Visiting My Teenage Daughter in the Psychiatric Ward
By Susan Dickman
The door clicks open, and I begin the familiar drill: sign in, deposit coat and bag in a room which the attendant will lock behind me. I follow the small herd of parents shuffling down the hallway to the common room, where the residents will enter from a separate door. Within moments we meet in all our awkward embraces and hellos.
A smile plays on my daughter’s face when she spots me, but I know better than to hug her. She allows me to deliver a brief kiss to the forehead, and then we settle into chairs, trying to knit together a conversation from stray and tangled comments. What she ate for lunch. The winter storm that is brewing. The latest antics the cat has been up to. All normal conversation for the adolescent psych ward, where we are all in collusion, pretending that to be there is to be utterly normal.
My daughter’s hair is greasy, and she has been wearing the same black corduroys for days. Yet she still can, at this point, pass for your average fifteen-year-old teenager. Or are they all this much at-risk, ready to drop off the edges of their fragile little worlds?
After a few minutes of conversation that dribbles off into nowhere, I suggest a game. Scrabble is something solid to land on, with its wooden alphabet letters perched on wooden benches, with its highly detailed rules and mathematically designed board.
It is her third stay in the ward, not counting the out-patient program at another hospital last year, when everything came to a crisis point in February. She has the idea she is in because she became suicidal; her father and I thought it was because she refused to go to school, and then threatened suicide when he took away the television remotes. Our daughter sincerely believes her own story. This is not the first time the phrase “distorted thinking” has appeared in my head. It will take her father and me a few days to realize that, to her way of thinking, there was a real connection between no television and suicide, that even getting to this psychic place of what could have remained a teenage tantrum spelled death for her, because her mind works like lightning and moves from thought to thought without weighing any of them. Suddenly, without knowing how or why, she is in fight or flight, cannot evaluate clearly what is a threat and what is not, and then all is lost. Or she believes it is. And because she has been in this place—the hospital, this way of thinking and reacting—she assumes she will be there again. And she does, and she is.
The other families are playing Scrabble or cards, fooseball or talking in soft voices over meals they have brought in and have had a staff member check. For what? I’m never quite certain. The room hums with the steady sound of people trying to relate to one another. Once in a while during a visit a resident will suddenly raise a voice in anger or pain, and a staff member will intervene with a gentle directive for the resident to leave the common room. It is jarring when a visit ends abruptly—a raised voice, a threatening tone, pathologies playing out in the genteel atmosphere of the visitors’ hours.
Sometimes I look around me and spot my wish-list mother-daughter duo. They’re playing Boggle and laughing, whispering jokes and secrets to one another. The mother rubs the daughter’s back and embraces her in a long, loving hug. Hugs don’t come naturally to my daughter; she does not like being touched. Sometimes I can administer one gently, as long as I ask, but they are rarely, if ever, exchanged. When she was a very young child she must have parroted back the “I love you” of a toddler, but I don’t remember.
The day after she arrived, the weekend psychiatrist asked a battery of questions. “Diagnosis?” “Take your pick,” I tell her. “Depression, Generalized Anxiety Disorder, Mood Dysregulation, Bipolar II.” I save that one for last; no one really wants to say that label, even the softer II designation. “Perhaps with a touch of Asperger’s,” I continue, repeating the words of the weekday shrink who has worked with us during the other visits, though I am not certain whether I believe these last two. “And an as-yet undiagnosed Processing Disorder thrown in as well.” The professionals, and we are ensconced in a team of good ones, are not necessarily eager to diagnose. The teenage brain is plastic, they tell me: growing, fluid, highly at-risk and yet able to bounce back, morph and change. Still, when pressed, the outside-the-hospital shrink will admit to characterizing my daughter as bipolar, even while cautioning against labels, which she says can change. Me, I love labels by this point: they inform, guide, direct. It’s just hard to utter them for fear of people’s reactions.
“She’s bipolar,” I want to tell the people in our lives. “And she is also her own beautiful self: bright, artistic, talented, funny, and fun to be around when not raging.”
