Teenage Suicide

There was a report today that a local 17 year old committed suicide. It wasn't too long ago that a 13 year old committed suicide locally. While we might not want to believe that a child (or anyone, for that matter) could be in that much pain, clearly they can be.

I hope and pray that I am never faced with needing to prevent a teen suicide but I have spent some time reading about it because of the mental illness in our family.

Here are some things that you can do.

If your teenager has been depressed, you should look closely for signs that he or she might be thinking of suicide:

- Has his personality changed dramatically?
- Is he having trouble with a girlfriend (or, for girls, with a boyfriend)? Or is he having trouble getting along with other friends or with parents? Has he withdrawn from people he used to feel close to?
- Is the quality of his schoolwork going down? Has he failed to live up to his own or someone else's standards (when it comes to school grades, for example)?
- Does he always seem bored, and is he having trouble concentrating?
- Is he acting like a rebel in an unexplained and severe way?
- Is she pregnant and finding it hard to cope with this major life change?
- Has he run away from home?
- Is your teen-ager abusing drugs and/or alcohol?
- Is she complaining of headaches, stomachaches, etc., that may or may not be real?
- Have his eating or sleeping habits changed?
- Has his or her appearance changed for the worse?
- Is he giving away some of his most prized possessions?
- Is he writing notes or poems about death?
- Does he talk about suicide, even jokingly? Has he said things such as, "That's the last straw," "I can't take it anymore," or "Nobody cares about me?" (Threatening to kill oneself precedes four out of five suicidal deaths.)
- Has he tried to commit suicide before?

If you suspect that your teenager might be thinking about suicide, do not remain silent. Suicide is preventable, but you must act quickly.

- Ask your teenager about it. Don't be afraid to say the word "suicide." Getting the word out in the open may help your teenager think someone has heard his cries for help.
- Reassure him that you love him. Remind him that no matter how awful his problems seem, they can be worked out, and you are willing to help.
- Ask her to talk about her feelings. Listen carefully. Do not dismiss her problems or get angry at her.
- Remove all lethal weapons from your home, including guns, pills, kitchen utensils and ropes.
- Seek professional help. Ask your teenager's pediatrician to guide you. A variety of outpatient and hospital-based treatment programs are available.

Don't be afraid to ask questions . . . asking someone who is suicidal about suicide will not plant the idea. Ask them if they have a plan? If they have a plan, there is a much deeper concern.

Seek help. Don't be embarrassed. Talk to a school counselor or teacher. Talk to your pastor or priest.

Most importantly, follow your gut instinct. If you think something is wrong, don't ignore it.

http://www.aap.org/advocacy/childhealthmonth/prevteensuicide.htm

Are you crazy??

I'm not one that feels burdened by the need to use politically correct terms. This isn't to say that I intentionally use derogatory terms to upset people just that I don't always think politically correct terminology really makes that much difference. I've often joked that if I ever get to be in the position anywhere, I want to be chairman of the board . . . not chairperson and not chairwoman. If you disagree with me, that's fine . . . I'll even call you the chairwoman of the board. But, for me, chairman is just easier.

I have, however, become very sensitive to some terms that are often used freely, without thought and with no regard to what their real meaning is. I don't believe that most people intend to offend others around them in using these terms but I'd like us all to be more aware.

Crazy, nuts, mad, insane . . . we all use these terms pretty regularly (including me). I'm not trying to offend someone but we've all associated those terms with unusual thoughts or actions. I'm not suggesting that everyone has to stop using them . . . just be aware of the meaning.

Looney bin . . . I've mentioned this term in an earlier post. Most of us have seen images of a mental hospital on TV or in movies. There is much more to a mental hospital than a room full of people talking to themselves or running around acting completely out of the ordinary (it's hard to describe without using the word crazy . . . but you'll understand what I mean). A mental hospital or the psychiatric ward of a hospital are as important to a patient with mental illness as a cardiac intensive care unit is to someone who has had a severe heart attack.

