All the Things We Never Knew (21 page)

“There's a good one at Good Samaritan hospital,” Robert said. “And another one in Gresham, but I assume you're going to need something close to your work.”

“That would be helpful.” My voice was thin, broken even. The
images flashing through my mind were not pretty—David in hospital gowns, David cutting himself in an old abandoned shack, David wandering through his girlfriend's home, the doctors shooting him full of sedatives. It was hard to believe that was the man I married.

“Sophie would really like to see her dad,” I said.

“Why don't you give him a couple of days?” Robert asked. “He was probably going downhill for a really long time. He may need to get back on his feet before he sees her again.”

Sophie would not accept that answer. She'd seen the side of David that was sad, yes, but never unstable. That was not her dad, not then, not now.

“I'd like to see him today, if it's possible.” A bead of sweat trickled down my chest. I would need to miss work again.

“That would be fine. Why don't we see what happens with a transfer later this afternoon, and I'll call you again.”

“Robert,” I asked, “when will I get to talk to a doctor?”

“As soon as we get him checked into a facility,” he answered.

David's sister Adele would be arriving later that afternoon. Somehow, I felt more prepared to deal with the mental health system with her by my side. She was a psychologist in Canada, and although the two health systems couldn't be more different, she would have good ideas about David's care. I wondered whether she'd diagnosed David and, if so, why she hadn't ever told me about his illness, when she had first seen it, how serious she thought it was.

We met in the hallway outside David's room at Emanuel Hospital, the second place he was taken while he waited for a permanent room.

David looked close to death. His eyes fluttered in a deep state of dreaming, but his breathing was so shallow his chest barely rose and fell. His skin had a yellowish tint to it, as if the drugs might not be all that good for his liver. He'd suffered from hepatitis C after traveling to Africa, and drugs affected David in the strangest way, as if his damaged liver just bounced the toxins back out through his skin.

He hadn't shaved, and his beard was starting to come in full again, this time with patches of gray instead of dark brown. It was shocking to see him age so quickly, as if a shrinking, aging machine had taken over his body. I felt completely helpless. I left Adele in the room and went home to be with Sophie. My last glimpse of Adele that night was her sitting next to David holding his big hand in hers. Tears rolled down her face. Maybe she felt as hopeless as I did.

 

SUICIDE AND PSYCHOTROPIC DRUGS

Psychotropic drugs affect your mood, behavior, and perception by changing the way your brain functions.

One class of psychotropic drugs, known as selective serotonin reuptake inhibitors (SSRIs), are prescribed for a variety of symptoms, including depression, bipolar disorder, attention deficit disorder (ADD), attention deficit hyperactivity disorder (ADHD), and schizophrenia. In addition, SSRIs are used to correct low levels of serotonin in the brain.

Although SSRIs have been used to successfully treat many patients, they can be disastrous when prescribed to people with bipolar disorder.
In a study of thirty-eight bipolar patients treated with an antidepressant, 55 percent developed mania and 23 percent turned into rapid cyclers. The group prescribed antidepressants also spent “significantly more time depressed” than bipolar patients not given the drug.

It may seem paradoxical that a treatment that is therapeutic for depression can worsen the course of bipolar disorder, but there are numerous studies to back up this claim.
Researchers find that “there are significant risks of mania and long-term worsening with antidepressants” among bipolar patients.
Use of antidepressants may “destabilize the illness, leading to an increase in the number of both manic and depressive episodes” and “increase the likelihood of a mixed state,” in which feelings of depression and mania occur simultaneously.

Once antidepressants induce rapid cycling, it abates in only one-third of patients over the long term, even after the offending antidepressant is withdrawn. Forty percent of patients who have worsened in this way continue to “cycle rapidly with unmodified severity” for years on end.
Antidepressants can induce a “chronic, dysphoric, irritable state” in bipolar patients.

In a large study by the National Institute of Mental Health, “the major predictor of worse outcome was antidepressant use.”
These patients were nearly four times more likely than the unexposed patients to develop rapid cycling, and twice as likely to have multiple manic or depressive episodes.

SSRIs carry mandatory warning labels about potential increased suicide risks for children, usually those being treated for ADD or ADHD. Increased suicide risk in adults is also a factor with SSRIs, but warnings are not as widespread, which has led to many unnecessary, avoidable deaths. It is important to understand the risk to people who may appear to be depressed, but, in fact, suffer from bipolar I or II.

Chapter Fifteen

I hadn't seen Colin since the birthday party. Part of me believed that I should cut it off. The other part longed for a partner again, a person to laugh with and to share the interior of my life. Balancing a new relationship was a ridiculous feat given what I was going through, but I had a powerful intuition about why Colin had entered my life when he had. I was not meant to live ridden with anxiety. I was as worthy of love as any other human being.

I think back on those early days of knowing Colin and wonder how I
knew
—knew that he was kind and compassionate and that he would be there for me not just in crisis but in the daily ups and downs of life. With all the betrayal, and the unmasking of David as a man I barely knew, how did I dare even trust a man I'd known only a few weeks?

Despite the sickening feeling that David had become a completely different person than the one I fell in love with, I felt intuitively that his isolation and dishonesty had contributed to his breakdown. If he'd loved openly and honestly, and shared with me his private horrors early on, our life together could have been saved. In David's mental breakdown, I saw what becomes of one who keeps his heart on a short lead. Yet I wasn't ready to give up on love. In fact, as my marriage crumbled, I felt more open and vulnerable than I had in
years. I was humbled by Colin's courage in dealing with what was an untenable beginning to a relationship. He was sturdy and reliable at the time I felt the most unsure. The least I could do was see if my hunch about him was correct.

