Auditory Hallucinations

[Liahona]

difficult child 1 has been having auditory hallucinations. He has had auditory and other types of hallucinations since age 4. They stopped when he was in the Residential Treatment Center (RTC). Two months after he got home they started again. Mostly they have been murmuring or yelling. They do scare difficult child 1. There is no way he is saying he has them for attention. (I have had years to practice unresponsiveness. I don't ignore them. He just doesn't get an emotional response from me.) There has been at least one every few weeks. These are not flashbacks due to PTSD. Last Monday he heard his name being called from inside the house while everyone (including him) was outside. He did have visitation with X on Monday. And X has been telling difficult child 1 that he, X, is moving away for months. difficult child 1 does not want him to move away from difficult child 1's friends. (Man won't keep his mouth shut about things that would stress difficult child 1. X probably isn't even moving at all.) difficult child 1's behavior has escalated the last few days. There hasn't been one specific problem. It has been a general controlling of others grouchiness. He has also been having nightmares. The frequency has been 4 out of 7 days he has nightmares. He did not have nightmares at the Residential Treatment Center (RTC) either. School has been great. He has been co-operative, only has had to be reminded 1 or 2 times to stay on task per task. He is actually do homework (very watered down but it something.)

I know nightmares can be related to anxiety. How about the hallucinations? A therapist that has known my family for years and comes to our home on a monthly bases is talking that he might need medications again. In the past we've tried everything the psychiatrist was ok giving a kid (both psychiatrists in 2 different settings) without needing blood draws. Last time he got a shot it required 3 adults to keep him still and then he fainted.

The therapist is having me validate difficult child 1's feelings and check it out to reassure him no one is there. I know from the past he will not be reassured by this. I don't think I would be either if it was me hearing voices. If I pay to much attention to him then he will say he hears them for attention. Then I won't know what he is hearing and what he is making up. This is not a nice tight wire I'm on.

What have you guys done when your kids have hallucinations? Have medications helped? Can they be caused by anxiety or made worse by anxiety? Why would all symptoms that point to bi-polar disappear for a year in the Residential Treatment Center (RTC) then re-surface later?

Thanks for reading this. I tried to include as much detail as possible.

 

[InsaneCdn]

Why would all symptoms that point to bi-polar disappear for a year in the Residential Treatment Center (RTC) then re-surface later?

I'm no expert on bi-polar. At all. But we know a few things about anxiety.
I'd be guessing that the environment at Residential Treatment Center (RTC) was structured in a way that worked well for him... and his current environment isn't nearly so structured or not structured the same way
Add change (shifting is NOT something most difficult children are good at) and anxiety and who knows what else... and any "just below the surface" problems are likely to come out.

 

[Liahona]

So the bi-polar would come out more during high anxiety, high stress times. I know autism symptoms come out more under stress.

 

[InsaneCdn]

So the bi-polar would come out more during high anxiety, high stress times. I know autism symptoms come out more under stress.

and ADHD symptoms, and coordination challenges, and auditory problems, and...

In other words, I'm not aware of too many issues that are made BETTER by stress!

 

[Liahona]

The problem is he is always stressed. There are worse times than others, but he does have constant anxiety.

 

[InsaneCdn]

Does the ebb and flow of anxiety sort of track with the ebb and flow of the other issues like hallucinations and/or nightmares?
If so, its a good case for a strong link.

 

[susiestar]

I am sorry. It is so hard to have your child hallucinate. I think that he needs to be seen by a psychiatrist. This could be bipolar, but it doesn't make sense to me that it would just go away while he was in Residential Treatment Center (RTC). I have not heard ANY stories here where that happened. I have heard of kids honeymooning for up to several months, but that is very different. I would want the doctors to evaluate him for schizoaffective disorder and to consider treatment for that. I also think that anxiety is playing a HUGE role in this.

It may be that symptoms resolved while he was in Residential Treatment Center (RTC) because of the very very strict scheduling and rigid structure of Residential Treatment Center (RTC). I don't know if you are on a schedule at home, but it might help to set up one and stick to it as much as you can with a large household. I say this, but am guessing you have likely already done a lot as far as setting up routines - most big families have to do this!

He NEEDS help for the anxiety. It is so frustrating to me to know how many of our kids here are so crippled with anxiety. Docs say they don't want to give anxiety medications because "addiction issues" but reality is that if left untreated, the anxiety will drive our kids to self medicate with drugs and alcohol. You may have to go back on medications for anxiety. controllilng his anxiety with medications may help reduce the hallucinations and may help with his other problems too.

