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.