Tuesday, November 26, 2013

Anxiously Anticipating Our Next Step—More Medication

Tonight I’m anxiously anticipating our appointment with my oldest son’s psychiatrist to determine what step we need to take next. Both our son’s psychiatrist and his therapist think it’s time to add more medication to help with his recent depression. So far, Wellbutrin, an anti-depressant has been offered since it has less side effects and is less likely to trigger mania. Unfortunately, our Psychiatrist doesn’t want to remove any of his current meds because it could make him unstable. He wants to get him through puberty before we try that. Uggg… more meds.

My husband reminded me that this could be a good thing and really help our son with his recent struggles. It’s not fair to let him suffer because I want things to be different. In a perfect world, we would never consider medication, let alone four, but we aren’t in a perfect world, I have to face our reality.

The other alternative suggested by our psychiatrist is having our son hospitalized. He feels that based on his violent outbursts and his expression of being “God’s mistake” is enough criteria to have him admitted.

When I expressed our concern that he wasn’t unstable and that hospitalizing him could do more harm than good, our Psychiatrist suggested that hospitalizing him may teach him that bad things happen when he acts violent.

I get his thinking, but this only takes into consideration one side of our son, on the other side, we have a child who has other issues that would become worse if we hospitalized him in his current state. Our therapist agrees.

I totally agree that if he was in a state where we couldn’t stop his violence, or he threatened us with serious danger, we would admit him. But I have a kid who is playing nicely with his brothers after a day of having fun in a field with a friend. His rage is long gone in his mind and he’s no longer being triggered by the stress of school. How can I admit him under these circumstances? Both my husband and I feel strongly that we won’t use hospitalization to “teach him a lesson”.

In the meantime, we need to discuss where we go from here, because “here” is no place to stay.


  1. We just added our third med. I so understand the struggle you are having. I'm curious how your son does at school or if you have ever blogged about it. My daughter just got an out of school suspension for punching her one on one aide. We are meeting with her IEP team in December to discuss a possible new placement in the district that can handle her behaviors better. This is so hard but your blog makes me not feel alone. Thank you!

    1. We are lucky that our son holds it together while at school. But I do know of many other moms who have been in your shoes. I have a friend whose son was moved and it worked well for him, they were better able to meet his needs and he seems to be thriving better in a smaller class setting. I hope things work out for you.

  2. The hospital is not the place for your son unless he really can't function day to day and that does not sound like the case for him at all. And by all means, don't use it as a punishment - that is just creepy. Your son may need some more down time at school or some classes in a smaller setting. I don't know. Ask him what it is that is stressful about the day. He may be able to tell you and then you can address that.

    1. I agree Meg. At our last appointment our psychiatrist compared it to "Jail" in order to teach him a lesson to not bully me when stressed. We won't use the hospital like that, we want it to be seen as a place of healing, not punishment.

      Can I email you? I have some questions I thought you might be able to help with. If so, contact me here so I can reply to you.

  3. Hello, I'm San (BP type 1, rapid cycle, psychosis, age 26, dx'd at 14). I was just released from the hospital - stress. Hospitalized 15+ times.

    Don't see it as a punishment, don't let your son see it as a punishment. Hospitals aren't "bedlam" and they are much more structured, patients are medically taken care of, and most have groups, therapists, social workers and the ability to see your psychiatrist on a daily basis. The nurses are always there, and I've found 99% of them very good, caring, someone to talk to, through my experience(s).

    I'm sorry you're in such a pickle. It's no fun. Your son must have incredible strength for school. You're an incredibly caring and supportive mom and you're very fortunate it's caught early enough to intervene and help him reach his potential. I have no doubt he's going to get through this.

    I wish you all the best in whatever happens, through this hard time.

    1. I agree the hospital can be very good, we just want to wait until he is unstable before having him go there. I know a lot of kids that have gotten better thanks to their care. Thank you for reminding us what a positive experience it can be.

  4. I have always loved going inpatient when I was out of control. I would be admitted in tears then after a good sleep I would wake up in a haze and put on my shoes (with no shoelaces lol). I think I can offer some insight into your aversion to inpatient treatment.
    The worst part about it is the initial commitment and paperwork to fill out.
    You are probably worried that your son will be mad at you if you put him inpatient and that could happen but he will get over it as he starts to feel better.
    When I went in I was suicidal and I had to be strip searched but I was 22 and they needed to be sure I wan't bringing in drugs or weapons. I don't feel that they would submit a younger person to this...but it is a good question to ask.
    My room was very clean and I shared a bathroom with only one other person. There are night checks where a nurse simply opens the door to see if the patient is sleeping well. You have group and individual therapy. Your psychiatrist gains insight from the 24 hour observation. Mandatory 72 hours I believe if in for suicide watch.
    But next time a Target episode happens I would take him to the hospital. He may see it as a threat but it is really a vacation for me. I have been inpatients twice and each time I came out with great tools and wonderful therapist.
    Hmmm....I hope this doesn't sound harsh but don't let him believe all they do at inpatient facilities is drug you up, tie you down, and label you as defective. It is a place of healing if you are willing to try. I helped my mom commit my brother twice against his will and he gained from each stay a bit of stability. The stability would have continued if he would have continued the meds.
    Oh and as far as Wellbutrin goes...it always revved me up and caused me to go into mixed episodes and there were other uncomfortable side effects. Each medicine will react differently to each individual.
    As always I wish you and your family the best.

    1. Thanks for your feedback. I agree with you that it can help someone, but right now our son doesn't appear unstable. I think school has just stressed him out. After his rage he was calm and playing nicely with his brothers. It seems weird to admit him under this circumstance. We would like to save the hospital for the situations that you share, I know then it will be just what he needs.

    2. I do hope it never comes to that point....where he is so far away mentally that he needs inpatient treatment. He is so young and I sometimes forget that he is developing control over his behavior (with help from you and your family) every day. If he is lucky he may never need inpatient care. Much love Mama Bear

    3. As always In The Pink, thank you for your help and support!

  5. Hello,
    How do you feel and how does your son feels about his psychiatrist ?
    Do you feel you can communicate with him ?

    Regard to hospitalize your son to teach him a lesson, I agree that it was the dumbest advice a psychiatrist can give.
    Hospital is meant to treat someone who is sick, not to punish a child or anyone for bad behavior.
    This piece of advice reminds the time I spent with my ex-psychiatrist,
    I am always very cautious with doctors giving these kind of dumb advice (and make me question their competences).

    I also believe that if hospital is used as a weapon to punish, then, the day your son is really unstable, he will not go to hospital.
    In terms of health, it would mean he will flat out refuse to do anything when unstable because of his association hospital = punishment. It would be detrimental to his health.

    Do you think your son's psychiatrist can hear this point ?

    1. I couldn’t agree with you more Guilia, we want the hospital to be a place of healing he'll want to go to when unstable, not something he sees as punishment. I think our psychiatrist understands our point, I just don't know if he agrees with it.

    2. So, at this point, do you feel you need to change psychiatrist or you can stay with the current one ?

      Will this psychiatrist respect your wish, or push you to change your mind ?