5 Things I Wish I’d Known About Mental Illness and Teens

Thursday, June 2nd, 2011

1. It May Not Look Like Mental Illness    I was a teenager who wore black, slept a lot and cried often. I ate too much or too little, couldn’t concentrate on my homework and wasn’t interested in a social life. I had no idea that these symptoms, if they last more than a couple of weeks, can signal serious depression.  I  simply thought this was what being a teenager was like. It wasn’t until I was 26 that I had my first “nervous breakdown” and was diagnosed with chronic depression. I was lucky. If I’d turned to drugs or alcohol as a way to solve my problems, I might have been another teenage drug addict or alcoholic, and never have gotten the help I needed. Even so, I didn’t recognize the symptoms in my son until it was too late. He was already doing drugs every day. He wasn’t diagnosed until he was 33.

2. Look for Mental Illness in the Family
Was there an aunt in your family who had a “nervous breakdown” when you were growing up? A grandparent who never spoke to anyone?  A relative who ‘burned out’ at work? A cousin who had to leave college because the stress was too much? A brother who was in trouble because of drinking or partying? These may pointer to underlying mental health issues. Many mental illnesses run in families. If there’s mental illness in yours, then your child’s drug activities may be an attempt to self-medicate the family disease.

3. Get Informed 
When I was dealing with my own depression and then my son’s there wasn’t the vast amount of information around that there is today. I had to look for books in the self-help section of the library or bookstore. I felt ashamed that I needed the books, and sure other people were judging me. These days, there is almost too much information around — so pick your sources carefully. The best information on drug addiction and mental health comes from reputable sites like The Partnership at Drugfree.org and the National Alliance on Mental Illness. Parents’ blogs can be helpful too, mainly because they tell you about other parents’ experiences, and may help you realize that you’re not alone in dealing with this.

4. Don’t Wait to Get Help   
If your child is showing signs of depression, don’t wait until they agree to see someone about it. Be proactive. You can begin with your child’s school counselor, sports coach, clergy or doctor.  These days, counselors have extensive information about outside resources to help both you and your child. They can recommend sliding scale counseling agencies that charge reasonable amounts and have access to emergency resources such as Mobile Crisis and the local Department of Children and Families, which can also point you in the right direction. But do it now. If you wait until your child is 17, you won’t have the right to make him or her get help.

5. If You Can’t Help Your Teen, Help Yourself
Sometimes, your child’s problems will seem overwhelming. Don’t let your child’s problems become your whole life. Make sure you take care of yourself first, so that you can help your child. A sick parent can’t do much to help a sick child. Get support (Al-Anon and 12 step groups are free and easy to find anywhere in the country). Ask your local hospital about support groups for parents, or see a counselor yourself. Join conversations online, or write a journal or blog. Eat right and get some exercise every day. You deserve looking after, too.

Editor’s Note: To learn more about co-occurring disorders, please visit Time To Get Help and download the Treatment eBook.

A Pound of Cure

To combat his bipolar disorder, Gabi Coatsworth’s son was given a cocktail of mood stabilizers—to disastrous effect.

The plane was late, but had finally landed. For the last hour, I’d been pacing the floor at LaGuardia, waiting for my son, Jason, who’d been in a psych hospital in Virginia for a week, to arrive home. I sipped a cup of watery coffee as I ran over the possible scenarios of Jason’s arrival in my head. He’d be looking fine and feeling good, because the doctors in Virginia had given him a shot of stabilizing medication that would last a month. Too optimistic. Maybe he’d be mad at me. He often was when he was sick—blaming me both for the illness and the treatment. Too scary.

I began to scan the passengers walking up the ramp, looking for Jason. The businessmen were off first, striding through the airport with determined faces. Then came the couples, families and older passengers. Where was Jason? I almost missed him. As the last wheelchair passenger trundled past me I looked along the concourse and wondered whether Jason had missed the flight. Only one old man was shambling along toward the exit. But the old man was carrying a guitar. I raised a hand to my mouth to prevent a gasp of horror. It was Jason. He must have waited until the last moment to leave the plane. So, he hadn’t wanted to see me.

I stepped forward to greet him.

“Hi, Jason.” He raised his bleary eyes to my face.

“Hey, Mom,” he slurred. He was stoned, or drunk, or both. How the hell had this happened? The hospital staff had taken him to the airport, and he had no money to buy drugs, I knew.

♦◊♦

I’d had nothing to do with this most recent hospitalization. I was in England when I heard that Jason had gone nuts and taken off from Connecticut toward Florida. The police had finally apprehended him in Virginia and hospitalized him for a week. I talked to Jason on my return, and I could tell he was far from well. Not only was he talking too fast, but his ideas were now delusional. I phoned the doctor at the hospital, begging him not to let Jason out yet, but since he had no health insurance, they weren’t about to keep him.

“We’re going to give him an injection of Haloperidol,” said the psychiatrist. “It’s an anti-psychotic, and the effects last for a month, which means your son won’t need to remember to take his medication. He’ll need a follow up shot when he gets home, and then it’s just once a month. He’ll still have to take the lithium, of course—there’ll never be a slow release form of that.”

“Why not?” I asked. “It would make life so much easier.”

“Lithium’s too cheap—and there’s no patent for it, so it’s not worth the drug companies’ bothering to make an injection or a patch—they couldn’t make any money.”

I wondered how much money it cost the insurance companies and the government to keep bipolar people in psychiatric wards when they failed to take their meds. Surely a guaranteed way of delivering the meds would save millions of dollars in hospital costs, and workdays not lost.

I walked slowly back to the car with Jason, trying to make a bit of conversation. He kept his eyes on the ground.

“I’m too tired for this, Mom.”

He fell asleep as soon as he was in the car and for the 90-minute trip back to Connecticut, he snored quietly next to me. As I drove, I wondered what on earth would happen now. I’d made an appointment for him to see his psychiatrist for his follow up shot and a kind of debriefing, but I wondered if Jason would be in a fit state to go.

♦◊♦

I couldn’t get to my computer until we reached home and Jason had fallen into bed, exhausted and seemingly out for the count. I looked up Haloperidol.

