give me some insights into depressed kids....

[pepperidge]

My oldest son has back home this year after a year away in Residential Treatment Center (RTC) where we thought he made great progress in getting himself out of school refusual mode that he has been in since K. We thought he had learned tools to cope with things that required persistence and much more of a sense of self efficacy.

We knew it would be hard for him to transition back to HS but he has a light acadmemic load. He is actually going to school, but not doing any homework, right now participating in class but not sure how much. But he is getting back into the "everything is stupid" mode--stupid he has to do so many hours before he can get his driver's license, stupid that he has to learn math and English, etc, stupid we are not wild about him driving around his beater truck once he does get a license without doors on it, etc. Take away things and he pretty much just goes to bed. Not an acting out behavior problem, his medications are ok (upped his lamictal awhile back). He has one of the worst self defeating ways of thinking. Not interested in therapy--has never been much of talker-- though he does have a therapist. Loves working with his hands, not even really interested in going to the local community college which he can do while still in HS to take hands on classes. He has one good friend who is spending more time with his girlfriend than my son which is a major cause of this recent two week or so funk.

My son just asked me tonight if he could go live with his friends' family. He thinks that spending more time with his friend will help him be less depressed and therefore he will work more at school. Sort of true, but it will be short-lived I think, and what happens if friend is off with girlfriend a lot? I am not sure they have really thought this through. Friend's parents apparently are ok with the idea but I don't think they have any idea what they would be getting into. My son admits that their expectations are higher than ours. Maybe it has some positive features, but lots of negatives. One of the reasons his therapist thought he should come home from Residential Treatment Center (RTC) is that he had some issues with being sent away --not good for adopted kids--and I fear telling him he can go will be seen in his deepest mind as sending him away again.

I'm trying not to rush in and solve all his problems-- hire fifteen more therapists, do major medication changes, go screaming at his teachers to make him like school. School is being pretty cooperative about modifying things etc. I am not sure anyone is really connecting with him there but maybe that is too much too ask. Did anyone ever worry with their kid that they were just going to keep digging and digging themselves into a hole and ultimately kill themselves? My son is a long way from that, but I could definitely see the possibility. Maybe he is just going through bit of reality-checking, seeing his dreams of all time he thought he would spend doing truck stuff with his best buddy not get realized, school being hard, etc. but he is thought patterns are so self-defeatist that I really wonder if he has the resilience and capacity to snap himself out of it.

At what point do you say, its your life buddy, make of it what you will, even though you know there are mental health challenges there. His birthmother and birthgrandmother essentially killed themselves through addiction. He has no drug issues, but obviously the danger of that is great.

I'm focusing on taking care of myself and all that but boy it is hard not to get dragged under.

Anyone ever really depressed as a teenager? what happened?

 

[BusynMember]

I was so depressed at times as a teen that sometimes I couldn't function. It would go in cycles and last for a year...ages 13, 15 (really bad depression) and then I would pull out of it a LITTLE bit (but still be kind of deprssed with high anxiety) and had another episode at nineteen. I can tell you what it was like for me and what happened.

1/When depressed, I did not want to go out or do anything. I felt as if I would feel this way forever and had tons of anxiety too. I did not want to socialize. I could barely fake a smile. It was like I was frozen in the unrelenting deprssion. I did not/could not care about school or homework nor could I concentrate. Many people don't know this, but clinical depression messes with your attention span. I'm a book lover, but while depressed I could not even read one chapter. I spent a lot of time in my room. I was aggitated, easily irritated and would rage or lash out if too much was expected of me because I did not have the mental energy to give to anybody. Then I'd snap out of my depression just like THAT. But it wouldn't last and was very rarely 100% gone. Still it would be better for a while.

2/I deliberately did not drink or do drugs because I knew I was messed up and did not want to make it worse and I felt that any substances would make me worse. To this day, I've never been drunk. However, to cheer myself up, I didn't mind getting into a bit of mischief with friends who DID do drugs, have sex, etc. And since I had access to a car, I was sometimes the only way that they could get to their mischief. Kind of a passive-aggressive rebellion against my dark mood. Excitement was a temporary high without drugs.