Still, I want to know this: Where is she? She was a stunningly gorgeous and artistic child with the ability to walk into a room and suss out every minor social nuance occurring. She drew whimsical pictures of creatures pulled from her vivid imagination. Intensely musical, she arrived in this world with perfect pitch and the ability to play, by ear and with two hands on piano, anything she heard. She still plays, sings, composes, writes screenplays, stories, film treatments, and graphic novels, though completes nothing. Always a bookworm, she has barely read anything in two years. There is static in her head; her emotional life takes up most of the grey matter. Where did she go?
We thought we were guiding her. We enrolled her in art classes, music classes; she played soccer and joined an area choir. The house was littered with her sketchbooks and drawings, her stories and comics. She went from violin to guitar and began composing her own songs.
The academic side of school never impressed her much, though she is bright, the kind of student who drove teachers crazy because they knew she could do better work if she tried. With a high-achieving older brother, we didn’t want to pressure her, and figured she would find her own path in school. But something held her up, and her mind began to appear less and less organized. Differently organized. Something began to seem wrong.
How did this happen? I want to know. My daughter was a planned pregnancy, a hoped-for child. I ate well prenatally, was happily married, and gave birth to her at home after a rather brief and normal labor. I breastfed and stayed home with all three children, working part-time for years. The house was filled with books and music. I fed them organic food and baked my own bread. We sat down to dinner as a family every night and didn’t watch television or spend much time at the computer.
Of course, her father and I hadn’t planned on divorce. And so I think about what might have been red flags way back when. At age five, upset by something minor, she explained away her extreme behavior by claiming she was an artist. I remember her anxiety at day camp, and the time she threw a block so hard it broke a window. I think about the blank fuck-you stare she gave the camera in so many photographs, the subversive humor, and the strangely quirky drawings she did even as a young child. I think about my parents’ decades of depression and my father’s inexplicable rages, my brother’s drug use and brother-in-law’s behavior problems at school. I consider my own struggles with depression and mood swings, wonder if I might have been diagnosed bipolar at some point. Except that I wasn’t, and instead, although it took me well into my forties, joke about being a poster-child for therapy and anti-depressants used at the right time. As a child I did not rage publicly or refuse school. I didn’t push boundaries and move into the realm of special education. I was too afraid to assert myself to that degree. I was an unhappy and anxious child, but apparently not to the extent that my daughter is. But now I am talking about myself, not her. And this is her path, her story, her life, and her illness is not my doing. And still I am defensive.
I had taken the highway up to the hospital, and Green Bay Road, which meanders through Wisconsin, back down. The snowy roads pull me past picturesque streets along winding ravines. The last time she was in the hospital, in summer, a statuesque buck suddenly bounded out of the surrounding scrim of woods at dusk, standing for a moment in the crosswalk of the quiet moneyed suburbs of the north shore. Now, crows wind in circles toward the frozen lake. Houses are dusted with new snow, and arctic temperatures are expected by nightfall. The winds have picked up to 40 miles an hour. But my daughter is safe and warm inside the adolescent psych ward.
And the truth of the matter is, my daughter is journeying into another landscape. We can only skirt the edges of the territory she has begun to traverse; we cannot go there with her. We can love and support and do our best to guide her, take her to appointments, try to keep her healthy, and continue working on being the parents she needs and not the ones she simply got. But we have to watch her walk out into this strange and troubled land without us, until she is ready—one day we hope she will be—to walk back to us, whole.
The evening she returns home she picks up her guitar and begins singing a tune she wrote with another repeat resident. Her sweet voice is full of light and mirth as she sings lyrics about the foibles of her sojourn in the psych ward. Like she did the last time she ended up there, she steadfastly refuses to cut-off her hospital bracelets. She is certain they will act as a charm against another stay.
Susan Dickman has most recently published work in Best of the Best American Poetry, Lilith, and Intellectual Refuge, and is the recipient of three Illinois Arts Council awards, as well as a Pushcart nomination.
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