"Lost in the Storm": Slate article about local child with suicidal depression

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I read the story. I've had some experience with my kid at an inpatient facility, and also lots of therapy and medication over the years.

I realize one of the challenges of an article like this is trying to condense a very long, complicated story into a single written piece. I also appreciate the need to leave out some details due to privacy issues.
That said... there was one part of the story that stuck out for me, and when I discussed the article with my DH, he related that he had the same reaction when he read it.

There is a point in the process where the care team is recommending an outpatient program. (This is after the second, more successful inpatient program.) The author says it sounds great, but then when the time of the program is changed to 4:30-7:30, the author makes a flat statement that is is "impossible with two other kids at home." The recommendation for this program even comes up again in the article, and author states they instead went with a virtual option. One they were doubtful would be helpful, and sure enough wasn't.

I fully appreciate that for a person with this severe level of mental health needs there will never be "one thing" can magically fixes everything. I also understand (as I said above) that I don't have all of the details.
However, while my reaction throughout reading this article had been nothing but sympathy, this part brought me up short. I just couldn't understand why this particular treatment was deemed impossible. At this point, the kid hasn't been in school, the author is taking family leave and ultimately quitting her job. There is already tremendous upheaval in their family life. I can only imagine the amount of upheaval that the siblings of this child are already experiencing. Needing to get a sitter, or arrange transport, or... something? That feels do-able based on all of the other things this family has done, and the crisis level of the suffering child. It left me scratching my head. Did anyone else have the same reaction? Am I missing something obvious?

The program is an hour away three days a week. 4:30-7:30 means she doesn't see her other kids three days a week. The parents are also divorced, so that means her kids sit by themselves three afternoons a week if those are her days

Sorry but thats exactly why it doesn't make sense. They're divorced. He should have taken the daughter 3 days a week.
Men can't fucgging pull up.

Dad is a physician. Mom is an attorney. Which one do you think has more bandwidth to be away from the office?

Dad.

No. A doctor treats patients. People. A lawyer is just a paper pusher.

Men are so much more important, PPP. Haven't you understood this yet? A man could never have a colleague cover for him while he takes care of his own daughter! What a silly woman headed thing for you to even think!

DP. It's the profession, not the gender/sex. If mom were the physician and dad were the lawyer, there would be no question that dad has the flexibility.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I read the story. I've had some experience with my kid at an inpatient facility, and also lots of therapy and medication over the years.

I realize one of the challenges of an article like this is trying to condense a very long, complicated story into a single written piece. I also appreciate the need to leave out some details due to privacy issues.
That said... there was one part of the story that stuck out for me, and when I discussed the article with my DH, he related that he had the same reaction when he read it.

There is a point in the process where the care team is recommending an outpatient program. (This is after the second, more successful inpatient program.) The author says it sounds great, but then when the time of the program is changed to 4:30-7:30, the author makes a flat statement that is is "impossible with two other kids at home." The recommendation for this program even comes up again in the article, and author states they instead went with a virtual option. One they were doubtful would be helpful, and sure enough wasn't.

I fully appreciate that for a person with this severe level of mental health needs there will never be "one thing" can magically fixes everything. I also understand (as I said above) that I don't have all of the details.
However, while my reaction throughout reading this article had been nothing but sympathy, this part brought me up short. I just couldn't understand why this particular treatment was deemed impossible. At this point, the kid hasn't been in school, the author is taking family leave and ultimately quitting her job. There is already tremendous upheaval in their family life. I can only imagine the amount of upheaval that the siblings of this child are already experiencing. Needing to get a sitter, or arrange transport, or... something? That feels do-able based on all of the other things this family has done, and the crisis level of the suffering child. It left me scratching my head. Did anyone else have the same reaction? Am I missing something obvious?

The program is an hour away three days a week. 4:30-7:30 means she doesn't see her other kids three days a week. The parents are also divorced, so that means her kids sit by themselves three afternoons a week if those are her days

Sorry but thats exactly why it doesn't make sense. They're divorced. He should have taken the daughter 3 days a week.
Men can't fucgging pull up.

Dad is a physician. Mom is an attorney. Which one do you think has more bandwidth to be away from the office?

