Highly gifted teen son - inpatient, outpatient, dropped out of school


New Member
Hello, all. Here because I'm not sure where to go next. Have read lots of good advice in other threads and hoping for some for my situation.

My son is about to turn 16. He's highly gifted (there are 5 levels of giftedness and he's between 4 and 5) and shows obvious signs of anxiety and depression. However, he thinks this is just who he is and though he will attend therapy appointments, he doesn't think anything will help because nothing needs to change.

These are some of the things he thinks or does that we hope he can improve:
  • Isn't motivated and says he'll live on the streets and be homeless if he has to
  • Won't attend school because being in a classroom for that long makes him anxious
  • Doesn't have friends and spends most time in his room
  • Completed drivers ed but has no interest in driving
  • Says that we are all just atoms bouncing around and that life is meaningless
Things he will do because we've asked:
  • Take junior college classes (don't have to be graduated from high school to do that)
  • Attend therapy sessions (though therapists keep telling us they can't help somebody who doesn't think they need to change)
  • General hygiene - he's very good about showering, brushing teeth, etc.
  • Cook - he's been learning to cook new things
  • Work on his programming business - he's been programming since third grade and says that's what he wants to do as his job so he spends his days working on various technical skills
Treatment options we've tried:
  • After he had several panic attacks, he participated in a 6 week outpatient program at a mental hospital. He never missed a day but I'm not sure it helped either.
  • After attending 1 week at a private school for accelerated kids (and it seemed he had a great week), he stopped speaking or attending school. I took him to an inpatient hospital where he stayed for a week.
  • Anxiety therapist who won't see him anymore because he doesn't think anything is wrong. She recommended a long-term residential stay for him to help him hit "rock bottom" and want to change.
  • Neurofeedback - he's currently doing this but this therapist again told us "I can't help somebody who doesn't want to change."
So that's where we are now. I believe that his slow processing speed (something that showed up on his IQ test) makes it hard for him to converse so social situations give him anxiety and he's learned to avoid them, and then depression is kind of a side effect perhaps of not being social or knowing how to express himself.

Toggling between 1.) throwing all options at him to see if anything sticks and 2.) giving up because I'm tired and want to wait for him to want to change. Any thoughts on where we go from here?


New Member
One more thing I forgot to add: he's tried 3 different antidepressants but only took each one for a couple of days because he hates the way it makes him feel (lots of insomnia, waking up hot at night, or darker thoughts than usual).


Active Member
It feels like high IQ plus anxiety is a perfect storm.

Their precociousness passes for maturity.

I wouldn't accord too much weight to what a 16 year old thinks he doesn't need. Baby geniuses have explanations for everything but actions speak for themselves. Is he well? I think we still need to hide the vegetables in the spaghetti sauce for those guys, as put together as they sound.

I have a friend with a kid with crippling social anxiety who was doing a lot of the same things (school refusal, being reclusive, etc). Also a smart kid. He had some gains from therapy but couldn't hang on to them as long as he had a place to hide. This family had seen the trajectory long enough and had the means to send him to a residential program (Waypoint,I think) which is targeted to teen boys with depression and anxiety. They did a lot of Exposure Response Therapy which basically forces them to feel the anxiety of certain situations and live through it, gradually diminishing the anxiety over time. Obsessive Compulsive Disorder (OCD) therapists and others do it too.

He didn't sign himself out when he turned 18. He took a gap year, finished the program, got a job working with the public and will start college this fall.
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New Member
Thank you. That residential program sounds like they treat boys exactly like our son. Their site doesn't indicate cost. Do you happen to know from your friend what the costs run?


Well-Known Member
Hi and welcome, CM

Would your son be interested in exploring religion/spitituality or possibly a different aspect if he is already religious, to help him find meaning in life?

Talking to a spiritual advisor of his choice?


Well-Known Member
Welcome and sorry you have to be here.

The child who brought me to this board, my Difficult Stepson, is now 17 and shares many characteristics with your son. Your son is much more compliant with your wishes, believe it or not, than my DS has ever been with ours.

In our case, DS has episodes of aggression and violence in addition to depression, severe social anxiety, and school refusal despite a high IQ, though I don't think he is quite as gifted as your guy.

We never found anything that worked for DS. We tried therapy, medications, a 504 plan at his high school, and none of it seemed to make much of a difference....I believe because of his refusal to accept authority and anti-social tendencies which led to my giving him the DS nickname here.

