My Daughter Experienced Major Depression. How Can She Move Forward?

Summary

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Podcast Summary: Talkaboutable with Dr. Susan Swick

Episode: My Daughter Experienced Major Depression. How Can She Move Forward?
Date: October 7, 2025
Host: Dr. Susan Swick (with Jessica Cordova Kramer)
Guest: Liz, mother of two surviving daughters

Episode Overview

This episode explores the challenges faced by Liz, a mother grappling with the aftermath of her middle daughter Alexa’s death in 2020. Liz describes helping her eldest daughter, Ava, navigate major depression and the journey toward adulthood, responsibility, and healing. The conversation covers grief, mental health, family dynamics, parenting through trauma, and practical steps to foster growth after immense loss.

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Key Discussion Points & Insights

Family Background and Traumatic Loss

• Introduction to Liz’s Family (01:27)

  • Liz lives with her husband Edward, her 18-year-old daughter Ava (just started community college), her nearly 14-year-old daughter Stella, two dogs, and a cat.
  • Middle daughter Alexa passed away in July 2020 from a rare illness (HLH – Hemophagocytic Lymphohistio).
  • The family experienced deep, ongoing grief and has tried to create space to process it together.

• Alexa’s Story (03:45)

  • Alexa was healthy until a sudden, persistent fever led to a rare diagnosis.
  • The COVID-19 pandemic delayed treatments and complicated her care.
  • Liz: “She got a really high fever just out of nowhere... and we lost her on July 7th of 2020.” (05:25)

Parenting Through Grief & Depression

• Ava’s Mental Health Struggles (06:18)

  • Following Alexa’s passing, Ava struggled with depression and was hospitalized twice for suicidal ideation.

  • Over two years, Ava cycled through therapists, medication adjustments, and hospital stays—most care was virtual due to the pandemic.

  • Liz wrestled with guilt over lowering household expectations for Ava during her darkest period.

    “I’m very aware of it...But now she is kind of playing you. And I was like, I know, but I was also grieving...”
    — Liz (09:11)

Shifting Family Dynamics & Parental Worries

• Ava’s Current State (06:18, 08:58)

  • Ava has started community college and shown some initiative (babysitting and driving jobs) but spends significant time alone and disengaged from family chores.
  • Liz is anxious about “how do I talk to her to get her to understand... now she really needs to become a productive member of our society and our household” (09:04).
  • Husband Edward notices Ava is more cooperative when Liz isn’t present.

• Guilt and Self-Reflection

  • Liz admits, “I created this problem,” referencing how she relaxed boundaries during Ava’s depression.

  • Dr. Susan Swick and Jessica reassure Liz, emphasizing her resilience as a mother:

    “Given the picture you paint of these three girls, you’re clearly an extraordinary mom... you need to pat yourself on the back every single day.” (11:30)

Return to Routines, Changes in Home Life

• Loss of Old Routines & Rebuilding (20:08, 21:10)
  • Family meals and togetherness changed after losing Alexa, worsened by losing their kitchen table and the pandemic forcing new routines.
  • After a recent home renovation, the family now gathers at a new kitchen island for meals, rebuilding a sense of togetherness.
  • “That’s a great metaphor...it is how it feels.” — Liz, on the “solar system” metaphor of their family’s changed dynamic (23:18).

Supporting Ava’s Progress & Independence

• Ava’s Relationship with Liz (33:54)

  • Ava is close to Liz but sometimes withholds information to avoid burdening her mother.
  • Family dinners have improved this dynamic by providing time for open conversation.

• Encouraging Ownership and Healthy Habits

  • Dr. Swick suggests reframing talks about chores as skill-building for future independence rather than punishment.

  • She emphasizes “leaning in with curiosity”—openly asking Ava about signs of depression, her emotional state, and how to differentiate tiredness from depression (37:24).

  • Encourages joint activities (like running) as opportunities for bonding and supporting Ava’s well-being.

    “Our most effective treatments, actually for mild to moderate depression, are good sleep and exercise three to five times a week is as effective as medication.” — Dr. Susan Swick (44:21)

• Moving Forward Together

  • Liz expresses excitement about establishing new routines, such as running together and redefining chore responsibilities.
  • There’s a new openness: “I think having the discussion and asking her, what do you think you could do?... I think that could work.” (46:11)

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Notable Quotes & Memorable Moments

• On Grief and Parenting:

  "Grief is never over... it’s a lifelong project of integrating and the legacy of it stays with you."
  — Jessica Cordova Kramer (05:39)

• On Maintaining Compassion While Setting Boundaries:

  “It’s how we show we love each other, that we take care of the tough stuff together… And what part could you do?”
  — Jessica Cordova Kramer (45:25)

• On Self-Compassion for Parents:

  "You can't just be her mom offering... You had to conduct a big disjointed orchestra on Zoom to get her what she needed. It is an epic, grueling undertaking. No wonder you didn't push her to do chores in the midst of this..."
  — Jessica Cordova Kramer (31:43)

