4 Months (8 Month
Break)
It's September 2013. I had no idea the problems this
month could hold. Not just for my son and I but for this generation of youth
that are struggling with what seems like everything. School started. The very
things that I grew up with that I really had no choice but to take in stride,
seems to be crippling some of my children's generation. I read an article the
other day on www.psychologytoday.com. It was an article titled A Nation of
Wimps. The full link is: http://www.psychologytoday.com/articles/200411/nation-wimps
Now don't get me wrong, I'm not trying to imply that we
are all raising wimps. However I do find myself questioning that in our quest to
give our children a better life then we had that we may be robbing them of some
basic coping skills. It seems that we may have tipped the scales just a little
bit further then we intended. We needed to be more aware and we needed to be
more involved so that our children could reap the benefits of that. However
have we become so caught up in making it easier that we have perhaps taking
away some of the very frustrations, disappointments and challenges that helped
us to build our own identities and forge a path for ourselves out of
perseverance. Anxiety is a normal part of life. It's a normal response to
uncertainty, trouble or feeling unprepared, it's a human emotion that everyone
experiences at times. I'm touching on
this because my son still resists learning how to deal with anxiety. The things
in life that make you anxious are not going to go away. If anything they will
continue to grow until they are unmanageable.
I'm still delaying on writing about spirituality.
Honestly I question more and more if it even pertains to what is going on in my
son's life or mind. I still support his goals to be a shaman healer or whatever
else he decides he wants to be but it's like me saying I'm an architect when I
haven't the faintest idea how to even start drawing up architectural plans. Saying
that I am doesn't make it so. I used the term spirituality in the past when
talking about my son and his right to explore it. Maybe I was afraid to
question what spirituality actually meant, at least to me anyways. I didn't
want to seem... close minded? I don't know. I guess it's like questioning
someone on their religious beliefs. It seems taboo. For me spirituality isn't
about ego or control. For my son... I think I need to find another term for his
quest. As with everything else I find myself with a lot more questions than
answers.
Now that those rambling thoughts are out of the way. An
update on my son. He was inpatient for 3 weeks. It was his 6th hospitalization.
The first one that I had to watch him go through. It was a slow decline over
about 2 weeks. For about a week or so after receiving disability he actually
managed to keep it together. Even though he was drinking he was taking his
medications and making progress in self care, etc. He couldn't sustain it.
Discipline started to become a problem again. His attitude started getting
worse. I started doing research into how to discipline adult children of ODD
(Oppositional Defiant Disorder) and ADHD (Attention Deficit Hyperactivity
Disorder). He hasn't been diagnosed with these but certainly has the symptoms
and I was looking for anything that would help to calm the situation. As each
day passed his insight into what was happening got less and less. His own
feelings of depression and anxiety toke over. Marijuana use increased. He was
being controlled by his addictions. About 6 days before I had to have him
admitted he decided to go off his medications. It took about 4 days for him to
really start to what they call decompress or show obvious signs of psychosis. 2
days later he was admitted. Once psychosis took over he went downhill fairly
quickly. 3 days of little to no sleep and little food was contributing to his
mental state. Small bouts of hysterical laughter that he was able to control
when talking to the crisis hotline that we were in touch with. I am very
grateful for the crisis mobile team that came and got him. They had been in
contact with us for about 2 days and where aware of his declining state, talked
to him about his hysterical laughter and confirmed that he was not suicidal.
When I called them informing them of an extended period of hysterical laughter
and the apparent emergence of a voice, on top of the no sleeping and eating,
they were at my door that afternoon. They were very gentle with him and
escorted him to the hospital.
For a week or so I struggled somewhat with wondering if I
could have done anything differently. Could I have gotten him admitted earlier?
I have been assured and reassured by our team that I could not have done
anything differently. Not being on medications alone is not enough to meet the
criteria of being involuntarily admitted for psychiatric assessment. I wish
that it was. Since living with me he was not been under any type of order that
stated he had to take medications. With his previous caregiver he was. I only
recently discovered this as I went through the 50 odd pages of notes that was
sent to us when he moved. I condensed these into 4 pages of notes consisting of
hospital admission and consultation dates, symptoms, medications and their dosages
and treatment plans. I did this partly for the hospital staff and his team and
partly for myself. Trying to go through 50 pages of notes to see what
medications and symptoms he previously had was going to be time consuming.
