Mental Illness

By Janine Crowley Haynes

“We hope that by heightening awareness about mental health challenges, we can make a difference in the lives of persons whose painful struggle can feel so bleak at times and to provide opportunities to seek valuable help and resources. 

Miles’ enduring love for his family and friends, gentle ways, and deep sensitivity he had for others will always remain within all of us. We are thankful to have clips of Miles playing his guitars, photos of him running at many of his track meets swift as a deer, countless family occasions and his poetry writings–a powerful means for us to connect to him, cherish the memories and to reflect on.

As the mother of Miles, my dream is for anyone who struggles with depression to not be afraid of reaching out to ask for help, and for the professionals to have better means of assessing depression from its earliest onset. My message is that there is always hope to see the light beyond the darkness–when one can muster the courage no matter how painful it may feel–and know that with a new day there is always a new beginning.   

Miles would have wanted us to spread the love so please let your readers know to hug someone they care about everyday!” Shari, Ed, Max and Hannah

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Along with so many in our Westchester community, my heart broke when I heard the news of Miles Applebaum’s untimely death.* Young people taking their own lives is happening all too often in our communities. The American Psychological Association (APA) notes that suicide is the third leading cause of death in teens and young people, ages 15-24, and that it’s increasing at an alarming rate. In addition, for every completed suicide, there are approximately 100-200 attempts.

The topic of mental illness and suicide, especially amongst our kids, is a complicated, emotionally charged topic not easily open for public discussion. For me, it unearths the pain and guilt of my own suicide attempt. I was diagnosed with bipolar disorder at 31, but looking back, I presented symptoms as a teen that flew under the radar. I am one in four (approximately 61.5 million) adult Americans struggling with a mental illness in a given year.

We all know the protocol when one is diagnosed with a mental illness. Early intervention is key. We do our research, seek professional help, and decide on the best form of treatment. But when our child is assigned a diagnosis, how do we know if they’re at risk for suicide? Not all children fit the clinical mold. According to Dr. Madeline Levine, author of The Price of Privilege and a featured speaker of both Chappaqua and Armonk PTAs last year, many of her adolescent patients “have a notable ability to put up a good front.”

“There are many components that go into whether a teen is at risk for suicide,” says William M. Dince, P.h.D., a psychologist and Chappaqua resident specializing in neuropsychologically-based assessment and treatment. “Parents can begin by looking at the APA list of warning signs. It is then essential to go for a consultation to assess the degree of risk. We can observe behaviors, body language, what a child talks about, etc. We talk with parents, get a sense of their family structure, their social environment…It is essential to measure the degree of impulsivity that is present, as many suicides are the result of an impulsive act during a moment of despair,” Dr. Dince adds. Impulsivity is the diminished ability to think through the consequences of one’s actions, and youth is a time of impulsivity.

Then comes the tough decision: Treatment. Choosing from all the different forms of therapy can be daunting, and, if a medication is prescribed, the list of serious side effects must be considered. Also, one medication may work wonders for one individual but adversely affect another. Sometimes additional medications are added. Some medications can work well for a while then be rendered ineffective. It can take months for a person to feel the full, positive effects. Recovery can be a painstakingly long road.

I turned to my psychiatrist, Dr. Anri Kissilenko, of Silver Hill Hospital, for his perspective. “There are times when it’s necessary to put a teen or young adult on medication, but it’s important to note this is a critical time period when a patient needs to be closely monitored,” says Dr. Kissilenko. “If a patient is being treated, let’s say, for depression, there’s a phase when the medication starts lifting symptoms and a patient begins to experience an increase in energy level. However, their total sense of wellbeing has not caught up. Stabilization has not yet been fully achieved. They may still be experiencing negative and suicidal thoughts. It’s during this critical time when a patient’s motivation [or impulsivity] to attempt suicide is high.”

In addition, there are the countless societal aspects to be considered. In our culture, our children graduate high school, go to college, then head off to work or graduate school by the young age of 22. We consider them ready to take on the challenges that go along with being an adult. Yet, from ages 18-24, the part of the brain that helps develop a sense of self/identity, continues to develop.