• Liz on Growth Amid Guilt:

  “I do acknowledge I’ve done a good job on the big things, but now I know it’s time to work on those little things and bring those back. I am kind of excited about moving forward a little bit.”
  — Liz (46:34)

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Timestamps for Important Segments

• Liz introduces her family: 01:27–02:47
• Alexa’s illness and passing: 03:45–05:39
• Ava’s depression and hospitalization: 06:18–07:30
• Liz’s guilt around chores & boundaries: 08:58–11:30
• Family meals before, during, after loss: 20:08–22:40
• Rebuilding routines after renovation: 21:10–23:18
• Dynamics with Ava and sharing feelings: 33:54–35:23
• Strategies for supporting Ava’s transition to adulthood: 37:24–39:44
• Encouraging exercise and shared activities: 43:31–45:22
• Action plan for chores and moving forward: 46:11–46:54

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Summary Takeaways

• Grief reshapes family life in both visible and subtle ways; routines and expectations must adapt.
• Parenting through a child’s depression requires both compassion and eventual reintroduction of boundaries, with an understanding that recovery is nonlinear.
• Open communication—with children and within oneself about guilt and limitations—is vital.
• Small, practical steps, like increasing shared activities and slowly reintroducing chores, help rebuild normalcy and foster readiness for independence.
• Parents deserve self-compassion when reflecting on choices made during crisis—survival and love guide those choices.
• Progress is incremental, not perfect: “The project is more about the process.”

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This episode offers tangible hope and gentle guidance for parents confronting the intertwined realities of grief, mental health, and the messy work of growing up—reminding listeners that healing and connection are both possible and worthy of patience.

Transcript

[Liz]

Lemonader. She's going into college. She just started her first year at our local community college. And how do I talk to her to get her to understand that while I kind of allowed it over while she was deep into the depression, now she really needs to become sort of a. How do you. I don't even know how to say it, but a productive member of our society and our household.

[Dr. Susan Swick]

I'm Dr. Susan Swick and this is Talk About Able. Liz is a mother and wife living.

[Jessica Cordova Kramer]

In the suburbs of San Francisco. In 2020, her family suffered an unspeakable loss. And since then they have together been trying to make the unspeakable speakable, or in our words, talk about Able. Her focus today is going to be.

[Dr. Susan Swick]

On how she's helping her oldest daughter.

[Jessica Cordova Kramer]

Handle the and move into the adult part of her life. And we're going to be talking together about how they've moved through their grief.

[Dr. Susan Swick]

This is a conversation about how sometimes our kids superpowers can also be their kryptonite.

[Jessica Cordova Kramer]

So let's jump in. I would love to start by finding out who's at home with you. Who lives in the house with you.

[Liz]

Yeah, so I live with my husband Edward and my 18 year old daughter Ava and our 14 year old. No. So she's 13, almost 14 year old daughter Stella. And we have two dogs and a cat.

[Jessica Cordova Kramer]

Whoa, two dogs and a cat, that's awesome. Is Ava a senior in high school?

[Liz]

Nope, she's actually just graduated in May and now she is in community college locally and living at home.

[Jessica Cordova Kramer]

Got it, got it, got it. And what's she studying?

[Liz]

She actually wants to do what you do. So she wants to either do psychiatry or psychology, but I think her ultimate dream is to own some sort of. She wants to run a group home for teenagers.

[Jessica Cordova Kramer]

Oh, wow. Well, she and I will follow up on this conversation.

[Liz]

Yes.

[Jessica Cordova Kramer]

Okay. And what about Stella? Is Stella a ninth grader or an eighth grader?

[Liz]

Eighth grader. Okay. And she is extremely, extremely motivated child. She's in all star cheer, which takes up all her time. She's recently decided she wants to do volleyball. So right now we're doing a volleyball clinic. But she has it in her head that she's going to do all sorts of things in high school. And yeah, she's kind of the opposite of her older sister.

[Jessica Cordova Kramer]

Got it, got it. Tell me about your husband's work.

[Liz]

He is in finance. He worked for the Same company for 22 years before he got laid off last year. So right now he is my. I joke he's my house husband, but he hates. And I see he's a stay at home dad at the moment, taking care of the kids and helping out with driving around. And he's probably gonna start looking again very soon. But we've enjoyed a year off after 22 years of him commuting an hour each way at 4am to San Francisco, so.

[Jessica Cordova Kramer]

Oh my gosh.

[Liz]

Yeah. But I think he's kind of enjoyed being at home and I think he needed the break as well. I think the timing is actually really good. As I'll tell you, we've all been craz grieving for the past five years and I think this has been a really good year of growth for him to have that time to actually grieve.

[Jessica Cordova Kramer]

Well, tell me, why don't we go right there. Tell me about Alexa.

