Programs, evaluations,
and finally medication.
A small hope dawns at last
Just before Nick finished his freshman year of high school, Julie recommended a hospital with an adolescent program in another state for a brief stay over the summer to satisfy his school, and hopefully help him. He had just turned fifteen, and we weren’t sure if a hospital was entirely appropriate for him, as their main focus was chemical dependency. These resources were the ones Julie knew best, and she still felt that there were ways for Nick to use them. We figured it couldn’t do any harm, as long as there were psychiatrists on hand to talk to him. We didn’t know what else to do, and the place had an excellent reputation.
We had to do something, we knew, and it just seemed to us that his psychiatrist was not yet as desperate as we were. He said he had nowhere to recommend for treatment for Nick, although we all recognized the fact that Nick was sinking daily deeper into depression, and there were even times when he no longer made much sense. I see it now more clearly as I read his journals.
Nick agreed to go to the hospital as kind of an experiment, although he wasn’t enthused about it. But as his school had required that he get some kind of help before coming back in the fall, he didn’t have much choice in the matter. And Nick’s psychiatrist approved of the place we were planning to send him.
Nick nearly missed his plane when he locked himself in the bathroom just before he left. He said there was something he had to do before he left the house, but I began to panic when someone in the house said he had gone into the bathroom, wearing rubber gloves. I pounded on the door, threatening to have someone break it down. I had a terrible premonition that something awful was happening in there. And when he finally opened the door and I saw him, I knew I hadn’t been entirely wrong. He stood there, grinning at me, with blue dye running down his neck and the sides of his face. His hair was still wet, and the hair dye was all over him, the floor, and the bathroom.
“It’s a new color. It’s called turquoise. How do you like it, Mom?” He looked like a kid who had just done his first finger painting in kindergarten. It was hard not to love him, or forgive him for the crazy things he did. “Don’t you love it?” Yeah, more than life itself, Nick. I hurried him then so he wouldn’t miss the plane.
Julie was flying with him to the hospital where he was supposed to stay for a month. I was going to Napa with the kids, and when he was through at the hospital he was going to join us there.
I was hoping, naively and foolishly in spite of experience with him, that this would be a peaceful experience this time. He would do his thirty days, call from time to time, tell us how well things were going, and come back better than he left. Julie was planning to spend the first week with him, at least, leave him there when he felt comfortable, and then return for the last week and bring him home.
But I knew Nick better than to have dreamed it would go smoothly. I must have been nuts to think it could possibly happen like that. Things were fine for the first few days, as his journal entries show. He was at least thinking clearly then.
If you are a nice person, others should be nice to you. If you’re an asshole, you deserve the same. I try to treat people with respect, even if I dislike them, so I’ll receive the same. If they in turn aren’t nice anyway, then they’re the asshole, not you. I think it’s especially important in here because you can’t really avoid anyone. Especially peers in your group because you constantly have to deal with them. It’s good practice for the future because in work situations you can’t just go off on people at random and expect them to be cool to you.
1. I admire honesty, loyalty, kindness, generosity, creativity, sensitivity, and strength. Not physical strength, but I admire people who went through hard times, and came out a more knowledgeable and smarter person because of it.
2. I admire my mother because she worked for everything she has. She started out poor and went through some very tough times, but came out stronger for it, instead of bitter. She is very kind, loving, generous, and honest. She can express her feelings, and she is extremely loyal to her family.
But something went wrong after the first few days, and things began to get out of hand. I can see it in his journal entries. He says that he thinks he is manic-depressive and crazy, and then writes about death, blood, pain, excrement, all in violent images filled with rage. And then he writes:
I am trapped in a state of boyhood. I’ve stunned myself with the journey through the wringer. I’m dirty. I lie. I am a chart, a picture of regression. I am the lowest creature in the cycle of evolution. I am filth. I am hate. I am war.
He was definitely not all right by then, and I’m not sure what happened to upset him in the intervening days.
He began insulting counselors, refused to follow the rules, wouldn’t go to group, and then, perhaps spurred by things said in groups, according to Julie, he decided he hated us, and announced that he was never coming home. Apparently, someone had talked to him quite a bit about what a burden it must be for him to have a famous mother, they had suggested to him that perhaps I never spent time with him, or maybe he had been shunted off so I could be free to pursue my own life. Nick ran with the ball they tossed him and went wild with it. He was trying to score a touchdown, but had no idea for what team, and after a week or two there, he had no idea which end was up. He hated them, he hated me, he hated John, and he hated Julie. He hated everyone, and when they asked him if he felt “abused” by us, he said yes. And they told him he could have himself made a ward of the court if he chose to.
When Julie returned to the hospital, she saw the state he was in. He was completely confused and very manic, frightened and hell-bent on becoming a ward of the court although he was no longer sure why he had come to that conclusion. She told us we had to bring him home and fast, before he got even more confused, and the hospital agreed with her. He had somehow felt too much pressure on him, and he couldn’t cope with it. Something in him had snapped, and Julie said he hardly knew who or where he was. But he had complicated the situation dramatically, by asking to become a ward of the court. In the end, I called my lawyer, who knew someone in a city near the hospital. My lawyer’s friend called the hospital for us, and Nick was so confused, and difficult by then, the hospital also thought he needed to come home to us. He had somehow become unstrung, panicked, confused, and couldn’t pull himself back together. Their specialty was not handling psychotics, it was handling kids who were suffering from addictions. Nicky’s problems seemed far greater to them, and to us.
