Note: This is a pretty long entry and a departure from the usual, bulleted "Friday Confessional" posts. But, this situation has been on my heart for a long time and I need to talk about it. I can't emphasize how important it is to acknowledge psychiatric illness, and seek treatment when appropriate. So, thank you for reading if you choose to.
It started when my mother called me one night last October, to tell me that she hadn't been to work in three days.
She was non-chalant, yet edgy, in her tone.
"I didn't want to tell you because I knew you had exams," she said over-dramatically.
I was meeting friends for dinner in a few minutes and I didn't want to hear the details. I didn't want to get upset about this before I saw them. Pacing up and down on a side street next to the medical school, I tried to ascertain exactly what had happened, over the phone.
She had been in a pre-glaucomic state for a while and so, she said something about her eyes. She couldn't see when she was at work, she said. She said that the room was "clouding up" at work and the walls were closing in. She had had to leave.
To a psychology major turned medical student, what she was describing sounded more like a panic attack than a medical issue. Still, I didn't want to discount her symptoms, so I kept trying to prod her more, coercing her to divulve the mystery behind her "eye issues."
"I don't know," she snapped, when I kept asking for better descriptions. "I couldn't see! I just couldn't see!"
"Mom!," I said sharply. "I can't help you if you don't tell me exactly what is happening. This is frustrating for me too, but you have to remember that I'm a medical student and if anyone can help you in the family, it's me."
My mother is an English teacher, who recently published her first book. I know that she can be articulate when she chooses to, so I was annoyed. There is well-established literature on the tendency of Asian-Americans to somatisize mental health issues, though. I know this. I shouldn't have been so foolish to keep pushing.
In the car with my friends, as we drove to dinner, I couldn't hide my emotions. I told my friends what was happening.
"You know, I don't want to downplay her medical symptoms, because I'm sure they're partially real, but there has to be a psychiatric component too."
My friend, Sara, agreed. (Hi, Sara!)
"At the least, she's having some sort of mild depression."
Sara was being kind, but what my mother was really having was a full-fledged major depressive episode, complete with crippling anxiety and panic attacks. She would never acknowledge this, but my sister (another healthcare professional with a psychology degree) agreed.
From our respective distant locations, all my sister and I could do was beg my mother to please take her eye medications and please get some Xanex now, to take the edge off, and please, start taking Lexapro again.
Half-heartedly, my mother began her Lexapro, but it would take her two weeks to get a presciption for Xanex (I'm guessing because she minimized her symptoms to her psychiatrist and refused to follow my and my sister's instructions to call the primary doctor on call and have it called into the pharmacy the same night).
She also refused to start taking a new eye medication until I got home for Thanksgiving.
"I'll just wait until you get here," she would say, demurely, when I would rant about statistics and the seriousness of people going blind from not taking their glaucoma eye drops.
This is probably where my burgeoning resentment began.
I had planned to visit a cousin in California for my (unusually) long Thanksgiving break. Having been a bona fide grown-up, living outside of my mother's house for 10 years now, I hoped this would be fine. I kind of knew it wouldn't, though. In my mother's mind, my obligation should be to her. Unmarried women don't trapse around the country, traveling alone (Although, it should be noted that this is exactly what I did when I worked in marketing after college. But, I digress.).
The conversation that I had with my mother about going to California was the last one before she announced that she hadn't been able to work "because of her eyes." She also started getting crazy(er), telling my sister and I about how she needed to sell her house, liquidate her retirement savings, and buy a short sale condo. Her grandiose plans were ridiculous and unfounded. It was clear that if one or both of us didn't go down to Florida to corral the situation, we'd be going down to pack up my mother's house, likely after she realized that she sold her house and had nowhere to go.
So, off to Florida I went on my Thanksgiving break. I walked into my childhood bedroom to find my nearly wedding dress laid out on my bed.
I tried to control by anger, but I had (somewhat harshly) asked my mother why it was that she needed to remove it from storage in the closet and why, if she had to move it, did she think it would be appropriate to store it on my bed? She couldn't understand why I was upset and merely moved it to the bedroom across the hall. I finally told her that she needed to properly package it in a wedding garment bag (which we had! for this precise purpose!) and that for the love of my sanity, I did not want to see that dress.
She didn't understand.
I got her to start taking her medications, but she was still non-functional. Every day, I would wake up to find her sitting on the living room couch--staring out into space. She would be wearing a house dress and sitting silently. When I would ask what she was thinking about, she would say suspicously, "Nothing," or sometimes, more believably, "All the regrets I have about my life."
After Thanksgiving, I left Florida, turning over the care of my mother to my very patient sister and brother-in-law, who went down for two weeks. After they left, it was expected that I return to spend my Christmas break with my mother. I did, but only because I was plagued by guilt and the belief that I should do the right thing.
My mother was jovial when I arrived in December.