Dad.

No. A doctor treats patients. People. A lawyer is just a paper pusher.

Men are so much more important, PPP. Haven't you understood this yet? A man could never have a colleague cover for him while he takes care of his own daughter! What a silly woman headed thing for you to even think!

He's a neurologist. You know, one of those specialists that people complain they have to wait forever to see. She's described as a special ed lawyer and educator. It seems like his services are more valuable and more in demand

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I read the story. I've had some experience with my kid at an inpatient facility, and also lots of therapy and medication over the years.

I realize one of the challenges of an article like this is trying to condense a very long, complicated story into a single written piece. I also appreciate the need to leave out some details due to privacy issues.
That said... there was one part of the story that stuck out for me, and when I discussed the article with my DH, he related that he had the same reaction when he read it.

There is a point in the process where the care team is recommending an outpatient program. (This is after the second, more successful inpatient program.) The author says it sounds great, but then when the time of the program is changed to 4:30-7:30, the author makes a flat statement that is is "impossible with two other kids at home." The recommendation for this program even comes up again in the article, and author states they instead went with a virtual option. One they were doubtful would be helpful, and sure enough wasn't.

I fully appreciate that for a person with this severe level of mental health needs there will never be "one thing" can magically fixes everything. I also understand (as I said above) that I don't have all of the details.
However, while my reaction throughout reading this article had been nothing but sympathy, this part brought me up short. I just couldn't understand why this particular treatment was deemed impossible. At this point, the kid hasn't been in school, the author is taking family leave and ultimately quitting her job. There is already tremendous upheaval in their family life. I can only imagine the amount of upheaval that the siblings of this child are already experiencing. Needing to get a sitter, or arrange transport, or... something? That feels do-able based on all of the other things this family has done, and the crisis level of the suffering child. It left me scratching my head. Did anyone else have the same reaction? Am I missing something obvious?

The program is an hour away three days a week. 4:30-7:30 means she doesn't see her other kids three days a week. The parents are also divorced, so that means her kids sit by themselves three afternoons a week if those are her days

Sorry but thats exactly why it doesn't make sense. They're divorced. He should have taken the daughter 3 days a week.
Men can't fucgging pull up.

Dad is a physician. Mom is an attorney. Which one do you think has more bandwidth to be away from the office?

Dad.

No. A doctor treats patients. People. A lawyer is just a paper pusher.

Men are so much more important, PPP. Haven't you understood this yet? A man could never have a colleague cover for him while he takes care of his own daughter! What a silly woman headed thing for you to even think!

You really need to take your off-topic, red herring and revolting misandry elsewhere. And get help for your issues -- your character defect here is nauseating.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I’m totally out of my depth here because my kid is an externalizer, not an internalizer. But - isn’t it possible that ignoring children’s statements about death/suicide might be better than the intense reactions described here? Making suicidal statements and gestures is a good way to get a big adult reaction, which in turn can reinforce the behaviors. And then simultaneously makes it difficult to discern if the child is actually at risk because there’s no way to discern if they have a plan and ability to carry it out if all statements result in going to the ER. I don’t know, it just seems like statements made by children this young should be handled differently from
statements made by adults and teens.

The child was CUTTING WITH EVERY AVAILABLE SHARP OBJECT.

Cutting isn’t necessarily suicidal. https://childmind.org/article/how-are-self-injury-and-suicide-related/

Yes, it can also be a sign of anxiety or OCD or even ADHD (related to impulse control and need to keep hands busy). It really depends on when/how it is done.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I read the story. I've had some experience with my kid at an inpatient facility, and also lots of therapy and medication over the years.

I realize one of the challenges of an article like this is trying to condense a very long, complicated story into a single written piece. I also appreciate the need to leave out some details due to privacy issues.
That said... there was one part of the story that stuck out for me, and when I discussed the article with my DH, he related that he had the same reaction when he read it.

There is a point in the process where the care team is recommending an outpatient program. (This is after the second, more successful inpatient program.) The author says it sounds great, but then when the time of the program is changed to 4:30-7:30, the author makes a flat statement that is is "impossible with two other kids at home." The recommendation for this program even comes up again in the article, and author states they instead went with a virtual option. One they were doubtful would be helpful, and sure enough wasn't.

