In the US military, the Purple Heart medal is awarded to a soldier who is wounded in battle, or who later dies of those wounds.
In the years of writing this blog, I have shared practical information on behavior and treatment, and offered encouragement and hope for parents. But hope and information cannot soften the impact of this horrible statistic: The mortality rates of teens with mental disorders are 3 to 4 times more deadly than most childhood cancers, and the statistics only measure those deaths by suicide: Mental illness more deadly than cancer for teens, young adults.
Death by suicide seems especially tragic because it appears to be a choice, and while we tell ourselves that mental illness is the cause, it’s not the same as a car accident being the cause or a tumor being the cause. Unsuccessful suicide attempts are no less traumatic, like a cancer that keeps returning, because you can’t come to terms with a “maybe.” A parent is held hostage by the anticipation of loss, a relentless moment-by-moment fear that your child will attempt again in the future until they are successful. It’s an emotional ride one’s subconscious never ever forgets, and it becomes your PTSD. You can carry it quietly with you for decades, until a sneak attack, when you find yourself overreacting to a news story, a scene in a movie, or a conversation with a friend.
My PTSD ambushed me recently. I was attending an evening class when suddenly a person next to me slammed down her cell phone, exclaimed “Oh my God!” and quickly grabbed up her things and dashed out. I followed to check on her and see if I could help with something. As she speed-walked to her car, she said her daughter had texted that she swallowed a poison because she was upset, but is now sorry and wants help. I got back to the classroom in shock, trembling, and completely unable to focus. It had been many years since I had received a similar message, but it felt like it had just happened again that moment.
You are not alone if you’ve ever secretly felt it would be a relief if your child ended their life, bringing peace to you both. (And you wouldn’t be a bad parent, either)
But death is more than self-inflicted suicide. You face a death of hope when child with a serious mental disorder that takes a long slow trajectory through addictions, high risk behaviors, and unstable reactions to life’s many insults. Families like ours bear witness but can’t intervene, or interventions don’t work. All we can do is wait and hope and do what we can for our child, day by day, and banish thoughts of a different future. I consoled myself with the knowledge that my child was getting by, and getting by was enough.
Another type of death caregivers face is the loss of their child’s “self” as they knew it, and their future as they imagined it. A mentally ill child or teen can morph from a fresh young person in a world that is wide open to them, to a scary being we don’t recognize as our own and cannot understand–a stranger, a changeling, a flame snuffed out too soon. It should not be this way. It is unfair. It is a tragedy. You start healing the grief when you are able to make the commitment to do the best you can anyway. YOU HAVE EARNED YOUR PURPLE HEART.
Any serious medical condition can devastate and traumatize a child’s family, but those with mental disorders impose a complicated trauma that’s hardly possible to resolve. The following stories are actual examples. Ask yourself: how does one be a loving responsible parent in these situations?
– When her daughter attempted suicide, an overwhelmed single mother discovered that her son had been sexually abusing and cutting her for 3 years, right under her nose. The guilt she felt was quadrupled by the guilt laid on her by others. She didn’t know how to go forward as a mother from here, after loving but failing both children.
– A teen girl attempted to hang herself in a very public place, and many found out about it before her parents. Their first trauma was the call from the emergency room, their second was from the shower of doubt others laid on them: Where were you? Why didn’t you help her before it got this far? What did you do to drive her to this? And it was unending. The daughter threw these doubts back at her parents repeatedly. There were several inappropriate people in the community who wanted to “rescue” the daughter, including a teacher, but undermined the parents’ authority completely, and their ability to get treatment for the girl.
– One couple devoted themselves to raising a difficult boy they adopted when he was 2. At 9, after years of problems, he sexually assaulted a playmate, and they found themselves disgusted and repulsed. The brokenhearted mother said she had long ago accepted that her boy would never be normal, but this was different. She didn’t want him anymore. (I’ve heard parents talk half-jokingly about taking their offspring to Nebraska. *)
You are not alone if you’ve ever secretly wanted your child to be taken away to never live with you again. You are not alone if you feel you’re DONE. (And you would not be a bad parent for thinking this.)
Consciously keep the good things alive. Display photos of the real child you know or knew, the one without the brain problems. Keep their writing or artwork or tests scored A+. Other parents experiencing a loss do this, whether the losses are from death by disease, or death of self due to brain damage from an accident. Speak often of the good things they were or are, as any proud parent might, keep the memories alive.
Get out of your trance and take yourself back to here and now. When you notice yourself caught up in a train of thought and obsessing on your fear or paranoia, get back in the room—get back to driving that car or attending that meeting or straightening the house. Get back to noticing the people you love, get back to making those helpful plans. Central to the philosophy of dialectical behavioral therapy (DBT) is the concept of “Mindfulness.”
Remember this wisdom: take one day at a time. You can handle one day, you can keep cool, do what must be done, feel accomplishment, in one day. Don’t think farther ahead. Since you are the linchpin, the one holding up the world, you probably don’t have the luxury of taking a break, and may have to hold things together until there is time for your own healing. The one-day-at-a-time approach is imperative.
When you’re leg is broken, you need a crutch. When you’re heart and mind are broken, use the “crutch” of a medication for depression, anxiety, or sleep. Do other healing things for yourself, whether exercise or therapy or asking for comfort from friends. Acknowledge your wounds and admit this is too much handle. You have earned your scars from bravery, so wear them as the badges of a hero.
A tragic event does not mean a tragic life. I know a mother whose son completed suicide as a young adult in his 20’s. She seemed remarkably cheerful and at peace with this. She spoke lovingly of him often, and her email address comprised his birth date. She continually did her grief work, was active in a suicide bereavement group, and often offered to visit with families facing such a loss.
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* In the United States, in 2008, the state of Nebraska enacted a “Safe Haven” law to reduce the tragedy of infant child abuse and neglect. The law allowed anyone to anonymously leave a child at a hospital with the promise that child would be cared for. But something unexpected happened. Parents from around the nation drove hundreds and hundreds of miles to leave their troubled older children instead. Nebraskans eventually amended the law with strict age limits for infants only.