It’s here again.
What I call my “black depression.”
I do not wish for death. The black depression is not a suicidal depression. It annoys me when I hear someone say of a suicide victim, “They took the easy way out.” Interestingly enough, the phrase does acknowledge the difficulty of life. If we are all prisoners in Plato’s cave, chained to the wall so that our heads cannot turn, we all suffer the various tortures that existence can bring, yet we condemn those who simply can’t take it anymore. Maybe it is jealousy on our parts. After all, to commit suicide means deciding to cross our greatest taboo: death itself. None of us know anything of what is on the other side of death. Whatever you or I believe we take on faith. And fear of the unknown is the most powerful fear we have. To kill yourself is to go to a place that no living human has ever gone to. You don’t know what is on the other side.
I’m in no particular hurry to find out.
But suicide also takes a certain level of energy. If you have ever experienced a truly black depression, simply dragging yourself out of bed takes supreme effort. The depression is so deep, the serotonin levels in the brain so high, that all you want to do is sleep. You have neither the energy nor the will to think of and carry out a suicide attempt.
This is why anti-depressants carry a “black box” warning when used in children or adolescents. The anti-depressant works by preventing re-uptake of Serotonin in the brain. Since Serotonin is the primary hormone secreted to make us sleep, preventing its re-uptake gives you energy, and that energy in turn can alleviate symptoms of depression. But if a second mental illness also exists, such as bipolar, or the child or adolescent is given to psychotic bouts of self-harm, the extra energy from the inhibited serotonin can give the child or adolescent just enough of a boost to carry out the sudden urge to kill themselves.
On September 14th, 1989, Joseph Wesbecker, who was on disability for mental illness, walked into his employer, Standard Gravure, and opened fire, killing eight and injuring 12, before putting a Sig Sauer 9mm pistol under his chin and killing himself. Less than a month before, Wesbecker had begun taking Prozac, which the families of the victims latched on to, suing Ely Lilly, at that time the patent-holder for Prozac. The families of the victims were understandably looking for someone to blame, and in those days not much was yet known about what SSRIs did to the brain. Did it change who you were? Did it rewire the brain?
Ignored was the fact that Wesbecker had a history of mental illness dating back to 1978, the year he was first hospitalized. He was hospitalized three times between 1978 and the shooting in 1989. In 1984, he was asked after a suicide attempt if he had ever felt like harming someone else as well (one of the three questions asked to determine if a patient can be held under a psychiatric hold). “Yes,” Wesbecker told the doctor. “Who?” the doctor asked. “My foreman, at work,” Wesbecker answered. By this time, Wesbecker had already attempted suicide 12 to 15 times.
12 to 15 times.
I have only consciously attempted suicide once. I cannot imagine what it would take to drive someone to try 12 to 15 times. That isn’t simple pain. 12 to 15 times over six years means you are trying to kill yourself at the same rate that the average American takes a vacation.
12 to 15 times in six years isn’t depression. That’s a compulsion.
Wesbecker’s colleagues, friends, and family describe him as growing increasingly paranoid between 1978 and 1989. When a new company took over his factory, he was transferred to a new position. After a few months, he requested to return to his old job, complaining of stress. His request was denied and he became increasingly hostile toward management and began to believe that management’s failure to return him to his old job was the result of a conspiracy against him.
Was he a paranoid schizophrenic? We will never know. Certainly, there is more evidence of disordered thinking than depression, but perhaps the doctors who treated him focused on the suicide attempts and treated him for depression.
A lot of people don’t like it when I humanize killers. The “neurotypical” population doesn’t like it because they want to believe in evil, because believing in evil allows them to draw a distinction between themselves and the killer. It also lets them off the hook. Adult schizophrenics don’t like because they think I am spreading the myth that the mentally ill are dangerous individuals. Neither side wants to own killers as having perhaps been once like them before they opened fire on the innocent.
The reason I do humanize killers like Wesbecker is because we can stop killings like this. If you choose to believe that Wesbecker was just evil, then there is nothing you need to do, is there? Evil just exists.
But I thought God gave us free will?
