Isobel

Age at interview: 46

Brief Outline: Isobel’s younger daughter took the first of three overdoses when she was 15, but has not repeated this for nearly a year. Isobel says she is more mature now and able to talk about how she feels.

Background: Isobel, age 46, is a social worker. She is single, with two daughters aged 17 and 22. Ethnic background: White British.

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Isobel’s daughter Lily [not her real name] took her first overdose when she was 15. Isobel and Lily’s father had split up acrimoniously, she and her daughters had just moved house and Lily was having trouble at school, worrying about exams. Lily also had problems in her relationships with friends and her boyfriend. Isobel had taken Lily to their GP, who referred Lily to the CAMHS (Child and Adolescent Mental Health Service), but they had not yet been given an appointment. Lily’s boyfriend warned Isobel that he was worried that Lily might do something. Then Lily took an overdose of some over-the-counter painkillers. Isobel took her to A&E. She felt quite annoyed and angry, but hid this from Lily as she saw the overdose as a cry for help and wanted to be supportive.

The nurses in the children’s part of the hospital were very warm and caring. Lily asked Isobel to talk to the hospital psychiatrist for her as she was tired and sick and didn’t want to talk. Isobel thinks the overdose speeded up their CAMHS treatment, which started within a week. 

Some months later Lily took a second overdose which also involved some of her mother’s strong painkillers. This time Isobel called an ambulance, though Lily begged her not to and said she wanted to die. The ambulance staff were very kind, but Isobel thought the nurses in the adult part of the general hospital were brusque and seemed uncaring. Soon after this Lily took a third overdose. Isobel’s father had just died in the same hospital and she didn’t want to go back there as she was feeling very low, so Lily’s aunt, her sister and paternal aunt went with her. She hasn’t taken an overdose for nearly a year. Isobel thinks this is because Lily is much more mature now she is almost 18; she is happy at college, has good friends and is able to talk about how she feels. 

Isobel stopped attending the family sessions with the CAMHS team as she didn’t agree with their way of working. Lily’s father now takes her to CAMHS meetings and Isobel is sent the care plan, but has no other contact with the service.

Lily’s sister was upset by the overdoses. She was annoyed as she thought Lily was being selfish, but tried to be supportive and sympathetic. Lily’s father didn’t show any outward emotion, but talked about practical things like Lily going to college. Isobel’s work were supportive, letting her have time off when she needed it. She found books, newspaper articles and websites helpful.

Isobel’s own childhood was difficult after her mother died when she was three. She and her sister took overdoses in their teens; her brother tried to kill himself last year. Lily knew about this and Isobel felt guilty that this might have made taking an overdose more acceptable to her. 

Isobel advises hospital staff not to make judgments about young people who take overdoses but to treat them sensitively and take them seriously. She thinks young people should know the facts about the dangers of overdoses – the tablets Lily took have damaged her liver. Parents should hide medication away, and salespeople should be concerned when distressed young people try to buy tablets. Isobel says to parents: ‘It’s not a blaming thing. Try really hard to be as supportive as you can, see your child from an outsider’s point of view, looking at your own part in your child’s development and what might have happened that’s beyond your control...and see if there are changes you can make in your family.’

Although the family still worry that Lily might take another overdose, Isobel thinks she knows the warning signs better now, and that as Lily is more able to talk about her problems, they could be proactive in dealing with them.

Isobel thinks her daughter's problems became too much for her. Taking an overdose was the only way she could think of to escape.

And did she say why particularly she’d done it? I mean did she want to die do you think? 

I think it was a cry for help.

Yes.

But I also think it to assume that is quite, one can never know can one? I can’t get inside her head. I can’t think she was, you know, she definitely didn’t want to die. It’s hard to think that a fifteen year old wants to die because it’s so unpalatable and horrible to think that a fifteen year old would want to die. I think part of her just wanted everything to go away and for her parents to get on and stop hating each other. And maybe that was the main issue and then the other things all built up, the school problems, the friend problems, the boyfriend problems until everything became too much and it was the only escape, the only thing she could think of to do.

Isobel’s daughter had problems in several areas of her life

And do you know what started it off? Was there any particular trigger or things that were going on?

Trying to sort of look at it now from what I realise now was going on, I I believe she was very upset at school, more upset than I’d realised and her exams were looming. She was very worried about having missed some school, not a great amount but, you know, a certain amount of school and that I think she’d never had a particularly happy time at that school, looking back on it.

And when she went to senior school, it was a time of great change. We’d just moved house and I’d and I’d split up so I don’t think she was ever particularly happy there. It’s a very big school, quite impersonal. She was having a few issues with her friends as well at that time and with her boyfriend and with her parents, with myself and her dad in that we don’t get on and it must be very difficult for her knowing that we don’t like each other. And we had the kind of normal teenage mother fallings out.

She was beginning to push boundaries quite a lot and, although it’s I mean my attitude to bringing up children is completely, vastly different to her father. I’m on the much more relaxed, perhaps too relaxed end of the scale. Her father is much more punitive and strict. So I think the conflict of having one parent, who was incredibly strict, and the other, who was too lax, was quite difficult for her to handle.

