Self-doubt and Adrenaline Crash: We sent our son to residential treatment

Discussion in 'General Parenting' started by BrainGoBoom, Feb 10, 2011.

  1. BrainGoBoom

    BrainGoBoom New Member

    Our difficult child was admitted yesterday for residential psychiatric treatment. This week has been one of the worst in my life. I found these boards this morning and I'm grateful for their existence.

    I am filled with self-doubt. Did we do the right thing by sending him to a residential program? Will he recover? What if the place turns out to be awful? How will we know?

    I was warned to expect an adrenaline crash after he left. I had no idea how debilitating an adrenaline crash could be. I feel tremendous ennui, weakness in all my muscles, and a lack of interest in anything but ice cream and Doritoes.

    I wish that psychiatric medicine didn't feel so much like throwing spaghetti at the wall.
  2. AnnieO

    AnnieO Shooting from the Hip

    BGB - welcome - and hugs.

    First off - what's the worst that can happen? The Residential Treatment Center (RTC) won't help, and he will come back the same as he left? Even if so - YOU WILL KNOW YOU TRIED!!!!!

    You have done the right thing. At the very least, he will learn to live with others. At best? He will get the treatment he needs. He will learn to work with his strengths and weaknesses to become a productive member of society.

    Since I don't know your story, this is all I can say... This is what I feel about sending my girl to psychiatric hospital and/or Residential Treatment Center (RTC).

    More hugs!!!
  3. JJJ

    JJJ Active Member

    That is a great description.

    As you can see from my signature, my oldest has been in Residential Treatment Center (RTC) for almost 3 years. I remember the crash after dropping her off. Give yourself permission to complete be a blob until Monday - eat Doritos and ice cream, order food delivered, sleep, dance, cry...whatever you feel like at that moment.

    You can deal with the next step on Monday. Take this time for you -- you earned it.
  4. slsh

    slsh member since 1999

    Oh my goodness - that has to be just about the very *best* description of it I have ever read!!!! You are utterly brilliant!!!

    Welcome, and I'm so glad you found us. I believe with all my heart that when a family starts to consider the option of Residential Treatment Center (RTC), they have probably more than exhausted all other options. The last thing we want to do is have our child live outside our home. So, without even knowing your story, I would guess that sending him to Residential Treatment Center (RTC) was probably your best option at this point.

    Will he recover? Can't tell you that. Some kids are able to utilize tools they learn at Residential Treatment Center (RTC) and learn how to function in their home communities. Others don't/won't/can't.

    How will you know if it's a good placement? Follow your gut, but temper initial knee-jerk responses. Communication with staff is essential. Talk with staff, and visit as frequently as possible. Look at the living quarters of the kids. Look at the other kids - not only their physical appearance but also their affect. Chances are, if you have good communication with- staff and are a frequent visitor, you are going to have a better feel for what is going on. If alarms are going off in your head, *talk* with staff and make sure that what they're telling you makes sense.

    Prepare yourself for tearful phone calls from him and for promises of miraculous improvements in behaviors if you will only bring him home. It seems to be part of the process. Doesn't make it any easier to deal with, but forewarned is forearmed.

    I think the most important thing you need to do is (walk away from the ice cream, LOL) take care of yourself. I'm sure you've been battered emotionally, if not physically, by the events surrounding your son's placement. It is time for TLC for dear old Mom and Dad. Do *NOT* feel guilty for taking pleasure in activities. You are allowed. You are *supposed* to have joy in your life. The first time my son left for Residential Treatment Center (RTC), it took me 6 months to figure that out, and another 6 months to figure out that life goes on, whether he's here or there (but I'm a really slow learner :winks: ). He's in a safe place, getting help at a level that you could never duplicate at home. He needs to work on his stuff, and you need to take care of you.

    Again - welcome. I'm so very sorry your family is going thru this right now, but know that you are not alone.
  5. BrainGoBoom

    BrainGoBoom New Member

    Thank you all! Geez, I know that support is really important, but sometimes I forget how important it is. All my friends have those perfect children who get good grades and participate in team sports. It's nice to find some fellow warriors in the trenches.

