I will never know for sure why my son chose to leave us because he is the only one who can tell me. Even so, I still want to try to understand. For those who knew him, they may find understanding helpful in their healing process. I do not know what it provides for me to write down what I think I know and understand. Perhaps writing it down stops my brain from continually spinning.
He did not share his diagnosis widely with his friends. I assume he did not want to be different, or maybe guys do not share that kind of personal information.
My son was diagnosed with attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADHD) when he was in the second grade. ADD/ADHD is a neurodevelopment disorder that comes with inattention, distractibility, and can be accompanied by hyperactivity and impulsivity. It affects 2%-12% of all children, and for 40%-60% of those affected children, it continues into adulthood. It can be linked to addictive behavior, greater use of alcohol and marijuana, anti-social personality disorder, and high risk of self-injury behaviors (Balazs, J. and A. Kereszteny, 2017). He did not share his diagnosis widely with his friends. I assume he did not want to be different, or maybe guys do not share that kind of personal information.
Two symptoms of ADD are the inability to follow through and avoidance of tasks that require mental effort, so he rarely would follow-through on seeking mental health services.
My son’s second-grade teacher suggested he be evaluated for ADD/ADHD because of the symptoms he displayed in class. He was such a happy boy, full of interests, talkative, caring, but he could not focus. Looking back, my husband and I see there were signs while he was in the first grade. He and his best friend were in the same classroom together. His friend was a lot like him, happy, full of energy, bouncing off the walls. They played hockey together, snowboarded, played T-ball. Every day a note came home from his teacher that he had been given a strike for misbehaving. Five strikes in a week brought us the luxury of talking to his teacher. At first, we just thought the notes were the consequence of young boys being boys. We are thankful for his second-grade teacher who figured out the cause of this behavior.
Our son went through a series of medications for ADD/ADHD. He did not like how they made him feel. He could not sleep. He would lay in bed, awake for hours, thinking of stories. He would sometimes draw them out in cartoons while under the glow of a flashlight. The medication made him more emotional. When he reached high school, we never forced him to take his medication because he hated how it made him feel, less in control. As a secondary illness, he would get migraines. I think stress was the cause. He would need a day of sleeping to overcome a migraine once he could get the migraine medication to stay down. At its worst, the occurrence of migraines was weekly. Later, when he was finishing up high school, he educated himself on ADD and wished we would have forced him to take medication.
When our son turned eighteen, his pediatrician moved to a hospital position, and we needed to find a new primary care doctor. His pediatrician never referred us to other mental health professionals, and I did not think to ask. We were on our own to find one. When he started college, we needed to locate a psychiatrist near the out-of-state university he was attending. Even though I found one, I could not schedule appointments on his behalf for privacy reasons. Two symptoms of ADD are the inability to follow through and avoidance of tasks that require mental effort, so he rarely would follow-through on seeking mental health services.
He had these bursts of greatness, and he enjoyed learning, but his ADD made it hard to manage everything required of a high school and college student.
My son was smart. He was good at math, completing high school math up through Advanced Placement (AP) calculus. He started college with credits for AP macro-economics. In his second year in college, he took an architecture class. Each person in the class had to design and build a hanging bridge out of popsicle sticks. He spent many late nights making the bridge in his dorm room. I remember him telling me it was an engineering effort to carry it across the campus in one piece. The judging was both on style and weight-bearing. The professor tested it based on how many books it could hold. His bridge held the second most number of books in the class. He excelled in his college microeconomics class, receiving accolades from his professor for his ability to grasp the concepts, propelling him into leadership roles on group assignments. My son also was a good writer. He was a sensitive person, thought a lot, and was able to channel his depth of thought into papers for school.
He had these bursts of greatness, and he enjoyed learning, but his ADD made it hard to manage everything required of a high school and college student. We created a 504 Plan (Section 504 of the Vocational Rehabilitation Act of 1973) with his high school and college, but he was on his own to ask each teacher/professor for accommodations, for example, asking for a mentor to help his manage deadlines. The 504 Plan does not require the teachers to be proactive in helping the student. One teacher told me, “I just cannot offer one to one help with over 100 students in my classes.” My son had to do it on his own. Young adults want to be like everyone else. They do not want to bring attention to themselves in a peer environment, so he rarely would stand up for himself to obtain needed accommodations. Earlier, I mentioned a symptom of ADD is difficulty following through, so that reality was already stacked up against him, undermining attempts on his part to follow through on using a 504 Plan.
He loved school, he loved learning and was a good writer. He wanted to be an economist, work in the banking industry, move to the British Virgin Islands, and sail. He just struggled to get through college with the symptoms of his ADD/ADHD.
Relationships
I read in research materials that those with ADD/ADHD will have difficulty with relationships, both at home and with friends. My son struggled with this in high school. He was self-aware and articulately wrote in college about how depressed and desperate the lack of friends made him feel when he was sixteen. He wrote about the importance of building relationships with friends. He wrote about his focus on trying to be a good listener and not complaining about his life, his parents, and his obstacles; he understood that complaining made his friends uncomfortable. He focused on how to be a good friend, to go the extra mile for them, and built genuine friendships across the globe. I know this because of the outpouring we have received and the beautiful stories his friends have shared with me.
