Emotionless WHAT DO YOU DO when they simply don't care?

[comatheart]

I haven't been here in awhile. We had a good few months, then he had a reaction to abilify and was weaned off. Things have been going downhill ever since.

I seriously don't know what to do with him anymore. I just don't get it. He has no emotion in any of this.

Grades are crashing to D's and F's. He was caught shoplifting. The store was willing to let it go, but this was offense #4 (that we are aware of) and so I told them to press charges. I would have balled my eyes out if I were caught shoplifting. If not then, when the police arrived to take me away! I would cry every day that I had to either be doing school work or housework and *nothing else*!

His court fees (so far) are $250. We have told him he is grounded from everything until that is paid back. We will "pay" him $20 a week to do all of the housework. At that rate, it will take 3 months to get ungrounded. If he chooses to do outside work then his restriction will only be over faster. (Did I mention he HATES work of any kind!?) He's mowed the neighbors backyard for $25, but only because we didn't give him an option when they asked him.

He. doesn't. care.

There is no emotion in him.

He apparently isn't scared of his D and F because now he has ANOTHER one. husband got a call from his biology teacher yesterday. He's disruptive in class and his grade is no longer passing because he isn't doing the work.

I am frankly at a complete loss.

He is getting his basic needs met, that's it. Besides beating him, there's not much else we could do to him!!

What do you do!?!?!?

We left his psychiatrist because they were horrible about returning phone calls when it was urgent (Abilify issue... our regular pediatrician finally stepped in and said he needed to come off it and helped us to wean him) I found a GREAT new doctor, but we are still waiting for his new patient appointment which isn't until the end of Oct.

 

[buddy]

wow, i just dont know what to say specifically to help but I really feel for you. I can certainly relate to a child who just does not get the same intrinsic rewards for doing things or trying as neuro-typicals. My son could care less about grades, they are off his radar. His IEP says he is graded based on his IEP goals because he has cognitive delays so can't perform at grade level, but still, he doesn't have a clue what grades mean and what they will earn him in the future. In his case other than finishing school he wont earn much with them anyway so I dont even bother worrying anymore about it. But he loves school (being there that is) mostly due to the routine...so at least we have that.

wow, to deal with a jerk of a psychiatrist....sorry you have to wait for what feels like forever to see another. Do they have a cancellation waiting list? Might be worth being on that.

I sometimes can even imagine myself in your position to a degree FOREVER since my difficult child is so disabled. Yikes, I am so sorry for you. Please know I care and wish there was an easy answer

(you didn't say if there is an IEP or school category he is taught under....If he is, time for a new FBA...they need to attack these behaviors on their end in an appropriate way, grades and failing him are not enough of an intervention method for him obviously) IF he is not, well time for one! smile.

 

[keista]

My official mom opinion (I have absolutely no letters behind my name) is that he's depressed. Possibly other stuff going on, but very little indication of anything else in what you wrote. Apathy (not feeling anything) is a defense mechanism against depression. Feeling nothing is preferable to feeling constant pain. Problem is, it could actually cause a lower level of functioning.

Unfortunately, in my opinion and experience, there is very little you can do for him right now, if he is unwilling to attempt to help himself. I'm not talking anything major, but he has to WANT to stop feeling miserable - doesn't mean he'll be able to, but he has to want it as a goal, very difficult in apathy - only then you can try therapeutic activities and such. Right now, you can wait for that psychiatrist appointment and hope the next medication might do him some good, and you can hyper-focus on anything positive in his life, and try ignoring the negatives. He got a D instead of an F on a test or quiz? YAY! Time to celebrate! He got that lawn mowed! YAY! Party time! Show him and prove to him that even the smallest little efforts mean a lot.

Poor kid, poor you. I hope the time to psychiatrist appointment flies by for all of you.

 

[BusynMember]

Depression and autistic spectrum disorder can make kids look emotionless. In the case of depression, which I have had since childhood, you actually feel numb and you get to the point where y ou just don't care about anything. Sometimes aggression and dangerous lifestyle is used to take your mind off of the neverending depression. I would do this at times, although never broke the law. I didn't care about my grades either. I was too depressed to care. I didn't care if I got yelled at. Again, too depressed to care. I wasn't trying to be difficult...I was sick. Alone, I cried a lot.

In the case of autistc spectrum, the kids care, but don't know how to show it and are often seen as emotionless, although they aren't. They have a lot inside of them. But they tend to wear a flat expression and often talk in a monotone, unless extremely excited by something.

I always like to point out that a bad reaction to any medication can cause depression and/or a flat affect as well. Never discount the medications. They are the reason for strange behavior more often then we like to think!

Those are the reasons I know of that cause this flat affect. I am guessing he is depressed because autistic kids DO get upset and may even rage if they do something wrong because they are sensitive kids who don't do criticism well and because they don't know how to show emotion except to over-react.

(((Hugs))) Hope you find the answer soon!

