Thea Fredericksen is an occupational therapist. She was 24 when I interviewed her in Los Angeles, CA on April 12, 2014.
I was first diagnosed with depression when I was 12. But in speaking to my mom about my childhood, from the age of five, I showed symptoms of depression. Like, I was always lonely, even when I had friends around. I always talked about how my heart hurt, which they didn't understand when I was really little, 'cause I didn't have words for things.
Des: Kinda true though, right?
Thea: Yeah. I still use that phrase ‘cause there's really no other better way to say it, I don't think.
My first attempt was when I was 12. It's hard for me to consider what I did as attempts because, at the time, they were really serious and it was how I was going to get out of the pain, but looking back, I was so naive. A 12 year old doesn't understand how to kill themselves. You know what I mean? If it hadn't been for the fact that I have a family who's extremely supportive and got really freaked out by it, it wouldn't have been treated like an attempt at all, which is what it was.
I went to the hospital. It was terrible. Our town didn't have any kind of pediatric psych unit, so I was in with individuals who were going through schizophrenic episodes, a lot of paranoia, and it was a horrible experience. I was afraid to be outside. I was there for a while; for probably three days. Then they released me. I went home, spent a week on my couch, ‘cause I was afraid to leave my couch. And then I got so afraid again that my mom had to take me back to the hospital. I was in again for maybe 12 hours and the doctor told me I had to leave because he said that my attempts were not serious enough, that I was just trying to get attention and so, yeah, they kicked me out of the hospital.
Des: Gives me the twitchy eye.
Now, as someone who works with kids, any attempt that a 12 year old makes is a pretty serious attempt. A 12 year old shouldn't have thoughts like that.
I had to go back to school. I went to school for two days and everyone made fun of me for trying to kill myself. I don't really know how they found out, but there was one boy in particular who'd follow me around and taunt me to kill myself.
I stopped going to school for like three months, which wouldn't, I don't think, have been acceptable, except that I did really well in school. I just did homework and everybody kind of dealt with it.
I was in counseling for a long time and was still suicidal off and on for two to three years, but didn't get hospitalized again until I was 15. That was my most serious attempt and that time Cody, [who is now] my husband, found me and had to like drag me out of my house, find my parents, take me to the hospital. It was terrible.
After that, just seeing how it affected him, I think was why I didn't ever really try again. But obviously, it's not something that goes away, and that's kind of been the hardest part. I mean, it's difficult for everyone, but I was just thinking today that I've had depression for half of my life, and I'm only 24. That's absurd! It's not something that anyone should ever have to experience, but for someone my age, for that to have been half of my life experience? I don't know.
So, I went to college.
Des: Went there, did that.
Thea: That was fine. Then I started grad school and things got really bad again, ‘cause there was a lot of stress and, despite the fact that I'm in a medical field that is largely focused on helping people function in their daily lives, there was a lot of stigma. Classmates were very vocal about the fact that they didn't think I should be in the program because I would have a hard time coming to class or a project might be a day late. On one occasion, in front of the entire class, someone stood up and said that I should not be part of the program. Professor didn't say anything. This is grad school so, you know, adult women who should probably have a hold of their shit and not try to pull that but, yeah, that was awesome.
Des: Did you punch 'em?
Thea: No I didn't, actually. I think I didn't go to school for three days, which really helped the issue, which went pretty well.
The whole reason I wanted to be an OT was because I've had these experiences. I think I have something to add to the profession. I can feel for a lot of our patients, I know what they're going through, I know how hard it is to take a shower some days. I can't do it if I don't have someone there helping me.
I had a professor who said, "You can either take that experience and let it break you and let these people break you, or you can take it and put it into your work and, ultimately, be a better therapist than they're going to be because you've experienced things that they never will."
At that point, I kinda turned it around, I guess. Since grad school, things haven't been quite as bad. I haven't been suicidal for probably a year, but I mean, it's just like everything else. It's never gonna go away, which has been one of the hardest things to realize.
When I was 12 and diagnosed, all the doctors were like... First of all, nobody wanted to call it depression. They said I was just being an emotional 12 year old, which is awesome. Let's just discount young women's feelings because they're young women.
But then it was, "Well, she'll grow out of it. She'll get to be 18, she'll be fine, it won't be a big deal, you won't have to take your meds anymore."
So, I got to be 18 and still had to take my meds.
Des: It's like being bisexual, right?
Thea: Right! Exactly! It's exactly like being bisexual. Yeah, you'll just "grow out of it."
Thea: Right. Yeah.
Still taking my meds at 18, and then they're like, "Maybe when you're 21, you'll grow out of it." Yeah.