And owning people like Wesbecker as mentally ill does not mean, you, as someone with schizophrenia or bipolar is also going to be a killer. You are taking control of your own health. You are taking medication and in therapy. And even if you were doing none of those things, most likely you would never kill, although in all likelihood we would find you dead one day, hit by a car while wandering the street or beaten up by thugs or just dead from exposure.
But you say “I need to get an education. I need to get a job that is fulfilling to me. I want a life. How can I get these things if people think I might kill or ‘go crazy’ one day?”
Because you don’t. You don’t “go crazy” at all.
“Neuroptypicals” concept of psychosis comes from Hollywood films, where they see images of McMurphy whipping the pajama-wearing inmates of an insane asylum into a frenzy in One Flew Over the Cuckoo’s Nest or Brad Pitt’s over-the-top Jeffrey Goines with the rapid hand gestures and winking eyes (the universal symbol for “crazy”) in 12 Monkeys or even Amanda Plummer’s “Honey Bunny” standing up on top of a diner table and screaming “Nobody move or I’ll execute every last one of you motherfuckers!” in Pulp Fiction.
Real psychosis looks nothing like that. Let me show you what real psychosis looks like.[video:
The two videos, above and below, were taken yesterday, in the lobby of the Santa Clarita Child & Family Center while waiting for Jani’s therapist. Jani takes the metal lock that allows the receptionist to secure the window between the reception area and the lobby. This piece of metal has teeth that form a serrated edge, designed to lock into the corresponding piece between the two panes of glass. Jani turns her wrist upside down and begins trying to cut herself with this serrated edge.
Jani has never seen anybody cut their wrist before, yet she somehow knew to cut the underside, where the ulnar artery passes through.
She is not rabid. Her movements are not rapid. She is just calmly sawing away at her own wrist. Susan tells her to stop. The receptionist, a stupid grin on her face, also asks Jani to give her the piece of metal and Jani complies.
The receptionist while smiling because she didn’t recognize that she was witnessing a psychotic episode. Jani was not emotional or difficult. She was simply passing the time by trying to cut off her wrist.[video:
In the second video, Susan asks Jani why she was trying to cut off her wrist. “So I can’t throw anything,” Jani replies. Jani is fighting the impulse to throw and be violent, so the solution in her mind is to cut off her hands.
This from a child who freaks out and runs behind me any time a bee comes near. That is, when she is not in a psychotic state.
When you go out tomorrow and go about your day, you will pass dozens of people who will be, at that moment, actively psychotic but you will never know. They will stand right next to you at Starbucks. While you order your latte, they will be struggling to ignore the voices in their head telling them that they are worthless and should run out into traffic and get hit by a car. They may be negotiating with these voices, asking them that if they will just let them out of the Starbucks and let them get home, they will break out the razor blade and cut themselves where no one can see, or pull out some hair. They will promise to hurt themselves in some fashion if the voices will just let them have this moment, in public.
And you will take your latte, smile at them, and be on your way.
You will never know.
Psychosis is not loud and violent. It is quiet and its main target is the person it inhabits. The psychotic person would always rather hurt themselves than hurt you. Even if the voices want them to hurt you, they can usually be placated by self-injury to the host.
When Jani’s therapist or her psychiatrist ask her about her hallucinations, Jani tries to avoid the question. If they push, Jani will hit me. There is no loss of control. She just starts hitting me, without the slightest change in her mood or demeanor. I suppose her hallucinations don’t like Jani answering questions about them, so she hits me or Susan to placate them. She won’t hit her therapist. She hits only those she knows will forgive her. She hits the ones who understand. She hits the ones who will not turn away, will not abandon her. She doesn’t trust her therapist enough to hit her yet, because her therapist, trained in behavior modification like most therapists, treats Jani like she can control it.
And one day, maybe, she might be able to. But right now she is a child.
In my online support group, I have heard countless stories of children and teens who we as parents know are schizophrenic but are not believed by medical professionals, therapists, and residential treatment center staff, because the violence, when it comes, comes out of nowhere. Because there is often so recognizable trigger to the violence, and the child or teen seems emotionless, the staff see it as behavioral problem. The child is “choosing” to act up.
They are not choosing at all.