Having said that, please be aware that more often than not I really do know that the words are not intended to be offensive. Some days I'm more sensitive than others . . . and some days I feel more strongly about awareness than others.

And, while I'm on the subject of words . . . just a reminder about the "r" word that is also used and can be VERY offensive. I've heard it used when talking about someone that makes a mistake. I've heard it abbreviated to 'tard or I've heard people talk about "the short bus." Mental retardation has to do with the ability for someone to learn. The brain of someone who has mental retardation is not able to learn as fast as those who do not. It doesn't make them stupid or any less of a person.

Let's all choose our words carefully. We shouldn't be afraid to speak (it is a free country) but we also should be considerate of those around us.

Putting yourself in our shoes . . .

Last night, on 20/20, there was a segment on Schizophrenia in Children. I haven't seen the entire episode but I did watch some of it on-line today. If you click here, it will take you to the video. While the behaviors are not exactly the same as what I see at home every day, there are some definite similarities.

Since this morning, I've read a number of comments on the story. I shouldn't read them but I do and they make me angry. Many of them are written in ignorance. Almost all of them are hurtful to the parents (or other caregivers) of the mentally ill. I'd just like to state my feelings on them.

- The behavior of our children is not a lack of discipline. In our particular case, we have tried just about every behavior modification you can think of . . . with little to no improvement. Yes, like any parent, I've made mistakes in how and when I've chosen to discipline but I don't let my children do whatever they want.

- The behaviors of mentally ill children are out of the norm. If you put a mentally ill child next to one who is mentally well and the same age, you are likely to see very distinct differences in the ways they act. Some of the behaviors you see may be very disturbing, some may just make the child seem much younger (or older) than they really are.

- For us, we pray for Sarah all of the time. Sarah understands, to the extent that a teen can understand, salvation. We pray for her, she prays for herself and others have been praying for us. We've asked for healing . . . but it appears that the answer is "no." Often, I find myself praying for my own strength - getting through some days is VERY difficult.

- If there are parents out there that have their child act this way for attention, than the parent definitely needs help. Nobody would want this for their child.

- While it often feels like all we do is medicate our child, we have seen the definite effects of no medication and it was not healthy or safe--for her or for the rest of the family.

- The DSM-IV diagnostic criteria is not perfect. Mental illness does not have a checklist of symptoms that identifies one illness over another in explicit terms. It's even worse in children because the signs & symptoms are the same for so many things and they are often unable to really tell you what is going on.

Most parents would tell you that they want only the best for their children. They want their children to grow and to flourish. They want them to have friends and to find something that they find fulfilling. It is heartbreaking to see your child lose friends because she is unable to control her own behavior. I understand the friends not wanting to be around but it doesn't make it any less sad to watch.

I hope that if you're reading this, you will take the time to watch the 20/20 video to get a sense of what families of the mentally ill must live with.

It just doesn't seem to get easier . . .

The longer we go, the further backwards we slide. The delusions and hallucinations may be gone but we're back to struggling with Sarah being angry about everything. On the ride to RI tonight, she went from being happy to being mad at me because my ipod wasn't charged. She has her own mp3 player but always wants to use mine.

She's told me twice this week that she doesn't want to live with me or doesn't want to be at home. When I ask her why, it's because we all make her mad and because there are rules. It doesn't matter how many times I explain it, she doesn't understand that there will be rules (in general) no matter where she lives. I guess the grass is always greener, right?

We are leaving for vacation in a week and I'm a little nervous about it. 7 or 8 hours in the car if she's bored, could be pretty miserable. It won't matter if we have movies or she has books, if she gets in one of her moods, there is no offering of suggestions. Nothing will work (her words in those moments). Please pray for us to have an enjoyable vacation. We all need it.

How can you possibly know that your child is mentally ill?

