Yes I told him he could come to dinner. His dad and I both like to cook and it is something that is usually appreciated. Want to come to dinner?
I just got off the phone with my son & his case manager.
He was thinking heād come home tomorrow, but they want to keep him until Monday since heās telling the nurses heās psychic and can make people faint over the phone.
He told me he got his shot on Monday or Tuesday. She says yesterday, but she also couldnāt tell me the dosage. of the shot - just the pills, so I donāt know.
He was OK when they said Monday would be definite, but you could tell he was disappointed.
Heās still not aware that heās heard voices in the past, but they think he is from his level of distraction. His answer is that heās stuck in his head, which would probably be a very good description.
So, weāll see. At least theyāre being cautious this time.
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Me son said today that if I would have just let Iām look in the mirror for a few minutes he would have been fine. In fact, mirrors seem to trigger punching.
Oh well, he did say he was taking his medicine but was going to have to move out. When he gets home. This is pretty typical. His nurse said he was doing a little better today and earned a yellow band which means he can move around a little more freely.
She couldnāt tell me about the meds at that time, only that she knew he was taking them. Hopefully, he can stay on them. I think the longer he stays the better. Funny how my attitude has changed since the first time he was admitted, isnāt it?
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My attitude about the hospital stays have changed too - and quickly.
I had a short visit with him tonight. He looks much better and sounds better, but heās still got plenty of room for improvement.
I saw the girl today. She was already visiting with two women who Iād guess were her mother & sister. She sounds incredibly young, talks a mile a minute, but she is either much older than my son or sheās lived a really hard life.
She didnāt sound psychotic, but I guess everyone presents differently, and she could have been in there for drugs or alcohol or something else.
By the way she was complaining about the lack of groups (only 3/4 a day, which is as much as my son can handle) & other things, she must be a frequent flyer.
He said hi to her and told me thatās who he had been talking about, but that was the extent of it.
You could always ask your son to ask her or ask him casually what sheās there for if you want to find out.
Thatās a good idea, but I donāt need to know.
I wish her the best, but I can already see this is just a bit of fantasy for my son.
Oh, she must be like 10+ years older than your son if thatās the case. Some guys like older women, but itās rare.
Heās majorly obsessed with his last therapist, and sheās probably 10 years older than him or close to it.
Itās not the age so much. Itās the fact that she looks & sounds like a major drug or alcohol abuser. Iāve been around enough of them that I know the signs.
She sounds nice enough & Iām sure sheās friendly with him, but heās not going to interest her like that.
And, heās so lonely and desperate to find a girlfriend that he would mistake kindness for more.
Itās OK - heāll be coming home on Monday & is anxious to get here. If he really liked her, heās want to stay longer.
As it is, he tried to talk them into releasing him tomorrow like they were talking about a few days ago.
Thatās more understandable. It can br easy to get up caught up in someone out of loneliness.
I went to visit my son in the hospital tonight.
They promised him he could come home Monday since they were telling him he could come home last Friday.
Heās still talking about being psychic & being on a TV show.
The only good thing was we talked about how it was OK to think youāre like someone, but not quite so OK to say you are someone. Since the Bible now makes sense to him, he should say heās like Jesus, rather than actually Jesus. That made sense to him, but it might have just been a case of him telling me what he thought I wanted to hear, because heās getting it in his head that telling people what they want to hear is what he should do to get out.
It was also very quiet when he went in there almost 2 weeks ago - and now itās really, really loud. He took a styrofoam cup and tore the bottom out to talk through it like a megaphone so I could hear him & it worked pretty good. He says heās not sleeping good now, so that could explain him going downhill a little.
Iām not going to try to convince anyone to keep him longer than Monday. Heās approved for the intensive treatment program finally and Iām going to see what we can do with him on an outpatient basis.
Needless to say, I had let my hope get away from me again & Iām more than a little sad and disappointed that Iām not seeing the same improvement I saw the first time he was given the Invega. Iām still hoping for the gradual 6 month recovery other people are talking about, but Iām kind of worried itās just not going to work for him.
