Monat: Dezember 2019

Why I talked about suicidal ideation to my 9yo

dieser text entstand ursprünglich für die kunstgalerie beeldend gesproken in Amsterdam, die sich auf werke von künstlern mit psychischen krankheiten spezialisiert hat. da sich die veröffentlichung dort noch etwas verzögern wird, hat mir meine auftraggeberin freundlicherweise erlaubt, den text hier vorab zu veröffentlichen.

Edit 4. Mai 2020: Wegen Corona habe ich gerade nicht viel anderes zu tun als dieses Blog (und für nicht viel mehr die Zeit), daher habe ich diesen Text, den ich immer noch sehr mag und der in der Krise aktueller ist denn je, als Audiodatei eingesprochen. Ich entschuldige mich für meine Aussprache, meine Ps und Ss und für die nicht optimale Tonqualität generell. Eigentlich wollte ich dies als Clip auch bei YouTube hochladen, aber dafür ist es 1min06sek zu lang. Und für eine gute Bearbeitung oder eine neue Aufnahme fehlen mit Technik und Zeit. Aber wer lieber hört als liest, kann sich den vorliegenden Text jetzt also von der Autorin gelesen zu Gemüte führen.

“Mom, do you use drugs?”
My 9yo has a knack for asking hard questions at bedtime, right when I’m about to turn off the light. I on the other hand am incapable of giving short, evasive or postponing answers to these hard questions – I mom like that. So of course, I sat down at her bedside and did my best to explain the general understanding of “drugs” to my daughter, how and why human beings use drugs and whether I personally “use drugs”. While I was confused at first as to how she came to ask this question, it dawned on me during our conversation that she was worried about me taking CBD oil. I had started it at the beginning of the year to help with my depressive episodes, brought on by the combination of my adjustment disorder, which is currently in a chronic state due to my professional situation, and a semi-mild case of Pre-Menstrual Disphoric Disorder (PMDD), which pulls me down several notches for two or three days on a monthly basis.

The adjustment disorder has been a part of my life since puberty; it manifests in depressive episodes following transformative events. There had been several of those in my life before I had children, and despite all hopes, having my first child did not cure me. On the contrary, I had a near burnout a year after her birth, when I had to return to my job in advertising that wasn’t very rewarding. I went to therapy, switched agencies and things seemed to be better. Then I had a second child and lost my job shortly after; since then, I have been trying to find a source of income, which is the main reason for my current mental fragility. PMDD with its cycle-related crises is relatively new in comparison, like a hormonal cherry on top of the adjustment disorder cake. In the last five years, the fact that “mom is sad” has unfortunately come to be a constant in my children’s life.

When I realized what the reason was for her initial question, I focused on drugs in terms of medication, specifically why I am taking CBD oil. Accepting my disorders as illnesses and experiencing my depressive episodes as symptoms – treatable symptoms! –  has helped me weather the worst times recently. I’m hoping that CBD oil will help me with the physical aspect of my illness, bringing a chemical balance to the brain that I cannot naturally achieve. Getting enough sleep, sometimes taking a break from my duties (also sometimes allowing the kids more screen time than I actually deem “okay”) and generally treating myself with care are other ways to handle my mental illness when it flares up. My daughter was intrigued by the aspect of chemical balance in the brain and asked me fearfully whether that meant I was “impaired”, and whether it was hereditary, so she might also have this illness. This was a bit difficult, since I see her hypersensitivity and tendency for anxiety, and recognize myself as a child, hypochondria and all. I told her it is a possibility but that didn’t have to mean she will be as affected by it as I am. I assured her I will always have an eye on her especially because of this and that it’s why I often take time to talk to her about her feelings and her self-image.

Nevertheless, the thorough girl wanted to know what exactly goes on in my head when I feel depressed. So I told her, there is this voice – that I know is the illness – telling me that I’m not good at what I do, that I am failing as a professional, or worse, as a mother, that things will always stay this bleak and nothing I do will change it. I wasn’t going to talk about suicidal ideation (the occurrence of suicidal thoughts), as I knew it would scare her, but alas, she is thorough and needs to know all if she knows one thing. She asked me point blank: “But did you ever not want to live anymore?”

