<p>To answer some of your questions -
A psychiatrist prescribed the meds, and he is seeing a psychotherapist, too. He’s only seen the therapist twice, so we are early in the process (it took several weeks to even get an appointment - there aren’t enough mental health care professionals for teens!) It’s so hard to know yet if it’s a good “fit” but he likes the guy and that’s a start. I don’t think we’re ready for a second opinion yet - I don’t want our son to think we’re just grasping here and have no confidence in this therapist.<br>
I honestly don’t think we’re dealing with any learning disabilities here - he’s an amazing test taker and loves puzzles and intellectually challenging stuff. Always has. No trouble processing information.<br>
He’s taken several online courses over the past 3 years, and they may be a good option at some point. Right now, however, anything connected to grades and homework puts him into a tailspin. Curled up on the couch, crying and holding his head. So sad to see - it’s breaking my heart.
On a happy note, he just went out the door to go to his Jazz band practice with a smile on his face. Such a contrast to the kid this morning who couldn’t even get out of bed…
Thank you SO MUCH for your incredible insights, advice and caring. I had no idea the support that exists here. I don’t feel so alone anymore.</p>
<p>
</p>
<p>Oh, that brought tears to my eyes. It is so very hard.</p>
<p>
</p>
<p>I’m so glad that his school is being understanding but I do wonder if perhaps medical leave might not be in order. Of course, that would take him out of his ec’s as well and those seem to be a lifeline for him right now. </p>
<p>I wish I had more wisdom for you. I can only offer encouragement and my admiration for the unconditional love and dignity with which you are treating your beloved son.</p>
<p>Some high schools will allow participation in ECs for students who are being homeschooled. Maybe your school would allow this during a medical leave.</p>
<p>I am wondering whether an outdoor program might be good for him during the summer. There are a couple of very good ones that are recommended by posters here on CC - I was reading the threads last year. I believe that one is NOLS - National Outdoor Leadership School, another is Outward Bound. Maybe a complete change of scenery, lots of physical activity, the chance to develop different kinds of skills, would be therapeutic for him? Of course, you don’t want to disrupt the therapy at this point, but maybe in a few months?</p>
<p>Ignore this, of course, if it is not helpful.</p>
<p>
</p>
<p>It is hard, but fortunate, too, in that there are medications now to help.</p>
<p>debMaine, there are indeed many paths, so don’t worry about that. I can’t really add any advice to what others have offered, but wish you well on this unexpected journey.</p>
<p>I agree with Outward Bound.</p>
<p>and get him off the zoloft.</p>
<p>OP, sending many hugs. You are definitely on the right track, and it’s great that the school is so willing to work with you. Give your S the gift of time that he needs to heal and to develop healthier attitudes about his grades and self-esteem. Better that he delays graduation for a year than getting to college, having a crisis and not having a support system in place. I’m very glad to hear he’s still involved in some outside activities – that’s a good place to begin.</p>
<p>This will be a long post; please bear with me.</p>
<p>Your son reminds me so much of my son’s best friend, except that his anxiety attacks began in middle school and accelerated through high school. This is a family where anxiety seems to be part of the DNA. The older son ran away from home as a senior because he couldn’t deal with the pressure but due to an understanding hs administration was still able to graduate. He went off to college that fall but dropped out after 6 weeks, then spent 2 years traveling and working before going back to college. He is finishing up his PhD in math at Cal, a living demonstration that a windy road can nevertheless lead to the same place as a straight one.</p>
<p>My son’s friend was diagnosed ADHD quite early in life but did very well academically, as he is quite gifted. The problems started after he was exposed to mono. Perhaps it was coincidental or perhaps the virus was a trigger, but he developed allergies, which have only gradually been discovered. When he didn’t feel well he shut down in exactly the way you describe - refused to go to school, couldn’t do any homework (said that his brain wouldn’t work), numbed himself endlessly with video games. It has taken his parents years of medical sleuthing and many wrong turns to figure out what is going on with him. </p>