On another note, I got a look at what full-blown SZ can look like tonight. There was a very large man there, maybe about my sonās age, maybe slightly older. In addition to being large, he appeared to be dressed for church and refused to leave the room where they did visitation. The staff tried to talk him into going into the other part of the unit, but it wasnāt happening so they finally moved visitation.
He was confronting the staff about who was in control, etc. and when the staff would back off a little to see if he would calm down, he was talking to the walls and the floors about the ministers in his family, and about how he knew Jesus and Jesus knew him (although he never said he was Jesus).
An hour later when visitation was over, he was still at it.
Between him, and the new people who my son described as having screaming fits (inside only, theyāre quiet outside on smoke breaks), I can see where it would be hard to sleep or even think.
EDIT: I guess I should add some good parts. He has been slow to answer - not tonight. The case manager was thinking his slow to answer was due to an inner dialog. So, no signs of visual or auditory hallucinations. He was not pacing, although he was rocking back & forth a little. He said it was because his back hurt, and when we were moved to the other room, he laid down on a couch while we talked & wasnāt figiting. I need to learn to look at the positives instead of focusing on what I want to see go away. After all, there is some definite progress.
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Reading everyoneās stories makes me feel like there are so many varying degrees of schizophrenia ā and at so many points of peopleās lives. After seeing the new psychiatrist he too is starting to feel like he should just say what people want to hear.
My son has not yet gotten the official SZ diagnosis, and since everyone wants a different label, Iāve decided I will say he has psychosis - because thatās what he has no matter what you want to call it.
NAMIās new-ish politically correct term is brain disorder, and while I know he has a brain disorder, itās too soft of a term for me. Somehow, it feels like Iām sugar coating something so other people donāt have to be uncomfortable - or that Iām trying to hide what he has.
Heās OK with psychosis too - he knows heās had psychotic breaks.
Yeah, I get what you mean. How come he doesnāt have a diagnosis, but heās on medications?
Because he had a psychiatrist from the time he was 17 until a few months ago who didnāt believe in labels. He was very casual & low key with everything, and my son seemed to like that. After all, he had dealt with labels most of his life due to his learning disability. With everything you have going on, Iām sure you can relate to someone always wanting to stick one more label on you.
So, the only time his old pdoc used one was when he filled out something for insurance. Plus, he was a pediatric psychiatrist and he had big hopes for my son beating this - for pretty much growing out of it. He finally saw that it was getting worse after a long period of staying pretty much the same with minor ups & downs & recommended that he switch to an adult psychiatrist who would know more about the different options out there. Before then, I would ask him about every 2 years if it was time to do that yet, and heād always told me he would keep working with him.
At first, it was depression & anxiety - he started seeing him after his 2nd psychotic break, but after the symptoms were gone. Back then, he was able to completely recover without any meds because the breaks were so fast. I think this happens to a lot of people and theyāre just better at hiding it than my son was. And, after the first one, I was always watching for it. So, this time, he was only given anti-depressants.
Then, major depression with psychotic features at his 3rd break - this time, he was put on Seroquel. When that didnāt work, he got Zyprexa which worked like a charm.
Later, it was psychotic NOS.
Next, major mood disorder - which is leaning towards bipolar instead of schizophrenia.
Schizophrenia, if you go by the book, is really hard to diagnose.
You have to have persistent symptoms over a long period of time, and he didnāt fit that category. And, you have to eliminate other things like drug use, etc.
Until this year, he responded well to meds, the psychosis went away quickly, and he had insight.
Even the hospitalization before this one, they were leaning towards psychotic depression because, as the case worker explained to me, he doesnāt have enough of the negative symptoms.
Maybe heās schizoaffective, maybe heās bipolar, or maybe heās heading into schizophrenia.
It doesnāt really matter all that much because no one fits the labels perfectly.
As far as telling them what they want to hear, in the family meetings, heās telling the case manager all the right things. How he isolated too much and how heās going to change that, how he was āstuck too much in his headā and thatās getting better. However, when it comes to the delusions he believes 100%, like that heās psychic and can make people faint over the phone, heās holding his ground, although he is starting to see that saying those kinds of things is why theyāre keeping him longer, so Iām expecting him to stop telling them. Heās no dummy - heāll figure out how to not be in the hospital soon enough.