[Liz]

Yeah. So Alexa is our middle daughter who would have been 16 right now, and she passed away in 2020. So her story is still hard to talk about a little bit. But it started with a fever. She was a very normal, healthy and she was out playing in her soccer game, first soccer game of the season. And she got a really high fever just out of nowhere. And that fever didn't go away. And so two weeks in and multiple tests, they sent her to Children's Hospital Oakland. And thankfully, actually in our perspective, there was another child there that had the disease that she was ultimately diagnosed with. And it's very rare and it's very hard to diagnose. And it's called hlh. It stands for Hemophagocytic Lymphohistio. And generally it means that the only cure is a stem cell transplant. So we started that process. It was determined that my husband was going to be the donor. And so we started the process. And Then March of 2020 hit and the pandemic and everything got slowed down. And by the time we got to the point where they were ready to proceed, she was very ill. She had progressively gotten worse. And so they kept delaying and delaying and trying different things. And she had an episode in June of 2020 where she. They didn't think she was going to make it through the night. She kind of powered through somehow, worked a miracle and she came back from it and they said, okay, it's not ideal, but this is the only path forward is we're just going to start the transplant, we're going to do it now. So they did her stem cell transplant and she to day 10 and had some complications and we lost her on July 7th of 2020.

[Jessica Cordova Kramer]

Liz, I'm so sorry. What an ordeal. What an odyssey. Grief is never over each person's grief story. It doesn't mean it's always the same day to day. But it's a lifelong project of integrating and the legacy of it stays with you. So maybe let's jump in and hear a little bit about what is giving you. We know it's giving you heartache. What's giving you a little heartburn right now. What are the things that are actually worrying or keeping you up at night these days?

[Liz]

Yeah, that's easy. It's the same thing that it has been since the day Alexa died, which is honestly Ava and her. It segued. What the worry is, I should say, over the years, but initially it was very much just her going into depression and some mental health challenges we had. And I don't want to go into too many details because it is her story, but she's okay with me sharing that she has twice been hospitalized for suicidal ideation. That was all within the first year and a half of Alexa passing away. Since then, she has been in a much more stable place because we've gotten the mental health help that she needs. But she now it has segued into where we are at the moment, which is that she has just turned 18. She is starting community college, but she is not driven. She does not want to do anything. She spends 90% of the time in her room. And I am going to openly admit that I created this problem. But she does not do chores. She does not do anything around the house. She does now have her license. And I will say she is now helping with driving her sister to places when she needs. We are paying for the car and the insurance and the gas most of the time. So she understands, understands that as a part of that is that she has to help us when we need her help. But she does not have a job. She did, I will say she's motivated herself recently to start doing some babysitting and she's now driving. This she did do on her own. I'm very proud of her. But only recently she found a family that needs somebody to drive their kids around after school. So she started that a couple weeks ago. She's driving them to picking them up from school and driving them to activities. So I'm just now starting to see a little bit of motivation in her. I just very, very worried going into. She's going into college. She just started her first year at our local community college. And how do I talk to her to get her to Understand that while I kind of allowed it over while she was deep into the depression, now she really needs to become sort of a. How do you. I don't even know how to say it, but a productive member of our society and our household. Not even just the bigger picture, but she does know what she wants to do. She's very clear that she. She knows she wants to continue school after this and get her not just her bachelor's, but her master's and possibly a PhD. And she's starting to research all of her programs and her options. And she does know her clear path in life. But I worry that she's not really going to be able to get there if she can't do so much as help me load the dishwasher every once in a while.

[Jessica Cordova Kramer]

Yeah, tell me about help me load the dishwasher. Are there times where you'll ask her for help and she declines? Or she starts and then sort of peters out and wanders away? How does it go?

[Liz]

She will mostly just decline and say, oh, you know, I just had a. And I know she's playing me a little bit. I'm very aware of it. But she will say, I just had a really hard day. You know, it was just. It was very hard. I had to drive the kids to three different places today. I mean, this is what our conversation was yesterday. Or, you know, if we ask her to walk the dog, she will. Occasionally she will do it, and then other times she will say, you know, I just. I can't tell today. I just can't today. I just need to go to my room and rest today. And I will say, I know I'm gonna. I said this now twice, but I know that I created this. And my husband has told me over the years, like, you've gotta stop doing this. It was okay when she really was in a deep depression, but she is not now. And now she is kind of playing you. And I was like, I know, but I was also grieving and I was also going through things, and it was just easier to say, okay, fine, I'll do it, than to do what I used to do. And the old me, the person pre Alexa getting sick, would have, you know, we. They all had chores. They all had a place in the family, and our family has shifted. I have changed. I am not the same mom I was before, and I'm not the same mom I think I would have been had she not died. I had to do what I had to do to get through my grief. I very much acknowledge that I'm aware of it. But now I've gotten myself into a place where I know that I. I have work to do to help Ava get to where she needs to go, and I just don't know how to get there.

[Jessica Cordova Kramer]

So you mentioned first that Edward said, this is sort of your doing, mom, that you said it was okay. So when she was depressed, were you kind of running interference for her and saying, just let her be? How did that go?

