AIBU to Contact the Doctor? <Child Mental Health>

[CremeEggThief]

On the school run this morning, DS (9) asked what I would do if I didn't have any money. I said, "Borrow some from you" and asked him what he would do. His reply shocked me: "Ask you for some, or kill myself". He said he wouldn't want to be homeless and it would be better to be dead (we saw some homeless people in our city centre last night. DS wasn't very kind about them, so I told him anyone could end up homeless, through wrong choices or bad luck, but it didn't mean they were bad people). I told him that not all homeless people stay homeless forever, and many eventually find homes, and that life is our most precious gift and to think about how we (DH and I) would feel if he was dead.

Should I make an appointment with the doctor to discuss this? I have had concerns over the last few months that he may be depressed, as he is cynical, negative and moody in his personality, and sometimes he lashes out or becomes disproportionately angry. I have told him that sometimes I don't feel he is as happy as he should be and maybe we should speak to the doctor, but he begs me not to make contact.

When he was 5, he occasionally said things like, "Oh no, do I have to, I'd rather kill myself", when his teacher in Reception asked him to come and do his work (I used to act as a parent-helper at the time, so witnessed this), and he threatened to jump off cliffs on holiday in Cornwall. I was very worried and contacted the GP, who referred him to a paediatrician. DS (then aged 6) took a dislike to the paediatrician, because he referred to him as an 'odd ball' in his presence on more than one occasion in his first few meetings with him, and asked us a lot of questions in front of DS about him that I would have preferred to be asked in private, to be honest. DS really played up in front of the paediatrician at subsequent meetings, because he didn't like him. He got the idea that the paediatrician didn't like him, thought he was mad and wanted to put him in an asylum (he's a big fan of Batman!), even though I reassured him this wouldn't happen and asylums don't even exist any more. Eventually, DS was 'signed off' without any diagnosis, although the paediatrician did discuss the possibility of AS tendencies. There wasn't enough evidence to give him a diagnosis, but they didn't completely rule it out. DS was also assessed by a speech therapist in school, at the paediatrician's request, but she was satisfied with his language. DS liked and respected her, so engaged well. My own feeling is that he may well have Asperger's Syndrome, but I am more concerned about his mental health. Is it time to take things further now, although DS won't like it, as he thinks all paediatricians are the same and want to 'get him'? Is this a case of where I might be failing DS by complying with his wishes? Or am I over-reacting?

I'd certainly take it further OP. Does he have to be referred to a paediatrician though?

He does sound very articulate for his age. Where is he getting his ideas from? I have to be honest, at that age, I would not have even known what suicide was, or thought of it.

Ultimately, he is the child, you are the parent, and you do what YOU think is best for his health, you dont be led by what the child wants. Would be my opinion on it..

mojitomania, I don't know if he would have to be referred to a paediatrician. The GP last time referred him, because he felt he needed more specialist intervention.

Creme Egg, I would think he would need to be referred to a paediatrician. I have just returned from my GP with my 9 year old DS. I wanted to look into medication for him to help with his ADD. The GP said he would need to be referred even though she has all his reports etc.

If he is on the ASD spectrum, then his thoughts, extremes, and black and white thinking wouldn?t be terribly unusual, (neither would depression) but he would need gentle repeat education on what success and failure really are, fixed thoughts and more flexible thinking.

Many ASD people don?t realise there are many options, often don?t understand cause and effect, and can often believe they can?t/don?t influence life events, other than with extreme methods.

They are also often totally unable to put themselves in another?s shoes, so how someone else would feel is either a mystery, irrelevant or purely theory.

Killing yourself is an ultimate method of having control, and in a very black and white practical unemotional ASD view, seems a perfectly reasonable solution. It?s scary to hear young children come out with things like this, but it isn?t always a sign of mental health problems.

I?d suggest you have a chat with both these people: www.youngminds.org.uk/ and these: www.autism.org.uk/

Good luck.

Do you think he might have heard it from somewhere used as a turn of phrase?