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Well label or no label, I think that was a pretty stupid psychiatrist. If youāre prescribing your patient something, then your patient clearly has something so what the hell are you doing feeding false ideas that theyāre going to get better while just giving them medications for a condition they have no insight to. I get that. If you want a diagnosis for him, start recording him ā whether itās voice recordings or cameras when heās psychotic. Itāll be the only way to get it if heās really good at pretending heās sane, which it doesnāt sound at all like heās sane, so I donāt what the heck theyāre doing in order to treat him or to understand his unidentified condition. By now he should already have that diagnosis with all the hospitalizations heās had and what heās been saying lately.
He had insight while he was seeing that doctor until the very end. Something changed not even a year ago and he lost his insight.
At the point this began to suspect SZ, he recommended we change to a doctor who would be more experienced with adult treatment.
And, some people do have a psychotic break, recover, and go on to have normal lives. It happens. Especially when theyāre like my son was early on. He knew what was going on wasnāt right, and he wanted it to stop so badly that we were fighting over him wanting more antipsychotics than he was prescribed instead of not wanting to take any.
And, he didnāt lead my son on with any false ideas. I would ask a lot of questions over the phone without my son so that I could understand. He told me, not my son, that only time would tell. That we would treat aggressively and wait to see what would happen. A small percentage of people do have some problems in their teen years and then as their brain develops and hormones settle, they get better. He even attempted to taper my son off the Zyprexa after two years of being stable. At that point, my son felt some symptoms come back and wanted to go back up.
I think this doctor was very good at reading my son, and he was trying to maintain trust. When my son would be symptomatic, there were only two people he thought were not trying to kill him. Me & this doctor. He even thought his father would kill him. And, he was very good at getting him to stay on his meds - until this year when something changed dramatically.
I donāt know that I care so much about the diagnosis. I know his symptoms, and I know they will treat him with the same meds no matter what they call it.
Itās all a guessing game anyway. A doctor observes their symptoms, applies their interpretation, and comes up with a diagnosis based on the best fit. But, thereās a lot of overlap & symptoms change over time. The next doctor might interpret the symptoms differently & come up with a different label. In the meantime, they treat them all with anti-psychotics because the main positive symptom is psychosis. And, they donāt even know how the meds work exactly - just that they seem to do the trick for many people.
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I mean insight into a condition heās not diagnosed with. Isnāt your son 22? It feels odd that a pediatric psychiatrist would continue a case with an adult for so long. Your son doesnāt have insight now into his condition and who knows if he ever will, but I would feel very betrayed if a psychiatrist knew I had something and didnāt diagnose me with something while just giving me pills. Like, youāre not giving me diagnosis, yet youāre giving me pills? I wouldnāt take them without a diagnosis, I canāt seem to comprehend how your son did without wondering what his condition was precisely.
Edit: What exactly is your sonās learning disability? And I didnāt know pediatric psychiatrists existed, but the moment your son turned 18 he shouldāve switched to an adult psychiatrist, because they have more experience delving into the disorders that come upon adulthood. Take a child for example ā pediatric psychiatrist diagnosed them with Oppositional Defiant Disorder. Someone who treats adults might diagnose them with sociopathy ā why? Because you canāt know for sure if a kid is psychopathic until they are of legal age or put a diagnosis upon them.
I wish the people who reply to comments on the bored do so in away that they can relate in their own person lives. You are not a Dr you donāt know everything or every situation. If and when you do comment say it as you can relate NOT is away that you are or think you are a professional in this field.
Itās better to reflect on your own situation than to deflect from your own situation.
My son is 27.
He had a psychotic break at 15. We took him to the ER because his school wanted him drug tested, but we didnāt know exactly what was going on with him other that he was acting strangely & wasnāt sleeping. They gave us no info other than they had no bed & would ship him off to another hospital, late at night, by himself. And, no we could not ride along with him. We brought him home, got him some sleep, and he was back to his normal self in a week. His pediatricianās office recommended we see a therapist. My son went a time or two, then didnāt want to go anymore, so I didnāt force him.
Everything I read at the time about no sleep & paranoia led me to drug abuse. His drug screen was clean.