So, didn't grow out of it. That's been the hardest thing, realizing that I'm going to be an old lady who has to take medication. I'm always going to struggle with agoraphobia and have to force myself to leave my house. It's complicated, but I get by day-by-day.
The fact that I've been so privileged that my family was really supportive and really involved, even though some members of my family didn't understand it. My parents went to group therapy with me. My mom did everything possible to make things better for me.
Once my relationship with them got bad, it was around the time that I had met Cody, and I just happened to luck out that he's a really patient person like that too. I guess he kind of took over the caretaker role, which is complicated and disturbing and upsets me sometimes, but I don't know. I guess I'm lucky to have had that, and I don't really know where I would be if I hadn't.
I guess I always thought I was going to get to a point where it wasn't going to be so bad and I was going to be able to take care of myself and I was going to be able to take a shower. It hasn't, and it might not ever. It may come to the day where Cody dies of old age and I have to move into a home where someone will tell me to shower, ‘cause that's what it's going to be.
It's hard to be dependent on people all the time and I feel like, especially because of my career, so much of the focus is on being independent and not needing people, and I think that's such a flawed concept because no one's really like that. People who are neurologically typical are not completely independent. Everyone depends on someone for something, and it's just recognizing how much you do so. I may depend on Cody to make sure I eat and shower, but he depends on me to, I don't know, have social interactions, ‘cause otherwise he's like a little hermit crab.
Des: Tell our lovely viewers what occupational therapy is.
Thea: Occupational therapy is not helping your cousin find a job, so don't make that joke because it's really old and everyone hates it.
Occupational therapy is helping individuals perform their daily activities that are important to them to the best of their ability. What I do in schools is mainly helping them function in school—to be able to access academic contact that they wouldn't be able to otherwise, like telling their teachers that it's okay for them to have wiggle break during the day. Teaching the kids how to control their bodies, helping them learn how to write. I used to do home health, and it was a lot of dealing with elderly individuals who wanted to stay in their homes and making sure they were safe there. It's just helping people live their lives as independently as possible which, once again, problematic, but...
Des: How do occupational therapy and mental health intersect?
Thea: So, obviously, mental health has a huge impact on your ability to function in your daily life.
With me, it's the hygiene thing. For other people, it's maintaining a job or sleeping at night. A lot of what we do is analyze an activity and figure out the sections of the activity that are actually giving you trouble. When you look at it like, "Okay, hygiene is hard for me," it's like, "What part of it? Am I physically unable to wash myself?" No, obviously not. It's the energy conservation, ‘cause that's one of the awesome things that depression has imparted upon me is a complete inability to maintain energy throughout the day. Which is why working in schools is great, ‘cause I only work six and a half hours a day, and then I can go home and sleep.
So, we do task analysis and then, a lot of things that a therapist would do, we can do as well. OT actually started as a mental health profession. During World War II when soldiers would get injured...
Des: Keep talking. I'm learning things!
Thea: When soldiers got injured, therapists would give them activities to take their mind off of it. OTs now try to separate themselves from this, but OT started as teaching people how to basket weave and do leather working and wood working and things like that, ‘cause they were stimulating activities that kept you busy. They kept your mind off of the fact that your brothers were fighting and dying. That's where it started out. It's interesting stuff.
What I like about OT is the crafty crap, ‘cause what I need is something to take my mind off of stuff, but other OTs are like, "No, it makes us look too womanly or something."
Des: How do OTs work with other professionals in order to get someone who struggles with, say, mental health difficulties, the care that they need?
Thea: OT in mental health is an area that is horribly underfunded, just like everything else with mental health, but OTs especially are not seen as a necessary service a lot of the time.
What OTs do is kind of bridge the gap. A lot of times therapists, psychiatrists, do that talking down thing without really meaning to because they live in a book world and OTs live in the physical realm—that's how I think of it. We try to dissect the information and present it to the people and, like I said, split it up. So, make a task like taking your medication more simple by creating tools and techniques that are going to make it easier for you throughout your day, like sticking up a note somewhere that reminds you. Using those pill keepers that everyone has now. They weren't so big until OTs really grabbed on to them. It's just about simplifying things and bringing it down to earth. A lot of what OTs do in the mental health realm is job training for individuals who are unable to hold a job: teaching them what their rights are as far as accommodations, ‘cause a lot of people don't realize that you have a right to ask for reasonable accommodations. Legally, they have to provide those and, unless you really advocate for yourself, they aren't going to do that.
