Thursday, October 18, 2012

Little One has Voices Inside His Head

This past weekend we experienced a first with our youngest son. After losing a game with his brothers, he became upset, which is pretty typical these days. As I was consoling him, he yelled out, “Stop laughing at me!” I jumped to his brothers defense and said, “Honey, your brothers weren’t laughing at you.” He responded, “I know, it’s not my brothers, it’s the voices inside my head.”

I immediately tried asking him about it, but he responded quickly, “I don’t want to talk about it!” This was the same response he gave when he shared he had bad thoughts in his head about a month ago.

So the next day I tried to ask him again, hoping that once removed from the situation he would be more comfortable. At first he was very hesitant. So I reassured him that he wouldn’t get in trouble for anything he said and that nothing bad would happen by telling me.

Appearing reluctant, my little one explained that he had voices in his head. Not Mommy, Daddy or his brothers, but voices of other kids, “strangers”. He told me that they call him bad names like idiot and dork and laugh at him a lot. They also tell him to do bad things like steal money from my purse, to beat up his brothers or to destroy property. These are his words as he described it. When I asked what would happen if he didn’t do the bad things, he said he would get a headache. He said that the voices make him feel sad or scared. When I asked if the voices were real, inside the house or inside his brain, he said that they were inside his brain. He said sometimes they are just one voice or sometimes they’re a group of voices.

Hmmm... that’s unsettling.

We definietly can see the correlation of what he shared with me and his behavior lately. It isn’t uncommon for him to run out of a room screamming, “Stop laughing at me!” when the family is laughing together (never at him). He’s quick to assume that people are putting him down when they aren’t and overreacts to a lot of situations. He’s also been putting himself down a lot saying that he’s a horrible person.

I gently let him know that the voices weren’t real and I would try to help them go away forever, but he needed to let me know when they tell him to do bad stuff or laugh at him. Later that day, he came to me twice about the laughing inside his head, I told him that we could stop it if we sang a song together. He was very willing to participate and asked, “Can we sing You Are My Sunshine?” We did and it seemed to do the trick.

I spoke with his therapist and right now she thinks this is related to his anxieties. She thinks the voices are maybe his own thoughts and feelings that he’s struggling with. So we’re making a big effort to give him lots of positive feedback, remind him constantly that he’s a great kid with hopes to override any negative thoughts he has inside.

It does concern me that the voices were described as being “strangers”, sometimes more than one and that they make him feel sad or scared at times. Poor guy, no wonder he seemed so stressed all the time.

I’m glad that he finally opened up and shared what he was experiencing. Now if I can just figure out how to make it all better—because that’s what mama bears do!


21 comments:

  1. My little one describes a very similar experiences. That voices in her brain would be telling her to do and feel things that another part of her brain didn't want to do. The monsters became more present when the voices were present. I just can not comprehend what it must be like inside their little bodies. she is only about to turn seven! oh It also makes her really sensitive to any other noise in the house when she feels like that. is it the same for your little person.

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    1. Yeah, my little one is 7 now, I remember being scared of the dark as a kid, I can't imagine living with this kind of stuff. It’s remarkable how well the kids do considering what they experience. And yes, my son is sensitive to sounds too.

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  2. I'm not sure I agree with the therapist. Sounds very detailed to be anxiety. Maybe as it happens more and he shares with you the better understanding you will get and get an idea of how to proceed. Hugs, Mama.

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    1. Thanks Meg for your feedback, I have a weird feeling about it, but I’m trying not to overreact. It does seem a little detailed doesn't it. What comes to your mind?

      I have a call into our psychiatrist to see what he'll have to say. I just remember a long time ago with my oldest (before medication) when we shared that he heard a voice talking to him and the doctor at the time said that it was nothing to worry about since the voice was telling him to do the right thing. He warned us that if a voice is ever telling a child to do something bad, we have to be concerned.

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  3. Is the therapist unwilling to consider that he's dealing with something more along the lines of like what his older brother has? Maybe it's time for a second opinion.

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    1. Her comment to me was that my son doesn't appear to be psychotic. But I am interested in having her look into this a little more. There is a lot going on with him, I just don't want to brush this off if it is indeed something more. I hope to get more information from our oldest son’s psychiatrist soon.

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  4. You described my son's experience almost to a tee. His doctors determined that they were actual hallucinations. They were so scary and had gone on (obviously unbeknownst to my husband and me) for awhile. At the time, he was on ADHD medication as he is extremely ADHD (in addition to having a mood disorder). His pdoc immediately took him off the stimulant he was taking. Right away the hallucinations went away!! I pray that you and your family find as easy a fix.

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    1. Wow, it’s that similar? Did you see any other behaviors? How did you find out about the voices? Was your son scared a lot (mine is)? Did he think the voices were in the room with him, or in his head?

