The Unimaginable

It has been six months since my son left me, along with the life I knew. He was the most beautiful, infectious, consistently warm, kind, pleasant person, and he was a genuine friend who cared. He should not have died. It was a bad day, things fell through, and he was alone. No one would have thought this was possible. Later we learned he was self-medicating with marijuana. He told a friend he felt anxious from the brownie, (laced with marijuana), he consumed earlier that day. There were signs, we individually noticed. We just did not put them together. I speculate that he would not have taken his life, if he had not ingested the marijuana, causing a psychotic episode (which does happen with marijuana, depending on how much of it is the body (National Institute on Drug Abuse (NIDA), 2018, June 25)).

As I write this, I am listening to one of my son's playlists. He loved music, he loved dancing, he loved being on the water, and he loved teaching children, helping them to gain life-long confidence. He taught alpine skiing in the winter and worked at a camp in PA, in the summer, teaching young campers how to water ski, wakeboard, sail, or to have fun on the water. He had a life. He was planning things. It was an instance he can not reverse.

If it were not for my son, our family would not have many of our friends. His fun, high-spirited, respectful, and just darn-cute personality, connected with adults. Even though our son was an introvert, he would introduce himself and always strike up a conversation. We transitioned him to a new pre-school when he was three. The pre-school was in a converted grade school. Waking down the long hallway, holding my son's hand, to head out of the main door, a parent called down the hallway, running towards us, " I have to meet the parents of this cute boy" "He comes up to me every day at the classroom door and greets me. He tells me about my son and what they did that day." My son was small compared to his friend, his friend being twice his size, even though my son was older. My son was always on the lower end of the growth charts. We became good friends with that family for many years. Just recently I reconnected with his friend's mother.

When my son grew older, he becomes self-conscious about not attaining a college degree, so he shied away from events where he had to answer questions like, "So, what are you doing now?"

His friends shared, "He was always more interested in hearing about you than talking about himself, but at the same time, he also loved to share his interests with others – a podcast he was listening to, new music he had heard, or even a dance move he'd learned. He was a scholar, staying up on politics, world events, and philosophical views on controversial questions of our time. He was a Marvel movie fanatic and supported his local sports team. He followed them all, but he had a passion for professional football and used his in-depth knowledge of the latest things going on in the sport to connect with others, welcoming them into the friend group.

His friends shared, "He went out of his way to make sure you were included. He had a gentle nature and huge heart. He had a genuine interest in people. He had an unconditional, contagious, unique 'only he can have' type of kindness. He had a goofball sense of humor that could catch you off guard with his one-liners. To his friends, he was never judgmental or uncaring. He was always so able to relate and empathize with his friends. He had a keen eye for how others were feeling and wouldn't hesitate to check in and see what was up. It could be something as simple as a friendly text message or going out of his way to make you feel included at a party when everyone else would be okay just passing you by."

What we now speculate, while caring about others, he was suffering inside. How could we all miss it? I had combed through his electronics and talked to his friends to try to identify when his deep suffering began. My son was diagnosed with attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADHD) when he was in grade school. Attention deficit disorder is a complex condition with two distinct presentations, both of which are officially known as ADHD. ADD is the term commonly used to describe symptoms of inattention, distractibility, and poor working memory. ADHD is the term used to describe additional symptoms of hyperactivity and impulsivity. Both are included in the medical diagnosis of ADHD (Russo Allison, ADDITIDE, 2018). We went through many medications before finding one that had the least side effects. While on the medication, he did not sleep well, and he had a reduced appetite. He was so skinny after his first year in college. He did not share his diagnosis widely with his friends. I assume he did not want to be different, or maybe guys do not share that kind of personal information.

In high school and college, my son filed for Section 504 accommodations with the schools.

[A 504 plan is a blueprint for how the school is to provide support and remove barriers for a student with a disability, so the student has equal access to the general education curriculum (The Understood Team, 2018)].

In high school, I could help advocate for accommodations, but in college, he was on his own. For him, he did not want to draw attention for being different. People with ADHD have difficulties following through, scheduling things for themselves, thinking ahead. I could not be there every step of the way in school to make sure he was standing up for himself to get the accommodations. Years later, when talking to a teacher, she told me she did not have time to keep track of children with accommodations, given her class sizes; she needed and expected her students to seek the accommodations from her continually. While he was in college, out of state, I couldn't get him to consistently see any medical professional, and because of privacy laws, doctors would not talk with me. I do not think the medical professionals and academic counselors understood, he could not follow through after leaving their office. By age, he was an adult, but with ADHD, he was not like the other students. He was smart and thrived on knowledge though. College did not work for him, and this weighed heavily on him, as it closed many professional doors.

After his death I have researched about mental illness, trying to find reasons why. I received material from my behavior health providers and mental health non-profits. There is a high correlation between those with ADD/ADHD and other psychiatric disorders and cannabis abuse/dependence. I now have learned that young adults with ADD/ADHD and other related disorders may use marijuana as self-medication to relieve their symptoms.

From his phone, I know everyone from whom he bought (the street marijuana). I know the originator of each of his sources. I know how much he bought each time.

My son was never diagnosed with other correlated mental disorders such as depression, anxiety, or substance abuse, which have well-known risk factors for suicide. He told me he was not that bad off, not like others seeking institutional and outpatient mental health services. I believed him. He did not want to take medicine; he did not like the side effects such as insomnia and anxiety.

