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Mental health Preventing suicide

At our recent educational forum on teen depression, at the Massachusetts State House, Sue, a school nurse, introduced herself to me. She handed me an essay written by her daughter, 17-year-old Caroline. Sue told me she’d like to become more involved in the issue of teen depression and suicide.

I read Caroline’s essay, “What it’s like.”

“In school I’m energetic, I talk a lot and have many friends,” Caroline wrote. “I go out on weekends. I wear ‘preppy’ clothing, and play sports. I do well in school and always attend sporting events ... My favorite color is yellow. I smile. When you look at me, I appear happy … what you don’t see is my pain. I am a 17-year-old girl who is depressed.”

Caroline thought others didn’t notice, but her parents knew something was wrong. “She was always in a bad mood,” Sue says. “I remember so clearly the day she said, ‘Maybe this family would be better off without me’. It was one of those ‘Oh, my God moments.’ ”

The next day at school, Sue pulled an article about teen suicide from a file she kept in her drawer. The article stated the importance of confronting a person who has directly or indirectly talked about taking their own life. But too many hesitate to do so, fearing they’ll plant an idea – this is a myth.

That afternoon, Sue asked Caroline whether she’d ever considered hurting herself. After a long pause, Caroline said, “I don’t know.”

Sue immediately sought professional help for her daughter. Her pediatrician referred her to a therapist. The therapist recommended that Caroline begin taking antidepressant medication in addition to attending regular therapy sessions. Caroline and Sue both resisted. “Even as a school nurse I wasn’t ready to accept that my daughter needed to be medicated. We were heading into the summer, and she seemed better.”

That fall, Caroline suffered an anxiety attack. When she described it to her pediatrician at her annual physical, Caroline’s doctor recommended anti-anxiety medication.

Caroline and her mom agreed it was time to try medicine.

To her mom, Caroline seemed less irritable. When she asked her how she felt Caroline said, “I guess OK.”

A few months later, Caroline took a handful of the pills and was rushed to the hospital. She told her mother she wasn’t trying to kill herself; she just wanted to escape the pain. “I think Caroline believed the medication was working, but in her mind just not fast enough.” Sue says. “In her distorted mind, in a desperate moment, she wanted the overwhelming emptiness to be gone.”

After the overdose, Caroline started to see a psychiatrist who tried several different medications, until he found a combination that helped. Caroline continued in therapy. A year later, she decided on her own to go off of her medicine and stop counseling. “I wanted to be normal,” Caroline writes. “I didn’t want to rely on a pill to be happy.”

Sue knew that sometimes when medicine and therapy are working, a person with depression thinks they are better and can stop therapy. When Caroline went off of her medication, she was difficult to live with, but told her parents that she didn’t need help. Sue begged her to continue her treatment, but Caroline refused.

Before long, she sank into a dark hole. Feeling alone and desperate, she overdosed again.

Finally, Caroline admitted that she was suffering from a serious illness. ”It’s more than a feeling. It’s a mental illness that you can’t help. It’s not your fault. It’s an emptiness. You feel as if you never will be happy again. … It sucks, but you can conquer it. People sometimes have this cliché on that those suffering with depression look like. Well they’re wrong. I don’t wear black. I don’t sit alone at lunch. I don’t do drugs. I’m a senior in high school and I’m depressed. And I’m not ashamed to admit it.”

Caroline wrote “What It’s Like” as a class paper, in response to being teased by schoolmates about her suicide attempt. She and her mother are committed to helping others learn about mental illness, so other families can be spared the pain they’ve experienced.

“If we don’t put a name and face to what depression is, nothing will ever change.” Sue says.

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