A long-acting antipsychotic injection for the treatment of acute and maintenance therapy in schizophrenia, it said. I ran my eye down the page to the possible side effects. Some degree of sedation, or possible catatonia they said. Jason seemed catatonic to me.

Extrapyramidal Symptoms. What the hell were they? Tremor, rigidity, hypersalivation, bradykinesia, akathisia, acute dystonia. I looked all these up. They were, among other things, also symptoms of Parkinson’s disease. Now I understood why Jason was walking and trembling like an old man. Then there were involuntary facial tics and twitches, which could become permanent. No sign of that yet, but then I hadn’t been looking for it. I stopped reading when I came to the insomnia, heart problems, incontinence, depression, confusion, agitation, epileptic seizures and the rest. It was clear to me that Jason had to come off this. But it would take a month for it to wear off.

The visit to Jason’s psychiatrist didn’t help matters. He told us Jason would have to have weekly blood tests.

“To check his lithium level?” I was familiar with this test. The idea was to make sure the lithium level in the blood never fell to a point where it became ineffective. And of course, it was a way to check on whether the patient was compliant.

“Not exactly,” said the doctor. I waited. Jason sat staring into space, which he’d been doing since we’d arrived. “With Haloperidol, there’s a possibility of his white blood cell count dropping to a dangerous level.”

I was close to tears. Was Jason’s choice going to be between becoming psychotic, and being a vegetable with a destroyed immune system? There must be another way.

Finally, Jason spoke up, through gritted teeth. “I’m not taking this ever again,” he said, and lapsed back into silence, trembling slightly as though the effort of speaking had exhausted him.

“We’ll see,” said the doctor. “The symptoms should improve.”

♦◊♦

It was going to be a long month. A month during which I watched him sleep and pushed his lithium pills on him. He was too exhausted to resist. I drove him to his outpatient appointments in a ramshackle Victorian house in Bridgeport that had seen better days. The outpatient treatment consisted of a “group” twice a week, where Jason argued with the moderator, fresh out of college and no match for my son. We went to the Social Security office and applied for some benefits, since it was obvious Jason couldn’t work. He could barely hold the pen to sign the forms, and his signature was illegible. They came through eventually, paid to me as his financial representative, since he clearly couldn’t manage his own finances. Every time he had a manic episode he’d pawn all his beloved guitars and start spending. I paid off some of his huge debts and together we waited for his symptoms to wear off. I tried to look on the bright side. Maybe this horrible experience would help him stay on his meds.

He did stay on his lithium. For almost a year.

On the Run

On vacation in England, Gabi Coatsworth receives an unnerving call: Jason, her manic-depressive son, has taken off to Florida with a drug-pushing girl who’s half his age.

“It’s Jason.” I could hear my daughter Helenka’s voice from the USA, faint but clearly distressed. “He’s disappeared. He said he was going to leave and now he’s gone and I don’t know where he is, and why do I have to take care of this?”

I had squelched my sense of foreboding when I’d left my bipolar son, Jason, and his problems behind for a week or two, and taken my first vacation in quite a while. I was in England, drinking in a little history, a little cappuccino, and the odd glass of wine, all of which were reducing my stress levels considerably. My husband, Jay, had taken our other two boys out to explore, and I was sitting, immersed in a Jane Austen novel, in the tiny garden of our rented apartment when my daughter called.

“Take a deep breath, darling,” I said, the way I used to when she was agitated over some tragedy as a teenager. I could picture her, twisting a strand of her long, dark hair around her finger. She was in her early 30s now, a middle-school teacher, and expecting her first child. No wonder she felt stressed. She really didn’t need Jason’s problems to deal with. I heard her breathe out, and I tried to do the same.

“Now, tell me,” I said. “What happened, exactly?”

“You know those people he’s been hanging out with in Norwalk?”

“Uh-huh,” I said. I knew a little about them, but had never met any of them, except for Jessica, the girl Jason was living with at the time. Jason liked to keep his life and mine separate, for the most part.

“He’s gone off with a 16-year-old girl who was scoring drugs for him,” Helenka continued.

This wasn’t good at all. Sixteen may be the age of consent, but Jason was over 30, and her family must have been worried and angry.

“Not with Jessica? Are you sure?” I asked.

“Yes.” Helenka was sounding impatient. “It’s all Jessica’s fault, though. Apparently she and Jason had a fight and she called the police—I guess they were both high.”

I wondered what Jason could have done. He’d never shown any signs of violence before. Maybe Jessica called the police because Jason, when manic, can be unpredictable, and therefore scary.

The English sparrows continued to chirp in the sunny garden.

“So if you call the police it’s an automatic domestic, and that means a court appearance,” Helenka continued. I wondered how on earth my daughter knew about things like this. “Anyway,” she went on, “he left with this 16-year-old. She had money and a VW Jetta. He said they were driving to Florida.”

♦◊♦

Florida was the place where Jason had always felt that he’d been free. He’d gone to live there when I’d given him an ultimatum about quitting marijuana. He’d been 17 then, and he’d lived there on and off for about five years before coming back to Connecticut.

“Why was he calling you, then?” I asked. I knew Helenka and Jason weren’t really close.

“He probably tried your cell and couldn’t get through. He only calls me when he’s nuts.”

Shit. I forgot. Jason didn’t have my international cell number. Thank God Helenka remembered it.

“He was demanding we wire him some money,” she went on. “I guess they’ve run out of cash.”

“OK,” I said, racking my brains for a way of finding Jason and getting him some help. “Look, next time he calls, see if he can tell you where he is so you can wire him the money. That way, we’ll have a way to find him.”

“I’ve already done that. He said he’d find a Western Union place and call back. But, Ma, he sounds completely crazy. He’s talking nonstop, and telling me these weird things about the sum of everything being one, and that’s the secret of the universe. I don’t like it.”

I was familiar with this line of thinking. Jason seemed desperate to make sense of his world when he was manic, and one way he did it was to come up with a pseudo-scientific theory which would explain it all. His equation—”0 = 1 = the universe = everything is one”—was a theme that recurred at times like this. I’d seen him fill whole notebooks with the same equation on each page, when he’d been manic before. It seemed to me that some distant part of his mind was aware that things weren’t right.

