Acquainted with the Night: A Parent's Quest to Understand Depression and Bipolar Disorder in His Children

Read an Excerpt

Chapter 1

It is the spring of 1996, after Alex's first hospitalization. He is 11 years old and in the fifth grade. He has left the hospital with no diagnosis. No one has told us what treatment he needs, or how we should proceed. He and his teacher, with whom he'd begun the year in an uneasy standoff, are now openly at war. It was Alex's sometimes rambunctious behavior in class, talking out of turn and cracking jokes at the wrong times, that had initially put her on guard. But it is his explosive emotional outbursts, which now occur once or twice a week, that have long since depleted her patience. Despite the hospitalization, the examinations, and the tests, we have no idea what is causing these emotional storms. Neither does Alex, who is as puzzled by his behavior as we are. His teacher isn't puzzled, however. She thinks she knows exactly what is going on. Alex is bent on attacking her, and all this talk about psychiatric problems is nonsense. He is simply a bad kid, who time and again has interfered with what she is trying to accomplish in class. She wants him out of there, but it is a small school, with only one fifth-grade class, and there is nowhere for him to go. She makes no secret of her distaste. Alex sees it as clearly as we do.

The outbursts are becoming more common at home, too. Liz and I know that he needs help, that the hospitalization was a failure, but we have no idea what to do. I am inclined to respond with ever stiffer punishment. We might not understand what is going on inside him, but if we're tough, we can control this behavior. Sometimes Liz agrees, and sometimes she doesn't. I can't pin her down on a plan of action. We argue about it often.

One quiet Sunday afternoon at home, some trivial incident I've forgotten prompts one of these outbursts. Alex is screaming, thrashing around the house, gripped by a boiling anger. I know immediately that it will be a long, difficult afternoon and evening before he settles down. Alex flings open the back door, runs out of the house and down the street to where it ends at railroad tracks. I run after him. He keeps going, through a thicket of weeds and scruffy saplings, down a small embankment on to the crumbled, gray rocks beside the tracks. When I get to the embankment, I look in both directions, to where the tracks, shiny and polished from frequent use, wink out of sight in the distance. There are no trains in view now, but this is a busy line, shared by New York City commuter trains and freights. Alex is crouching on the rocks, not far from the tracks. "I'm going to stand in front of the train and die," he screams. He waits. I stand near the trees, where he can see me. I dare not move closer, for fear he will run on to the tracks. I try to coax him toward me. He turns away and looks at the tracks. I wait. He picks up a rock and tosses it toward the rails. A faint breeze stirs the trees. I have no idea whether he is serious about jumping in front of a train. Is this a cry for help, or does he really mean it? After a few long minutes, I ask him to come back to the house and talk. He doesn't say anything. I am growing frantic, wondering whether I should run down and grab him and drag him away from the tracks, but I'm not sure I can catch him. I'm not sure of anything, except that I'm ready to explode. These could be the last minutes I see Alex alive.

Liz is behind me; I don't know exactly where. I don't expect any help from her. We never agree on what to do about Alex, even in calm moments. We certainly won't be able to work out a plan now. I watch Alex and try to edge closer, but he moves away, closer to the tracks. Trembling, I stumble backwards through the trees, back to the house, leaving Alex there alone. I need to call someone. But whom? An ambulance? The psychiatrist Alex has seen twice? It is a Sunday; the psychiatrist's office is closed, and there is no answering service or night number. This guy doesn't do emergencies. In desperation, I call the police. "My son is sitting by the railroad tracks, threatening to kill himself," I say with a shaking voice. "Can you come and get him?" They will send a car over, an officer tells me. I put down the phone and jog back to the tracks, to keep an eye on Alex. I wonder what the police will do. He isn't threatening anyone but himself. Can they arrest him? And I wonder what kind of father I've become, turning over the care of my child to a stranger in a blue uniform.

A police car arrives a few minutes later, quietly, with no lights flashing and no siren. I move away, where I can watch but stay out of the patrolman's way. He walks up to Alex, saying something I can't hear. Alex follows him to the police car and gets into the back seat. The policeman calls to me. "Follow me to the station in a few minutes," he says. He gets into the car and drives away with Alex.