For example, if you are someone, like me, who can only maintain energy for a certain amount of time during the day, you can advocate for yourself—or someone else can help you advocate—that you don't have the energy, like somebody with a physical illness, to work an eight hour shift and that you have to be able to work smaller shifts throughout the week, but still maintain a full-time employee status. As well as, if you can't work, giving you mental health days, essentially.
Des: This isn't nationwide, though.
Thea: It's one of those things that you really have to push. And not all employers are going to do it. The other thing is that employers realize that nobody has the money to sue them if they don't do it. It's just like everything else. But OTs are really good at helping you access that information. A big part of what we do is advocate training, like caregiver training, which is really important working with the family and setting it up. Cody could probably use an OT to help him deal with me, but doesn't know many.
Des: Why did you decide to tell your story?
Thea: That was a big thing for me, ‘cause like I said, as much as OTs like to be like, "Oh yeah, we love people with mental illness, we're here for them," there's a huge stigma within our actual career against people with illness.
You'll see OTs who are paralyzed; that's an obvious disability. We see it, we know they can still do their job ‘cause we help advocate for people to be able to do their job with that disability.
But for whatever reason, when it comes to mental illness, no one is willing to say, "Hey, I'm dealing with it too."
Like I said, in school, that was really hard for me, because I put myself out there and was met with animosity by my classmates that I was not going to be able to do the job. So I think it's important for professionals to come out and say, "We're actually human beings too, and we have our own life experiences that we're bringing to this, and that's part of what makes us able to relate to our clients."
The other thing is, because I was so young, I feel like stories like mine are often discredited because of the whole teenage girl thing. We have this thing in this country for whatever reason where teenage girls get to be the butt of our jokes and that's cool, and I think that's ridiculous. I feel like there were a lot of years before I was diagnosed that I was trying to get people to believe me that what I was going through was not normal, [that I wasn't] just a hormonal girl—"not a big deal, she'll grow out of it."
We can't treat young women that way. We can't continue to act like it's just a hormonal thing, like it's a systemic problem. Yeah, your hormones play a part, but I was born with a fucked up brain. That's just the way it is, and if people hadn't eventually taken me seriously, I might not be here.
I know that there's other girls out there who cut and people are like, "Oh, they're just doing it to get attention."
Even if that is what they're doing, even if they're just doing it to get attention, if that's the only way they think they can get attention, then there's something seriously wrong. That's not something to just brush off as teenage behavior.
I think it's important for people who have lived an experience like mine where I felt really torn about whether or not to share my story because they are, looking back, kind of trivial attempts, but in my mind as a 12 year old girl, I wanted to die. I didn't want to be there anymore, and that was the only way that I could imagine doing it.
I think it's just time. We see younger and younger kids killing themselves, and how many of them have been brushed off as hormones?
Des: Do you still have suicidal thoughts?
Thea: It's tough. I went to school in the Twin Cities and then Cody lived in Mankato and, especially in grad school I was very emotionally vulnerable, so every weekend I would drive down.
Then, when I would have to leave on Sunday night or Monday morning, on the drive the whole time I would think, "If I just crashed into that tree right now, I'd be done. I wouldn't have to go back to school. I wouldn't have to deal with the bitches who think I shouldn't be here. No one would get to laugh at me anymore. I wouldn't have to justify to my professors why my paper is a day late because I spent all of yesterday trembling in my bed, afraid to leave it. It'll be done. I'll be fine."
Obviously I never did, but it was every single weekend. It was that thought, "I'll just crash into something."
Since then, it's been much more simple things. I don't really have that plan thought anymore. It's just like, "Wow, it would be a lot easier if I wasn't here."
What's really fucked up is that what's kept me from having those thoughts as much is my student debt because, now that I'm married, I worry that Cody would have to take it on and would have to pay it off, and it just upsets me so much that I'm like, "I can't. There's no way out of it. I have to stay alive ‘cause I have to pay off my student loans."
Des: The one time student debt is useful.
Thea: Right! Yeah. Those student loans have to be paid.
Des: Suicide prevention!
Thea: Right?! Thanks, government!
Des: Thanks for fucking me over!
Thea: Yeah. It works pretty well.
Des: Hey, whatever works. That's a new one, it was good. I like it.
Thea: Thanks. Yeah, now I got Disneyland passes too and I found out that, even if you die, you have to finish paying them off, so I'm like, "Yeah, I might as well stay alive and use them." I don't know who Cody's going to take to Disneyland. He doesn't even like it that much.
Des: How would you like to have been treated by mental health professionals and are you still "in the system?"
