I began taking the tranquilizers as they were prescribed, and with medication, therapy, and lots of long walks, the debilitating attacks eventually began to subside.
I now understand that anxiety is a brain disorder I will live with and manage for the rest of my life. Even when I am not in crisis, the possibility is always with me. Because of this vulnerability, I carefully monitor my response to stress, as people at high risk for stroke monitor their blood pressure. I meditate, do yoga and deep breathing exercises, and exercise daily. I see a therapist and take antidepressant medication if I need extra help. Over time, I have come to listen to my anxiety, and to recognize it as an indication of something amiss.
As the years passed, the distance between Tom and me continued to widen, leaving us with almost no common ground and no way to build a bridge back to each other. In 2014, after forty-three years of marriage, we decided to part ways—a decision I could only make after I realized that the thought of staying in the relationship made me feel more stress than the idea of leaving it. We ended our marriage to save our friendship, and I believe we will always care for each other. I am grateful for that.
As I emerged from the dark and terrifying period of those last panic attacks, I felt like Dorothy stepping cautiously into the Technicolor land of Oz. Once safe on the other side, I saw that my own crisis had served as an enlightenment of sorts. It had taught me some things I needed to know in order to better understand Dylan’s life, and his death.
• • •
The World Health Organization defines mental health as “a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.”
My anxiety disorder showed me what it feels like to be trapped inside a malfunctioning mind. When our brains are impaired, we cannot manage our own thoughts. No matter what I did to try to think myself back to balance, I didn’t have the tools to do it. I understood for the first time what it meant not to be in control of my brain.
Understanding this gave me a great deal of empathy for others who suffer. I’d been trying for years to understand how Dylan could have done what he did. Then my own mind ran out of control and I entered the world on the other side of the looking glass, a private, seething hell in which unwanted thoughts took control and called the shots.
The sad, scary truth is we never know when we (or someone we love) may experience a serious brain health crisis.
Once I was feeling better, I couldn’t believe how distorted some of my thinking had been. For the first time, I understood how Dylan could have thought he was going in the right direction when it had been anything but.
I still can’t fathom what Dylan and Eric did; I cannot understand how anyone on earth could do such a thing, let alone my own son. I find it easy, if painful, to empathize with someone who has died by suicide, but Dylan killed. It is not something I will ever get used to or get over.
Was he evil? I’ve spent a lot of time wrestling with that question. In the end, I don’t think he was. Most people believe suicide is a choice, and violence is a choice; those things are under a person’s control. Yet we know from talking to survivors of suicide attempts that their decision-making ability shifts in some way we don’t well understand. In our conversation, psychologist and suicide researcher Dr. Matthew Nock at Harvard used a phrase I like very much: dysfunction in decision making. If suicide seems like the only way out of an existence so painful it has become intolerable, is that really an exercise of free will?
Of course, Dylan did not simply die by suicide. He committed murder; he killed people. We’ve all felt angry enough to fantasize about killing someone else. What allows the vast majority of us to feel appalled and frightened by the mere impulse, and another person to go through with it? If someone chooses to hurt others, what governs the ability to make that choice? If what we think of as evil is really the absence of conscience, then we have to ask, how is it a person ceases to connect with their conscience?
My own struggle showed me, in a way nothing else could, that when our thoughts are broken, we are at their mercy. In the last months of his life, Dylan turned his back on a lifetime of moral education, empathy, and his own conscience. Everything I have learned supports my belief that he was not in his right mind.
Brain illness is not a hall pass. Dylan is guilty of the crimes he committed. I believe he did know the difference between right and wrong at the end of his life, and that what he did was profoundly wrong. But we cannot dedicate ourselves to preventing violence if we do not take into account the role depression and brain dysfunction can play in the decision to commit it.
Of course, that is a risky thing to say. The idea that people with brain disorders are dangerous is among the most pervasive and destructive myths out there, and it is largely false. Most people with brain disorders and illnesses are not violent, but some percentage are. We must arrive at a way to discuss the intersection between brain health and violence in an open and nonjudgmental manner, and we cannot do that without first talking about stigma.
You can probably name several Olympic gold medalists and star quarterbacks who have blown out their knees, or major-league pitchers who’ve had Tommy John surgery. But most of us can’t name a single celebrity who has struggled—successfully, anyway—with depression or another mood disorder. Even celebrities are afraid of losing their jobs or being seen as a danger to their children. Wealth, power, and the love of the public is no defense against that stigma.
My own experience with anxiety showed me the risk and shame involved in making my pain known to others. I believe I am a profoundly honest person—sometimes to a fault. And yet, when I was experiencing spikes of panic, I felt so ashamed of what I was going through, so humiliated by my inability to “get on top” of the problem, that I went to great lengths to conceal my experience. Afraid of being seen as weak or unstable, I had done my utmost to hide (or at least, disguise) my inner storms from colleagues and friends.
