Expanding a dialogue

On a Sunday morning in early spring of 2017, Clark Kelley stood onstage at Riverchase Church of Christ, exhibiting courage that his family said was powerful and inspiring. For the second time in two years, he was sharing some of his hardest struggles — the result of mental illness — with a crowd of people, only some of whom he knew.

Then again, that’s what Clark was like. He genuinely cared. 

He was someone who valued friendships and took time to have the hard conversations, his best friend, Viny Memula, said. If there was a chance he might help someone, his father, John Kelley said, he did. 

“[That day] he just jumped right up there after the service and spoke very eloquently. Clark was a very intelligent, articulate young man,” Kelley said. “It was a powerful message. He got flooded with responses.”

John Clark Franklin Kelley was 22 when he died, but he was diagnosed with obsessive-compulsive disorder when he was 15 and a freshman at Oak Mountain High School, according to his family. 

“He probably thought that these thoughts he was having were things that everybody dealt with,” his sister, Kristin Copeland, said, referring to the beginning years of the diagnosis. 

Later, his father said, Clark’s physiatrist and therapist conveyed that it was a severe case of OCD and depression.

According to the International OCD Foundation, OCD is a long-lasting mental health disorder — one that 1 in 100 adults and 1 in 200 kids are estimated to have — that occurs when someone gets caught in a cycle of uncontrollable and unwanted reoccurring obsessions and compulsions.

When people have OCD, they experience chronic, intrusive thoughts that are difficult or impossible to stop thinking about, which can produce anxiety in day-to-day life and often result in them coping through a compulsion or mental ritual, according to the National Institute of Mental Health.

Clark had a form of OCD that doctors call Pure O, for pure obsession, his family said, which primarily focuses on “mental rituals,” like reassurance-seeking or avoidance behaviors. Some examples for Clark included how he was unable to stop songs from playing in his head, and how he couldn’t stop rhyming words in his head. He had pervasive and intrusive thoughts, Kelley said. 

Depression is often comorbid with people with OCD, and this was the case for Clark, Copeland said.

“He would sink down deep, but he would eventually come out,” Kelley said. “I kept telling him, ‘Clark, you always come out of these things. Remember that, remember that.’”

Depression made treatment all the more difficult. 

“He would basically have these torturous thoughts all day and tons of anxiety that comes with it while living a normal 22-year-old’s life and going to college and being an engineering student, being a fun friend and brother and son, and it was very difficult,” Copeland said. 

Copeland said that Clark’s struggle got progressively worse, and on Saturday, Aug. 5, he was alone at their parents’ house and took his own life. 

On the days leading up to his suicide, Copeland said, Clark had been doing well and was optimistic of his new medication. He had agreed to call his siblings if he felt bad, Copeland said. He even had plans to go get lunch with Memula that Sunday.

 “After reading Clark’s note that he left, it was just really heartbreaking. I mean, we all knew that he had been battling this for years, but it was just heartbreaking for him to think that there was no other option, that what he was going through was so bad he couldn’t continue to live,” said Memula, who had been Clark’s friend since middle school.  

TREATMENTS/MEDICATIONS

Even though she was 10 years his senior, Copeland described her relationship with Clark as close. She and her husband visited Clark at Auburn University, and he would stay with her in Georgia to watch football games, and later to get treatments for his OCD in the month before his death. Kelley said their whole family was tight-knit, and he would often openly talk about his struggles. 

Clark wasn’t afraid to tell his friends that he was working out psychiatric issues, Copeland said, but she wasn’t sure of the extent that he talked to them.

Memula, who was a grade above Clark, used to spend most weekends during middle and high school with Clark and another friend, playing sports and video games or going to Friday night football games. When he went off to college, Memula said that he and Clark stayed close.

“Clark was someone who, no matter what would happen, he would make every effort he could to keep a friendship with you,” he said.

Clark, Copeland agreed, was caring and outgoing, always wanting to connect with people.

The week before Clark’s death, Memula was staying with him in Auburn. He said most nights, they got dinner together, and although they started to talk more about Clark’s OCD, he never mentioned suicide. 

