On Saturday evening, March 10, 2001, my 17-year-old son, Will, returned from an evening of bowling with friends. He sat at the kitchen table and told me he'd had a great night: He bowled over 100 twice in a row, he said, and then he, his girlfriend and cousin went to a pizza joint afterward. He appeared cheerful and light.
"You seem to be feeling a lot better, Will," I told him. It wasn't a casual remark; Will had been diagnosed with major depression in the fall of 2000, and after an agonizing and worrisome few months, he appeared to be shaking it off. I thought the latest medications were finally beginning to take effect. Or maybe it was just the passage of time, but by all markers, he looked as though he was genuinely on the mend.
"Yeah, Mom, I think I am better. No, really, I think I'm okay."
I kissed him on the forehead and went to bed buoyed by our exchange. For the first time in months I felt confident that we, that he, had turned the corner.
Will watched the basketball playoffs with his stepsister and her friends for an hour or so. He then went to his bedroom, wrote out four suicide notes and at 3 a.m. ingested 100 times the normal dose of the sedative antidepressant Remeron, washed down with a bottle of Snapple Iced Tea.
I discovered Will late the next morning in his bed, semi-conscious, gagging and incoherent, his heart racing and skin covered in sweat. We rushed him to the emergency room at George Washington University Hospital. After a day-long battle by a medical team to stabilize his vital signs, we came face to face with the devastating realization that our son had attempted to take his own life. It was the worst moment of my life.
Thankfully, Will survived.
How do you explain the suicidal impulses of a child? We give our children life; we think we know everything about them. And why shouldn't we? We tell them what to think and do from the moment they are born. So it comes as a terrible shock to learn that your child is harboring such a deadly secret.
Suicide is not a rational act; it is, rather, the worst possible outcome of a treatable illness, depression. A child in the throes of depression is suffering mental anguish not unlike the bodily pain of a wrenching physical illness. And the process of healing is no different: The sooner you obtain relief, the better the prognosis.
In the immediate aftermath of Will's suicide attempt, our family and a set of clinicians came together to analyze what went wrong. We began an urgent and heart-rending process to determine the next course of action -- a treatment plan for Will that at a minimum might safeguard against another suicide attempt and at best might conquer his depression.
As we grappled with the situation, we learned a lot about our son, and about the limited treatment options for teen depression.
We immersed ourselves in the controversy over the use of antidepressants to treat teenage patients and weighed the advantages and drawbacks of outpatient vs. residential treatment.
