“You would love the Eddy I know. The Eddy I know is loving, kind, talented, and so funny it hurts. This kid you’re seeing isn’t the Eddy I know.”
Those were the words of a father at his wits end, pleading with the medical team at the adolescent outpatient psychiatric hospital not to give up on his son. Fifteen minutes earlier, the attending child psychiatrist, Dr. Erickson, and I were sitting down in the lunchroom with Eddy. He was a sagging figure rolled up in his high school hoodie, face down in his laptop, desperately searching for an escape from the anxiety that had brought him into the treatment program. Eddy sat there one week out from his graduation from the program looking far worse than when he first arrived. It was hard to imagine this kid was once a high achieving theater student with college dreams and big aspirations.
The adolescent unit of the outpatient psychiatric ward was run less like a hospital and more like a high school. Teens at risk for substance abuse, post-traumatic stress disorder, major depressive disorder, eating disorders, and other issues spent their days working through therapeutic activities or making up class credits among supportive peers to hopefully move towards a return to their old life. To those kids, whatever struggles burdened their existence beyond the walls of the unit did not matter. All that mattered was striving to heal from their pains. The walls of the hallway were lined with art projects and positive words that lit the hospital wing with a warm light. Despite this, the lunchroom’s lone figure, backlit by the storm outside, pounding on the windows, drained the room of emotion.
“You guys, I’m taking the antidepressants and my sleep is fine, but I just can’t build up the energy or motivation to go to class. Why do I feel like this?” Both his trauma and diagnosis of Major Depressive Disorder were palpable in his slow drawl that oozed with the effort of pronunciation.
I was stumped. Any progress Eddy had made in the past few weeks seemed erased. Four weeks total. That’s all he had. If we had only one week to turn Eddy around 180 degrees, I was certain the inpatient locked unit would be admitting him in the coming weeks. The insurance caps on maximum treatment length looked like a noose around Eddy’s wellbeing right then.
“I’m sorry you’re feeling this way today, Eddy. It means a lot to us that you made the effort to come in today even though you aren’t feeling the best. Would you be able to at least attend group therapy? I bet it will give you some insight into what you might be feeling. We’ll give you some space.” Dr. Erickson gave off an air of compassion and confidence that experience affords you, but as he and I filed out of the lunchroom, his body language seemed to betray a small sense of confusion and concern. The same thoughts flooded my mind 100-fold after seeing Eddy’s presentation.
“In your experience Dr. Erickson, how often do kids like that bounce back and end up doing well outside of treatment?” A second passed and Dr. Erickson responded with a cryptic, “You’d be surprised. We’ll see what Eddy looks like tomorrow.”
The next day we were once again met with a sole figure sitting in the lunchroom with his laptop, but this time his posture gave off a strangely optimistic tone. Eddy sat up straight, college hoodie down, playing music from his computer as Dr. Erickson and I entered. He spoke with enthusiasm and energy that contrasted sharply with his previous presentation. I could almost see the individual neurons in Dr. Erickson’s brain flipping through the DSM-V ruling out new mood disorders. As my own neurons were flipping through mine, I ultimately came to the conclusion that teenagers are an enigma.
“Eddy, I have to ask what happened between yesterday and today?” Without hesitation, Eddy responded with a thoughtful message I would not forget. “I went to group therapy yesterday feeling pretty bad about my life, and the therapist wasn’t dealing with any of it. He started throwing jokes my way and really pointed out the absurdity of how I was acting and thinking. He got me to laugh at myself. I went home, put on some comedy videos and music, and I just felt like the absurdity of my life was actually pretty funny. I guess I just needed some perspective.” With my jaw slightly agape, I glanced over at Dr. Erickson, who gave me a shrug and a smile. He was not surprised. He and the therapist had known something I did not.
At Dr. Erickson’s suggestion, I tracked down Eddy’s therapist and dissected his reasoning for how he knew to make fun of the sad, depressed kid in his group session. “Oh, Eddy? Yeah, he was too caught up in himself. I knew he was just having an off day and needed to chill out a bit. I knew he could handle it because I taught him how. He’ll be fine.”
I learned three big things that day that I will carry with me in my practice: I learned that taking steps backwards doesn’t mean you are not making progress. I learned that finding a new perspective can help you heal. And lastly, that young people are incredibly, beautifully resilient.