One of the key “negative” symptoms of psychosis is what is called a “flat affect,” or lack of emotion. This flat affect is not constant. One of the signs of psychosis is a failure to respond with appropriate emotions to external situations, or where the emotional response isn’t appropriate to the external stimuli. Someone who is psychotic will not give you warning by flying into a rage before they try to hurt themselves. Everything will be fine and suddenly they are trying to cut their own wrists. There are no tears, no screaming, no “I hate you!” or what we associate with teen angst.
There is just a thought: If I cut off my wrists I can’t throw anything anymore.
Psychosis is not violence. It is the absence of logical thought.
Emotional state will give you no warning of psychosis.
This is why the “behaviorist” model of intervention is a total failure for kids who suffer from psychosis. Behavior modification is about teaching the child to be “aware” of feelings and then take appropriate action to deal with those feelings.
But psychosis does not come from feelings. It comes from thoughts, and once a child is in a psychotic state, they cannot “think” and “take appropriate action” because logical thought is no longer available.
It is possible to teach a person to be aware that they are thinking irrationally (which is a rational thought, hence the conflict) but this kind of training takes years. The only schizophrenics I know of who have done it are adults. Kids already have to deal with unstable emotions, and schizophrenic children have to deal with unstable thoughts on top of that.
By the way, after Susan told me what happened, I called UCLA for a direct admit. The nurse told me she would consult with Dr. DeAntonio, the head of the Child & Adolescent Psychiatric Unit at Resnick Neuropsychiatric Hospital at UCLA. A few hours later, she called me back to say that she had spoken to DeAntonio and he did not feel Jani needed to come back in.
Apparently, trying to cut your wrists with a piece of metal does not qualify as grounds for readmission. I guess it needs to be a real knife and there needs to be blood. What is really helpful is if you cut an artery and nearly bleed to death. Blue Shield can’t argue with that.
After all, the motto of American insurance companies when it comes to mental health is: Nearly die and then we will help you… maybe.”
It is pretty hard to “Thrive” as Kaiser Permanente likes to tell us in their commercials when your mind is telling you to hurt yourself.
The therapist was quick to tell us that “Jani was fine,” in the following session, clearly insinuating that we were the problem. No, Miss Therapist, Jani was “fine” because she had been restored to her normal schedule after you went on vacation.
Schizophrenia doesn’t take a vacation.
The next day we received a letter of rules from the Santa Clarita Child & Family Center. Number one was that video recording is not allowed to protect the safety and confidentiality of their patients.
They knew we had filmed what had happened.
I am not a fan of “no camera” rules because they aren’t really there to protect patient confidentiality. They are there to protect the facility so there is no visual record if they are not doing what they are supposed to be doing.
Individuals suffering from mental illness are at the mercy of whatever institution or organization is treating them and bringing in a camera is the only way the mentally ill can protect themselves and make sure they get the therapy and services they are entitled to under the law.
I was also struck by the final rule: If your child becomes violent toward staff, destroys property, or is otherwise disruptive, the parent must remove the child from the premises.
Oh, I see. They will only help Jani if she is a good little girl.
Then why the fuck would we be there in the first place?
It is like telling a child undergoing chemotherapy that you will not treat them anymore if they vomit from the chemo.
Rules like this are universal to “outpatient” clinics and they are, flat out, immoral. It is morally wrong to kick out a child because of symptoms of their illness.
Any child in a psychotic state or rage can be calmed down. You just have to stay calm yourself and ride it out. Do the therapy session outside. Go for a walk with the patient. Get your fat ass off the chair.
Newsflash to future psychologists: You can’t help people by just sitting in a chair. You can’t help people just by talking. You can’t ignore a patient in crisis simply because it isn’t convenient to you. In the end, you can’t sit on your ass in your office and see somebody once a week and then go home feeling like you have done good in the world. You haven’t. Anybody can do that.
If you want to help somebody, you have to make an effort. You have to try, even if you fail. You have to stay with the patient, through thick and thin. You cannot get rid of somebody simply because they are too hard.
At the bottom of this message was a number for the source of these policies, an Ari Levy, the Director of Programs for the Santa Clarita Child & Family Center. So I called him.
“Doctor Levy,” he answered the phone. Oh, a doctor. Of what, I wonder? Calling yourself a doctor, even if you actually have a PhD, is like buying a large sports car to make up for other deficiencies.