I fully appreciate that for a person with this severe level of mental health needs there will never be "one thing" can magically fixes everything. I also understand (as I said above) that I don't have all of the details.
However, while my reaction throughout reading this article had been nothing but sympathy, this part brought me up short. I just couldn't understand why this particular treatment was deemed impossible. At this point, the kid hasn't been in school, the author is taking family leave and ultimately quitting her job. There is already tremendous upheaval in their family life. I can only imagine the amount of upheaval that the siblings of this child are already experiencing. Needing to get a sitter, or arrange transport, or... something? That feels do-able based on all of the other things this family has done, and the crisis level of the suffering child. It left me scratching my head. Did anyone else have the same reaction? Am I missing something obvious?

The program is an hour away three days a week. 4:30-7:30 means she doesn't see her other kids three days a week. The parents are also divorced, so that means her kids sit by themselves three afternoons a week if those are her days

Sorry but thats exactly why it doesn't make sense. They're divorced. He should have taken the daughter 3 days a week.
Men can't fucgging pull up.

Dad is a physician. Mom is an attorney. Which one do you think has more bandwidth to be away from the office?

Dad.

No. A doctor treats patients. People. A lawyer is just a paper pusher.

Men are so much more important, PPP. Haven't you understood this yet? A man could never have a colleague cover for him while he takes care of his own daughter! What a silly woman headed thing for you to even think!

He's a neurologist. You know, one of those specialists that people complain they have to wait forever to see. She's described as a special ed lawyer and educator. It seems like his services are more valuable and more in demand

Both of their services are required, in one way or another, by most people reading this, sometimes in ways that are time-sensitive.

[Anonymous]

Anonymous wrote:
I would also love to see more research on how puberty hormones affect anxiety in young teen or teen girls. I’ve seen so many that are sudden fly struck by crushing anxiety within a year or so of getting their period and who are then significantly better by 8th grade or so. Now living through perimenopause i think there is insufficient understanding of how female hormones contribute to anxiety.

This is really wise. I’m a parent to a kid who’s been absolutely leveled by anxiety (including panic attacks, suicidal ideation, depression, and ocd-like symptoms) correlating almost perfectly with the start of her period. My kid also has ongoing PMDD symptoms and there seem to be few avenues to discuss treatment options. I would love to see the medical profession try to tackle what is happening with these girls.

[Anonymous]

Anonymous wrote:

Anonymous wrote:
I would also love to see more research on how puberty hormones affect anxiety in young teen or teen girls. I’ve seen so many that are sudden fly struck by crushing anxiety within a year or so of getting their period and who are then significantly better by 8th grade or so. Now living through perimenopause i think there is insufficient understanding of how female hormones contribute to anxiety.

This is really wise. I’m a parent to a kid who’s been absolutely leveled by anxiety (including panic attacks, suicidal ideation, depression, and ocd-like symptoms) correlating almost perfectly with the start of her period. My kid also has ongoing PMDD symptoms and there seem to be few avenues to discuss treatment options. I would love to see the medical profession try to tackle what is happening with these girls.

My DD also.

[Anonymous]

Anonymous wrote:

Anonymous wrote:
I would also love to see more research on how puberty hormones affect anxiety in young teen or teen girls. I’ve seen so many that are sudden fly struck by crushing anxiety within a year or so of getting their period and who are then significantly better by 8th grade or so. Now living through perimenopause i think there is insufficient understanding of how female hormones contribute to anxiety.

This is really wise. I’m a parent to a kid who’s been absolutely leveled by anxiety (including panic attacks, suicidal ideation, depression, and ocd-like symptoms) correlating almost perfectly with the start of her period. My kid also has ongoing PMDD symptoms and there seem to be few avenues to discuss treatment options. I would love to see the medical profession try to tackle what is happening with these girls.

