I’m Not Meant to Stay in This World for Long, Mom

The early onset of bipolar depression

Viacheslav Iakobchuk

“I want you to take me to a brain doctor”

As I first heard these words spoken by my then 6-year-old, they didn’t strike me with near the fear that they would later invoke. I was a neuro ICU nurse at the time. I naturally thought she was just playing around with some context she was exposed to — I was wrong. She continued on to explain what I best understand to be racing thoughts.

“words bounce inside my head like ping pong balls so fast that I can’t keep them in order, I can’t say what I’m trying to think. I can’t think what I’m trying to say.”

Little did I know those words were just the beginning of the most frightening years of my life

These are some profound verbalizations coming from someone her age. In fact, looking back on things, much of what followed was and remains to be surreal to me. The headbanging — an attempt to open her brain and let the thoughts out. The hair pulling — trying to stretch out her skull to make room for all of the activity in there. The actual attempt to fly out of her window — an effort to visit her dead dog who was residing in his heaven cloud.

Her first suicide note was written at only seven precious years old. Reading it, my world stopped and began to spin simultaneously. How could this be happening, why? Our lives weren’t perfect but we had everything we needed including a good support system. Our relationship was healthy, open, and loving. I initially suspected it was somehow related to the fact that I was a single mom, that the other kids in her class had a dad to talk about but she didn’t. I knew she felt embarrassed. If only that were it.

She developed a temper, which I later learned from her psychologist is how depression often presents itself in children. She began to display signs of compulsive and overly aggressive behavior. She became attention deficit in nature and heck, because why not, she began to speak in tongues. And as scary as that is, what could be worse than hearing this from your eight-year-old?

“I’m not meant to stay in this world for long mom”

Yes, I’ll take the tongues back, please. What follows these developments is multifaceted. First, there was therapy, or rather, therapist shopping. I don’t mean to criticize those not chosen, but without someone she could feel comfortable with there was seemingly no point to invest the time and effort in going. You shouldn’t either. Though rapport can only be built over time and through shared experiences or conversations, there still has to be a natural chemistry of trust and openness between the patient and the therapist. I let my daughter lead the way. I would consider this my first concrete piece of advice.

Get professional help ASAP — but choose wisely

what could it hurt? Even if nothing is out of the ordinary, speaking with a professional doesn’t hurt the process. I let her follow her gut until we found the right match when she met them and worked with them. after all, she was the one who first noted that something was wrong and was confident enough in both herself and our relationship to externalize what she was feeling. I did, however, begin to doubt she would ever “choose” one after the third.

I began to think I should have just gone with option A and given her no choice in the matter. I figured, at this point, that she would begrudge every option provided to her. I’m so glad I continued on because, in this case, the fourth therapist was the charm. So with her chosen therapist, she was able to trust and connect.

This method of getting started with a consistent therapist, though overwhelmingly anxiety-provoking, and expensive, is what I advise more than anything. To someone seeking any sort of mental health guidance, if you cannot trust, you will not be honest and then you are doing nothing but cheating yourself.

We went twice a week, and she and her therapist began to build a good rapport. Spoiler alert — She got worse. We did continue to go of course because the help was good, it was the disease process that was beating her.

Researching pharmacologic therapies became an obsession of mine

I knew she was on the fence in that department. On one hand, I think it is fortunate that she was never medicated but trust me when I tell you that I sometimes wish I had. Even now, I kick myself when I think of how her quality of life during those worst few years may have improved even a little or perhaps a bit sooner, had I chosen to go that route. I focused on the idea of wanting her body and brain to develop without the addition of medicines and their side effects. The amount of danger her well being was in certainly warranted more aggressive treatments though. I know that now. It was a hard and very close call.

My advice here, of course in conjunction with yours or your child’s physician, is to be openminded towards the thought of medicine as an adjunctive therapy and forgive yourself for any shortcomings you may perceive as your fault. This is a tough position to be in. Try to remember that you weren’t downloaded with the information to control this and there is no exact answer to the battle of mental wellness vs illness.

Remind yourself that there is an actual chemical imbalance in the brain

I’m not suggesting to jump straight to them, I’m just a proponent of more extensive therapies when things become as dangerous as they had in her case. You have to sort of stack them on top of each other, watch for changes, and try to change only one variable at a time if possible in order to know which change is affecting which behaviors. When to try them is obviously up to you and your physician. But my daughter, She was on the fence. I was on the fence. We both fell off the fence — for a while.

Eventually, things began to change

Most objectively, it was the weather. The mania stopped as the sun hid away and those winter clouds blanketed her with a frigid mood; a constant state of sadness and irritability ensued. Tears were everywhere. It was about this time that she began dialectical behavioral therapy. This form of cognitive therapy, while used for multiple reasons, is specifically for those diagnosed with bipolar depression and other mood disorders. A few weeks into this surprisingly hard work, I began to feel a little hope. For the first time in two solid years, I wasn’t afraid that I would enter her room to find herself curled in a ball, screaming at me, or, in my darkest of thoughts, having hurt herself past the point of return. My daughter — dead. My daughter — dead — because I did not protect her from herself.

I started to recognize the blessings that came along with her curse

Along the path I did, and still do, let her lead the way. That place between her head and heart — her gut, is simply amazing. She’s intelligent and intuitive. She is a right-brained child. On the sunny side of all of this, I believe the process has served to increase her ability to empathize with others and has, overall, taught her to strive to be a better person, to set standards for both herself and those she surrounds herself with appropriately high. She learned to respect herself instead of being self-deprecating and practicing self-harm.

Having an open line of communication with your child is essential

If they can’t come to you who will they confide in? What will be the outcome? It all boils down to talking, getting the right help by following your gut, and researching whatever areas you may have knowledge deficits in using evidence-based practice as your go-to. Always remain open-minded to adjunctive therapies, as in, don’t avoid certain things due only to stigmas when what you’ve got so far is not working. Stop staring at the wall; try painting it by reminding yourself that there is a real, chemical imbalance creating these problems. Most importantly, forgive yourself. You are only human and you are only going to get better.