Anything I could do to make it easier for them was in everyone's best interest.
It also helped me to put things into perspective. A history of non compliance
with medications and either lying about or downplaying positive symptoms. Every
admission was due to a significant re-emergence of positive symptoms. Substance
abuse always has and still does play a key role.
This lead me to talk to my counsellor about the benefits
of outpatient treatment orders or community treatment orders (CTO's) like he
previously was under. From his team's point of view they would rather build a
network of trust between my son and his psychiatrist with regards to taking his
medications. However the possibilities of putting another one in place is
certainly a consideration as my son has a history of being non compliant. At
one point he was receiving injections for this very reason. I was cautioned
however that even with a CTO in place he still has to meet a certain criteria
to be involuntarily admitted. Possibly he could have to submit to a psychiatric
assessment sooner but still would have to have symptoms that justify an
admission. The only benefit I see to a CTO is if he's receiving his medications
through injection and it's part of the order that he attend for treatment. At
least that is my understanding of what I have been told. I find that having a
better knowledge of how the system works helps me to have more realistic
expectations of what can and does happen.
So I find myself again questioning what is more
important. His rights or his mental health. It's a tricky situation. It took
about a week for me to have access to his file as he had to sign a release
first. He's legally an adult now and I don't have any type of guardianship or
conservatorship. He only signed the release because he wanted me to talk to the
doctor about getting him out. I told him I couldn't because I didn't have
access. Without that he was protected under The Mental Health Act and they
couldn't give me particulars about his treatment. I acknowledge that he has
rights but I also know that some of these very same rights are only causing him
harm and getting in the way of recovery. We want the very same system or act that
supports his right to self harm to protect him from himself. Doesn't make sense
to me. Perhaps The Mental Health Act needs to be fixed. I probably have too
much to say on this so I will end it here.
How is my son doing? The first couple of days had their
own difficulties. Paranoia and psychosis had certainly taken hold. For a period
he didn't even believe that he was in the hospital. He was in his own world of
delusions and happily so. Getting him stable again is going to take time. His only
insight into being there was that he wasn't eating and sleeping. According to
him he started eating and sleeping good so he should have been able to come home.
I'm the last person he wanted discussing his psychosis so that was making
things difficult. I couldn't give him any answers that he was willing to accept
about why he was still there. He did a lot of writing and doodling. He had some
ups and downs as they changed medications. My son complains of high anxiety and
depression. I have a hard time with this. He's depressed after abusing drugs
and alcohol. Same with his anxiety symptoms. When not abusing he rarely has symptoms
and doesn't even talk about it. Anyways he was put on Valium. He liked it, I
didn't. My son's idea of being without anxiety when dealing with withdrawal
symptoms or even boredom seems to be, for lack of a better word, high. I guess
that's why the first couple of paragraphs of this chapter had been playing on
my mind for awhile now. My son in my opinion has very little coping skills
which is different than high anxiety. I'm not a doctor and I could be way off
here but I can only go by what I see. They had to wean him off the Valium using
Benadryl. He was tried on a couple of new medications, Clonidine and Trazodone.
I was actually hopeful about these helping him as even though my son has not
been diagnosed, he has always displayed characteristics of ADHD, OCD and according
to him anxiety. Not sure exactly which symptoms his doctor was prescribing them
for and no one seemed to be volunteering that information. This is something
that I'm having difficulty with. I can do all the research I want on what he's
being prescribed but then I get cautioned to not always go by what I can find
on the internet because each doctor has their own approach and reasons for
prescribing certain medications. After one day of being on the Clonidine my son
said he didn't like it and they discontinued it. He wasn't minding the
Trazodone as it's pretty calming and sedating. Still he wanted the Valium so
they put him on Gabapentin. They got his Clozapine back up to the 300 mg that
he was originally prescribed to get him stable and back on his Lithium. Other
then bringing up to me a couple of times that he wanted to come home he seemed
fairly content. Surprisingly he did not asked for his computer. Only once asked
about going for a smoke and since he declined nicotine gum I think the
motivation behind that was more about getting out. Trying to keep him supplied
with enough treats was hard however I was glad his appetite had picked up.
