This post is Part One of three on the costs associated with mental illness in a family--especially as it manifests and develops in a child. But readers of any age who love and care for someone with mental health challenges--or who are living with such challenges themselves--will likely see bits and pieces of themselves and their experiences here.

Part One focuses on the physical and emotional costs to caregivers. Look for Part Two (on finances) to appear tomorrow, September 3rd, and Part Three (on contentment) on Friday (September 5th).

 I am kicking off this little series with a pop-quiz, Readers. Forgive me, OK? It’s a dirty job, this quizzing, but somebody’s got to do it. (Thank goodness it’s me and not you.)

 So, here we go.

Following are three questions/scenarios with multiple-choice answers. The stakes are horribly high. The world is counting on you, Quizees. Do your best not to screw up.

 1. It appears that your twelve-year-old son with bipolar and panic disorders is going to be up all night for the third night in a row. The psychiatrist’s tinkering with his cocktail of meds hasn’t made a damned difference. You’ve been on duty the second and third nights, because your job pays less than your partner’s, so is slightly more expendable. You have gone to work in-between the bouts of darkness because neither you nor your partner have any paid time off left.

 Facing a second day at work in which your sloppiness, distraction, and fatigue will be noticed, you:

 a. Give your son three Benadryl tablets and pray they make him sleep but don’t kill him.

 b. Pour the two of you a tall glass of cheap scotch, neat, and assure him you’ll both feel better after knocking it back. Then do what I suggested you do in the predicate of the first answer.

 c. Mutter “The hell with everything,” take the Benadryl and the scotch for yourself, and crawl into bed, leaving the kid to his own devices. Pray that he sleeps, but really? Nothing much matters anymore.

d. Collapse sobbing on the floor, crawl into the kitchen and gaze stupidly at the knife block, hide the knife block, fantasize about the world without you in it, without him in it, without both of you in it, conclude that would not be advisable, and continue what you were doing in the first place (following your son as he pings around the house, into the yard, tries a bath, eats junk food, despairs, and lobbies for New Stuff).

e. Separate yourself from your agonized feelings, tell him you love him, beg him to get into bed, and when he finally does, spend the last hour before you have to wake up for work snoozing, wrapped around him like a blanket. Wake after fifty minutes, confirm everyone, including you, is breathing, and drink six bottles of Diet Coke to store energy for the coming twenty-four hours though you know that stuff is slowly poisoning you.

2. A friend notices your distended abdomen, your unhealthy skin, your two conversational modes these days--silent, and endless droning about all things mental illness--and tells you that you need a break. She offers to treat you to a weekend away from home at a beautiful country Inn.

 You respond by:

a. Having a panic attack at the thought of voyaging beyond your gerrymandered universe, re-drawn within the roads and highways connecting the hospitals of greater Boston, plus the supermarket and your brother’s house.

b. Affecting outrage that she noticed the unwholesome skin, the belly fat, and the boring conversation.

c. Bursting into tears of despair, because the two full-time jobs you HAVE to do, one for love, one so you can pay the hospitals that have redistricted you, prevent you from self-care of any sort--and you think you might not have brushed your teeth in more than a month.

d. Streaming “Stress, The Silent Killer” on a night your kid is sleeping but you can’t, and resolving to call your doctor the next morning, because it seems that cortisol is surging and brain cells are dying, and we can’t have that if we are to work two jobs and never sleep.

e. Accepting her offer graciously and figuring out how to break the news to your partner, who is not going to like it.

3. You are a single mom of two teenagers with mental health issues. You work two part-time jobs to keep the three of you in boxed macaroni and cheese and shoe leather. You are pretty certain that one teen is cutting herself and the other abusing alcohol and marijuana. Your anxiety over this unsustainable situation is killing you--possibly literally. There is nothing to do but make a choice: focus on the needs of your kids and you, or the needs of the folks writing your two monthly paychecks..

 What the hell do you do?

a. Ask your bosses to grant you unpaid leave to take care of family matters (even though you’re afraid they’ll simply fire you), then send a humiliating appeal to family and friends for dough.

b. Leave an urgent message on the school counselor’s voice mail and cross fingers she calls you back within a week--and that with 250 students on her caseload, she’ll have time to do anything but pretend she’s going to do something.

c. Consider imploring your kids’ friends to look out for them, even though you know full well it is desperation that put such a lousy idea in your head.

d. Do a profit and loss calculation to try and figure out which will hurt more--hunger, or confronting the fact that the children you love and are supposed to protect are sinking.

e. Have a physical or emotional breakdown--maybe both--because the case is utterly hopeless. Hey, at least in the hospital you’ll get to relax

So, how do you think you did? Oh--there was a problem with the test, you say? No reasonable answers? Damned if you do, damned if you don’t?

YES. NO. YES. And welcome to the world of childhood mental illness.

About the Author

Deborah Vlock, Ph.D.

Deborah Vlock is a Boston-based writer of fiction and creative non-fiction. She spent many dark years fighting, with and for her young son, against the pull of suicidality.

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