I realize you live in a small town. How far is it to the nearest big city with a university or children's hospital? I ask because you NEED a comprehensive evaluation of your child sooner rather than later. The earlier this is done, the more interventions can help him. His increasing talk of suicide when he already had that idea in his head is quite disturbing.
My son requires 3 antidepressants to function as an adult. This is just to get out of bed and do normal things, not to be super happy and cheery. 2 of these have other "primary" functions, but also work as antidepressants. With other medications that didn't have that antidepressant function, my son couldn't function. He has what is known as intractible unipolar depression. In addition to Aspergers.
Most people would NEVER see the Aspergers (or High Functioning Autism, as it is now called). He is so high functioning that you must know him VERY well to know that he has it at all. Not everyone on the spectrum shows symptoms the same way. Often lay people, even parents, cannot diagnose it. Wiz hit his developmental milestones on time or ahead of time. He is still on the autism spectrum, very much so.
Making the journey to have him fully evaluated is worth it. We spent a long time having to drive an hour to an hour and a half for any type of doctor or therapy session other than his primary care doctor. It was worth it.
One of the most worthwhile things we did was to have our son tested for Sensory Integration Disorder. This is when the brain doesn't process signals from the senses correctly. They can need more of a certain sense or less of a certain sense. I think most kids who are acting out in elementary school should be tested for this. You have them tested by an occupational therapist. I generally think looking for a private therapist is better than a school therapist. Why? A school therapist will look for how this is impacting his life at school. A private therapist will look at how this is impacting his whole life. It is often worth the extra money to get the whole picture that a private therapist can give you. If your child has this disorder, the fix does NOT involve pills. It involves providing a sensory diet of activities that your child will actually be drawn to. (It is the only type of therapy we ever had that my kids wanted to do!!! I loved that!). there is also another type of therapy that is taught by the therapist that is called brushing that helps to teach the brain to use input from the senses correctly. Again, it involves no medication and as long as you do it the way you are taught, it has no bad side effects. It is well worth reading more about this in The Out of Sync Child by Kranowitz.
One other book I think might be helpful is What Your Explosive Child Is Trying to Tell You by Douglas Riley.