Ask the local children's hospital (if you are near one) to set you up with biofeedback for him. He should be able to do it. Also consider having him listen to guided meditations. There are a lot of good meditation programs and many are free online. My husband uses a lot of them and I will ask him for names/websites if you want. Also consider aromatherapy. it isn't going to "fix" him, but if these things can help take an edge off of the anxiety then it can't HURT. (Though they are not an alternative to seeing a psychiatrist or developmental pediatrician). One mom here got a gizmo called a stress eraser for her son - he put his finger into the machine and would breathe slowly and try to calm himself and progress was shown in little red lights. It was just a simple method of biofeedback but it seemed to really help her son learn to take control of his anxiety. If you check amazon or ebay for stress eraser you should be able to find out more about it.

As for blood draws, I know they are an ordeal. Has your son ever verbalized or communicated why he was so upset/angry/scared of the blood draw? Asking that at a CALM time, when one is not imminent, could give important clues to help keep it from being so bad the next time. Lidocaine cream is also a BIG help. I know one prand is called LMX4 and is OTC but you have to ask the pharmacist for it. Or the doctor can write an rx for lidocaine cream or for emla cream (lidocaine and prilocaine cream). Just apply the cream about 20-30 min before the shot or blood draw and the area will be numb. The creams are also great for splinters and many other things. If the doctor won't give you the rx and/or the pharm is out, check the area with stuff for burns and get a bottle of BurnJel Plus. It is about $7 for 4 oz as far as I remember. It has lidocaine in it and will help with the blood work, just put a thick layer on and let it soak in. (it is awesome for a LOT of things - esp acne because it has tea tree oil and really really speeds healing and stops picking because it numbs the area!).

IF you can get difficult child to talk about WHY he freaks out at blood draws, you may be surprised. Whatever his reasons, you will have a place to start to help him through this - because we ALL need bloodwork and/or shots at some point in our lives.

 

[flutterby]

I knew my daughter had auditory hallucinations, but didn't realize how often it was happening until last week at the psychiatrist's office. There was a lot she didn't tell me. And they scare her, too. A lot. Like your kiddo, they aren't command hallucinations...she hears murmuring, giggling, people talking but can't make out what they're saying, even tv shows that don't exist.

She was just started on risperdal. We do have to get a baseline cholesterol and glucose, but as far as I know there aren't regular blood draws.

 

[flutterby]

Honestly, if he has to have blood draws for a medication, I would ask for Ativan or something to chill him out. If he's hallucinating, he's not going to be in any kind of condition to be able to control his anxiety at this point. You can work on that later.

 

[BusynMember]

If my child were hallucinating, I'd definitely put him on medications to stop them. Untreated, they can get worse and turn into command hallucinations. I don't know if a diagnosis. is as important right now as getting rid of the hallucinations. I never had any myself, but I've been in a psychiatric hospital three times and the adults who hallucinated were very frightened of them and some were totally out of touch with reality. I'd rather stop that symptom early on.


Huggggz! I agree...he needs a psychiatrist, not a therapist.

 

[ready2run]

my grandmother has hallucinations and she takes resperidone for them, and it seems to work. i have no idea what you have tried but if that isn't on the list it may be something to discuss with the doctor. it is, coincidentally, the same medication that difficult child takes to rid him of his compulsion to hurt himself on a regular basis and control some of his emotional outbursts. he does have to do blood draws but not on a regular basis. he had one when he went on the medications and one a few months ago when he was having a heart problem. lidocain can be purchased at tattoo supply shops.

 

[Liahona]

Thanks for the idea of the pain cream before the blood draw! I will look into that.

After reading your posts and thinking about it I've decided that yes, he will go to another psychiatrist. You're right. It doesn't matter what the diagnosis is he needs more help. We have tried all the medications you all have suggested but it was at least a year(s) ago.

He is not a great one for sitting down and trying to calm himself. It is worth a try though and this is going to be interesting. :/ I think I'll start tomorrow.

 

[gcvmom]

I second the advice to get a better treatment plan in place for his anxiety, even if that means medications. My oldest had horrible panic attacks, became violent, and nearly passed out every time he needed a blood draw (which was really frequently for awhile just before he was diagnosed with Crohn's disease around age 10). We learned that he had a needle phobia -- it wasn't the blood at all -- but regardless, it was horrible and traumatic for both of us every time he had to go in for bloodwork.

We eventually got through it with medications for anxiety (intially it was Ativan), therapy (guided imagery to help him learn to mentally cope with the procedures), and a prescription for EMLA cream (that's lidocaine in a cream). It took us a while to get the medications right, but in the mean time with all the other supports, it gradually got much easier. I made sure we only went to a lab where the staff was patient and sensitive to his pain (mental and physical) -- which turned out to be connected with our local children's hospital. It meant I had to drive 30 minutes each way, but it was worth every mile because it lowered his stress knowing that the people there wouldn't try to bully him into submission. They gave him all the time he needed to psychiatric up for it while I sat with him coaching through the whole procedure.

