Editor's Note: Lucy's story has an optimistic conclusion, though the long-term outlook is unknown. Among other things, Lucy's experience highlights the dangers of bullying behavior, especially for children who already are depressed, and how important it is for parents to carefully monitor their child and take responsibility for making important judgments about causes and helpful solutions.
This essay describes how our New Zealand family managed
the onset of depression in our daughter “Lucy”. I’ve written it to
describe our experiences and perhaps help some other people to come
through these difficult times.
Lucy was ten when the depression manifested itself in a
serious way. However, for years beforehand there had been warning
signs that all was not well. Before going to school. Lucy attended
day care, where she was identified by the staff as a compliant child
who had difficulty relating to other children and who tended to be a
“victim” of bullying children.
In one incident, Lucy attended a birthday party -- with
some reluctance and only because of our encouragement. At this
party, she was bullied by another child and for some time afterwards
was deeply angry with us for placing her in this situation. It also
brought home to us that Lucy had poor defences for coping with
bullying.
When she was five, Lucy started school. The school was
a public school, very large (800 pupils) and well administered.
However, it did not provide the kind of caring environment that the
day care facility had. There were a series of incidents with other
children and bullying, including one where Lucy cut her hair,
damaged her possessions and blamed another child. It became clear
to us that if Lucy was in a class with a teacher with poor control
over the students, that there would be problems. Lucy also attended
the after school care. In her first year this was well run; but in
the second it changed hands and became much less structured and
caring.
It was obvious to us that Lucy was not happy; however we
kept hoping that matters would become better. After two years at
the school, my wife took leave from her job to take university
coursework. This allowed us to withdraw Lucy from the after school
-- to Lucy’s considerable relief. For a while, matters seemed to
improve. Lucy had a good teacher and nice children in her class.
She began to make friends. We encouraged her in this and sleepovers
became common among her circle of friends; we encouraged these as
well. However, at the same time, some worrisome signs began to
develop. Lucy had always found it difficult to go to sleep at night
and frequently my wife had to spend a long time putting her to
sleep. Also, Lucy stopped eating with us; she would have tea in the
dining room, where she could watch television, rather than in the
kitchen with the rest of us. The relationship between her and
myself as her father steadily deteriorated.
Lucy resumed school when she was nine without incident,
and we hoped that she was moving past her issues. She formed a
close friendship with two girls and was pleased by her new bike she
received for Christmas. But she refused to do any work around the
house, and her behaviour towards both my wife and myself was hostile
and contemptuous, particularly to me. I responded as if this was a
disciplinary issue, and there were a number of confrontations.
In April, for Lucy’s birthday, we had a disastrous
sleepover. There were fights among the girls, and it rammed home to
us that there were power games that were being played among them.
However, they remained Lucy’s friends and we sought to adjust
ourselves to them and encouraged the friendship with one of them who
seemed the most pleasant. The girls formed a little clique from
which at one time or another various members would be included or
excluded. Lucy complained of being bored at school and,
increasingly, was unhappy with her relationships with the other
girls. She also had some trouble with one or two boys.
The relationship between Lucy and myself continued to
deteriorate and then, in August, my wife was confronted by Lucy
miming holding the large sharp bread knife to her throat. This is
quite a dangerous knife. By now we were alarmed but also quite
unsure what to do. Summer was coming and we hoped that in the fine
weather matters would ease. It was clear to us that the Lucy’s
experience at school was a problem, but whether that was the key to
the problem or whether there were other issues we weren’t sure of.
Her schoolwork, which up to then put her at the top of the class,
collapsed in quality.
We asked Lucy if she wanted to move to another school
in the new year to put this behind her. Lucy herself was uncertain
on this; on the one hand she wanted to be elsewhere; on the other
hand she was fearful that she might end up in a worse situation --
friendless at a new school with unknown routines. We also
considered talking to the school she formerly attended, but it was
hard to see what the school could do in this situation apart from
put Lucy in a different class. And to be frank, we had talked to
the school before and found that they were hard work. Typically
they denied the problem and only did anything about it if we really
pushed hard. We couldn’t see how talking to the school would help,
and I still don’t think they would have done anything.
