On April 23, a week prior to the start of Mental Health Awareness Month, the New York Times published the article, “‘It’s Life or Death’: The Mental Health Crisis Among U.S. Teens.” I imagine that parents must be terrified. I’m not a parent, but I was that child who terrified her parents with the severity of her mental illness. I was that child whose psychiatrist took my parents aside and told them not to hope for much, that my prognosis was poor.
I starved myself, cut myself, and attempted suicide four times. After my second suicide attempt in 1990 (I kept my first attempt a secret), I was diagnosed with borderline personality disorder (BPD). I then spent 10 months on a long-term unit specifically for patients diagnosed with BPD being treated with intensive DBT (dialectical behavior therapy). After my mother passed away in 2002, her best friend told me that she lived in terror that I would make another attempt and succeed. Her cigarette smoking increased to four packs a day. She smoked Larks in the dark red package with white lettering, lighting one cigarette from the end of the other. Her chain-smoking contributed to her early death at 67 from pancreatic cancer.
Mom was a workaholic, having started her own custom software development firm in the 1980s. Before my brother and I were born, she worked as a programmer on the Univac (UNIVersal Automatic Computer) and then gave up programming to raise us. After she and my father divorced during my senior year in college, she updated her skills and founded what turned out to be a successful company. The intricacies of programming represented one of her defenses against her fear and the severity of my illness.
The author with her mother.
Source: © David Rosenhaft
I did not know until after her death that my mother had been bulimic since she was 15. I remember her as overweight most of the time, interspersed with periods of extreme thinness. She lost all her teeth when she was 35. I was diagnosed with anorexia in my twenties. I lost all my teeth in my fifties, not from purging, but from bone loss due to severe malnutrition. We now know eating disorders have a genetic component.
In the early 1990s, I was on an inpatient eating disorder unit being fed through a nasogastric tube running up my nose down into my stomach. I had not told my mother and she made a surprise visit to see me one evening. She looked me up and down. “Nice,” was her only comment.
I learned—again, after her death, from my aunt—that she went home that night and mixed wine and Klonopin (which I had given her). Her boyfriend had to take her to the emergency room. Whether it was a suicide attempt remains unknown, but she was discharged the same evening.
I can only imagine the myriad of feelings that flooded her mind as she saw me, with a tube up my nose, liquid nutrition pouring into my skeletal frame. She must have rightly assumed I’d refused to eat. Anger, frustration, guilt, helplessness, love, overwhelm, hopelessness, and more rushing through her brain. My mother never yelled, she never made a scene. I can’t recall her being sarcastic before that night.
Sarcasm was my father’s specialty. He coped with my illness by retreating into a depression he had been medicating with Johnnie Walker Red for decades. When he was inebriated, he lashed out with his intelligence that fueled cruel barbs. He sobered up when I was 13, and having lost his job, disappeared into his bedroom and became a recluse. Once my parents divorced, my mother moved up to Connecticut (we grew up in Queens, NY) and he rarely left the apartment. He almost never came to visit me in the psychiatric hospital—I had over 20 inpatient admissions spread over 21 years. I felt abandoned and rejected during a time when I needed him and it was his death in 2013 that was a precipitating factor in my last suicide attempt a year later.
I wasn’t properly diagnosed and treated competently until my late twenties. Today, clinicians are diagnosing adolescents prior to the age of 18 with psychiatric illnesses such as BPD and bipolar disorder. Early diagnosis means early intervention and treatment, and an improved prognosis and outcome.
I learned all the DBT skills, but I was too ill to practice them when I was in a self-destructive mode and alone. I was eventually referred to a psychiatrist who specialized in a psychodynamic treatment for BPD called TFP, or transference-focused psychotherapy. Per McLean Hospital, “The primary goal of TFP is to bring the patient’s split-off parts together through a process called integration. TFP’s goals include not just changing a person’s behavior, but changing their emotions and sense of self as well.” The work with my psychiatrist in TFP saved my life and gave me a life worth living.
I’m aware that parents hesitate to have their children evaluated for fear of getting a formal diagnosis and having their children labeled. The young adults with whom I work often tell me what psychiatric illness they suspect they may have and are relieved when they receive a diagnosis, even if it is not what they believed it to be. They simply want validation that they have been suffering. They are glad to be getting treatment and moving forward with their lives.
Today, I’m thriving. I’m a licensed clinical social worker, a published writer, a blogger on the topic of mental health and recovery, and an entrepreneur—the founder of a mental health treatment consultation and insurance advocacy organization. I never married or had children, but I have no regrets about remaining single and childfree. My brother and I are extremely close and we talk and see each other often. My 14-year-old niece is a delight. I have a circle of close friends from various aspects of my life—writing friends, entrepreneur friends, social-worker friends and several strays I’ve met along the way.
I regret that my illness has eaten up so much of my life, but I’m grateful to have had access to the intensive treatment I needed to recover. My treatment was funded through a combination of insurance, family, and the generosity of my psychiatrist who, when I was struggling financially, lowered her regular fee so we could continue working together and who, at times, let me carry a balance, trusting I’d pay it back.
Parents, if you suspect your kids are hurting, talk to them and let them know you hear they are depressed or anxious or struggling with their eating. Offer to get them professional help. This is a sign of courage, not one of weakness. That they are willing to open up to a therapist, make themselves vulnerable, and take a risk in therapy means you have a strong and resilient child.
When my mother died, I don’t know if she still held out hope that I would recover. It had been a long haul for her. I hadn’t yet started with my psychiatrist in TFP. I want you as parents to know there is always hope with the right treatment. Be persistent and insistent. For me, dialectical behavior therapy did not turn out to be the gold-star treatment for borderline personality disorder. If I had continued to follow the well-worn path, I would most likely not be around to write this essay.
Thanks for reading,
Source: © Andrea Rosenhaft