She accompanied my high school friend to pick me up from the airport and wanted to go out to lunch with us afterwards. She was eager to have me at her mercy, dragging me into and out of the supermarket, Wal-Mart, the farmer's market. The list of ordinary tasks she had accumulated was endless and I was annoyed that she expected me to accompany her on all of them. I found her doting tendencies, asking me what she could cook for me and if I needed my laundry done, to be ingratiating.
I didn't want to be at home and I didn't want her treating me like an 18 year old college freshman, home from the dorm. When I actually was a college freshman, she was absorbed with other things in her life, and didn't have the time to worry about me. I remember being envious of friends who said that their mothers had eagerly greeted them at the airport, then had their favorite meals prepared during breaks. I routinely waited two or more hours at the airport for a ride, before learning that I should make arrangements with my own friends when I was home on break. If I wanted a home-cooked meal, it was also contingent upon me going to the supermarket, buying food, and cooking it myself (which I frequently did).
I was understanding of my mother's position as a single mother, working two jobs, during those years. Now, her attempts to baby me felt belated and insincere.
"I bought you these black bean burgers, so you can take them back and freeze them," my mother told me at Thanksgiving.
"Mom, you don't have to do that. I have grocery stores in Virginia and I'm an adult. Besides, I brought a carry-on. I'm not taking those back."
"But you don't have time to cook," she would counter.
"I don't cook because I'm never at home. The burgers are just going to sit in the freezer and I'm still going to buy dinner at the hospital every night."
She had no concept of my life, but I didn't know what to do about it. She had always been hard on my sister and me--pushing us to be better and stronger. Now, we were. But with that growth came independence. I thought that by now, she would understand that there was no chance of me moving back to Florida. I have roots, a career, and a life in Washington, D.C. She chooses to believe what she wants to about my life, though. I think there is still a suppressed hope that one day, I'm going to move back to my hometown.
I know that her attempts at mothering affection were some sort of delayed reaction to empty nest syndrome, but I didn't have the patience for it last fall.
"Mom, I won't always be able to do this, you know," I would say, referring to her expectation that I keep flying down to Florida every couple of months. "This is my last year with holidays off and when I'm a resident, I won't have any vacation."
"I know that!," she would bark. "You keep telling me that!"
And yet, when I talked to her two nights ago, she wanted to know when my semester was ending. I gave an estimated date and asked why she wanted to know.
"No reason," she said sweetly.
As for my mother's depressive episode and what could have triggered it, my sister and I struggled to figure this out for a long time. She has had a number of depressive cycles throughout her life--during her horrible marriage to my father, and again after her mother died. When the latter happened, my sister and I had sprung into action in much the same way. I was in graduate school and working two part time jobs, but one of those jobs was in marketing and I had a ton of frequent flyer miles. We took turns flying down to Florida to force my mother to take her psychiatric medications. Like many psychiatric patients, though, as soon as she felt a modicum of normality, she stopped. She refused to listen to either my sister or my pleas about the data on recurrence and much to our chagrin, did what she wanted to do--bragging about it to everyone. She had gotten better so fast, she told them. She was no longer on anti-depressants.
This is probably a good time to mention that I am a huge advocate of anti-depressants. After my parents' divorce when I was 13, I refused to talk to a therapist with curly, dyed black hair and a saccharine smile, that my mother took me to see. I had no abandonment feelings or emotions about the fact that my father had left. I was glad my father left and I hoped that he would die a tragic, horrible death alone. I used to tell my friends, "At least if he dies, we'll get his life insurance policy money and then we won't lose our house." I wish I could say that I was just a stupid, bratty kid, but even know, I realize that I was simply wise beyond my years.
(With the exception of a very painful phone call when I was 19, I have never seen or spoke with my father since I was 13. The only means to communicate with my sister and I that he left was a P.O. box, when we were teenagers. That address was court-ordered, as my father was still legally required to pay half of our medical bills. I don't need to tell you that my father also refused to pay child support. Thankfully, his wages were eventually garnished, which prevented the foreclosure of my mother's home when I was 13.)
At age 18, though, the tragedy of life as I knew it was facing me head on. I had worked aggressively in high school at every extracurricular and volunteer activity imaginable, knowing that the only way I'd be able to attend an ivy league school was on a full scholarship. The alternative, in my mind, was letting my father win. After cleaning out my sister and my college and savings funds, as well as all of the joint accounts he had with my mother, I knew that he wanted to see us struggling and penniless. I knew that what he wanted was for me to end up barefoot and pregnant with some minimum-wage job in my hometown. What I hoped and prayed for more than anything was to grow up and have a life that would declare the opposite. Although I was too naive and lacking in self-awareness to put the words to it, I wanted to tell my father that I was too good, too pretty, too smart, and too capable to not succeed. I wanted to tell him that he could take the money and go to hell.
When I was accepted at my first choice college, Harvard, I was elated. In the end, though, my father had the last laugh when he refused to return my financial aid paperwork or even a sign a statement that he would not be contributing to my college education. After a month of inconsistent communication with my father, my financial aid officer at Harvard told me that he didn't believe my story because my father, among having several outside investments that made him wealthy, was a middle school principal.
