Friday, March 13, 2009

Breakdown






(Some of you might recognize this essay from its previous publication in Washington DC's now prematurely folded Beta-Culture 11. I include it here because it's an important episode in my life).


I find him laid out face-first on the floor of the garage. He’s banging his forehead against the concrete floor, punching it with tight fists. I can hear the screaming coming from all the way across the apartment complex common. The sounds of his rants are like knives piercing my sternum. He wants to be free of the dreaded weight. He wants out of life.

To witness the nervous breakdown of your own child is no different than watching cancer devour a young body. Like cancer, depression is a powerful disease that can render even the strongest of parents paralyzed. Maybe this isn’t my first encounter with his depression-like symptoms, but it is the first encounter with a clinical breakdown.

It is not the stuff for the faint of heart.
When a child like my son Jack suffers a nervous breakdown, it’s as if he has become possessed. The violence is a traumatic thing to experience, a frightening scene to witness. He issues guttural screams. He claws at himself, tears at his clothing. He punches the wall full-force, enough to break skin and bone. But he will not feel the pain so much as he will welcome it, covet it, the same way an addict lusts for a drug. This is not Jack lashing out. This is Jack hurting himself. Rather, by hurting himself he is trying to cauterize the deeper pain that has consumed his soul. This is as close as Jack will get to harming himself, without actually committing suicide.

By breakdowns end, the boy is spent.
He is soaked through with sweat; face and chest moist from tears, saliva and snot. Dark hair is mussed and matted. Hands and knees are encrusted with dirt from the garage floor, some of the cinders having cut into his skin. He is cut and bleeding in more than a few places. It’s possible he’s broken a finger; maybe a pulled muscle. His exhaustion is so profound, he wraps his arm around my shoulder allowing me to support most of his weight for the journey from the rented garage to our terrace apartment.

On the walk across the common, his head will hang low, chin against chest. Big tears fall, but the sobs more quiet now. Voice will be a hoarse whisper.
“I’m sick,” he will mutter. “I’m sick.”
It’s all I can do to hold back my own tears as I get him through the back door and onto the couch.

What to do next?
I don’t know what to do next. I’ve never before experienced the breakdown of my child. All I do know is that my pulse pounds, mouth is dry, hands tremble. I need a drink.

Looking at Jack laid out on the couch, eyelids at half-mast, I consider dialing 911. But I fear the move will absolve me of all control. In every “Cuckoo’s Nest” sense of the word, I picture the nuthouse. I see straight jackets, injections, big powerful men dressed all in white who instead toss Jack into a rubber room, bolt the door behind him.

Not over my dead body.

I decide to do something totally out of character: I call his mother, seek out her help.
Once more I hold back tears when I tell her, “I can’t handle it.”
My ex-wife insists he needs a hospital. That she knows what he’s going through; that she too had a breakdown not long after our separation which led to months of rehab and a strong medicine which she will ingest for the rest of her life. In the end, her bipolar condition is what led the courts to hand over custody of my two boys to me.
Since then I have tried to play Mr. Mom and Mr. Dad, but looking at my son sprawled out on the couch I feel a failure.

My ex, however is willing to do what she can. She’s going to place a call to her doc at the Four Winds Psychiatric facility in Saratoga. The doc will in turn call me in order to get a better idea of Jack’s symptoms.

I await the call.

When the doc calls I am no longer able to hold back my emotions. The flood gates open. It’s some time before I can get my message across.

“My son is sick,” I tell him, reiterating Jack’s words precisely. “I don’t know what to do.”
Doc tells me to calm down. That if I fear for Jack’s life; for my own life, to immediately get him to the emergency room. I tell him that it’s not necessary. I trust my son, even in this condition. I trust in him; trust that he will not do anything to harm himself or me or his little brother.
Then comes the question: Do I have guns in the house? If so, get rid of them. Get rid of anything you might constitute as a dangerous weapon. Hunting knives, ropes, darts, razor blades.
“Ditch the bottle of Tylenol,” the doc says. “An overdose can be lethal.”
“I prefer Ibuprofen,” I tell him.
“Excellent,” he says.