And I’d been able to do so with little difficulty, even though I believed my mind was trying to kill me. I’m sure my colleagues and casual acquaintances noticed all was not well. Does Sue look thin/shaky/pale/distracted to you? Except there was a perfectly good reason for me to seem under the weather. No wonder she seems run-down—you know what she’s been through. Just as I had once said to Tom, Dylan’s course load must be too heavy; he looks tired, and Of course he’d rather play video games than hang out with his parents; he’s a teenager!
Once I’d emerged on the other side of my own health crisis, I could see how shrouding it had isolated me. But the experience also helped me relate to others who hide the enormous pain they’re in. Most of these issues are treatable, as long as people get help. Yet many do not seek the treatment they need, and stigma is one reason why.
If you hurt your knee, you wouldn’t wait until you couldn’t walk before seeking help. You’d ice the joint, elevate it, skip your workouts—and then, if you didn’t see any improvement after a couple of days, you’d make an appointment with an orthopedist. Unfortunately, most people don’t turn to a mental health professional for help until they’re in real crisis. Nobody expects to heal their knees themselves, using self-discipline and gumption. Because of stigma, though, we do expect to be able to think our way out of the pain in our minds.
As soon as my own anxiety disorder was under control and I began to emerge from the quicksand, it was suddenly as clear as day: a brain health crisis was a health issue, the same as a heart condition, or a torn ligament. As with those health issues, it can be treatable. But first it has to be caught and diagnosed. Every day, mammograms and breast exams help doctors catch and treat cancers they would have missed fifty years ago. I survived cancer myself because of these, and can only hope that someday we’ll have screenings and interventions at least as effective for brain health.
Indeed, we must. Like many other diseases, brain
illnesses can be dangerous if they are not recognized and treated. The person most likely to suffer from a destructive impulse is usually the one who has it. In some exceptional cases, people may behave violently toward others as well. That’s not a given, or even a likelihood, but it does happen. Untreated illnesses can jeopardize the people who have them, and those around them.
When people who are struggling cannot get access to the lifesaving treatment they need, it puts them at increased risk of doing harm to themselves or others. Self-medication with drugs and alcohol is common when people aren’t getting proper treatment and support, and abusing those substances is a factor that dramatically increases the likelihood of violence among those with mental illness.
Whenever I interviewed an expert for this book, I asked them this question: How do we talk about the intersection of brain disorders or mental illness and violence, without contributing to the stigma? Dr. Kent Kiehl summed it up neatly: “The best way to eliminate the belief that people with mental health issues are violent is to help them so that they’re not violent.”
• • •
It’s very hard to know who is going to commit an act of violence. Profiling doesn’t work. But violence can be prevented. In fact, threat assessment professionals have a saying: Prevention does not require prediction. It does require, however, that we increase overall access to brain health interventions.
Dr. Reid Meloy, a pioneer in the field, uses this analogy: A cardiologist may not know which of her patients is going to have a heart attack, but if she treats known risk factors such as high cholesterol in all of them, cardiac events will go down. The rates will improve further if she attends closely to patients at increased risk—the smokers and the overweight—and they’ll go down even more if she makes sure that patients who have already had heart attacks comply with heart-healthy programs and take their medications.
A similar tiered system is already working in some schools. At the tier-one level, everyone should have access to brain health screenings and first aid, to conflict resolution programs, and to suicide prevention education. Peer intervention programs teach kids to seek help from trained adults for friends they’re worried about without fear of repercussion.
A second tier of attention is trained on kids going through a hard time—a student grieving a lost parent, one who has suffered teasing or bullying, or those in known high-risk populations. For instance, gay, lesbian, bisexual, and transgender kids are at disproportionate risk for bullying, so special efforts might be made to connect those kids to resources.
The third level of intervention comes into play when a child has emerged as a particular concern. Perhaps he or she has an ongoing emotional disorder, has talked about suicide, or—as Dylan did—has turned in a paper with violent or disturbing subject matter. The student is then referred to a team of specially trained teachers and other professionals who will interview him or her, look at the student’s social media and other evidence, and speak to friends, parents, local law enforcement, counselors, and teachers.
The real beauty of these measures is not that they catch potential school shooters, but how effectively they help schools to identify teens struggling with all different kinds of issues: bullying, eating disorders, cutting, undiagnosed learning disorders, addiction, abuse at home, and partner violence—just to name a few. In rare cases, a team may discover that the student has made a concrete plan to hurt himself or others, at which point law enforcement may become involved. In the overwhelming majority of these cases, though, simply getting a kid help is enough.
“People who are involved in targeted violence are usually involved because of an underlying issue,” Dr. Randazzo told me. “Often, that is a mental health issue. Usually, those mental health issues can be resolved if they are discovered and treated effectively. Better mental health resources can without question help to prevent violence.”