[Liz]

Yes, I think that was pretty much exactly how it went. He would say, you really should. We should make her do it. And I would say, no, I really think that we need to be, you know, lax with this. And I have asked him recently how, you know, how is she when I'm not there when you ask her to do something and I'm not there? And he told me she will do it. Most of the time, she will do it well.

[Jessica Cordova Kramer]

And I feel like there's a piece of this story that I'm going to invite you to not be quite so hard on yourself, that given the picture you paint of these three girls, that you're clearly an extraordinary mom. And you and Edward have raised beautiful girls, and you've been through an experience that is extreme. The hardest experience I think parents can go through, and you're still raising your girls, and that is a wonder, and it deserves admiration and applause. And you need to pat yourself on the back every single day. That's incredible. And I wanna. It sounds like this sort of accommodating her wish to retreat. That happened mostly when she was depressed, and she was really depressed for a while. It sounds like it takes a lot to get into a hospital, just from an insurance perspective. I would imagine that you make it sound like you just were lazy and didn't push her, but I would imagine it was as much about wanting to find a way to keep her safe. You lost one girl, you didn't want to lose two, you don't want to lose two. And trying to find a way forward that is going to get her the treatment she needs, needed, and maybe still needs and keep her safe, rather than it being you giving up your job.

[Liz]

Yeah.

[Jessica Cordova Kramer]

Yeah.

[Dr. Susan Swick]

After this short break, Liz will tell me more about her family's home life. This episode is sponsored by BetterHelp. October 10th is World Mental Health Day. And this year, Better Help is shining a spotlight on therapists who are doing their part to make the world a better place each and every day. Think about all the stories you've heard about success, love, personal growth. Now think about just how many of those Outcomes were possible because of the.

[Jessica Cordova Kramer]

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[Dr. Susan Swick]

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[Liz]

Up until 2015, I actually was home mostly. I worked just very part time a couple days a week while they were at school. So they had me home when they were younger, right up until Stella was in, I think, first grade. So they were used to mom being the one to handle kind of most of it landed on me. Now, my husband is, you know, he's a great dad. He's very into gold mining, and he goes gold panning, and he would take them on the weekends to go gold panning and. But he. He was more the fun dad.

[Jessica Cordova Kramer]

Okay, I got it.

[Liz]

I would say, yeah. But at the same time, I, you know, I was. It wasn't super hard. I wasn't super hard on them, but everyone had, you know, a couple of chores that they would do each day. They'd help me set the table, and some would help me with loading the dishwasher and, you know, just very little things around the house. It was. Nobody had any. They each had, I think, two chores. We didn't have a chore chart. It wasn't. I wasn't watching it. They did not get an allowance, though, either. It was just, you do this because we're a family, and we all held that.

[Jessica Cordova Kramer]

Okay. That's actually more than most families do, by the way, because it takes a lot to set expectations, to spell it out, to hold the line, to create some routines that reinforce those expectations so it doesn't maybe all feel punishing. Some kids doing a chore is its own reward. They feel proud. Other kids need a lot of feedback and support. Other kids just need the threat of punishment if they didn't do it. Did you have a sense? Was each of your girls one of those kinds of kids, or did everyone just go along with it?

[Liz]

Well, so Ava's my rule follower, just like me. So she just did the chores. She didn't ask. She didn't. It was just. Just no problem. And Alexa, she'd grumble a little bit, but she would also just do it because she, you know, whatever was supposed to be done, she had to make sure it was done. And it was, you know, she was the one who had her homework done. Second, she came home from school. Ava. We'd have to push a little more to do it, but then she would be like, okay, I know I have to do it. Stella. No threat. Nothing would get her to do it. And she. We usually ended up. And she was a lot. When by the time I went back to work full time and things shifted a little bit then she was, you know, still only in first grade. So she had very, like. She was the one to sort of, like, help me put these plates on the table type of thing. So she didn't have any kind of specific. I'm waiting for you to do this type of chore. And then now, though, which is quite ironic, is that Stella, I have no trouble getting her to do things around the house. We'd give her an allowance if she does them. If she doesn't do them, she doesn't get it. But she is responsible for loading the dishwasher every night. And she at least twice a week will vacuum and sometimes mop the floors for me. And some of that she just sort of takes up on her own, like, hey, I see that it needs to be vacuum. So I'm going to go ahead and do that tonight, which I appreciate. She's shifted quite a bit in recent years.

[Jessica Cordova Kramer]

Yeah. Well, it sounds like she has internalized what you maybe told them, that they're all citizens, you're all part of the same family, you're on the same team.

[Liz]

Yeah.

[Jessica Cordova Kramer]

That's fantastic. I'm curious about family dinners. When they were little, did you guys all eat together once Edward got home from the city?

[Liz]

Yes. Yep.

[Jessica Cordova Kramer]

So you had dinner together almost every night?

[Liz]

Yes. Yes.

[Jessica Cordova Kramer]

Yeah. What was dinner like?