I attend a support group for suicided survivors. The group is small, but there are commonalities of what we know about our loved ones. These numbers are not actuarially credible, so keep that in consideration, as you read these. The majority who suicided were male. There is a broader grouping who suicided between the ages of 23 and 24. There is a commonality of academic struggles, with a grouping that was diagnosed with ADD/ADHD. All came from stable, loving, family relationships. Suicide did not discriminate with their families' income levels or access to health care. All had some interaction with behavioral health services. The majority did not reach out for help beforehand such as calling 911 or a suicide hotline. None of them, themselves, ever used that service, that we are aware of them using.

One of my son's favorite singer/songwriters is John Mayer. John Mayer has a song titled, "Waiting On the World to Change" (2006). Here is what I wish to change:

Schools, teachers, and counselors take suicide prevention seriously by including it in their curriculum. They need to introduce the curriculum early on, so talking about mental health and mental disabilities (including ADD/ADHD) is normal and asking for help is considered courageous; treating those that do so as mighty. They need to proactively follow up and follow through with students on a 504 disability plan, even if their struggles are not visible. They need to staff, so ADD/ADHD students have an advocate; helping those with ADD/ADHD to be successful, could save a life.

Curriculum for children, teens, and young adults should include the warning signs of someone struggling with their mental health and how to ask for help, and it should be required, no different than sex education or substance abuse. Use the school system as an outreach to teach parents about the warning signs, statistics, and correlations between mental illness, mental disabilities, and suicide.

My son and his friends came from an excellent high school, and most of them completed secondary education; yet, as adults, they take marijuana. I am sure schools taught them about the adverse effects. This teaching needs to be continued to be reinforced throughout high school, college, and by medical professionals. Dr. Jennifer Ashton, ABC News Chief Medical Correspondent (Twitter @DrJAshton), recently spoke on the morning news, about a spike in marijuana use by college age, young adults; the highest use in three decades. The increase in marijuana use is happening, and has adverse effects, even if the user says it is just "social."

Adult celebrities need to stop glamorizing the use of psychedelics, including non-medicinal marijuana.

Bullying needs to end. Realize that it comes in many forms, beyond the outwardly physical abuse and name calling; exclusion is a form of bullying too. What the schools are currently doing is not enough. Children and teens are suffering in silence, and it stays with them forever.

Schools, parents, and society need to teach and demonstrate inclusion, respect, caring, compassion and patience.

Behavioral health and medical providers need to dig deeper and build caring relationships with their patients, getting their patients to be honest with them, and trust them. Providers need to follow-up with their patients, so they continue to seek care, even if it is helping to find care with someone else that is a better fit. Just do not let them fall through the cracks. There needs to be more availability of providers; once every three weeks is not enough. There needs to be better coordination of care between therapists, psychiatrists, and facilities, even if they are not within the same contracted provider group. Providers need to take every fleeting thought of suicide seriously, even if their patient says they do not have a plan. There needs to be more medical research done to identify when someone is at risk or has a mental illness that is correlated with suicide. Moreover, educate, educate, educate to reduce the negative stigma. Create on-going communication campaigns using avenues and celebrities that reach the most susceptible age groups, and that having a mental illness or mental disability is normal and okay and seeking treatment is no different than seeking treatment for any other disease.

Most likely you know of someone who is affected by suicide; therefore, we all need to work to change this crisis trajectory. You have seen these statistics on the news, but each time I see these, I am taken aback. These are US suicide statistics from SAVE.org that I think are relevant.

• Suicide is the 10th leading cause of death in the US for all ages. (CDC)
• Every day, approximately 123 Americans die by suicide. (CDC)
• There is one death by suicide in the US every 12 minutes. (CDC)
• Depression affects 20-25% of Americans ages 18+ in a given year. (CDC)
• Suicide takes the lives of over 44,965 Americans every year. (CDC)
• The highest suicide rates in the US are among Whites, American Indians, and Alaska Natives.
• Only half of all Americans experiencing an episode of major depression receive treatment. (NAMI)
• 80% -90% of people that seek treatment for depression are treated successfully using therapy and/or medication. (TAPS study)
• An estimated quarter million people each year become suicide survivors (AAS).
• There is one suicide for every estimated 25 suicide attempts. (CDC)
• Now, I write as grief therapy for myself, and to articulate what is like to be a parent of a child who died by suicide. I write to connect with those who do not know how to put into words, what they too are feeling, going through such a loss. I also want to share what the new me is going through, so others can understand. So lastly, I write to honor my son and share his story. He was such a beautiful person, and he deserves to have his story told.

You can read more of our story at lifewithoutmychild.com. If you are new to my blog, I recommend you start at the beginning. You can also follow me on Twitter.

REFERENCES

NIDA. (2018, June 25). Marijuana. Is there a link between marijuana use and psychiatric disorders?. Retrieved from <https://www.drugabuse.gov/publications/research-reports/marijuana/there-link-between-marijuana-use-psychiatric-disorders> on 2018, September 5

Russo, Allison, ADDITUDE, 2018, ADD Symptoms Vs.ADHD Symptoms: What’s the Difference, viewed 24 August, 2018, Retrieved from <https://www.additudemag.com/add-adhd-symptoms-difference/>.

Suicide Awareness Voices of Education (SAVE.org) 2018, Suicide Statistics and Facts, viewed 21 August 2018. Retrieved from <https://save.org/about-suicide/suicide-facts/>.

The Understood Team, understood.org, 2018, Understanding 504 Plans, viewed August 2018, Retrieved from <https://www.understood.org/en/school-learning/special-services/504-plan/understanding-504-plans>.