Sunday, May 31, 2015

Moving Beyond the Moment of Diagnosis

Last Wednesday, I sat across from the psychiatrist who would tell me that we have exhausted the "wait and see" options for my 12 year old's situation and that we should consider the plunge forward into more strident interventions.

I was ready to hear her tell me the relative promise of the pros and the slim margin of cons to medication, and she did. She laid everything out, speaking in gentle, somewhat hesitant and careful ways. She is practiced in the art of identifying anxiety and could navigate those waters with what appeared effortless and natural ease.

I asked, as she was ready to wrap things up, what diagnosis, if any could be reached. After a year of watching, waiting, and wondering. I needed to know if what it was had a name, had a reality. She told me, up front, that with mental health cases like these, labels are perfunctory at best, and rife with maybes and variables that feel compliant with diagnosis one moment, and contra-indicative the next. And once she had couched the idea in the safety of "maybe", she told me.

My daughter has Generalized Anxiety Disorder. And that her level is Severe, despite J's atypical presentation.

I felt like she punched me in the gut.

I know I asked. I know that I had prepared myself, somewhat, to hear those words spoken. I know that, given all that we heard and felt and seen, it was accurate. But I wanted her to say it was mild, moderate at worst. I wanted my kid, selfishly, perhaps, to not be at the highest alarm rate, the fastest triage, the leap to the top of a heap no one wanted to be King of.

I knew, too, in that split second of wishful thinking, that I could never have realistically believed that to be true. That all the evidence--the triage nurse in the Emergency Room who arranged a private and observed room for her and told me that she was triaged as "priority", the psychiatrist who bumped her to be seen within the month, the other psychiatrist who had a personal phone conversation with the principal and agreed, sight unseen, to take her as a patient without sitting on the wait list...all the evidence that should have pointed to the reality of this moment.

The rest of the appointment passed by in a bit of a fugue.

I feel somewhat conflicted about diagnosis. On the one hand it is a relief to just *know* that it really isn't something we could just have dealt with at home (that people were wrong when they said she was just "being dramatic", that she was "like any other teenager", that she could just "get over it", or that we, as parents, weren't just being permissive and enabling.)


A diagnosis means that there is a new round of advocacy ahead, doctor visits and therapy. None of it is more than I want to do, but it does require some fortitude as we move forward.

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