If we are serious about preventing violence, we must also recognize the cost to society when we make firearms so easily accessible. Dylan did not do what he did because he was able to purchase guns, but there is tremendous danger in having these highly lethal tools readily available when someone is at their most vulnerable. These risks are demonstrated, and we must insert them into the equation when we are talking about how we can make our communities healthier and safer.
• • •
When tragedies like Columbine or Virginia Tech or Sandy Hook happen, the first question everyone asks is always “Why?” Perhaps this is the wrong question. I have come to believe the better question is “How?”
Trying to explain why something happens is how we can end up latching on to simple answers without actionable solutions. Only someone already in distress and with a vulnerability to suicide sees death as a logical solution to life’s inevitable setbacks. It’s dangerous to condition ourselves to view suicide as a natural response to disappointment, when it is really the result of illness.
The same thing, I believe, is true about what happened at Columbine. Dylan was vulnerable in many ways—unquestionably emotionally immature, depressed, possibly suffering from a more serious mood or personality disorder. Tom and I failed to recognize these conditions and to curtail the influences—violent entertainment, his friendship with Eric—that exacerbated them.
Asking “how” instead of “why” allows us to frame the descent into self-destructive behavior as the process that it is. How does someone progress along a path toward hurting oneself or others? How does the brain obscure access to its own tools of self-governance, self-preservation, and conscience? How can distorted thinking be identified and corrected earlier? How do we know the most effective treatments at various places along the continuum, and make sure they’re available in any medical setting?
How long can we fail to recognize that brain health is health, and identify what can be done to maintain it?
These are the issues that urgently need our attention. Asking “why” only makes us feel hopeless. Asking “how” points the way forward, and shows us what we must do.
As I learned all too well, brain health isn’t an “us versus them” situation. Every one of us has the capacity to suffer in this way, and most of us—at some time in our lives—will. We teach our kids the importance of good dental care, proper nutrition, and financial responsibility. How many of us teach our children to monitor their own brain health, or know how to do it ourselves?
I did not know, and the greatest regret of my life is that I did not teach Dylan.
CONCLUSION
Knowable Folds
Sue Klebold. Colorado Chapter. Loss and Bereavement Council. Lost my son Dylan in a murder-suicide at Columbine High School in 1999. Still asking why. I support research.
—The tweet-length description I wrote to introduce myself at the American Foundation for Suicide Prevention, Chapter Leadership Conference, 2015
A day does not pass that I do not feel a sense of overwhelming guilt—both for the myriad ways I failed Dylan and for the destruction he left in his wake.
Sixteen years later, I think every day about the people Dylan and Eric killed. I think about the last moments of their lives—about their terror, their pain. I think about the people who loved them: the parents of all the children, of course, but also Dave Sanders’s wife, children, and grandchildren. I think about their siblings and cousins and classmates. I think of those who were injured, many left with permanent disabilities. I think about all the people whose lives touched those of the Columbine victims—the elementary school teachers and babysitters and neighbors for whom the world became a more frightening and incomprehensible place because of what Dylan did.
The loss of the people Dylan killed, ultimately, is unquantifiable. I think about the families they would have had, the Little League teams they would have coached, the music they would have made.
I wish I had known what Dylan was planning. I wish that I had stopped him. I wish I’d had the opportunity to trade my own life for those that were lost. But a thousand passionate
wishes aside, I know I can’t go back. I do try to conduct my life so it will honor those whose lives were shattered or taken by my son. The work I do is in their memory. I work, too, to hold on to the love I still have for Dylan, who will always remain my child despite the horrors he perpetrated.
I think often of watching Dylan do origami. Whereas most paper folders are meticulous about lining up the edges, fourth-grade Dylan tended to be more slapdash, and his figures were sometimes sloppy. But he’d only have to see a complicated pattern once to be able to duplicate it.
I loved to make a cup of tea and sit quietly beside him, watching his hands moving as quickly as hummingbirds, delighted to see Dylan turn a square of paper into a frog or a bear or a lobster. I’d always marvel at how something as straightforward as a piece of paper can be completely transformed with only a few creases, to become suddenly replete with new significance. Then I’d marvel at the finished form, the complex folds hidden and unknowable to me.
In many ways, that experience mirrored the one I would have after Columbine. I would have to turn what I thought I knew about myself, my son, and my family inside out and around, watching as a boy became a monster, and then a boy again.
Origami is not magic. Even the most complex pattern is knowable, something that can be mapped and understood. So it is, too, with brain illness and violence, and this mapping is the work we must now do. Depression and other types of brain disorders do not strip someone of a moral compass, and yet these are potentially life-threatening diseases that can impair judgment and distort a person’s sense of reality. We must turn our attention to researching and raising awareness about these diseases—and to dispelling the myths that prevent us from helping those who most need it. We must do so, not only for the sake of the afflicted, but also for the innocents who will continue to register as their casualties if we do not.
Mother's Reckoning : Living in the Aftermath of Tragedy (9781101902769) Page 31