“We’re going to get him some help,” I said, with more confidence than I felt. “For now, just try and leave the phone lines free, and let me know if he contacts you again.”

♦◊♦

I felt powerless again, as I did so frequently when dealing with Jason’s disease. The sunny day had clouded over, and was threatening rain, as I waited for news.

It was five the next morning before Helenka rang back.

“They’ve got him.” She sounded relieved. “He called me from a strip mall in Virginia, so I called the police and they’ve got him.”

“How …”

“He told me he was in Virginia, and would I send him some money. I said I needed the address of the Western Union store, so I could send it. He didn’t know the address but he told me it was a Winn-Dixie store off the highway somewhere.”

“OK,” I interrupted, “but how did the police manage to find him?”

“I called 911 from the landline, while I was talking to Jason, and they patched me through to the police in Virginia. They were super nice and asked me if he had a weapon; I said no. ‘Was he a danger to others?’ I said I wasn’t sure, but I told them he might be suicidal.”

My stomach clenched. “Did Jason say he was suicidal?” I was trying to sound calm, but I knew this was a real possibility with bipolar people. My research had shown that two out of 10 bipolar people attempt suicide, and half of those succeed. I managed to forget this most of the time, but at times like this it was at the forefront of my mind.

“No, Mom, but you know they won’t do anything otherwise.” Right, right. If Jason wasn’t causing a disturbance or breaking the law, there was no way to get him help without claiming he was a danger to himself or to others.

“Helenka,” I told her, “you’re terrific. I know you hate doing this, but you may have saved his life. Look, I’ll be back in three days. Is there a number for the police so I can call and find out where he is?”

She gave it to me, and I called. They’d taken him to the local psychiatric hospital and checked him in for his own protection.

♦◊♦

So far, so good. The second I touched down at JFK three days later, I called the hospital again and spoke to Jason. He still sounded crazy to me, so I was shocked when the doctors told me they would be letting him go within the next two or three days.

“But he’s still sick,” I said. “I can’t come and fetch him until next week.”

I was stalling for time, hoping they’d keep Jason there a few days longer. But they were adamant.

“He doesn’t have any insurance and we only keep psychiatric cases here for seven days without insurance,” Helenka said. “We’ll give him a bus ticket to New York.”

I knew that the chances of Jason showing up in New York if he was still sick and taking a bus were slim. There were too many places between Virginia and New York where he could get off the bus and disappear.

“Don’t do that,” I begged. “I’ll send him an airline ticket.” I checked my credit cards for the one with enough credit to buy Jason a one-way ticket.

And as I did so, I wondered what the hell I would do with a sick son when he finally came home.

♦◊♦

Reading Between the Silences

As Gabi Coatsworth’s son’s bipolar disorder gave way to full-blown manic episodes, she watched her husband slip deeper into drink and detachment.

“You never really liked him, did you?” I wailed. My husband, Jay, and I were standing in our kitchen having the same argument we’d had so many times since we’d married 10 years before. Jay was Jason’s stepfather, and their mutual resentment had often been a thorn in the bed of roses I had expected our marriage to be.

“He could’ve been a nice kid, but you weren’t tough enough with him,” said Jay, as he topped off his vodka and tonic, mainly with vodka.

Now I was really angry. How dare he say that I was a bad mother? I took another giant cookie off the counter and bit savagely into it.

“He was fine until I married you and moved to this godforsaken town,” I said.

“Well, if that’s the way you feel about it …” And we were off, ostensibly rowing over my son, Jason. When Jay and I wanted to fight, we had two things to fight over—Jason and politics. And basically it was the same fight. I was too liberal and Jay was too right wing, not just politically, but in the way we viewed the world, and the way we brought up our kids.

♦◊♦

When I married Jay, Jason had been 14, and he, his sister, and I had moved from bustling Evanston, Illinois, to backcountry Fairfield—not exactly godforsaken, to be sure, but five miles from town. There were many things that Jason and Helenka hated about that move. They didn’t want to leave their friends and everything familiar to live with a man who was the love of my life, but the bane of theirs. I’d been divorced for 10 years and the children and I had carved out a life where I worked and their street smarts made up for me not being there all day. I gave them a fair amount of leeway—maybe too much, but as a working mother it was hard to cover all the bases.

Jay had been married before, too. His two lovely girls were well behaved, studied hard, and never caused a moment’s worry for their parents. I knew my kids weren’t like that, and knew they never would be.

What I didn’t know was that, at the age of 13, Jason had started self-medicating his depression—his first symptom of bipolar disorder—which would finally come to a crisis when he was 33. Jay was convinced we had a drug addict on our hands. I was hoping it was just a phase, but eventually I agreed to give Jason an ultimatum—quit or leave. Jason decided to leave. In my grief, I blamed Jay for the loss of my son.

I wondered, sometimes, why on earth Jay and I had married each other. We were such opposites, and neither of us was prepared to change anytime soon. What had I seen in him? And then I remembered. Jay just didn’t quit. When the chips were down, Jay would always do the right thing.

When my sister died in England aged 41, Jay hadn’t hesitated when I told him her boys, 5 and 8, needed a home. “Of course we’ll take them,” he said, and they came to live with us. He’d always wanted a son, and Jason certainly hadn’t come up to the mark. Now he could try again. But losing a sister and having two new children to take care of, exactly 20 years younger than my own, had made me tired and depressed, with almost no energy left to be a wife.

Five years later, Jason had his first full-blown manic episode and I went into in-charge-mom mode. Jay said nothing, but I read between the silences. “Jason might have been OK—if I hadn’t been such a bad mother.”

♦◊♦

So when I had to choose between Jason and his unpredictable crises and the two needy little boys or Jay, Jay lost out. The boys really couldn’t cope without me—Jay could. Still, he hung in there, though the same old arguments continued. When I was too tired to smile, or just plain weepy, Jay would blame Jason.

“I don’t hate Jason,” he said, “but I hate that he makes you upset.”

“He doesn’t,” I lied. “But he’s the one who needs me right now.”

Jay’s jaw tightened and he said nothing. But I could read his mind by now. He was pissed that I worried more about Jason than him.

