So today I would like to say a word (or a hundred) about anxiety, stress and medication. You may notice as this goes on, that you might possibly read a little anger between the lines. I have no idea what is going to come out as this is the first time I dare put words to emotions and speak of the last two months.
Those of you who know me or who follow my blogs know that when my 18 year old was five, his father died suddenly of a brain aneurysm. Z was home alone with his dad for five hours before I arrived home. It was July 2nd and I thought they were out getting fireworks. Z had been told by his dad not to touch the phone or go near the door as Tim was about to take a shower before the aneurysm burst. Z did as he was told and there he sat for all those hours, by himself trying to make sense of the senseless. After this, I took Z to see a therapist for awhile. Finally I was told that he had gone as long as was necessary at that point. He had processed all that he could for a five year old. She told me to take him home, make life as normal as our new normal could be and just watch him. I was cautioned that as hormones took a hold or certain life experiences happened, that it would be a good idea for him to see a therapist again just to reprocess, but that he would be fine.
The therapist was right and a couple of times over the years when hormones hit or in times of extreme stress (remember he was bullied for almost an entire year), I would take him back to a therapist and he would do the work of reprocessing and then when he was good, he would move on again. We have been fortunate over the years to have therapists that were actually in it to help and not just for the paycheck. When they knew Z had gotten to where he needed to be, they didn't insist he keep coming back. On the contrary, they would send him on his way with their number in hand to call if he needed to. Neither therapist that he has seen in the past is still in the area though, so about two months ago when Z started feeling a bit stressed and anxious, he decided he would like to see a therapist again. For Z, it was as much an act of independence as it was a need to process. He is 18 now and when he knew he was starting to feel the signs of stress, he reached out to a therapist on his own. Other than informing me of the decision, he wanted me to sit back and let him handle everything from finding a therapist to making the appointment and getting himself there. I was both proud and a bit apprehensive over his ability to take the bull by the horns with this situation. Being mom though, I did caution him that many therapists want to take a medicinal approach to therapy as a first line of action rather than giving a person coping tools. He assured me that he was only interested in talking and processing and not band aiding his stress with medication.
Now here I should tell you a little about what brought Z to the decision to go to a therapist. He is a senior and it is/was getting close to finals. We had just come out from under four months of extreme stress in all our lives with Davids surgeries, hospital stays and health issues.....not to mention Z's stress of being afraid to ask for anything school or non-school related because he knew that I financially couldn't give him much help. He was a senior who was having to cut corners and make do and I know it was hard. It was a culmination of both past and present events that were closing in and he knew he needed someone completely neutral to confide in and give him direction. I marveled at what a smart young man he was and wondered how many other 18 year olds would recognize this kind of stress and take proactive measures to fix the problem? He wanted to enjoy what was left of his senior year, the summer and ultimately start college feeling good about life and the world around him.
On the outside, the only thing I saw as far as Z's being stressed was that he had a quicker temper and a sharper tongue. Even then though, he would catch himself and say I need to be by myself for a bit. He would go downstairs or outside for a few and then he would come to me, apologize and be fine. I chalked it up to his being a senior.
After Z's first appointment with the therapist, he came home pretty pleased. He said that he liked her and that he thought it would be really good for him. Apparently my son, who is not much of a talker on personal issues and who keeps things pretty close to the vest, opened up to this therapist and I was happy for him. The following day, Z had a major panic attack. He had never had one before and it scared us both. Once he was through it, he decided he should call his therapist. She wanted to see him the next day. She said she wanted to make sure he was processing properly. He went in to see her and he came home saying that she was putting him on meds. In the course of 48 hours, he had gone from first time visit, to a panic attack, to a second visit, a trip to his MD's office and now he stood before me with anti-anxiety medication. Lexapro to be precise. I was not pleased to say the least. I asked him why she did this and he said because she felt that it would help with his therapy. It was here that I asked just what his therapy was. I didn't need details, all I wanted to know is if she was allowing him to bring all his stress to the surface but not giving him any tools to emotionally deal with that stress. This is exactly what happened. What followed in the next few weeks has been a nightmare that I wouldn't wish on someone I hated.
Z's independence and stubbornness made him so want to handle this situation on his own. He wanted to keep me out of the loop for a couple of reasons: 1) He didn't want me to feel like I had more on my plate to handle and 2) He definitely saw this as a way to be in charge of his own life and his own destiny. However, he quickly learned that from that first dose of Lexapro.....he was in over his head. Within a week of his first therapy visit, he had three anxiety/panic attacks and he began getting really sick. He was either throwing up, dying with a headache or both. His therapist simply said, this is normal. I made him go to his MD who also said.....this is normal. I was wondering how normal it was for him to go into a therapist to process some stress and a week later, be having multiple panic attacks and sick as a dog. Still Z wanted to handle it all.