    Is there an introductions item somewhere that I should go tell my story? I'm happy to share it, but my signature seems a bit too small.
  6. slsh

    slsh member since 1999

    You can either share it on this thread, or start a new thread. Your choice. We kinda just dive right in. :bigsmile: Your signature is great.
  7. Wiped Out

    Wiped Out Well-Known Member Staff Member

    Adding in my welcome and I also like your spaghetti on the wall comparison. As Sue said, if you've reached the point of Residential Treatment Center (RTC) you have probably tried just about everything else. Sending gentle hugs your way. Take care of you!
  8. pepperidge

    pepperidge New Member

    I placed my son in a wilderness program over mOther's weekend. It was so sad, but so the right thing to do. I went for walks and walks in the forest. It was hard getting those first few letters of how angry he was etc. But I had support and stayed strong for him. Do give yourself permission to feel like you have been run over by a truck this weekend.
    and please tell us your story. I suspect that there are many here who can relate.

    My only advice is to do as much reading as you can on psychiatric medications so that you can ask intelligent questions. That will help increase your comfort level. If nothing else even if it isn't very helpful use the time that he is there to get yourself strong and prepared for whatever the next phase is.
  9. Steely

    Steely Active Member

    In retrospect you will realize what you just did is probably the hardest decision you have ever had to make.
    I wish I could tell it is all roses from here - but it is not. It is only a step, a step towards helping him take accountability for his future. A step for you and for your family to live in a healthy way for awhile.
    The adrenaline crash will go away, and I agree with the others to do what it takes to take care of you right now. I made the mistake of deciding that once Matt was in residential I could conquer the world. I took a new career in a new state, and six months later everything came crashing down around me. It is really important to take this time NOW to heal.
    You are not alone, and we are here whenever you need anything.
  10. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    I'm sure you did the best thing for him. We are here for you.
    It WOULD help to know the story of your child, from infancy to now. Any delays, quirks, strange behaviors from early on? Any problems with socializing? Any psychiatric problems on either side of his family tree? Reactive Attachment Disorder (RAD) is usually for children who had very very disconnected, unstable early years. Is he adopted?
  11. BrainGoBoom

    BrainGoBoom New Member

    Here is the story of my Bug--I'll call him that because I'm quite grateful for the anonymity of this board. I'm an active blogger, and I've been wanting to write about this, but not doing it because I blog under my real life name and want to respect his privacy.

    We (husband and I) adopted Bug from Cambodia in 1998. He was 10 weeks old at the time of his adoption. The director of the orphanage told us his birth story. He was the first, planned-for child of his parents, who were political activists living on a farm commune near Phnom Penh. In July of 98 there was a major election in Cambodia. Bug's birth father was shot and killed in a political activity. Three weeks later, Bug was born. 10 days later his birth mother relinquished him to the orphanage.

    It's fair to say that there was neo-natal stress. His birth mother went from looking forward to the birth of her first child to losing her partner and her baby within a month. We don't know anything more about his birth family history or gestational history.

    Bug spent 8 weeks in the orphanage, then we picked him up and brought him home. He was malnourished. He turned out to be allergic to the formula he was being fed. Initially, we thought he was deaf. He was totally non-responsive to sound. One day I waited until he fell asleep, then clanged two pan lids together in front of his face. He did not even flinch from the draft of the swiftly moving lids. The pediatrician he was seeing at the time told us not to worry now; if he were deaf there would be no treatment for it at this phase of infancy.

    Two months later, I used the food processor to grind up some walnuts. He'd been asleep, but startled hard at the sound of the grinding nuts and started to cry. Huzzah! He was not deaf.

    His development continued typically until he was 18 months, when he got a bad case of coxsackie including a secondary ear infection. His speech development stopped completely. By the time he turned two, he was diagnosed with an expressive language delay and received speech therapy and special education therapy under the auspices of Early Intervention.

    When he was three, we moved across the country with IEP in hand. By the time I hooked up with the local Early Intervention group, he had met all the goals of the IEP, so he stopped receiving services from them.

    Bug is a strikingly beautiful child. Silky black hair, eyelashes to die for, and an easygoing, charismatic personality that charms everyone. He's bright and has astonishing spatial abilities--after our cross-country move, he learned the local geography in about a week, started reading maps, and became our accurate navigator--better than Google Maps!

    He spent three years in preschool. His teacher suspected some fine/gross motor delays and we sought treatment for those. However, he didn't improve much with the treatment and we abandoned it.

    We held him back a year, so he was six at the time he entered kindergarten. We chose a focus option school based on constructivist education principles, which we felt would provide a better environment for our Bug. He thrived there until 5th grade, by which time the school had lost its founder/leader and gained an inept principal. Bullying became a school-wide problem. In addition, Bug had a teacher with anger management issues. I learned that his teacher yelled at the kids frequently and was known to have thrown a pencil at one of the students.