Actually, I was concerned about Jay too, but in a more chronic way. He was working longer and longer hours; he was drinking more but it was relaxing him less. When I was finding life hard, he became withdrawn, as though becoming entangled in the problems of family life was too much for him. He began to spend more time at our weekend place in New Hampshire, while I stayed in Connecticut, keeping an eye on Jason.

I knew I couldn’t do much about Jay’s drinking, but I could get help for Jason, and I did. Over the next six or seven years, as one manic episode succeeded another, Jay cautiously became a little more involved. He visited Jason in the hospital a couple of times, and was startled to hear Jason telling the hospital staff that Jay was the head of the CIA and would bring the hospital to its knees if it didn’t let Jason go—right now.

Even so, the strain was beginning to tell on me. I’d been a mother for nearly 40 years, and a wife for 25, and the constant push and pull between Jay and Jason was taking its toll. I was already taking two antidepressants, but I was feeling more and more depressed. By the Christmas of 2007 I needed a third.

♦◊♦

Jason went into the hospital twice in 2008, and Jay finally began to understand that being bipolar wasn’t a lifestyle choice, it was an incurable condition. He became less judgmental, and when, not long after our 25th wedding anniversary, he quit drinking, that helped too. Finally, I felt that I wasn’t the referee between my husband and my son, and I began to relax. When Jason was admitted to hospital in Vermont last fall, Jay didn’t complain when I drove the two and a half hours three times a week to visit him. Jason was there for six weeks this time, but when he came out, Jay was there to help him get his life back on track. Jay’s encouragement meant as much to Jason as any practical help, though that, too, was forthcoming.

For the first time, I felt that Jay and I were on the same side. In fact, to my amazement, and maybe even his, Jay voted for Obama. We still don’t discuss politics, though, just in case

A Slippery Road

In this installment of ‘Bipolar Planet,’ Gabi Coatsworth’s son, Jason, struggles to stay on the path to recovery.

I paid extra attention to the road as I peered through the windshield, which was slowly icing up. I was giving Jason a lift back to the homeless shelter in Westport, where he’d been living for the past few months. He’d come home for a Sunday family dinner.

“It doesn’t feel right,” he said, suddenly.

“What doesn’t?” At least half my mind was on the road.

“When I’m at your house—it doesn’t seem like the real world at all.”

That summed things up pretty well. Jason had grown up, at least until he was a teenager, in our world of middle-class affluence, with log fires, roast dinners, and cozy evenings spent together. Now he felt most at home on the streets. At night, when my mind wouldn’t let me rest, I pictured him alone, wandering alone until it was time to check in at the homeless shelter again.

“So, what does feel real?” I asked.

“Florida, maybe.”

“What, with Dad?” He’d spent several years living with his alcoholic father in Fort Lauderdale, trying, and failing, to earn his approval.

“God, no. That was the worst. No, when I lived with my friends and we played music all the time.”

And did drugs all day, I thought.

“Well,” I said, terrified that this might actually happen, “once you get on your feet, you’ll be able to go back there if you want.” I knew that if he was 1,500 miles away, the chances of his managing his bipolar condition would be infinitesimal, but I didn’t want to have a row about it at that moment. I braked to avoid a opossum creeping across a patch of ice in the road. My grip on the steering wheel tightened, and a sweat broke out all over as I fought to bring the car back under control.

“I hate the winters up here,” he said.

♦◊♦

I had bought him a heavy workman’s jacket and boots to keep him warm, and he wore them, although he preferred to dress in the Brooks Bros. and Barney’s castoffs that appeared regularly as donations at the homeless shelter. He rode a bicycle around town, or, when the weather was too bad, he waited for the bus. His car was long gone—given away, maybe, or traded for drugs. He couldn’t remember; he’d been manic at the time.

His social worker had helped him find a job, so now he was working at the local CVS, developing photos. My friends, most unaware of his condition, would stop by to see him, and told me how nice he was, how efficient, too. Things seemed to be going well. I began to relax a little.

Since he’d been working for almost a year, the homeless shelter had moved him into a halfway house, also in Westport. It was a small cottage, with room for four, on the Post Road near McDonalds; I’d passed it a million times without ever noticing it.

All Jason had to do was follow the rules. They were designed to keep the occupants on the right track, so although they were numerous, they weren’t exactly draconian. You had to go to work, clean up after yourself, keep taking your meds, go to outpatient services, and attend a weekly house meeting. No overnight guests.

I was ecstatic. Now that Jason had a home, a job, and some structure, I knew he was well on his way to full recovery.

♦◊♦

Then the calls started coming. They came to me, since Jason had no cell phone. First CVS. Jason hadn’t turned up for work, again. Then the social worker; he hadn’t been attending weekly meetings. She’d heard he had had a woman in the house overnight. That was forbidden.

I raced to the halfway house, determined to find out what was going on. No one answered the door when I rang the bell. After several rings, and after throwing some stones at the bedroom window, Jason appeared at the door, his long hair tangled on his shoulders, a grubby sheet clutched around his waist. His eyes looked puffy. It was early afternoon and he was still sleeping.

I followed him up to his bedroom and paused in the doorway. It was almost impossible to navigate the floor, covered as it was with a jumble of guitar catalogs, unopened mail, and clothes. His guitar was propped precariously against the bedside table, where a full ashtray threatened to fall off at any moment. The bed, of course, was unmade, and Jimi Hendrix stared down from the poster on the wall with a stoner’s weary eyes.

“Have you got any clean clothes?” I asked. For my own sake, I needed to inject a note of normality into the situation.

“What for?” Jason mumbled.

“Because you’re going to work. If you don’t, you’ll lose your job, and they’ll throw you out of here.” I was keeping my voice steady, aided by the cold fist that had my gut in its grip. Why the hell wasn’t he trying?

“What time is it?” he asked. “I’m not working until the evening shift.”

I hesitated. Maybe he was right? But CVS had definitely said that he was supposed to be at work. Maybe they’d changed the shift and Jason had forgotten?

“Well, they want you there right now.”

