Monday, January 27, 2014

mental illness is forever

The descent into mental illness has returned.  It was almost an entire year since Matthew's last placement at Healy house or in the hospital, but on Thursday Matthew went back into Healy House so that he was safe and so that the rest of us were safe while we try to get some new medications to work.  What is strange is how quickly the demons of mental illness came back this time.  Two weeks ago I thought Matthew had an appointment with this psychiatrist and I called to cancel it because he was doing so well.  Not two days later, the laughter of mania had returned and so had the hostility and explosions.

The descent into a bipolar episode breaks my heart and raises my anxiety.  The problem is that there is no predictability or structure that goes with the bipolar episodes.  He can be happy and sweet and gentle and loving one moment and within minutes Matthew can be up or down.  As he starts his descent the first thing I notice is that Matthew stops sleeping.  He goes to sleep at night because many of his nighttime medications make him tired,but he is awake again at midnight and at 2 or 3 and then is up for the day at 5 AM.  For an entire week, Matthew was up at 5, and wanted to be downstairs watching tv.  Unfortunately, when he gets up at 5, he wakes the whole house at 5.  There is simply no reason for all of us to be up at 5 am listening to the Wiggles blasting or hearing whatever other tv show Matthew was obsessing about.

He walked around the house for almost a week repeating a mattress commercial over and over and over and over again.  Each time he said the tag line he laughed like it was the first time he had heard it.  He kept rubbing Jacob's head each and every time he walked past him.  He seemed obsessed with touching Jacob hundreds of times throughout the day.

It quickly became obvious that I was going to need Matthew to be supervised more than I can supervise him while he goes through this cycle.  He needed to be somewhere where there was staff who could watch him when he was up at 5 Am, and somewhere where people could help support him when he got angry without the little boys having to watch him explode.  Once again I was faced with the hell of finding and accessing care for my son with mental illness. Once again I was reminded of the hell of jumping through all of the hoops.

Of course, I am just the mom, so I cannot make the referral for him to go to Healy House.  Of course the school counselor cannot make the referral to Healy House.  Of course there is a mass of paperwork to be gathered and things to do, but there is no way of knowing until it is all done whether there even is an opening at Healy House.

Thankfully our service coordinator heard my intense need for help and in less than 24 hours he had gathered all of the paperwork and we found out that there was an opening for Matthew to go on Thursday.

Since Thursday, it has been really strange.  I have seen Matthew each day because he has had a few appointments to go to, but there has also been this odd feeling.  When I brought Matthew to Healy House, he walked in like he was going to see a long last friend.  He was and still is very detached.  he will say over and over again that he misses me and his brothers, but it is all said very unemotionally.  It is basically just rote.  He will say that he wants to come home and he will tell you how many more days he has left at Healy house- it is a 3 week program- all with little emotion more just repetitive conversation.

I left him at Healy House on Thursday and went to work.  It felt strange, and like this has become too routine for us.  I remember leaving him the first time and sobbing, and wanting to go back and get him.  This time, I knew he was safe and I knew that he was where he needed to be but I still felt like I had been punched in the stomach.  However, I have not told many people where Matthew is, it is like he has just vanished.  I have just gone along with life, going to work, and doing our other daily activities, but one person short.  The house is quiet.  very, very quiet.  It is calm, and it is what I need, and yet I feel guilty saying that.  The little boys have been sleeping late, it is like they are catching up on a lot of missed sleep and they are enjoying the more predictable rhythms of our house.

That said, when matthew calls, Jacob asks to talk to him and is eager to hear what he is doing.  No matter how stressful Jacob finds Matthew at times, what is certainly true is that Matthew is Jacob's big brother and Jacob, like all little brothers, loves his big bro.

We saw the psychiatrist on Saturday and he started Matthew on some new medications and is taking him off another medication.  We have another 2.5 weeks while Matthew is at Healy House for these medications to start to work and for this cycle to end.  My hope is that over the course of this week we will see changes start to occur and Matthew's moods will level out.

Thursday, January 9, 2014

supporting Jacob

One  of the things that I have realized about Jacob,and to a lesser degree myself recently, is that as life with Matthew has settled down, he has started to be more on edge.  In some ways it seems as if all of the stress over the last few years that there was not time to process or cope with is finally being processed.  Jacob is responding to Matthew recently like he is being poked with a red hot poker.  A two week winter vacation was the straw that broke the camels back for Jacob, and for him family bonding became too much togetherness.  Since vacation,all Matthew has to do is walk by and Jacob is screaming.

Two weeks is a long time to have all 3 boys without their normal schedules, especially because both Matthew and David truly depend on their routine and structure.  That said, I tried hard to create some structure to each day and to ensure that we had an activity each day that got us out of the house and active and on our best days, we were with friends.  Even with daily activities though, there was a lot of togetherness and a lot of time at home for the boys to just be together.

Over the course of the 2 weeks, Jacob's ability to cope with life deteriorated.  I truly think he is just exhausted.  I think Jacob is more a child who likes to think, and create, and like many good artists, he enjoys the quiet and he could spend hours just creating and being with his materials.  Unfortunately the being that is Matthew, doesn't allow for the quiet that Jacob requires.

When Jacob saw his therapist tonight he told the therapist that he is scared; always scared when he is with Matthew without a grown up.  As a mom, this is heartbreaking.  What is hardest is that every parent has moments when they leave the room or their children are not being supervised closely, especially when the children are 12, 10 and 7 years old.  It would be impossible for me to cook, do the laundry and do all of the other things moms do and have my eyes on the boys 100% of the time.  However, to hear Jacob describe it, this is essentially what he needs.  Whether it is real or not, Jacob is afraid whenever I am not in the room.  He says that this is when Matthew teases him or picks on him and then when he tries to tell me or get help, Matthew hurts him or threatens to hurt him.

As always, I am trying to balance the fact that all boys fight, and tease, and threaten each other with the fact that I have a 12 year old who has been aggressive, and a 7 year old who feels scared.  I am consistently trying to ensure that Jacob knows that I am here for him, while also realizing that in every family there will be a certain amount of rivalry.

What amazed me, and the therapist tonight, was when we were talking about Matthew, and how we were going to implement some techniques to help Jacob to feel safe, Jacob told the therapist that all we have to do is get the alcohol out of Matthew's brain.  I have been honest with Jacob about Matthew's struggles, so I knew that he knew that Matthew's challenges were caused by his birthmoms use of alcohol during her pregnancy, but I didn't realize that in Jacob's mind he thought that if we just took the alcohol out of Matthew's brain it would all get better.

The therapist explained to Jacob that you can't just take the alcohol out and that the challenges for Matthew will always be there, but that we are going to all work together to help everyone be their best.  I promised Jacob that I would be more careful to keep Matthew and him separated.  Most nights I try to clean the kitchen while the boys get their pajamas on, but from now on, I will send Matthew up first and then I will send up David and Jacob to get their pajamas on.

I am so lucky that Jacob is able to express clearly, when he is calm, what he is thinking.  I am beyond thankful that he could tell me tonight what he needs and how I can help him to feel safe.  Every person should feel safe at home.  This is a basic human requirement.  Home is where you rejuvenate, kick back and relax.  At this point I need to focus on ways to build Jacobs feeling of safety at home, and to build his confidence that he is safe.  I also need to help him relax and  continue to build a bond between Matthew and Jacob that is built on a premise of kindness, safety and brotherhood.