By week two we not only were still dealing with the attacks and the sickness but now I was seeing someone emerge who looked like my son, but was definitely not my son. The panic attacks were turning into fits of anger. You could actually see a physical transformation when they would come on. He would become extremely pale, his fists would clench, he would start to sweat and his blue eyes would literally go dark. The first time I saw it happen, it terrified me. He suddenly had a hair trigger temper and he didn't care who he lashed out at. It was affecting every aspect of his life....home, school and friends. I was trying desperately to defuse and redirect all day every day just to keep Z from imploding his life. He would send me texts from school telling me that some kid was making him angry and he just wanted to beat him bloody or that he was just going to walk out of school. He was too close to graduating and I wasn't going to let whatever was going on derail 12 years of hard work. I finally had to have a conversation with the principal and vice principal and see what could be done. I told them a little about what was going on, but I was not about to ruin their opinion of Z with all the gory details. Luckily, they like Z and were willing to let him finish the year with home bound schooling. Why or how this all came about I am not sure as it was not the norm at all for seniors just weeks from graduating. I can't help but think this was a God thing all on it's own.
By week two and three, life in my house had become a war zone. Z's anger would go from zero to a thousand, in the blink of an eye. I never knew what would set him off. It was as if he lost any ability at all to control his anger and he had stepped across the threshold to rage. While he never physically touched me or anyone else that I know of, his words became vile and my house took a beating. His episodes became more and more frequent and they always either started or ended with a panic/anxiety attack. The attacks alone were taking a toll on Z's physical state as his body would tense up to the point of causing him back spasms and muscle knots. He was throwing up and when he wasn't acting out, he was suffering with his head. When the episodes had run their course, Z was always apologetic, confused and he was starting to fear for his own sanity. He really thought he was going crazy. I never thought that was the case, but I knew something horrible was happening and I was fighting to find out what it was.
Things continued to escalate and Z's rages included him yelling every four letter word he had ever heard to the top of his lungs. I know our neighbors had to be wondering what was going on and a couple of times I was afraid things were so loud that someone might call the police. They never did but I ended up calling them a couple of times myself. Our local police have what they call CIT officers (I think that's what they are called anyway). They are specifically trained to help in situations like what we were having and since I had no one else to turn to, I had no choice but to turn to them. The CIT officers would come to the house and basically talk Z off his emotional ledge. It probably helped that they were men too. It was one of the CIT officers that first brought up the Lexapro and the possibility that this was the culprit. They gave us some mental health resources to look into, along with crisis help lines. I really couldn't believe that our lives had come to this in just a few short weeks.
In Z's non-episodic moments, he was trying desperately to fix what was obviously broken but he was getting more and more terrified that he was unfixable. He went so far as to wait in the psychiatric ER one night for five hours just to get some answers. He refused to allow me to go with him (he was 18 after all) and apparently he was not treated very well during the wait. Once there he was not allowed his phone, he could not leave and they couldn't guarantee that he would be able to see anyone. Once he did get to see the doc, it was only for about 10 minutes. She did tell him though, that she had concerns about the Lexapro and she was very unsure of why the MD had put him on the highest FDA approved dosage. Since she was just an intake doc, she didn't change anything and told him to talk to his MD about the meds.
Z did not see this as a win, especially when he talked to his MD and was told that he had not had the Lexapro in his system long enough to have any results from it one way or another. The episodes continued and you could see them taking a physical toll on Z. They were taking a toll on me too. I was not sleeping, I was walking on egg shells trying not to set him off and I was terrified every time he walked out the door, not knowing how he would come home or even if he would come home. Life was a living hell and neither Z nor I had anyone we felt we could talk to or go to over all of this. I started wondering if this was going to be the thing that broke this family. Amazingly though (another God thing I know), Z only had one episode when David was home. It happened while David was asleep and he never budged during the whole thing. I was so grateful! So was Z.
My days had become nothing more than watching Z and trying to read what might be coming next. I was seeing less and less of the young man I knew and more and more of this person who had no impulse control and a hair trigger temper. Finally after a particularly horrible incident, when he had calmed down and was as much the old Z as he ever was anymore, I asked him to let me help. He was frustrated with his therapist and his MD who kept saying that there was nothing wrong and that the Lexapro just wasn't to full therapuetic levels yet and the ER was no help at all. I knew that although Z thought of himself as a man, that these people saw him as a kid and therefore, he was getting nowhere with anyone. I told him that he had done his best, but sometimes when we run out of skills, it is time to turn it over to someone with "more" skills and I pointed out that I had years of experience dealing with doctors and hospitals. He gratefully handed it all over and I took him to a crisis center. This was the beginning of the end of the nightmare.
At the crisis center, after hearing his story the therapist immediately told him to lose his current therapist. She also told him that he wasNOT crazy and this was not something he had done, but rather something that had been done to him. She said that she believed everything he had gone through was due to the high dose of Lexapro he was on. She went on to say that you never give a first time anxiety patient the highest dose of any med. It gives you no where else to go. She said he needed a psychiatric MD to start weening him off the med. Then she made an appointment for him that was three weeks out. While it wasn't a cure all, it did give at least me, some peace of mind.