He did not speak to us at all during pretty much all of his 16th year. This spring relations thawed after we agreed to let him try online schooling. The results academically have been lackluster, though he's been more productive recently than he was at first; however, his social anxiety is much improved. He is more confident and for the first time in his life, has a circle of good friends. His interactions with us have been warmer than ever before as well.

DS has taught me that potential means nothing and that what seems like a blessing can also be a curse. His quick mind is a gift but because of his personality and perhaps, deeper mental health issues, he would be happier with less intelligence and much better able to function in the world.

Our family is now in the midst of a life-changing crisis with our younger son and DS' issues are on the back burner for us at the moment. He is handling the crisis very well, all things considered, and we're in a much better place with him than before. If I could give you any piece of advice it would be to allow him to develop at his own pace while at the same time, holding him accountable with the help of therapists. I would also gently add that many of his negative thoughts and feelings might be helped by medication, though at his age, if he insists on non-compliance there's probably little you can do short of hospitalizing him.

I don't know what more to say except hang in there and keep posting, this is a wonderful community.


New Member
Thank you. That residential program sounds like they treat boys exactly like our son. Their site doesn't indicate cost. Do you happen to know from your friend what the costs run?

Emailed them and got an answer. $11,000/month. $23,000 due at enrollment. Insurance doesn't usually cover much, if any. We're in the top 5% of income earners and can't afford that. Sigh.


Active Member
I know there are regular therapists who do exposure response therapy. Maybe you could recreate some aspects locally. Like work with a therapist to find an actual or volunteer job that will give him significant contact with peers. There are even teenlines kids can man. Maybe there are resources or books waypoint could recommend?


Well-Known Member
Sounds very much like Aspergers Syndtome. Look it up. Even if psychiatrists said he doesnt have it. Please read on.

Aspies are often scary bright and very different thinkers. Anxiety is part and parcel of Aspergers. So is Obsessive Compulsive Disorder (OCD) and obsessive interests and social problems. All are part of very high functioning autism/aspergers. Depression is also common. The smart ones often dont achieve to potential and I was on a site for Aspies (check out the site Wrong Planet) and most were similar to your son. Brilliant and different.

I think you should check it out with a neuro psychologist before even considering residential, which is for mental illness. If he has Aspergers that could traumatize him and probably wont help him...aspergers is a neurological difference, not a mental illness, although many on the autism spectrum have unusual behaviors...not due to mental illness.

If he has not seen a neuro psychologist and taken the ADOS evaluation test, take him to have one before taking action for a mental illness that may not be one. My don had a total of ten hours testing at Mayo Clinic. Worth every minute. Every dime. Finally somebody "got" him and his life rapidly improved.

My son is 24 and on the high end of the spectrum
He was wrongly diagnosed by psychiatric professionals. They really dont know much about Aspergers and often try to pass off Aspies as having mental health problems.

Mental health is their field. Neuro psychologists ARE psychologists with extra training in the workings of the brain. They are thorough and good diagnosticians who test for BOTH psychiatric AND neuroligical differences. They test intensively. You can find them at university clinics. They rock. Cant stress this enough.

Your son in my opinion needs further evaluating and needs to be understood. Do test him if only to rule him in or out of the spectrum. So many red flags he has.There is specific testing for this. My guess is he never had full scale testing for this possibility.

medications help some Aspies, dont help others.My son is better off of medications. He is overly sensitive to medication rractions, like MANY on the spectrum!! Son is doing very well. He thinks he is good just the way he is too, although he is more conventional than your son. He has his own apartment and works, but likes the way he is. Very comfortable being himself! I am so proud of him!

Your son is probably at a higher intellectual level than mine so he thinks way outside the box...normal for Autism Spectrum Disorders (ASD). Mine is just a tad above average. It makes a difference in how these different thinkers choose their lives. And they also evolve and change with time and proper help.Few therapists know how to relate to aspies. Often therapy accimplishes nothing. They dont (aspies) form bonds with strangers well, which you need in good therapy.

Good luck. It is hard, but smart to cover every base. Have a peaceful night. Tey not to worry. There is help. He is young. by the way many aspies refuse to drive. Mine as well. They are too anxious. But my son gets to where he needs to go! He has one close friend who is also different and prefers being alone, but sees people at work and when he bowls. He would rather be alone and he mostly stayed in his room when he lived with us and will never be a social butterfly, which is A-okay with us. He is being himself.
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Well-Known Member
We have gifted students like that at our school. They are bored mostly, but some of them do have Asperger's. They do best in different types of non-traditional academic environments. I think it's great that he wants to do computer programming for a career. But, no matter how skilled he is, no one will hire him if he doesn't finish school and get some certifications. A full college degree is what most companies prefer for programmers, but some hire people who get certificates in areas of expertise.