With this, I had to make a decision on the spot: Do I stick to my principle of honesty and completeness, with the risk of scaring my child, or do I tell her a lie, saving her from the burden of knowledge? Since my default mode is honesty, and hesitation is an answer in itself, I answered: “Yes, that is a thought that sometimes comes along with the others.” I knew right at that moment that I was going to have to explain this decision to at least one person – her father, who does not have the same experience with mental illness as I do – but I also knew instantly that I made the right decision, for both myself and my daughter.

Before I lay out my reasons here, let me say that, yes, my answer made her cry, but our conversation continued until I was able to soothe and comfort her, so when I left her bedside, she was calm and in her usual 9yo bedtime mood. I pondered over our exchange, realizing and formulating the reasons for my instinctive decision in hindsight as well as foreknowledge of the discussions I was going to have about it. It was already the next day that I had the opportunity for a test run of my argumentation. My daughter’s teacher called me around noon, telling me the child had had a crying fit during school hours because “my mom doesn’t want to live anymore”. She was by then comforted and playing with her friends, but the teacher had wanted to check the urgency of my situation. The reasoning I am laying out here is almost completely based on my exchange with the teacher, a caring person who I greatly respect for prioritizing her students’ well-being above all.

As I mentioned, honesty and age-appropriate completeness are my most valued guidelines in conversations with my children. Honesty goes without saying, simply because I want my children to keep on trusting me through puberty and in their adult lives; absolute, yet kind honesty is the only certain way I know how to ensure that. What’s age-appropriate and what is not may be debatable, but in my experience, if they can ask the question, they can handle the answer. Phrasing it in a way their growing mind can work with is my task as a responsible parent. Yet, I don’t practice honesty purely on principle, but also to unburden the hard topics from shame. In child-rearing, mental health is as fraught with taboo as sexuality – if not more, since the generally accepted guideline for today’s parents is to call the private body parts by their official names so as to free them from said shame. Part of the thinking behind it is, when you can talk about body parts and occurrences “shamelessly”, when you can give it a name and are well-informed about its function, you are consequently able to discuss variation and distinguish healthy from unhealthy, thus tackling medical issues before they become catastrophes.

This understanding we have in sexual education, in my opinion, should be transferred to mental health education, and that is what I did at the time. To wit, when my daughter was shocked about the fact that I sometimes don’t want to live anymore, I was very quick to point out to her that it is only that: Ideation that I do not gladly or willfully conjure, but that rises up along with the other (untrue) ideas about myself or rather, as the tail end of my self-deprecation, and as such it is a symptom of my illness. I reiterated to her what I learned from my meditation app (thank you Headspace), that our minds are as the sky, neutrally existing, and our thoughts and feelings are clouds passing over it. They can be the white clouds of a summer’s day, and they can be a dark and threatening hailstorm, but whatever they are, they pass, leaving the mind ultimately untouched. This framing has helped myself tremendously when experiencing suicidal ideation, and I hope learning about it so early in life will enable my daughter to manage her own mental health journey far better than I did. Writing about it now and admittedly riding my comparison of mental health education and sexual education to death, I’m inclined to say: Suicidal ideation is the fetid discharge of a depressed brain, and not being able to put a name to it, not being able to talk about it because of shame, prevents us from seeking help and will only lead to aggravation; in the case of mental health, this aggravation can be deadly.

My daughter’s teacher rightfully pointed out that knowing about these thoughts is a heavy burden for a child; the burden is not heavy, though, due to suicidal ideation itself being so rare or inevitably leading to suicidal acts. It isn’t, and it doesn’t, but our society has difficulties making the distinction between one of the symptoms of depression and its incidental outcome. Certainly, this is in line with the general taboo around mental health issues that still prevails, often doubling the burden for the person suffering. Despite being a very common and widespread illness that afflicts persons from all walks of life, depression is not a topic generally discussed in its prevalence and, to the media, rather boring manifestation of exhaustion, lack of motivation and hopelessness. Except of course when a public figure commits the “interesting” act of suicide and, as witnessed again and again, the media and minds of the public are suddenly full of commiseration with and facts about depression. As I said to my daughter’s teacher: Society speaks about suicide and depression only when someone prominent has committed the ultimate act, but there is silence around the many sufferers of depression who continually have suicidal thoughts without taking action. In all our minds, the idea of suicide is considered one with the action because we do not talk about the desire to die. It is taboo for many reasons, suicide being a cardinal sin in our basically Christian value system among the most harmful.

