How much good can I do for my suicidal niece?

She's a troubled soul, and we're in the parental role, but I wonder when I will drop from exhaustion

By Cary Tennis

Published April 22, 2011 12:20AM (EDT)

Dear Cary,

I just helped my 19-year-old niece check herself into a psychiatric ward of a hospital. Her boyfriend appealed to me for help because she was suicidal, and after one failed attempt with her mother, waiting nine hours in a city emergency-department hallway with drunks and crazy people peeing in the hall, the boyfriend and I succeeded by taking her to a crisis center that saw her immediately. During the first try with her mother, my niece pulled herself together and convinced the social worker who finally saw her after nine hours that she was fine. The second time we were able to see a social worker while she was still in her suicidal state. She checked herself in voluntarily, though the social worker told me that if she hadn't, they would have put the legal gears in motion to check her in because of the high risk of suicide.

She made a suicide attempt when she was 16 and spent a week or two in treatment. Since then she has graduated from high school and started community college, getting good grades, and held a variety of jobs. But the last few months she has been paranoid and erratic. She has hidden much of this behavior from everyone but her boyfriend, who appealed first to her mother, who was able to see it but felt she could do nothing because my niece is an adult. He got desperate and appealed to me. I believe he saved her life.

I am finding myself in a difficult role. My niece has had a very rough life with her mother. As a little girl, she witnessed her father beating her mother regularly and using crack. She did not speak until she was nearly 4. Her mother finally got the strength to leave her father when she was 6 and moved across the country with my niece and her little sister, near where I live. Her mother has had a series of boyfriends, one of whom she had a third child with, and now lives with a man with four kids of his own in a very crowded house.

My niece's mother is my husband's sister and we have stepped in, in parental roles, at various times over the years. My sister-in-law has never really dealt with having been a battered wife, and her three kids act out in various ways. We love them dearly, and worry about them, and help when we can. We take the kids on vacation with us to a lake every summer, and this is pretty much the only vacation they get from their stressful lives, since their family doesn't have much money. For a while my sister-in-law rented the first floor of our two-family house, but it didn't go well. We saw up-close how dysfunctional she was. She was very depressed and we ended up feeding her kids most nights; she was cited by the state for neglect of her middle daughter who missed a lot of school and had emotional problems; and for six months or so after she moved in with her present boyfriend, she left my niece alone in the apartment downstairs (at age 16), which was a complete mess and for a while had no heat or hot water. It was spring so not too cold and our niece took showers in our apartment. We did what we could and were on the verge of calling Child Services when she moved out completely (after months of not paying rent), bringing her daughter along. Soon after this was her daughter's first suicide attempt. We had hoped that the therapy she received at that time had helped, and things seemed to be more stable in their family.

Now my niece is nearly 20. She has always been a little odd and shut down emotionally, but also sweet and loving and committed to her schoolwork and other interests she was passionate about. She has been living part-time with us again, finding her home life intolerable. She had a private entrance to the room we gave her and we thought at first that she was doing well, keeping up with school and work. Her boyfriend let me know that this was not the case.

She claims not to remember when she has crying jags, or when she accuses her boyfriend of not caring about her, or when she screams at her mother. She says she does not remember expressing suicidal intentions, though we have several text messages that state this clearly. The doctors in the psychiatric unit are not buying it. They want her to take responsibility for her behavior. She has been there four days so far and is very resistant to treatment. I don't think they will let her leave if they can help it, until they can get a clear diagnosis and treatment plan. I hope this can happen.

Since I am the one who helped her get checked into the psych unit, I have been thrust into a parental role. Her mother does not seem to mind; she seems to appreciate the help. I am walking a fine line -- I feel I need to tell the psychiatrist and social worker about my niece's traumatic past (and I'm sure there is much I do not know). I care about my sister-in-law and know she has deep trauma of her own, but I need to tell my niece's psychiatric team what I know of her past.