<p>The psychological - besides the ADHD, he is an obsessive perfectionist who sets ridiculously high standards for himself and whose self-image has been wrapped up to a considerable extent with his performance in school (thankfully that seems to be easing somewhat).</p>
<p>Food allergies - various grains (plus he needs to be on a gluten-free diet), but the biggie is yeast. If he eats yeast his ability to think and organize completely shuts down. </p>
<p>Airborne allergies - esp. mold. His sinus passages are such a mess from the years of irritation that he is scheduled for surgery this spring. He pretty much can’t breathe through his nose. As a result he has had sleep apnea for the last few years. He can sleep for 12 hours and still not feel rested because he can’t stay asleep long enough to experience REM sleep. You can imagine how being chronically sleep-deprived could aggravate one’s anxiety.</p>
<p>Allergy to strep bacteria. When he was in middle school and this was all starting, every time he would start shutting down I would ask his mom if she had gotten him a strep test. Sure enough it would come back positive.</p>
<p>He struggled through a couple of years at our public high school but then transferred to a very small private school. He will be graduating in June and attending a well respected LAC, majoring in film production (and his NMF status earned him good merit aid - hooray).</p>
<p>So my advice is to explore not only the psychological issues, which you are doing, but also to look for any possible physiological triggers - illnesses, allergies, etc. Wouldn’t be a bad idea to get him tested for mono, as I know at least one kid (my daughter’s friend) who had none of the ordinary symptoms - her only symptom was that she was just horribly tired all the time. When you have a kid who is pushing himself to the limit and then doesn’t feel well, he may not recognize that the reason he feels so overwhelmed and miserable is because he is sick.</p>
<p>Hugs to you and your son - you will get through this, and his dreams in the long run are not dust.</p>
<p>So sorry your son is ill. It is great he still wants to participate in social activities/EC’s. You are doing exactly what you should be doing: love him up and get him the medical help he needs. In the long run of his life, it does not matter if he takes a year off in his teens and plays video games. It isn’t “normal” for a teen to want to quit school. When your son is healthier, he will not want to sit around playing video games while all of his peers are going to school. He will choose to go to school as soon as he is able. In other words, when he feels normal, he will be able to resume his normal activities. Until then, who cares what he does? His intellect will not be damaged by this depression. He will eventually graduate from high school and then attend a college that is right for him. Good luck with your family!</p>
<p>You might consider tests to check for observable physical problems if this hasn’t already been done: drug testing, EEG, MRI.</p>
<p>You might try to characterize the manifestation of the anxiety. How does he feel when the anxiety hits? Is he feeling something mentally or sensory that causes so much pain? Are there observable cycles to the attacks? Are there external triggers?</p>
<p>Does the Zoloft remove most, part or just a bit of the problem?</p>
<p>Do you have any relatives with similar problems?</p>
<p>Someone should page Shrinkrap to this thread.</p>
<p>this may be a rather cold thing to say, I’m sorry - but first take the video games away - bite the bullet - video games are an addiction as bad as drugs to some kids.</p>
<p>You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Sertraline is FDA-approved for children with obsessive-compulsive disorder (OCD). It is not approved for treating depression in children. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.</p>
<p>get him off the zoloft.</p>
<p>Its absolutely inappropriate to suggest the OP remove Zoloft from S. A final diagnosis has not been made. We have no idea what is behind the symptoms of OP’s S. Its scary, but let Dx be left to MD and PhD. This situation is complex. Indeed, some SSRIs have been approved for adolescents, eg Lexapro and Luvox & Zoloft. I have no doubt that the caring OP is in contact with psychiatrist.</p>
<p>jdjaguar, you need to go look at newer research findings.</p>
<p>I am patently against the prescription of anti-depressants to adolescents.</p>
<p>as I said before…a good Outward Bound program would equal 1000 doses of so called “approved” medications.</p>
<p>and I’ll leave it at that.</p>
<p>Yes to bookworm and owlice.</p>
<p>I also wanted to add that “taking away the video games” is one thing when a child is doing fine, during a crisis it’s another. I’m sure the OP and the professionals involved in her son’s care are making the best decisions they can with far, far more information than we have here.</p>
