(warning - suicide references)
Clare’s story ended on the twenty seventh of October 2000 when she made a tragic decision to end her life. There had been other attempts but always there had been someone near by to seek help. Medical help and intensive care had always brought her back to us. This time was to be different. On that day she was determined to be successful and escape the Bi-polar disorder that had made her life a shambles.
She was born the youngest of six children; She was a loved and loving child of high intelligence. With so many brothers and sisters there was always someone available to do her bidding. When she was three years old her father and I separated and we went to live in a regional city in South Australia. It was here that she went to crèche and then started school. I know that she missed her father of whom we saw very little but overall she seemed a happy child who readily made friends. Clare was six years old when we returned to Victoria to live because of the terminal illness of my father.
I can think of nothing in her primary school years that indicated anything amiss.
We took a trip to England where I worked for a year. It was probably here that her love of that country began. In later unhappier times she was to speak of the happy times she had there. After our return to Australia she started Secondary school. There were no problems in year seven but in year eight she began to change. In my ignorance I thought it was just teenage moodiness but in hindsight I should have been less complacent. She was often excitable and excited yet at other times she was lethargic and disinterested. She began to truant from school and to become quite aggressive. She would steal her sister’s clothes and give them away to other people. The first of her self -harming occurred when she cut a large hole in her leg with a bottle top. I transferred her to another school in the hope of changing things but it was to no avail. At fifteen she refused to go back to school. I felt this to be a sad step as she was a very bright girl who would have been capable of achieving many things.
Clare began to work as a sales assistant. This bored her and she changed her job several times. Her nightmares had begun and they so frightened her that she began to sleep with the light on and to leave her radio playing softly all night.
Alarm bells should have begun to ring for me yet I still thought she would grow out of her aggressive behavior, her risk - taking and moodiness. I knew that my husband’s mother had been in and out of mental institutions, as they were then called, and had heard stories of her contradictory actions but she had died some years before Clare was born so I made no connection. My husband had also suffered a lot of depression and had used alcohol to help him cope. I now know that this is a common coping mechanism, particularly among men.
Again we went back to England, this time for three years, to my old hometown. Clare began work and made some friends. She was more stable in her moods in that there was less aggression and paranoia but there was still some excited and risky behavior. One memorable example of this type of behavior was her overnight disappearance to London, some 200 miles away. The following evening I received a phone call from her from a small village about forty miles from home. She asked me to pick her up, as there was no transport from there. She did not ever give me any explanation as to how she got there or where she had been so the obvious conclusion is she had just gone off on a hitch- hiking spree.
In Clare’s sixteenth year she had a brief affair with a man twelve years older than her and became pregnant to him. Initially she put the baby up for adoption but after he was born changed her mind and decided to keep him. The next two years were very stable years for Clare. The nightmares disappeared and although there was a little depression there were no major happenings. She was absorbed in her baby and was a very careful mother. She remained living with me and our relationship was warm and close.
Eventually we returned to Australia. Very shortly after our return she met, and later married, the man who was to be the father of her second son and her little daughter.
The depression and mood changes returned, as did the nightmares. Her behavior became unpredictable. She would go on a spending spree and use money she knew was for her bills. Clare began to be paranoid about how other people viewed her and to see hurt where none was intended or even existed. She would spend hours on the phone running up huge bills. She cut off all contact with the brother to whom she was closest, over a perceived slight. She said to me that she felt her persistent nightmare was now occurring while she was awake.
On one occasion she put the children into the car and headed off for Central Australia. There was not even a spare tyre in the car. Fortunately she did not get further than Adelaide where she had turned up at a relative’s house at two o’clock in the morning. Her husband was then able to make contact with her and persuade her to return. He found that she had not being paying the rent and frantic negotiations were necessary to avoid eviction.
Now it was my turn to be cut off for an imagined slight. I received many abusive phone calls and Clare threatened to call the police if I tried to see the children or her.
Clare had been involved in a car accident shortly after we returned from England and had received some quite severe injuries. Some years later she was to receive a relatively small compensation payment for a permanent injury. On the receipt of this money she and the children disappeared. Again we discovered that she had not been paying the rent and eviction was imminent. We were eventually able to trace them to the north of England. She had simply bought tickets and traveled without luggage to England. Here she changed her name, telling the children that someone was out to get her. A few months later she was persuaded to return. She had spent the entire compensation money on fares and living expenses.
It was obvious on her return that she was now very ill. She was very thin and taking so much medication that her hands shook continually. She made the first of her suicide attempts by overdosing on medication. On her recovery she took out a restraining order against me with all sorts of fanciful accusations even though I had made no attempt to contact her. Her second brother was the next recipient of her irrational anger and was cut off from all contact with her. This period of isolation from her was very difficult for all of us as we now realised how very ill she was but were unable to help in anyway. Three more attempts at suicide followed, the last of them came very close to being fatal. She remained in a coma for four days before regaining consciousness.
By now she was being more appropriately medicated and there followed a period of relative stability. Clare began working again and was fairly content. It was not to last. Gradually the depression took such a hold on her that she had to give up work, as her attendance was unreliable.
Clare made efforts to re-establish contact with her family. First she contacted the brother closest to her and then some months later she telephoned me and said that she wanted her family back. I was so delighted as it had been nearly three years since I had been able to see her. I found that she was very ill and that the dominant emotion was now depression. Clare felt that the psychiatric support was very poor and principally consisted of a fifteen-minute consultation resulted in yet another prescription.
Not long before her death she was on six different medications. This left her lethargic and unable to express any genuine emotion. Most of her day was spent in bed and the state of the house deteriorated greatly. After her death I was to learn that if you have plenty of money you have access to some fairly successful therapies and too, hospitalisation when your condition deteriorates.
Clare had for some months been self-harming. She regularly slashed herself with knives and razors and required stitches. Although each time this occurred she attended a hospital no medical person saw fit to do more than stitch her up and send her home.
Clare’s husband James could no longer cope and went to live in a caravan park nearby, although he came to see her each day and to assist with the children.
Clare could not sleep without medication and told me she felt her nightmare was taking possession of her. One night, when a group of people was at the house, she said that she was going for a walk but in actual fact had taken an overdose of all her medication. Fortunately one of the group participants followed her and was able to call for an ambulance. The skill of the hospital staff saved her life. She was sectioned and remained in hospital in a psychiatric ward for a week. Although still not yet well she was sent home. Because all of her suicide attempts had been by overdose the medical staff decided to remove ALL her medication. This abrupt removal without any support or crisis care, I believe, was for Clare the final straw. In the last week of her life she made two unsuccessful attempts to contact support groups. One of them told her she was too aggressive in her manner for them to see her!
I visited Clare, finding her in bed curled up in the foetal position. She told me “I can’t cope. My head’s doing me in, Mum, it’s doing me in.”
On Friday the twenty-seventh Clare took her oldest boy to secondary school where he was in year seven and then drove the other two children to their primary school. At twenty past ten she called her husband at work and asked him to pick up the children after school, as she would be unable to do so. He asked her where she was going and she replied that she wasn’t going anywhere but would not be able to collect them. She told him that she loved him. They were to be the last words she was to speak to anyone.
When he returned to the house she was not there. Later that night she was found dead in her car on an unmade road not far from her home. She had made the final decision.
Since her death we have tried to learn as much as possible about Bi-polar Disorder and we are aware that the disease can largely be managed by appropriate care and support. It is apparent however that there are inadequate crisis care places and that good psychiatric care requires one to have plenty of money. I believe, as does Clare’s husband that if Clare could have had access to these facilities she would still be here with us.