Re katespade's comment, I have a tendency to say, "Oh we'll, it's not the end of the world," in response to trivial problems. Dd1 (5) recently picked me up on this. Now she keeps asking about the end of the world and gets quite upset thinking about it. Point being, perhaps he heard/ read something about suicide and it affected him deeply. Adult Concepts such as these can be very overwhelming and distressing for children and sometimes they can try to introduce them into conversations, even casually, to try to get a handle on them, as it were, or to see what sort of reaction they provoke. I wouldn't necessarily take the discussion of suicide alone as a sign of a mental health issue. Of course, you know your ds best and if it is part of a broader problem it is certainly worth pursuing further with your Gp.

can you go to a GP and ask for a referral to CAMHS?

perhaps have a word with his teacher?

Yes, i agree with cornflowers you know him best of course but he might not be depressed or anything wrong with him. You could go the GP just to be on the safe side,

I only mentioned it, as me and my friends used it once as a turn of phrase whilst we were in uni, deadline week, very stressed and the teacher saw me going into the toilet to with a pair of scissors (to change my dressing), all that coupled together meant she thought i was depressed, and i had to go and see a councillor, it couldn't have been further from the truth. I think with ''depression'' people jump to conclusions and panic, when everyone feel's fed up and sad from time to time and isn't depressed.

I hope you get it sorted out!

do children of that age properly grasp the permanence of death?

is he doing ok otherwise - school, friends, activities?

I agree with justgiving, if you ds does have AS then this is a quite common thing. A lot of children with ASD are unable to process only the most extreme of emotions and will speak of death. It doesn't mean that is what he means but that is the way he expresses it. I would go and see your GP and ask for a referral to either CAMHS or a paediatrician.

Thank you for all your kind responses.

I had a chat with DS on the way home from school, and he said he was just joking this morning (although he also said he'll never be homeless anyway, because he's going to be a billionaire!). I believe him, but I still find it worrying that a 9 year old thinks it's ok to joke about such a thing, and I spoke to him about how it wasn't funny and it makes me feel sad to hear him even joking about something like that. Then I asked him again how he would feel about speaking to somebody who is trained to help people and listen to them, and he said maybe, but he's also worried about the cost and wants to look on the website of psychologists to check their prices! I'm trying to use our actual wording as much as possible, so sorry if the wording's coming across a bit strange. I reassured him that it doesn't matter how much it costs (not quite true, but he doesn't need to know that) and that nobody else has to know if he is seeing somebody, apart from possibly his teacher. They might ask about how he is in school, but they won't tell her anything he tells them. I also spoke to him about the paediatrician to find out how much he remembered. He said he didn't like being called an 'oddball' and that he didn't like the way the paediatrician stared at him and asked us 'lots of nosy questions', but I told him the paediatrician was just trying to find out if he had a condition called Asperger's Syndrome, so that's why he needed to know everything about him. I asked if he'd made the paediatrician worse in his mind than he actually was, and he agreed he might have, although I agreed with him that it was upsetting the paediatrician called him an oddball. I also pointed out that not all paediatricians are like that!

He has had a hard few months, because about 8 months ago DH took a job in London after being made redundant from his job here in the North East, and it started very suddenly. DH has also only come back every other weekend for the most part. At first he came back most weekends, and DS seemed to cope quite well, but from September it changed to every other weekend. I think this is what has caused the change in his behaviour. We asked DH at Christmas time if he would come back every weekend again, which he agreed to, but he hasn't kept his word about this.

So, in summary, I think it's positive that he has agreed to speak to somebody about how he feels, so my next step is to contact the GP and ask for a referral to CAMHS.
Thanks again, everyone, and I will also check out those links a few of you have given me.

I have a dd who has threatened to kill herself recently.
I would go and see the dr on your own, so you can talk freely about your ds without him listening.

I forgot to say that whenever I read through symptoms of Asperger's, a lot of them fit DS, except for the imaginative play. He has always had a great imagination (if anything, he is over-imaginative) and put it into practice in his play. Also, cornflowers, he is a very sensitive, emotional child and I know that they learned Hitler committed suicide in a bunker when they were learning about World War 11 and he tends to fixate and almost obsess over things that catch his interest. I was like that to an extent; I was captivated by Anne Frank when I was 8 or 9 and read her diary and then I read lots of other memoirs of concentration camp survivors at a very young age (between 10 and 13), which has made me hyper-sensitive to violence as an adult. So I always try to shield him as much as I can from anything I feel is too adult.