So what’s one cultural difference for this generation? What’s changed in our communities that make our children susceptible? “Welcome to Stresschester,” a mom recently said to me. I laughed, but that statement packs quite a punch. Our kids have enormous pressures placed on them. On top of rigorous academic programs, their schedules are filled with extracurricular activities. For the most part, our children thrive. My son did, but not without feeling the stress. As parents, we want to provide them with every advantage to succeed in this highly competitive world. Join some clubs, take music lessons, be an athlete, be a dual athlete, volunteer time–sound familiar? With such a full schedule, “there’s an absence of 
what’s called unstructured play,” 
Dr. Dince remarks.

We don’t have to dip far into the past to compare our childhood to our children’s. Most of us went to school, came home, got a snack, did some homework, and ran outside to play with friends. We ran into conflict, learned how to compromise and resolved problems with our peers without too much parental intervention. “Unstructured play helps to develop our sense of self and equips us with a social skill set that prepares us for the real world filled with conflict, rejection, and failure,” states Dr. Dince.

This topic is multifaceted, and I am limited when it comes to speaking authoritatively. However, what I can offer is my personal perspective as one who attempted suicide. I had all the right boxes checked. Loving, supportive family? Check. Healthcare? Check. Top doctors and hospital? Check and check. So how could I conceivably have the audacity to attempt suicide?

My only answer is to try to explain to a healthy brain how a sick brain works. To the healthy brain, suicide is an incomprehensible, selfish act. However, to a sick brain, it feels like the only logical solution. I convinced myself that my family would be better off without me and my illness. After 10 years of going in and out of vicious bipolar cycles, I couldn’t bear another second. I wanted out of my body. So, without consideration of the destruction I’d leave behind, I swallowed a bunch of pills to end my misery. In hindsight, I experienced that moment of impulsivity. A sick brain doesn’t consider the devastating consequences. I’ve been episode-free for ten years now, yet I still carry the guilt of that dark day. But I’m one of the lucky ones. I survived. I’ve learned to manage and treat my bipolar disorder as if it were any other potentially life-threatening illness.

At this point, I wish I could provide a fail-safe list for attaining and maintaining a state of wellbeing, but there are too many variables in life to have one specific formula. However, I don’t want to end this discussion without acknowledging some of the positive life lessons that came out of something so horrible. Taking ownership of my bipolar disorder and apologizing for my suicide attempt was important to healing as a family unit. The compassion, understanding, and forgiveness I received from my family has been one powerful elixir. Although my family has not come away unscathed, we have managed to come to a place of peace and resolve.

From the human perspective, losing a child is every parent’s worst nightmare. A loss to suicide should not be put into a separate category from the child we lose to any other life-threatening illness. May their struggles not be forgotten or stigmatized. May their families find comfort in the outpouring of love from our communities. Above all, may we honor and remember them for all the love, joy, and laughter they brought into our lives.

Janine Crowley Haynes is a Chappaqua resident and author of My Kind of Crazy: Living in a Bipolar World

*Publisher’s Note: Early in October, the life of the multi-dimensional and exceptionally talented 21-year-old Miles Applebaum was celebrated during a beautiful service attended by hundreds at Congregation B’nai Yisrael in Armonk.  Miles’ deep love for his family and friends–his absolute passion for music and poetry, and most of all, his gentle soul–were all lovingly remembered.  All of us here at Inside Armonk also offer our utmost condolences to the Applebaum family during this difficult period.

– Grace

Also see “When It’s Personal: a Dad Speaks out on the Loss of his Son” by Chappaqua’s Richard Klein.

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Resources & References

If you know someone is in 
immediate danger of hurting themselves or others, call 911.

• The 24-Hour National Suicide 
Prevention Lifeline:
1-800-273-TALK (8255) 
www.suicidepreventionlifeline.org

• The Mental Health Association of Westchester (MHAW), whose mission is to promote mental health in Westchester County through advocacy, community education, and direct services. www.mhawestchester.org

• National Alliance on Mental Illness (NAMI) www.nami.org

• The Brain & Behavior Research Foundation, committed to awarding grants that will lead to advances and breakthroughs in scientific research. 
www.bbrfoundation.org

• American Psychological Association (APA) www.apa.org