On the Cutting Edge
By Laura Amann
From a photograph on my desk, my daughter’s face peers out at me. Her eyes are crinkled; her chicklets-perfect teeth are held by a wide grin. Her dark hair curls in fat, sausage ringlets. She is wearing a princess gown. She is five.
Periodically, I look at that photo and close my eyes. I do the same thing when I come across her papers from grade school, with the hearts on top of the i’s and the puppy dogs doodled in the corners.
Today her long, glossy hair has alternately sported thick dreadlocks, been chopped short and bleached an unnatural blond, and been dyed with streaks of blue, green, or pink. Her brown eyes are now muted by a ring of heavy, thick, black eyeliner. Her ear- lobes are stretched and weighted down with huge earrings.
She is still stunningly beautiful and this makes me sad.
It breaks my heart because I know all of her attempts to be different are really a cry of pain. She has struggled with mighty demons as she has wrested her way through adolescence.
Depression runs through the women in my family like a thick, pulsing vein. It strangles our self-confidence, saps our energy, and leaves us limp and lonely. I have watched my sister and mother struggle with it. I have fought my own conflict. I have listened to stories of my grandmother and great-grandmother taking to their beds.
But when I learn that she is cutting, my stomach recoils and I am physically sick—nauseous and clammy as if the flu has suddenly possessed my body. Soon, she starts wearing long sleeves all the time or a thick crowd of bracelets to hide her scars. I learn she has a secret blog and through a concerned friend of hers, I log on. It is so dark and disturbing that I lay awake at night thinking of what I’ve seen.
She had already been seeing a therapist and a psychiatrist for a year when the cutting starts. Now we up the ante. Intense, twice-weekly dialectical therapy, coupled with weekly visits to the psychiatrist and regular group therapy sessions take up much of her time. She visits the school social worker almost daily.
I suspect that she began cutting as a way to cultivate an image she wanted to convey: that of a hipster with a dark and daring soul. But the allure of the cuts quickly spiraled out of control, becoming its own form of addiction and destruction.
When she first came to me three years ago, crying and scared about her mood swings, I was concerned but not shocked. “I know I should be great right now,” she said. “But I just want to be by myself and be sad.”
But who as a teenager hasn’t felt some depths of despair? I remember those teenage feelings of angst and anxiety only too well, which is why in the beginning I was eager to direct her to a nutritionist or a new exercise group. Good food! Brisk air! Let’s just drum those bad feelings right out! For months I optimistically bucked her up, nauseating myself in my own faux cheeriness. I clung to her smallest request, as if an order of Kung Pao chicken could make her unhappiness disappear. But I also had a friend commit suicide in high school and I know the edge of the cliff can spring up quicker than expected.
Soon I learn that I can’t leave her by herself. I scrutinize every outfit. Grab her wrists. Take the sharp objects and prescription medications with me when I leave the house.
In the midst of her chaos, we transfer our home movies from videotape to DVD. The process requires it to be done in real time with the machine playing back what it is recording. I’m mesmerized. There she is as a baby, our first child, and her dad and I are completely in love with her. Her every move is recorded, nothing seemingly unworthy of the camera’s attention. As a toddler and a little girl, she is captivating. Her clear eyes gaze at the camera, lovingly looking at us. She is the ring leader, the head of family plays and sing-a-longs.
She orchestrates her siblings’ moves with confidence and assurance. I can’t stop watching, looking for some sign of the sullen girl who lives with us now.
Her clothing styles change as rapidly as her moods. First, she shed the trendy shirts and skinny jeans for men’s over-size clothing. That look gave way to black rock concert T-shirts which gave way to ’60s style bell bottoms and fringe vests. Each personality adjustment comes with a slew of other refinements. In addition to the new style of clothes, she adapts a new makeup look and a new personality design for her bedroom.
She draws all over her walls. Beautiful swirls, elaborate scrolls of flowers, inspirational quotes, and images. It’s stunning. She takes one wall and creates a vision board, filled with images she finds inspiring—yoga poses, New York City, Janis Joplin, Bob Dylan, Jimi Hendrix and plenty of other tortured souls who killed or nearly killed themselves with their creativity.