Jason groaned as I began sorting through the shirts on the floor. I gave them a cursory sniff, and picked the least offensive one. “Here,” I said and handed him the shirt and a pair of passable jeans. Jason reached for the hairbrush that was under the bed.

♦◊♦

CVS took him back, but it didn’t last. When he lost that job, he had to leave the halfway house.

“No problem,” he said. “I was planning on moving in with Jessica anyway.”

Jessica was his girlfriend, the first in a long time. She lived in Norwalk, which would be nearer to the outpatient center, but farther away from us. She was a nice girl, but had serious problems of her own. That was exactly what attracted Jason.

“I can give her advice on how to deal with her problems. She’s adopted, and hates her parents, and they’ve thrown her out, but I know I can help her.”

I helped Jason move into Jessica’s one-bedroom apartment on the upper floor of a small house behind the local porn store. The yard was paved with cracked concrete; it stored a variety of rusty artifacts that should have been at the dump. Eventually, Jason found a job selling vacuum cleaners. Make Up to $3,000 a Week, the ads had said.

“I have to train for two weeks, then they give me a list of people they’ve contacted by phone, and I go around and sell them one.”

My husband, Jay, and I knew this wasn’t going to be as simple as it sounded, but it was a job.

“They want me to do a couple of sample sales to friends or relatives to show I can do it,” he said. “Do you think you and Jay could be one of them?”

Jason came round with his sample vacuum, and showed us how it worked. It weighed a ton, and it cost $1,500, but Jay wanted to be supportive, so he bought two. Three years later, I was still paying them off.

After I’d driven Jason to a couple of sales calls some 20 miles away, we bought him a used Hyundai, but he never made another sale, and the pressure on him to produce was too much. Soon he was without a job again. Then the car had its rear window smashed in. Jason couldn’t afford to fix it.

♦◊♦

Jay insisted that I needed a break, and truthfully, I was happy to get away when he suggested we go to England, my home country. Just for a couple of weeks, I wouldn’t have to worry about what Jason was doing. So I didn’t. Until one day, as I was relaxing over a cappuccino, my daughter, Jason’s sister, phoned.

“Mom,” she said, her voice giving way, “Jason’s disappeared.”

♦◊♦

My Son, Homeless

In the fourth installment of ‘Bipolar Planet,’ Gabi Coatsworth recounts a parent’s nightmare: finding a homeless shelter for her son.

Jason would have to leave his mental hospital soon, said the social worker assigned to his case. He would have to go to a homeless shelter—in a part of Hartford whose murder rate was one of the highest in Connecticut. And it was all my fault.

He was about to become one of the homeless people I’d read about. The people who panhandled at the traffic lights or on the sidewalk, who slept in doorways or who wandered around town with a shopping cart, talking to themselves. Now Jason would be one of them.

♦♦♦

He’d made an earlier attempt to get out of Cedarcrest hospital after he’d been there for a month, but both the doctors and I agreed that he still wasn’t right. Being bipolar isn’t something you can cure, but I was hoping he’d at least be functional before he was allowed to leave. At the moment he was making an enormous effort to appear cool and in control, but I sensed that the slightest setback might set him off again. I dreaded being the one who caused the setback. By law, they can’t force people to stay in mental hospitals unless they’re a danger to themselves or others. So Jason was hoping that, with my support, and the help of the pro bono lawyer he’d found, they’d let him out. 

As I drove up I-91 to Hartford on the chilly, overcast morning of the hearing, I was straining to keep my emotions in check. I knew he’d already been in there for a month, living in a locked ward, and I understood his frustration, but I simply couldn’t look after him at home. I had the rest of the family to think about. What would the judge ask me at the hearing? Would he expect me to take Jason home today?

My clammy hands gripped the steering wheel tighter as I thought about what might happen when I said I couldn’t look after Jason. My thoughts were interrupted by the piercing sound of a police siren; a glance in my rearview mirror told me I was the criminal they were after. I pulled over, wound down the window, and waited. The burly state trooper, looming beside the car, asked me the familiar question: “How fast do you think you were going?”

This was too much for me to handle today. I burst into tears as I tried to explain that I was going to see my son at Cedarcrest, because he was seriously ill.

“Sorry to hear that, ma’am,” he said, and handed me a speeding ticket for $287.00.

“You can appeal it if you want,” he added with the sort of intonation that indicated it really wouldn’t be worth it. I fumbled for a Kleenex and dabbed at my eyes. Then I looked at myself in the rearview mirror. I looked like hell, but I would have to drive on or I’d be late for the hearing.

They sat, the judge and the doctor, the lawyer and Jason, facing each other across a beaten-up table in a dingy room whose brown and cream paint looked to be decades old. I didn’t know where to put myself. Whose side was I on?

As I apologized for my lateness, I took a chair at one end of the table, not joining either side. The lawyer presented Jason’s case.

“My client has a home to go to,” he said, “and should be allowed to leave.”

“I can stay with you, right?” said Jason. I couldn’t speak. A scared look came into his eyes. “Right, Mom?”

I let out the breath I’d been holding. “I don’t think so, Jason.”

“Why?” His voice rose. “Why the hell not?”

“Jason, there are the boys to consider,” I said. “We—Jay and I—don’t think it would be good for them to be in the same house with you right now.”

The boys were my sister’s sons. She had died in England six years before and they were now 11 and 14. Their father had been diagnosed as clinically depressed, possibly schizophrenic. They had already been through a lot, and didn’t need any more trauma. This was not the time to expose them to the scary uncertainty of Jason’s moods.

The doctor was trying to calm Jason down, and it wasn’t going well. Jason had been managing to appear quite rational until I’d refused his request. Then he suddenly lost control. He began banging his fist on the table, yelling threats at the judge and the doctor.

“You can’t do this to me. I’m going to get a better lawyer than this useless bastard and I’m going to sue. I could get millions. Then I won’t need any of you anymore.” He was flushed with rage.

The judge raised his eyebrows, but otherwise his face was expressionless. “I think it’s clear that Jason might still pose a threat to others,” said the judge. “He’s not ready to leave here yet.” He picked up his elegant fountain pen and signed off on his decision.

