Anti-depressants and Brexit

brexitThis post isn’t really about Brexit. I only mentioned Brexit because I was recently interviewed on Radio 4’s PM programme by Evan Davis. The interview was sandwiched either side of the ongoing debate around Brexit. In fact, there’s so much about Brexit in the news right now, I’m surprised PM managed to fit me in at all!

So, how did I end up on Radio 4? Well, over the last few weeks, the PM programme has been looking at anti-depressants, specifically around the difficulties some people face when they stop taking this medication.

As I’ve said previously, I believe anti-depressants were key to Nora’s recovery. I don’t know how she could have come out of that dark and empty place without medication.

Before Nora fell ill, I believed – like almost every parent I’ve ever spoken to on this subject – that medicating a child with anti-depressants is ‘a very bad thing to do’. I had no scientific evidence to back up this opinion. My views were based purely on what I’d read and heard in the mainstream media.

I was wrong. And I wanted to join the ongoing debate on PM to share our (largely positive) experiences with anti-depressants.

medicationI wasn’t trying to say that prescribing anti-depressants to children is always the right thing to do. I know that too many children are being prescribed anti-depressants in the UK today. I also know that this is happening because of the shocking lack of resources available to treat children with mental health problems.

In an ideal world, every child with a debilitating mental health problem would be referred to CAMHS, where they would be assessed and get the treatment they need. This isn’t happening, because CAMHS are woefully under-funded and under-resourced.

GPs are having to fill a gap they’re simply not equipped to fill. They are being forced to make shortcuts and prescribe medication in the absence of more suitable forms of treatment. This is a dire situation that will only change when the government start to properly address the lack of funding and resources for children’s mental health.

But…despite the fact that too many children are being prescribed anti-depressants, sometimes medication is the right thing to do. It was right thing for Nora, and it’s the right thing for thousands of other children too.

Nora’s psychiatrist called me this morning, after hearing PM last night. She told me she never prescribes anti-depressants unless she’s absolutely certain it’s the right thing to do. She said she felt ‘humbled’ and ’emotional’ hearing me talk. And she said that treating children like Nora, and being part of their recovery, is what makes her job worthwhile.

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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.

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Make a real difference this Christmas

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Photo by Gratisography on Pexels.com

Four months ago today, I wrote the Nora’s story page of this site.

Re-reading this now, it seems extraordinary to think how ill Nora was, and how rapidly she is recovering.

Four months ago, my beautiful daughter was in the grip of a crippling depression. She had stopped speaking (she was completely mute for several months), she was unable to get out of bed or get dressed without help, and she had lost so much weight we thought she’d have to be fed through a tube.

Nora’s anguish was so unbearable she didn’t want to continue living. More than once, she was admitted to hospital after serious suicide attempts.

It was a terrible time for our family but, even during the worst of it, we never stopped believing Nora would get better.

Four months on, and Nora’s recovery has been nothing short of miraculous. She is no longer suicidal or self-harming. The symptoms of her psycho-motor retardation are gone. She is speaking again, having fun and engaging with life.

Since I started this blog, I’ve met so many parents taking care of children with mental health problems. Parents, like me, who are struggling to deal with the challenges of supporting a child with a mental illness. Parents who desperately need help that simply isn’t available.

It’s no secret that the lack of resourcing and funding for children’s mental health in the UK is disgraceful. This is something I’ve blogged about previously, and it’s a topic I’m sure I’ll come back to again.

The problem isn’t just with children’s mental health, either. One in four people in the UK are reportedly suffering from some form of mental illness. Yet, all too often, these people are not getting the help they need.

It’s left to mental health charities to fill the gaps in mental health provision. Yet these charities, too, are stretched to their limits.

That’s why I am asking all readers of this blog to support this year’s Telegraph Christmas Charity appeal, which is raising much-needed funds for three mental health charities:

  • Changing Faces – which provides advice and support for people with a visible difference through counselling, networks and skin camouflage services.
  • Young Minds – a charity that offers a vital lifeline to thousands of parents and carers to prevent young people from coming to harm.
  • The Fire Fighters charity – which offers psychological support to firefighters in the wake of major incidents.

You may not have suffered mental health problems yourself, but I guarantee you know someone who has. Mental health charities offer an essential service to families and individuals who desperately need help.

Please help these charities to carry on doing the great work they do.

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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

 

 

Mental health and education

Rant alert: if you’d rather not listen to me having a good old rant, stop reading now.

classroomWhen your child is too ill to go to school, your local authority is obliged to offer you alternative access to education. In Nora’s case, she gets ten hours of online learning each week, and two one-to-one hour-long sessions with a tutor .