Hopefully that too will even out as he is was eating a lot. Not that I mind him
gaining weight but I'm aware that he may end up using that as an excuse to not
be on his Clozapine. He can exaggerate side effects as easily as he downplays
positive symptoms.
After 3 weeks he was discharged. 2 day passes on the
weekend that went reasonably well and discharged on Monday. They had already
switched him from involuntary to voluntary the previous Friday. Currently on 5 medications. I think it's a
little much but my son didn't want me talking to them about streamlining them
before letting him out. When first admitted they had put him on Risperidone
which I thought they had taken him off of but apparently not. So he has to take
medications 5 times a day. We have an appointment with his psychiatrist next
week so hopefully we can start lowering some of them. The Risperidone is meant
to be short term to give the Clozapine time to work.
He is still having some symptoms of being a little
delusional although that has never completely gone away, even at his best. A
lot of his ideas or beliefs seem to stem from a childlike view of the world.
Until I can teach him about things like science, etc. then his understanding of
what is going on in this world will continue as it is. I had some concerns that
perhaps I had allowed him to come home to early as he is still displaying some
signs of psychosis and his emotions were still relatively unstable. I had to
step back and give myself time to think it all through. If it takes time to
recover from a break then keeping him in the hospital because he was still
showing residual signs of psychosis from this break could mean him being
inpatient for a fairly long time. If recovery from a break can take up to a
year, as they say, then it only makes sense that these symptoms will take time
to go away as medications continue to build and stabilize. In stepping back I also had to recall the
first month or so when he first came to live with me. Almost literally climbing
the walls from withdrawal, hours spent trying to do telekinesis that spirits
would not allow him to do and seeing if I could feel his chi. Emotions that
were completely out of control. Voices and paranoia. As always I am so thankful
for my counselor as she again helped me to realize that they could not have
kept him inpatient to much longer. Other then when he was first admitted no
signs of voices. They have again receded to background noise. As he puts it, a
happy singing. My counselor reassured me on this as well as my son has some
pretty obvious signs of when he is hearing voices. The delusions or ideas that
he currently has are based on his very limited knowledge of how the world
works.
The first couple of days were a little tough. I allowed
myself to get pulled into some pretty childish manipulations. At first I
thought they were delusions until I brought them out into the open and he told
me the truth. I made it clear that these types of lies and manipulations cannot
continue. If this was psychosis related and a delusion then he would have held
firm to the lies but he didn't. I'm glad that I got it out in the open as a
change in attitude took place fairly quickly. I had deflated his justification
for defiance. I pointed out that he can't expect me to treat him like an adult
when his behaviour was so obviously childish. Sounds a little harsh but we help
our children grow up but helping them to recognize behaviours that it is time
they outgrew.
We had a good discussion yesterday, that he instigated,
about my expectations and what he can deliver. We agreed that studying can wait
for a month to give him time to recover. We also agreed that the other rules
previously put in place regarding him picking up after himself and not slamming
doors, etc. are still reasonable. So I'm back to learning how to cope and
discipline adult children with symptoms of ADHD (Attention Deficit
Hyperactivity Disorder) and ODD (Oppositional Defiant Disorder). Make the rules
and expectations clear. Make them reasonable. Give positive feedback whenever
possible. Stand firm on consequences and walk away from arguments.
From my point of view he is currently doing better than
he was 4 months ago. It's to be expected that my son will have relapses as he
tries to figure out how much control he wants and learns to recognize that for
the moment anyways he needs to do certain things to remain stable and out of
hospital. It's been just over 3 weeks since his break and already we are back
to where we were about 2 months ago. That means back on the road to recovery.
His attitude is better. He's starting to pick up after himself. He's agreeing
to meet with his support group. Other then the first couple of days he appears
to be taking his medications. I can't watch him do this all the time. I have to
put some faith in him and if he decides not to take them then whether I agree
or not it's currently his choice. He went 8 months between his last 2 relapses
which is the longest yet. If we can make the next one 10-12 months... If not, we
will deal with them as they happen. I guess the real test will come when he
receives his next disability payment. Myself and his support group have tried
to get it released into my name but so far no luck. I could probably write for
hours on my own feelings regarding this but in my opinion I'm fighting a broken
system.
Until next time....
Mom
BarbieBF
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