Liz and I silently get into the car and drive to the station, leaving Matt, who was then 14, and Alicia, 9, at home. We are brought into a small, bare room, with a couple of scarred desks and a few chairs, where a police officer has been talking to Alex. I can't tell whether it's the one who took him away; my mind is too fogged to be able to tell one officer from another. I don't know what he has said, but Alex seems a little better now. He meets my eye briefly, uneasily, before looking away again. We talk with the policeman and Alex for an hour or two about what has been bothering Alex and what he might do to calm himself. Then we take Alex home. We wait. We try to eat. We watch him. We move slowly around the house. Nobody talks much. We don't know how to keep this from happening again.

It's difficult to say where this story begins. Alex was a happy, bright-eyed child. He loved roughhousing and was always nicking a shin or twisting an ankle. He was friendly and affectionate, and liked to play with his older brother. For the first few years of Alex's life, Matt and Alex were best friends. Alex wasn't happy being alone. He was always looking for playmates, and he made friends easily. He could be shy with adults, but he was comfortable with other kids. From the time he was a toddler, he was taller and stronger than most other children his age. But he was far too gentle to use his size or strength to bully anyone. He was funny; he would win over the other kids by making them laugh. When he was excited, he'd be charged with nervous energy, shaking one leg up and down when sitting in a chair, fidgeting, and absent-mindedly twirling his blond curls around his finger.

Along with his size came a precocious athletic ability. I was one of those kids who, during pickup baseball games, was always chosen last and parked in right field, the traditional refuge of kids who can neither catch the ball nor throw it very well. Alex, on the other hand, was a natural athlete. I was amazed by what he could do. He knew how to catch and to throw a baseball from the first time he picked one up. All he wanted to do was play catch, or get out the equipment for hockey, or basketball, or football. What he lacked as an athlete was competitiveness and aggressiveness. He was too gentle and amiable to want to vanquish an opponent.

He seemed to have a special talent for baseball, and he looked like a ball player. On the field, he assumed just the right slouch between plays (how do kids learn that?), but he sprang into readiness, punching his mitt and bending his knees, whenever a batter stepped up to the plate. Because he was good, when he started Little League he was asked if he'd like to pitch. I encouraged him to give it a try; he had a strong delivery, and I thought he would excel as a pitcher. He pitched one or two innings, over the course of several games, and then abandoned any interest in pitching. He pitched well. But the pressure of being alone on the mound, with all eyes on him, and the game depending heavily on his performance overwhelmed him. When he gave up a hit or a run, he'd come back to the bench in tears. He didn't want to be a pitcher, he told me. I ached to see him so upset, and worried, a little, that I'd pushed him too hard. But I'd encouraged him only because he was good at it, and he liked it. I was sorry to see baseball make him sad.

Alex was a natural builder. If I left a few pieces of scrap wood on the floor in my basement workshop, Alex would disappear down there. After an hour or two of banging, cutting and sanding, he'd emerge and ask me to drill a couple of holes for him. The projects varied, from a table for his room, to a shelf for his model cars. For one school project, he designed an alarm system for his room, so he would know when his brother was coming. I wondered whether he might become an engineer or an architect one day.

Alex was easily the most injury-prone of the three kids. When he was two years old, he and Liz were coming out of a Chinese restaurant with a bag of takeout food when Alex tripped on the sidewalk, fell and hit his head. He might have been unconscious for a moment; she couldn't tell. Somebody called an ambulance, and he was taken to the emergency room. As far as doctors could determine, the fall did no damage. That was the first of what would be a dozen or so trips to emergency rooms. Alex broke his wrist twice, one of his feet, an arm, and I'm not sure what else. That's not counting the pulls, tears, twists and bruises that seemed serious but turned out not to be.