In October (early spring in New Zealand), matters came
to a head. Lucy refused again to clean up around the house (we had
given up on her room) and there was a major confrontation between
her and me. By now there was also considerable anger and dissension
between my wife
and me about Lucy's behaviour. I felt this was
basically a discipline issue while my wife felt something deeper was
wrong. I was annoyed because my wife wouldn’t back me up on the
discipline, and she was annoyed because she felt I should be more
responsive to the issues with Lucy.
On the next Monday, Lucy refused to go to school. In
the ensuing confrontation, she made it clear that if she was taken
to school she would be kicking and screaming all the way. Then she
ran away.
Several things became clear:
The school was unable to help us. A special education teacher was sent around, but she had confrontations first with Lucy and then with my wife; she was a complete disaster and was completely unsuccessful in returning her to the school.
Lucy was prepared to go to a school, but not to the
school where her former friends were. Further, if we dragged her
into the school she would fight and scream and be as disruptive as
possible and she would run away.
Lucy opened up to my wife over the next few days and
consequently the extent of the bullying and mind games that had been
played on her by the group of friends became much clearer. Lucy also
found herself unable to sleep in her own room and insisted on
sleeping in our bedroom, which my wife and I found difficult for our
own relationship.
This late in the year it was not possible to change
schools. We therefore accepted Lucy’s ultimatum that she stay at
home. By now we were also concerned that Lucy might be suicidal and
felt that the school was aggravating her condition. We also decided
to seek professional assistance and went to the local Hospital Board
child psychological service. Lucy was diagnosed as suffering from
severe depression and medium to severe anxiety. She had regular
thoughts about killing herself, although she had made no plans to do
so. She also told staff about hearing voices, though later she told
us that she made this up in response to leading questions from the
staff. Lucy was aggressively hostile to her counsellor.
At this stage, Lucy was running away from home every
couple of days to go down to the park. She was having regular
confrontations with my wife and continued to ignore her household
chores. We had one incident when she ran away and was caught in a
sudden cold downpour that soaked her to the skin; however the good
side of this was that she didn’t run away again.
My wife and I felt that the first thing to do was to find Lucy
a new school that was strongly structured and which would also fully
engage Lucy’s considerable natural intelligence, which wasn’t being
adequately engaged. We found a private school that met these
criteria and commenced enrolment, despite considerable additional
expense.
The holidays commenced and we began a camping vacation
with an angry, depressed and anxious child. However, we also
noticed some things: (1) Lucy performed much better in a strongly
structured environment; (2) the absence of TV meant that we had to
talk to each other and also really reduced the level of “noise” in
the family; (3) that we functioned much better in the camping tent
than we did in the motel unit, and (4) that Lucy felt much better
when she played at the playground.
Upon the return from the camping trip, we enrolled Lucy
in her new school. Under the advice of the Hospital Board mental
health councillor, we attempted to involve the councillor in the
enrolment process. This was a mistake. The school, upon hearing
that the councillor was involved, put Lucy's enrolment on hold and
we had to jump through several hoops to convince them that we were
not palming them off a basket case.
We also accepted a recommendation from the service to
put Lucy onto Prozac, starting with 2.5 mg, a very low dose. The
literature we reviewed before Lucy started stated that it was wise
to start low and work up. The prescribing psychiatrist was very
professional and we found it straightforward to have a sensible
discussion with him.
Also at this time, Lucy became very keen on the
simulation game “The Sims”. She found this helpful as a way of
trying out social interactions in a fun kind of way. We think this
game has contributed greatly to Lucy’s therapy – probably more than
any of the official therapists.
When Lucy started her new school, my wife and I decided
on a strategy to ensure that she went every day to school. We would
completely prepare everything the night before, and then in the
morning focus Lucy on a few tasks. If Lucy balked, we wouldn’t
force her but nor would we give up; we would just stand over her,
both of us, until she went to school. If there was any doubt I
would stay at home until Lucy left. This strategy was effective and
we were able to build Lucy into a pattern of regular school
attendance.