Thea: I think it would have been nice to be treated like I actually knew what I was talking about. A lot of times I was just brushed off and they would talk to my mom instead of me which, yeah, I was twelve, I was young. I still understood what was going on, ‘cause I was the one attempting it, so it would've been nice for them to talk to me like that. It would have been nice to be understood a little bit instead of saying that it wasn't a serious attempt and them trying to tell me what I was feeling, which is an experience that a lot of people that have to deal with that system deal with. I'm not really in the system anymore.
I went to counseling from the time I was twelve until I was sixteen, maybe, then I had a break 'til grad school. Then, when I kept thinking about crashing my car, I was like, "I should maybe talk to someone. That might be a good idea," so I saw a therapist for like two sessions and then it made me too anxious, so I had to quit going. Another great thing about anxiety and depression.
Des: Therapy anxiety.
Thea: Right? So helpful! Thank you, brain!
Des: Do you come into contact with suicidal people frequently as an OT?
Thea: Yes, but not now. I work with kids. Most of them are non-verbal, so I don't have to worry about that as much. But when I worked in home health, we lived in this really bizarre area of Iowa, really poor, one of the most food insecure areas in the nation, which is interesting ‘cause there's a lot of farming there. There was a pig processing plant in the town, but no one could afford to feed themselves. So I dealt with a lot of elders whose families had abandoned them, or their families were using them for their social security, or they were hoarders and they lived in horrible situations filled with roaches and bed bugs and all sorts of fun stuff.
Des: All things I love.
Thea: Yeah, all that great stuff. I did deal with suicidal people in that situation and it was interesting.
I don't want to talk bad about places that I've worked or whatever, but people kind of brushed it off as like, "Well, they're just talkin'. They're just trying to get attention."
The same thing that happened to me. So, apparently, if you're either a teenage girl or an elderly individual, you're just trying to get attention. I don't really know when you get taken seriously, but I haven't found that age yet.
Des: If you're suicidal, you don't.
Thea: Yeah. So that was fun. There were people who, it was frustrating ‘cause you'd go to their house, and most of my job there was like re-teaching people how to use their bathroom safely. And they had no interest in bathing. What a surprise. They didn't want to talk, they didn't want me there, they were angry and upset because they didn't want to be alive anymore. Unfortunately, Medicare does not like to pay for me to sit there and talk them through their problems.
Des: Why would it?
Thea: Right. Why would it do that?
So, you always had to work in like, "We're going to do our arm exercises today, but tell me about your grandkids."
It was something I came across a lot, and I think a lot of my coworkers and other OTs don't really know how to deal with it. It's one of those things, when somebody tells you that, you just kind of freeze for a second. You don't really know how to process it. But I think that was one of those situations where my experience helped me, ‘cause I knew they probably didn't really want to talk about why, but if we talked about something that made them happy, maybe that would get them through 'til two days from then when I was going to come back to do arm exercises again.
Des: Do OTs get suicide prevention training?
Thea: Not really. We got mental health training. We did have a course that was on theory and then a course that was on practice. We talked about it a little bit, like warning signs and things like that, but a lot of it is like, "If this happens, notify this person."
Sometimes there is that chain [of command] available to you, but sometimes when you're the only OT working in a home health facility in the middle of nowhere, there is not that chain and you just have to kind of wing it. I think it's hard for a lot of people.
One of the things that bothers me the most is that I went to school with several people who, despite the fact that we have all of this training, are very much like, "Well, if you're not going to fix it, there's nothing I can do. You have to fix it yourself. If you're not going to try..." or "They're just trying to get attention," or "There's nothing I can do about it," and that's so counter-intuitive to what our job is.
I think being someone who's been there—I hope, at least—that I was able to make a difference in those people's lives, but I don't know if I did ‘cause they live in Iowa and I live in California now. So, what are you going to do?
Des: I'm sure you did.
Des: What do older suicidal people look like?
Thea: All of them. Any person.
A lot of times they're the people who are really dirty, and so then people don't want to talk to 'em, but it's ‘cause they don't give a shit what they look like.
One of the people that I had who was suicidal did happen to die while I was there. He didn't kill himself. He fell. He was blind and a hoarder, which is a really awesome combination. Most of the hoarders I worked with, there was some sort of method, but because this guy was blind, there was zero method to the madness. It was just piles of garbage and stuff. Everyone hated him. All of my coworkers couldn't deal with him. He was very difficult to work with ‘cause he was just angry about everything and very much of the mindset that he had made it to this age and it was his decision what he was going to do with his life, which is hard to argue with.
