Triggered

by Allison Spears, WFU JD Candidate ’22

The silence creeps in as the psychiatrist, Dr. Good, approaches my family in the waiting room. An uncomfortable pause and sideward glances are exchanged between us. The room feels like ice and smells like stinging alcohol. Nobody knows what to say or do at this moment. I mean, how could we? I know I never wanted to have to face something like this in my life. I can’t even imagine how my parents are feeling. The reality of my sister’s condition was frightening. Even more so because we were all in the dark for so long while she was struggling with something that we didn’t even know existed. The feeling was equivalent to how it feels when you are about to take the first plummet on a rollercoaster. My stomach felt like it was going to come up and out of my mouth. We all felt that way – uneasy and uncertain. Who would have known one event could put her in a downward spiral in the blink of an eye? I think we all blame ourselves.

***

           My name is Carly. I am 18 years old, just started my first year of college, and my life is anything but normal. Well, I had a normal childhood for the most part—at least by twentieth-century standards. I mean, all families in the twentieth century go through a divorce at some point, right? The legal system could not even fix my parents’ issues with custody battles; fate did that all on its own. Other than that? Yeah, normal. I grew up in a small suburban town in the heart of Tennessee, played a few sports, and all of my family was still alive, thankfully. I even had some amazing friends that kept me sane through it all.

Both of my parents remarried after the divorce, which meant a new mom, dad, and siblings. They were all seemingly normal at the time. We did the best we could to fit our new families in with one another, but the custody battles were nasty. It seemed like nothing was going to end them—at least nothing possible through negotiations or court hearings. I still remember my mom taking me to Sears to pick out a new dress for one of the most important hearings. I hated that pink plaid. She told me it made me seem more “serious” at the age of 13. Fast forward back to the present—I tend to get distracted when I talk about this stuff. You might be wondering, why is this girl telling me about her life growing up? Didn’t this start in a hospital? Yes, I am getting there. I know I am being vague, but it will all make sense soon enough. It was vague for me too; even more so now. I feel as though the past 5 years are jaded by a fog that I can’t quite understand. 

My sister, Trinity, is 3 years younger than me, so she is 15 now. We were close growing up and did absolutely everything together. I don’t like to brag, but I am totally the reason she learned how to ride a bike on her own. I also pulled her first tooth, but that might have been because I wanted to see her squirm—big sister to the rescue! My little sister has always been the tiny, meek one of the two of us, but she was always happy and had the brightest smile on her face. Her laugh lit up the room. Her eyes were so wide. She could give those puppy dog eyes to anyone and get what she wanted in a split second. You would never have thought anything was wrong with her because she never let any of her troubles in life be known to others. I watched over her during the divorce and made sure she was okay, or, as okay as she could have been during that time. Mentally, divorce takes quite a toll on children, and it took a bigger toll on Trinity than it did on me. Even during the divorce, I would hear her quietly crying in her room. I had to grow up faster to ensure that I could be there for her—at least, I tried to be there for her.

When Trinity was 12, the world as we knew it stood still. She came forward about something that would end the custody battles, the heartache, and the confusion. Trinity had been sexually abused by our stepfather. When the news came out, the only emotion I could feel was anger. Angry with the person who did this to her, angry with her for not telling me about it, and angry with myself. How could I have missed this? I was supposed to be the one person there to protect her. I didn’t even do that. It took me a long time to forgive myself. I finally did, but the thoughts that I should have known still linger in the back of my head. I should have seen that something was wrong. Trinity was my best friend. 

Following the news, our dad obtained full custody. Our mother chose to stay with our stepfather and would cease contact for the following years. Trinity got a restraining order against our stepfather, but that only kept him physically from harming her; the emotional damage had already been done. We moved in with our dad, transferred schools, and began a new life. Trinity struggled with the transition. She now had a life without abuse, but also a life where she would forever deal with the repercussions of the past. I started at the same high school as her; I was a senior and she was a freshman. We didn’t talk much; there was an uncomfortable distance that grew between us after the news. Not to mention, Trinity’s personality did a complete 180. She stopped smiling. The reality she had been hiding with her once fake smile had finally come out to the world. But Trinity did what she did best: she buried herself in honors courses, took on an insane amount of extracurriculars, and refused to talk about anything. We just assumed this was her new “normal.” Little did we know, she was hiding even more than before. 

So why were we at the hospital? Trinity had attempted to take her own life that night and I guess we missed the signs. That is, until I went to check on her and found her passed out next to an empty bottle of pills she had snuck from our stepmom. I remember that moment vividly in time. It’s one of those situations we think we are prepared to handle, in the sense that we will do whatever we need for the people we love. But all I could do was hover above her body in shock. Staring at her lying there so peacefully, the neurons in my body did not register movement or sensation because I was could not process what I was seeing. Thankfully, my screams and sobbing following the initial shock had woken my dad up. He called the EMTs immediately and we rushed to the hospital. 

When we got to the hospital, it wasn’t looking good. Trinity’s heart had stopped beating. Nurses and doctors were poking and prodding her, had paddles out to resuscitate, and were pushing new medicines to counteract whatever she had done to herself. Thirty minutes later, they were able to stabilize her. The emergency medicine physician came out to speak with us. She asked the typical questions: Did we notice anything strange about Trinity’s behavior? Did she seem withdrawn? Did she say anything out of the ordinary? The answers were all no. Again, this all seemed too familiar—I felt angry. I looked over to my father and he looked distraught. I could tell he was just as confused as I was. Another situation where Trinity was struggling on her own, seemingly helpless.  