[Liz]

I mean, your typical family dinner. Same as it was in my house growing up. But, you know, we would sit around the table, we'd talk about how their days went, how school was and, you know, and some of that shifted when Alexa was in the hospital. It was very much a transition of when she got sick. But while she was away in the hospital and we were full time, there was a period, a point where she was no longer able to be at home. So we had about four months straight where she was in the hospital. And we were all. My husband and I had to take turns because of the pandemic going in, and our children had to stay at his brother's house with their family, and they kind of had to quarantine with them for a period. It was a challenging time. But during that time, we had some neighbors who kind of went in and helped us with some stuff. And we had had our kitchen table never really fit in the spot in which we had it in our kitchen was. It was just too large and it was very old. And so our neighbors asked, can we get rid of it? Because we had some family that were going to come when she got very ill. And so we let them get rid of the table. And so when we came back from the hospital after Alexa passed away and we were all back in the house again, we came back to this house with no actual place for all of us to Sit together. Besides our formal dining room, which never felt right, we never wanted to do that. And dinners would be frequently just somebody in one person in front of the tv, a couple people at the counter. Ava might take her food to her room. And so that was something we had never allowed. We had never allowed you to take your food away from us at dinner. But it felt at the time what we needed to do. We all really just wanted our space. Every single one of us wanted our space at dinner. And we just sort of got into that habit and it took a long time. And then. And last year we renovated, actually it took a long time and we had a six month long complete renovation of our first floor. And now we have this very large kitchen island and that is where we usually sit to eat together. And whether we order dinner out and get takeout or I'm cooking dinner, my husband's cooking dinner, once the food is there on the island, everybody just sits and they sit and they stay. And you know, even the nights where Ava's like, you know, mom, I really want to go to my room tonight. Which is, is not often anymore. She will usually just sit with us, but sometimes I can still talk her into it. Like, are you sure you want to go upstairs? What if we just talk about how your day was? And usually she'll be like, okay, let's do that.

[Jessica Cordova Kramer]

Such a beautiful story that losing anyone, but losing a child is an earthquake, and bigger than an earthquake. It reorders your solar system. And it sounds like you've begun to settle into a new constellation where you can be in each other's orbit in a way that feels loving and generative and doesn't just hurt, doesn't just highlight what's missing. So it's a beautiful story. I'm glad you have that island to gather at.

[Liz]

Thank you. That's a great metaphor that explains it very well. It is how it feels.

[Jessica Cordova Kramer]

Yeah. And it sounds like you very naturally let everyone do what they needed. In the aftermath of this, I find myself wondering, when Alexa passed away, were Ava and Stella, were they surprised or had they been kind of. I mean, it's really hard for a 12 year old to maybe appreciate sort of, how is someone doing? And it sounds like actually it's there was hope at every step of the way that she was going to stabilize and be able to respond to the treatment. But did it feel connected to what had been happening in the weeks or days right before? Or did you feel like it came a little out of the blue?

[Liz]

I think by the time it happened. They were aware because we had the incident about a month before she passed away, where she was. We were told she wasn't gonna make it through the night. And we flew. My parents flew out, my cousin, my best friend from high school, my sisters, all three of my sisters, everybody flew out and came to the hospital and said goodbye. And then, and then she turned around, which was, I mean, it was fabulous at the time and we were so thankful. But that was the point where we actually had to sit down with them and tell them. That was the point where they were very shocked. They were. It did not cross my mind that she was not going to get better. But then she turned around and came back and yes, we all got hopeful again. But when it took a turn for the worse, again, they were very aware that it could happen. And so they were a little more prepared, I think. And again, I wasn't with them a lot of that. And they were relying on my amazing sister in law and brother in law to really be the ones to let you know, to cry on them. And they explained a lot of it to them. Like every time something happened that needed to be passed on to my girls, they took care of making sure they understood what was going on.

[Jessica Cordova Kramer]

How wonderful that you had a loving committee. Your solar system had a lot of big planets in it to take care of them so that you could do the impossible, which is to take care of your acutely and seriously ill child and two other children in the midst of a pandemic. I mean, it's a little, it's kind of mind boggling that you did this.

[Liz]

I think this is one of my favorite phrases of it was that the pandemic sort of cushioned our grief quite a bit. It allowed us the world. I think one of the things I hear other grieving parents is that the hardest part is that as soon as the funeral is over, everybody's life goes back to normal. And you are still very much in this deep state of shock and just deep, deep in the grief. But for us, the world was not normal. Nobody was back to work. It allowed me time to ease back into work. It allowed me time to, with the kids, not rushing back into activities. You know, we had time to kind of sit in our grief in a way that I think other families don't get. And so while it was awful and the pandemic was awful and the pandemic is awful for everybody, it also, there were pieces of it that were actually beneficial to our family at that time.

[Jessica Cordova Kramer]

Yeah, yeah, it's a Wonderful observation. I can see how grief, I've often heard it described as also feeling like. Like you're moving in slow motion compared with everyone around you. And to be in sort of, you know, quarantined, essentially, like we all were in your home with everything being virtual, you have that buffer so that you and your family could move in slow motion together. How did you first figure out that Ava was depressed or getting depressed? Did she talk to you or was it just you and your husband noticing things? How did that emerge?