He wants to see Jack first thing in the morning, start him on medication. No more school for a while, no more friends or activities. “Keep a close watch on him. Let him sleep if he wants to sleep. Above all, don’t excite him.”
He hangs up.
I feel drained.
Drained, stomped on, gutted, bled out, crushed….
I pop a beer, drink down half of it on one swallow. The alcohol goes right to the sweet spot in my brain, tempers my despair, my anxiety. I stare at Jack on the couch. He’s fetal, sleeping like a baby. I remember him as a baby, like it was yesterday. I remember changing his diapers, holding him against me, tossing him in the air, hearing him laugh. The boy passed out on the couch I do not recognize.
_ _ _

What follows over a period of 24 hours is a series of tests and consultations with psychiatrists and psychologists. Jack is placed on anti-anxiety/anti-depression medication. While admittance to a hospital is once more discussed, it is argued by the professionals that to lump Jack in with persons suffering from schizophrenia and psychosis would be a grave mistake. At this stage of the game, that is. This news comes as a relief, although I’m not entirely sure if the relief is for me or for him (I dread the thought of visiting my son in a psychiatric hospital).

Steps must be taken in order to get at the root of the depression. Initially the steps are simple and practical.
Do I possess firearms?
There’s that question again.
If so, I must remove them from the premises.
There’s the answer once again provided for me.
Does Jack appear suicidal? Does he speak of hurting anyone besides himself? Do I fear for my own well being when in his presence?
All the same questions that I fielded during my initial phone conversation the previous evening.
As necessary as the question are, they are disturbing.
I am a gun owner. But I don’t fear that Jack is about to use them on me or anyone else, least of all himself.
But of course, this is exactly the attitude that will get someone killed.
The guns will be removed this afternoon, I assure the doc.

It will be decided that while Jack takes a break from school he is to begin a series of therapy sessions with his psychologist. These will occur three times a week for an hour at a time. The sessions begin the very next day.
His mother and I are called in first to discuss Jack’s childhood. Was there fighting around him?
Yes, that’s why we divorced.
Did he have tantrums?
Yes, major ones, lasted for hours at a time.
Did he exhibit signs of obsession and/or compulsion?
Yes. For instance, if you didn’t tie his shoes perfectly, he’d go into a kind of seizure.
Later, as a pre-teen, he would not leave his bedroom without knocking five times on the wall.
How did he take your divorce?
Not well. He lashed out at his mother.
Etc, etc., etc.

By the end of this first fact-finding session I am again crushed, bled out, drained. I am convinced that this boy’s problem rests with me and me alone. I am at fault for his breakdown. The way I’ve raised him is the problem. My ex-wife and I—all the fighting: it is the root cause of Jack’s depression.

But then the doctor inquires about my family history and a different story emerges altogether. My ex-wife’s side has two documented suicides and several more of depression and bipolar syndrome. My ex-wife herself is bipolar.
As for my side, it’s no better.
I immediately recall a story my dad told me about his own early teenage years. How one afternoon he came home from school and without warning found himself clutching at the driveway, convinced he was about to climb up on the roof, toss himself off. A nervous breakdown followed. He was later diagnosed with depression, at a time when depression was considered shameful. Those persons afflicted with it were to be hidden, kept out of sight of the “normal” people.
My father would go on to beat his depression to become a successful business owner. Yet he would still suffer two more breakdowns. Because the depression never really leaves you. It disappears, goes into a kind of remission. You can’t fight genetics. One day he would tell me of my great grandfather who committed suicide at the dinner table—by cutting his own neck with a straight razor in front of the whole family.

The doctor looks at my ex-wife and I, raises his right hand up and down and up again.
“This depression is genetic in nature,” he says. “And it is weaving its way in and out of your bloodline.”
Bloodline.
Sitting there inside that office I suddenly regret having had children.
It is not a good thought.
This is not so good either: Jack is not genetically blessed and it breaks my heart.
But this is the modern world. Medicine and therapies are available now that can afford Jack a “normal” life. So the doc encourages.
Nor is the stigma of depression an issue.
I have no problem writing about it. It is my own therapy to write about it. If only I could step inside my son’s mind, observe the grinding wheels and gears, observe the monster hidden behind them. I might understand more, be able to better write about it.
But no matter how close I am to my child, I am an outsider looking in. I am on my knees looking down into the pit. There is nothing but cold darkness.
_ _ _
The news is not all bad.
In one week’s time, Jack makes his first advance.
He cracks a smile.
I’m not entirely sure what provokes it. Something I say or his little brother says.
Maybe something Kramer spits on a “Seinfeld” rerun.
A simple smile. A grin really.
It’s not a whole lot. You might not give it a second thought under any other circumstance. Anything normal that is.
But for me, that smile represents hope. It is the future and it is possibility.
It warms my soul like mother’s milk.
I know that we have a long road ahead. There will be more breakdowns. But perhaps the next time it happens, Jack will be ready for it.
When it does, I will be there to carry his weight.

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