They wanted Nick out of there as badly as we wanted him home. He had been there for exactly two weeks, and although he had been depressed when he left, he had been functional. Now he sounded completely bonkers, and out of control.
Julie asked us to have a bodyguard meet her, to help bring him home. Nick was in such a state that she was nervous that he might bolt, or panic on the flight. And we sent someone very nice out to fly home with her and Nicky. But as soon as they got to the airport, after leaving the hospital, she called. He had already calmed down a lot. But what worried all of us was realizing that he had come as badly unhinged as he had in the hospital. He didn’t sound like he was in any kind of shape to come home, and we were once again faced with what to do with him when he got off the plane. He needed a kind of interim base where he could slowly pull himself back together. I called his psychiatrist, who couldn’t think of anyplace appropriate to put him. Nick wasn’t dangerous to himself or anyone else, didn’t belong in a hospital, and according to the doctor, he still didn’t feel Nick needed medication. As usual by now, I felt utterly helpless. And it was obvious to me that Nick was too sick to come directly home. I couldn’t manage him myself, and had to think of the other kids at home as well.
I met Nick as he came off the plane, with a fair degree of trepidation. He had been telling me on the phone how much he hated me for the past week, how I had let him down, how little I cared, and all I was interested in was my career and my fame. He was no longer
rational and seemed to blame me for all his problems.
It would have been useless to try to reason with him on the phone during his hospital stay, to remind him of how much time I spent with him and the other children. Nick had become a full-time job by then. I was constantly dealing with his school, his psychiatrist, talking to Julie about him. There weren’t enough hours in the day to devote to him, spend quality time with the other kids, work late into the night on TV shows and books. I was hardly sleeping. And I was always behind the eight ball. Always apologizing for being late, or spending hours on the phone, trying to dig up new resources for Nicky. It was a challenging existence, but perhaps in some ways something Nick wasn’t entirely aware of. He didn’t know how many hours it took out of a day to try and help him. All he knew was what he didn’t like about his life, like most teenagers. Like many kids his age, he was extremely self-centered, and very demanding of everyone’s attention and time, particularly mine.
But as I stood waiting for him at the airport on the fifth of July, 1993, all my problems seemed to disappear when I saw Nick, just as they did the day he was born. All I saw was that smile, those eyes, and that face I loved so much. And as he saw me, he beamed at me, and ran over to give me an enormous hug. The first thing he said to me was “I love you, Mom,” and then he looked down at me with the sheepish look I knew so well, and added, “I don’t know why I got so mad at you. I think I got confused. But I’m not mad anymore. Everything’s fine now.” I knew it was the moment I saw him, but I also knew that he had hit the nail on the head. He got confused there. Either their treatment plan simply hadn’t worked for him, or something in their groups put too much strain on him, through no fault of theirs. It was hard to figure out what had happened, but it had surely done him no good. Our goals for him had not been met. If anything, he was sicker than when he had left, more confused, more depressed, though at least relieved to see me. Maybe it was just a natural progression of his disease, and might have happened anywhere. The timer on the time bomb of his disease was constantly ticking for Nicky.
But he still needed help, and in extremis Julie had come up with a temporary solution. At this point, one has to realize that we still had no idea what was wrong with Nick. Whatever ailed him, and it was obviously considerable, was still a mystery to us. As yet, no one had given us a firm diagnosis of his problem, or a solution that would work.
Our game plan that day was to put him into a program where Julie knew several people who ran it. She had called, and asked for their help, and they were willing to take him, straight from the airport, which was a godsend. It was another drug program, which wasn’t entirely appropriate for him, as his problems were more psychiatric than drug related, but he didn’t appear to qualify for a mental hospital at this point, and we had no one to check him into one. We needed a place to put him until he recovered some of his balance. And although we knew drug programs didn’t fully address the problem for Nick, the only option we had were the resources Julie had to draw on. He wasn’t functional enough to be at home just then. So far no doctor had felt a mental hospital was suitable for him, and we believed that all Julie could do was help us get him into drug programs where they knew her, however limited the benefits to Nicky. We were still groping in the dark for solutions. And we had not yet realized that the drug programs, where he didn’t fit in, and couldn’t function adequately, only unwound him further. But we had nowhere else to turn.
When I saw the program we took him to that day, I wasn’t sure it was the right place for him. I was almost sure it wasn’t. It was a small building with no greenery, no garden, no place for him to exercise. But we felt we had no choice. Although he was calmer than he’d been a few days before, he was still too confused and too wound up to take him home to the other children. We hoped to keep him there for a few weeks, and this time he agreed without negotiation. He knew he wasn’t well enough to come home. But he didn’t like the place when he saw it. All I could do was promise to bring him home as soon as I could. And I knew he trusted me to do that. I had given him my word, and he knew that when I did, I lived by it.