NP - scientific understanding of the impact of (female) hormones on virtually everything is unconscionably inadequate. The medical profession can’t do much if science doesn’t give the necessary information. We’re doing a bit more, but not nearly enough.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The standout, to me, is the lack of national or state standards for psychiatric care----- which should BEGIN _ not end_ with medical evaluation. Medical evaluation isn't mentioned once in the article and I bet not one of the many "professionals " she and her daughter have seen, including the inpatient hospitals, did any medical evaluation. She should be tested for the known biological causes of anxiety and depression, first.
But no one in the psychiatric community has any long term benefit from doing so.

After, and ruling out biology, there needs to basic standards of care of psychiatric patients. There are none.
Same for education. There are none.

Has your kid ever been hospitalized? They absolutely do medical evaluations. And it sounds like the author's kid was at Shepherd Pratt, where my kid has also spent quite a lot of time. They 100% do medical evals.

Please tell us what medical evaluations at SP entail?

Oh lord, let me try to remember the specifics: they tested blood sugar levels to make spikes/changers weren't causing symptoms, checked for signs of infection that could cause psych symptoms, including "sneaky" things like lyme, liver function tests (which I think was just blood testing).

Someone always writes questioning medicals. I don’t know why people assume that. My kid had full medical work ups at every hospitalization, at every ER visit, by the ped and my thr RTC. It’s pretty standard practice to rule out a medical issue.

[Anonymous]

Anonymous wrote:

Anonymous wrote:
I would also love to see more research on how puberty hormones affect anxiety in young teen or teen girls. I’ve seen so many that are sudden fly struck by crushing anxiety within a year or so of getting their period and who are then significantly better by 8th grade or so. Now living through perimenopause i think there is insufficient understanding of how female hormones contribute to anxiety.

This is really wise. I’m a parent to a kid who’s been absolutely leveled by anxiety (including panic attacks, suicidal ideation, depression, and ocd-like symptoms) correlating almost perfectly with the start of her period. My kid also has ongoing PMDD symptoms and there seem to be few avenues to discuss treatment options. I would love to see the medical profession try to tackle what is happening with these girls.

Teen girls have always been susceptible to enormous emotional volatility at the time of onset of puberty; this transcends culture and time. I have genuinely wondered before if this is an evolutionary adaptation that is maladaptive to modern life. In other words, the Neolithic teen girl of who had an enormously heightened sense of anxiety that came with the onset of puberty was probably more likely to survive the onset of fertility (e.g. avoid male predation) and if she became pregnant, her child would be more likely to live. And then you add in all the hormone-mimickers that are in plastics, some processed foods, etc, and teen girls today get an additional hit at the same time they are also exposed to the known new harm of social media.

It is appalling how little we know about hormonal impact on women, in short.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I really don't understand turning down the 8 week intensive program in the afternoon. If your child is in crisis and that is the only option, you make it work especially with a doctor and an attorney as parents. If the child had to take her to cancer treatments or for dialysis at that time the parents would make it there.

I also don't understand the threats by the DBT program to hospitalize. Go ahead and call to report the family. There aren't many in patient treatment centers so most ER's aren't going to move forward with admitting a nine or ten year old no matter what the treating psychologist says.

You didn't understand what they were doing there? They wanted to dump her as a patient. Hence the demand for a treatment contract that was totally unreasonable. Child's issues were too difficult. Private practices like EASY patients.

As someone whose kid went through DBT, I don't think this is right. The DBT program--by definition--is typically a year long program that involves a weekly group session, a weekly individual session, and, for minors, a parent group. You can't just do a little bit of DBT because it would be like doing a little bit of calculus class -- it's a skills based program and all the skills need to work together. It really demands a fair amount of commitment, and it's definitely a much harder modality for the practicioners beause they are typically available for check-ins with the patients througout the week to help them use the skills. But like all practicioners, they need to do certain things to maintain their liability coverage and comply with mandated reporting laws -- and if a child is repeatedly stating a suicidal ideation that is concrete enough, they really don't have much choice about reporting it. (Reading between the lines, I also really wonder if the DBT professionals thought the parents were not being realistic, and that requiring the in-person consultant was a way to get them more educated about options.) If they wanted to dump her as a patient, they could have just said "We can't meet her needs."