<p>Mental Health problems can result in a feedback loop where the problem gets worse and worse resulting in hospitalization and the use of medication to get over a crisis. In some cases, there can be permanent cumulative effects of the symptoms of crisis. If something as simple as video games can alleviate major problems, then I’d say go for it.</p>
<p>If someone is having a heart attack, suggesting an outward bound program wouldn’t be appropriate. Drugs, procedures and even electric shock would be called for. Modern psychiatric drugs can be miracle workers today. I wouldn’t presume to know much of the details of the OP’s details and so I wouldn’t know if Outward Bound would be useful in their situation. It probably wouldn’t be.</p>
<p>One benefit to finding out about the problem is that the environment is far more controllable. This does happen in college too and it can make for a far rougher time for parents and student as the student doesn’t have the family support network available.</p>
<br>
<br>
<p>My understanding is that a kid can be brilliant and still have a gap in cognitive function, which may not become apparent until high school or college when he is being challenged to a limit. One might have a verbal IQ of 140 or 160 and a performance IQ 20, 30, 50 points lower. You climb the academic hill until at some point you hit a wall. </p>
<p>You’re the Mom, you know your own child. Nobody wants to lead you down a blind alley, but it may be worth quietly exploring a few different possibilities before you settle on an approach beyond the immediate crisis.</p>
<p>The video games are part of how he is presenting. They don’t sound like they are the problem. I should mention that my son’s friend also was able to enjoy his EC’s and friends even when in the midst of one of his crises. That’s why it took so long to figure out what was going on. Everyone just assumed that it was just a psychological response to the pressure of schoolwork, not realizing that there were some physiological issues as well.</p>
<p>It is so hard going through this. About 6 months after my DH died, my younger daughter developed what spiraled down into severe depression with suicidal ideation. She had 2 hospitalizations. After discharge, she went into partial day hospitalization, meaning going to a school scenario for kids who are emotionally unable to attend school. Light on school stuff, heavy on ‘dealing’. There is no way she could attend regular school till she was really well again. She did return to school the following year, and was on meds for about a year after she was discharged. She is better than fine now. </p>
<p>A few tips: </p>
<ol>
<li><p>Make sure the psychiatrist is a pediatric psychiatrist and that the therapist is a pediatric therapist.</p></li>
<li><p>DO NOT listen to the anti-medication people out there. There are many many people who think that mental illness is a weakness that can be cured by ‘getting a grip on yourself’, or exercising more, or any myriad of self-help activities. </p></li>
<li><p>Your son is acutely ill right now. He should do only what he is able to do. </p></li>
<li><p>He has to sleep. If he is not sleeping well, the psychiatrist definitely needs to know. Medication will help if he needs it. He won’t need it forever. </p></li>
<li><p>If his condition worsens, i.e., he begins having more and more anxiety, or develops depression, or whatever, do not hesitate to take him to the ER of a hospital with inpatient psychiatric facilities. An inpatient stay may be called for at some point. Follow your gut on this one. They won’t admit the kid if he doesn’t need to be admitted. Being admitted frees the kid up from having to ‘cope’, when they just don’t have the mental energy to cope.<br>
The couch behavior you describe seems pretty acute to me-and he is obviously self-medicating with the video games–(my daughter wanted to listen to really heavy death metal music all the time–said it helped. Her docs and I decided to initially severely limit her exposure to it since it was so very very dark.) Use your judgement on the video games. More or different medication/therapy might be better than hours of video games. But video games seems no worse than Ativan or Xanax. Be on the lookout for excalation. The parent has to be calm but vigilant. </p></li>
<li><p>There is no stigma to this at all. No different than a physical sickness. Your kid will see it in whatever terms you see it in. Serious, but not a failing. Important to get treatment for. He needs to know to tell you if he thinks things are getting worse.</p></li>
</ol>
<p>HTH. YMMV.</p>
<p>Debbie</p>