“He was very open about [his OCD], he would never try to hide the things that were going on with him,” he said. “He was also telling me about the things he wasn’t able to do anymore, in socializing, in school.”

Clark was one of the smartest kids he knew, Memula said. They were on the math team in high school, and he had excellent grades. Of course, Copeland said, he also often felt embarrassed and inadequate while working through his OCD and depression.

No treatments for OCD are quick-fixes, and they usually take months to be effective, Clark’s family learned. If they aren’t working, then the process has to restart.

Clark tried countless medications, experimental therapies such as transcranial magnetic stimulation and ketamine infusions, Copeland said, and took a GeneSight test, which determined that he had a unique case that made him a hard patient to treat.

“Nothing really touched his OCD. It would help his depression every once in a while, but the medications didn’t give him much relief,” she said.

Kelley said the medicines also had physical side effects that were debilitating at times. 

In the fall of 2015, Clark took time off school and went to an Exposure and Response Prevention (ERP) Therapy out-patient program at the Rogers Behavior Heath Clinic in Nashville. 

Copeland and Kelley said he did well in it and learned the importance to practice confronting fears and obsessions so he could get more “used” to them in a long-term way. This tactic aims for the eventual goal of having the individual grow so accustomed to the fears that they no longer feel compelled to engage in the compulsions.

For the months that followed, ERP had a positive impact on him, Kelley said, but the trouble was in maintenance once he got back. There is only one therapist trained in ERP therapy for OCD in Birmingham, according to the listing on International Obsessive Disorder Association. 

This limited Clark’s resources, Kelley and Copeland said.

NEXT STEPS

Clark had mentioned suicidal thoughts before, Copeland said, and his family hospitalized him a few times for it, for which he expressed appreciation. “He didn’t want to die,” Copeland said, but he couldn’t get it out of his head. Kelley said that he had talked Clark off the edge many times before.

“He was a fighter,” he said. 

Thoughts about self-harm are a common obsession people with OCD have, according to the National Institute of Mental Health. 

In the weeks before Clark died, Copeland found the International OCD Foundation, a nonprofit that offers an annual conference and resources, including the online portal to find specialists.

“I would encourage people to use that website as a resource, and encourage people to reach past Alabama, out of state, for resources,” Kelley said. “Don’t be afraid to seek help, don’t be embarrassed to get treatment.”

Copeland and her family would like for people to be able to more easily gain resources on OCD, as well as suicide prevention.  

“I want to make sure anyone who knows about OCD — or thinks they might have it or knows someone who has it — immediately has these resources come to mind,” she said. 

Mental health, Copeland said, is a kind of silent disease, and that needs to be changed.

“It requires aggressive treatment and maintenance just like a physical disease,” Kelley said. “It requires a combination of correct drugs and correct counseling.”

As a way to raise awareness and get rid of stigma, the American Foundation for Suicide Prevention puts on an annual Alabama Out of the Darkness Walk, and this year it was on Nov. 5 at Heardmont Park.

For survivors of suicide, Copeland said that these walks can be a way to talk about grieving, shed light on mental illness and meet other people in similar situations. Clark’s family attended, along with more than 100 other friends, family or church members. Everyone wore a T-shirt to commemorate Clark that read “Team Clark: Fighting the Stigma.”

At the request of Clark in one of the final notes he wrote, Clark’s family is establishing a few Auburn University scholarship funds in the fields of psychology and pharmacy. The scholarship will be in Clarks name and for the sake of advancing mental health maintenance, Kelley said. He encourages someone who is inspired by it to reach out and see if it’s available.

 “We would like to leave Clark’s life, Clark’s death to be a legacy of helping other people,” Kelley said. “That’s what Clark would have wanted.”

Additional resources

For more information or resources on OCD, check out these organizations:

► National Institute of Mental Health, nimh.nih.gov

► International OCD Foundation, iocdf.org

► Peace of Mind Foundation, peaceofmind.com

► Intrusive Thoughts, intrusivethoughts.org