I read "Dear Abby" in today's newspaper and there was one letter about a couple whose granddaughter had visited and kept "finding" money. When the granddaughter went home, they discovered where she really had found the money. When they told the daughter, her response was non-chalant and asked how much she had taken. I don't know if that daughter knew the truth and was embarrassed by it or if she was in denial but that is never easy news to hear regardless of the circumstances.

There have been many times in Sarah's life, that I have been asked the question "how can you possibly know at that age?" Over the course of the last few weeks, I've had the opportunity to think about a lot of things that have gone on with her since she was a baby that pointed to something being wrong.

When Sarah first came home from the hospital, she slept 5 hours at night. It was great for a while . . . but, it never really changed. She would wake up in the middle of the night as a toddler and want to play. I would be so tired that I could hardly keep my eyes open but could not go back to sleep. At that time, I co-slept (whether you agree with that practice or not is irrelevant but I am aware of the dangers that exist and am blessed that nothing happened). We tried letting her cry to go to sleep but I had a hard time with it and I would always end up with her back in my bed. It was keeping me from sleeping. My mother told me that I just needed to let her cry. So, when we lived in a not-so-great apartment complex with paper-thin walls, I finally decided to do it. When she woke up at 2 am, I didn't get up; I let her cry. The only problem was that she didn't just cry . . . she yelled "help me" over and over. One of our neighbors called the police. We didn't do that again.

During the day, when she was a toddler, Sarah would often have something (generally involving me saying "no" to something) that would lead her to start what I commonly called a "fit." Those fits would go on for up to 2 hours and involved her screaming, crying and kicking her feet. She would follow me around the apartment doing it. There were many times that I would give in to get it to stop (if you've never dealt with it, it is unlikely that you would understand what it's like to have your 2 year old in a full blown tantrum for two hours). The only thing was, it wouldn't stop. It would continue but I actually made it worse by giving her what she wanted. Often, these tantrums happened 5 - 6 times a day.

I had a friend that would babysit for her that lived about 40 minutes from us. Almost every time we left the friend's house, it was with Sarah screaming. By the time I would get home, I often would be in tears myself.

She also "found" money at my sister's house once. It belonged to one of my niece's and was returned. Yes, I know that taking things that don't belong to a child can be normal behavior . . . but most of them get it when they are caught. Sarah definitely didn't get it.

Having a toddler with mental illness versus a mentally well toddler is like comparing traditional sports to extreme sports. Many of the things they do are the same . . . but the mentally ill toddler's behaviors are extreme and often unending. Some of it makes no sense at all. I remember days of locking myself in my bedroom and sitting against the door crying and praying so she couldn't hit me or kick me anymore and so that I would be able to control my own anger and frustrations.

The anger and rage didn't change much. Some of the other behaviors did. Two years ago, on the Sunday of Memorial Day weekend, I didn't stay at church for the second service and Sarah was upset with me. This time her screaming and yelling led to threatening to kill herself on the way home. She didn't just say "I'm going to kill myself" . . . she said that she was going to get a knife and stab herself when we got back to Grandma's house. In the middle of it, she saw that I was upset and calmed down.

I should note here that I told Sarah's therapist about the suicide threat the next day. I asked him to talk to her about it because I couldn't do it. He didn't seem to take it seriously . . . and when he finally talked to her, he said "I know you didn't mean it when you said those words. You should choose different words." In my opinion, nobody should ever assume that a child (even at the age of 10) didn't mean it. There have been cases of suicide at that age (or younger) in the recent past. I mentioned this incident to the clinician recently and was told that maybe he was nervous about confronting her and sending her home with me. But, I said, "wouldn't it be better for me to know that she meant it and get her the help she really needs?"

I pray that if you're reading this, you never have to figure out if your child's behavior is normal. But, if you do, trust your instinct.

NOTE ON SUICIDE: If someone you love is threatening suicide, take it seriously and get them help. Don't worry about them being mad at you . . . better alive and mad than gone because they didn't know any other way to deal with it. I have read that it should not be swept under the carpet. Don't be afraid to ask them if they have a plan. And, never be afraid to call for help.

