“They’ll Think I’m Crazy”

“I’ve been thinking about jumping off a bridge. I haven’t told my parents because they’ll think I’m crazy.”

The Case

These were the words of my 12-year-old patient who walked into my office last week. We’ll call her Jessica to protect her identity. Jessica is from a multicultural family and emigrated to the US when she was young. For the last 2 years, she has suffered from depression, requiring a combination of psychotherapy and medications. She has had some rough times, but overall her depression had been improving.


Recently, a classmate of hers began tormenting her incessantly. It became so bad that she started refusing to go to school. She was feeling hopeless and having difficulty falling asleep, concentrating, and eating.


Suicide as an Option

Most concerning, however, was the fact that she had begun contemplating suicide. She was thinking of jumping off a bridge and the only thing holding her back was her fear of what the afterlife would bring. She did not think that her family or friends would miss her. I asked if she had discussed these thoughts with her parents and she responded, “No. they will think I’m crazy if I tell them”. I asked if she felt safe and if there was anyone she would speak with if she came closer to implementing this plan. She cried and looking at the floor shook her head no.


Bringing the Mother Into the Conversation

I discussed with Jessica the gravity of the situation and the need to include her mother in the conversation. She reluctantly consented. I filled Jessica’s  mother in on what we had been speaking about. I expected her to be concerned, give her daughter a big hug and show her sympathy. To my amazement, she responded ” Jessica whats wrong with you? I have had such a harder life. I give you everything you want. Why can’t you just be happy? Stop being sad and making all of our lives so difficult”. Jessica broke down crying.


I explained to the mother that Depression is a biological illness with real changes in the brain. Just like a child has little control over developing diabetes, so too they cannot control whether they have depression and intense negative feelings. I spoke of my concern for Jessica’s safety and the need to have her admitted to the hospital for further monitoring and treatment. The mother responded “I haven’t had dinner yet. I don’t have all day to spend with her if she wants to go to the hospital”. I was shocked. Jessica was right. Her mom did think she was crazy.



Benefit of Being Admitted to Inpatient Psychiatry

Initially, I was reluctant to uproot this 12-year old’s life and admit her to the psychiatric ward. I realized, however, that the hospital is the best place, not only to keep her safe but to allow her to experience care and compassion. No doubt, caring for someone with mental illness is difficult and stressful. However, when those closest to a person cannot understand them and show compassion, It is unlikely they will be able to persevere and recover.


As her mother left, Jessica and I waited in the office for the ambulance to transport her to the hospital. Between tears, Jessica asked “was I born with this? Will I ever be able to get better?” I told her she was born with a predisposition for depression and that environment is a large component as well. I emphasized that in the hospital she would meet lots of children suffering from a similar illness. she would meet lots of doctors, nurses, social workers, and therapist who would care about her and do their best to help her on the road to recovery. She brightened a little knowing that she would not be alone.


Lessons That Can Be Learned From This Story

It is well known that people with mental illness who have a stronger support system do better. We are so fortunate to have people who dedicate their lives to working in healthcare and showing compassion to people like Jessica. However, you do not need to be a professional to offer support. If Jessica and many like her have more support at home, school, work or in a religious environment, they may not need hospitalization and likely would experience greater quality of life. We all have the power to save and improve lives. Next time you are considering whether or not to go out of your comfort zone and offer unsolicited support, go for it. It may be what they need to turn the corner and realize people don’t think they’re crazy.


What do you think? Have you been the recipient of support at the right time? Have you attempted to provide emotional support to those in need? Share your thoughts and questions below.


Ariel Mintz, MD
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