The school was also excellent. It has a Presbyterian
heritage, uniform, a strong educational focus and is highly
structured. Class sizes are restricted to 20 and it has a record of
handling young girls having troubles. It costs a lot but has proven
worth it. The teacher was very strong and provided a firm framework
within which Lucy was able to find herself. At the school’s
suggestion each term we have a meeting with the head of the junior
school and Lucy’s teacher. Lucy's schoolwork steadily improved,
indicating greater peace of mind. There were a few incidents at
school between Lucy and other girls, but each time the teachers
acted promptly to resolve them. We find that e-mail contact with
the school works best, with rapid follow-up in person.
We also put some new rules in place. Sleepovers were
cut out and social interactions with her remaining friends were
restricted to a maximum of three hours. One of the interesting
things we noticed was that at her new school sleepovers were very
unusual, whereas at her previous school they had been frequent and
we had gained the impression they were being used as a cheap form of
baby-sitting. Bedtime was enforced as much as we could; we noticed
a rapid and acute deterioration in her behaviour if she became
tired. We also implemented a tidying rule that on the weekend she
could only play the Sims if she tidied up first. A regular pattern
emerged where there would be major tantrums at first and then, as we
stuck to the rules but refused to be provoked, she steadily began to
accept those rules.
Term-by-term, we saw a slow improvement. In the third
term, there were some major changes for the better. The first
change was that after a lot of discussion we bought pet rabbits.
Lucy and I worked together to build the rabbit cages and doing so
helped our relationship to improve. Once the rabbits were
purchased, they provided a huge amount of comfort to Lucy and after
a couple of weeks Lucy said she thought she could sleep in her own
bedroom if a rabbit slept in with her in a cage! We did this and it
has worked well. Recently she decided that she no longer needed the
rabbit in her room and she sleeps on her own and goes to bed on her
own.
We also changed the way we managed Lucy. We always gave
her advance notice when we wanted her to do something. For example,
if we wanted her to get off the computer and go to bed, we gave her
a 15-minute warning. We also virtually eliminated television. We
had been steadily watching less and less and when we got the
rabbits, there wasn’t really any time left for TV. Lucy said she
didn’t mind eliminating television. We still use it for children’s
videos, but the noise and clutter of TV has gone from our lives,
with no regrets.
We found the counselling less and less useful as the
year went on. Their counselling was poor and Lucy’s dislike of the
counsellor became fierce. Lucy felt that the counsellor was
manipulative and also focussed too much on Lucy's early childhood.
Lucy didn't think those events mattered. Lucy's dislike turned to
contempt when she was able to fool the counsellor into believing
some made up stories about her past. The only medical professional
she liked was the psychiatrist who prescribed the Prozac, because he
treated her in a straightforward way. He increased her Prozac
prescription to 7.5 mg and proposed raising it to 15mg; but we
talked to the psychiatrist and explained that we felt that Lucy was
improving on her own and we all agreed that the dosage could stay at
its current point.
We also spent some money on a private psychiatrist that
the school recommended to us who has taught Lucy some valuable
coping skills. However we are also noticing the same pattern of
hostility building up with respect to this psychiatrist and we will
not continue this service. In general we have been disappointed
with the quality of counselling services provided. The private
service was better than the public service, but neither really
helped in the way we hoped for.
Lucy still has issues. She collapses easily in
stressful situations and doesn’t cope well with bullying. But we
can recognise the signs now and with the help of the school can
quickly squash them.
I would say that the things we did that changed the
situation, in order of importance are:
We put Lucy in a good, caring, and structured school. This costs a lot of money but it was worth it.
The rabbits. Having something outside herself to unconditionally love and care for. She has been really good about working with them.
Prozac definitely helped. It took the edge off so that she could rebuild her own life at the new school. Nonetheless, we will discuss with the psychiatrist lowering the dosage when we meet again in November.
The SIMs were very helpful in that they provided an emotion “sandpit”. If anyone isn’t aware of this game, it’s the world‘s most popular and largely played by pre-teen and teenage girls. There are 84,000 stories written by this audience in the last 3 years, entirely voluntarily, on the SIMS official web site.
Professional counselling. This has been very much a mixed bag. The counsellors have provided a framework which has been useful, but for specific issues we found that the public service counsellor was unable to build a relationship with Helen and the private one cost a lot more and after an initial positive few meetings again failed to make progress.
At the moment we seem to be on a steady improvement. We are not out of the woods yet, but we are much better off than we were, and I think we will make it. I hope the information provided above helps others who find themselves in this situation.