I don't know about other states, but in the state of CT, you can call 2-1-1. They have a mobile psychiatric unit that can deal with these issues. The police (nothing against policemen) are not always trained to handle issues of mental illness.

Real Fears for the Mentally Ill

As I looked at the first of many medical claims from this recent hospitalization, the fear of the numbers I will see is starting to come through. I am genuinely grateful for the insurance I have. Not as many are as fortunate as I am (and I do understand that).

I've heard many horror stories and have had some minor difficulties with insurance but I don't know what would happen without it. I told the doctor that pharmaceuticals are making the drugs that would be the most beneficial for mentally ill and made them unaffordable for them. If you've never spent anytime understanding pharmaceuticals, they are constantly coming out with new drugs for all kinds of things. It's a good thing BUT the drugs need to be affordable (especially for people who might not be fortunate enough to have good commercial insurance). And, they find ways to renew their patents so that generics cannot be made often for well over 20 years from the time the drug was originally manufactured.

The program that Sarah was in used to be six weeks long and they rarely saw someone return after they were discharged. The program included overnight passes and an opportunity for the team there to understand what problems there were on those overnight passes. They could try different meds and teach different coping mechanisms. With how insurance is now, often there is someone fighting to keep the patient in the hospital for long enough to stabilize them. There is one insurance in particular that was named in parent meetings that as soon as they see any sign of stabilization from a patient wants them out. If we had that insurance, Sarah wouldn't have been in long enough for them to see some of the issues that we have.

I understand that there must be limitations. Hospitalizations are extremely expensive but I think the pharmaceuticals, hospitals and insurance companies need to work together for the best interest of the people of this country rather than the stockholders and executives. I find it extremely frustrating when I see ad after ad on TV for pharmaceuticals. Ad spots cost millions of dollars. And, there's thousands more (if not millions) in creating the ads. What if they stopped those advertisements and used that money for research and development?

So the real fear . . . what happens when the mentally ill person can't hold a job without treatment and doesn't have social security and medicare or another state funded program? What happens if they are an adult and refuse treatment (they cannot be held against their will unless they are an immediate danger to themselves or others)? It's a pretty vicious cycle . . . no treatment, no job . . . no job, no treatment. Hospitalizations will stabilize and can't be refused but once they walk out the door . . . it's up to them to take care of themselves. Sadly, so many of the drugs have awful side effects and cause "dulling" that the patient doesn't like. So, once they "feel better," they stop taking them. Puts them back at square one again.

It's an ugly situation.

Coming Home . . .

After nearly three weeks, Sarah is coming home from the hospital. While I'm sure it wasn't a magic cure and she won't suddenly be a compliant child, I think that the things that put her in the hospital have been taken care of.

I'm a little nervous about things going back to what they were but am working on planning how to keep that from happening. More structure, goals set each day and a system that allows for earned rewards. The hospital uses a system that never takes something away . . . they just don't earn it if they don't get all of their checks for the day (they have about 50 things that they get checks for each day). They also have grounding (24 hours, in general, and it means they are not able to watch TV at all or to watch the movie in the evening with their group) and being restricted which means they are not allowed to leave their rooms except to use the bathroom.

She still has a lot of work ahead of her . . . she needs to learn how to apply coping strategies before things escalate out of control. She needs to slowly rebuild the trust of family and friends (easier said than done, unfortunately).

She won't go back to school until next week. The school has requested a PPT tomorrow. I realize how blessed I am to live where we do . . . the school system has been unbelievably supportive from Day 1 of kindergarten. I've heard so many stories where parents have to hire advocates to get kids the help that they really need. I think some of this is probably back to what I mentioned in my original blog - the fact that many don't understand mental illness. Often, whether they mean to or not, they assume it's behavioral and that the parent just doesn't discipline well enough. Or, the school system doesn't want to, or doesn't have the budget for, some of the required testing. It's not easy for the school systems and their staff either.