    It was about this time that we started seeing the beginnings of the intermittent explosive disorder. Not a huge surprise: I figured that if his day-to-day authority figure was thinking it okay to yell, that Bug would, too. We also learned that he was failing math. His teacher told us he simply would not do the work, he'd space out in class. But he flew under the radar until assessment testing was done because he would not misbehave in class, he simply refused to work. Worst of all, I learned that Bug had become a part of the bullying problem in the school.

    I applied to have Bug transferred back to our neighborhood school last February, about a year ago. The transfer was granted. It was really tough for Bug to switch schools in the middle of 5th grade. There was much screaming and yelling on his part. Luckily, he landed in the classroom of the best teacher in the school, and after an adjustment period, his grades improved.

    At about the same time, we sought out a therapist to work with him. We were starting to suspect attention and anxiety issues. Through blind luck we stumbled into the office of a FABULOUS therapist who practices Collaborative Problem Solving. Our biggest complaint is that the therapist is so busy--he works in the school system as well as having a small private practice--that he could not give Bug the time that he really needs.

    In spite of therapy, we continued to see explosive anger at home. Bug has been able to hold himself together at school, but comes home and blows up. We went for evaluation by a cognitive psychologist and a psychiatrist. The results of those evaluations were that we started Bug on medication for ADHD. We learned that he has a pretty high IQ, but does have some fine motor issues.

    The ADHD medication (metadate) seemed to amp up Bug's anxiety. We added Celexa and Buspar to the chemical cocktail.

    And here, my story becomes muddled, because Bug just got worse and worse, and my brain seems to defend itself by blocking out/compartmentalizing away the stress and difficulties. The gist is that the following behaviors started to emerge:
    - Increase in lying
    - Increase in deceitful/manipulative behavior
    - Increase in video addiction
    - Explosions became less violent--less furniture being thrown but more destruction of property going on. Bug has been disassembling our house piece by piece. Doorknobs, computer components: nothing is really safe.
    - Increase in stealing--mostly our electronics. We are both dependent on computers to earn our livings, it's not feasible to live without consumer electronics. We took to locking them up. Bug took to lock picking.
    - Increase in suicidal ideation
    - Increase in aggressive behavior to his Dad--mostly verbal ("You're FAT!") but also head-butts to the stomach.
    - Increase in magical thinking along with re-inventing history to suit his purposes.
    - Display of no remorse for lying/stealing/deceitful manipulation.
    - Increase in sleep problems. Bug could not fall asleep easily, would feign sleep, then wander the house at night. If he was successful at stealing an electronic device, he would watch YouTube all night. If not, he would eat in his room (forbidden.)

    I know I'm forgetting symptoms here.

    Oh--he's definitely hit puberty. His voice has changed. He likes to wear girls swim suits. Looking at his browser history is quite disturbing--he frequently searches on the terms "girls drowning" or "girls underwater". He told us last summer that he was having gender identity issues. He says he has resolved them now, and has a girlfriend at school, but he still does like to wear the girl's swim suits. He had stolen a bunch of them from a friend's stash kept on hand for guests who wanted to use the hot tub. We had Bug return the suits, and later he and I went to Goodwill and purchased some for him to have for himself. (I don't particularly mind if he wants to wear women's swim suits as he experiments with his sexuality; but I don't want them to be stolen.)

    In any event, the final straw came 3 weeks ago when we were having a family meeting --using CPS techniques, even!--to discuss his continued attempts to steal our electronics. He told me that Dad (the primary caregiver) would physically abuse him while I was at work. "He shakes me like a rag doll. He punches me."

    I responded that if this were true, we would be able to see physical evidence on his body. I asked him to show me evidence of the abuse. He pointed to a spot on his arm and said there was a bruise there. I could see no bruise. I said that we needed to go to a hospital and have him examined for evidence of abuse because if what he said is true, we would need that evidence documented so we could figure out what our next steps were. I said he'd be examined and probably x-rayed for evidence of bruises, contusions, and broken bones.

    Bug backed down and said, "Okay, there's no physical abuse. But there IS mental abuse."

    I do not and did not for a second ever believe that my husband abused Bug. However, because Bug made the allegation, I arrived at the conclusion that we were in way over our heads and needed a lot more help than we were getting.

    The last three weeks have been a whirlwind of gathering paperwork, reports, referrals, blah blah blah and completing the process of placing Bug in a residential treatment facility.

    And here we are. Day Two of our Bug in Residential Treatment Facility (RTF).