I also need to take care of myself. I have two children of my own, age 11 and 14. I have a full-time job. My husband is a bit checked out on this issue because he is overwhelmed by it. He agrees that I did the right thing helping our niece, but he doesn't seem to be eager to be involved in the follow-up. I find myself trying to support my niece, who is resisting treatment, my sister-in-law, who has a lot of denial, and my niece's boyfriend, who is a great kid but only 20 and overwhelmed by the situation.

I am not sure exactly what my question is. I just know that I am involved and can't get uninvolved, but I also need to attend to my own children, my job, my own life. How do I strike a balance? It seems that my niece's mental illness is going to be a long, rough road. It could take years. I want her to make it. I want to do what I can, but not get completely emotionally sapped and resentful.

Exhausted Aunt

Dear Exhausted Aunt,

I'm not exactly sure what the question is either, but neither am I sure what the question is when I see a car run off the road or a guy puking in the gutter or 10 billion stars winking silently in a snowy night, or what the question is in the poodle's eyes when she's staring at me from her primordial crouch, curled into inscrutable canine dreams. What do we do with all this life? What do we do with these phenomena? We try to keep our balance, for one thing, walking toe-to-heel along the long single rail as it curves into a distance we don't know the name of.

You try to keep your balance. You put your arms out to your sides like a tightrope walker, except when you extend them out in front like a sleepwalker, craving balance and trying not to walk into things.

Maybe you chant to yourself as you walk, saying, I know I'm doing the right thing but there's going to be times it feels wrong, and I know everybody can only do what they can do but I'd like to strangle some people who just stand around helpless, and Oh Lord, won't you buy me a Mercedes Benz, my friends all drive Porsches, I must make amends, and Wouldn't it be nice to spend the spring in St. Barts, and Why can't boyfriends grow up faster and be stronger, and Can't modern medicine do more for suicidal young women?

We assume you know the warning signs of incurable helping of others too much, but if you don't you will learn them, and you will read the canonical texts on being too darned involved in other people's lives when there is only so much one person can do, and you will decode your childhood sainthood of helping Mommy or helping Daddy or taking over the water brigade or the town sewer system or saving cats from extinction or whatever kind, good and world-beating activity drew you out of yourself to the extent that sometimes you felt lost. And yes, you will learn to know the difference between your good and selfless involvement and some other, darker hunger for martyrdom and chaos. You will keep going and at times when you collapse from exhaustion there will be no one there to lift you up and you will curse the day you were born. But then you will get up again. I know you will. And there will be suddenly nice days with ice cream. There will be. I know that too. So you have to do the simple things like avoiding all the assholes and not getting too proud of yourself and always keeping a little gin around for visitors.

I tell ya, it's a long road. I know it's a long road. And there are documented professionals and there are charlatans and there are those like me who are somewhere in between, like traffic cops on some days and punk musicians on others, and there are writers and painters scarcely of this earth who will take you out of yourself when you need to be taken out.

And that's my impractical answer for today.

I am trying to say that I hear you. I hear you and you are doing the right thing and of course if all the questions had to be clear we would not talk at all. It is more like we are on that park bench again, sharing our observations, shaking our heads, going on with it. I am trying to say that I hear you and you know how it is when you are balancing on the railroad track and someone tries to help you balance, taking your elbow or offering a hand? More often than not it throws you off. So I stand back and cheer and offer to be there if you stumble, and I hope others in your life will do the same. And remember this: When you do need specific help on specific tasks you can always ask. Not everybody gets it that they're supposed to offer, and not everybody can handle it the way you can. So it might seem idiotic that you have to spell it out, but when you need help, don't be afraid to be specific: I need a ride to the hospital at 2:30. I need you to pick me up some Vicodin. I need somebody to spell me so I can catch my breath.

Creative Getaway

What? You want more advice?


Cary Tennis

MORE FROM Cary TennisFOLLOW @carytennisLIKE Cary Tennis

Related Topics ------------------------------------------

Since You Asked