She silently glides out of the house. She has a new group of friends. Earlier, when she didn’t have friends and spent hours and days alone in her room, I worried. Now when she’s out with these new friends all the time, I worry. She tells me to relax, assures me she’s fine, her friends are what she needs right now.
I don’t trust this new group of friends, but without proof (and I desperately search for proof), I feel powerless as she slowly slips further away. Later I will learn that my suspicions were correct; she was engaging in high-risk behaviors on many levels. But I want to believe her. Desperately. Even though the line of pills I need to dole out to her every night is a constant reminder that she is anything but okay.
Eventually, I get a call from the social worker at high school, her voice belying her news. She tells me that there was “a setback” last night. I speak the language and know what that means. The social worker sent her to the nurse and when I go to pick up my daughter, I hug her and tell her I love her. She gently lifts her sleeve and I am stunned and heartbroken at the large hospital-like bandage covering the length of her arm. I am scared to see what lies underneath. Scared to see what she did to herself while I slept, oblivious, in the next room. My mind cannot go in the direction of the darkness she clung to last night. But I will fight for her.
* * *
A few hours later, we are on our way to check her into a psychiatric hospital; we stop for coffee and bagels—black for me and a coffee/hot chocolate/whipped cream concoction for her. We order bagels as well because, well, we’re hungry. And I’m not sure of the protocol for checking your daughter into the psych ward. Etiquette books don’t cover such topics.
I look over at my daughter, my first-born, my amazing girl, and try to imagine how we got to this point where she needs to spend time in what is euphemistically dubbed a behavioral health center. What words can I say right now that will make this okay? Do I optimistically give a pep talk about new beginnings? Do I break down crying like I want to? I’m hoping she recognizes the symbolism and love represented by the Dunkaccino. I sip coffee and chew my bagel despite the curious lack of salvia in my mouth. It’s almost painful to swallow.
She seems oddly calm, almost relieved. I fall squarely in the devastated and terrified category. I want to prolong the time I’m with her and perhaps commemorate the moment. I come up with a soppy, heartfelt, caffeine-laden toast to the future.
* * *
The adolescent psych ward is both everything I imagined and nothing I expected. The waiting room is full of people just like me, parents wearing the same expression of exhaustion, worry, and a tinge of relief. We don’t make eye contact; there is no need—it’s all too unbearable and we know it. And we are the lucky ones. In the hallway outside the waiting room, patients are being wheeled in, strapped to gurneys followed by familiar-looking parents. By familiar, I mean normal. Someone I would see at the grocery store. I don’t know why I find this surprising.
The kids getting checked in all wear a haunted, blank expression. The girls have the same black-rimmed, heavy eye-lined eyes and nails covered in black, chipped polish. Their clothes are grungy and baggy. The surprise is that my daughter fits right in. She looks just like them.
How had I not seen that before? In my quest to keep her out of the hospital, had I waited too long? How could a hospital stay possibly undo years of dark, deep depression? Where had my little girl gone who was on the soccer team and swim team, and loved going to church and hanging with her family?
We pass through three sets of locked doors before checking her in on the self-harm/eating disorder unit, where skeleton-like bodies with haunted eyes peer at her above their jutted collar bones. Quickly, these become familiar faces. A cross between a hospital ward and a bland dorm hall, the unit has both a nurse’s station and traditional dorm furniture (albeit, bolted to the wall). We have to relinquish everything from underwire bras to spiral notebooks and anything with staples.
This isn’t a retreat. There are no colorful posters or inspirational bulletin boards, encouraging residents to “hang in there, baby.” The nurses and clinical staff are professional but not sympathetic. I want them to smile or reassure me I am doing the right thing. But they don’t. They hand me forms to sign and packages of information, none of which are stapled.
The following days are a blur of phone calls to relatives, the school, teachers, doctors, therapists, insurance, and a few close friends. It’s exhausting and emotionally draining and every conversation seems to take an hour. I have three other kids who are scared and concerned. The younger two had no idea of the extent of their sister’s depression. We take a mental health day.
I spend the next week narrating my life, one step removed: I am folding the laundry while my daughter is in the psych unit. I am answering work email while my daughter is in the psych unit. I am driving a carpool while my daughter is in the psych unit.