Roll With It
I think you need to continue to explore medication. You need to insist he take the medications for longer than a couple of days even if you have to give him the pill and watch him swallow it daily. Actually I recommend that with your son.

Why? Because this way he will be taking it and you will be sure of it. Make him show you that he swallowed it (open mouth, show you under his tongue, then take a bite of food and chew/swallow) each time.

Have the doctor do a genetic test to see which type(s) of antidepressants are most likely to work for him. Insurance pays for this (usually, confirm with your ins co of course) and I have heard it is very helpful. It can take up to 6 weeks at the therapeutic level to know if an antidepressant will work. Usually you have some idea before that, but it can take that long. And that is after you work up to the therapeutic dose. It isn't easy, but it can be super worth it.

My oldest son, Wiz (short for nickname Wizard) has Asperger's (now just lumped in with autism spectrum disorders ). That includes (for him) Obsessive Compulsive Disorder (OCD), ADHD, sensory integration disorder, and unipolar depression. This means he does not ever go into a manic state, he only gets depressed or is normal. Wiz takes his medications. He always has. It was the one thing he never fought us over, oddly enough. We did listen if he said they were creating problems.

Any of these can be tricky to treat. My son's biggest challenge to treat was the depression. He struggles with it quite a lot. The most successful medication combo uses different types of antidepressants to treat his issues. He takes Strattera to treat his ADHD. It is not a terribly effective antidepressant, but it is one. It just works better on ADHD and is used primarily for that. Wiz takes trazodone, a tricyclic antidepressant, at night to help him sleep. Without it, Wiz would only sleep about every 3rd or 4th night. The tricyclic antidepressants are older medications that are more sedating, but they can be effective for depression as well as sleep issues. Wiz also takes Luvox for the depression and Obsessive Compulsive Disorder (OCD). It helps him quite a lot. Having all 3 of these medications working together really works for Wiz. Any time he tries to take one of the medications out of the mix, he starts to have problems. It has kept him stable for 5 or 6 years now, so it is helping.

It may take some trial and error to help find the right medications for your son. This is why I suggested the DNA testing. That can help find the right medications faster. Most psychiatrists know about this and if you ask for it, they should be able to do it. If you find medications that help, it could open us a truly amazing world for him. One where he might choose to go to college, or at least to open up his world a little.

The exposure therapy sounds like a very good thing also. It would be especially great if you combined it with medication. It may sound like I am just pushing pills. I don't mean to. I just believe that the right medications, especially when combined with therapies like exposure therapy and sensory therapies, can really make a whole new life for someone with problems like our kids.

You only have a very little bit of time until your son is 18. Once he is 18 you have almost no options. Do all that you can to help him NOW. Do it ASAP. Get him in to see any doctors/therapists that you can. Reward him for taking his medications if you must. It could totally change his world. Do make sure that they don't treat the anxiety with benzodiazepines though. It would open up a world of addiction possibly, and who needs that?

One thing I recommend you do BEFORE he turns 18 is to start thinking about life with him after he turns 18. How long do you want him to live at home? Under what conditions? Will he need to pay rent? How much? How often? What will you do with the rent? (I know parents who use it for expenses, who bank it and give it to the kid later when they get their first apartment, and one who used it to pay for her own vacation.) If he is in your house after he turns 18, what do your local laws say about his rights as your tenant? What makes him a tenant? What would make him a guest? What would you have to do to get him out of your house if you needed to get him out?

It is better to know this now, and to figure out how you want to handle it than to wait and have to figure it out when you are in the middle of a crisis.

I strongly recommend that you insist he put you on every HIPPA form at every doctors' office as someone who can have medical information and can speak to the doctors or else he has to leave. That sounds harsh. It is to help you be able to talk to his doctors if there is a problem or emergency. Often a parent can articulate something a teen cannot, but the parent cannot talk to the doctor due to the HIPPA forms. Unless he is hiding something like a drug problem, this should not be an issue. It is a good rule for as long as he is living under your roof.
Sounds like a pretty awesome, unique kid who sees the world a bit differently.

You may have the next Steve Jobs on your hands.

My only comment would be, be careful what treatment and medications you subject him to. Panic, defiance, isolation, lashing out...are common responses to being put in an uncomfortable environment. This can lead to additional diagnoses and medications that aren’t always appropriate.

Just my thoughts...
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