For now, I will enjoy the pleasant time with Sarah and will continue to pray for healing for her and patience for me and my family.

Why does hospitalization seem so scary?

Outside of the cost of care that scares so many of us today, why is hospitalization so scary? I think we probably all have images in our head of what a psychiatric hospital is. Names ranging from the insane asylum to the nut house bring all sorts of weird images of people walking around in straight jackets ("hug me" jackets) or strapped to their beds. Images of people out in a big room all acting strange. The idea of putting your child in a place like you've seen on TV or in the movies is frightening.

I think that image is wrong and should be corrected. While not all facilities are alike and I'm SURE that some are far worse than others, for the most part, I suspect that they are safe environments where sick children can receive the care that they so desperately need. I stress again that people wouldn't question your child being put in the hospital if they were physically ill and could die, they shouldn't question their being in the hospital if they are mentally ill and a danger either to themselves or to others. And, danger can come in very different forms. For some, it may be that they are suicidal . . . others are severely depressed and can't function . . . some may even be homicidal. None of these things are good either for the ill person or for the people around them (regardless of how much we might love our family member).

The unit where Sarah is staying is nothing like what I've seen on TV. It is a safe environment that is kept locked so that the children cannot leave. They are under 24 hour supervision. There is a room where they have their meals. There is a public restroom in the center of the unit that is unlocked and available for use most of the time. The bathrooms in their rooms are locked most of the time and opened for them to use for showers. There are nurses, technicians, psychiatrists and therapists that all work with the patients.

The program is very structured. They have time for school where the kids are either given schoolwork by the teacher that is on staff there or is sent in from their own schools. This gives the opportunity for the staff to show kids how to deal with frustrations in every day settings.

They are given goals each day that they must work on. Some of these are very simple but extremely important. If they get enough "checks" on their goal chart, they get earned time that they can use to play video games or watch TV for a limited times. This can help teach socialization skills--learning to take turns, make choices together, accept choices that others have made, etc. These are the skills that so many kids learn in kindergarten . . . but so few kids with mental illness seem to grasp.

They have individual therapy, group therapy and are in an environment where they can change meds under complete medical supervision. With some of the side effects that are associated with psychiatric drugs, that supervision is very important. Reading side effects for psychiatric drugs can be very scary . . . but, at some point, any of us who have ill family members realize that the benefits outweigh the risks and to have a chance at a normal life, medication may be an absolute necessity.

As it turns out, hospitalization probably didn't need to be feared. Sarah says she wanted the help and we know that she desperately needed it. I don't have expectations that Sarah will come home and be immediately compliant and life will become completely calm in my house. But, I do have hope that life may get better for her and for all of us.

"For I know the plans I have for you, declares the Lord, "plans to prosper you and not to harm you, plans to give you hope and a future." - Jeremiah 29:11

Medication, Hospitalization and Stabilization . . .

After hearing some very disturbing news over the past week, the psychiatrist first tried a new medication (which didn't make enough of a difference) and then recommended that we have Sarah hospitalized. A visit to the psychiatrist every few weeks for a 1/2 hour (even once a week) just wasn't doing enough to make a difference. Those are tough words to hear even when you know they are coming.

We spent hours in the ER on Friday while we waited for the team to evaluate her. There were so many other kids there. So many look just like everyone else around them and even act fine for periods of time. You might not know just to look at them that something is wrong. I heard another mother say "looks can be deceiving" and I understood exactly how she felt. The team there didn't really agree with the diagnoses, or possible diagnoses, given by her own psychiatrist but they also felt that she needed, at a minimum, further evaluation. After a night in the extension to the children's hospital, they were able to find her a bed in a psychiatric unit for kids her age. This is a surprisingly difficult task . . . no where near enough beds . . . and, my guess is that it's true for adults, too.

When I heard that they had found a place, suddenly I started questioning it . . . what if she's making it all up? Maybe it's not as bad as it really seems. I do know it is as bad as it really seems and it was the right decision but it's not an easy one. Sarah seemed almost happy to be in the ER and the extension and even seemed to enjoy the trip to the hospital. It wasn't until she realized that I was leaving that she started to get sad. I think reality was starting to set in.

