Inpatients recs (OCD, Depression, OCD)?

[Anonymous]

Looking for inpatient treatment for young adult who is really struggling. Last semester was a disaster with failing 3 classes. Tried outpatient but aren't seeing any improvements even after being put on meds. They always seem tired and have no motivation to do their work even after folks are threatening to take away financial support if they don't seek mental help. They are incredibly bright and suspect they might have ASD/ADHD but therapist said even with diagnosis it wouldn't change treatment. One parent thinks OCD is the primary problem (won't turn in work unless perfect) while other parent thinks depression. Meanwhile young adult is struggling and needs help. Looking for recommendations for best inpatient in US but bonus points if close to DC area, NY, or FL region.

[Anonymous]

Get a new therapist. An ASD diagnosis would absolutely change the treatment. Had your kid not had a neuropsych evaluation yet? You NEED this done.

[Anonymous]

Np: while I think a neuropsych is a good idea, I am in exactly the same place with my college student who has had an ASD and OCD dx since childhood, and nobody seems to have any treatments beyond treating depression, coaching time management, encouraging him to get exercise, eat well, etc. PP, what do you think an ASD dx would change?

For my child there seems to be a lethargy/depression component and being overwhelmed by a heavy workload and extreme task initiation aversion and focus challenges. Suspect he’d do better taking fewer classes at a time.

[Anonymous]

I’m neuropsych poster. I have an autistic child and other autistic teen family members - one of which sounds similar to OP’s kid. A child with “just depression” symptoms should be treated differently than a child with autism that is displaying similar behaviors. If there is “just depression” - then the right medication and support hasn’t been found yet and this should be pursued. If it’s “just ADHD and depression,” I would say something similar.

Unfortunately, as you know, if ASD is involved - nothing is simple and medications may not work. Are you familiar with autistic burnout? https://www.autism.org.uk/advice-and-guidance/professional-practice/autistic-burnout

Which is NOT depression. If your child is liable to this, expectations need to change and so does the treatment. Preferably, with a therapist with autism experience. Unfortunately, they are hard to find.

[Anonymous]

Have you ruled out a medical cause?

[Anonymous]

I might not get a neuropsch right away just because it’s a pretty grueling set of tests. Tackle the emotional distress first.

[Anonymous]

Rogers in Wisconsin and McLean in Massachusetts are the two most reputable OCD residential treatment centers. I know Rogers has a combined OCD/depression program. I imagine McLean does as well.

[Anonymous]

Anonymous wrote:I’m neuropsych poster. I have an autistic child and other autistic teen family members - one of which sounds similar to OP’s kid. A child with “just depression” symptoms should be treated differently than a child with autism that is displaying similar behaviors. If there is “just depression” - then the right medication and support hasn’t been found yet and this should be pursued. If it’s “just ADHD and depression,” I would say something similar.

Unfortunately, as you know, if ASD is involved - nothing is simple and medications may not work. Are you familiar with autistic burnout? https://www.autism.org.uk/advice-and-guidance/professional-practice/autistic-burnout

Which is NOT depression. If your child is liable to this, expectations need to change and so does the treatment. Preferably, with a therapist with autism experience. Unfortunately, they are hard to find.

NP Can you elaborate more about what you mean in terms of differences between depression and autistic burnout and how you would treat differently?

[Anonymous]

It's far from here, but a friend's young adult child with autism and treatment resistant depression had a really good experience here: https://theneurodivergentcollective.com/

[Anonymous]

Jon Hershfield is Director of The Center for OCD and Anxiety at Sheppard Pratt in Baltimore. He also oversees their residential OCD Program at The Retreat. He’s written many books on OCD and is a frequent presenter at conferences.

Starobin Counseling in Olney, MD provides both outpatient therapy and support groups for OCD as well as autism.

You can also go to the International OCD Foundation’s website to find providers and resources.

[Anonymous]

This program is in Weston Florida and has particular expertise with OCD and ASD but it is out of network: https://www.nbiranch.com/

Sheppard Pratt Retreat is a customized program for each patient but also out of network. And may not have a cohort of other people with similar struggles which could be beneficial.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I’m neuropsych poster. I have an autistic child and other autistic teen family members - one of which sounds similar to OP’s kid. A child with “just depression” symptoms should be treated differently than a child with autism that is displaying similar behaviors. If there is “just depression” - then the right medication and support hasn’t been found yet and this should be pursued. If it’s “just ADHD and depression,” I would say something similar.

Unfortunately, as you know, if ASD is involved - nothing is simple and medications may not work. Are you familiar with autistic burnout? https://www.autism.org.uk/advice-and-guidance/professional-practice/autistic-burnout

Which is NOT depression. If your child is liable to this, expectations need to change and so does the treatment. Preferably, with a therapist with autism experience. Unfortunately, they are hard to find.

NP Can you elaborate more about what you mean in terms of differences between depression and autistic burnout and how you would treat differently?

DP from PP with a question for NP. Did you read the article PP linked in their post? From the summary, it seems the article will address your questions. As well, below the article is a link to guidance on autistic fatigue and burnout that is tailored for autistic young adults, parents/caregivers, and professionals.

“Understanding autistic burnout
Published on 01 March 2022
Author: Dr Dora Raymaker

Dr Dora Raymaker, Research Assistant Professor at Portland State University, discusses research exploring autistic people's experiences of autistic burnout. This includes what autistic burnout feels like, why it might happen and what can be done to prevent it.“

[Anonymous]

I read the article and it’s interesting, but I don’t see it as all that separate from depression (my child had depression and autism, maybe burnout too but depression is the baseline). The suggested treatment is similar to the treatment of depression generally, and largely the same things my child’s IOP focused on: self-care, reduced expectations, self-acceptance, accommodations, treating yourself gently.

[Anonymous]

Mountain Valley in NH specializes in OCD. They use exposure therapy. It is $$$ but high quality care.

[Anonymous]

OP, you probably realize this, but it is totally possible to have OCD with depression and with autism. They're often co-morbid. The perfectionistic tendencies go along with all the other stuff.