Hours went by until the physician came out to give us an update. The news was better than we thought. Based on the scans, Trinity’s brain was not severely damaged. When she woke up, the emergency medicine physician was able to ask her some questions. A few hours passed by before we heard anything else. When the psychiatrist, Dr. Good, approached my family in the waiting room, we got news that none of us were prepared to hear. She wanted to admit Trinity to the psychiatric unit so they could figure out how to best help my sister. That was it. No telling us why she did this, how she was feeling, or how we could help her – just asking to send her away. That sounds so easy: “Just send her away.” As if to say, “You don’t have to deal with this problem, it’s not like she’s related to you or anything.” I couldn’t even believe that was an option. It sounded so easy to do, but it wasn’t. And the unfortunate reality was that it wasn’t my decision, or Trinity’s. It was up to my parents since she was a minor.

Dr. Good had talked with Trinity about admitting her to a psychiatric facility. According to her, Trinity didn’t react at that moment. She gave a blank stare, started crying again, and went to sleep. My parents had a big decision to make. Do we send Trinity away to get the help she needs, or do we try to take her home, risking that the next time she might be successful in taking her own life? The latter made me sick to my stomach, and it must have made my parents feel the same. The papers were signed, and Trinity was soon admitted to the adolescent psychiatric unit a day later. Signing on the dotted line meant that my parents no longer had a say. She would only be released once she was no longer a danger to herself. A room filled with only a bed, metal toilet, and a barred window would be her new life as a high school student. In this room, she would be forced to face her traumatic reality, cry herself to sleep at night, and wish every day that she would have been successful with her suicide attempt—cold, lonely, and fearful.

We got a few updates in the following months. Dr. Good diagnosed Trinity with post-traumatic stress disorder (PTSD), depression, and anxiety. She discussed with us that Trinity’s attempt was most likely due to her PTSD being triggered. Her body naturally went into fight-or-flight mode, and she did not know how to deal with it. Instead of reaching out for a temporary solution to her pain, she reached out for a permanent solution. This would be something Trinity would deal with for the rest of her life. The PTSD not only had an emotional effect, but it had a physiological effect as well. We got word that Trinity’s hippocampus had shrunk. This meant her past and present memories could become mixed up, putting her back in the time of her trauma. She now had increased activity in her amygdala, which meant she had more difficulty controlling her emotions and an increased fear response. Finally, her ventromedial prefrontal cortex had also decreased in size. This meant she processed more negative emotions than usual when she was confronted with specific stimuli. Dr. Good chose to put Trinity on a set of medications to fix this imbalance. We could visit Trinity for the first time once they had screened her for an emotional balance. They determined that she would be able to handle seeing us, whether she wanted to or not. 

***

I enter the lobby of the psychiatric facility. The same feeling and smell from the day my sister went to the hospital overwhelms my senses. We are greeted by the nurse, sign in, and wait for our name to be called. We are then escorted through the hallway to a small room with three couches. We sit down and wait for Trinity to enter the room. Dr. Good comes in a few moments later, Trinity in tow. She looks good; happy, even. For the first time in a long time, I can finally see my sister again. Dr. Good tells us that Trinity has made significant progress. She has adjusted to her new medicine, made some friends, and even has gone a couple of weeks without any relapses. Dr. Good is positive about Trinity’s prognosis and even says that Trinity could possibly be released in a few weeks. She leaves the room and we have a few moments with Trinity alone. The room goes silent for a few minutes, then I speak up. I was told not to ask her why she did what she did, so I just make small talk – asking how she is, how she was feeling, and if the food was good. She laughs at the last one, so I feel like the conversation was good. 

***

Things were going well until they weren’t. Trinity retaliated against my dad. She asked him how he could put her in the facility. It was not what she wanted. She would forever be known as the girl who had to be sent to the psychiatric unit, if anyone found out. Trinity was bothered enough to think that people would know. He tried to calm her, but nothing was working. Trinity started screaming and crying. She reached out to attack my parents, but they got away, dragging me with them from the room. Trinity was left alone in a ball on the floor begging for someone to take her life. Soon enough, a nurse entered the room to sedate her. They took her away so we could talk with Dr. Good one more time. She said based on this episode, she would want to keep Trinity for a few more months. Again, this one situation had set Trinity’s life on another track in the blink of an eye. Trinity never asked for any of this, yet she somehow had to pay for all of it. None of this was fair—but is life ever fair?

The realities of mental illness are scary, especially as an adolescent. As a minor, Trinity’s fate was decided by a single event that impacted her life, and then by her parents. She needed the help, but she never had a say in any of her own care.

***

Right now, we aren’t sure where Trinity’s life will go. Situations can change in the blink of an eye. One path leads down another, to where you are meant to be. Our family can only hope that we made the right decision for Trinity: a decision to ensure that once she is okay, she will be ready to take on the world one step at a time. 

(Image attribution: Photo by Anthony Tran on Unsplash)

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