I just finished reading this multi-layered and beautifully written book about teen mental illness. It accurately portrays various experiences, depression, bipolar disorder, schizophrenia and how each person is able to connect with the others and a wise and compassionate psychiatrist.
Vicky attempts suicide because she feels like she can’t put effort into a life where she’s getting no enjoyment or connection. Her mother died a few years back from cancer. Six months later her father married Barbara, a superficial (only interested in shopping) woman. The two only think of appearances and intelligence as defined by going to Harvard or other top schools, working in an office and being socially on top. Becca, Vicky’s big sister went to Harvard and really didn’t pay attention to Vicky after that. To make matters worse, her family is planning to send their long time housekeeper/ nannie back to Mexico because of physical health issues and not being able to work as she used to.
At school she is failing classes, dropped out of debate, and has no friends.
When she wakes up in the hospital she meets Dr. Desai who suggests she stay at Lakeview hospital for a couple weeks. Every day she will have individual therapy, and group therapy (what they call group therapy healing). In addition each patient does a job in the hospital, like helping fold laundry, working on the grounds of the hospital or in the kitchen. She really doesn’t want to but after one night the other patients convince her to try and stay. Her father and stepmother do not want this but Dr. Desai says it’s up to her and she decides to go for it.
The other patients are Mona, who has bipolar disorder and has come from an abusive family, Gabriel who is wise and mysterious and for the longest time no one knows what’s going on, and E.M there for anger management extremely blunt to the point of total insensitivity but totally caring in his own way.
Vicky finds a friend in Mona. Gabriel and E.M are harder for her to connect with. E.M says some really mean things several times about suicide being for cowards, and when she is persuaded to talk about her family, her mother dying and parents totally not understanding her, he says no one will feel sorry for her. His comments are so cutting that I was surprised Dr. Disai didn’t stop and correct him. She only said let’s not insult people when Mona called him a psychopath and he thought she said psycho Pat LOL
Gabriel is much softer spoken and calmer. He tells her not wanting to live is the illness which resonates with her.
In her meetings with Dr. Desai she goes into more depth about what it’s like in her head, and circumstances of her family. It becomes clear that she lived in an environment full of pressure to excel at things that she didn’t feel were important, didn’t match her values, or that she couldn’t even do. She was totally lost at school, my impression is she might even have a learning disability as she describes how hard taking in information is for her. Dr. Desai mostly listens and challenges her thinking. She is CBT based, but uses wonderful metaphors and a mindful attitude that make her stance gentler than a standard CBT therapist, but at the same time quite firm.
Vicky researches depression on her own. And says she imagines the different chemicals being blocked from interacting right as “brain elves” delivering messages around her brain that get stuck in the tar/ fog of depression. As someone who deals with depression I can totally resonate with these feelings.
At the GTHS Vicky and all others are made to be completely honest. This brings them closer together.
Being able to leave the hospital (something that I doubt would happen in real life) in the midst of their stay to attend Gabriel’s birthday party, gives Vicky a taste of a different kind of family and a possible solution for her Nanny that doesn’t involve having to move.
More and More Vicky is experiencing all of her emotions, and learning to communicate honestly. She’s accepting new truths about herself and her family, and her own strengths as well as choices that she can make even in this tough situation. Dr. Desai and the others empower her to constantly look at herself, be honest and then decide how to present herself to others.
However towards the end of the two weeks Vicky feels like there’s no way she can return home. D Dr. Desai agrees. But instead of extending her time at the hospital itself she tells the group that she has a ranch where she often takes patients on a kind of retreat. They do work around the farm, and have group and individual therapy. It continues the work but in a peaceful natural setting. At the meeting to discuss this with her parents, (who are as against mental healthcare as ever) she’s able to stand up for herself with the help of Dr. Desai.
The time at the ranch expands and deepens what is learned by everyone at the hospital. Vicky finds a different side to E.M She learns the limits of what a friend can do when Mona’s bipolar takes over, and watches helplessly as Gabriel descends into severe psychosis.
There are many lose ends by the time she leaves the ranch with the group having gone through a big crisis and then being split up.
In some ways going home is just as terrible as she thought. Getting through the days at home, the conversations, the way people just aren’t honest with each other wears her out. She tries to hold on to the metaphors and advice that she got back at the hospital. In talking to Dr. Desai at the end of her first week there she says that she should start medication.
This does not sit well with her father. Nor does a meeting at the school where it is suggested she drop some of her courses or even go to a public school. Using the inner strength discovered at Lakeview she is able to put her foot down and firmly catch her father’s attention. She makes him see things he previously hadn’t or hadn’t want to admit like how he pulled away from the family when her mom died. She makes her own choices, that include supporting her new friends through more emotionally breathtaking crisis situations. Help from her older sister, who did some deep thinking about their life at that point as well seems to really show him that this family needs to make a change.
The writing is amazing, the characters so fully developed that you could perfectly imagine running into them on the street.
Some things that got to me. When someone goes to a psych hospital they don’t go off to a ranch after. If they do the program is presented at the beginning of the stay not just something you go and do at the last minute.
Dr. Desai tells the group way too much about other member’s treatment than anyone would ever do! This is important to know as someone reading this could think if they meet a friend in the hospital they could reach out to staff with questions about that person. Rather than getting any answers, never mind the ones Dr. Desai gave, they would be told about confidentiality and HIPPA laws. I know Vicky and others getting this information from Dr. Desai was instrumental in the book but I wanted to point this out.
Patients also do not leave the psych unit, at least nowadays for any reason. At least in the US. We don’t have unlocked units. And so they wouldn’t be doing jobs around the hospital or even eating down in the cafeteria.
The rest holds true to form in terms of mental health treatment. I highly recommend this book for that reason, and the characters true to life experiences of mental illness.