[Liz]

So towards the end of Alexa's illness, she had expressed that she really wanted to talk to somebody. And so, and I honestly don't remember the timing, but I am pretty sure before she passed away, we did find a therapist, but it was challenging because it was. Everything was virtual. Every. Every child needed a therapist. There just weren't enough openings. But we did manage to find somebody. And so she continued to see her after. And there was a point where her therapist had reached out to me to say, I'm extremely concerned about her mental health and I think she needs more than just talking to me. So that was the point where we sought a medical doctor to help prescribe some meds. And we got her on some meds. But that takes. That was one of the things people don't talk about. People don't know that it takes a very long time to get the right meds, to really do the trick for each person. And so it was a couple year journey of trying different things. And we even had to switch doctors at one point to find one that she felt a little more comfortable with. And all of this again during the pandemic. Everything was on Zoom. It was super challenging, but we did get through that. But that two year journey, like I said, it included some inpatient stays in the hospital. We changed therapists. There was a point where that, that therapist said, this is a little more than I can handle on Zoom. I'm not, you know, she was very open that she just didn't feel like she could take her on. So we found somebody else. And she saw a different therapist for quite some time. And that at one point, that did go in person for a little bit, and then it went back to Zoom. And so. And yeah, and then she's been seeing the same therapist the last year and a half or so, but we were actually switching again now. Just some things going on with this transition to high school and or college. She asked to see. She said she'd like to see somebody else. We changed insurance again, so kind of coincided with that. And so now we're actually looking for a new therapist, and this time I'd really like to switch to in person. She's been on Zoom for many years, so I'm hoping to find her an in person therapist.

[Jessica Cordova Kramer]

I mean, again, you're going to get bored of me patting you on the back, but I do want to. To point out that it's extraordinary that you are able to. It's such a difficult thing to manage, looking for mental health support for a child. It just is. It was 10 times tougher during COVID as you've described doing it in the aftermath, in the midst of grief, in the midst of COVID It's extraordinary.

[Liz]

It was not easy, and I. It sounds simple now, years later, but it was not. I was actually just thinking about this the other day. I remember taking a walk with one of my closest friends who lives in my neighborhood, and it was right before Ava went inpatient, or maybe it was while she was inpatient, and that may have been while we were out, but we were deep, deep, deep in it at the time. And I remember saying to her, I just can't handle this. I cannot do. This is so much harder than when Alexa was sick. And I was like, I can't get the resources could. When Alexa was sick. And. And I just. Everything is already so hard. I just was. I was bawling. Just. I remember we're walking. Just walking down the street with the dogs, and. And I was like, why. Why can't it just. I just can't handle this right now. Like, I just want to tell Ava I'm sorry.

[Jessica Cordova Kramer]

You can't.

[Liz]

You can't be depressed today. I need you to be okay, because I can't handle it. But I was like, but I can't do that. I need to find her help.

[Jessica Cordova Kramer]

And.

[Liz]

And it's. And I have a great. Like, I do have a really great network of friends and family that have been able to be here for me. And that's when she helped me. She helped me find some people to talk to that could help me find the right resources. And we did find. You know, we did. We were able to get her what she needed.

[Jessica Cordova Kramer]

But you couldn't just be her mom, and you couldn't just be her mom offering. Keeping her talking with you, keeping her connected, giving space for grief and depression, which are different things, but connected, and they rhyme with each other. You had to do that and conduct a big disjointed orchestra on Zoom to get her what she needed. And it is an epic grueling undertaking. No wonder that you didn't push her to do chores in the midst of this without it even being about fears for her safety and wanting to make sure that first and foremost she's safe, that you're providing her with that safe holding environment.

[Liz]

Yes.

[Jessica Cordova Kramer]

We're going to take a quick break.

[Dr. Susan Swick]

And then we'll be right back with Liz.

[James Corden]

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[Jessica Cordova Kramer]

Okay, so I have a, I have a question about the present. Now come back to the present. When is Ava likely to talk to you? Now. And are you two, she's still an empath. Is she a talker? Is she a talker with you? Or is she a quiet and private child?

[Liz]

She does talk to me. And actually I have had every one of the therapists she has seen has told me that it's very apparent to them how close she is with me and how much she, how much she values her relationship with me very much. Which really makes me feel good that I've at least done that. Right. But that said, she, I would seem to answer your question. She does talk to me about certain things. I think, again, because of her empathy. I think there are, I think she's cautious with what she tells me, but I don't dig into that. I think she's very much aware that there are things that might hurt me and she doesn't want to make that. And so every once in a while she'll hint at something that I'm like, well, I didn't know about that. Why have you not, like you talked to me about a lot of things and I didn't know that. And it's just little things here and there. And I realized, I've come to realize that it's because she doesn't want to burden me with that piece of it, that she feels she can handle it without me. And I know she does have some friends that she's close with that she talks to, but I know there's a whole side of her she doesn't share but she does talk to me. She does tell me a lot. And these family dinners now where she can sit down and talk to us have been very nice, I would say just since we finished our renovation last October is when we're starting. It's shifting more and more the right direction.