 

[InsaneCdn]

Are we sounding like a broken record yet?
I'm guessing... secondary depression, as an option.

The difference between primary depression and secondary depression is:
- with primary depression, the depression diagnosis IS the major problem... and other problems come as a result. In this case, you have to deal with the depression in order to make any progress.

- with secondary depression, however, OTHER dxes - and especially other un-diagnosed conditions! - can lead to depression, especially where accommodations and interventions and medications are not in place and/or not working properly. In this case, you have to find and get solutions for the other, underlying problems. We've been there done that. To a far worse level of depression than you are describing...

It would be helpful to know what other testing has ever been done, and any dxes, accommodations, interventions and medications...
Also helpful to know... how has he done in school in general? (up to now)

 

[Methuselah]

Hi Comatheart. I am sorry you and your family are suffering. One question: is your son without any emotions or is he not feeling guilt, shame or remorse for something a person would normally feel badly about doing?

 

[Zardo]

I agree with the depression suggestion, but I am also wondering if he could be using substances. Belive me, I mean no judgement. We had a similar situation, similar age and found out that that had been a contributing factor. You would be surprised to know that they don't have to be going out to use them. Some use at school, some at home, in their rooms at night, etc., etc. I know many that got caught up in that during this age and showed similar symptoms. It may not be the case at all, but I would keep a watchful eye.

 

[flutterby]

MWM nailed it with her description, I think.

 

[susiestar]

This is just anecdotal, but I have been here long enough to see it often enough that it greatly concerns me. I would INSIST the doctor change him from zoloft to another antidepressant, pref NOT effexor. In males that have had parents come to this board, after a few months on zoloft they get more depressed and sometimes even violent. My son could not tell me what was wrong, but after about 3 months on zoloft he got surly, more violent and then NOTHING mattered to him - total apathy and depression far worse than ever before and then he started cutting and otherwise purposely hurting himself. At the same time, three other moms here saw the same thing with their sons on zoloft. I have yet to find a doctor who even will LISTEN to us, but we ALL found that when we got a different antidepressant on board then we saw HUGE improvement.

DO NOT STOP THE ZOLOFT SUDDENLY OR with-O STARTING ANOTHER medication AS YOU TAPER IT OFF. You do NOT need withdrawal on top of it. That is a HUGE reason why I do NTO recommend effexor. It is one of the shortest acting antidepressants of its type and if you are as little as thirty MINUTES late with the next dose you get all sorts of awful symptoms like brain shivers (feels like an electrical shock in your brain, strangest thing I have EVER felt and it was AWFUL) AND you have a nasty withdrawal syndrome that can last for over a month unless you get a substantial dose of another antidepressant on board. My son has done amazingly on luvox for six years, but it isn't right for everyone.

We saw what you are seeing when our son was on zoloft. It wasn't until after he was on another antidepressant (also SSRI type, they can be very effective) that he was able to tell us taht with the zoloft he could not feel anything at all. Nothing mattered to him except his obsessions (part of his asperger's) and even those didn't mean much. He watned to die but couldn't even work up enough feeling to try -that was terrifying to me, worse even than suicidal ideation. At least with wanting to kill yourself you want something, even if it isn't a good thing. That may nto sound rational, and of course we didn't want him to kill himself, but the idea that my very passionate son with opinions about EVERYTHING was not feeling or wanting anything was truly one of the scariest things I ever thought/felt.

NOT all males experience this on zoloft. Most don't report it if they do. Few docs have a real clue about ssri/snri antidepressant withdrawal or side effects - they hear too much from the drug co reps and too little from patients. Heck, my own doctor didn't remember I had been on effexor or had bad reactions/side effects (same that my son had, we were on it at the same time). The third time that she tried to rx it to me, after I had told her verbally and in writing about how it made me feel, was when I got a new doctor. He hates effexor because he had the same feelings and problems. If a doctor can't take the medication properly to avoid the withdrawal, even with his staff helping him take it on time, no way can a regular person.

 

[comatheart]

Thank you for your responses.

I agree, he is depressed. I think that has become very clear in the past week. He swears he is not depressed. He has sworn this for over a year to us and his counselor and old psychiatrist. Everyone could see it but him.

Someone asked....He isn't without emotion, his emotions are just not appropriate. For example, on Thursday a child in the neighborhood came to our door after school and told my husband that our son had been messing with kids on the bus and threatening them with mace! The kids here all ride the same bus K-12, so there were teenagers and small children around him. My husband came into the kitchen to discuss it with our son who denied doing anything wrong as usual. Turns out he had gone into our room and stole the mace from us and taken it to school "for protection". He could have been expelled from school for threatening kids with mace if he had been caught. When we explained that to him, all he can manage to do is smile about it! He didn't care one bit!

