I hear that all the time. There is no simple answer. But answering it is the focus of my daily life. Every day. The real answer is Gabriel’s not OK. Gabriel is Bipolar. His moods shift. Daily. Weekly. Yearly. He is never OK. I spend my days like a detective trying to sniff out any small clue of a mood change, charting, taking notes, observing him. Worrying about him.
He spent 10 months of the last 12 (literally, not figuratively) suicidal, dangerous, aggressive, and explosive. His meds are controlling that a little, but he is manic right now. Which is dangerous in other ways. And his meds aren’t holding that in. They aren’t ‘stabilizing’ him like they are supposed to. And without going into a tirade about doctors, I don’t have a ‘handle’ on this the way I PROMISED myself I would last October. And last May. And last July. You get the point.
The fact that mania seeps out now means that Gabriel is hyper (he isn’t normally at all), he is giddy, inappropriate (laughing, jokes, rude comments, butt jokes, pulling his pants down in front of a friend during a play date, etc), and more likely to jump off the roof (or trick his brothers into doing it) than anything else. Which is, in some ways, better than the dangerous depressive side. However, as October comes to a close, so will the mania, and the bipolar depression will replace my giddy-inappropriate child with one who hates the world. Who hates me. Who hates his brothers. One who is so negative and dangerous that he threatens to take knives to school and kill people. That kid is hard to live with. That kid is hard to keep safe. That kid threatens my sanity and the safety of my other two children.
We have to put him on another medication. A stronger medication. And although our ‘nurse practitioner’ is willing to give him a new medicine now, (they want to put him on Lamictal), my next appointment with his actual doctor, a real psychiatrist, isn’t until November 24.
Yes, the day before Thanksgiving.
Why wait? Because Lamictal has a 1 in 1000 chance of a deadly side effect. A deadly rash that may just start itself in the depth of my son’s mouth where I am less likely to see it. Less likely to be able to get him the immediate medical attention required. That scares me.
And scares my husband. So much so, that he refuses to give our son this drug until we see our psychiatrist. Who we can see the day before Thanksgiving.
So, I will bake pies early this year. And spend the that glorious Wednesday afternoon admiring the artwork on the walls of Children’s Hospital, nervously wondering if I will be rushing Gabriel to the ER with a rash on Thanksgiving day, and trying to hold down all those bites of pie I shoved in my throat in the anticipation of this moment where we are forced to make, yet another, hard decision about our son’s care.
But I have no choice. So we wait.
But the cycling won’t wait.
Depression is nipping at his heels and I am not sure we can out run it.
We left home for the ER around 7:45 Tuesday evening. I packed a bag for Princess- a few changes of clothes (no drawstrings, hoods, scarves, belts or jewelry), a few books, some toiletries (not her hair pick, no bar soap). I brought my knitting and a magazine to read.
By now I know the answers the nurses and doctors need to hear. I rattled off the history of the previous visits and hospitalizations. I identified her current and previous medications, by name, dosage and treatment schedule. The terminology is almost second nature now- she is not in active crisis, but is unable to ensure that she is fully capable of maintaining her own safety at home.
The bipolar tendencies were first diagnosed in September, and her brother’s mood disorder (the ever popular “NOS,” which in layman’s terms means “your kid’s brand of crazy doesn’t fit the current DSM definition”) was diagnosed about 20 months ago. There is no diagnosed history from parents or previous generations.
Note that I don’t say there is no mental illness in the parents or previous generations; I firmly believe that there has to be something on both sides that we just don’t have on paper. I can’t accept that I ended up with two children with such significant mood disorders just by the luck of the draw.
The transport to the psychiatric hospital came at 7:30 on Wednesday. We were ready to leave. 24 hours of hospital food and sleeping on a the chair that pulls out to a cot took its toll. I survived the 35 minute drive, as I followed the ambulance, without significant incident. The blowout I got during that same drive in September remained in the back of my mind. We got her checked in without any snags. A couple of the nurses recognized her name when the paperwork was handed to them. They checked her bag, noting that everything was acceptable (I learn from experience). She hugged me goodbye and asked if I was coming to visit every day. I promised that we would try to visit, and would call if we could not be there in person.
No one cried.
I feel numb and empty.
The experts tell me what to do, I do those things, and yet we are not able to help her. I have come to believe that she needs a specialized school situation, one which provides the cognitive behavioral therapy that she needs to combat the irrational thoughts before they become emotional actions. The medication is not enough.
But the specialized school will require many, many hoops to be jumped through. I am in the process of the educational evaluation that has the potential to put her in this type of school without me needing to go bankrupt. But I am scared to admit to my husband or my parents or my friends or the current school that the special school is what I really want for Princess. They fear a stigma, or an inability to re-assimilate to the life we’d planned for her (e.g., attendance at the private school at which her dad is the band director). I fear that the adjustment to a new group of students and a new school will be more anxiety-provoking than returning to her current situation, although she reverts to the harmful behaviors when she is back at school for more than a few weeks.
The more I research and the more I learn, the less I really know about any of this.