New Here - Son Hospitalized, Need Advice

[Provencia]

I'm not going to type out my son's life story here, but I'll give a brief rundown. He's never been diagnosed with Autism, but I do believe he has some characteristics of the condition. I'm a single mom who works full time. My son has been able to stay in school and not get in too much trouble until this year. He's an 8th grader, 15 years old, and he was recently expelled from regular school for an outburst in which he made "terroristic" threats to a teacher. He was placed in alternative education two weeks ago. On Saturday night he got angry with me because I would not buy him a pack of cigarettes, which he's managed to become addicted to by picking up butts off the ground and smoking them, and I think over spring break his friend gave him some as well when he was staying with my mother.

His tendency is to take things to the extreme when he doesn't get his way, almost like a chemical imbalance. He threatens to hurt himself, get himself thrown in jail, or kill himself if I don't give in. Alot of times I do give in, because I don't know what else to do and I sure don't want him dead or in jail. But one thing I will not do is buy him cigarettes. So he ran out the door, down the street, and according to the police officer who saw him, threw himself in front of a bus. Luckily the bus did not hit him. The police officer, after receiving my consent, took him to the ER. They recommended he be placed in an inpatient program so he could get help from a doctor immediately. He's been there since Saturday night. When I left him, he was perfectly fine, coherent, not suicidal, and in pretty good shape. As of last night when I talked to him on the phone, I can tell he is not doing well at all. He begged me to come and get him, said he wanted to kill himself, called me a bad mother (which is not something he normally does), and just seemed to be doing really poorly.

While he's been in the hopsital, they've started him on prozac and depakote. I was told the depakote was to treat his mood disorder. Seems to me like its making him worse.

I'm not even sure he has a mood disorder. I believe most of his behavior stems from a neurological condition. How should I proceed? How much control do I have over influencing the doctor? Can I pull him out and put him in an outpatient program?

Please help.

 

[BusynMember]

Hi there. Sorry you have to be here, but welcome.

Aside from this hospitalization, has your son EVER been evaluated at all? It sounds as if he has had problems all of his life. Did he have any delays as a toddler and, if so, were they addressed? If not, what makes you think he has autism? He could have it, but he also sounds like he could have a mood disorder. At any rate, unless he is evaluated, and I suggest a neuropsychologist, you won't know what he has. I don't like when doctors medicate quickly or with two drugs at one time, but that's usually how the psychiatric hospitals work. I've been in three of them (one time each). They do not have time to really get to know the patient these days so I am not sure how they can diagnose so quickly, which is why I asked if he has been evaluated before.

I am biased against Depakote. Hate it. My children who were given it both hated it. We didn't like Prozac much better and I was on it once and it did make me worse. My daughter pulled a knife on herself after three weeks on Prozac...to give you all the facts though, she was also using illegal drugs. You have to make up your own mind about his medication. medications aside, I think the best thing you can do for your child is to talk him into seeing a neuropsychologist for an evaluation and then take his advice on which road to take for treatment. neuropsychologist evaluations take six-ten hours, usually broken up into two appointments, but they test in every area of function. I had two done as an adult and found them far more accurate than from psychiatrists. I am SO not a fan of psychiatric hospitals only keeping people for a few days, yet declaring diagnoses and changing things...often when nobody on staff has ever seen the patient before. When I was in the hospitals, over twenty years ago, you stayed until you were diagnosed and stable. Once I stayed for ten weeks and the other two times were just for medication adjustments yet I was still there for three weeks. What can you learn in three days???

I hope this helped, at least a little bit. And I wish you both the best. Use your Mom Gut! I trust that a lot

 

[JJJ]

He needs a complete neuropsychologist evaluation to figure out what is wrong. While he may have some signs of Autism, he also has some clear signs of a mood disorder. The hospital should be able to do some testing, even if they can't do a full evaluation.

It is too soon for the Depakote to be at therapeutic levels and the Prozac may just be starting to kick in. It is unlikely that the decrease in his affect is being caused by the medications. Many time a child will be calm when they first enter a psychiatric hospital because (1) they are finally getting intensive help and (2) when it is their first psychiatric hospital stay, they do not understand what they are in for. He is likely not happy about having to deal with his problems because the psychiatric hospital staffis not going to give into threats. It sounds like he is where he needs to be.

 

[Liahona]

I don't know what your hospital does but this is what the Residential Treatment Center (RTC) difficult child 1 was in did to include me in his care. There was a therapist I could call with questions and concerns. They had a monthly staff mtg that I attended where how he was doing evaluated and what the staff is going to do the next month was discussed. We talked about medication changes at the staff mtg and I could say no to any course of treatment. Of course they could refuse to do things I wanted them to. Mostly we got along. I could take him out of the Residential Treatment Center (RTC) any time.

if he is willing to throw himself in front of a bus when you say no I don't think you're going to be able to parent him in your house.