Everyone with depression is different. I desperately wanted to get well and tried therapy early with disappointing results and bad therapists so they did not help. But I think therapists CAN be better now, especially those with cognitive behavioral therapy.

In spite of thinking about suicide a lot, I never attempted it. I did not end up in trouble. I did have a lot of trouble with interpersonal relationships as I grew up and had significant trouble holding a job. The depressions did not go away completely until I found the right medication.

I don't know if this helped, but this is what it was like for me. In fact, I was depressed (but not as bad) all of my life. As a child this manifested in a lot of crying, phobias, and poor grades. Everything hit the fan at thirteen.

I was eventually diagnosed with bipolar II, which has been changed to mood dysregulation disorder. I live a normal, happy life with a great family. I still have a slight tendency to think "the glass is half empty." But it's manageable. I never ever skip my medication. It is like a diabetic's insulin to me. I have tried life without medications and that is when I would go way out of control and was in danger of suicide.

 

[crazymama30]

I have not had any experience in this, but just wanted to offer my support. It sounds like he is just not in a good place. I wish there was some activity or something he could do to improve his sense of purpose. He sounds like he is silently struggling.

 

[keista]

I was depressed as a teen, but didn't know it. I just figured it was normal teen moods and stuff. I thought every teen thought of committing suicide, but only a very few actually did it. I honestly don't remember much, but know that I just barely functioned at times. In school this was not an issue for me. As long as I was present I absorbed enough information to get mostly A's (I get seriously bummed thinking what I could have accomplished and done with my life if I applied myself even a little bit). I know I WANTED to hang with the "cool kids" (difficult children) but they considered me too "straight laced" - I probably was. I started smoking at 14. Smokes became my constant companion - ppl were way too unreliable. I tried keeping busy - job, volleyball, other random activites. It helped in temporary spurts, but they didn't' make the constant ache go away AND the activities were my choice and initiated by me. I functioned, but I wouldn't call it living.

Son went into DEEP depression when he entered middle school. He pretty much ceased to function. He'd get up and go to school, but would just lay his head on the desk. Most times he'd zip his head into his backpack to help drown out the class. At home he'd lay on the couch, or follow me around and make himself 'comfortable' where I was. If there was no seat, he'd curl up on the floor. He HATES my smoking, but would follow me out when I went for a smoke. He would barely talk, and barely eat. Would NOT play any of his computer games, let alone do any of his school work. The only way I could get him out of his DEEP funk was to start building a kinex set. At first he'd tell me that he wasn't going to join in. I wouldn't protest. I just started building. Eventually he would actually get intrigued and join me, then take over. This would only get him out of the really deep dark places and functioning within the home. He still "wasn't right". He could go a day or two in this "medium" mode, but still not being very productive in school, and then fall back into the deep funk. I got him on medications as soon as I could. I eventually got my son back to his normal.

 

[InsaneCdn]

We just went through that - and came out the other side.
But... its not a magic formula.

1) Is the depression primary? or secondary? i.e. which came first, depression, or other problems? Note, this is not an easy question to answer, because you don't necessarily know when the depression started. We sure didn't. The reason this is important is that the approach is different for primary vs. secondary. If it is secondary, you must get to the bottom of whatever other problems are going on, and you won't necessarily know what those are.

2) I'm not familiar with your family situation - do you have a S/O? is this a long-term father figure for the boys? Has the situation changed in the last few years?

Feel free to PM me if you prefer...

 

[pepperidge]

Thanks for the responses. I do have a SO, husband is in the picture, good father and we are on the same page. Well actually we are not sure exactly what page we are on, but we are there in confusion together...lol

I think my child has been depressed from about the age of 4 or so -- I think there is depression in his genes. medications have been very helpful. But school is tortue to him.
What's going on now to me feels like the result of all those years of feeling different, struggling at school etc. He wants to be normal but knows he isn't.

And now he is throwing the you sent me to Residential Treatment Center (RTC) against my will thing back in my face. It is almost like he is daring us to place him again. ON the one hand we want to say, we want you at home, we don't think that is the right course of action now, on the other if he is going to refuse to get out of bed, we are sitting looking at him and saying that this kid is sick and needs help. How can we tell him we won't seek help for him if he needs it?