Ten hours of online learning probably doesn’t sound like a lot, but it’s a challenge for Nora. She is severely dyslexic so trying to concentrate on a screen-based lesson for two consecutive hours is exhausting. And she is still recovering from a debilitating illness, which means she gets tired very easily.

The pressure of having to log on for two hours a day has added to her general anxiety. Clearly, this isn’t ideal. Her CAMHS counsellor has told us that putting too much pressure on Nora at this stage could be detrimental to her recovery.

So, I contacted the learning provider. Our conversation went like this:

Learning Provider (LP): She really should try to log on to every class.

Me: Well, CAMHS have strongly advised this isn’t a good idea and I need to ease her back into learning slowly.

LP (slightly dismissive): Oh, CAMHS always say that.

Me: Really? Why?

LP: They only care about the child’s mental health.

Me: Um…

That was yesterday. I’m still speechless. Surely Nora’s mental health is all that matters?

To add insult to injury, I’ve since found out that Nora’s usual English class has been cancelled for the next two weeks and she will have to join an older class. I only realised this when we tried to access her usual class and it wasn’t available. When I questioned why this was, the provider told me that Nora’s English teacher is on jury service so Nora’s class will have to join an older class for the next two weeks.

This morning, I emailed the provider to ask how it will benefit Nora to spend two weeks in a class designed for older students, discussing a book she’s never read. So far, I haven’t had a reply.

The whole experience has left me pretty dispirited. It’s made me question whether the alternative support we’re getting is less about Nora’s education and more about ticking boxes.

Is the number of times Nora logs on to an online class – even one not aimed at her age or ability – really more important than her mental health? Apparently some people think it is.

End of rant.

tick box

When your child takes anti-depressants

tabletsThere’s a widely accepted belief among many parents that giving anti-depressants to a child is ‘a very bad thing’. Before Nora fell ill, I was one of ‘those’ parents.

I believed that the medical profession routinely over-prescribed anti-depressants to children who ‘didn’t really need them’. I believed this on the basis of no real evidence. I believed it because other parents believed it. I believed it because I read opinion pieces in broadsheet newspapers about the damaging effects of proscribing anti-depressants to young people.

I believed it because I was incredibly ignorant about mental health problems and the devastating effects they can have on young people and their families.

The purpose of this post isn’t to debate the pros and cons of giving anti-depressants to young people. I’ve had my fair share of negative reactions from other parents who ‘don’t think it’s wise’ for my child (yep, my child not theirs) to be taking drugs that can help her get better again. Quite frankly, I’m tired of trying to explain to people that if Nora wasn’t taking anti-depressants, she would very possibly be dead.

If you’re a parent wondering whether or not anti-depressants are the right choice for you child, I can’t help you make that choice. But I can tell you this: I absolutely believe that anti-depressants saved my daughter’s life.

This post is for parents who made the same choice we did.

Based my experiences with Nora, here are the five things I wish I’d known earlier. If I had, it would have saved me a whole lot of heartache and far too many hours searching the internet for answers.

They take time to work

When Nora was first prescribed anti-depressants we had unrealistic expectations of how quickly they would work. We watched her, day after day, for any signs of improvement. For the longest time, nothing changed.

It doesn’t help that it took time to get her dosage right (see below), but the waiting really was tough.

Nora’s been taking anti-depressants for five months now. During that time, her recovery has been remarkable. She’s still not ‘better’, but she is significantly different from the mute, withdrawn, suicidal child she was a few short months ago.

I know that her recovery isn’t only down to the anti-depressants, but they’ve certainly helped.

So, if you and your child are at the start of your journey with anti-depressants, hang on in there. It takes time, but the wait really is worth it.

You may not get the dosage right first time

Because mental health is so complicated, and children’s brains are still developing, finding the right level of the right kind of anti-depressant for a child can take time.

Nora is taking an SSRI (selective serotonin reuptake inhibitor) anti-depressant called Fluoxetine (commonly known as Prozac). We had to try the drug at three different levels before we saw any effects. Because the side effects are so horrible in kids, increasing the level of medication has to be done gradually.

Again, all of this takes time. Again, it’s worth hanging in if you can.

The side effects are horrible, but they pass quickly

One of the (very valid) reasons parents are reluctant to give anti-depressants to their children is because of the side effects. They are horrific.

Nora’s depression meant she was extremely suicidal and unable to eat. She tried to kill herself several times. She was self-harming. She lost so much weight we thought she might have be fed through a tube.

