In 2007, at the start of my son’s fourth grade year, the teacher who I will call Ms. L, gave the class an assignment. They were to write letters to their “future selves” outlining the things they envisioned and hoped for over the course of the coming year. Ms. L. would give the letters back to the children at the end of the year so they could see how their “future selves” aligned with the vision they held at the start of the year.
Though my son, ten at the time, showed no outward signs of anything wrong, the letter he wrote was filled with sentiments of self-loathing. For example, he wrote things such as “I hate you” and “I wish you were dead”
Unfortunately, I did not find this out until he was 16.
You see, Ms. L never gave our son back his letter. And, in a well-intentioned but very naïve attempt to spare our feelings, never told my husband and me about it. It was a chance meeting at a memorial service six years later during which Ms. L had a change of heart, pulled me aside and shared the contents of the letter. By this time we were well aware our son was struggling. I wish we had known sooner.
There are many parents who say with firm conviction – I know, I used to be one of them – that if their child was depressed they would know. They can’t fathom the notion of having a close, connected relationship with their child and overlooking such an “obvious” problem. Parents who do, they contend, must surely be distracted, disconnected, out of touch with their child.
I’ve learned the hard way this is hogwash. My son at ten years old had numerous friends, was curious, engaged, and funny and lived in a loving, stable home in which he could freely express his emotions; which he often did. He thrived in things he enjoyed such as skiing, summer camp and vacations spent with an extended family of loving grandparents and cousins.
He even had a therapist. After a traumatic burn accident he suffered when he was 7, we felt he should get therapy. “Great kid. Doesn’t need therapy,” I recall one clinician telling me.
But he had a secret. And that was that there was a darkness much deeper than typical sadness brewing in his little brain. A darkness called clinical depression that he was too young to understand. In hindsight I often wonder if our having such a “normal” and for the most part “happy” family life was part of the reason he kept his despair to himself.
“Perceived burdensomeness” is a phrase researchers have coined in regard to children who feel – typically for reasons that are true only to them – that they are a burden on the family. They keep their despair to themselves to avoid causing pain to those they love and who love them back.
Our son did eventually let us know, at fifteen, that he was suffering. We were fortunate he did this and that we were able to get him the best help we could find at the time.
Ms. L should have told us immediately but she didn’t know better. She was very young and frank discussions about children and mental health were less common in 2007 than today. Consequently, in her attempts to protect our feelings she prevented us from acting on the problem sooner; before it had time to fester and expand. By the time our son was 16, the illness in his brain had become fiercer and scarier. He experienced feelings of panic and rage and unending urges for pain relief; feelings and urges that are much harder to manage in a teenager than in a ten year old.
In hindsight, there is something I too could have done differently, but like Ms. L, I did not know better.
Children who undergo a traumatic experience – such as a medical trauma, an accident, a family member’s death or a natural disaster to name a few – are at increased risk for depression, suicidal ideation, addiction and mental health issues. When my son had his burn accident in 2004 the term “trauma” in regard to emotional health was not as much a part of the lexicon as it now is. Though he received excellent medical care, the term PTSD never came up during his treatment and the goal, after he came home from a month long hospital stay, was simply to get back to “normal;” which we did.
Had I known more about the insidiousness of childhood trauma, I could have alerted Ms. L and asked her to keep an eye out for anything that might indicate he was struggling. For example, by the time my son was sixteen, I had learned enough to know to alert the dentist to prescribe few if any opioids when my son had his wisdom teeth out. When you know better you do better.
Throughout his teenage years, our son worked diligently to overcome his illness but it ultimately proved to be too much and he died in 2020 at the age of 22. When I travel down those inevitable rabbit holes of “what if’s” I sometimes feel anger toward Ms. L. fantasizing that had we known sooner we could have nipped his illness in the bud. This however, is just that, a fantasy. For one, the majority of educators are doing their best with the information they have available to them at the time. This was true of Ms. L.
Also, even if we had known, life after fourth grade brought our son further challenges; challenges that would be hard for anyone to manage yet alone a young person managing a medical trauma and depression. In high school, our son and his classmates endured a three hour lockdown-inside a small crawl space while our community experienced a mass shooting, And, a few years later he lost a good friend and mentor to suicide.
For some children – especially those who have not endured such complexities - early detection may make a difference. Thankfully, since 2007 much has changed in that conversations about the mental health of our children are more common and I’d like to think most teachers today, if faced with a letter like the one my son wrote, know enough to alert the child’s parents or caregivers. Yet we still have a ways to go. In a perfect world, anyone who loves and/or works with children – parents, caregivers, teachers, coaches, dentists, pediatricians… – would be well versed on the signs of depression and/or PTSD. Also, mental health conversations with our children would be as routine as conversations around wearing seat belts, smoking cigarettes and taking drugs; regardless of whether or not a child is showing signs of distress. We don’t wait until a child is already smoking a pack a day, driving on the highway or drinking alcohol to have these discussions – why wait to have them around depression, suicide and mental health?
When we know better we do better.