      My youngest has never been on medication, so I know that can't be the source, I wonder what it is?

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  5. I'm so glad you are already set up with a therapist AND a psychiatrist. That's half the battle right there!!! Should you and your son track these instances? Look for frequency or triggers and see what you come up with. I'm glad singing and some attention from you made your son feel better. What a positive thing! Cathy

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  6. Thank Cathy, I agree that I should start tracking these things. It really helps to see if there are patterns that are recognizable over time.

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  7. I have these kinds of voices as part of anorexia, a disorder underpinned by anxiety. It is hell. These voices are not uncommon in anxiety disorders and depression, they are just not often talked about by sufferers, probably due to the connotation that it is related to psychosis and therefore makes you a 'bad' person (when of course it doesn't, even if it were psychosis).

    There are fundamental differences between these sorts of voices and auditory hallucinations. For starters, people with anxiety will experience the voices inside their brain, whereas people with psychosis will experience the voices as being outside their head even if they know they aren't real. With anxiety, the voices are not audible; with auditory hallucinations you really can hear them just as you can hear someone talking to you. The type of voices that people with anxiety and similar conditions experience is often misdiagnosed as psychosis; it takes a trained eye to ask the right questions and see the difference.

    It is great that your son opened up to you about this, as he can now learn how to cope with and fight the voices. And if it does turn out to be bipolar-related hallucinations, then you have caught it early and are experienced and well-equipped having helped your eldest.

    If someone has experienced auditory hallucinations and I have not explained it well, please jump in. I have not had them, but I did experience visual hallucinations due to lithium toxicity (taken for depression). In my case I knew what I was seeing wasn't really there, but I still saw it plain as day -- it
    was just being projected by my brain. I am assuming this is the same as auditory hallucinations, but with different senses.

    I apologise for the essay, I am hoping it may help you understand.

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    1. Thank you Sam for your feedback, I really appreciate it!

      It’s interesting that you mention the voices and it's relation to anxiety. I have been wondering if this is what my son is experiencing. Thank you for clarifying the differences between the two types of voices.

      For you, did you ever feel scared by these voices? Do they feel like your own thoughts or do they sound to you to be different people in your head that? Are they brought on when you feel a surge of anxiety, but quiet when you are feeling good? What can you do to live with them?

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    2. With anxiety, I suffer from tinnitus. I can compare my tinnitus with the sound of a bee, or a fridge working.
      At the beginning, I thought it was a hearing loss. Turned out it was a really bad anxiety.
      For me, no, they are not voices, but tinnitus. In my remaining ear (I suffer from Single Sided Deafness).

      Most of the time, I can ignore it. Otherwise, I go away and do something else.

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  8. Oh Mama Bear,

    Big hugs to you and your family. You all have so much more on your plate than any family deserves. We haven't had much in the way of voices. At one point my son told me he could read minds and that the thoughts of the people in the grocery store sounded like whispering. This happened when he was 9, not on medication, and the most deregulated.

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  9. >> For you, did you ever feel scared by these voices?

    I am scared by what the voices can compell me to do because such actions hurt my loved ones and could kill me. More than anything though, I find them distressing, much like how it would be distressing to have someone hurling abuse at you 24/7, threatening and taunting you, screaming at you to do this, do that, don't do this or that.

    I can understand why they would be particularly scary to a child, especially if it has come on relatively suddenly.

    A caveat: sometimes the voices aren't scary at all, sometimes they try to convince me that they are my best friends, acting in my best interest, that I will feel a whole lot better if I do what they say. And I DO feel better if I do what they say, but this feeling is only temporary. When I was younger the voices were not at all scary or distressing because I just did what I was told and had no insight as to the nature of what was gonig on.

    >> Do they feel like your own thoughts or do they sound to you to be different people in your head that?

    They don't feel like my own thoughts, or really like thoughts at all to be honest. It feels foreign/alien. I consider it to be my illness(es) talking.

    >> Are they brought on when you feel a surge of anxiety, but quiet when you are feeling good?

    Oh, most definitely! It should be noted, though, that they further aggravate any anxiety/distress that I have to begin with, so it can be a vicious cycle.

    This is actually one of the reasons why I know equivocably that the voices are not ME. They are significantly muted when I am well.

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  10. >> What can you do to live with them?

    I have found a number of things helpful:

    - Dialectical Behavioural Therapy (DBT). This is used most often in people with Borderline Personality Disorder and/or who self-harm, but it teaches a number of skills which are excellent for improving distress tolerance. I think it would be too complex for a child, and I don't know of anyone adapting it for children, but a therapist or psychologist with training in DBT could certainly teach some age-appropriate principles and skills. You might find this website useful: http://www.dbtselfhelp.com/ particularly DBT Lessons -> Distress Tolerance.