♦♦♦

Two months later, Jason was finally ready to leave, but the situation at home hadn’t changed. Before we could let Jason share our life, we had to know he could manage his own.

“We can’t find any halfway house that will take him,” said the social worker at Cedarcrest. “It will have to be a homeless shelter.” I shivered.

By now, Jay, Jason’s stepfather, had persuaded me that a homeless shelter wasn’t such a bad idea. Jason would have somewhere to sleep and a chance to get back on his feet.

“Can he, at least, come to one nearer to us?” I asked. We lived an hour away from Hartford, and having Jason closer would enable me to offer, at the very least, moral support.

The social worker said they could try. The next day, as I researched halfway houses, still hoping for a reprieve for Jason, they reported back. “Fairfield has a waiting list of 25,” they told me. “And Westport’s full, too.”

So Jason went to the Hartford shelter a day or two later, carrying a plastic bag containing a change of underwear, his toothbrush and comb, and a bottle of Diet Coke. I went to see him the next day. The location didn’t seem terrible, but as I approached the door, I could see that the doors were bolted shut and getting in was as hard as getting out. He couldn’t stay here, I decided. It was too much like a prison.

The social worker was done with him now, so it was up to me. I called the Fairfield shelter the same day, and they confirmed that their waiting list was long. The Westport shelter told me they had a waiting list and only 14 beds.

“How does someone ever find a place?” I asked, beginning to despair.

“You have to call every day, and report that you’re still homeless,” a friendly voice answered. “If someone has left the shelter, we can offer you a place.”

Thank God, I thought. I’d come a long way since the days when I’d thought that going into a mental hospital meant being cured and coming home to resume a normal life. Now I had no idea what a normal life might be for someone like Jason.

“But phone between 11 and 12,” she said, “or there’ll be no one here.”

I picked up Jason a day later and brought him home, with Jay’s reluctant agreement. Jason slept in the basement and only emerged for meals, where I made sure he was taking his meds. He was quiet and seemed withdrawn, but that was so much better than the mania that I didn’t complain. Every day he asked if he could stay, and every day I stiffened my spine and made him phone the homeless shelter in Westport.

A week later, they told him he could come and be interviewed to see if he qualified. If he did, he would have a place. I drove him over to Westport, and found the tiny building behind Restoration Hardware. The contrast between the store’s luxurious interior and the bare-bones shelter with fluorescent lighting did not escape me. Sitting with the director in his cramped office, we listened while he explained the rules. Jason would have a curfew of 8 p.m., and would have to leave the shelter at 8 every morning before he could return at 5. He would have to attend house meetings and outpatient appointments. He would be expected to do chores to help pay for his keep.

But he was in. For the time being, at least.

My Son, Committed

In the third installment of “Bipolar Planet,” Gabi Coatsworth recalls visiting her son in a mental institution.

Cedarcrest. It sounded so restful. I pictured it, in the green area west of Hartford, as a place where my son Jason would be able to regroup. Lord knows, he needed the sleep. He’d been awake for seventy-two hours until the staff at Hartford Hospital shot him with enough sedatives to fell an ox, and he crashed into unconsciousness.

Jason had just been diagnosed as manic (and therefore bipolar), which explained why he had been talking non-stop and fizzing with unnatural energy since I’d tracked him down earlier that day. My own adrenaline levels had risen with each hour that passed, until now, when I knew someone would take care of him. He was being forcibly committed to a mental hospital where he could pose no “threat to himself or to others.”

“There’s no point in you waiting around. He’s going to be asleep for quite a while,” explained the social worker at Hartford Hospital. “We’ll transfer him to Cedarcrest—our mental health facility—sometime later today, when we have an ambulance free.”

“When will they let me see him?” I asked her.

“You’ll have to call the hospital. They may want to keep him in isolation for a few days to get him stabilized, but you should call them tomorrow.”

I felt a guilty wave of relief wash over me. Thank God, I’d be off the hook for a bit. It wasn’t good that Jason was locked up in a loony bin, but at least he was safe. I’d have time to organize things at home, make dinner, help our two younger boys with homework, and talk to my husband Jay about what we should do next.

When Jason came out in a few days, we’d have his living arrangements sorted out and get him a new start. I drove home, feeling more optimistic than I had since Jason had first started acting weird. Was that only a week ago?

♦♦♦

Cedarcrest brought me down to earth—fast—when I called the next day to find out how he was doing. The operator wouldn’t tell me anything. “You need permission from the patient,” she said.

“So he is a patient here?” I asked.

“I can’t confirm that.” she said. I racked my brain.

“If, hypothetically, you had a newly admitted bipolar patient,” I suggested carefully, “which ward would he be on?”

Apparently, the operator felt able to tell me this, so I asked her to put me through. When I reached the desk, I asked if a patient called Jason could please phone his mother.

“We can’t confirm that,” they said. I hung up, frustrated and close to tears.

But someone did give Jason the message, because he called two days later. He sounded as though he was deep underwater.

“Get me out of here, Mom,” he slurred.

“Of course, darling,” I lied, willing myself to smile so that he wouldn’t hear the duplicity in my voice. “But you’ll have to give permission for me to talk to the nurses, or I can’t do anything. Can you get one of them to come to the phone?”

The nurse told me that I would be able to see Jason in a few days if he behaved himself. Behaved himself? What did they mean? He wasn’t violent, just a little crazy.

“Your son has a few problems,” he explained. “First, he’s in the midst of a manic episode. And of course, he’s suffering withdrawal symptoms from a number of drugs.”

I seemed to be having trouble breathing. Manic and a drug addict? I took a deep breath and squared my shoulders. “So, when can I see him?”

“Why don’t you call in a few days time?”

I called every day. Three days later, they told me I could visit. Jason phoned me when he found out.

“You’re coming to take me home, right?” He sounded better.

“Not today, darling,” I said. “I’m just visiting today. But soon.”

I waited for him to explode. But all he said was, “So, can you bring me a six pack of Coke, some shoes, toothbrush, toothpaste, and a change of clothes. And maybe some Cadbury’s chocolate?”

I understood his asking for chocolate. He’d loved Cadbury’s ever since he’d been little. But shoes?

“Shoes?”

