“Hello?”

“Hi, this is the ACH calling, how are you this evening?”

“…………Fiine………..thankyou…..”

“Well, that’s good.  There’s been an escalation tonight.  It was pretty serious, but everything is ok”

“Really?  But the day seemed so good…I don’t get it…is there anything I need to do?

“No, everything is ok now.  The team will call you in the morning”

“Can I speak to her?”

“No, that’s not possible right now”

“Ok, thanks for calling me.  Please let me know if there is any change”

“Will do, have a good sleep.”

“Sleep?  Right.  I guess I should sleep.  Thank you”

I’ve had that call 5 times now.  I can’t quite describe the feeling.  I actually have felt the blood run out of my face.  The fear is intense and the sadness overwhelming, however as I begin to understand, the intensity does lessen.

Over the last 4.5 months, we have been through 2 residents, many, many nurses, TA’s (therapy assistants), and have had 1 main family counselor and 1 main psychiatrist. You would think that with all of the intense counseling, classes, treatments, cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), sessions and medications that everything would be fixed by now.  That’s just not how mental health works.  It’s complicated, twisted and has many layers to it, and revisits in different ways.

Have you ever tried to lose weight?  I have, and it’s brutal.  I really thought I succeeded a few times, but for some reason it keeps coming back.  You make the decision – I’m going to lose weight.  You set yourself up, clean the pantry and get rid of temptations, put some positive slogans around the house, set up a good app on your phone, and you might even join a support group.  The first day goes pretty good.  “I can do this, oh yes I can.  I’ve got this.”  First day goes pretty good.  Can’t say you don’t think about eating a big bag of chips, or perhaps getting the pastry along with your coffee, but you don’t do it.  You’re tempted, but you don’t.  The first week goes pretty good.  A few minor challenges, but overall, not too bad.  Week 2 comes.  You’re a little tired, maybe discouraged a little, but still trying to focus on the goal.  You make it through breakfast, and you’re still a little hungry.  Have a glass of water, think about something else, go for a walk, get out of the kitchen.  You know this is what you have to do.  You know it so strongly, but for some reason, something speaks to you – maybe the fluffy white bread you bought for your kids is now calling your name.  You know what to do, but before you know it, you’re elbow deep.  You’ve not only made yourself a couple extra pieces of toast, with butter….and what the heck, jam too, but you’ve also scooped up a spoonful of peanut butter to eat while you’re putting the rest together.  You finish the toast, so quickly you don’t even really taste it – and the peanut butter is stuck to the roof of your mouth so the 20 oz. of juice you just chugged was totally necessary.

The aftermath of that experience is never good.  Guilt, frustration, disgust, disappointment.  How could I loose control like that! I just ruined all the hard work I’ve done.  Oh well, tomorrow is another day.  Eventually, the distractions and temptations are so overwhelming that you just give up.  Whatever, I can’t do this!  Why do I even try – this just never changes.  People say to you “just quit eating so much”, “go for a walk – just exercise more”, “just put your mind to it”, “all it takes is willpower”.  If you’ve tried, you’ve heard all of this – I know I sure have.

Now, lets take this scenario, and put it to mental health – specifically depression and anxiety. (I now believe that being over weight is just as much a mental health issue as anything else, but that’s a different discussion). A person feels depressed, and I don’t mean just a little down, I mean clinically depressed. They fight hard and say all of the same things as above. “I can do this.  I’ve got this.  Things aren’t really that bad.  There’s a light at the end of the tunnel”. The problem is, when you’re in the hole of depression, it doesn’t matter how much positive thinking and talk there is, it just doesn’t work – at least not until you’re ready.    It’s like being a tiny little creature in the middle of a big bucket of swirling water.  It desperately treads water, trying and trying, sinking a little bit more each time.  It might come for air a little bit, but no matter how hard it tries, it cant even see the edge of the bucket, let alone reach it.  People who are depressed can be ok for a time.  They try, stay distracted, use their tools, perhaps try and follow a safety plan, but sometimes things just come unwound and before you know it, they’re elbow deep.  The tricky part is that even though they may get through this one, they know another one is coming, which can be incredibly discouraging and overwhelming.

Sound hopeless?  Not at all.  That tiny little creature above somehow comes up with a last little piece of energy, changes direction, flips things around and starts inching towards the edge.  Why?  The bell rang.  Something happened that made sense and gave the little guy the will to live more than the desire to quit.  That desire to fight was ignited and the edge of that bucket came in to site.

I have had numerous conversations with the entire medical team, and often with my daughter about this very theme.  “Just try. Remember you’re tools.  Don’t you want to come home?”  It wasn’t until yesterday that I realized that for some reason, the bell hasn’t rung yet. I also learned that she is just as frustrated as we are, questioning why can’t I do this, when so many others seem to be able to. Pieces are there, and ocassionally there is a small light, but often still, the dark moments are so overwhelming that fighting through seems hopeless.

This is where we come in.  Don’t get me wrong, this is terribly frustrating, but if we quit being impatient, stop thinking about what we want and start thinking about what people need, we can begin to understand and be there for support.  Often there’s no need to even say anything.  A serious bout of depression or anxiety leading to an escalation can be terrifying to the one experiencing it, and I’ve found by just being there, and not saying anything at all, you can show how much you care. We don’t need to mock, or judge, or criticize when faced with someone in crisis.  Be there.  Stay neutral.  Try and listen or understand  how hard it really is, and just love unconditionally.  Most of all, don’t give up.  The bell will ring eventually – I have to believe that.

We need to talk about mental health.  The only way the stigma will disappear is if people start talking, stop judging and try to understand.  It will happen – it will.