[Jessica Cordova Kramer]

Yeah, no, you're rebuilding that time together. You're building something that's new, too. It's a new table. It's lovely. I'm not surprised to hear that she's worried about burdening you. That's what empathic kids are like, especially oldest kids and oldest kids that have been through a really disruptive time and grief loss. I wonder if when she's telling you a little something that you're like, why didn't you tell me this before? I wonder if you could actually share that. Your observations that you've shared with me, where you get to say, you know, I wonder. It can be as explicit as mentioning that you treasure her empathy, her deep attunement, the thing that makes her interested in pursuing psychology or psychiatry. And that deep attunement also makes her maybe vulnerable to worrying about others, wanting to buffer others from all that she feels, and may be vulnerable herself to getting overwhelmed sometimes by all that she carries. You could wonder about that with her. Say that, I know that's your superpower. And superpowers often have that shadow side. They confer some vulnerability. And to say, you know, I'm always. I'm always here for you. I want to hear about all of it. You don't owe it to me. But to say, I can handle it. I can sit next to you. And you and I have been through some pretty heavy things. Some pretty heavy things, and we can bear this one together. I also wonder, when you see her retreating or staying at home, are you at all worried that she's sort of getting depressed again?

[Liz]

Yeah, absolutely.

[Jessica Cordova Kramer]

Yeah. Okay. Because that's natural. But you could ask her about that. You could just say, hey, you say, I have some expertise on you. I've known you a long time. And you say, but you have even more expertise on you, especially about what's happening inside you today. And say when you're in your room a lot, or when you say you're too tired to help with dishes, there's a little radar that goes up for me of like, is she just tired because she's in a new school and she's doing a new job and taking care of little kids really is tiring? Or is this depression? Because depression can look like all of that and Say, how would you know? You could say to her, how would you know Ava? Like, can you tell the difference between just being tired and the inklings of depression and wonder with her? How does she sort out that difference and maybe even the difference between those two things and grief to wonder out loud with her because she's figuring this out while also trying to launch and be a functional adult. And the good news is, although maybe her physical habits are ones of maybe retreat, some avoidance, lower energy, her ambition is present, she has interests, she wants to pursue them, she wants to study. It sounds like she has friends. So if you were talking to me as a psychiatrist, I would say, well, I need more information from her. But so far the outward signs are promising that what's going on is we need to help, give her some nudges to help her maybe take good care of her physical self, whether it's sleep or exercise or good nutrition, and help her start internalizing some of those habits, some of that discipline, maybe that's what we're talking about. So that when she's living on campus or living on her own, she can do those things. Things leaning in to inquiring, inquiring with her about it. Does that feel possible or is it such a. Yeah. Do you guys talk that way?

[Liz]

You know, we do a little bit. But I have to admit that, you know, when Alexa first died and you know, she turned 13 just a few weeks later and I know now with my 13 year old at home that 13 year olds don't talk to you. I mean, if I am with Stella, I mean, everything I do, my laugh annoys her and embarrasses her, I talk too loud and. Which I do, but I don't need her to tell me that. But everything I do is wrong. And with Ava being my oldest and I was not in any state to know anything at that point, I mean, I don't even. Honestly, the first year after she died was very much a fog. I thought I was fine at the time. And I look back thinking I don't even, I don't think I knew that I was even walking somewhere. I would, I was just in this really, really weird place. So I, I didn't know any different. And so I think I very much got used to her not talking to me and like that was just the norm and, and I don't, I didn't know any different. And so now, now that she's older and she does want to talk more, I'm not really, I, I'm seeing, oh, 18 year olds do start to talk to you again. And I didn't know that could. So I think some, some of me is still like, okay, you're still my baby. And then there's also the piece of it too that you brought up of me being very afraid of, you know, she's going to go back into a depression. You know, I was just thinking the other day. So she actually came home a couple days ago and said that she just took a job dog sitting at somebody's house. So she's going to go and stay at the home for a week, a full week. And my first thought was, and I don't think I was even aware of it until just now, my first thought was, you can't be away from me for a week. And I was thinking, how am I going to know that you're okay? And now And. But we had, we actually had a very lovely conversation about it where I was like, wait, what? You're not going to be home? How you're going to sleep somewhere else? And she was like, mom, I thought you wanted me to be more independent. And I'm like, I do, but. And she goes, don't worry mom, I'll still rely on you to eat. I'll come by for dinner and I'm sure she's going to ask for me, for me to doordash her some food occasionally. But yeah, so. But I was good, glad she took the gig but it was hard for me to be to I really. It's taken me three days to come to the conclusion that, okay, this is more about me. She's doing what I've asked her to do, she's doing what I wanted her to do. And here I am being like, you can't go away.