I feng shui her entire room, cleaning, scrubbing, and airing everything out. I wash and refold her clothes, dust her shelves, take down the dark tapestries which cover the windows and buy a plant.
My feelings slide on a scale ranging from anger to relief to hope. I’m angry that it’s come to this—angry I didn’t do more sooner, even as I recognize that there was nothing more I could have done.
But there is also relief. Relief that she is in someone else’s care. That for a short while I won’t have to check on her constantly. That my heart won’t race going up to her room when she is the only one home. That I won’t need to look out the window waiting for her to come home.
That I can briefly stop questioning the medicine, the therapy, her psychiatrist, her school load, me, her father, our family—always wondering where we went wrong. Someone else can do all of that now. It is out of my hands for now.
And of course, there is hope. Hope that she is finally getting the help she needs. Hope that perhaps her future will be returned to her, a future where the possibility of college and a life outside of home exists.
We are periodically allowed one-and-a-half hour visits where we sit on uncomfortable chairs in a hallway near other patients and nurses. She is lonely and scared at first (which is hard) then excited and almost happy to have met so many people like her (which is maybe even more difficult) and finally desperate and anxious to get home.
We also meet for family meetings with other parents whose stories are just as awful as ours. And like my daughter, I feel an excitement and kinship with these people. Finally, someone else who understands the true struggle of watching a child battle demons.
Because the reality of mental illness is that it’s still extremely difficult to discuss. Those of us navigating the dark pathways are often too emotionally fraught to fight against other people’s assumptions or battle the stigma as we should. Many of us are too busy blaming ourselves as it is. And so the veil of silence continues. Who are we, the parents of children who suffer, who cut, who starve? Who among us shares this heartache?
When she is finally released, we walk slowly to the car and sit together for a while. She begins to weep. I hug her and cry with her. Then I ease the car into the road and begin the drive home.
* * *
The second time she is hospitalized it is less traumatic, but not easier.
She only made it a year before relapsing. After her first hospitalization, she participated in an outpatient program for an additional two months. She managed to keep up her coursework and return to her job. And to my relief, she moved away from her group of friends.
But if there is anything I’ve learned from this journey, it’s to expect the unexpected. Studies show that self-injury can be as addicting as alcohol and drugs.
The second time around, we are even more careful who we tell. My daughter’s illness is chronic and at times it can be life-threatening. And yet, her battles are fought internally, and sadly, we’ve learned that some people find it easier not to inquire.
My daughter, my husband, and I have each lost friends or distanced ourselves from people since the first round. Although we had told only a few people, we learned that the same folks who organize a chemotherapy support brigade don’t phone to check in. And the people who volunteer with the disabled don’t necessarily understand a psychiatric hospital.
But our family sticks together, at times straining at the seams. Before being hospitalized the first time, my daughter made me a CD (a mixed tape of love) and the haunting song “Beautiful Girl” by William Fitzsimmons swims through my brain in gentle laps.
Let the sunrise come again
May the weight of world resign
You will get better
Her doctors told us that the adolescent brain doesn’t completely stabilize until around age twenty-three. There is a good chance that she will age out of the cycle of self-injury and depression. There is also a chance that she will be fighting this battle the rest of her life. And so it’s up to me in the brief time she has left living at home and in our care, to make sure that she has the tools and knowledge to monitor her disease and keep herself safe.
For now that means supervising her medications, checking in with her daily, staying in communication with her school social worker and her therapist. And yes, ensuring that she is eating healthy food, drinking water, and getting exercise.
And sometimes it means simply ordering Kung Pao chicken on a bad night.
Author’s Note: Since this story isn’t mine alone, I showed it to my daughter before sending it into the world. Any hesitancy I had evaporated when she read it and encouraged me to put it out there. We’re hopeful we can assure someone who is experiencing a similar struggle that they’re not alone. Our journey continues, and although the path we’re taking remains murky, we’re both a lot stronger than we were when we started out.
Laura Amann is a writer and editor who mothers a brood of four in the Chicago area. Her award-winning essays have appeared in the Chicago Sun-Times, Brain, Child, Salon, and Chicago Parent. Her reported pieces have appeared in Your Teen, Scholastic Parent, among others.
Illustration by Mikela Provost