Gary has been depressed. He has excellent reasons for being depressed. His parents aren't his parents any more. He is angry and hurt. There is a plan to adopt him, which is good, but is horribly stressful all by itself. He is turning 18 in six months, and this almost always a crisis for kids in foster care. Even when they KNOW they are welcome, nay WANTED, they so often feel like they are supposed to move out and turn into completely independent adults at that moment.
Then of course there is the romantic problems. He broke up with one girl because it was getting too serious and he couldn't take that. She loved him and he isn't worthy of being loved and so he had to break up with her. He was honest about it. He told her how much she meant to him and that that was why he couldn't date her any more. He really did want to be friends though.
Then he started dated her previous best friend.
According to Gary she has behaved in inexplicable ways. She apparently doesn't like him very much anymore.
She has a new boyfriend and he keeps throwing it in Gary's face that she is his and not Gary's anymore. The new boyfriend is also a douche-bag who tries to control her all the time and Gary wants better for her, but they both get upset with him when he tries to protect her. So the text messages, the MySp*ce bullying has been flying.
He doesn't sleep, because he is up all night texting people.
So he is depressed. And it has nothing to do with his parents or with this horrible boyfriend, or the girl, except it has everything to do with them.
So he texted his social worker at 4am saying he was miserable and felt like dying. He had previously promised her that he would tell her if his depression got so bad that he felt like hurting himself.
She got the text around noon and called me. He didn't want to say much, but he couldn't promise me that he would be safe, so we went to the emergency room. I expected/hoped they would talk him into taking antidepressants, at least as a trial, and I would take him home. In the first five hours in the emergency room we established:
1. It is wrong for him to take anti-depressants and he won't take then even as a trial run.
2. Yes, he does think about committing suicide. He doesn't have a plan because he doesn't need one. It isn't HARD. If he decided to do it, he will, no plan required.
3. Yes, he feels like injuring others. In fact there are two particular boys at school that he would like to beat the crap out of.
4. No, he doesn't have a PLAN for what to do if he feels like beating them up. He doesn't think he will. He has good self-control. Of course, all the martial arts training has made his reflexes almost sub-conscious and he did black out that one time when someone threatened him, so he might beat the crap out of them anyway.
5. Being admitted into the psychiatric ward is a stupid idea because it will only make him feel worse.
He had the sort of warped thinking that comes with deep depression. He would tell me that he wanted to go home and then just as I was thinking about asserting that I thought it was a good idea he would tell me something else that indicated he needed to be admitted. The third time he told someone that he wasn't sure that he could refrain from beating up these two boys at school tomorrow I knew it was over.
Since the local hospital does not have an adolescent unit he had to be transported to another facility in The City. They were inclined to transport him by ambulance. The doctor told him that there had been a situation not long ago when someone was being transported by a relative and he jumped out of the car and over a bridge on the way. The physician asked Gary if he would do anything like that.
Gary stopped to think about it, and then said, "Probably not."
At this point my dark humor side nearly lost it. I wanted to say, "Darlin' if you want to convince the nice doctor that you don't need to go to the adolescent psych unit don't tell him that you probably won't jump off a bridge on the way there."
So Gary went to the psych unit in an ambulance and we followed a bit later in the car. I had a possibly hysterical laughing fit in the car imaging what Gary might have thought was going to happen after telling people that he would only give the first names of the boys he really wanted to beat up. I imagined the doctor calling the school telling them that he had a legal obligation to warn them that Gary was a danger to two boys in the high school, but he only had their first names. But Gary didn't want to go to the hospital because he would miss school and fall behind.
Because, in Gary's current world, it makes perfect sense that he would be allowed to go to school after telling three psych professionals that he couldn't be sure he wasn't going to beat the crap out of two students.
We finally said goodbye to him seven hours after we first left for the ER. On one hand, I think he doesn't need to be there. I think he is at low risk for hurting himself or anyone else. I don't think there is anything wrong with him that could not be addressed with outpatient treatment. If he will agree to that, he could easily be out in 24-48 hours
On the other hand, he thinks he deserves to feel the way he does and so it would be contrary to his personal moral beliefs to take anti-depressants. If that continues to be his attitude, he could be there quite a bit longer.
When he was being admitted to the psych unit he did make much more reasonable statements. At that point he admitted that there were a couple of kids that he was really angry at, but he doesn't solve problems with violence. If he feels threatened he will defend himself, but that's all.