Alex's most serious injury occurred when he was six. We were on a family vacation with my parents in northern Michigan, when I stopped the car on a causeway to take a picture of a sunset over the water. I walked across the road and was standing on the opposite shoulder, focusing my camera, when Alex jumped out of the car and ran toward me. He didn't look for traffic. "Daddy!" he yelled, with his arms stretched out toward me and a big smile on his face. I turned just in time to see the smile replaced by a confused, wide-eyed look as he was scooped up by the front bumper of an oncoming car. The collision threw him up on to the hood of the car, near the windshield. As the car slowed and stopped, he rolled forward, tumbling off the front of the car on to the ground. I ran toward him, howling with anger and disbelief. There was no other traffic on the road; only my car, and the car that hit him. He landed on his face and was rolling over on to his back as I got to him. He was conscious, and slightly stunned. He wasn't crying. We were miles from a hospital, a doctor, or even a telephone. Knowing that it was wrong to pick up someone who was injured, for fear of aggravating the injuries, I picked him up anyway, and put him in the back seat with Liz.

By this time, a passing car had stopped. The driver said there was a doctor about 10 miles away, and he gave me quick directions. Behind the wheel of the car that hit Alex sat an elderly woman, alone. She started straight ahead, with her hands covering her mouth. She didn't move. When she hit Alex, she had been driving below the speed limit, perhaps only 20 or 25 miles an hour. If she'd been going any faster, Alex probably would have been killed.

I sped off with Alex in the back. He was now crying, and yelling, "It hurts! It hurts!" We got to the doctor's office, and in my confusion, I went inside and stood behind a patient talking to the receptionist through a window. I waited. Liz ran in behind me and shouted, "We have a boy who was hit by a car. It's an emergency." The doctor ran outside with a stretcher, brought Alex inside, examined him and determined that he should be moved to a hospital. An ambulance arrived a few minutes later to take Alex to the hospital. I rode in the front. Liz rode with Alex in the back, and my parents followed in our car, with Matt and Alicia. During the 45-minute ride, I overheard one of the emergency medical technicians radio the hospital, saying "patient's left eye is dilated." I didn't know exactly what that meant, but I knew it wasn't good. At the hospital, after a series of CT scans and physical exams, the doctors said that Alex, miraculously, had only broken one leg. His mental faculties seemed fine; the ambulance technician had been mistaken about the dilation of the eye. Could the accident have caused some subtle brain damage that wasn't apparent at the time? Nothing turned up in any of the tests, so the answer is: Probably not. But it's impossible to be sure.

The only hint of the emotional troubles Alex would experience later came when he was four years old and in nursery school. One of his teachers called Liz and me to the school for a conference. She said she was concerned about the way Alex was behaving with his classmates. It was something about the way he played with the other children; he wasn't connecting with them as he should be. Perhaps, she said, we should have him evaluated by a therapist. We thanked her and left, before I had a chance to blurt out what I was thinking: You must be out of your mind. A four-year-old seeing a therapist? Don't tell me my child needs a therapist. Maybe you're the one who needs an evaluation.

When Alex was in the first grade, he was a bright and eager student. A few months into the school year, his teacher wrote on his report card that he was capable of working independently, enjoyed participating in group discussions, enjoyed writing, and took pride in his written work. He was a good reader, and he pushed himself to take on more difficult books. The only concerns on his first report card were that he was sluggish in the morning and that he sometimes got sidetracked during class and had to complete his assignments during recess. He continued to advance the following year. "Alex has grown into quite a writer," his second-grade teacher wrote. He began to display a particular talent for math and for research, or what passes for research in the second grade. "Alex has a very inventive mind and is filled with interesting insights," his teacher wrote. He was soon asking for extra math assignments, and he represented his class in a school-wide mathematics competition. He was becoming a leader in class discussions and projects. There were times, his teacher noted, when he was easily distracted by others and his behavior was "inappropriate." He'd make a wisecrack that disrupted the class, or joke with other students during group projects. These "obstacles" sometimes interfered with his development "as an independent learner." Even so, she concluded that he was "a very capable student with mature interests and learning goals." By the end of the school year, Alex's good reports were still tempered with similar concerns. "Our goal continues to be appropriateness in his behavior," his teacher wrote. "He realizes that he can work much more efficiently when he has self control."