back.

Looking back, I had concerns from the outset. I decided to put those to one side and give the counsellor a chance to do her job. This was a mistake.

Those sessions did huge harm. Nora went from having complete faith in mental health professionals to believing no one could help her.

The wrong decision about school

Nora’s anxiety began soon after she started secondary school. We (her father and I) knew school was the trigger but it was difficult to pinpoint exactly what the problem was. She wasn’t being bullied (she was adamant on this point and conversations with the school backed this up) and all evidence seemed to indicate that Nora was, in fact, very popular.

Yes, she worried about shifting friendships and arguments within her peer group, but all of this seemed manageable. We knew friendship problems were causing Nora to worry, but we didn’t think the issue was bad enough for her to skip school.

This view was backed up by the counsellor, who was adamant Nora should continue going to school. It was an awful time. Nora was extremely upset each morning but we persisted in sending her in, telling ourselves the counsellor knew best.

Eventually, it was the school who decided Nora should stop going in. They said they could see how upsetting it was for her, and they didn’t believe it was doing her any good.

It was such a relief to stop forcing her to go in each morning. But I shouldn’t have let things get that far in the first place.

The wrong response to suicidal thoughts

Nora was eleven years’ old the first time she told me she wanted to die. By then, she had been ill for about two months. At this point in her illness, we had a diagnosis of anxiety with obsessive thoughts. I knew Nora was ill, but I really had no idea how ill she was.

When she told me that she wanted to die, I thought she was exaggerating. I told her ‘not to think like that’. I didn’t realise she meant it, or that telling me this was a symptom of how ill she really was.

It simply never occurred to me that someone so young could harbour serious thoughts of suicide. I didn’t take it seriously. I was wrong.

lonlinessYou’re not alone

I have no idea how things might have turned out for Nora if I’d made different choices early in her illness. Maybe she wouldn’t have got as sick as she eventually did. Or maybe it would have happened anyway. I really don’t know.

I do know that parents make mistakes all the time. But the mistakes that involve your child’s health and wellbeing are hard to live with.

I hope that other parents of sick children will read this and know they are not alone.