[Jessica Cordova Kramer]

Well, I love that is such a beautiful story because it highlights that there may even be this unspoken peace which is she may feel like that's what I'm doing to help my mom. Mom, I'm just staying very close. I don't know what the two of you do together for fun. It doesn't sound like there's a lot of time, but I wonder if there is dog walking that could happen together. Or whenever she is likely to be in a talking place for you to be able to be curious about the things we've been talking about and even including your fears, you know that when you go to your room or you're too tired, I worry you might be getting depressed again. And just to say that, that it should, there's no reason not to discuss it, that it is not A threat to your well being. You show her that when you talk about it. And in fact, that her job as she becomes a full adult is to be an owner of her gifts and her strengths and her vulnerabilities and to know when to ask for help.

[Liz]

That's great. That's a great suggestion. I have to say, she did actually mention to me not too long ago that she feels like she hasn't been super healthy and she's considering taking a breath running, which is interesting because this child has never done exercise in years. It's a big one for a little while. She actually did acrobatic silks for a little bit. And that was. She was in pretty good shape then, but she hasn't done that in a few years. And so I was like, okay, well, that's interesting. And I used to run. I completely stopped and now my workouts are at my. I have a peloton and I'm. I do my workouts at home in the mornings. But now that you're saying that, I was like, you know, this is. That is the perfect opportunity for me to. I could start running with her. She will talk to me then. I love that as an idea, and I'm saying it here to hold myself accountable to that because I love it. Okay, I'm gonna.

[Dr. Susan Swick]

We're gonna check in with you.

[Jessica Cordova Kramer]

And remember, perfect is not the project. The project is more about the process. And you might even tell her, this is gonna help me to do it. I really wanna. Will you do it with me? And you can do walk runs for starters. And it's a lovely time to be talking about that project of how do we take care of ourselves? How do we take care of ourselves when we've suffered an immeasurable loss that leaves a hole that makes every other pain or discomfort pale, but also can make it hard to know when they deserve attention too. That depression is treatable. Right? And our most effective treatments, actually for mild to moderate depression are good sleep and exercise three to five times a week is as effective as medication. And so making it a routine with her can be so protective.

[Liz]

I love that. I'm going to do it.

[Jessica Cordova Kramer]

I love it. I love it. Oh, I was going to say that's the piece that would be so important, is can you add in a few chores where you just get to say, look, it's not meant to be punishing and I'm here to support your health and your growth. And when we, when you live alone, you're going to have all these chores on your shoulders. I want to help you build the sort of muscle memory to do things even when you're a little tired. And it's the kind of family we are, you know, that we. It's how we show we love each other, that we take care of the tough stuff together. And what part could you do and then. And you get to think about that maybe on the run, too.

[Liz]

Yeah. I think that will be key with her. I think having the discussion and asking her, what do you think you could do? Could I give you just that the bathroom she shares with her sister becomes her responsibility? Or I know she'll push back on that one, but maybe I give her some suggestions, but let her ultimately choose. I think that could work.

[Jessica Cordova Kramer]

Yeah.

[Liz]

I do acknowledge I've done a good job on the big things, but now I do know that it's time to work on those little things and bring those back. So I. I am. I'm actually kind of excited about moving forward a little bit.

[Jessica Cordova Kramer]

Yeah. Yeah. Well, you're back to having dinner together. I love the idea of going on a walk or a run. It's so beautiful.

[Liz]

Thank you.

[Jessica Cordova Kramer]

All right, well, thank you so much. Thank you, Liz.

[Liz]

You're welcome.

[Dr. Susan Swick]

If you haven't subscribed to Lemonada Premium yet, now is the perfect time. You can listen to Talk about Able completely ad free. Plus you'll unlock exclusive content, like a special meditation from me that'll help you find peace through some of your biggest parenting challenges. Just tap the subscribe button on Apple podcasts. Head to lemonadapremium.com to subscribe on any other app or listen ad free on Amazon Music with your prime membership. That's lemonadapremium.com don't miss out. Talk about Able is produced by Lemonada Media in partnership with the Ohana center for Child and Family Mental Health at Montaj Health and made possible through funding from the Montage Health Foundation. Together, we are committed to helping families talk about the issues that children, teens, and young adults are facing today. We believe that when these conversations happen at home, even the most challenging subjects, children build the skills they need to flourish. Because when families are connected, the hard moments become more bearable, the good moments become even better, and it all becomes Talk about Able. This show is produced by Aria Bracci. Mixing and sound design by Brian Castillo. Kristen Lepore is senior director of new content, and Jackie Danziger is vice president of narrative and production. Maggie Crowshaw is our main managing director of partnerships. Executive producers include myself, Jessica Cordova Kramer, and Stephanie Whittles. Wax and a Very special thanks to Kelsey Talley and Maya Smith. You can help others find our show by leaving us a rating and writing a review. Thanks so much for listening.

[Jessica Cordova Kramer]

Talk to you next week.