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

[Anonymous]

Anonymous wrote:

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.

Show of hands on those with hospitalizations who received hormone panels?

[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!

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.

Dad absolutely has more flexibility. There are many times more neurologists in the area than special Ed lawyers!
Dad has colleagues that can cover for him. Mom has far less control over her schedule which must be set by schools and school boards, in large part.
Very disheartening to hear a group of parents----who are discussing the lack of help available to them--- petition for the importance of Dad in this situation!
Very meta and ironic!

[Anonymous]

Anonymous wrote:

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 ahttps://www.google.com/search?q=sitting+in+a+railway+station&ie=UTF-8&oe=UTF-8&hl=en-us&client=safarilways 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.

I feel confident that all testing was done. The basics cited in the post I replied to (infection, Lyme, liver functioning) and more were done at virtually every stop. Others were done during the course of treatment. While important to rule out, it is rare that medical issues are the cause.

I will say that the hormone conversation is important but I don’t think it’s limited to girls. My sons mental health issues during puberty were off the charts. Now that he’s moving past that, the mental health issues are becoming so much more manageable. Not gone. But not erratic and as severe.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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.

Show of hands on those with hospitalizations who received hormone panels?

What’s that have to do with research? Hormone panel is not as helpful if the role of hormones is not well understood

[Anonymous]

It sounds like the “good” hospital is Kennedy Krieger, right? I’ve always hoped that if we ever have to go inpatient, we could go there.

[Anonymous]

Anonymous wrote:It sounds like the “good” hospital is Kennedy Krieger, right? I’ve always hoped that if we ever have to go inpatient, we could go there.

I was guessing Sheppard Pratt.

[Anonymous]

Anonymous wrote:

Anonymous wrote:It sounds like the “good” hospital is Kennedy Krieger, right? I’ve always hoped that if we ever have to go inpatient, we could go there.

I was guessing Sheppard Pratt.

Thank you!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.

Show of hands on those with hospitalizations who received hormone panels?

What’s that have to do with research? Hormone panel is not as helpful if the role of hormones is not well understood

Right because it's a women's issue and not studied.
The more obvious medical correlation between periods and anxiety and depression is iron deficiency.
Iron deficiency doesn't show up until you look very specifically for it. It takes a good deal of time vefore it shows on cbc. You can also have chronic iron deficiency and your cbc will be low but within the range.

I haven't heard anyone of the "they're doing enough" crowd mention ferritin studies.

[Anonymous]

Anonymous wrote:It sounds like the “good” hospital is Kennedy Krieger, right? I’ve always hoped that if we ever have to go inpatient, we could go there.

Kennedy Krieger doesn’t have in patient psych.

[Anonymous]

Anonymous wrote:

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!

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.

Dad absolutely has more flexibility. There are many times more neurologists in the area than special Ed lawyers!
Dad has colleagues that can cover for him. Mom has far less control over her schedule which must be set by schools and school boards, in large part.
Very disheartening to hear a group of parents----who are discussing the lack of help available to them--- petition for the importance of Dad in this situation!
Very meta and ironic!

Does mom have clients? Her foray into pro se work isn’t exactly going well

[Anonymous]

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?

Same here. But its easy to say for us that it was doable but we are not in her shoes. Maybe there were options for child care and taking turns with her ex to drive the daughter to therapy, help from other relatives and getting child care. I dont know, like I said easy to say what she could have done, but we are not in her shoes

[Anonymous]

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?

I had exactly the same reaction. I also disagree with some of the responses you've received in this thread. 3:30-8:30 is actually a relatively easy time to find care for school-aged children. If one of my kids' friends' families had this happening in their life, I would take a sibling that was a similar/compatible age to one of my children in a heartbeat. But also, this program is only 2 months, right? Isn't the worst case scenario that she takes the two siblings with her? Picks them up afterschool and brings them back for bedtime? They can sit in a car for 5 hours for 2 months to save their sister's life, no? And that's absolute worst case, I'm sure there is something else you can do with them for some of that time... Some care you can get for them on some days. She also mentions a grandpa and a boyfriend, in addition to the dad. I totally get that not everyone has a village, and maybe they are cutting a lot of the explanation out, but the decision not to take that outpatient program seemed genuinely baffling to me.