Welcome.

 

[Provencia]

I went to visit my son last night and he seemed much more stable. I'm not freaking out at this point, at least. He didn't seem overmedicated, which was one of my concerns. He understands why he has to stay there for now, although he's still not happy about it. You know, for years he was fixated on the idea of prison. He watched hours and hours of Lockup and prison documentaries. It was sort of a fascination for him. I'm pretty sure that won't be an issue anymore, now that he's seen it from the "other side". Even though the treatment center isn't exactly prison, it sure feels like it to him right now. Still worried about how things will go when I get him back home, but I'll deal with that next week when it actually happens. Thanks for reading my post. It helps just to get it all out and feel like someone might actually be listening.

 

[buddy]

The hospital my son was in had a neuropsychologist on staff. It was a child mental health psychiatric hospital.
Maybe you could check to see if they could do a comprehensive evaluation ( you'd have lots of forms to fill out too and there are many many tests, so thats how you'll know if they do it). Make sure it's a neuropsychologist not a general psychiatric. They have specialized training and can better sort thru developmental conditions vs. Mental health conditions. Typically general psychologists and psychiatrists would only diagnosis autism if the patient showed classic, lower on the spectrum signs like spinning, hand flapping, no eye contact etc. But that's only a limited number of those who really have Autism Spectrum Disorders (ASD). It needs a comprehensive evaluation to be diagnosed.

If not, start looking while he is inpatient because wait lists for good neuropsychologists are usually longer.

I hope they keep him or find appropriate placement. He is far too impulsive and black/white thinking to be safe at home.

 

[Provencia]

Hmm ok, well I'm hoping the medication can help with the impulsive behavior. Not ready to ship him off just yet.

 

[buddy]

I get that. I have a very challenging child too. But, no other kids. Anyway I had people suggesting he couldn't stay home and I wasn't ready.

He is still home and actually is better.

But I do know that can change. He would be too afraid to try to kill himself though, thank God. He can be rough on me though.

by the way, Depakote was fine for my son when young (for seizures)
And it works well for my sister (bipolar )

Hugs, hang in there. You live it. Only you know what you and your family can handle.

 

[Provencia]

That's encouraging to hear, Buddy. Thanks for sharing.
My son is an only child too, so I'm able to focus on his needs. I don't think he was actually trying to kill himself (according to him), but the effort to take things to the extreme went a little farther than they had in the past. He was pretty embarrassed about it after the fact. Hoping we can get those extreme impulses that occur when he's angry, under control. He certainly has expressed the desire for that not to happen again.

 

[DDD]

I wish you good luck with his current placement. Depakote was very helpful for one of my boys. The problem with medications is that what may be terrific for one can be a nightmare for another so it takes time to find the right combo. I, too, strongly recommend a full neuro/psychiatric evaluation so that you, and he, and the medical professionals actually know what needs to be addressed. Hugs DDD

 

[HaoZi]

Make sure you get referrals for after care and therapy before he comes home from the hospital. The one here didn't do any testing, just decided my daughter was bi-polar and medicated her that way. I still question it, but those medications do help so for now since there's no major side-effects on her current ones I'm not pushing the issue. Does he have an IEP and BIP at school?

 

[Wiped Out]

Hello and welcome. I'm sorry you are dealing with you son in the psychiatric hospital. Mine has been there several times and I know how difficult that is. However, it sounds like he is where he needs to be at this time so that he is safe. I definitely agree with the others about having a neuro-psychiatric evaluation done.

In my experience they won't keep him in the hospital longer than need be because insurances are very picky about that. They tend most of the time to want patients out before they are even ready. In the meantime, use some of this time to recharge your batteries and take care of yourself. Sending some gentle hugs your way.

 

[Provencia]

He is supposed to move to the outpatient program when he leaves, but they haven't given me pricing on that yet, so I don't know if I can afford it. If he can't move to that, they will have something alternative set in place for him. I don't know what an IEP and BIP are, but I do have him in special education under a general non-specified designation.

 

[Provencia]

In the meantime, use some of this time to recharge your batteries and take care of yourself. Sending some gentle hugs your way.

Thank you. Good advice.

 

[TerryJ2]

Hi Provencia,
welcome.
Wow, I am so sorry he has gotten this extreme.
The one big disappointment I had when my son was at the psychiatric hospital was that they just treated the immediate symptoms and did not really care about an overall evaluation or diagnosis. Their job is just to get the person stable and open up a bed for the next person.
He has serious issues with-impulse control. Unfortunately, that is a signature for most anything, from bipolar to autism.
Definitely, get him into therapy, with a therapist who can help him think through his impulses so he knows enough about himself to know when he's going to act. And medications can really help with-that. It's a long journey.

Many hugs.