“Yeah. They’ve given me some socks. I might have some shoes at your house.”

“Okay,” I said, already planning a visit to the mall, to buy him clothes.

I drove through the gates the following day, and my heart sank as I surveyed the daunting red brick façade ahead of me. It looked like a factory, only less welcoming. In a kind of cage to one side, some unkempt people were hanging out, smoking cigarettes. Did they keep the patients caged up? Pushing the thought aside, I headed for the front door, clutching my plastic bag of gifts.

At the front desk, they made me fill out a form and show my ID before giving me directions to the ward. I felt completely alone as I heard only my footsteps echoing in the silent and deserted corridors. I passed doors with small, wired glass windows and big locks. I reached Jason’s ward and rang the bell, my heart beginning to pound. I wondered what lay ahead.

♦♦♦

The intercom next to me buzzed: “Yes?”

“I’m Jason’s mom,” I said, and they buzzed again to let me through.

“I’ll take that,” said the nurse, lifting the plastic bag from my hand before I had a chance to protest. She tipped the contents out on the desk.

“Contraband,” she said, picking up the six bottles of Coke.

“Contraband,” she said again, looking critically at the leather belt threaded through a pair of chinos.

“Contraband,” she repeated, lifting up the pair of shoes.

She looked up and saw my expression of bewilderment. “Bottles are weapons, the belt,” (she passed a finger across her throat in a meaningful way) “and laces—same thing.” She swept them all back into the bag. “I’ll give these back when you leave.”

Her voice softened as she saw my expression. “He’s allowed sweat pants, Adidas slip-ons, and cans of Coke. You’ll get the hang of it,” she said.

I don’t want to get the hang of it—I wanted to scream. I want it all to be like it was before. But I knew that wasn’t possible. Jason had to stay here if he had any chance of being cured.

“Shall we go and find him?” The nurse interrupted my thoughts. I nodded, dumbly.

She walked me along to his room. “He’s still in isolation,” she said, “but he’s almost ready to join the rest of the patients.”

She opened the door and I stepped into the room. I was expecting to see my son, but I saw Rasputin sitting on the bed, clutching a sheet around his waist, his long hair matted and unkempt, his eyes glazed as he turned his head to look at me. I blinked away the tears welling in my eyes.

“Hi Mom,” he said. “Are we going home now?”

“Not quite yet,” I said, trying to keep my voice steady. “But, soon.”

It would be three torturous months before they let him leave.

My Son Goes off the Deep End

When Gabi Coatsworth’s son was arrested, she soon learned that the law was the least of his problems.

Part of me had been expecting this phone call. “It’s about Jason.” Something bad, for sure. My stomach did a somersault.

“Who’s speaking?” Don’t overreact, I told myself. Maybe it’s nothing.

“Just a friend of his,” said the voice. “The name’s not important.”

I’d heard about Jason’s friends. There was the double amputee who kept live snakes in his apartment. There was the psychotic former lover who kept Jason in indentured servitude by telling him that he owed her more money than he could ever hope to repay. This called sounded like he might be Jason’s smoking buddy. Right now, his name didn’t matter.

“Jason’s been arrested for drug possession,” he announced.

“Okay,” I said, my British voice nonchalant, my mother’s heart pounding. “Where is he?”

“Main Police station in Hartford. I think he’s going to court tomorrow at 9am.”

“Right,” I said. “I’ll be there.”

“One thing,” said the friend. “He seems to be acting weird. Got to go.” And he hung up.

♦♦♦

I drove to the court in Hartford the next day, raging inwardly about the damage drugs had done to my son. “Acting weird” didn’t begin to cover it. Jason had phoned me just a week ago, excited about a great new plan he had for making money. Could I come and see him?

I didn’t expect that his idea would be any good, but I was pleased that he sounded happy, and I arranged to meet him for lunch at a little café near his house. When he walked in, he looked as though he hadn’t slept for days. But he seemed full of energy. Maybe he just needed a shower and a hairbrush for his long, tangled hair.

“I’ve got this great idea,” he began. “I’m going to get the drug dealers in Hartford to make money without dealing and then they won’t have to mess up people’s lives by supplying them with drugs.”

I stared, lost for words. Jason barely paused for breath.

“Here’s the thing. It’s brilliant. The dealers pay me to give advice to poor people, their customers and such, and those people pay $100 for my advice and I tell them how to improve their life. I’ve been studying psychology so I can solve all their problems, see?”

“But Jason,” I ventured, “How could poor people afford $100?”

He frowned in irritation.

“You’ve never had any faith in me,” he said. “I’m going to be Mayor of Hartford, and then I’m going to legalize pot so it won’t be a crime any more. That’ll convince you.”

Legalizing pot was not a new idea of his. Anytime he wanted to wind me up, he’d drag out this dead cat of an argument and taunt me with it. So I knew better than to respond, but I was worried. I looked intently at his eyes, trying to determine if he was stoned. I’d never been good at this—way too gullible.

“Jason,” I said, “Are you on something?”

“Yup,” he said, “Cloud 9. And I’ve got this great idea. I’m going to get the drug dealers in Hartford to make money without dealing and then they won’t have to mess up people’s lives by supplying them with drugs.”

Wait, I thought. He’s already told me that, word for word. I masked my increasing consternation as he started the tape for a third time. He had to be on something. What kind of drug would produce this effect? I was pretty sure he’d tried hallucinogens and maybe even some cocaine, but these symptoms were something I’d never seen before. After lunch, I dropped him off at his house.

“You’re the best, Mum,” he said as I drove off, my mind racing.

I knew I wasn’t the best. If I’d been the best, Jason wouldn’t be in this mess. Now 33, Jason was supposed to be finishing a degree he’d started seven years before. In spite of his off-the-scale IQ, his studies never went very well. I blamed it on pot—it made Jason apathetic to the point where he couldn’t get out of bed to go to class.

And a couple of years before his leg had been broken. He’d been mugged, he said, but the story didn’t ring true. Reluctantly, he told me that the drug dealers who lived on the corner of his street had mistaken him for someone else and broken his leg. There hadn’t been any mistake, but I didn’t know that then.

