Today's psychiatric hospital visit

[klmno]

I just came back from visiting difficult child. He has been in psychiatric hospital since Tues. and has been lethargic- really looking pretty bad until today. (The cw said they couldn't tell if that was depression or just being in there- I didn't think it was just being in there.) Anyway, I think he was hypomanic tonight. He claims he's just angry at the counselors because they keep wanting him to answer questions about what is going on with him. difficult child says nothing is going on with him, he is only in there because he needed medication changes (I told him it is true that he needed medication changes, but there had been things going on with him and that this would be a good time and place to get some of that off his chest.) He doesn't know what I'm talking about- he hasn't been stressed or depressed (grandiose thoughts??). Mind you, his nails are almost bitten off and he's started on the skin around the nails now. I pointed this out to him and he said he was only doing it (biting nails) because he was so angry and this was the only thing keeping him from going off at the counselors. (He does this every time he isn't stable, whether he is angry or not.)

I mentioned that they might decide to not discharge him tomorrow. He won't hear of it- he is adamant that he is coming home tomorrow. It knid of reminded me of the few times he has approached me bold-eyed, stating matter-of-factly that he WILL be moving out tomorrow into his own apartment where he can live alone and he will get a job to pay for it himself.
UHMMMM!

 

[susiestar]

I am sorry. It is so hard to visit them in the psychiatric hospital, esp when they clearly are not well, and are demanding to come home.

Hugs,

Susie

 

[witzend]

I hope for his sake that they won't release him tomorrow. It's not fair to keep him for four days to tweak medications if he won't also talk about what's wrong. He can even blame the medications if he wants, but the fact of the matter is that you won't be there to fix it forever, and if it is the medications, he needs to recognize the problems it causes when his medications are not right. Especially when he's got his own apartment and needs to keep a job for his rent and food!

 

[TerryJ2]

Ah, there you are!
Clearly, he's in the right place. He's got a few more days to go to clear up his issues--emotional and medical. If only he could see what others see.
Sigh.
Be strong.
Take care.

 

[klmno]

Thanks for the chuckle, Witz! (Can he get that apartment and job tomorrow- PLEASE?)

This is an acute psychiatric hospital so the typical stay is 3-5 days. My insurance covered 7 days when he was in there 2 years ago, but that was it- he had to be sent home. The psychiatric hospital itself though is set up only to deal with acute situations, unfortunately. For some reason, difficult child can recognize and discuss (with me or psychiatrist- not to just anyone) symptoms when he is stable. When he isn't stable, he just seems to either not see them or refuse to admit it. It is wierd to see the deep denial come and go with the other sympotms.

I hope he is this way tomorrow and that the psychiatrist notices before discharging- I'm thinking maybe I should call first thing in am and leaave a message for him.

 

[klmno]

Well, I called this am and reported my concerns. psychiatrist calls back and says difficult child is calm and stable and staff reports from weekend just indicate quietness and being guarded. So, he is being discharged today. I did ask and psychiatrist agreed, to increase the seroquel dosage instead of leaving difficult child on the "starter" dose since he won't be seeing his regular psychiatrist for 2 1/2 weeks.

The strangest thing- psychiatrist was saying that blood test are revealing fluctuation in thyroid (something- English is his second language and I didn't understand) psychiatrist says, difficult child informed him that this happens all the time with him so not to worry about it. psychiatrist says, ok, well it is only a very small amount so I guss it isn't a big deal. Now, I haven't even heard of this coming up with difficult child so I KNOW difficult child hasn't heard anything about it before today and he sat there and winged it enough to convince this psychiatrist that he knew his thyroid levels fluctuated a little.....I'll be having a conversation with regular psychiatrist about this one.

Oh- whatever the thyroid thing was, the psychiatrist said it went from 0.9 to 1.0 and he didn't like to see it over 1.0 in kids so he just wanted it to be watched to make sure it doesn't go higher. Anyone know what this means and if I should be concerned a little or a lot?

 

[mstang67chic]

Re: Thyroid

Usually, the normal range for thyroid levels are anywhere from 0-4ish. Some docs prefer them to be closer to zero, others are ok with it closer to 4, just depends on the doctor and the patient. The higher the level (hypothyroidism), the more you gain weight, feel tired and sluggish and basically your body just slows down. If your levels are lower, (hyperthyroidism) you are jittery, have problems sleeping and can't seem to gain weight. This COULD be what he was talking about although I don't know what the preferred level is for kids. If this is what he's talking about, ask your doctor. .9 - 1.0 seems like a good level to me but I'm only used to dealing with my levels as an adult.

 

[gcvmom]

Ya know... his comment about the whole apartment/job thing to me is both delusional and grandiose thinking... totally out of touch with reality and convinced it's all true, and it's something completely beyond the scope of a person his age (that's the grandiose part).

Why do some mental health professionals blow off behaviors or comments like that from kids?

 

[klmno]

difficult child is home- making cookies right now to include in his grandmother's gift basket (her b-day is a couple of days away from Mother's Day). The psychiatrist at psychiatric hospital wants a blood test for lithium levels and thyroid done again within one week- that actually makes me feel better. difficult child is like his grandmother in the sense that she has very strong (sometimes very bad) reactions to normal doses of medications sometimes, so if his levels are fluctuating, this might have a lot to do with him being jittery, maybe biting nails and other things that I though indicated cycling.

The apartment statements- well, psychiatrist knows the jest of these things and this helped get the BiPolar (BP) diagnosis. I try to watch for signs of hallucinations and even split-personality (which cycling almost seems that way sometimes). I'm not sure where the exact line is for delusional, but I hope the AP can help with it. So far, it appears to be more like his "mood" took over and he is speaking and acting based on the overwhelming mood, with no sense of rationality, when this happens. Of course, it is always during the unstable periods and completely goes away in satble periods. I do worry about it, though, especially with some of the erratic things he has done in the past. Let's just say, I keep an eye out for packed suitcaases and bus tickets, or whatever might be an indication of a plan for the most recent "strange" thing he has mentioned.

 

[Wiped Out]

KLMNO,
I remember when difficult child was on Lithium he ended up having thyroid problems and had to be put on Levothyroxine (a small dosage)for awhile. I hope he will do better at home right now.