Keista you son sounds like mine. He spent most of 5th grade reading comics in the back of the class. just refused to do anything else.

MWM, your description of depression sounds like what I imagine it to be. I think that is what my son would be like off medications. But it is not such a pretty picture on medications.

 

[BusynMember]

It took me twenty years to find medications that REALLY got rid of the depression. The other antidepressants made it possible for me to sort of function and not commit suicide. Hang in there. He's getting help a lot younger than I did!

Once you feel he is old enough to comprehend it, I found cogntive behavioral therapy great. I like Dialectal Behavioral Therapy even more. It teaches you to live in the moment and think with a "wise mind" (objectively). Depression causes black and white thinking and a lack of hope. It's a symptom of depression. I found these two forms of therapy to be invaluable to me.

School was also a huge stress for me as a kid. I would have horrible panic attacks and would be too nervous to even concentrate on what the teachers was saying. A couple of times I thought I was going to pass out, which was a phobia of mine, so I ran out of the room screaming. The kids called me "mental" after that. They were right. I needed help, but there WAS no help back then.

Depression is often genetic. It runs (along with mucho anxiety) big time on my family tree. Clinical depression, if that's what it is, does not go away when your circumstances change or your life is good. It is an illness and if you don't get good help, it can really hamper every aspect of your life.

I've been in a psychiatric hospital three times, all three times voluntarily. I always got a lot out of them, but I was very motivated. They make you get out of bed and participate in therapy and other stuff and, at least back then, they were able to adjust the medications and wait and see if they helped. I think they throw people out too soon now.

You're a good mom for helping him NOW. He knows that too, somewhere in the back of his mind.

 

[InsaneCdn]

But school is tortue to him.
What's going on now to me feels like the result of all those years of feeling different, struggling at school etc. He wants to be normal but knows he isn't.

Any chance of hidden learning disabilities? motor skills issues? auditory issues (Central Auditory Processing Disorder (CAPD), Auditory Processing Disorders (APD) etc.)?
Any of these are enough to drive a kid to insanity at school. And each of these makes the kid more different at school.
If they are not caught and properly dealt with... it is not uncommon to generate mood disorders (i.e. secondary anxiety or secondary depression) - so of course, would also make primary depression worse.

Any testing done along those lines?

 

[pepperidge]

Insane,

We have had two full neuropsychologist testings done, one in 2nd, one in 9th grade. Motor skills issues are definitely way above average, though he did have dysgraphia. The only thing the neuropysch testing has shown is that he has low processing speed, low working memory (like in the 80-90 range) but the verbal part of the IQ was 110-120. Spatial not quite as high.

He does find it hard to focus, mostly I think it is hard for him to sustain attention to difficult things like math but he can do it. Like many of you have mentioned he suffers from anxiety (some separation anxiety when younger, always worried about natural disasters, introverted, socially uncomfortable) and I think that just exacerbated the depression and difficulties at school. Neuropsychs have tended to conclude that while he does have some learning challenges, his mood/anxiety issues really exacerbate his difficulties at school particularly when he was younger. Had I understood this all better when he was younger maybe I would have taken much more dramatic action to try to improve the school environment for him then. He really needed some form of alternative education.

We found early on that a low dose of Adderall seemed to improve his task persistence and often acted like this switch -he became more talkative, able to access more rational thoughts about future actions, etc.

We tried him on various anti depressants when he was in grade school. Not pretty at all--led to a lot of disinhibited behavior.
He doesn't meet diagnosis criteria for bipolar, but Lamictal has been a godsend.

His therapist at the Residential Treatment Center (RTC) said he was one of the most difficult kids to figure out that she has ever had, and I think she was pretty good.

He refused to go to school this morning, we got a lot of nobody understands me, nobody know how difficult it is for me, I have aDhd I can't do anything,, school is stupid, you made me go to Residential Treatment Center (RTC) how can I trust you now. We listened a bit sympathethically, but told him that there were lots of people with disabilities who go to school and try really hard, that if he needed further accommodations (school is very good about working with him) he needed to get his butt in there and talk to counselor as he says he is 16 and old enough to run his life), counselor is getting him an internship at local small engine rental and repair place and basically to get over the pity party. Nicely of course.