He now goes in the lab by himself, does not need the cream at all OR the Ativan, and he simply does his deep breathing and mental self-calming and it's over in a flash.

But none of this would be possible if we didn't have his anxiety under control -- and yes it can be debilitating and yes, I would expect it could be exacerbating the hallucinations your difficult child is having. I really think you need to start with that problem and go from there.

 

[seriously]

In your spare time, here's a relatively short article covering auditory hallucinations.

http://www.psychiatrictimes.com/cme/content/article/10168/1534546

You've gotten good advice. Yes anxiety could be causing or making the hallucinations worse. They are also associated with PTSD. If ALL symptoms of mood fluctuations disappeared when he was in Residential Treatment Center (RTC) then I would really have to question the Bipolar diagnosis. However, anxiety can be a symptom of bipolar illness as well as a separate co-morbid condition. So if the anxiety seems to fluctuate like a mood disorder, it may be the most obvious symptom of an underlying mood disorder.

I think trying to treat the anxiety may be the place to start since he is also having nightmares which I am thinking are connected to the anxiety as well.

Cognitive therapy is the ideal treatment for anxiety but he may be too young to benefit from that yet. And I personally think it works best when the person has some medications on board at the start so that they can ease into using the techniques after they've had some training in ways to handle the anxiety. Then they can work on the exercises without the medications but have them if needed.

You might also think about getting him into a yoga class or getting a yoga video and practicing that with him. The pace and breathing exercises can be very helpful in calming the body and mind. It encourages mindfulness which helps too.

The emla cream is helpful IF you know where the blood draw is going to be done. If he's a hard stick because it's hard to find a good vein, then it is not that helpful since you can't slather his whole arm with the stuff. It must be applied at least 30 minutes before the draw and covered with plastic wrap or something like that. So it's a pain.

We always use a pediatric blood draw location for blood draws even now that my son is 15. They are very accustomed to working with kids and usually have the best techs. Usually you can find one at a children's hospital or where there is a cluster of pediatricians sharing a lab or adjacent to a lab. We go to the same place each time so there is no worry about where we are or what the place is like. If you think it will help, you can talk to the lab and settle on one person to do his draws. Then you call ahead and find out when that person is on and only go when you can have that tech.

Holding him down is not helpful in my experience. It increases the trauma and anxiety which makes things worse the next time.

You can try desensitization - after each step you leave without having a blood draw so he learns that he can handle the anxiety of each step and you may have to repeat each step several times. First you go and just sit in the parking lot of the lab. Then you go and walk in the building and sit for a bit. Then go to the lab and just sit (no blood draw). etc. Each step should allow him to stay put long enough for him to get relaxed and over most of the anxiety associated with just being there. If the lab will let you, even take it as far as going in and sitting in the chair without having a blood draw etc. If it's a small lab you can ask when they are likely to be slow and go then to do the desensitization stuff.

 

[BusynMember]

I have had anxiety (bad) all my life and panic attacks. They almost rendered me housebound. medications were the only thing that helped me calm down enough to do my therapy and make a lot of positive, wonderful changes in my life. If he is hallucinating stress WOULD make that worse. Heck, stress makes ALL mental health issues worse (and even physical symtpoms). However anxiety alone does not cause hallucinations. Anxiety is almost always a partner of any mental health issue. So you have anxiety working against whatever else is going on.

I hope your psychiatrist is helpful to your precious little one. It is not fun to lose your childhood to mental health issues. Thank God there is help now...unlike when I was a child. Do take advantage of this fortunate change!

 

[Liahona]

Mostly venting, but if you have any ideas to help I'd really like to hear them.

Well new perspective. I learned on the internet last night that while very rare anxiety can cause hallucinations. Monday right after visitation difficult child 1 hears voices. His behavior gets increasing worse during the week. Right before the next visitation he melts down.


"NO I'M NOT GOING TO X's HOUSE. HE's SCARY!"


I try to get him to tell me why X is scary. (I'm not disagreeing with him; to me X is one straw short of satan, but I do not let difficult child 1 see that is what I think.). difficult child 1 will not tell me why X is scary. More questions just lead to more yelling. I stop questioning him and call the drop-off place to give them the heads up and hopefully get some help. No help. I call difficult child 1's therapist, but its Friday right before 5pm; no one there. difficult child 1 has a very good relationship with my mom. I call her.

difficult child 1 opens up to her and talks about X. difficult child 1 is scared about X moving.