That afternoon, Z went through the another bad one. It was all the usual x 10 plus, which resulted in destruction....and then he just walked out the door. After several friends had seen him walking and tried to talk to him with absolutely no response, they came to the house worried about him. They were not even sure he heard them although they were standing right next to him. I was at my wits end and terrified. My own nerves were shattered and I didn't know what else to do but call the CIT officer. Knowing Z and what was going on, he went looking for him. He found him at the local convenience store and he "detained" Z in front of a dozen people or so. There was no fight, he just didn't want Z to try and run, especially not knowing what his frame of mind might be at any given moment. However, by the next day....the story was that Z tried to tear up the store. Had that been the case, he would have been more than detained! Oh well...you gotta love the small town life.
Once back home, the CIT officer was ready to cut through all the red tape and get to the bottom of Z's issue. It resulted in an ambulance ride to the ER and we ended up spending eight hours there. In the process Z had two panic attacks and I prayed like I had never prayed before. At the end of our night, the doc gave us a plan of action as to seeking out a therapist and told Z he needed off the meds. The next day I called and got an appointment with a therapist who worked along side an psychiatric MD. They couldn't get us in until the next day, but it was progress. Then....the worst episode of all time happened. It resulted in a horrid panic attack that I was afraid might actually be a heart attack and for a bit his actions went to a new level that could potentially have ruined his chances for graduating and even his immediate future. When it was over, he was beyond terrified and I had an awful lot of smoothing over to do. We were both beyond exhausted and so over this. We needed help!
Going to see the therapist and MD were not the miracle we hoped for, but they were the catalyst for the light at the end of the tunnel. They agreed that the Lexapro had to go and told Z how to ween off them. Then immediately they began talking more meds. Z refused. He told them he was through with anxiety meds and asked what would happen if he went cold turkey. Of course the worst side effect could be suicidal tenancies and physical sickness. They gave him some options for therapists as these two were just intake and they sent us on our way with information pamphlets. On the way home Z was quiet and then he spoke up. Once again the take charge young man was back. He had his own plan of action. He decided that he was going off these meds cold turkey. He felt that the side effects couldn't be worse than what he had already gone through. He had learned that the Lexapro was not killing his anxiety as it was suppose to, but on the other hand was killing any impulse control he had and causing rage. He felt that knowing this information was half the battle. As for therapy....he still wanted to go, but he wanted me to help find him agood therapist. One that would give him tools to deal with life instead of meds.
Since that day which was about two and half weeks ago, my Z has slowly returned. The first week was the worst for him as he was physically pretty sick. I gradually saw his episodes have less and less fire and more and more he was taking control of them, instead of them controlling him. His language became less sailorish and more Zish and then the day came when he actually laughed. I had no idea how much I missed that laugh and then I heard a song coming from the basement. It was the first time that I realized that I had not heard Z sing in almost six weeks and he was down there singing. I cried.
Yesterday as I walked outside and saw my pool sides twisted and caved in from the wind, I held my breath in fear that this might set him off. Instead he said, "Grab a side and see if we can fix it." Again there were tears and I grabbed him and hugged him right there in the yard. He didn't even realize the magnitude of the moment until I hugged him.
Z is still struggling with a bit of anxiety as the meds finally leave his system. His impulse control though seems to have been restored and when the anxiety starts to hit, he just removes himself from the situation. I have helped him pick out an amazing therapist and all involved feel that with a little anxiety therapy and some coping tools/skills (all he ever wanted in the first place), that he will be absolutely fine.
These last couple of months have been a nightmare, but they have also been an education. I know that there are those that need anxiety and depression meds and I don't discount them at all. What I do discount are therapist who use meds as a first line attack rather than a last resort on someone who is simply stressed. I discount MD's who are not psychiatrists dispensing these kinds of meds. Had we not been as proactive as we were and just sat back and listened to the therapist and the MD, likely Z would have ended up on several different meds, each trying to counteract the other and really screwing with both his mind and body. This hell that he went through was not necessary and never should have happened. That being said, Z and I decided to take all of this negative and try to make it a positive. We have talked at great length about what positives we can pull from this individually and as a family. Z decided that he doesn't want this moment in his life to define him but he doesn't want to discount it either. These last couple of months have made him much stronger and given him a much better view of what he is ready for in life and what he still needs guidance on. Most of all though, he wanted me to tell his story as a cautionary tale. He feels that maybe this experience can help someone else and give insight into the importance of researching a therapist or any mental health provider. Never get anxiety or depression meds from anyone other than a psychiatrist and most of all.....don't be afraid to ask for help if you need it.
As a family, we have only grown stronger over this ordeal. What I though might actually break us, has ultimately made us better. I also found strength I didn't know existed, pulled from faith that I wasn't sure was there and in the end.....I got my Z back. We are blessed and once again we pull ourselves up, brush ourselves off and move forward into the future. This upcoming graduation is going to mean more to us as a family than anyone will know. Not just for Z, but for us all.....we are closing a chapter of our lives and anxiously awaiting what the future has to hold.