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Failure to Thrive
Highly gifted teen son - inpatient, outpatient, dropped out of school
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<blockquote data-quote="susiestar" data-source="post: 719319" data-attributes="member: 1233"><p>I think you need to continue to explore medication. You need to insist he take the medications for longer than a couple of days even if you have to give him the pill and watch him swallow it daily. Actually I recommend that with your son. </p><p></p><p>Why? Because this way he will be taking it and you will be sure of it. Make him show you that he swallowed it (open mouth, show you under his tongue, then take a bite of food and chew/swallow) each time. </p><p></p><p>Have the doctor do a genetic test to see which type(s) of antidepressants are most likely to work for him. Insurance pays for this (usually, confirm with your ins co of course) and I have heard it is very helpful. It can take up to 6 weeks at the therapeutic level to know if an antidepressant will work. Usually you have some idea before that, but it can take that long. And that is after you work up to the therapeutic dose. It isn't easy, but it can be super worth it.</p><p></p><p>My oldest son, Wiz (short for nickname Wizard) has Asperger's (now just lumped in with autism spectrum disorders ). That includes (for him) Obsessive Compulsive Disorder (OCD), ADHD, sensory integration disorder, and unipolar depression. This means he does not ever go into a manic state, he only gets depressed or is normal. Wiz takes his medications. He always has. It was the one thing he never fought us over, oddly enough. We did listen if he said they were creating problems. </p><p></p><p>Any of these can be tricky to treat. My son's biggest challenge to treat was the depression. He struggles with it quite a lot. The most successful medication combo uses different types of antidepressants to treat his issues. He takes Strattera to treat his ADHD. It is not a terribly effective antidepressant, but it is one. It just works better on ADHD and is used primarily for that. Wiz takes trazodone, a tricyclic antidepressant, at night to help him sleep. Without it, Wiz would only sleep about every 3rd or 4th night. The tricyclic antidepressants are older medications that are more sedating, but they can be effective for depression as well as sleep issues. Wiz also takes Luvox for the depression and Obsessive Compulsive Disorder (OCD). It helps him quite a lot. Having all 3 of these medications working together really works for Wiz. Any time he tries to take one of the medications out of the mix, he starts to have problems. It has kept him stable for 5 or 6 years now, so it is helping. </p><p></p><p>It may take some trial and error to help find the right medications for your son. This is why I suggested the DNA testing. That can help find the right medications faster. Most psychiatrists know about this and if you ask for it, they should be able to do it. If you find medications that help, it could open us a truly amazing world for him. One where he might choose to go to college, or at least to open up his world a little.</p><p></p><p>The exposure therapy sounds like a very good thing also. It would be especially great if you combined it with medication. It may sound like I am just pushing pills. I don't mean to. I just believe that the right medications, especially when combined with therapies like exposure therapy and sensory therapies, can really make a whole new life for someone with problems like our kids. </p><p></p><p>You only have a very little bit of time until your son is 18. Once he is 18 you have almost no options. Do all that you can to help him NOW. Do it ASAP. Get him in to see any doctors/therapists that you can. Reward him for taking his medications if you must. It could totally change his world. Do make sure that they don't treat the anxiety with benzodiazepines though. It would open up a world of addiction possibly, and who needs that?</p><p></p><p>One thing I recommend you do BEFORE he turns 18 is to start thinking about life with him after he turns 18. How long do you want him to live at home? Under what conditions? Will he need to pay rent? How much? How often? What will you do with the rent? (I know parents who use it for expenses, who bank it and give it to the kid later when they get their first apartment, and one who used it to pay for her own vacation.) If he is in your house after he turns 18, what do your local laws say about his rights as your tenant? What makes him a tenant? What would make him a guest? What would you have to do to get him out of your house if you needed to get him out?</p><p></p><p>It is better to know this now, and to figure out how you want to handle it than to wait and have to figure it out when you are in the middle of a crisis. </p><p></p><p>I strongly recommend that you insist he put you on every HIPPA form at every doctors' office as someone who can have medical information and can speak to the doctors or else he has to leave. That sounds harsh. It is to help you be able to talk to his doctors if there is a problem or emergency. Often a parent can articulate something a teen cannot, but the parent cannot talk to the doctor due to the HIPPA forms. Unless he is hiding something like a drug problem, this should not be an issue. It is a good rule for as long as he is living under your roof.</p></blockquote><p></p>
