Troubled children become focus of family


PLYMOUTH, Mass. --When Haley Abaspour started seeing things that were not there - bugs and mice crawling on her parents' bed, imaginary friends sitting next to her on the couch, dead people at a church that housed her preschool - her parents were unsure what to think. After all, she was a little girl.

"I thought for a long time, `She's just gifted,'" said her father, Bejan Abaspour. "`This is good. Don't worry about it.'"

But as Haley got older, things got worse. She developed tics - dolphin squeaks, throat-clearing, clenching her face and body as if moving her bowels. She heard voices, banging, cymbals in her head. She became anxiety-ridden over ordinary things: ambulance sirens, train rides. Her mood switched suddenly from excitedly chatty to inconsolably distraught.

"It's like watching The Sound of Music and The Exorcist all at the same time," Bejan Abaspour said.

For her family, life with Haley, now 10, has been a turbulent stream of symptoms, diagnoses, medications and unrealized expectations. Diagnosed as a combination of bipolar disorder with psychotic features, obsessive-compulsive disorder, generalized anxiety disorder and Tourette syndrome, her illness dominates every moment, every relationship, every decision.

Haley's fears, moods and obsessions seep into her family's most pedestrian routines - dinnertime, bedtime, getting ready for school. Excruciating worries permeate her parents' sleep; unanswerable questions end in frustrated hopes.

"The first time we took Haley to the hospital, I guess I expected that they would put it all back together," said her mother, Christine Abaspour. "But it's never all back together."

At least 6 million American children have difficulties that are diagnosed as serious mental disorders, according to government surveys - a number that has tripled since the early 1990s. Most are treated with psychiatric medications and therapy. The children sometimes attend special schools.

But while these measures can help, they often do not help enough, and the families are left on their own to sort through a cacophony of conflicting advice.

The illness, and sometimes the treatment, can strain marriages, jobs, finances. Parents must monitor medications, navigate therapy sessions, arrange special school services. Some families must switch neighborhoods or schools to escape unhealthy situations or to find support and services. Some keep friends and relatives away.

Parents can feel guilt, anger, helplessness. Siblings can feel neglected, resentful or pressured to be problem-free themselves.

"It kind of ricochets to other family members," said Dr. Robert L. Hendren, president-elect of the American Academy of Child and Adolescent Psychiatry. "I see so many parents who just hurt badly for their children and then, in a sense, start hurting for themselves."

Christine Abaspour, 39, struggles to master the details of Haley's illness, to answer her obsessive questions, to keep her occupied. Laid off from a medical assistant's job, she fears being unable to find an employer who will tolerate her frequent need to interrupt work for Haley's sake.

Bejan Abaspour, 50, who long believed that Haley was "going to grow out of it," has been gripped by anxious thoughts and intrusive images that rattle him to tears on the hourlong commute to his job as an anesthesia engineer at a Boston hospital. He imagines people being crushed by trucks, Haley getting assaulted, his own death.

Haley's sister, Megan, 13, has been so focused on Haley and determined not to add to her family's burden that in June, after a quarrel with her parents, the anxiety led her to tie a T-shirt around her neck in a suicidal gesture.

"I feel like she gets all the problems, and I feel like I have to take some of that off of her," Megan said. "It's really difficult a lot to try to stay away from babying her and helping her. I try to stay still, but it just hurts, it hurts inside."

Haley, with her shy smile and obsidian eyes, is increasingly aware of her own problems, although she cannot always express exactly what is going on inside. "My mind says I need some help," is how she described it recently.

Her illness has caused great financial strain; although the Abaspours have health insurance, they have been forced to draw on their savings and lean heavily on their credit cards for living expenses. They have bought a trailer in a New Hampshire campground because there Haley finds occasional solace, and relatives nearby understand the family's ordeal.

The family wrestles with deciding whom to tell about Haley's illness and what to say. Her worst symptoms are most visible at home and less apparent at the public school and the state-financed therapeutic after-school program she attends. Her parents say she works hard to hold herself together during the day and then later, feeling more comfortable with her family, falls apart.

This disparity in behavior is not uncommon, said Dr. Joseph A. Jackson IV, Haley's psychiatrist, and, "Parents often get the brunt."

Because of the contrast in Haley's public and private behavior, her parents are wary of telling people that she is mentally ill.

"I don't want anybody to pity her," Bejan Abaspour said. But they also get frustrated when teachers or relatives play down the seriousness of Haley's illness or conclude that she is being manipulative or that another child-rearing approach would help.

"We're sick and tired of trying to prove it to people," Christine Abaspour said.

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