What we didn’t bargain for, although we should have by then, was how the people at the program would react to me. I was suddenly faced with a now familiar dichotomy. While on the one hand, they apparently were impressed by my celebrity, and everyone wanted autographs as soon as we arrived, they also seemed resentful of me. Julie knew several people there, and had chosen the program, and they had agreed, in an unofficial capacity, that she could be part of Nick’s treatment. She had the advantage of both her skill and experience, and knowing him better than they did. One of the problems for Nick in drug programs was that as other kids began to normalize and find balance again, without drugs, Nick would only seem to get worse and function less well than the others within the confines of their rules and structure. He was in effect far less functional than they were, and far less so than he appeared. It was easy to expect too much of him, and to be fooled by the affect he presented. He was brilliant and sweet and funny, and everyone who met him fell prey to his charm. And at first, he usually appeared more “normal” than he really was.
Within a short time, they attempted to apply some of their normal rules to him, regarding responsibilities, attending groups and dress code. And Nick refused, or was unable, to comply with them. And at the same time, the program decided not to let Julie collaborate with them on Nick’s treatment. When I called him there, he was unreachable, and they were uncooperative with us in small, unimportant ways that were hard to pinpoint. But I felt I had to bend over backwards to prove that we were ordinary folks and not expecting special treatment. But one thing was clear to us, and to them eventually. The more they tightened the rules on Nick, the less he was able to function, until he could no longer function at all.
The problem of their attitude was a small one compared to the mental state that Nick was in. He didn’t cause any trouble this time. He didn’t ask to become a ward of the court. But it was obvious within days that he was unable at that point to conform to their rules and do what they wanted. He had fallen apart so badly in the past month that, in the face of all their requests of him, all he could do was shut down emotionally and stay in bed, sleeping. They seemed to be challenging him beyond his capabilities, and he was slowly turning into a vegetable, losing touch, losing his grip, losing his will to live, through no fault of theirs. His reaction must have been part of his illness at the time.
After endless hours on the phone, discussing the situation we were in, Julie and I made an executive decision to take him out of the program and bring him home. Our attempts at treatment for him that summer had utterly failed, and if anything, had set him back further. He seemed more dysfunctional than ever.
I took him up to Napa with me, babied him, coddled him, and cajoled him as best I could. But for a long time, I got nowhere. He was in a deep depression from which Julie and I couldn’t seem to rouse him. She came to see him every day, and sometimes she just came and sat with me in my kitchen and cried after she saw him. It hurt us both to see him in so much pain. We could hardly get him to come out of his room, or out of bed, and I realized then that it was time for desperate measures. At Julie’s suggestion, I called the psychiatrist Nick had seen all year, and told him that we felt Nick needed medication, and quickly. He said he couldn’t give it to him until an evaluation had been done, and he wanted to recommend someone else to do that. He gave me the name of a psychologist who could do the evaluation for us, and I was upset. I wanted him to give Nick the medication we thought he so desperately needed, without waiting any longer. But I took the name of the doctor he gave me, and without waiting another minute, called him.
The doctor whose name I had been given to do the evaluation took a day or two to return my call, as Julie and I grew ever more frantic. And Nick grew more depressed by the hour. He was fifteen years old, and he was so depressed, he could barely function. But when I explained the situation to the psychologist, he promised to help us.
He said he would do the evaluation as quickly as he could, and if he agreed that it was necessary, he would ask the psychiatrist to prescribe medication. But first, he had to do the evaluation. He didn’t want to be hasty or careless. But I was worried about the delay, and what it might mean for Nicky.
Nick was so depressed he wouldn’t get out of bed. I felt as though Nick’s life was on the line, and reading his journal entries from that time confirms it. I truly believed then that Nicky was losing hope, and Julie and I were both afraid of what he would do about it.
It was a miserable time. I was told that the evaluation would take several sessions, and with great, great effort, I talked Nick into getting out of bed and going to the Peninsula to see the doctor. He was willing to talk to the new doctor, which was a miracle, but by then, maybe even he knew how sick he was. There was nothing manic about him at that point, it was all depression. But I was relieved when he liked the doctor, and cooperated with the tests. After he went for a session, the doctor broke the news to me that he couldn’t finish the evaluation, as he was going to be traveling. He was deeply apologetic, but there was nothing he could do about it.
He said that he suspected from the psychological tests he had already administered that Nick was perhaps atypically manic-depressive, but he didn’t want to be premature in his diagnosis. He had to complete the tests first. Furthermore, he said patiently, it was very unusual for a boy of fifteen to be manic-depressive in his opinion, and he wasn’t sure he should be given medication. He didn’t want to be hasty or presumptuous in his assessment. But I wanted him to hurry.
But when I called the psychiatrist who referred him, to ask him to speed things along, I found that he was out of town as well. There was nothing we could do except wait. I made a plea for medication in the interim, to tide Nick over till the doctor got back. Prozac. Valium. Aspirin. Rolaids. Anything. Just give this kid a break. But the psychiatrist had told us that we would have to be patient, and Nick had to wait for the evaluation to be completed.
His Bright Light Page 13