The average stay in the unit is about two weeks. Our hope is that they will adjust her medication (or change it completely) and that they will be able to stabilize her and that she will learn some coping mechanisms to deal with the anger that she has. After she rages, she often will be extremely apologetic and talk about how she doesn't want to act that way. She just can't seem to find a way to stop.

There are days when I think that she wants to act the way that she does or that she can control the way she is acting. It's hard to admit that she really can't help all of it. I do believe that she can help some of it . . . just not all of it. Between the meds and the therapy, they are trying to find ways to stop what she can't stop herself and give her tools to stop the things that she can.

I can't thank my friends and family enough for their prayers and support. It really does mean so much.


Pam

How I Wish She Was Just Physically Ill

This week we heard the news that she has clear breaks from reality. I felt like I had been punched in the stomach. Regardless of how bad the behavior gets, I somehow am able to deny how bad some of it is in my head. God's mercies? If I spent every day thinking about diagnoses and how bad things are, I would want to crawl under the covers and not come out (which is how I do feel somedays).

Over the last few months, we had slowly weaned her off of her anti-psychotic - first, because we didn't know what it was doing and her former psychiatrist's answer to everything was to add or change meds and second, because with my new insurance, the cost of her prescription went from $150 for 90 days to $1800 for 90 days. No, that's not a typo - that is the cost for one of her medications. After we meet our deductible, we'd still have to pay 20% of that cost. Over the last two weeks, she has finished what was left of that medication and it has completely left the system. The doctor immediately changed her medication - removed one and added a new one (a much cheaper one). It's supposed to take about a week for the medication to build up in her system. The last few days have been better but it might just be coincidence since not all days are bad.

When we first took my daughter to a therapist, the therapist recommended that we read the Bipolar Child. I did . . . cover to cover. She also recommended some websites to me. I can't remember where I read it but there was a doctor that said he would rather his child have leukemia than bipolar disorder. I understand that. It's not that either of us would wish cancer on our child (or anyone else's) but there are so many things that are easier with leukemia. There are known treatments for leukemia, that in most cases will help and likely put the child into remission. People are supportive and understand Leukemia. I wouldn't have to be embarrassed to tell them that my child is sick with Leukemia. This isn't to say that people aren't supportive (I am so grateful for the support of my friends and family) just that, in general, people know what Leukemia is and what they can do to help.

I was telling her tonight that it would be so much easier if she just had something physical. If she broke her leg, I could take her to the hospital and it would be fixed. If she had cancer, it is likely that, if caught early enough, that they could treat her and she would survive it. Unfortunately, with mental illness, it's not an exact science. The best we can do is pray for her and hope that the new meds will work.

My friend Carrie sent me the lyrics to a song (Blessings by Laura Story) the other day that has already becoming very meaningful to me. The chorus says:

What if your blessings come through raindrops?
What if your healing comes through tears?
What if a 1000 sleepless nights are
what it takes to know you're near

What if trials of this life
are your mercies in disguise?

The full song is below.

http://www.youtube.com/watch?v=1CSVqHcdhXQ

For a period of time, I constantly saw reference to the scripture Jeremiah 29:11: "For I know the plans I have for you and I will prosper you." This has been a constant reminder for me of God's working in my life and how I have to wait for Him and His timing. I'm generally not that patient but maybe some of my lessons are in that alone.

I thank you for your support and your love. It means so much to me.