    Thank you for asking, and if you're still reading, thank you for reading.
  12. pepperidge

    pepperidge New Member

    Wow. I don't know what to say. I have many of same behaviors with my kids. For starters I would suspect that he is not on the right medications and the ones he is on may be making him worse. Both of my kids have had problems with SSRIs (Celexa) leading to disinhibition. In addition we have seen more rage like behaviors on stimulants (but also improvements once other medications were on board).

    We too have to keep all electronics locked up but I don't think my son (difficult child 2) is as smart as yours, although come to think of it he went through all my husband's files until he found the code to the safe so we had to buy a whole new mechanism for it.

    Do you think there is an chance he might have any fetal alcohol disorder? Some of what you describe is very typical. It helps to know because it might help distinguish what is a psychiatric issue from a neurobiological issue and might keep you from going down fruitless medication pathways.

    Are you happy with the medical resources you have consulted with? Have you had a really high quality neuropsychological assessment done on him?
  13. bugdaddy

    bugdaddy New Member

    Hi there. I'm Bug's Dad, and BrainGoBoom is my wife. Finding you all is a godsend. Thank you.

    Fetal Alcohol Syndrome (FAS) would probably surprise us a little, but for no very good reason. We don't really have any evidence one way or another.

    We have not had a neuropsychologist evaluation - what does a neuropsychologist look for that a psychiatrist doesn't? He's had several evaluations, but all were by psychologists and psychiatrists.
  14. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    From his symptoms, I'd say that he at least has a typical case of autistic spectrum disorder. I mean CLASSIC. Many parents with Autism Spectrum Disorders (ASD) kids get them hearing tests as they are non-responsive. A speech delay is also classic. Nobody knows what causes this, but it is often often OFTEN (did I say often?) mistaken for psychiatric problems. It isn't one. It's a Neurological disorder. I know you are very invested in his current diagnoses and of course I'm not a doctor. It would probably not hurt to take him to a neuropsychologist when he gets out to see if he is on the spectrum. If so, he needs very specific treatment that he won't or can't get in residential his brain would be wired differently. I know this is a new idea and probably one you won't want to have been told for so long that it is other things...but I wanted to throw it out there. My own son was diagnosed at age 11. Until then he got a whole slew of wrong diagnosis. and was on a ton of medications.

    These kids have amazing memories. My son could recognize most words by age two. We thought he was a genuis. In fact, he had no idea what they meant. He just memorized them as well as many television programs verbatim. These kids are often very bright. Your son sounds like he had a geography obsession, also typical to Autism Spectrum Disorders (ASD). These kids tend to raise, especially in new situations, or high stimuli situations, or when they have to transition from one activity to another one. Although this doesn't happen all the time, some autistic kids do lose t heir speech around 18 months...they seem to regress at that time. in my opinion this is something you should pursues, rather than just assuming it is behavioral or due to his adoption. My son is also adopted.

    Of course even if his is on the spectrum, he has other issues too. The gender identity is worrisome, but not sure it can be fixed in an Residential Treatment Center (RTC).

    Whatever you decide to do, good luck.
  15. BrainGoBoom

    BrainGoBoom New Member

    Huh, MidwestMom. Autistic Spectrum Disorder was mentioned at an IEP meeting we had a few weeks ago by the school's counselor. If that's what he has, it would explain why his behavior has deteriorated rather than improved with the medications and therapy we've pursued in the last year. I will by all means ask his primary therapist about it and see if we can arrange a neuro psychiatric evaluation. If you can enlighten us any as to what that looks at and what is involved, I'd really appreciate it.

  16. BrainGoBoom

    BrainGoBoom New Member

    MWM--is there some bias in the therapeutic community against neuropsychologist evaluations? I'm wondering why you say he can't or won't get treated for it at an Residential Treatment Facility (RTF).

    Also--I don't think he needs treatment for his gender identity issues. He is who he is. He needs treatment for the maladaptive behaviors of stealing and deceiving.
  17. JJJ

    JJJ Active Member

    BrainGoBoom & BugsDaddy,

    Eeyore had a diagnosis of Gender Identity Disorder as a 5 year old. Like you, it didn't bother me if he wanted to wear girl clothes. Heck, in his life before we got him all of the men were either violent or lazy and the women kept the children safe and fed --- who wouldn't want to be a women in that case? On the first day of kindergarten, he went straight to the dress up box and put on a wedding dress, high heels and a tiara and left it on the whole day. He was the prettiest kindergartner in the building

    That is now a treasured family story. At 15, it is now pretty clear that he is feminine but heterosexual and I think a huge part of his mental health improvement was our acceptance of his exploration of who he was and whoever he would become.

