Down and Out: The story of one mother’s journey through her son’s depression -- Part 4
Medication
Once again I write to Dr. Thornton before our next visit and I tell her: “His negative disposition is still difficult to turn around. If I can encourage Nicholas to participate in some physical activity, releasing those endorphins, he can usually work his way out of a bad mood. I say ‘usually’ because sometimes he seems so down that he cannot entertain the thought of moving from one place to another, especially not in an energetic way.
What I don’t say in my note to the doctor is that I am profoundly saddened when Nicholas uses negative self-talk, describing himself as “stupid” or “bad.” Sometimes this talk becomes even more troubling and morbid. Perhaps my own hyper-sensitivity towards deprecating self-talk plays an overwhelming role in my concern, and I suffer my own form of depression. My father was an alcoholic most of his adult life. He often called my sister and me “stupid” or worse “stupid-idiot.” I hated these labels but had enough self-esteem to ignore the hurtful words. My sister was too little to dodge the verbal bullets. I vowed that, if ever I had children, I would never call them degrading names. I never have. But Nicholas acts as if he is emotionally or physically abused and that is so far from the truth.
As Nicholas and I sit in Dr. Thornton’s office, he curls up in my lap and falls asleep, leaving me free to describe the current situation without disturbing him.
“We saw the therapist you recommended. Dr. James taught him to meditate last month and sometimes that helps. It is true that Nicholas stopped rubbing his mouth or scratching his head lately. No new sores. But now he has uncontrollable blinking episodes. When I ask him if he can stop blinking, he says ‘I can’t. I’m not doing it on purpose Mom, and it doesn’t hurt.” Yesterday, during one of the “blinking” episodes, I asked him if something worried him. “No,” he replied.
So… is this his problem or mine?
But I worry about next week. Nicholas starts at a new school. He is familiar with the school. We’ve spent many hours with him there, getting to know the teachers, the classrooms. He already knows some of the students. The classes are small. The room quiet. Seems like the perfect school setting for my son.
Dr. Thornton acknowledges my concern. “I believe I mentioned to you before that Nicholas may be the perfect candidate for homeschooling.” I wince. He may be the “perfect candidate” but I’m not. When I don’t respond, Dr. Thornton continues: “Usually I don’t like to start school-age patients on medication without a long lead time for assimilation. In this case, I may need to make an exception. I have watched you in my office for a couple of years now. I know you do not take this next step lightly. Are you willing to try medication at this point?”
Deep breath. “What are my options?”
Now it’s Dr. Thornton’s turn to take a deep breath. “First you must understand that according to the National Institute of Mental Health research, depression in children and adolescents is treatable. Some antidepressant medications, called Selective Serotonin Reuptake Inhibitors (SSRIs), are often beneficial to children and adolescents. But, and this is a big BUT, our knowledge of antidepressant treatments in youth, especially someone as young as Nicholas, is very limited. I would like to start him on a small course of Valium at night to help him sleep and to see how he handles medication. Valium is not an SSRI. It is an anti-anxiety medication that is often given to infants in the hospital so we know that it is safe. Are you willing to start here?”
I look at my son asleep. Unable to cope, he always shuts down.
“Yes,” I say, not sure what door I have opened.
Dr. Thornton writes the prescription. “Give this to Nicholas at bedtime and exactly as I prescribed.”
After the initial shock and numbness wears off, I realize that I never asked the important questions: Are there side effects? What do I do if he develops any? Will Nicholas become addicted? How long before we notice the effects of the medication? How long will he need to be on the medication?
Selfishly I fill the prescription without ever asking these questions. After more than five years of sleep deprivation and worry, I am willing to proceed almost blindly to help my son and our family.
Part Five: The Medication Journey Continues
Read Part One, Part Two, Part Three, Part Four.
