The Demons of Childhood
Young brains break. Then comes the broken care system
Alex was treated at Charter for a week. At one point a social worker told Troyer that she needed to place him in a long-term-care facility. The strain of keeping him at home would destroy the family, Troyer was told. "When she told me that, it fueled the fire in me," says Troyer. "I was so determined that this was not going to happen, I said, `I don't care what needs to be done because we are not going to do that.' "
Even if she had wanted to institutionalize Alex, her options would have been limited. Across the country, long-term-care facilities for mentally ill children--and adults for that matter--have disappeared. State hospitals have closed, and most private long-term options are colossally expensive.
The talk of institutionalization frightened Troyer. She turned to DeLong and asked what the outcomes for children like Alex could be. DeLong, who has worked with bipolar disorder in children for over 30 years, acknowledged that in the end, each child is different. Some become Eagle Scouts, others commit suicide, others finally are forced to live in long-term facilities. Then he looked her straight in the eye and said, "Alex will be OK." It was all Troyer needed.
IT IS 5:45 IN THE MORNING AND STILL dark when Alex gets ready to catch the 6:00 bus to his school. While the trip is less than half an hour by car, this bus is for disabled children throughout Greenville and stops at several different schools and neighborhoods. Alex is the first picked up and the last dropped off, so by the time he arrives he has been riding, and napping, for an hour and a half. His clothes are carefully laid out on the chair in the order in which he needs to put them on. He dresses quickly and goes into the kitchen, where Troyer gives him his medicine.
Every day, twice a day, Alex takes the anticonvulsant Depakote to stabilize his mood; lithium to calm the excitability of bipolar disorder and ease his symptoms; Risperdal, which is a major tranquilizer and antipsychotic; and clonidine, an antidepressant. Risperdal alone costs $700 a month, and the others bring the total medication cost to nearly $1,500 a month. Including Hudson's medicine, the monthly bill for medication is several thousand dollars. "I tell people that if anyone broke into our house their best bet would be to go for the drugs," jokes Troyer. Alex responded well to the lithium. Hudson, however, was a different story.
Even Troyer didn't see a problem with Hudson early on. But after Alex chased Hudson around the house with a butcher knife, the happy 3-year-old was transformed into a withdrawn and moody child almost overnight. The family had no idea what had happened until several weeks later, when Alex admitted what he had done. In some cases such a trauma can trigger an underlying disorder that might never have appeared otherwise.
Hudson began to act out in school, urinating on his classmates. Troyer had been so accustomed to the profound dysfunction of Alex that she didn't realize Hudson was beginning the dramatic slide into bipolar disorder as well. "I would have all these thoughts going through my head really, really fast," says Hudson. "Then they would start buzzing like bees until it got louder and louder, so I couldn't stand it." At 51/2, Hudson was in the midst of pediatric mania. DeLong recalls that Hudson couldn't calm down when they first met, and his words came out garbled and giddy. He was not as neurologically damaged or developmentally delayed as his older brother, but it's likely they share genetic predisposition to the illness. Now Hudson, too, takes a small pile of pills with his morning and evening glass of milk. In the beginning one of them was lithium. It had worked so well with Alex, Hudson was likely to benefit too.