Take A Deep Breath and Count to 10

Back in December one of my favorite D-moms posted an article about diabetes and depression in children.  It is an anonymous D-mom’s story about her 11-year-old son suffering from depression and ultimately ending up in a psychiatric hospital for stabilization.  The story touched me in many ways, at first because I have a child who is 11.  Second, because I’ve personally had the experience of spending some time in a psychiatric hospital for severe depression.   The story made me feel very deeply for this family because it was hard to imagine watching my own child go through this same sort of downward spiral and not fully realizing exactly how deep that spiral had gone.  And then having the added fear of not only hearing your child say they want to end their own life, but then also trying to make arrangements for them to be safe, when everyone you talk to at the facility they are going to doesn’t understand or know how to manage their diabetes.  And because your child is depressed and suicidal they can’t manage their own care because, in case you didn’t realize it, too much insulin can be a deadly.  Lack of insulin can be deadly. Having suicidal thoughts and not getting proper treatment can be deadly.  I don’t want to even think about how helpless that mom must have felt having to make those arrangements.

A few weeks before this article I had been growing increasingly concerned about Angelina’s mental health.  Her therapist had also expressed some concern about her moods and was concerned about depression.  She had become more withdrawn in her therapy sessions and about every third session she wouldn’t speak at all, but sit and sulk.  At the beginning of January we met with her psychiatrist (who prescribed medications for her ADHD) and I had briefly mentioned we were concerned about depression and requested that she reach out to the therapist. I signed a release form and hoped that the therapist would be able to explain better than I was what was going on.  The psychiatrist seemed unaffected and said that mood swings were common at this stage.  We discussed how her current ADHD medication didn’t seem to be working well for her anymore and she prescribed a new one to try.  She suggested that we keep an eye on things and follow-up next month.

Things continued this way at therapy for the month of January.  The first week of February we met with the psychiatrist again and again I expressed concern about depression, as well as the therapist’s concern about depression.  She seemed to take things a little more seriously this time, but we still mainly focused on how things were going with the new ADHD medication and general talking points “How’s school?” Fine. “How are your grades?” I don’t know. “Are you hanging out with any friends?” No, I don’t really have any friends.   Those were about the only words muttered by Angelina in our 25 minute visit before she sort of curled up on the end of the sofa and started at the floor.  Any further attempts to engage her were met with stony silence.  At 20 minutes into the appointment, after nearly 3 minutes of no one saying anything the therapist says “We’ll follow-up in a month.  If she’s having more bad days than good we can possibly discuss medication.”  and we scheduled our next appointment and left.

That brings us to the past month. There are still more good days than bad, but there are more of those days where one minute things are fine and the next minute her entire attitude, mood and disposition change and she is sullen and completely withdrawn and refuses to speak or interact. About 3 weeks ago Angelina’s therapist asked me back to talk alone for a few minutes, and I ended up talking to her the entire session time while Angelina sat in the waiting room.  We discussed the possibility of antidepressants and her response was “I’m a therapist.  I don’t automatically jump to medication to try to help people.  But I’ve been seeing Angelina for a year and a half and in the past few months she talks to me less and less and I’m at the point that I don’t know what to do or how to reach her.  I can’t help her if she doesn’t talk to me. It’s obviously your decision, but at this point I think medication might be a good idea.”  About a week after our last visit with the psychiatrist I mentioned to my husband that we had discussed medication for depression.  I was a bit surprised when his response was “No. She’s already on enough medications. I don’t think that’s necessary.  A lot of kids this age deal with depression.  She doesn’t need to be medicated.”  And for the past few weeks we’ve dug up this discussion a few times, always meeting at a stalemate.  We were finally able to reach an agreement yesterday.

Today Angelina saw her psychiatrist and tomorrow she sees her therapist and will start taking an antidepressant.

#Dblogweek 3 – What Brings Me Down

dblogweek

 

Click for the What Brings Me Down – Wednesday 5/14 Link List.
May is Mental Health Month so now seems like a great time to explore the emotional side of living with, or caring for someone with, diabetes. What things can make dealing with diabetes an emotional issue for you and / or your loved one, and how do you cope? (Thanks go out to Scott of Strangely Diabetic for coordinating this topic.)

from bittersweet diabetes

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Well, I just have to say that May being mental health month was something I was aware of long before diabetes entered our lives.  I try to stay away from talking about my bipolar on this blog, because, well, this blog is supposed to be about diabetes. And plus, I have a whole other blog dedicated to my journey with bipolar (Which has been sadly neglected the last year or so).

But, I feel like today would be an okay day to blog about my bipolar and our family’s overall mental status in regards to T1D.  It’s been over a year now since Angelina’s diagnosis and I feel like we are in a good place.  I’ve made being a diabetes expert my life’s goal (joking, sort of.) and even being relatively newly diagnosed, I am quickly reaching expert status.  Angelina’s endo actually called me an expert at her check up two weeks ago, that was weird, but made me feel all warm and fuzzy inside.  Part of my mental issues are that my version of reality is something grossly WRONG compared to other people’s.  I tend to question and second guess myself often because of this and then swing wildly the other way and believe that I know better than almost anyone else.  It just reminds me of the totally cheesy 90’s commercial for Sure Deodorant.  Anyone remember those?  That is me on a daily basis, except I’m not worried about damp armpits.

 

So, I come off being either totally arrogant, or neurotic and wishy-washy.

On another note, bipolar and diabetes have a lot in common.  When you’re out of your “normal range” you may act oddly and have little control over it, you may be cranky and irritable, you may want to just lie down and sleep all day, you may want to eat everything in sight, or maybe not ever eat anything ever again.  You may realize that you are high or low and try to do something about it, only to find yourself plummeting dangerously in the opposite direction, seemingly spinning out of control.  Or, you may not recognize when you are high or low until someone else points out that you are acting strangely.  Sometimes highs or lows (blood sugar or moods) happen for no apparent reason and may stick around stubbornly despite your best efforts to try to control them.  Sometimes you get stuck in a rut and just give up on trying to control it, despite the consequences.  Sometimes you put in no extra effort and things are wonderful.

Moods and blood sugars can both be affected by: food, hormones, stress, exercise/activity, weather, medications, illness, other medical conditions, changes in routine or sleep, your support system (or lack of), proper professional support (dr, therapist, etc) and education.

Both conditions are subject to being misunderstood and stigmatized by the general population.  Both conditions are often the brunt of jokes or flippant statements that are only loosely based in fact, if at all.  Neither condition has a cure.  Both conditions are very serious and require intensive management and treatment to avoid immediate and future complications.  Both conditions are prone to not be taken seriously unless you have them or are very close to or a caregiver for someone who has either of them.

On the other side of that coin, they are different.  T1 has a very medically measurable physical cause, bipolar doesn’t usually.  T1 is more physically painful with all the pricks and pokes and is often more publicly visible.  Bipolar is more mentally and emotionally painful and often is “invisible”.  While T1 is a physical disorder and bipolar a mental disorder, they both effect the mental and physical side of a person.  Neither are easy.