[QUOTE="susiestar, post: 719319, member: 1233"] I think you need to continue to explore medication. You need to insist he take the medications for longer than a couple of days even if you have to give him the pill and watch him swallow it daily. Actually I recommend that with your son. Why? Because this way he will be taking it and you will be sure of it. Make him show you that he swallowed it (open mouth, show you under his tongue, then take a bite of food and chew/swallow) each time. Have the doctor do a genetic test to see which type(s) of antidepressants are most likely to work for him. Insurance pays for this (usually, confirm with your ins co of course) and I have heard it is very helpful. It can take up to 6 weeks at the therapeutic level to know if an antidepressant will work. Usually you have some idea before that, but it can take that long. And that is after you work up to the therapeutic dose. It isn't easy, but it can be super worth it. My oldest son, Wiz (short for nickname Wizard) has Asperger's (now just lumped in with autism spectrum disorders ). That includes (for him) Obsessive Compulsive Disorder (OCD), ADHD, sensory integration disorder, and unipolar depression. This means he does not ever go into a manic state, he only gets depressed or is normal. Wiz takes his medications. He always has. It was the one thing he never fought us over, oddly enough. We did listen if he said they were creating problems. Any of these can be tricky to treat. My son's biggest challenge to treat was the depression. He struggles with it quite a lot. The most successful medication combo uses different types of antidepressants to treat his issues. He takes Strattera to treat his ADHD. It is not a terribly effective antidepressant, but it is one. It just works better on ADHD and is used primarily for that. Wiz takes trazodone, a tricyclic antidepressant, at night to help him sleep. Without it, Wiz would only sleep about every 3rd or 4th night. The tricyclic antidepressants are older medications that are more sedating, but they can be effective for depression as well as sleep issues. Wiz also takes Luvox for the depression and Obsessive Compulsive Disorder (OCD). It helps him quite a lot. Having all 3 of these medications working together really works for Wiz. Any time he tries to take one of the medications out of the mix, he starts to have problems. It has kept him stable for 5 or 6 years now, so it is helping. It may take some trial and error to help find the right medications for your son. This is why I suggested the DNA testing. That can help find the right medications faster. Most psychiatrists know about this and if you ask for it, they should be able to do it. If you find medications that help, it could open us a truly amazing world for him. One where he might choose to go to college, or at least to open up his world a little. The exposure therapy sounds like a very good thing also. It would be especially great if you combined it with medication. It may sound like I am just pushing pills. I don't mean to. I just believe that the right medications, especially when combined with therapies like exposure therapy and sensory therapies, can really make a whole new life for someone with problems like our kids. You only have a very little bit of time until your son is 18. Once he is 18 you have almost no options. Do all that you can to help him NOW. Do it ASAP. Get him in to see any doctors/therapists that you can. Reward him for taking his medications if you must. It could totally change his world. Do make sure that they don't treat the anxiety with benzodiazepines though. It would open up a world of addiction possibly, and who needs that? One thing I recommend you do BEFORE he turns 18 is to start thinking about life with him after he turns 18. How long do you want him to live at home? Under what conditions? Will he need to pay rent? How much? How often? What will you do with the rent? (I know parents who use it for expenses, who bank it and give it to the kid later when they get their first apartment, and one who used it to pay for her own vacation.) If he is in your house after he turns 18, what do your local laws say about his rights as your tenant? What makes him a tenant? What would make him a guest? What would you have to do to get him out of your house if you needed to get him out? It is better to know this now, and to figure out how you want to handle it than to wait and have to figure it out when you are in the middle of a crisis. I strongly recommend that you insist he put you on every HIPPA form at every doctors' office as someone who can have medical information and can speak to the doctors or else he has to leave. That sounds harsh. It is to help you be able to talk to his doctors if there is a problem or emergency. Often a parent can articulate something a teen cannot, but the parent cannot talk to the doctor due to the HIPPA forms. Unless he is hiding something like a drug problem, this should not be an issue. It is a good rule for as long as he is living under your roof. [/QUOTE]
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Highly gifted teen son - inpatient, outpatient, dropped out of school
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