Last year one of our kids had three hospitalizations. During each of those (lasted about a week) the whole family’s life is thrown upside down - if the facility allows visits, you try to visit (few people do), you are taking to doctors, you are super stressed about your child.

We have other children at home and we are trying to keep things stable/routine for them, and also not get fired from our jobs. Everyone is sympathetic at first, and then they just get tired of you being unreliable.

PHP or IOP programs can run for weeks - usually at least 2. You take any spot you can get so they can be far away. And then when they are home they aren’t fully stable so they needs lots of care.

I totally get why this family couldn’t make the program work. It’s so hard to balance the care for one child with the needs of your other kids. You do the best you can to care for all your kids.

It took nine months for my child to stabilize. You hit a point after a few months where you realize you can’t let every decision be dominated by what is going on with your one child - it’s not healthy for anyone and (at least for me) it was physically and emotionally unsustainable.

[Anonymous]

I found the writer not very likeable. DMV has lots of resources and specializations available. Very trained specialists and high quality professionals. I don’t think this is the best case of mental health shortages in the US.

Try flyover country where you may drive 5 hours to see a mental health specialist.

Her daughter sounds very difficult and may not be stable at all. Sounds very tough.

[Anonymous]

Anonymous wrote:I found the writer not very likeable. DMV has lots of resources and specializations available. Very trained specialists and high quality professionals. I don’t think this is the best case of mental health shortages in the US.

Try flyover country where you may drive 5 hours to see a mental health specialist.

Her daughter sounds very difficult and may not be stable at all. Sounds very tough.

Wow you are a piece of work.

[Anonymous]

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?

I had exactly the same reaction. I also disagree with some of the responses you've received in this thread. 3:30-8:30 is actually a relatively easy time to find care for school-aged children. If one of my kids' friends' families had this happening in their life, I would take a sibling that was a similar/compatible age to one of my children in a heartbeat. But also, this program is only 2 months, right? Isn't the worst case scenario that she takes the two siblings with her? Picks them up afterschool and brings them back for bedtime? They can sit in a car for 5 hours for 2 months to save their sister's life, no? And that's absolute worst case, I'm sure there is something else you can do with them for some of that time... Some care you can get for them on some days. She also mentions a grandpa and a boyfriend, in addition to the dad. I totally get that not everyone has a village, and maybe they are cutting a lot of the explanation out, but the decision not to take that outpatient program seemed genuinely baffling to me.

Last year one of our kids had three hospitalizations. During each of those (lasted about a week) the whole family’s life is thrown upside down - if the facility allows visits, you try to visit (few people do), you are taking to doctors, you are super stressed about your child.

We have other children at home and we are trying to keep things stable/routine for them, and also not get fired from our jobs. Everyone is sympathetic at first, and then they just get tired of you being unreliable.

PHP or IOP programs can run for weeks - usually at least 2. You take any spot you can get so they can be far away. And then when they are home they aren’t fully stable so they needs lots of care.

I totally get why this family couldn’t make the program work. It’s so hard to balance the care for one child with the needs of your other kids. You do the best you can to care for all your kids.

It took nine months for my child to stabilize. You hit a point after a few months where you realize you can’t let every decision be dominated by what is going on with your one child - it’s not healthy for anyone and (at least for me) it was physically and emotionally unsustainable.

Yes, this is my feeling too. I also think that focusing on this one small piece of the story where the mom might be at fault is exactly part of the problem in sweeping the far worse systemic issues she was writing about under the table.

No parent is perfect, but this was so clearly *not* a bad parent, even if this one decision maybe wasn't right (not sure I think that, though). How about instead of blaming her, we work on getting more PHP options available so families don't have to make impossible choices over scheduling and transportation? And work on better emergency/crisis care so families don't have to feel like their only option is leaving their kids in literal prison?

My family is not in her shoes yet, but I'm terrified things like this could be in our future and doing my best to keep us out of them. I wish we had more options, and even just more understanding from the supposed professionals we have to interact with.