X has been saying for the last 6 months that he is going to move. Move to a dirty, mouse infested place 45 min from the nearest neighbors (the nearest neighbors are X's parents.) Its in the middle of a dessert. Coyotes come right up to the windows. The cats difficult child 1 loves keep disappearing and he found the skeleton of one. There are rattlesnakes all over. Mice all over (we worry about haunta virus.) No electricity, no phone, no running water, no heat, no air conditioning. He hates his cousins. They don't have rules and aren't nice. difficult child 1 needs rules. He needs to know what to expect from peoples behavior.


X has a m/o. He moves to the city to find a wife. He targets young (early 20's) single moms of special needs kids. After awhile he moves them to a place where no one can hear them scream. Then the abuse which was bad before gets life threatening. Then the wife leaves (so far he hasn't managed to kill one, but he has come close.) Then he moves back to a city and it all starts again.


This house he says he is moving to is one of the places he moves the wife to. His family owns it. He has lived there in the past and difficult child 1 knows what to expect. Its where he tried to run me over with a car while I was hold a 4 month old difficult child 1 that was so sick he needed to go to the er. Our life was bad there. Even though he was just 4 months old difficult child 1 has described some of it to me in therapy. I sure don't tell him details of the abuse and I doubt X would (X tries to be Disney dad.) X does talk about when we were married but he tells difficult child 1 how wonderful it was.

difficult child 1 has very good reason to be terrified. This time there is no wife. I worry all the abuse will land on difficult child 1. I can't stop the visitation though. If the court thinks I am denying X visitation (again) they will put me in jail and X will probably win custody of difficult child 1. The only way I can stop the visitation is for difficult child 1 to open up to the right person about the abuse he has seen or experienced. My mom isn't the right person. The court won't believe her. It has to be the drop off person, his therapist, a dcfs person, his teacher. No one in my family. No one he is comfortable with that he has opened up to in the past. X has told difficult child 1 not to talk to these people. Very frustrating for the therapist. To complicate things difficult child 1 doesn't always want to open up. When X showers him with gifts difficult child 1 doesn't want to lose his dad. He has told me in the past that he is not going to talk to those people because he doesn't want to lose his dad.


difficult child 1 wants my mom to call him everyday. My mom said she would. A few problems: no phone service, cell phones don't work there, X will use my mom calling to try to hurt me, X might use her calling to try to hurt difficult child 1, X will take her calling difficult child 1 as permission for him or his parents to call difficult child 1 all hours of the day. I really hate X. Mom is going to try to call difficult child 1. We felt that reassuring difficult child 1 was worth all the consequences that could happen. Yesterday she didn't get through.

X will probably NOT move right now. He has to sell his house first. He is just talking about it and all the above is worrying difficult child 1. Next weekend (if X has let difficult child 1 play enough X box) difficult child 1 will want to go. This is a catch-22.

All I can do is take difficult child 1 to the psychiatrist, work on calming techniques, and try to get difficult child 1 to talk to the ttherapist. I feel its like trying to putting out a burning house with a squirt gun.

 

[seriously]

Oh my - that is surely a lot for an 11 yr old difficult child to cope with. And a lot of worry for you.

Is there an official history of domestic violence? Can you use this to lever the social work people into checking on difficult child 1 at least once while he's with X?

Otherwise - I hate to say it - but it sounds like you are going to have to sit on your hands and wait for the bad stuff to hit the fan and hope your presence in his life will help difficult child 1 recover from whatever happens quickly.

I am not at all surprised that difficult child 1 isn't willing to tell on X. Typical behavior in such a situation. Makes your heart break to see a kid caught in that ugly vise that even adults have a hard time coping with.

Many hugs.

 

[keista]

OMW my heart aches for both of you. ((((HUGS)))) and prayers out.

 

[Liahona]

There is no "official" history. X is way to smart for there to be any evidence. He has the wives to cowed to do anything. Out of 5 wives I'm the only one to stand up to him in court. How he got a house is one of the wives bought one and left it when she ran for her life. Coming back to bite him now that he can't get rid of it. I could talk the social workers into going out there but the chances of them actually seeing anything when they go out there are slim to none. Then the situation would be worse for difficult child 1 and me.

 

[BusynMember]

That's terrifying! I may be temped if I had that sort of ex to run across the country, if that were possible (I know sometimes it's not). Then let him fight for custody in Massachusetts when he lives in California (just an example). And no Mom's house to run to either. I don't see how even medications can reduce his anxiety when he has to go there. That poor kid. Are there any other options for you? CAN you take him across the state line?

X tried to run you over? Really? And he can still see this poor child?

If it were possible, and I know this is just dreaming, too bad you can't take him to Mexico or Canada.

(((Hugggz)))