“Yes, hi. I am Michael Schofield, the father of Jani.” I have learned from past experience that it is better to start of pleasant. People tend to shut down when you are hostile. “I was wondering if we could schedule a meeting.”
“Why?” This surprised me. All these people do is take meetings, but his tone and the bluntness of his answer caught me off guard.
“Well, Jani has been receiving therapy from the Child & Family Center for almost two years now and we’ve had some issues with the services in the past so I thought it might be good for us to sit down and make sure we are all on the same page.”
“What kind of issues?” It was becoming clear to me that this Ari Levy thought he could just blow me off.
“Well, yesterday, while waiting for her appointment with her therapist, my daughter took a sharp piece of metal and tried to cut her hands off. The staff did nothing. It’s not first time something like that has happened. A few months ago, Jani was pounding on the glass and we were afraid that she would put her hands through the glass. Again the staff did nothing.”
“Well, I don’t know too much about Jani, or her situation, or you, but I have read her file. Didn’t DMH (Department of Mental Health) recommend residential?”
“Would you send your eight year old child to residential, Mr. Levy?”
“I can’t say. I really can’t say. I would depend on the situation.”
Okay, Ari Leavy, either your commitment to your own children is paper thin or you are giving me the safe, bureaucratic answer. I am guessing the latter. I have found that being a bureaucrat often destroys one’s ability to empathize with one’s fellow human beings.
“Well, it’s not something I am willing to do. The only residential placements we were offered were out of state.”
“Really? They offered you nothing in state?”
Is this guy really this stupid or is he just playing with me.
“Yes. The only two facilities who would take a girl her age turned her down.”
“Turned her down? Why?”
“They said she was ‘too staff intensive.’ Maryvale turned her down and Five Acres turned her down. Basically, she needs a one-to-one at all times, and right now that is us, her parents.”
“But the out-of-state facilities felt they could help her?”
A few days prior, I had learned about a 14 year old girl, the daughter of an old friend, who is currently in residential in Colorado at a Deveroux facility. Deveroux, it turns out, took her under false pretences. This girl has finally been diagnosed with schizophrenia (the previous diagnosis was bipolar with psychotic features). The girl is now on Clozaril, but so far she is not responding. When this girl has a psychotic episode, the staff try to put her in “time out” and she calls her mother, begging her to not let them do so. Because if you are being attacked by hallucinations, the worst thing you can do is put that person by themselves. Places like Deveroux are behavior modification centers, and as I discussed earlier, behavior modification does not work for severely mentally ill patients. So now Deveroux is telling this mother that they really can’t help her daughter. The mother wants to move her daughter back to California, but DMH won’t allow it.
That is why Jani will go to residential over my dead body. I am not going to hand her over to an organization that really doesn’t understand severe mental illness, who treats kids with schizophrenia like they are just “acting up.”
“I don’t think separating a young child from her family would be helpful,” I answered.
“Has it occurred to you that we may not be able to provide the services your daughter needs?”
I am well aware that he is suggesting that residential could “meet” Jani’s “needs” better than they could, but I am not going to send my daughter to residential just because the Santa Clarita Child & Family Center can’t meet her needs.
Try, for Christ’s sake.
“I mean,” he continued, “we can only provide the services we provide.”
“I understand that, but you are also the only game in town. As for Jani, we have gotten her therapist to agree to coordinate her vacation time with Jani’s other therapists so that not everyone is gone at the same time, so the next problem that I can see is Christmas. You are closed for a week and the school district is not obligated to provide anything during breaks. I realize money is tight, I work for the state myself, but would it be possible for you to set it up so Jani could see a therapist at the beginning of the Christmas week and then again at the end. That way she doesn’t go a full week without a session. It would require a little overtime but is that possible?”
I thought it was a reasonable request.
No! I was floored.
“We can’t just go outside of our existing programs.”
Oh, I see. So you won’t go the extra mile for sick little girl just so she can stay with her family and enjoy Christmas. I was really, really beginning to dislike Ari Levy.