    - Cognitive Behavioural Therapy (CBT). This is an evidence-based therapy for anxiety disorders. It has been adapted for children but you would need to find someone with specific training. CBT has helped strengthen my own 'healthy voice'.

    - Distraction techniques. When it is particularly 'noisy' in my head listening to music or having a television playing in the background helps give me something else on which to focus. I find this is particularly important at night time, when the voices tend to be at their worst (probably because there are less distractions at night time!). Sometimes music/tv isn't enough and I have to distraction further by doing something else with my hands/brain such as playing a game on my iphone. If I am really anxious and do not have something to do with my hands, I have a tendency to sub-consciously start hurting myself and will not realise until someone points it out to me. Talking to someone also helps distract me from the voices. Sometimes I may not be able to engage in conversation, but hearing someone talk still helps. I find it most helpful when the person talking is calm and talkes about something else. Of course, there is a time and place to talk about these things but that time is generally not when I'm in a state of severe distress!

    - Many people benefit from guided meditation or other forms of meditation. I personally find these things aggravating as it ends up just being me and the voices duking it out in my head. I do find pilates helpful though, because while it is relaxing there's still enough for me to concentrate on.

    - High intensity cardiovascular exercise. You know how anxiety creates a surge of adrenaline and cortisol? It is basically the body prepping you to fight a battle which doesn't necessary exist, like a bear chasing you or whatever. Exercise is a good way to release these stress hormones, but it must be suitably intense. This is more for the anxiety than the voices but since they play into each other, it is worth noting.

    (NB, in the unlikely event that a parent with an AN child is reading this, please note that I am not allowed to exercise unless I am at a healthy-enough weight to do so and am eating enough to account for the energy expenditure. DO NOT permit exercise otherwise!).

    - Doing the Opposite. I do the exact opposite of what the voices tell me to do. Doing the Opposite makes one's anxiety shoot through the roof in the short term but it helps over time. It takes a lot of practice.

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    1. Thank you Sam for your thoughtful answers, it was quite interesting to hear about it from your perspective. It sounds like a terrible thing to live with, but I find it encouraging to see so many ways you have tried to manage it. I find it interesting that the voices don't feel a part of you and that you described them as "foreign/alien", just as my son described them as “strangers."

      Did you ever feel like something bad would happen if you didn't follow through with the voices’ commands?

      Do you remember how old you were when it started?

      Also, what are theses voices called?

      Could I share your answers in a post for those that may be interested in what you have to share?

      Thanks so much for giving this insight, it’s really helpful for understanding my little one!

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    2. > Did you ever feel like something bad would happen if you didn't follow through with the voices’ commands?

      Oh yes. I would become fat, I would be greedy, a sloth, disgusting, repulsive, lazy. I would be a failure, amount to nothing, and let everyone including myself down. To avoid these outcomes I had/have to do whatever the voices say.

      This probably sounds very similar to OCD, but when I've had OCD episodes they are very much intrusive thoughts, not intrusive voices.

      > Do you remember how old you were when it started?

      I don't know when it started. I became more aware of them when they became particularly vicious during treatment for anorexia. However, I am certain that they were there while the anorexia was developing, but that they were silenced by doing what I was told, so I was not bothered by them.

      It is possible that they were there earlier. Looking back, I had sub-clinical depression and anxiety when I was a mere four year old, along with what I would call proto-anorexic thoughts and behaviours (scary!).

      > Also, what are theses voices called?

      I have no idea, sorry!

      > Could I share your answers in a post for those that may be interested in what you have to share?

      Sure. :)

      > Thanks so much for giving this insight, it’s really helpful for understanding my little one!

      It is a pleasure. I do not often respond to blog posts but I thought in this instance I might have something to offer.

      I do not believe that parents can prevent their children developing mental illnesses, particularly those which strong biological links (bipolar disorder, anorexia nervosa, some forms of anxiety and depression). You should NEVER blame yourselves! There are, however, so many things you can do to help your child cope and whip their illness into submission. Your sons are so blessed to have you guiding and advocating for them.

      Ooh, I just realised that I left off a vital component of my 'what helps me cope with the voices' list: my superhero dog, Malcolm! When I am particularly distressed he will insist upon climbing onto my chest and he will refuse to move until I have calmed down. There is something about the weight of his body laying on me which is particularly beneficial. I have since learnt that this is one of the skills they teach to psychiatric and autism service dogs. He has no such training!

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    3. Thank you so much for your helpful information, I look forward to sharing them with others! I love that your dog helps, how awesome is that!

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  11. This happened to Caroline too and didn't stop until she was put on an anti-psychotic. Very scary! She also had hallucinations of a devil like person holding a knife out to her telling her to harm herself. She was 9 I think.

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    1. Wow, thanks for sharing Megan. Do you remember if Caroline thought these voices were real (in the room with her) or in her head? The devil like person sounds just frightening!

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