    I agree with MWM -- Bug is showing TONS of red flags for Autism Spectrum Disorders (ASD). Reactive Attachment Disorder (RAD) is an unusual diagnosis in a child that has been with the same parents since 3 months old. Try this screening and see what you get:

    You may be able to get the neuropsychologist done in the Residential Treatment Facility (RTF). A neuropysch exam is really a collection of tests given so that they can look at many possible areas: organic brain issues, personality testing, reality testing, language, reading, intelligence, learning disabilities, attachment, etc. At that bottom of my signature is a link to an outline for a parent report, I'd strongly recommend you start one and make it as complete as possible. You will find that writing it helps put everything in order and makes it more useful for the professionals and it may bring some things into focus for you as well (I always said Kanga's issues got severe at 11 but in doing the parent report, I realized that it was really at 9 but we just didn't understand.)

    Welcome to our little corner of the web. I've been here for over 9 years and many of these posters have become as close as family. In fact, when one of my kids are in crisis, I come here first. We understand, we really do.
  18. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    NeuroPsychs can totally help you the most. No bias against them at all, but some psychiatrists I've known feel THEY are always right and discourage second opinioins. Ours discouraged it and even after son was doing 90% better, he insisted He had been right (it was bipolar) and that the neuropsychologist had been wrong (although son was functional and happy for the first time ever). Whatever he wants to think!!!! I do what I see is working for my son.

    What works for psychiatric problems doesn't help for Autism Spectrum Disorders (ASD). These kid's brains are wired differently and they need Autism Spectrum Disorders (ASD) specific help. Most therapists are ill equipped for it and don't even recognize it. Sadly, some psychiatrists aren't either. These kids thrive with structure and sameness. Some can learn to deal with changes, some can't. My son has done pretty well with tolerating changes, yet he is still "different." He is 17. As an adult, he will still need supports because he is too socially clueless to exist 100% on his own.

    I don't feel Residential Treatment Center (RTC)'s either acknowledge or understand autistic spectrum disorder. It's NOT a psychiatric problem, although it can cause behavioral problems that are related to frustration. I feel the restraint/punishing part of RTCs can truly traumatize an Autism Spectrum Disorders (ASD) child and make him even worse. You can't change the brain of a child with Autism Spectrum Disorders (ASD), but you can help the child understand the world better. I've seen really good things from Autism Spectrum Disorders (ASD) kids who got appropriate treatment. My son is one of them :)
  19. AnnieO

    AnnieO Shooting from the Hip

    BGB & BD - Everyone else has pretty much given you some great advice (like they did me when I first found this oasis of sanity... OK, semi-sanity!).

    Honestly? Bug sounds like a conglomeration of my two. Yeah, they're my step-kids, but much of it is similar. And I have to agree - he really, really sounds like he's on the spectrum... Somewhere. (Just like my Jett, though he's been diagnosis'd with Fetal Alcohol Syndrome (FAS) - sigh - and we know that's most likely true.)

    I strongly back those who have suggested a neuropsychologist evaluation. It has helped us figure out a LOT about Jett, and get help in place at school.

  20. BrainGoBoom

    BrainGoBoom New Member

    Thank you all for such good advice. I'll definitely be asking the Residential Treatment Center (RTC) if a neuropsychologist evaluation can be done. After reading up on it and Autism Spectrum Disorders (ASD) yesterday, I pinged his school psychologist--she had been concerned about Autism Spectrum Disorders (ASD) also, and is most of the way through his IEP evaluation. Here is her answer:

    "From the intereactions that I've had thus far with Bug, what I've seen doesn't send up a 'red flag' for Autism to me. There are four areas of concern that are needed for a diagnosis of Autism: impairments in communication, impairments in social interactions, sensory concerns, and repetitive/stereotypic patterns of behavior and/or interests. I honestly haven't seen evidence of these things. In order to diagnose Autism, it's also necessary to rule out that the concerns are due primarily to an Emotional Disturbance. I think that we would have a very hard time doing that at this point."

    A question for fellow parents with a kid in Residential Treatment Center (RTC): How long did it take after you checked your kid in before you started feeling human again? All I want to do is curl up with a blanket, cup of tea, and knit. I don't want to talk to anyone. I don't want to think. At the end of yesterday, I thought: tomorrow I'll feel better. I'll be able to do laundry, strip his bed, start repairing broken stuff around the house.

    This morning: not so much.