Two of the most common side effects of Fluoxetine in children are increased suicidal thoughts and nausea. If your child is already suicidal, and already struggling to eat enough food to survive, you really don’t want her taking something that’s going to make this worse.

Did we see any side effects? Yes. Nora threw up for several nights after she first started taking Fluoxetine. And she was extremely suicidal (although, if I’m honest, I couldn’t say whether this was because of the drugs or part of her general illness).

However, the side effects pass. In Nora’s case, they passed relatively quickly (I would say they had disappeared completely after three weeks).

They won’t ‘cure’ your child but they will help

I really wish I’d known this earlier. Somehow, I believed anti-depressants would miraculously ‘cure’ my daughter. I read other people’s experiences of taking anti-depressants. They spoke about waking one morning and feeling as if a cloud had lifted from them. I thought this was how it would be for Nora, but this wasn’t our experience.

Nora’s recovery was gradual. Day by day, we started to notice small improvements. Taken together, those improvements are dramatic. But they are still only part of her recovery.

The really key part from now on will be the work she does with her CAMHS counsellor, helping her to manage her feelings and build the resilience she needs to navigate her way through her teenage years.

When they start to work, it’s the best thing ever

This is why you have to hang in there when your child starts taking anti-depressants. For all the reasons listed above, it’s not easy. But it’s worth it.

My child was so very ill. She had stopped talking. She wanted to die. She had developed psycho-motor retardation, a condition that slows down your thought processes and body movements.

Today, she is engaged with the world again. She can fall asleep without needing me to be with her. She speaks and laughs and cracks jokes with her brother. She sees her friends. We go swimming in the sea. She is alive and embracing life.

All of this means more than anything. My girl is coming back to me.

We chose to give Nora anti-depressants, exactly as we would choose to give her life saving medication if she had cancer or any other illness. I am very glad we did.

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A mother’s love

I have just watched this deeply moving video and wanted to share it. This poor woman expresses the deep sadness and feelings of helplessness a parent feels when their child tells them they want to die.

Please watch this BBC video and share widely. Click here to see it.

Shelagh

 

Tips for parenting a depressed child

background conceptual contemporary creativity
Photo by Public Domain Pictures on Pexels.com

I have never suffered from depression, or lived with someone who has. So, when Nora first fell ill, I wasn’t equipped to help her. I did my best, but I made a lot of mistakes along the way.

Over the last six months, I’ve learned a huge amount about mental illness in general, and depression in particular. Through trial and error, I have gained some understanding of the practical ways a parent can support a child who is suffering from depression.

Here are my top five tips for parenting a depressed child. I hope they help.

Stay calm

Supporting your depressed child is exhausting, time consuming and deeply distressing. When Nora first fell ill, I stupidly thought it might help if she knew how upset I was. As if this might, somehow, reverse the course of her illness and bring back the happy, confident girl she used to be.

I realise now how ridiculous this was. Depression isn’t something its sufferers can ‘control.’ It’s a real illness, that leaves you feeling empty, terrified and utterly helpless.

More than anything, a depressed child needs to feel safe and loved. They will not feel safe if you’re crying and falling apart. This will make them even more scared than they already are. They will not feel loved if that love comes with ‘conditions’ (ie, that your love is somehow connected to them ‘not being sick’).

Don’t be afraid to talk about suicide

I’ve already blogged about this. Talking openly about with your child about suicide is a terrifying prospect. Like many parents, I worried that doing so might ‘put thoughts’ into my child’s head.

This is a fallacy.

If your child is depressed and self-harming, then there is a very strong likelihood your child has – at one stage or another – also had suicidal thoughts. These thoughts will be extremely frightening for your child. They may feel they cannot speak to you about them for fear of upsetting you.

It will be a huge relief if they know they can talk openly with you about suicidal thoughts. So, don’t be afraid to ask your child this very simple question: ‘Have you had any suicidal thoughts?’

If they say no, leave if for now but keep a close eye on them. If they remain depressed and are still self-harming, ask them the same question again in a few days’ time.

You can tell them it’s very common for depressed people to have suicidal thoughts. You can tell them it might help them to talk about this. Let them know it’s okay for them to talk to you about what they are thinking. Let them know you want to understand how they’re feeling and what you can do to help.

Most importantly of all, remember this: In the UK, suicide accounts for 14% of deaths in 10 – 19 year olds. Young people can – and do – kill themselves.