I punched in his number.

“Hey,” he said, “I've been worried about you. Can you meet us for a quick bite?”

“Us?” I asked tentatively.

“My beautiful, lovely daughters,” Colin said. “Meet us at Twenty-third and Lovejoy. Santa Fe—the taco joint. See you there in half an hour.”

I hesitated and then whispered the mantra that helped me through so many of the decisions I made during the first few months with Colin. “Stay open.” The phrase struck me then as it does now—oddly simple and profoundly powerful. I replaced my T-shirt with a long-sleeved sweater and ran a brush through my hair.

Colin introduced me as a friend. His girls were largely oblivious to me as they doted on their dad. One tied pigtails in the top of his hair. The other sat on his lap. The oldest, Charlotte, was eight. She had her dad's beautiful blue eyes and dark brown curly hair.

The youngest, Olivia, was a tiny, lithe, blonde five-year-old, smiling sheepishly from her dad's lap while she took bites of a bean and cheese burrito. He was patient, cutting Olivia's food into tiny bites for her and filling the guacamole cup three times.

I mostly listened to them talk about school and their teachers. I looked for any clues they might be irreversibly scarred from divorce. Nothing out of the ordinary. They had big appetites, reminding me to pick up more groceries for Sophie and all the relatives staying at my house.

Colin held the girls' hands as we crossed the street for gelato. The girls sat at the ice cream bar while we talked at a table nearby.

“It's really good to see you,” he said. “How are you holding up?”

I wanted to bury myself in his shoulder and surrender all my worries to him. Instead, I faked a smile.

“It's good to see you, too,” I said, telling the truth. It was good to see him. Just being here with him made me calmer, more centered. “I'm doing okay, I think. The bureaucracy is unbelievable. We don't know when David will get into a treatment facility, and we can't really move forward until the county tells us where to go.” I bit the inside of my mouth. I didn't want to worry him, but I also didn't want to hide something so important. “They never found the gun.”

Colin interrupted, “They don't know where the gun is? You mean, he could go back up there and get it?” His eyes were concerned, his brows narrowed. Colin, I knew by now, was not a man prone to dramatics. “Do they think he hid it, or dropped it, or what?”

I knew what he was thinking—that David could escape and hurt me, or Sophie. Even Colin or his daughters.

“I don't know, but we're doing everything we can to find out,” I said, underscoring the need for concern. “His girlfriend is looking for the gun. But she's on twenty-five acres up there; it's not like carefully manicured trails or anything. It is deep brush and trees. It could be anywhere.”

“Wow,” he sighed. “This is unreal, isn't it? I don't know how you're doing it, Sheila.” He held my hand across the table. I suppressed the anxiety and fear and put on a brave smile.

“Would you consider staying with me?” he asked. “Just until we know you're safe.”

“No, thanks,” I said. “I'll be fine. Really, we'll be okay.”

The girls turned from the bar with gelato mustaches and smiles on their faces. “We're done, Daddy,” Olivia said. “Can we go?”

Colin threw me a conflicted glance, his fingers lingering around my hand. I squeezed his hand back, careful not to show how frightened I'd really become. Colin cleared the gelato cups from the bar, tipped the waitress generously, and then carefully folded a paper napkin before he dabbed the gelato mustaches from his daughters' lips. “There you go,” he said gently. Seeing that familiar gesture of affection and caring, one I'd seen so many times when David dabbed Sophie's upper lip, made me shudder.

“I really want you to stay in touch with me,” Colin said. “Okay?” I nodded, grateful, but wondered whether I was complicating my life rather than straightening it out. I watched out the window as they headed to the sidewalk. Colin instinctively reached down to grab his girls' hands before reaching the intersection.

David was transferred to a psychiatric care facility two days after his suicide attempt. Robert Stellar, the caseworker, had obviously pulled strings to get David to a facility so quickly, and one that was so close to my work. He called me whenever there was a new piece of information, anything for me to hang on to. David would be transferred while I was at work. His sister could stay with him during the transition. I could visit when I got off. I signed off wondering if listeners had any idea how much stress I was under, whether my voice sounded broken and scared, or whether the years of training really could mask my anxiety.

I parked in a space in front of the hospital. Outside, three young skateboarders dressed in baggy shorts and T-shirts loitered around the entrance, skating, stopping, starting over. There were good stairs, handrails, and smooth cement here:
A skater's paradise,
I thought to myself. The worlds outside and inside a hospital could not be more different.

The receptionist gave me directions to the psychiatric center. It took up one wing of Good Samaritan hospital. Robert had prepared me on the phone for what I'd encounter once I got to the psychiatric center: A small box on the wall with a button. You push it, and the people inside look at you through a camera to determine if you are safe. Two sets of heavily locked doors open. Then you surrender your purse, your shoes, and your belt. Only then can you see the patient.

The communal room was bare of windows, no pictures, no art anywhere. (Glass is considered dangerous.) Four tables were set up on one side of the room leading to a kitchen. There were small
seating areas for families to visit, the kind of furniture you see in group homes that haven't been updated in a decade. The room was full of the stink of Brussels sprouts just cooked, the clank of people cleaning up from dinner.