14yo seeing bugs - Do I take him to A&E?

I’m a mental health nurse. Hmmm it’s impossible to tell exactly what is wrong through a screen. It could be anxiety or sleep deprivation, but conversely it could be the start of a psychotic episode or serious physical illness, so you do need to get him checked out.
What I do want to say is that if it is psychosis-and, hopefully, it’s not- that doesn’t mean he’s now “schizophrenic” and his life is ruined forever. Psychosis is like every other illness in that plenty of people have a single episode which is medicated and never have another one. Sometimes that does develop into schizophrenia, but single episode psychosis is very very common, especially in young men with low mood. I would take any help that is offered, and, if there is any indication of psychosis at all (including psychotic like thoughts caused by anxiety), reach out to your local Early Intervention in Psychosis Team. This is a link to the one in my trust but most areas have one https://hiowhealthcare.nhs.uk/our-services/a-z-list-of-services/early-intervention-psychosis-service . They work with young people/young adults experiencing psychotic like symptoms.
Plus keep posting here if you can and take care of yourself. Mental distress can be very frightening even if it’s someone you love.

wo0uldnt sit in a and e all night that wont help hope they can advise something else

Agree with others - please get medical help/out of hours appt asap.

I'm glad you've phoned 111. Just sending you lots of support x

This happened to me at a particularly exhausting and stressful time in life when I was struggling with severe fatigue and my mental health was pretty dire - I kept seeing black shapes like mice or rats running under the furniture and random insects flapping across the room and disappearing as soon as tried to look directly at them. It lasted about a week. I didn't end up seeing anyone about it and it hasn't happened since then, but since your son is a young person who still requires you to advocate for him, I'd want him fully checked out if it were me.

….there were three in my DS room when I went to say goodnight last night as he had the window open 🤦🏻‍♀️

So sorry OP. Our oldest only got her autism diagnosed after she started showing psychotic symptoms. The effort to make sense of information overload can lead to that.

She got a low dose of risperdal and a lot of therapy and is much better. Yes get the ball rolling. Seeing bugs that aren't there is hopefully acute enough to get you a reaction from the sluggish mh services.

Are you absolutely sure there isn’t genuinely just a moth in his room? They’re everywhere at the moment.

I’m so sorry, OP. Another vote for looking into PANS/PANDAS. Your description of not speaking or eating, the anxiety and exhaustion and insomnia, ‘feeling weird but can’t explain it’, all remind me of my child who has Long Covid and has periods with PANS symptoms as part of that. OTC antihistamines (my kiddo also likely now has MCAS), absolute rest and ibuprofen are very useful for managing acute episodes. Doctors tried hard to argue it was all anxiety and school refusal, until we got to appropriate specialists. I hope things improve soon xx

Does he have a fear of spiders or insects? My kid is neurodivergent and has a fear of spiders, if he sees 1 spider he can spiral and have vivid images of spiders in the room or crawling on him. He will also have difficulty sleeping as he’s convinced spiders are in the room. It takes some talking and reasoning with him that they are not really there.

If it's not too late I'd start with a visit to the opticians, the symptoms you've mentioned. Could be mental health or hallucinations but could also be the start of retinal detachment, a retinal haemorrhage, or a brain tumor.

Check if he has a fever, if not I'd get him assessed ASAP by optician or eye casualty as a starting point

My autistic DD has seen things when sleep deprived previously on several occasions, but this was also tied in with increased levels of stress and declining mental health.

I would definitely find out the best way via 111 to get him seen locally by a mental health professional, because he also is pacing and has a flat demeanor, he is clearly struggling and needs help.

This is how my cousins schizophrenia first manifested. Interestingly he also has autism and adhd.

Don't leave it; if that is what it is, he needs medicating for it ASAP. My cousin ignored it ages and eventually had a complete break from reality.

I would take him to a&e, I really doubt it is this because he’s so young but a much older relative of mine (90s) said this and it was something pressing on his brain causing it. It doesn’t sound the same with your son because he can acknowledge they aren’t actually there and thus relative was convinced they were. You’ve nothing to lose by going! Plus, if they then give the ok then give him a drowsy antihistamine so that he sleeps well tonight. It’s probably exhausted and that’s why he is seeing them.

Forgot the link:

https://childmind.org/guide/parents-guide-to-pans-and-pandas/#block_63f776096eb92

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There are a number of things this could be so he needs to see a doctor. What sprang to my mind because a friend’s child was affected (and saw bugs) is PANDAS. Has your son been ill recently?

I had some thing similar with my Ds when he was about 10 .. He was screaming around the house . I called Gp .. we were put in a side room saw duty Gp . I think they decided it was anxiety attack . It never happened again but yes get him seen I would call 111 though get directed to the right service

I would suggest an A+E dept is the last place an extremely anxious / agitated young lad with ?ASD needs

awful places, overwhelming / overstimulating places you will wait hours to be seen in, by an non mental health professional… bad idea

call NHS 111 press the mental health option and be directed to appropriate services

If he's had so little sleep the he could be hallucinating
It happened to me after my son was born, and must be frightening for a child. I'd take him to a&e for advice.

My ND son didn't sleep for about 48 hours once and he was seeing spiders and bugs on his bedroom walls and ceiling. He was put on to Sertraline soon after this.

I would start with 111 and take it from there. But get him to drink as well. If you have something sugary, like a full fat coke etc., that might help if he is dehydrated.

Bless him and you all,
sounds like autistic burn out ? / acute anxiety

seeing things is common in young people with high levels of anxiety / poor sleep -

the best advise here is call 111 - use mental health option,

Monday - call Cahms, say he is on wait list and things have deteriorated and ask for urgent appt

if your Cahms has the usual resource problems and cannot help, I would go private with psychiatry UK -
I had to do this, and although I ended up paying with my overdraft - no regrets

I agree with PP - it'd be a good idea to call NHS 24 and choose the mental health option. They can advise.

Stress, anxiety, lack of food, lack of sleep, and the heat will do funny things to the brain.
Call 111

I wouldn’t call 999 and probably wouldn’t go to A&E unless you think something is really really wrong and that he may have psychosis. I would look up the symptoms and see if they fit, but being flat, staring at the ceiling and seeming depressed don’t fit my experiences of psychosis (although different people act differently). Hallucinations are common in sleep deprivation and dehydration can make you see “stars”. Have you asked about the bugs - do they make a sound? What do they look like? I would definitely try to get in to see the GP or go private for his MH on Monday/next week though