The more you understand about what your child is thinking, the better able you are to keep them safe.

familyDon’t try to do this alone

As parents, we want to do everything we can to keep our children safe. We believe no one in the world is better placed than us to do this. Most of the time, we’re right to think this. But not when our child has a serious illness.

If your child has mental health issues, you need help. You need professional help from your doctor and mental health experts. And you need all the support you can get from friends and family.

There is no shame in admitting you cannot do this by yourself. You can’t, and the sooner you accept that, the sooner you’ll be able to give your child the support they need.

The first thing you need to do is make an appointment with your family doctor. Tell your doctor your child is ill and needs help. Insist on a CAMHS referral.

Due to woefully inadequate funding of children and adolescent mental health services, you may or may not get seen by CAMHS. If CAMHS are unable to see you, don’t give up hope.

Take your child directly to the emergency unit of your local hospital. Tell the people there that you are worried about your child’s safety. Tell them you do not want to take your child home without a psychiatric assessment. Be as pushy as you have to be to get the help your child needs.

At the same time as you are pushing for medical help, don’t be afraid to reach out to friends and family. Taking care of a child with a mental illness is a very lonely experience. Most of your friends and family will have very little knowledge of mental health issues. But if your friends and family are anything like mine, that doesn’t matter.

They may not understand what you’re going through – and that’s really okay because how could they? – but they will be there for you. Tell them what’s happening. Explain your child’s illness to them. Ask for help. Keep asking for help. Your friends and family will want to help. So let them.

Trust the mental health experts

In an earlier blog, I spoke about the doctor we met who ‘didn’t believe’ in mental illness. I’ve also blogged about our negative experience with one CBT counsellor. These bad experiences are the exception. Almost every other medical professional we’ve met has been amazing.

Your child’s psychiatrist, mental health nurse and counsellor have all spent years studying young people’s mental health. While you are the person with expert knowledge about your child, they are the people with expert knowledge about your child’s illness.

It’s important you listen to their advice, particularly when it comes to choosing the right course of treatment for your child.

Remain hopeful

During the worst of my daughter’s illness, I never let go of the belief that she would get better. It was the single thing that kept me going. I was right to be hopeful.

Slowly, after six of the most harrowing months of my entire life, Nora is showing signs of recovery.  She has started speaking again, she can eat enough food to stop her losing any more weight. Most importantly of all, she has started to engage with life again. She still isn’t ‘better’ but she is definitely ‘getting better’.

Your child will get better too. Never let yourself stop believing this.

There will be days – many days – when you feel as if you cannot bear what is happening to your child. You can bear it. You must bear it. Now, more than any other time in your child’s life, they need you to be strong.

One of the things that helped me enormously was reading Matt Haig’s blog Reasons to stay alive.

For months I read this every day. I read it to myself, and I read it to Nora.

If you are feeling hopeless right now, I urge you to read it too.

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Ignorance is no excuse

hospitalIf 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.

doctorWhen 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.

However…

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.

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Photo by Public Domain Pictures on Pexels.com

Let’s talk about…suicide

lonely boyMy daughter was eleven years’ old the first time she told me she wanted to die. As she likes to remind me, I didn’t take her seriously.

‘Don’t think like that,’ I said.

By then, I already knew Nora was ill. Her extreme anxiety meant she was barely attending school any longer. I assumed her anxiety was school-related. When she wasn’t in school, Nora seemed okay. She was able to carry on with her out of school activities and seemed happy being with her friends. She was still engaged with life.

When she told me she wanted to die, I didn’t believe for one second that she meant it. Also, she was eleven. It simply never occurred to me that an eleven-year-old child might have suicidal thoughts.

I was wrong.

The last six months have been a journey of discovery about mental illness in general, and childhood depression in particular. I have read harrowing stories of childhood suicides. I have watched my own daughter try to kill herself more than once.

Too frequently, when children talk of suicide it’s seen as ‘a cry for help’. I’m sure it often is. Sometimes, however, when a child says they want to kill themselves they mean exactly that. Their existence at this time is so horrific all they can think of is ending it.

Suicide is the leading cause of death in young people in the UK. It accounts for 14% of deaths in 10 – 19-year olds.  Over half of children who commit suicide have a history of self-harm.

I’m not saying if your child is self-harming they are also considering suicide. I’m saying it’s a possibility. My daughter was eleven the first time she self-harmed. She was still eleven the first time she tried to kill herself.

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If you’re reading this, the chances are you’re a parent who’s worried about your child. Maybe your child is self-harming and you’re scared about what else they might do. Or perhaps your child has already expressed suicidal thoughts and you’re still reeling from the shock.