During our initial conversation, I had stressed the fact to my daughter that a thought, even one as “I don’t want to live anymore”, is very different from plans and even more so from actions. Making this distinction wasn’t only important for our current situation, me being the mother with suicidal ideation and her my worried daughter. It was also important for the eventuality in our future that she is affected by mental health issues as I was and am, during puberty and beyond. I not only needed her to understand right now that I wasn’t in a constant state of wanting to die, but that suicidal thoughts occur in crisis and pass as the crisis does, that while it isn’t pleasant or to be taken lightly, it is very much not an actual suicide plan. Just as much, I needed her to understand that should she herself experience depression and suicidal ideation, it would not mean that her path then was inevitably set towards suicide – which is what had frightened me most when I felt I didn’t want to live anymore for the first time in my youth. At the time, I had no one explain to me the difference between the thought and the act, I had no grasp of the symptoms of depression, I did not even know myself that I was suffering from depression. All I knew was that people who died by suicide may or may have not been thinking and speaking about it before. What lies between the thought and the act was a blank to me, just as much as the number of people who are going through their whole lives or at least phases with suicidal ideation who never form a genuine plan. The wish of not wanting to live anymore, to me, felt like the last and only step on the way to actual suicide; I had no one explain to me that there are a lot more steps between this sad and painful feeling and hands-on termination of one’s own life, which I may never feel inclined to take. This I needed my daughter to know before she came to that point herself, so she feels safe to come to me for understanding and support.

My daughter’s teacher – maybe because she had no experience to compare and argue with – conceded and we ended the conversation amicably, with me promising to pick it up with my daughter for closure. When my daughter came home, I gently repeated these important points to her: It is not a constant state of mind, I am not in acute danger of killing myself, it is an occasional symptom of my condition that should prompt me to take care of my mental health.

It turned out later, when I spoke to my mother about it all, that she supported my decision for these exact same reasons. She had experienced suicidal ideation herself during puberty and hadn’t felt able to speak to her parents about it; if I had known this during my youth, I would have felt free to come to her then, when I was in the situation for the first time. My mental health journey would have been less lonely, less scary from the beginning. Of course, my mother’s silence, as much as her parents’ silence around the hereditary affliction on their side, wasn’t malevolent. It was borne out of shame which in turn was borne out of ignorance. “Not being right in the head” was still something to be shamefully silent about for my grandparents, depression still put people into asylums in my parents’ generation. Suffering from depression and suicidal thoughts was definitely nothing to be discussed liberally, least so with the children. The societal taboo around mental illness created a silence between parents and kids, in my own generation still. This silence between fellow depressives in a family, in my opinion, causes far worse issues than I could have done by being open with my daughter – seeing as she may have walked on eggshells around me and was exceedingly cheerful, obliging and helpful for three days after our conversation, but soon returned to her natural headstrong and obstinate self, healthily lacking any worry about how her occasional “being difficult” could affect my mental health. What remained was a sensitive intuition when “mom is sad”; she will reach out her hand or come to hug me, and I will gratefully accept her comfort, hoping that she will allow me to repay it if she should ever fall into the same darkness.

Months now after having the initial conversation with her, I am more convinced than ever that my blunt honesty has not traumatized her but laid the groundwork for clear and open communication about feelings and mental health. We still butt heads and have tiresome discussions over bedtime and screen time, as you do. She is heading towards puberty and adequately scared and elated at the prospects of her future. I am still taking CBD oil; I am still struggling through days and weeks of depressive episodes. I am still fending off suicidal thoughts with the most effective argument against killing myself: I need to model for my children that you can make it through, that sadness, hopelessness and suicidal ideation passes, that sometimes showing up and breathing is all you can and need to do to make it another day. That suicide is not the way “out”, and that I will always be there for them.