At 17, he had another break - very similar to the first. We took him to the his regular doctor this time. She diagnosed him with panic attacks and wanted him to see a psychiatrist, and I found out how hard it is to make an appointment, especially if itās for someone under 18. Finally, a different doctor in the practice got us worked in with my sonās first pediatric psychiatrist - he was a friend & it was a favor to see him immediately. By this time, he was once again well, although a little anxious.
During the appt, he asked my son all of what I assume are the standard questions. The answers gave my son a diagnosis of depression and general anxiety & he was given medication. He refused to take the first set of meds - I guess he was testing the doctor. The doctor said thatās fine, letās try this - and he took those for the next 9 months until he had a third break about the time he turned 18.
At 18, on his third break, was the first time the doctor saw him while he was in psychosis. Because he only showed a lot of depression before and only has psychosis with no cognitive deficits or negative symptoms, he said it was major depression with psychosis and we started on the anti-psychotics.
From 18 until 27, he had ups & downs, mostly with anxiety, but was not paranoid or delusional, and did not hallucinate other than rare instances where he would hear people say things they didnāt. I wrote this off to his extreme social anxiety, but now I know better. When that would happen, we would up his meds a little and it seemed to take care of things. Thatās the same thing you would do even if it was SZ.
I asked his pdoc every few years if we should switch, and he said he would stick with him because my son seemed to trust him. He could easily have sent my son along his way, but I think he really cared about what happened to him and was doing his best to help him. My son doesnāt trust easily, so I thought it was very important.
This doctor would also return my calls the same day & adjust meds based on what either me or my son told him without making him wait to come in for a visit. He talked to my son like a person, remembered his interests and encouraged him to do a lot of things. Youāve been on here complaining about doctors who could care less - Iām sure you can appreciate how we hung onto one who did all those things as long as we could.
If you think we just ignored things, we didnāt. Depression, anxiety, psychosis, suicide and all the rest have been regular topics of discussion in our house. If anything, we focused on it too much because I have been waiting on something bad to happen the entire time.
In the past year, since he lost insight, he has seen 3 different psychiatrists, 3 different therapists, and 3 different case workers. Some think a SZ-type disorder and others are still thinking psychotic depression. Maybe itās just psychotic NOS and thatās a real diagnosis.
Growing up, he had an unspecified learning disorder, which meant it didnāt fit any other category, so I wouldnāt be surprised if he has psychosis that doesnāt fit any other category.
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My son has an unspecified learning disability - meaning it doesnāt fit a labeled category like dyslexia.
When tested, he has deficits in working/processing memory, long-term memory & short-term memory.
He also tested off the charts for coming up with unique solutions to unusual problems.
What that boils down to is that he has an imagination thatās so wonderful, he doesnāt just think outside the box, he doesnāt even know there is a box. He canāt learn by memorization, which makes school hard, but when he knows something, he knows it forever.
Heās very creative. The physical part of writing is not easy for him, but he is a great storyteller. He won several silver awards for his artwork in the annual scholastic competitions in high school, his work at that time was being shown around our area, and he taught himself how to play several instruments by ear even though he canāt quite get how to read sheet music.
For the sake of argument, whether someone has oppositional defiant disorder or is labeled a sociopath, that label doesnāt change who they are or how they present.
Just like if my son getās a schizophrenic diagnosis - heās still the same person with the same symptoms after he gets that label as he was before it. As long as they are treating his symptoms, Iām OK with it.
And, why the moment he turned 18. I agree he maybe should have switched before now, but a switch doesnāt flip the day you turn 18, and he had a psychotic break right before he turned 18. No way would I have switched him in the middle of a crisis.
My son was comfortable with him, and they were both willing to continue the relationship. He was stable & I wasnāt rocking the boat. Trust me, this year, I have rocked all kinds of boats - I am extremely aggressive with everything once I feel itās needed.
Anyway, I think weāre going to have to agree to disagree on this subject. Itās in the past, it canāt be changed, and I did what I thought was right in the moment. Iām very thankful for everything that doctor did for my son, and for better or worse, Iām not going to continue to try to justify it. Iām a little disappointed and a lot exhausted right now.
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