We can't make him do things. All we can do is provide structure and let him make choices and then ultimately make our own in consequence. So we just left him in bed. Eventually got up and took and shower, said he was in a better mood and went to school. One thing that I have thought about is that we need to give him his Adderall about an hour earlier than he is getting now (which is about 1/2 hour before he has to get up) and maybe it will be kicking in by the time he needs to get out of bed.

 

[InsaneCdn]

Does he have accommodations for he dysgraphia? Technology is not enough, usually - these kids often need oral exams, alternative presentation formats, multiple-choice, etc.

Some of which overlaps with the working memory stuff... (no way they can do 100% recall-only exams like essay format!).

We have had to move the clock around here... the day shuts down at 8, so we can be up at 6:15... because its the only way difficult child can make a smooth transition into the day... b'fast at 7 means medications have time to work, etc.

How much sleep is he gettng anyway??

 

[flutterby]

I've struggled with depression for most of my life. I had my first major depressive episode at 14 - I went to school, came home, went to my room, sat on the floor by my stereo and didn't even turn on the lights when it got dark. I thought about suicide every day. My junior year of high school I missed at least one day of school a week and thought about suicide every day. That's when I started dissociating.

I made bad choices because I was just trying to survive and you don't always make the best choices when you're struggling to keep your head above water and and, the other hand, I really didn't care. I never did drugs, did get drunk a few times - and I have a strong family history of addiction and drug abuse. Mostly I just wanted to go away and make it all stop.

Finally, when I was 16 my mom took me to a counselor who was wonderful. I didn't start medication until I was 27-28, though.

I wish I could tell you there was something magical that happened that will help your son, but I can't. I got pregnant in my senior year and I had someone else to take care of. Hormones played a huge role and I felt better while I was pregnant than I ever had before.

I think that your son has insight into what is going on with him and that is a huge plus. So many people don't and, in my experience, those are the ones who stagnate. I see the idea of living with a friend as just trying something - anything - to feel better. You're right in that it probably won't change anything. You can't run away from it. But I know where it's coming from because when you feel that horrible, it's an almost desperate feeling to do something to make it stop.

My best advice? Let him find his way knowing that he has a soft place to land should he fall.

 

[pepperidge]

He is not sleeping as well as I would like, despite his Risperdal in evening (which was added to help with anxiety type issues). He seems to be going to sleep around midnight (we pretty much cut off things at 9-9:30, maybe we need to move that back). That's partly why I am thinking that we should give Adderall at 6, he needs to leave for school at about 7:45. He is getting a lot of physical exercise which we thought would help with sleep. I am not terribly interested in adding any more medications for sleep and we have actually been thinking about eliminating the Rispderal which of his three medications is the most questionable one in terms of need.

Anybody on lamictal? we give 200 in morning and 100 in evening because there seemed to be some stomach issues. Maybe it is activating a little and we should give it all in morning with breakfast.

I will talk to teachers about oral accommodations for tests. I think that would help in science and parts of LA that don't deal with writing. What if they say, why not computer? What's the reasoning there?

 

[flutterby]

I would talk to the psychiatrist about taking the lamictal in the morning. I take 100mg, but when I tried to increase it, it caused insomnia. Risperdal doesn't really address anxiety - just talked to our psychiatrist about that - but helps with mood regulation which in and of itself can help anxiety.

 

[InsaneCdn]

I will talk to teachers about oral accommodations for tests. I think that would help in science and parts of LA that don't deal with writing. What if they say, why not computer? What's the reasoning there?

If you have a motor skills issue - Developmental Coordination Disorder (DCD), say, or any of a number of other problems including being a quad, technology helps... if the fingers can't do the writing, then technology definitely helps. In this case, they might allow some oral stuff to speed things up so the kid can "keep up" depending on the actual problem, but given enough time, this disability does not interfere with the ability to produce written output in some format.