Isobel was aware of depression on both sides of the family and a possible family suicide but it wasn't discussed.

And has there been anyone else in the family who’s had any sort of serious mental health problems?

No, not as far as I know. I think if you go further back, I was brought up by my grandparents and I think, my maternal grandparents, and I think my grandmother possibly had depression but I wouldn’t have known what depression what it was and she died when I was fifteen. But she did talk about her own, it was either her mother or her grandmother, having early onset dementia or I think she said in the parlance of that she would have used that she went a bit ga-ga and I can’t remember if that was her mother or her  grandmother. But certainly no one in my or my father’s side or my mother’s side have had any significant mental illness.

It’s depression in our family that would be, if any, the sort of mental illness that anybody has suffered from is depression, long term depression.

And in her father’s family, were there any?

It’s a personal view, I think he’s mentally ill. I think he’s possibly got a personality disorder. 

There’s that expression, you know, normal is as normal does. To my mind, I think my family were normal. I don’t think his family were. They’re incredibly punitive and strict and, whereas I was brought up with lots of chaos and love, he was brought up with lots of rules and not showing much emotion.

And her, my daughter’s granny’s father, so her great grandfather, had some kind of mental illness but I’m not sure what it was and there was possibly a suicide in their family too, but I can’t remember the details because I split up from him quite a while ago.

And again they wouldn’t have talked about it. He wouldn’t have talked about it. He wouldn’t have talked about it.

Yes.

Because he didn’t talk about emotions so. 

Isobel was scared when her daughter told her she found self-harm websites helpful

One thing I would say is those awful websites that encourage young people to, I don’t know what could be done to sort of, to stop them.

I suppose you can’t really. It’s free speech but they really do seem to be, you know, very, very instrumental and I know that my daughter has looked at them. She’s admitted to me that she’s looked at them and she’s found them helpful, which kind of scares me.

Is that mostly the cutting ones?

I’m not sure.

Or is that ones for overdoses too?

Yes, there are ones to tell you how to over, you know, how to commit suicide and  and you know, supporting your feelings of suicide and I know there have people been doing it online and it’s just horrible. I, you know, I wish something could be done about that because when you think how much time young people spend online and…

Yes.

And seeing that, it’s just awful, you know, reinforcing the ideas that you should go through with it and young people do, you know, imitate each other.

Isobel was angry at first but tried to be supportive of her daughter.

I felt very protective towards her. But also, I’ll admit, especially the first time, really quite frustrated and annoyed. 

I have to be honest, I was quite annoyed that she’d done it and angry because I was felt that there were there were other things she could have done because I did feel, at that time, that it was cry for help. It wasn’t a serious, there wasn’t serious intent because of the amounts of tablets but, nevertheless, I was supportive and I kept sort of softening, sort of going through a range of emotions, which hopefully I didn’t project particularly but I tried to show her the soft side and sort of very supportive and I was very tactile with her as I always am. 

Isobel wasn’t happy with the CAMHS approach and stopped going to therapy sessions.

And what is it about CAMHS that you don’t like or you haven’t found satisfactory?

I found them not to be impartial and, in fact, it’s in a meeting and my daughter painstakingly explained something that her father had had done, which was to my mind horrible and unforgiveable and just showing his controlling nature, making her stand out in the cold weather waiting for a bus. It might not sound much but it’s, you’d have to know him, and it was a horrible example of how he can have power over his daughter. So I think I made a comment like, oh, I sighed or something and the psychiatrist said, “Oh, it sounds to me like it was a mistake, a misunderstanding.” And that made me very angry because I didn’t think they were taking the content of what [my daughter] was saying seriously so I got quite upset and then I think something else happened later on in the meeting. I think they’d asked me to help, no, my child had asked me to help to talk for her, so I started saying a few things that I thought it might have been, the reason why she took the second overdose and again, the psychiatrist busted in and said, “It’s not helpful having these lists and just giving lists to [my daughter]. She needs to talk about it.” And I got very upset.

Yes.

I have to say, and I walked out of the meeting, and I haven’t been back since, but I would say that this is, sort of backs up with my experience of CAMHS as, in in my job and myself and my colleagues do often get very frustrated with, they seem to deal with minutia of life without looking, [sighs] well, I suppose we’re coming at it from two different ways. Because I’m a social worker, I would look at problem solving, I would look at how to make this family exist better and that might be that they need a washing machine. It might not always be terribly sort of small insignificant thing that happened when they were three or. I just find CAMHS labour a point too much but I was prepared to go along with their, the way that they work because of my daughter and I’m just hands off now.

Yes.

I certainly would never stop her going but I just don’t get involved.

So do they try and communicate with you or that’s?

They send me the meetings, the care plan.

Right. Yes.

But other than that, her father takes her, he, if needed he’ll go into meetings with her but I’m nothing to do with it anymore and I’m glad.