Hospitalization for mental illness

[Anonymous]

Anonymous wrote:

OP - So sorry your son and your famly are going through this. I can only relate that our oldest daughter was a very, very hard case to identify in terms of medications and she was not identified as having a mental health issue until she went away to college and it reached the point that she hospitalized herself. It was a very, very hard time for all as on paper she was just what every parent would want in a daughter, student, community member etc. She had to withdraw from a top tier college, came home and fortunately found a good psychiatrist here to work with though as you have seen there were ups and downs over her college and grad school years. Since you seem so at the end of your rope, I will share some of the things that may be considered:

- She was very hard to diagnose, beyond the anxiety - but probably was a derivative of the bi-polar family. But with not classic it was hard to say if meds dealing with that would help. Ativan was med given to her to help keep mood stabilized, but more to take when in a panic or escalating situation. As an adult she still uses it today when she knows she will be in overtly stressful environment.

- She could get started on something and have her anxiety and her "acting out" escalate which for her was calling others on the phone or when home being in your face and unable to sleep. And I mean she could go without sleep or much for days even taking meds. I would definitely say this is not the med to start with if it can be avoided at all, but she was put on Klonopin at least for a time. It was the severe lack of sleep, fueled by anxiety that could escalate though not in dangerous behavior, but still very debilitating such as no concentration etc.

- Inability to sleep runs in the family and when my husband had an adjustment to retirement a few years ago, the same psychiatrist helped him to get his system righted, BUT the key was finding a sleep medicine. What finally worked was an older medication called Doxepin. For him the fact that it also seems to deal with allergies was also very helpful as that had been the start of a physical downturn at the same time.

- For her anxiety/depression she, too, went through several medications while in college and then grad school, and it was very frustrating because one would work for even a couple of years and then seem not to. And you probably due know that to really try a new one or mix means coming off for a period of time. I know at one time she was on Lithium, which while scary to think of, really did work in bringing her system into balance. Eventually she found Lexapro to work.

- In terms of treatment she always had a team of a psychiatrist and a psychologist, who worked together though not in the same practice group. While in graduate school after two years of great stability, things came apart again and at that time, it was recommended she go to a day treatment program so she could also pick up her school program as soon as possible because it was important that she reestablish a routine.

- The impact on the siblings as well as parents is real, and you can't isolate one from the other. About the best you can do is to try and spend special time with the other siblings and let them know they are loved and that the one in turmoil is due to an illness.

- Are there no options in the DC area for a hospital based day program with an educational component once the teen is stabilized? Or it would seem if you get your son into a hospital for stabilization that he would need to be released to a therapeutic day treatment program to start with.

Not sure any of this will apply, but thought I would share.

Wow. You keep referencing anxiety. You think it’s an acceptable issue and you’re embarrassed or whatever of the issue that your DD really has.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP here. The psychiatrist has a long term plan (a 2-3 year plan), but nothing seems to be getting better, and these rages are destroying our other kids (and us, but whatever). They pop up at random times and there is no stopping them until they run their course. And in the meantime, he's not going to school and is not functioning in society. And we have less than a year until he's 18 and we lose some levers to get him care. I'm just at a loss.

I am concerned that the doctor cannot control the outbursts with meds. This alone is a good reason to hospitalize and tweek meds under 24 hour supervision. Have you seeked a second opinion?

OP here. This is his fourth psychiatrist, although the first since he had a real breakdown in his ability to deal with anxiety at all. The biggest problem is his lack of sleep. The doc keeps tinkering with his meds, but nothing seems to enable him to sleep at night and function during the day (the meds that make him sleep render him totally nonfunctional).

Have you talked to the doc about the big guns, like Abilify? Have you done a genetic test for med absorbtion (genesight)?

Was going to suggest something similar. My DD had SSRI-resistant anxiety and was put on Zyprexa, an anti-psychotic. While I am not a fan of this class of drugs (and have written here before about that, extreme caution is required), Zyprexa has helped a lot and she is now on a quite low dose doing fine. Her anxiety attacks were terrible and very destructive. Not rage exactly but she would scream hateful things and would systematically and almost robotically trash everything around her as though she were in a trance.

Sorry but that is NOT anxiety.

I disagree. Anxiety can definitely drive rage behavior, especially in kids. OP, you should also be looking into the possibility of some kind of guardianship once he is 18--you want to start the process ahead of time. Made a big difference for some parents I know.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP here. The psychiatrist has a long term plan (a 2-3 year plan), but nothing seems to be getting better, and these rages are destroying our other kids (and us, but whatever). They pop up at random times and there is no stopping them until they run their course. And in the meantime, he's not going to school and is not functioning in society. And we have less than a year until he's 18 and we lose some levers to get him care. I'm just at a loss.

I am concerned that the doctor cannot control the outbursts with meds. This alone is a good reason to hospitalize and tweek meds under 24 hour supervision. Have you seeked a second opinion?

OP here. This is his fourth psychiatrist, although the first since he had a real breakdown in his ability to deal with anxiety at all. The biggest problem is his lack of sleep. The doc keeps tinkering with his meds, but nothing seems to enable him to sleep at night and function during the day (the meds that make him sleep render him totally nonfunctional).

Have you talked to the doc about the big guns, like Abilify? Have you done a genetic test for med absorbtion (genesight)?

Was going to suggest something similar. My DD had SSRI-resistant anxiety and was put on Zyprexa, an anti-psychotic. While I am not a fan of this class of drugs (and have written here before about that, extreme caution is required), Zyprexa has helped a lot and she is now on a quite low dose doing fine. Her anxiety attacks were terrible and very destructive. Not rage exactly but she would scream hateful things and would systematically and almost robotically trash everything around her as though she were in a trance.

Sorry but that is NOT anxiety.

I disagree. Anxiety can definitely drive rage behavior, especially in kids. OP, you should also be looking into the possibility of some kind of guardianship once he is 18--you want to start the process ahead of time. Made a big difference for some parents I know.

Severe anxiety can definitely cause this kind of rage.