If you have true dysgraphia, then the problem isn't the fingers, its the brain... as in, the brain has trouble putting thoughts into written format, no matter WHAT tool is used. Having said that... sometimes, the computer can be somewhat useful as a tool but not as the complete answer - as a tool, the kid can point-form or whatever, and then go back and edit and re-edit and learn how to produce written output. But they will NEVER be good at written output. Even at the university level, this gets recognized, and they look for ways to actually test what the student knows - rather than testing their writing ability.

 

[Steely]

My best advice? Let him find his way knowing that he has a soft place to land should he fall.

I think flutter said it perfectly. More than anything, he needs to know that you are there, and supporting him.

I struggled with extreme depression from 14 forward. At 16 my parents made some really life altering choices for me, and caused me to never be able to truly trust them again. That was a huge deal breaker in my depressed mind. I couldn't even trust my parents.

So when I turned 18 I walked out the door and never went back. I got into drugs for awhile, but then figured things out on my own. Slowly. It wasn't until Matt was 6 that I got therapy or medications, and that helped a ton. Yet, still on this particular day, I am struggling massively with depression. It is such a horrible feeling, so dark, and oppressive. Like your son, I have not wanted to move out of my bedroom all day. It takes SO much will power to do anything when you are that depressed that even the small things seem insurmountable.

Just keep doing what you are doing....and things will work themselves out. He knows you support and love him, and that matters the most.

Just curious, why is he not on an SSRI? Did those not work for him?

Wow, playing on the radio as I am typing is 'Shine on Crazy Diamond', by Pink Floyd, written about Syd Barrett and his mental illness. This song makes me cry every time I hear it. Shoot....that is what we all want for our kids, right? To shine....despite their challenges they all have so much to offer.

 

[BusynMember]

I want to add, stimulants make me MORE depressed. The moodswings of stimulants were a dealbreaker for me. I preferred ADHD to the dark pit I fell into each time a dose wore off. Stimulants would make me inititally feel great and almost high, then when they wore off *crash!* I'm not sure they are good, ADHD or not, for anybody with a mood disorder, even with other medications in place.

Steely describes depression well. The world seems gray. Everything is hard. Living is hard. Your brain is foggy and your ability to perform in every way is stifled. You cry easily. Some depressed people are so irritable that they constantly snap because they are in so much pain. I used to tell my therapist that it is like a broken leg that can't be treated. The pain is relentless and neverending. You cannot 'snap out of it.'

 

[pepperidge]

Thanks, guy.

We did try SSRIs--he started knocking over desksin his class, shoplifting etc. Major disinhibition, not once but twice. Maybe as an adult he will be able to take them, but lamictal has really been key to his doing better.

We had a good talk with his therapist. Part of the family dynamic is that he knows how to play the depression card and get us to reduce our expectations of what he can accomplish. He doesn't do it consciously. But when he was unmedicated and depressed in elementary school it worked pretty well, he has us well trained. So it is always a balancing act to have reasonable expectations but taken into account with his real depressive tendencies.

You all help me to have compassion, there are times I just want to yell at him to knock it off. And times I just want to give up...

 

[BusynMember]

Hearing "Just SNAP OUT OF IT!" used to make me feel so helpless I would be even less functional. It did not work as a wake up call, but only made me feel worse because I couldn't do it. I can't speak for everyone who is depressed, but it was truly very hard for me to function in any capacity when I was really at such a low point. Depression can interfer with sleep and eating too...it was explained to me that depression is not just feeling sad, it is a disruption of body rhythm too. You are out of whack...one thing leads to another. Not sleeping isn't good for you, but you can't help it. Often you have nightmares and wake up a lot when you DO sleep. You are not hungry OR some depressed people overeat (I was one who could not eat). All these things combined make things worse. It is important to try to break the cycle of just being "off."

Good luck...being there for him and not snapping on him is soooooooo important.

 

[keista]

MWM I wish I had your symptoms. jk I would overeat and oversleep 12-15 hrs a day.

Frustrating when the symptom list gives you so many "too much or too little"s, but it really can go either way.

 

[Steely]

Just snap out of it makes me literally snap....it has to be equal to telling a manic person to calm down.