"It's just extremely hard to believe that a man who is spending his life encouraging others to pursue higher education would not want to pay for his daughter to attend Harvard," my financial aid officer told me. "I've never encountered a parent who doesn't want their child to attend Harvard."
I remember the grimness of that conversation, the stabbing, piercing heartache, and the way I swallowed my bitterness by politely thanking him for having taken the time to work so diligently on my case. The day after this conversation, I accepted a full scholarship at a very prestigious research institution in Baltimore and tried to convince myself that this would be OK.
I hated everything about the place. The students were pretentious and elitist. The professors were inapproachable. The pre-medical advising office refused to see me, telling me that I wasn't "medical school material." I internalized so much rejection and self-loathing from that experience, it's unbelievable. Little did I know that several years later, I would be offered 9 interviews from the 15 medical schools that I had applied to. I would have had three acceptances before voluntarily withdrawing the remainder of my applications, because I had been accepted to my first choice. I would end up attending a medical school with a 1% acceptance rate--having been chosen to be part of a class of 170, from an application pool of 14,000.
But, I didn't have the life experience or foresight to know that one advisor's opinion can't control your destiny. Instead, I found that I could no longer find the will to live under the weight of my dreams, which had been crushed so easily.
I became so severely depressed that by the time I returned home the first summer after college, I had at least six workable plans to commit suicide. I would obsess about them constantly, thinking about the potency of the chemicals I was working with in my summer research lab, or how easily it was to just brake slightly, as I crossed the train tracks on the way home. The only reason I didn't hang myself in my college dorm room that first year was because I knew my roommate would be the one to find my body. As much as I hated her, I knew that ruining her life along with my own would be wrong. It was solely a haunting vision of my lifeless body, and her entrance to the room after I was gone, that stopped me.
During this time, I asked my mother to take me to a psychiatrist. I told her that I had researched the symptoms and that I was having many of them. I told her I knew that what I was feeling was serious. She said no. She said that everyone's first year of college is hard and that what I was feeling was normal. In much the same way she refuses to acknowledge her own issues now, she also refused to acknowledge mine. When I finally did see a psychiatrist that summer, it was the beginning of a rapid transition to being an adult that required me to take the reigns of my own healthcare. I never asked my mother for help or medical advice after that summer. I just found my own doctors and took care of my own medical issues.
She hassled me and bothered me for the entire two and a half years that I was on anti-depressants, telling me that I needed to stop taking my medications. Thankfully, I was learning to stand on my own when it came to making serious decisions. I sternly countered, telling her that 70% of first time depressive patients relapse because they stop their medication too soon. After two and a half years on anti-depressants and the same amount of time in therapy, I realized that seeking mental healthcare was the single most life-changing event of my adolescence. It very literally saved my life.
I still use the coping skills I learned in therapy and when my world came to a crashing halt this past summer, it was not one, but two different therapist's office, in which I appeared. (I also saw a psychiatrist, which is a requirement of my university before seeking counseling. The psychiatrist said that she felt that I was doing fine with my coping skills and didn't want to prescribe an anti-depressant. I agreed, but if I had felt differently, make no mistake that I'd be unashamedly taking Lexapro myself right now.) I am not afraid of mental illness. I am afraid of what it can do when it is ignored.
This is why my mother's situation is so frustrating. She is grudgingly seeing a therapist, but only because my sister and I are forcing her to. Because I know she is not invested, I have doubts about the efficacy of this approach. I use avoidance behavior to cope, because if I think about the next time my mother is going to have a breakdown--and the implication it will have on my life--I start getting anxious.
My aunt recently told my sister and I that she thinks that the trigger for this depressive episode may have been my breakup with Rich, since my mother admitted to my aunt that she was experiencing a recurrence of emotions from her own divorce. Since learning this, I have been mad. Annoyed and resentful and mad.
After feeling like I just got on my feet after the breakup, and doing my best to use coping skills and get through MS1-The Dejavu Version, it is my mother who is depressed? Whether or not these feelings are valid, I feel like she should be the one who is there for me right now. She should wiping my tears and telling me that everything will be fine. Instead, I have to console her about a breakup that she had no part of?
I'm trying to be understanding, but it's not working. I don't want to speak to her and I definitely don't want to see her. I'm sorry that she is depressed, but I also feel like she is not taking ownership of her issues. Both my sister and I sought, and continue to seek, professional help when we face emotional challenges in life. I think that it is selfish and irresponsible that she refuses to do the same. When she starts involving my life and my issues, and then cycles through her periods of deterioriation, just expecting that I will come home and clean up the mess, it makes me angry.
So, I am going to make an appointment to see a therapist. I don't know how to handle this anymore, but I don't think that my present course of avoidance and denial is healthy. How ironic that my mother's refusal to confront her own mental health issues is now driving me to see a therapist to confront them for her. God bless the man who falls in love with me, because he has no idea what special kind of crazy he's going to be marrying into.