“I understand you are making a choice not to send your daughter to residential…”
“It’s not a choice,” I cut him off. “A choice implies that you have at least two options. The only option DMH gave us was to send Jani to out of state residential. That’s not a choice. There has to be something between no services at all and residential. It’s the same complaint that I hear all the time from parents of mentally ill children in an online support group I set up.”
“You mentioned the other parents experience this problem,” he sounds like he doesn’t quite believe me that there are other parents like us and other kids like Jani out there. “What do they do?”
“Most of them leave the system. The pull back from agencies like yours because they get no actual help, just judgment. It was like when we had your WrapAround service. All they did was sit on our couch, sipping Starbucks, and telling us how to parent Jani when they even admitted they didn’t know anything about psychosis in children.”
“Let me put it this way, though. If you have a plumbing problem, you don’t call for a carpenter and expect him to fix the problem. You call a plumber.”
I can’t believe this. We are talking about a child, not home improvement.
“What if there is no plumber? Like I said, you are the only game in town. The biggest issue is that your programs are behavioral based and that doesn’t work for children with psychosis. Now, I would be willing to help train staff in how to deal with psychotic children.”
“That is a new program, though. Approval for that would have to come through DMH.”
“Well, who in your organization handles proposals to DMH?”
“Me. That’s my job.”
I almost laughed. “Okay, so why don’t we work on a proposal to DMH to create a new program that caters to children suffering from psychosis.”
‘Well, we could do that but creating new programs takes a long time, at least six months to a year. How does that help Jani now?”
“Maybe it doesn’t but it will help other kids and other families who are going to come after us. She isn’t the only one. More and more of your clientele are severely mentally ill and you need to come up with a way to adequately serve this population.
“Look, I know I sound flippant…” Yes, you do. I can tell he doesn’t believe me that there are more mentally ill kids in his agency right now and more on the way. He doesn’t believe that Jani represents the tip of the iceberg.
“but like I said, you don’t get a carpenter when you need a plumber.”
Is this the only metaphor this idiot knows?
“But when there is no plumber,” I answer, “then you have to get a carpenter. You get a carpenter and you teach him to be a plumber.”
I used to be a dyed in the wool liberal, but there is a fatal flaw in public non-profit agencies like Santa Clarita Child & Family Center. Since their funding comes from the State government and not from those they “serve,” they are under no inherent pressure to do a better job. In private industry, in order to keep customers, you either have to create a better product or give better service than your competitors. You cannot ignore the needs of your customers because they are how you stay in business. But public agencies don’t have any competition. They win bids from the state. They are monopolies. Santa Clarita Child & Family Center is the only game in the Santa Clarita Valley. They have no competition driving them to be better. Second, their clients are often poor or, like us, lack choices because there is no other choice. This means that the Santa Clarita Child & Family Center can treat it clients like shit and get away with it, because if people get fed up and walk away, as they often do, as the mother of the girl in Colorado did, then what has the Santa Clarita Child & Family Center lost? Nothing. Their funding is still guaranteed by DMH. And all DMH cares about is keeping costs down.
The fundamental flaw in mental health in America is that nobody cares about customer service because the customer has no choice.
Four months ago, Susan and I participated in the NAMI/BringChange2Mind walk in Ventura County. It was a nice three mile walk along the beach and into the swamps where the Ventura River lets out into the sea.
What is the point of marching if no one is going to see you?
Did we march only to make ourselves feel better?
I am in a black depression because Jani is slipping and I am so attached her to that her mood is my mood. And I am depressed because it didn’t have to happen.
We should not be marching in swamps.
We should be marching on the Santa Clarita Child & Family Center. We should be marching on the Department of Mental Health. The fact that these organizations would throw away our children is morally wrong. They must change and we can change them. We outnumber them.
So I am going to set up my own march. If you are interested in joining me in the fight to give our children a decent life, email me and let me know. If enough of us march on DMH, they will have to take notice.
Also, the Jani Foundation now has a You Tube channel: www.youtube.com/janifoundation. We want this channel to showcase mentally ill children, both in good moments and in bad. Please consider sending in your videos and showing the world that your child exists. You can email videos to email@example.com. Please try to keep your video submissions short (under five minutes). We do have the ability to edit videos (Will Stenner, close friend and musician, will edit, blur out any faces of bystanders if necessary, and add music if you wish).[video: