Dealing with Depression

By BRENDA HIMELFARB Palisadian-Post Contributor It had been a hectic Saturday for Josh Mills, a Palisades High School junior. As a talented drama student, he had directed four shows for a regional high school drama festival, had gotten very little sleep and was totally exhausted. ”So, Sunday morning, when his mother, Ruth, insisted that he study for his Spanish test, Josh could hardly move. Having to do anything, particularly study for a test, was the last thing he wanted to do. He was simply wiped! Josh finally dragged himself out of bed and over to the dining room table where Ruth, a teacher at Palisades High, had placed all the books together to begin their work. He sat there, half asleep, at times laying his head down on the table, eyes closed. He just didn’t have any energy. In fact, it got to the point where Ruth had to constantly awaken him to answer questions. This went on for a time, and then Josh ‘lost it.’ He absolutely had had enough. In a rage, Josh jumped up from the table, threw a chair cushion and began screaming at his mother, then his father, who rushed into the room to see what was going on. Ruth recalls that her husband later said that the eyes of the boy he saw were like those of a wild man. The ranting, screaming person Ruth and her husband were watching was not the gentle Josh they knew. That Sunday’November 8, 1998’is a date that Ruth and Josh will never, ever forget. They know exactly where they were, what they were doing and how unreal it all seemed. Their lives were forever changed. ‘I had gotten mad and had yelled at my mom before’all teenagers do’but this was different,’ recalls Josh. ‘Afterwards, instead of getting over it, I kind of shut down. I don’t remember what my mood was or whether I talked the rest of the day, but I do remember thinking, the next day, that I wanted space from mom, my whole family. It wasn’t so much that I was mad. I just needed space and I wasn’t getting it. ‘I went to school for a few days and then I stopped going to school. I really couldn’t go and I really didn’t want to go. And it wasn’t the ‘don’t want to go to school’ like every kid says every so often. It was that I really didn’t care. I had no interest in a future or anything.’ ”Ruth called the school psychologist, Bella McGowan, but this made Josh furious and, once again, he got very angry. Finally, he agreed to see her with his parents. ‘Josh told Bella that he didn’t feel like doing anything,’ Ruth remembers. ‘He didn’t feel like getting up or going to school any more. He was having trouble sleeping at night, and then sleeping too much during the day. He had always been thin, but suddenly he began losing weight.’ What Josh was going through are just some of the signs of teenage depression. And the statistics are staggering. Among adolescents, one in eight suffers from depression. Only about 30 percent receive any sort of intervention or treatment. The other 70 percent simply struggle through much pain and turmoil, doing their best to make it to adulthood. Josh was fortunate to have such love and support from his sister, Jeanette, and his parents, who insisted that he needed help and were committed to finding the right treatment for their son. ‘It’s not Bella’s place to make a diagnosis, but she said that it sounded like it could be depression and she suggested that we take him to a clinic where Josh could see a psychologist, and if he needed medication, a psychiatrist,’ Ruth explained. ‘So we took him to the St. John’s Child and Family Development Center, where we met a psychiatrist who agreed that there was a moderate degree of depression and a medication was prescribed.’ Josh did well for awhile. But then his grades began to fall, and in less than six months he had a relapse. In March 1999, Josh entered UCLA’s NeuroPsychiatric Institute (NPI) in the Adolescent Partial Hospitalization Program, an outpatient program that offers three hours of school daily. ‘I really didn’t want to go there,’ admits Josh. ‘I thought it was a step backward. Part of me was hoping that eventually I would feel better and be able to go back to school, but that wasn’t going to happen. My parents and my psychologist and her supervisor, whom I had never even met, all talked to me. I was really mad. It was almost like an intervention. They told me that I had to do this, that I just couldn’t sit around the house every day. They told me I was ‘stuck’ and that I was going to be an in-patient if I didn’t go. So, very reluctantly, I joined the program.’ Most teens are admitted for two to four weeks. Josh spent time in the program from March until June, receiving several types of therapy: group, individual, recreational, occupational and educational. His depression manifested itself as a school-related anxiety. ‘This was a kid who had sailed through school,’ Ruth said. ‘But he was at a point where he literally couldn’t open a book, so the educational psychiatrist worked with him. ‘The first day they sat there and looked at the book. The second day, they would open the book. The third day, they would open the book to his assignment. And on the fourth day, they would have Josh answer one of the questions from the assignment. Josh gradually went from that helpless condition to being able to work with an outpatient educational therapist. Then he was able to do his work if one of us helped him. Then, if one of us just sat in his room. And this went on into the beginning of college. Finally he got to the point where, like any other student, he would come home and do his assignments on his own, which you expect from a high school kid.’ Josh graduated with his high-school class and recently completed Santa Monica College. He begins UCLA this month. ‘I took a lot of time getting through SMC. I took things slowly and never took a heavy load,’ says Josh. ‘I didn’t even take classes every semester. Attending UCLA has been a lifelong dream of mine. I’m nervous about going, but I know that’s a natural feeling for any new college student.’ These days Josh says he feels ‘really good.’ He’s on two medications: Effexor and Risperdal, an anti-anxiety drug that helps calm him down at the end of the day. ‘We’re at the point where I am able to lower my dose,’ says Josh, happily. ‘Depression is something that can be dealt with, ‘ he adds. ‘Even if it can’t be completely cured, you can have a normal life, a great life. And if you deal with it, you can move on and if you don’t get help, who knows what can happen to you? It’s one of those things that you have to acknowledge and say, ‘This is where we are. We need to deal with it. We can’t ignore it. We can’t hide it.’ ‘Depression affects the whole family, not just the patient,’ Ruth said. ‘For parents of teenagers, it’s very hard to tell how much is normal teenage rebellious behavior and how much is depression. If your child is suddenly confrontational, if his grades start to drop, if the things that have always given him pleasure stop giving him pleasure, it should be noted. So many parents don’t know what it is when it hits. We were lucky, because I worked at his school and I knew the school psychologist and we immediately had someone to go to. And we had what turned out to be a correct diagnosis within 48 hours. ‘When Josh first got depressed, I thought, What did we do? Should I not have helped him with Spanish that day? Is that what triggered it? That was a trigger that day. Another day it would have been something else. But I was assured that this was inevitable. This was going to happen.’ Dealing with depression is not always easy, something Josh readily acknowledges. ‘I think I’m certainly on the outside of it now,’ Josh says. ‘I don’t ever want to press my luck and say it’s all behind me. I know that there’s always the possibility that it will come back. I do worry about it coming back, but that is out of my control. And I know that if I keep doing the things that I need to do and lead the life that I know is good for me, the chances of depression coming back are probably pretty slim.’ (Editor’s Note: See related story about Bella McGowan, the Palisades High School psychologist, on page 15.)