He goes through these ups and downs in mood. When he gets this careless attitude, his grades (which are very good otherwise, he is even enrolled in AP courses) plummet, he does stupid things such as lie, steal, cut himself, injure or threaten to injure his siblings. We've caught him abusing drugs (marijuana) in the past. He swears he's clean right now and hasn't touched drugs since we last caught him. He will be submitting a drug test tomorrow for the court so we'll see....

It's just so frustrating. It seems none of our punishments work because he doesn't care. Therefore he doesn't learn from his experiences and continues to do hurtful and illegal things. We're basically raising a cold hearted criminal! We try to be good parents and are very involved and consistent but with this kid, it simply doesn't matter what we do.

 

[TeDo]

I agree with susie. Definitely sounds like a medication change is warranted, sooner better than later.

 

[keista]

I agree, he is depressed. I think that has become very clear in the past week. He swears he is not depressed. He has sworn this for over a year to us and his counselor and old psychiatrist. Everyone could see it but him.

He won't see it if this is "normal" for him. I don't know his hx, but I do know that DD1 didn't realize how off she was until she wasn't off. I saw symptoms in her at a very young age.

All that negative behavior is him trying to feel something, or trying to find a reason for all those negative emotions that he is feeling. Once he succeeds in "feeling" something, he gets a certain satisfaction from it, and as a result feels a certain joy or happiness. Twisted as it sounds, that's what usually is going on with depressed teens.

Have you considered tweaking his medications? If you can't get through to him, a medication adjustment may help, at least to the point that he sees a glimmer of hope in his future and then you can get through to him.

 

[TerryJ2]

Great advice and ideas here. I agree. Best of luck with-the new dr. Fingers crossed.
And many hugs.

 

[Wiped Out]

Sending gentle hugs your way. My daughter has dealt a lot with depression and when she gets apathetic it is so hard to deal with because nothing meant anything to her. She is a very smart girl who completely tanked her grades; she didn't care-too depressed. This was always so hard for us to deal with. Both my husband and I are teachers and so it was very difficult for us to understand the not caring about school (along with anything else).

She graduated this past summer and is taking her medications on a regular basis right now and we are seeing much improvement.

 

[susiestar]

MANY people have NO idea how off they are until they are not "off" again. My mom went on and off prozac for years. She would stop it because she was coping well and enjoying life and it would be fine for months or up to a bit over a year. then she would have problems and not see it and then end up back on it. It has been this way for a couple of decades. There are a few behaviors that start at the beginning of depression for her, and after a few years of it all, she would have me tell her or her doctor or therapist if she started them, then she would go on medications and it worked well. A lot of her depression is from having a chronic illness (several actually) and the pain.

SO that is normal.

Has he ever been evaluated for mood disorder/bipolar? The cycle you are explaining COULD be bipolar. Not all people experience the stereotypical "high" of mania. It can present differently or a person can get into a "mixed" state.

If he hasn't ever been on ONLY mood stabilizers or mood stabs and an atypical antipsychotic, then that might be a road you want to try.

Why not antidepressants? Well, they can cause mania in some people. they also cause mood cycling in those with bipolar. Seems odd, as though the depressed part of bipolar should be treated with antidepressants. It just doesn't work that way. WHen you find the right mood stabilizers/antpsychotic cocktail, it can get rid of all of the depression and other symptoms of things like adhd, etc.... If it doesn't but moods are stable, then you can add adhd medications, antidepressants, etc.... in small amounts.

Or it might be really really persistent depression. Wiz is on THREE antidepressants. One for adhd (strattera), one for depression (luvox) and one for insomnia (trazodone, a tricyclic antidepressant). Also, not all antidepressants are ssri/snri medications. there ARE other types and for some people the ssri/snri ad's just don't work well but the older types are more effective. It would be worth researching the types of ad's available and then asking the doctor about that or about trying the medication protocol approved by the board of psychiatrists for bipolar (using mood stabs and antipsychotics until stable, then treating whatever sx are left).

 

[comatheart]

Has he ever been evaluated for mood disorder/bipolar? The cycle you are explaining COULD be bipolar. Not all people experience the stereotypical "high" of mania. It can present differently or a person can get into a "mixed" state.

Yes, his old Psychiatrist felt he was bipolar. I started to doubt it after our daughter started seeing this new Psychiatrist over the summer for severe behavioral concerns. Her Psychiatrist feels quite strongly she will have a bipolar diagnosis when she is older. Her birthmom had bipolar and she has clear, classic signs of it now, plus she reacted very badly to an antidepressant which further pointed in that direction. Her wild behavior is so different from that of my son's, I thought he must have been misdiagnosed!?

Anyway, we are switching my son to the Psychiatrist my daughter sees. She seems to really know her stuff and I admire the fact that she will not label my 6 yr old bipolar even though the odds are that is indeed what she is suffering from. I am anxious to see what she thinks is going on with my son.

We had a pre-hearing today at the court for his Larceny. So far, he owes $789 in court fees. My husband and I are making him pay us for the court fees as his punishment. I just know the increased amount is going to make him go further and further into hopelessness.