By HEATHER BOERNER
Sentinel staff writer

LIVE OAK — When, as a teenager, Kelsey Wilshusen Pfotenhauer told her parents she didn’t like strangers, they couldn’t have known that nervousness would blossom into overwhelming anxiety and delusions and eventually lead her to kill herself at Four Mile Beach earlier this week.

Kelsey, 19, had been diagnosed just last month with a mental illness called schizophreniform disorder.

Her family did everything they could to get her help, but the despair over whether she would get better was too much for her.

Her funeral is today.

Even as her family mourns her, they want others to know their stories don’t have to end this way. The Pfotenhauer Wilshusen family approached the Sentinel to talk about their tragedy, to dispel the stigma associated with mental illness and to show other families there is hope.

They say it’s that stigma and hopelessness that may have prevented Kelsey from disclosing her illness earlier and from persisting with treatment until it could take effect.

"She’s not the victim of a bad childhood; she’s not the victim of a bad family," her father, Rock Pfotenhauer, said Thursday, arms crossed over his chest, tears streaming down his face. "She’s the victim of a disease. She’s the same as people who are victims of cancer or diabetes. It’s just that her disease was in an organ that’s the last to be understood and the most complex.

"I just want people to be able to understand that people who have this can get some help," he said. "There are people out there who recover from this, and there’s help for their family and for people who love them."

Not alone

Carla McSweeney had a similar diagnosis as Kelsey. She grew up in Aptos and still lives in the county, where she holds a job, has an apartment and has, she says, a pretty good life.

"It’s so hard when you have a psychotic break. You aren’t even aware enough to know that you are in a psychotic state," said McSweeney, now 37 and healthy. "You just do what your mind tells you to do. But there is a way out. You just need to keep asking for help and find the right medicine for your disease."

Kelsey’s life was, by most accounts, blessed.

The daughter of successful, compassionate parents — her father, Rock Pfotenhauer is a dean at Cabrillo College and her mother, Linda Wilshusen, is executive director of the Santa Cruz County Regional Transportation Commission — Kelsey was a goofy, bubbly child.

She was active inschool and high-achieving in her classes, starting new clubs and building close relationships.

She found it difficult to make decisions and was anxious in large groups.

As a teenager, she found herself as an artist and writer. Her flair was for photography.

"She brought her camera with her everywhere," said older sister Zephyr Wilshusen Pfotenhauer, who lives in London. "She was very into composition and framing, very organized."

She had a fun, constantly changing sense of style. She took a year off between high school and college, visiting her sister and traveling around Europe.

It wasn’t until she started Antioch College in Ohio last year that her anxiety escalated and new problems arose. At first, her mother said, she seemed to blossom with the new ideas and information. She was enjoying her civic journalism class.

But she began saying the information was too much, she couldn’t "organize it," her father said. She was too anxious to eat in the cafeteria, and she told her parents that an area of town had "an evil presence and she would be harmed by it if she went there."

The hidden disease waxed and waned. She would be anxious, and then the family would get a "wonderfully written, eloquent" e-mail. Christmas was wonderful and Kelsey seemed to be "her old goofy, funny self."

She was talking to a counselor, but was having panic attacks. In early April, she checked herself in to a hospital. She was having delusions and felt she couldn’t breath, like the anxiety was taking over.

That’s when Wilshusen flew out to take care of her. That’s when it became clear to her that Kelsey needed to be home and needed help.

When she came home, she took an overdose of medication.

"I remember talking to her and her saying, ‘I can’t live anymore. You have to let me go,’ " said Rock Pfotenhauer. "That’s when it became abundantly clear that she was seriously ill."

No return

Thus began the painful descent that ended Monday. She checked into Dominican Hospital, but the safety provided by the staff was short-lived. She withdrew and refused to let the doctors talk to her parents.

But she seemed to improve. She was released from the hospital, only to begin the last week of her life.

The family had been talking to mental health agencies and attending classes held by the National Alliance for the Mentally Ill’s Santa Cruz County chapter to help them understand what Kelsey was going through. Kelsey was going to El Dorado, an outpatient mental health clinic.

Still, Wilshusen said, "We were scared to death, and every day we were anxious about whether she would make it through the day."

She told her father she "felt like she was dying.

"Inside her there was something killing her. She told me to leave her alone," Rock Pfotenhauer said. "It was so hard for us. She was so clear about setting boundaries, and we wanted to respect that."

The day before her death, her parents said, she seemed to "turn a corner." She took a long walk with her mother. She drove her grandparents home. The night before she died, her father sat next to her and asked, "Is there anything I can do for you?"

"She said, ‘No. Just go to bed and sleep,’ " he said. "It was such a loving gesture, like, ‘I’m all right. You can sleep.’ "

But she wasn’t all right. The next morning, she slept in, then left for the beach, leaving a note: "Gone to the beach. Be back at 2. Love, Kelsey."

She didn’t return at 2 p.m. An hour later, Rock started worrying. He began visiting nearby beaches, the Mental Health Client Action Network, a drop-in center. Then he thought to check the North Coast, an area Kelsey found beautiful.