Pam

Hope

I have found since Sarah was little, that she has very little ability to think logically. She seems unable to connect consequences to her actions. This makes it exceptionally difficult to discipline her for anything she does. I assume that this is common in the mentally ill. I've seen it with my brother-in-law, too. It doesn't seem to matter what they do, it is never their fault. If Sarah breaks something in anger, it is my fault because I made her angry. If Sarah loses something, it is her sister's fault (or someone else in the house) because they had to have taken it. Often, it is just that she has put it down someplace other than where she remembered. If she is unable to find someone to come over and play on a weekend, I didn't let her have a playdate. While these things seem somewhat small, the reactions when things are not exactly as she wishes are far worse than you see from most kids. It generally involves yelling and screaming, jumping up and down and sometimes, even violence towards me (strangely enough, more often me than my husband) or her siblings. What makes it even harder, is that as soon as she is "calm" after one of these episodes, she expects that life will go on as if nothing ever happened. Because of this inability to truly connect the discipline she receives to her behavior, the behavior continues and seems to be getting progressively worse. I am struggling to figure out any ways to modify her behavior and feeling so hopeless.

The Journey through Mental Illness

I've started this blog because I need some place to record my thoughts. Living with someone with mental illness is challenging and, often, emotionally draining. With younger children, it can be exceptionally difficult because the behavior is so often misunderstood and we are thought to have undisciplined or unruly children. Or, outside of the house, people may only see the "good" side of your child and not believe what the child can be like at home. Our journey started very early. I noticed when my first daughter was very young that her behavior was not typical of other children. She was very angry and extremely prone to tantrums. I know . . . most kids are prone to tantrums. But, these were different. Something would trigger a tantrum and that tantrum could last for 2 or more hours. At some points, I would give in because I couldn't take it anymore . . . the screaming was unpleasant and unbearable. Unfortunately, not only did giving in NOT end the tantrum but it made it worse the next time. And, these would happen multiple times daily. I knew she was different but couldn't bring myself to admit it. I didn't want to take her to the psychiatrist . . . that would mean she was crazy and my daughter couldn't be crazy. I just had to change how and when I disciplined her. For three more years, I continued to live in denial. In kindergarten, there were days that the school would call and say we had to pick her up because they were afraid to have her get on the bus because she was out of control. More than once this happened because she was told that another classmate had to pick up his own toys. In February of that kindergarten year, after she kicked me hard enough during a tantrum that I thought she had broken my thumb, I finally gave in and called the psychiatrist. This started us down a long and painful road. Child psychiatrists are hard to find and most of them don't do therapy--you have to get a pscyhologist to do therapy. The psychiatrist we started taking her to put her on medication and in the last eight years, those meds have changed multiple times. They all have side effects. Some seem to help. Some seem to do nothing at all. And, often, they are very expensive. What makes mental illness harder than physical illness is that there are very few definitive tests. There aren't blood tests that will show that your child has early onset bipolar disorder, anxiety, ADHD or ODD or a myriad of other diagnoses that many of us have received. There are no x-rays. It is all trial and error. If the patient is put on an anti-depressant and it causes a manic episode, they are likely to have bipolar disorder. If one drug doesn't work, they have to try another. As they age, the original medication that you finally got the right dose of doesn't work anymore. And, for adults with mental illness, you have the added difficulty that the right medication will often make the mentally ill feel cured . . . and then they want to go off their meds and a new viscious cycle begins. With our oldest, she has had diagnoses of early onset bipolar disorder, anxiety, depression and, now, ODD, mood disorder NOS, ADHD, and anxiety. And, more recently, my third has been diagnosed with ADHD. The third presented with classic symptoms but I didn't want another child with "issues." I should tell you, though, not taking your child to the psychiatrist doesn't keep them from having mental illness anymore than not taking your child to the doctor would keep them from having cancer. My other two children are "normal" - at least from the perspective of mental illness. They also have to learn to live with the mental illness and all it brings into our house. I'd also like to note right from the start, making the choice to put my child on meds was extremely difficult. Nobody wants that for their child. For many mental illnesses, they are needed. These are neurological disorders that require treatment for the child to try to live a normal life. You would not be judged for putting your child on insulin. You wouldn't be judged for medications for heart disease, cancer, allergies or any other physical medical malady. Please consider this before you make any judgements on my decision to medicate my children.