I discovered he was a good writer, perhaps because he was sensitive and was aware of his feelings.
He never dated much even though he would receive pages and pages of requests each week on Tinder, a social search mobile app enabling users to chat if both are agreeable. Many of his friends are females. He was such a nice guy and good- looking. He just did not like casual dating and the pressure that comes with it. He had one serious girlfriend who broke his heart. I found a journal of letters in his room after they broke up. Reading these letters is when I discovered he was a good writer. I think it is because he was sensitive. We talked about his writing. I am thankful I had a chance to tell him he had a gift for writing. As his mother, it was hard to see him go through that heartache.
He had a his tendency to avoid things that were difficult, like finding a job and dating. He told her he smoked marijuana socially, but it did not impact his executive functioning.
My son’s close friend died two-and-a-half years before him. This friend was wise, non-judgmental, a confidant with whom to share his “secrets.” My son shared his struggles with his friend who dealt with cancer most of his life, practicing to maintain composure. It is hard for a young person to lose a friend at such a young age. It impacted him, and I do not think his friend’s death is anything he ever got over, having spent so many of his developmental years with him in his life.
As an adult in his twenties, he was happier living with friends than at home. In the last year, after moving in with a friend, the parental deal was he had to seek mental health care. He saw a therapist for six months, went to the psychiatrist once, but was not interested in medication. He stopped seeing his therapist once he found a job, and he seemed happy. After my son’s death, his therapist was willing to share some things with me about my son. As with all people who had known my son, she was outwardly upset because he was such a wonderful person. She shared that their discussions center on how to cope with his ADD. They talked about his tendency to avoid things that were difficult, like finding a job and dating. He told her he smoked marijuana socially, but it did not impact his executive functioning. They talked about suicide. He said he never had a plan, never thought about it seriously.
I spoke with his employers. They too were outwardly upset. His last boss cried on the phone when we talked. They each shared beautiful things about my son. “He took his job seriously.” “He went above and beyond,” they told me. “He was so well liked.” “Such a happy person.” He stopped working at his last job, four months before, to look for something he liked better. He was making progress. He was working on his resume, looking for jobs. The week after his death he received notification that he, having passed the exams, had been granted his bartender’s license. He kept his apartment clean. We went grocery shopping. He did social things with friends.
My son was never diagnosed with other correlated mental disorders such as depression, anxiety, or substance abuse.
My therapist directed me to a national resource on mental illness, National Alliance on Mental Illness (NAMI). Through Twitter I connected with the Minnesota chapter; they have been a useful resource for me to understand what my son had to face. At my request, they have shared relevant information from medical publications.
A high correlation exists between those with ADD/ADHD and other psychiatric disorders. A high correlation, 33%-38%, exists between ADD/ADHD and cannabis abuse/dependence (DeMaria, Peter A. Jr, 2016).
My son was never diagnosed with other correlated mental disorders such as depression, anxiety, or substance abuse, which have well-known risk factors for suicide. He told me he was not that bad off, not like others seeking institutional and outpatient mental health services. I believed him. He did not want to take medicine to function with his ADD/ADHD; he did not like the side effects such as insomnia and anxiety.
I now have learned that young adults with ADD/ADHD and other related disorders may use marijuana as self-medication to relieve their symptoms (DeMaria, Peter A. Jr, 2016). Several friends told me he was smoking marijuana every day (some say it was only social). His dad and I never knew.
I will never know for sure the cause.......
I know everyone from whom he bought (the street marijuana). I know the originator of each of his sources. I know how much he purchased each time.
From what his friends shared with me after his death, he displayed signs of withdrawal and despair that they each individually noticed. It is hard to say if other undiagnosed mental disorders were the primary cause or if the substance abuse reduced his executive functioning and caring, which triggered the despair, and heightened the impulsive tendency that comes with ADD/ADHD.
We are not better off with out him.
I have read stories about those who attempted suicide and survived. Some of the survivors thought, at the time of the attempt, the people in their lives would be better off without them. If my son felt that, I hope where ever he is now, with his friend, my mom, and his aunt and uncle, he can see we are not better off. I wonder if God shields those in their new spiritual place from seeing us grieve because it would be so painful for them to see their loved ones hurting.
I miss him, as do his friends and family. I miss the future life I wanted with my son. His death did not need to happen. His life could have been saved that day. I will forever live with this.
Cited References
Balazs, Judit and A. Kereszteny, Attention-deficit/hyperactivity disorder and suicide: A systematic review, World J Psychiatry. 2017 Mar 22; 7(1): 44–59.
Published online 2017 Mar 22. doi: 10.5498/wjp.v7.i1.44
<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5371172/>
DeMaria, Peter A. Jr, Cannabis Use Disorders and ADHD, Journal of Addiction Medicine: January/February 2016 – Volume 10 – Issue 1 – p 70; doi: 10.1097/ADM.0000000000000184
Letters to the Editor <https://journals.lww.com/journaladdictionmedicine/Citation/2016/02000/Cannabis_Use_Disorders_and_ADHD.12.aspx>
Other References
https://namimn.org/education-public-awareness/health-library/
<http://www.chadd.org/Understanding-ADHD/For-Parents-Caregivers/Education/Section-504.aspx>