Jason and his broken leg came back to our house. He stayed there for several weeks while his leg healed. Then he was gone again, saying he had to go back to school to catch up. He never did catch up.

♦♦♦

I reached the courtroom and checked the lists of cases. Jason’s name wasn’t on any of them. He’d been sentenced to community service the day before and was now working in a park somewhere. I headed to the community service office and tried to explain the problem.

“There’s something really wrong with him,” I said to the bored woman at the information desk. I had to get him into rehab, I explained. This might be my only chance to get him off whatever he was on before he destroyed himself completely.

“That’s nothing to do with us.”

“You don’t understand. He’s on drugs and needs help.”

“They’re all on drugs,” she said impatiently. “That’s why they’ve been arrested.”

I tried not to act frantic. I wanted to throttle her.

“He’s likely to get himself killed.” I said. She sat up straighter.

“What?”

“He’s going round saying that drug dealers can make money by letting him give advice to poor people. And he won’t stop. If he says it to their face, they’ll kill him.”

Reluctantly, she agreed to see what she could do. When the Jason came back at noon, she went to talk to him. He was surprised but seemed pleased. Her reaction was something else. “He just propositioned me,” she told me. “I’m calling the cops.”

They took him to Hartford Hospital, where he explained that he was going to be Mayor of Hartford one day, and then proposed to the woman doctor who was checking him over.

“If you marry me, I’ll show you the best sex you’ve ever had,” he told her.

“Restraints!” she yelled. And before Jason or I could react, two burly male nurses strapped him, struggling, to the gurney. The doctor gave him a shot.

I saw a terrified pleading in his baby-blue eyes just before he passed out.

The doctor came over to me. “He needs to be admitted to a mental hospital,” she said.

At last, I thought. “For rehab, right?” I said.

“Well, that’s part of it. But the main thing is, he’s bipolar.” I was about to find out what that meant.

Lost Boy

Sneaking out, smoking pot, stealing from step-dad’s wallet—Gabi Coatsworth wonders if she should have seen her son’s bipolar diagnosis coming.

He’s running along the L train tracks in Evanston, Illinois, with his best friend, Devin. After a while, they collapse laughing on the side of the tracks and, fumbling in his pocket, Devin hands Jason a crumpled joint. Jason’s the one with the lighter, and he thumbs it to life, puts the joint between his lips, and takes a deep drag. They are both 13. I am at home, asleep, undisturbed. And why not? It’s 2 a.m. As far as I know, my little angel is asleep in his bed.

Was that when it started? Or was it some sort of sign that, had I known about it, I would have picked up on? I knew Jason hadn’t always been happy since we moved from a fairly settled existence in London to Chicago, where my new career consumed most of my attention. When I took him to the pediatrician for a stomach ache that wouldn’t go away, the doctor explained that the problem was psychosomatic. “There’s nothing physically wrong with him,” he told me, peering over his glasses. “He needs to see a psychologist.”

I was British—part of me still is—and the British view psychotherapy as just an excuse to sit and whine for an hour. But I dutifully took Jason along to Dr. R, a wizened pixie of a man, barely taller than Jason. They met once a week, until I married my second husband and we moved from Chicago to Connecticut.

In our wedding photos, we’re standing on the extended deck of the picturesque house we’d found in Fairfield’s backcountry—it’s a dreamy scene—except that Jason and his younger sister, Helenka, are standing to one side of us, scowling. And Jay’s two daughters are on the other side, smiling through clenched teeth. As we’re speaking our final vows, a thunderclap and a flash of lightning announce a pounding rain, and we run for the house. Looking back, I wonder whether I should have taken it as a warning from the Gods.

Jason never settled down with Jay and I. He stole money from Jay’s wallet and even axed his way through a locked closet door to find cash. I blamed myself. If only I’d been a better mother…

He was skipping school, and before long, smoking pot was his preferred occupation. Raiding the liquor cabinet ran a close second—until we put a padlock on it. This is a boy with an IQ of 130-something, an incredible and indelible memory, and a talent for languages, writing, art and music. That was the boy I remembered and wanted to see again.

Jay and I began to take it out on each other. Jay thought I’d brought Jason up too leniently. I fired back, claiming his girls were lacking in street smarts and would break out in rebellion one day. (They didn’t.) We tried taking Jason to a local outpatient facility for teenagers and their long suffering parents. We tried therapists. Finally we took him to an actual psychiatrist for an evaluation.

We assured Jason that everything he said would be in confidence, and we believed it. When the shrink came out to talk to us, he looked almost benign. But his next words were like heavy blows raining down on my head. He told us that Jason had taken so many drugs that he’d altered his brain chemistry. And he couldn’t diagnose Jason unless we admitted him to the Institute for Living in Hartford for immediate rehab. “You’d better do it fast,” the doctor said. “When he turns 17, you won’t have the parental legal power over him.”

What I heard was: Lock up your drug addict (whack) for detox (whack) and throw away the key (whack). Today (whack). I sank into a chair, my mind racing. Drug addict. Detox. Today.

I couldn’t do it. And he wouldn’t go anyway, he told us. When I spoke to his father (an Englishman living in Florida) about the situation, he was not sympathetic. “I’ll sort him out,” he said. “I’ve done enough of these things myself that he won’t be able to get away with anything. Send him down here for a couple of months.”

I was relieved. Maybe this would work? A couple of months turned into several years. Years when Jason kept running: to Spain, Florida, New Haven, and Hartford. He would visit us occasionally, when he felt okay. But there were long periods when he was unreachable, physically and mentally. I would pray that I would hear something about him. “Be careful what you wish for,” a friend said.

I visualized two policemen with grave faces at my door, wondering how to tell me the worst. I stopped praying for anything except that he was still alive somewhere. It would take sixteen years and an arrest in Hartford for marijuana possession before anyone mentioned the words that would explain everything: bipolar. For the first time, at the age of 33, my boy Jason was forced to stop running.

I couldn’t know then that when my sister died, I would inherit her boys—and one of them would also turn out to be bipolar. Or that schizophrenia would rear its ugly head. Or that, bloodied but unbowed, we would survive it all. Bipolar Planet is a column about this psychiatric disorder has impacted my family—and our world.