As he was driving, he got a call from his wife saying Kelsey’s bottle of sleeping pills was empty. Rock called the police.

The rest is a blur. Eventually, he found her car parked at Four Mile Beach, and a sheriff’s deputy told him what he never wanted to hear. She had jumped from the cliff and was dead.

She left a note: "Mom and Dad and Zephyr, I love you and that’s all you need to know, Kelsey."

"That’s so typical of her," he said, beginning to cry. "She was taking care of us. It was the most beautiful, eloquent note someone could leave."

And then the family, who clung to each other and their friends for support, broke down.

"That night the pain I was feeling was so great," he said. "If that was the pain she was feeling I could understand why she would take her life, and if I hadn’t had Linda and Zephyr, I think I would have taken my own life. She didn’t know a way out of it.

"In getting help, we met all kinds of people with mental illnesses who had jobs, had happiness. We were hopeful she could have that, too, someday."

Looking back, the family can see what now seem to be early signs of her illness: She had a head injury as a child (about 30 percent of people with schizophrenia suffered head injuries); she seemed to use her photography to "organize" the world; her fear of strangers and her general anxiety.

All now seem to have been early symptoms — symptoms they couldn’t differentiate from adolescent stress.

It’s not uncommon for mental illnesses to appear in late teens, said Shuyun David Lo, the psychiatric medical director for Santa Cruz County Health Services Agency. They often appear in times of extreme stress, so it makes sense that it strikes young adults when they move away from home and are dealing with shifting and evaporating boundaries and instability.

"Severe stress can trigger a break," he said.

Psychotic break is a term used to describe the onset of serious mental-illnes symptoms.

Suzanne Koebler, executive director of the Mental Health Client Action Network, said the first break can be the most difficult.

Even if the person figures out they’re having a break, medication takes nearly a month to begin to take an effect.

Kelsey’s parents said she was frustrated she wasn’t getting better.

"We get so many messages from people here who are diagnosed for the first time," said Koebler, who has recovered from a mental illness. "They feel like it’s a life sentence, like they’ll never get better. ... But it can get better. You won’t build the life you had before, but you can have a good life."

McSweeney suffered her first psychotic break after she dropped out of college in her early 20s. At one point, she jumped off a third-floor balcony. Without a diagnosis and because she didn’t know she could get better, McSweeney spent more than three years on the streets.

Her symptoms started with delusions that people in her office were having a party while she worked. They escalated to the point she couldn’t hold a job or care for herself.

When she became pregnant, living in and out of hotel rooms, the voices started. There were lots of them, including a man who repeated phrases over and over again, such as, "be mean to her" or "back at you."

Both children she had when she was homeless were taken away.

She was in and out of Dominican’s behavioral health unit until she was told to either take medication or go to jail. She tried medications that didn’t work and had bad side effects.

Then she found one that worked. And just like that, the voices went silent.

"It was such a relief," she said. "Those voices had just taken over. It took all my energy to deal with them."

Soon after, she found a job at Mental Health Client Action Network, moved out of the group home, and now has a regular life.

"It’s been wonderful," she said. "I want to thank (Kelsey’s parents) for wanting to get help for other people and talking about this.

"And I just want to lay it out for other people: These are lifelong diseases. You have to go to the doctor and get help. You have to persevere to find the right medication. The best thing you can do is talk to someone."

Where you can get help

If you think you may have a mental illness and want to talk to someone, these mental health agencies may be able to help:

Santa Cruz County Mental Health Access Team

(800) 952-2335, 24-hOUR HOTLINE

The team comprises bilingual senior mental health clinicians and psychiatrists who assess and refer to mental health services, and who are trained to answer your questions. They will help you determine if you are eligible for county mental health services.

Dominican Behavioral Health Unit

462-7719

If you think you need to be admitted to the hospital for your own safety.

Suicide Prevention Hotline

(877) 663-5433 toll free OR 458-5300 — 24 hour

Mental Health Client Action Network

469-0462

A peer run, self-help, drop-in center where people with psychiatric disabilities can congregate and socialize in a safe place, free from the stigma of mental illness imposed by society.

Mental Health Client Resource Center

768-8132

The Volunteer Center program offers education, information referrals, technical help, community outreach and volunteer opportunities for people with psychiatric disabilities, their families, friends, teachers, colleagues, employers and therapists.

Community Support Services

459-0444

Staffed by county psychiatrist and case coordinators, the team has a special emphasis on people with both a mental illness and a drug or alcohol addiction, and clients living in supported housing. They provide crisis support, rehabilitation, case management and are on call after hours, weekends and holidays.

Alliance for the Mentally Ill

427-8020

Families, friends and individuals dedicated to improving the quality of life of those affected by a serious neuro-biological brain disorder, and to the ultimate eradication of these diseases. They offer support groups for family and friends of people with mental illnesses as well as research, education and advocacy.

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You can find this story online at:
http://www.santacruzsentinel.com/archive/2004/May/08/local/stories/01local.htm