Whatever your personal circumstances, I started this blog to help other parents. So, for you, here are some things I’ve learned about what to do – and not do – when your child tells you they want to die.

Don’t think they’re too young

I genuinely had no idea children as young as eleven would consider killing themselves. It may not be common for eleven-year-olds to commit suicide, but it certainly happens. Between 2005 and 2014, 98 children aged between 10 and 14 killed themselves in the UK.

The support group Healing Untold Grief (HUGG) was set up by the parents of an eleven-year-old girl who killed herself.

If your child starts talking to you about suicide, listen. Never think, ‘oh you’re far too young to think like that.’

Don’t think ‘not my child’

Until Nora got sick, I lived in this bubble where I believed ‘bad things happened to other people’s children’.

Yes, I’d heard tragic stories of children who’d killed themselves. I simply didn’t believe that one of my own children might ever contemplate such a terrible, desperate act.

Don’t promise to keep secrets you can’t keep

Your child will be deeply ashamed and traumatised about their suicidal thoughts. When they finally work up the courage to tell you what they’re thinking, they may ask you not to tell anyone else.

This isn’t a promise you can keep, so don’t make it in the first place. Trust is important in any parent-child relationship. It’s crucial when you’re trying to support your child with their mental illness.

If you make a promise you can’t keep (and you cannot keep this a secret; you must get professional help), you’ll break that trust. If that happens, you won’t be able to help your child.

Do remain calm

This is difficult. When you realise your child has suicidal thoughts, you will feel shocked, upset and overwhelmed.

So, let me say this: suicidal thoughts are not the end of the world.

There are different ways of finding out your child has suicidal thoughts. They may tell you they want to die. You may know nothing about it until they actually try to kill themselves. I didn’t realise how suicidal Nora really was until she tried to cut her wrists.

I didn’t react well. I panicked, I got upset, I thought my world as I knew it had come crumbling down.

You know what? My world is still here. Nora is still here. And now, thanks to my increased awareness of her illness, we are able to talk openly about her suicidal thoughts and feelings.

I am able to remain calm when she tells me she is ‘feeling very suicidal today’. I know when she tells me this, she needs a hug. More than anything, she needs to feel safe. The best way I can let her know she is safe is by remaining calm and simply being there for her.

It’s not easy. None of this is easy. But knowing the right way to respond, and knowing that is helping your child, can be an enormous comfort.

Do discuss it openly

Yes, this is hard too. Heartbreakingly difficult, in fact. But you don’t really have a choice. Your child is suicidal. You need to understand what this means, and – crucially – what you can do to keep them safe.

You need to ask them questions. Lots of questions. This really is okay. I was scared – very scared – that asking questions would ‘put ideas into her head’. Nah. Those ideas are already there.

So, try to find out what methods your child is considering, and also if they’ve thought about when they might do something. Are they planning to cut their wrists or throw themselves in front of a train or try to hang themselves? Have they decided on a particular date (Christmas, Easter, birthday, new school term)?

I know this is deeply upsetting. But remember, knowledge is power. If you know what your child is thinking, you can do so much to prevent them going through with it. You can lock up knives and other sharp objects. You can hide prescription drugs. You can take away dressing gown cords and belts. You can lock upstairs windows.

Crucially, you will understand the moments when your child is most likely to try something. You will know the moments in the day (or week or month) when you need to be at your most vigilant.

I know you might do all these things and they may not be enough. But your actions might keep your child safe if – in that moment when everything gets too much – they are unable to hurt themselves because you’ve put measures in place to stop this happening.

handDo get help

If your child has suicidal thoughts, they need help. Your family needs help. Please do not make the mistake of thinking you can do this alone.

Make an emergency appointment with your GP. Insist on a CAMHS referral. If your GP can’t arrange this, or the waiting list for CAMHS is too long, take your child to the emergency unit at your local hospital. Insist on getting your child assessed by a mental health expert. Tell every doctor, nurse and mental health professional you speak to that you are worried about your child’s safety. Ask to be kept in overnight if you are worried you won’t be able to keep your child safe at home.

If you are at home and you think your child is in danger, dial 999 right away. Do not wait.

Most of all, when you are going through the worst of times, know that they will pass. Your child will get better. You will both wake up one day soon and this dreadful black cloud that has fallen over your life will have cleared.

In the meantime, dear parent, stay strong for your precious child.

I am not a mental health professional. This blog  is based on my own experiences as the mother of a severely depressed child. Reading it is no substitute for seeking professional help. If you are worried your child is having suicidal thoughts, you need to get help right away.