I didn't want to be like, "Well, no, actually you have to hang on," because the truth was that nobody cared anymore. His kids weren't involved. He just lived in this nasty house by himself and tried to take care of himself. He was just really angry, and I think that's why people didn't listen to the fact that he was suicidal, ‘cause they just wrote him off as an angry old man.
But then I had a really sweet woman who looked like your typical grandma, like cute little pastel pant suits, you know? Great hair.
The first thing she does when you walk in is like, "Are you married? ‘Cause I have a grandson who would love you."
Every time. Every time.
Des: That's amazing.
Thea: But then you sit for five minutes and she starts talking about how she's done. All of her friends are dead. She doesn't want to be alive anymore. Why should she have to do arm exercises? She doesn't care. Why should she install a shower bench so she doesn't fall and break her hip? If she breaks her hip, she might die in the hospital. She'll be done.
For whatever reason, once again, old people, young girls just get written off as nonsensical and angry or emotional, but it's a lot of them. I think it's just a matter of being aware of that.
It might be your grandma. Maybe you should go visit her.
Des: What does a suicidal person look like?
Thea: Everyone. This is so dumb that I'm even going to say this...
Des: Say it.
Thea: I never think of myself as like looking like somebody with mental illness. You can't tell. I put on a pretty good face. I can get enough energy in the morning to put on makeup and put on a cute outfit and hide it. The fact that we look for physical signs of it—it's not a reliable source at all. It's so easy to hide something like that. As a teenager, I looked like a suicidal teenager. I wore a lot of black and wore black lipstick. But now I need to keep a job, so I can hide it pretty well.
Des: That wasn't a dumb thing at all. It's funny how everyone I interview prefaces something really brilliant by saying it's going to be really dumb. I enjoy that.
Thea: Yeah, nobody has faith in their own genius.
Des: Is suicide still an option?
Thea: At this point, today? No. I can't say about tomorrow.
Des: How about yesterday?
Thea: Yesterday was good, I think. I don't remember what happened yesterday. Yeah, yesterday was a pretty good day. I got to play Minion Rush with one of my kids for 45 minutes, so that's what I call a good day.
Thea: But yeah, I can't say. I don't know. It's something I'm going to deal with forever, as I've finally come to terms with. I like to think that it's not an option anymore, that I have other outlets, that I have reached a point in my life where I know how to express myself and I have a community—albeit online—where I can talk to people about things like that, but there's no way to say one way or the other, I guess. I don't know. It's not on the table today, though, so it's a good day.
Des: What would you want to say directly to a person reading your story?
Thea: I don't know, sometimes I feel like I'm pumping myself up too much by saying this, but I feel like I have accomplished a lot for someone who, at the age of twelve, thought their life was over. I made it through high school, I made it through college, I made it through grad school, I got my license, I work the job that I love. It's possible. It's not easy at all and it's probably not going to go away, but you have to find something to hold on for.
That was the only thing I remember from my therapy was that I made a list of things I wanted to live for, but it had to be a chronological list. So, first I had to go to this dance. Once I went to that dance, it was okay, I could die. But, oh wait, no. I want to go to Spain. Got to do that our junior year of high school. As long as I made it to Spain, then I could die. But wait, no. Actually, now I just want to volunteer at this place. So it's just about, as the OT in me would say, "breaking it up into smaller tasks"—just finding something for tomorrow. Sundays I just think about, like, "If I wake up today, I can eat ice cream tonight."
Des: Fuck tonight! Eat ice cream for breakfast!
Thea: I don't have time in the morning. I wake up, I throw on clothes, I put on some mascara, and I'm out the door. But yeah, that's what it is.
Or like, "If I wake up today, I don't really have to work that hard, I just have to play with Play-Doh. It'll be cool. It's fine. We'll talk about Monkey Space Princess all day. It'll be awesome."
It's just that and not being afraid to—it's easier said than done—but not being afraid to talk to people about it. Finding people who love you and talking to them and realizing that some people aren't going to have the best reaction, but that doesn't mean that everyone's going to be an asshole. Yeah, I had some doctors who were dicks to me and treated me like I was an idiot, but I also had a therapist who was amazing and who was like my best friend for a while.
Just try not to lose your faith in humanity as a whole, ‘cause there's a lot of us out here who have experienced the same thing and who want to help.
If you’re feeling suicidal, please talk to somebody. You can reach the National Suicide Prevention Lifeline at 1-800-273-8255 or Trans Lifeline at 1-877-565-8860. If you don't like the phone, check out Lifeline Crisis Chat or Crisis Text Line. If you're not in the U.S., click here for a link to crisis centers around the world.
Thanks to Matthew Parr for providing the transcription for Thea's interview. Thanks to Josh Voelker for filming.
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