On the reporting, this is where the system is totally f-ed up. The mandated reporters have to report. If you refuse to take them to an ER for assessment, they may have to call CPS and report you for medical neglect. Regardless of the fact that there aren't available beds and the treatment doesn't actually cure anything (but will keep the child safe for a brief moment while they are inside). So if the school counsel or the therapist or whoever tells you they are going to call, you have to go to the ER and hope you can talk the ER person out of commiting the child. IME, the ERs that actually have a juvenile unit are more likely to send you home -- they know they need to save those beds for the really serious cases and are better able to suss out the kids that are just attention seeking. The ERs that do NOT have a juvenile unit are worried about their liability, aren't skilled in interviewing kids/teens so won't ask the right questions, and will keep you sitting in a random ER bed indefinitely while they wait for a bed to open up God-knows-where. So the worse case scenario is some therapist or counselor who doesn't know much forces you to take the kid to an ER where they don't know much, and then you end up stuck going to the worst option for in-patient, just because that's where there's an open bed.

yikes. I’m going to put that one in my back pocket in case I ever need it (hope not).

Don't forget being required to pay the ER bill every time. My dc was in a placement that sent him to the ER in an ambulance multiple times in one year. The cost was astronomical and he was always discharged from the ER once he calmed down.

[Anonymous]

This was such a sad story.

[Anonymous]

Anonymous wrote:PP, I had the same reaction, but if the program was an hour away, she would be gone from 3:30 to 8:30. That’s a really difficult time to find child care for other children as a single parent household. If they are younger, that might be most of their waking, non-school hours. I could see decisions about trade offs going either way.

Same reaction. How about mom gives up 2 hours to drop daughter off and dad gives up 2 hours to pick her up???? Or grandpa helping out? Or hire a sitter??? Expensive, but necessary.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
I would also love to see more research on how puberty hormones affect anxiety in young teen or teen girls. I’ve seen so many that are sudden fly struck by crushing anxiety within a year or so of getting their period and who are then significantly better by 8th grade or so. Now living through perimenopause i think there is insufficient understanding of how female hormones contribute to anxiety.

This is really wise. I’m a parent to a kid who’s been absolutely leveled by anxiety (including panic attacks, suicidal ideation, depression, and ocd-like symptoms) correlating almost perfectly with the start of her period. My kid also has ongoing PMDD symptoms and there seem to be few avenues to discuss treatment options. I would love to see the medical profession try to tackle what is happening with these girls.

NP - scientific understanding of the impact of (female) hormones on virtually everything is unconscionably inadequate. The medical profession can’t do much if science doesn’t give the necessary information. We’re doing a bit more, but not nearly enough.

This is a core problem of our system now - pharmaceuticals are what is profitable to research and develop and also to prescribe.

I am not saying pharmaceuticals should not be used in psychiatry, btw - I am saying we have way too many eggs in that basket and not enough looking at root causes for this type of disfunction.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The standout, to me, is the lack of national or state standards for psychiatric care----- which should BEGIN _ not end_ with medical evaluation. Medical evaluation isn't mentioned once in the article and I bet not one of the many "professionals " she and her daughter have seen, including the inpatient hospitals, did any medical evaluation. She should be tested for the known biological causes of anxiety and depression, first.
But no one in the psychiatric community has any long term benefit from doing so.

After, and ruling out biology, there needs to basic standards of care of psychiatric patients. There are none.
Same for education. There are none.

Has your kid ever been hospitalized? They absolutely do medical evaluations. And it sounds like the author's kid was at Shepherd Pratt, where my kid has also spent quite a lot of time. They 100% do medical evals.

Please tell us what medical evaluations at SP entail?

Oh lord, let me try to remember the specifics: they tested blood sugar levels to make spikes/changers weren't causing symptoms, checked for signs of infection that could cause psych symptoms, including "sneaky" things like lyme, liver function tests (which I think was just blood testing).

Someone always writes questioning medicals. I don’t know why people assume that. My kid had full medical work ups at every hospitalization, at every ER visit, by the ped and my thr RTC. It’s pretty standard practice to rule out a medical issue.

I find it difficult to believe they did genetic testing during your er visits. They probably didn't many of the other tests that would rule in or out physiological causes that we now know are behind depression and anxiety either. You don't know what you don't know.