Sickness

The Serenity Prayer plays frequently in my mind:

“God, grant me the serenity to accept the things I cannot change,
The courage to change the things I can,
And the wisdom to know the difference.”

It doesn’t always help, since my biggest concern is something I have little control over, can’t fix—and yet I desperately hope that something can be done. It’s my youngest daughter’s mental health problems.

My youngest daughter doesn’t seem to be getting better—the episodes of madness, of inchoate and unreasoning rage, remain. The only plus in this is that the meltdowns are shorter now, though no less intense—and thankfully lacking in property damage and physical violence directed at me. Verbal abuse continues, however.

After an explosion, as always, there is remorse. She experiences confusion, sorrow, and she desperately wants the episodes of madness to end—but once an episode begins, the otherwise pleasant, cheerful and caring person utterly vanishes. The person who wants to be there cannot be found.

A simple thing this weekend tripped her into instant, blinding, screaming rage: her laptop computer was out of power, even though she insisted it was plugged in. Of course, the plug was loose. Easily correctable. But for her, the rational person vanished in a moment, replaced by a raging, cursing, inferno that resisted all attempts at solving the problem.

Intermittent Explosive Disorder it is called. IED would be the acronym, which brings to mind the improvised explosive devices notorious in Iraq and Afghanistan that have created such havoc and suffering for our soldiers in those far off lands. But this IED, the IED that has infested my daughter’s brain, that explodes on my wife and I without warning and without obvious cause is described this way by Wikipedia:

“Intermittent explosive disorder (IED) is a behavioral disorder characterized by explosive outbursts of anger, often to the point of rage, that are disproportionate to the situation at hand (i.e., impulsive screaming triggered by relatively inconsequential events). Impulsive aggression is unpremeditated, and is defined by a disproportionate reaction to any provocation, real or perceived. Some individuals have reported affective changes prior to an outburst (e.g., tension, mood changes, energy changes, etc.).
“The disorder is currently categorized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) under the “Disruptive, Impulse-Control, and Conduct Disorders” category. The disorder itself is not easily characterized and often exhibits comorbidity with other mood disorders, particularly bipolar disorder. Individuals diagnosed with IED report their outbursts as being brief (lasting less than an hour), with a variety of bodily symptoms (sweating, stuttering, chest tightness, twitching, palpitations) reported by a third of one sample. Aggressive acts are frequently reported accompanied by a sensation of relief and in some cases pleasure, but often followed by later remorse.”

The Wikipedia article certainly describes her symptoms well. As it points out, in our youngest daughter’s case, it is indeed related to her bipolar disorder. If the triggers were predictable, if she always reacted to a problem with an explosion, then it might be easier to handle, easier to cope with, easier to fix. Unfortunately, a word, a phrase, a problem that yesterday she took in stride, today sends her off to kick a hole in the wall while she screams blistering invective and yells that “You’re not my father!” and “You never do anything for me” and “you don’t care about me.”

She has a psychiatrist that she sees monthly, but she needs a therapist on top of that. It has taken us awhile to find a therapist for her, however. Therapist after therapist that we contacted worked only with people who had suffered some trauma—soldiers back from the war with post-traumatic stress disorder, crime victims, those recovering from serious illness or those trying to get past their grief after having lost a loved one. But to find a therapist who wants to work with someone who may take years to improve, someone who has ongoing mental health issues not related to any trauma, was surprisingly difficult. We finally managed it, and so her first appointment is scheduled for the middle of October.

Our goal, the goal of her psychiatrist, the goal of her school psychologist, is that she get stabilized. The current medications that she is on have helped tremendously—but she is not at all stable—not by a long shot. She has returned to independent study at school. Unlike other people her age, she cannot get a driver’s license, she cannot travel by airplane. She has difficulty maintaining friendships, she is largely unemployable, and she cannot enjoy the activities and freedoms of a normal high school senior. She knows that she is missing out and she understands and accepts the reasons when she is not raging. She likes coming to church and she attends prayer meeting, where she regularly and clearly describes her mental health issues and asks for specific prayer regarding them.

Thankfully, our church family understands and accepts the reality of her mental health problems. We are fortunate in that regard. We know a former missionary who faces severe depression to the point that she has on occasion had to have electroshock therapy. She cannot tell people in her church about her suffering; she even keeps it from one of her daughters and her son-in-law. Most of the people in that church believe that mental disorders are not an illness. They believe it is something that people can fix for themselves “if only they prayed more” or “if only they weren’t such a sinner.”

Telling a mentally ill person just to “snap out of it” or “stop acting like that” or “pray more,” or “stop sinning” or “if you just had more faith”—is akin to telling a paraplegic to stop being so lazy and wicked: “Just get out of that wheel chair. You know you can.” Or telling her parents, “if you’d spank her more, then she’d start walking.”

A broken brain is no more your fault than a broken back.

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About R.P. Nettelhorst

I'm married with three daughters. I live in southern California and I'm the interim pastor at Quartz Hill Community Church. I have written several books. I spent a couple of summers while I was in college working on a kibbutz in Israel. In 2004, I was a volunteer with the Ansari X-Prize at the winning launches of SpaceShipOne. Member of Society of Biblical Literature, American Academy of Religion, and The Authors Guild
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