He sounds like a really bright boy who thinks deeply about things. It's good that you're taking him to the GP but it might take some time to get a referral to CAMHS - it might be quicker to talk to his school and discuss the possibility of him seeing an educational psychologist, who would be able to assess him for Asperger's Syndrome.

Overall I'd be tempted to say try not to put too much weight on what he says. He's still young and possibly doesn't understand the impact of his words. My worry is that if he sees you reacting in a worried way to his thoughts that he might clam up and be afraid to talk in the future. By telling him that hearing what he said makes you sad you might be giving him the message that he needs to protect you from his thoughts -does that make sense? Perhaps in future if he does say something like this again, don't have any particular reaction just say "Oh what do you mean by that?" and if he says "It's just a joke!" again don't betray that you're worried or that you don't believe him just ask him in an interested way why he told that joke, what does he think it means etc. He needs to be able to know that even if he does have dark thoughts about suicide that he can still tell you and you'll listen and be open to what he says.

Oh and by the way I contemplated throwing myself down the stairs when I was 7, on a regular basis. I wasn't suicidal really I just couldn't face going to school to be bullied by my psycho teacher. So it is possible to have thoughts of self harm even at a really young age.

WRT to the imaginative play - if you gave your DS, say a rubber band, an egg carton, and a lolly pop stick would he be able to act out an imaginative scenario with them? What I mean is would he be able to pretend that the egg carton was a spaceship, the rubber band was headphones and the lolly stick was a spaceman? Or are his imaginative scenarios very tied to what he's read?

Thanks Cailin. I did manage to stay calm and am nowhere near as worried as when this happened when he was younger. It was just a very dark topic for first thing in the morning. I will have a word with him to let him know he can always confide in me too. WRT his imaginative play, when he was younger, he was able to substitute items in the way you described and I remember him saying once when I expressed disbelief about an event in a film, "Shush, Mum, it's a movie, and you know anything can happen in movies", but he also used influences from books, films and history. For example, I remember him putting some stones in an old jam jar and saying it was a canopic jar, or make a totem pole from cardboard tubes. He spent his nearly all his choosing time at the junk modelling table in Reception, although this was a slight concern for me, as I felt it probably would have been good to encourage him to try other activities from time to time. He also loved dressing up, although at times he seemed to use this as an escape, and I can remember feeling worried once when he was about 3 and he said, "I don't want to be myself anymore".

I am really sorry to hear that your teacher made you feel like that .

OP - in the kindest possible way and as the mother of two teenagers and a husband who probably had a father who was on the aspergers syndrom although dh isn't, so have mulled over a few ups and downs in my time, including a 12 year old who we had to get help for when she started on a potentially anorexic slid, I am really worried about the last sentence in your first paragraph. You wrote that you told your ds (9) to think how you and dh would feel if he was dead. In my eyes that is grossly morbid and very worrying; it is something noone should ask their child to think.

It sounds as though your relationship with your dh and ds's father might be having a troubled patch and I do wonder if perhaps all of you might need some family support. To an outsider you all appear to be going through a troubled time and for the child in the circle the trouble will appear far greater than for the adults even though the child might not be able to articulate them.

He sounds like a very bright boy who may be struggling to reconcile with the fact his dad is away at the moment and he knows that talk of suicide presses all the right buttons with mum?
Im not saying dont get him referred but may be worth seeing if he will open up about?

I agree he sounds articulate and sensitive and I am coming to realise that some children need more cossetting from the world than others for longer, if that makes sense? Maybe he is just unsettled and needing some reassurance or maybe he is overly anxious - it wouldn't hurt to have a chat to the doctor. He's still young enough for you to be largely in control of what happens - if he's defiantly anti-doctor as a hulking great 14 year old you'll have a lot less success helping him so I'd try now as far as poss but make it clear that its to help him stop feeling anxious and to make positive changes.

I would definitely discuss it with your GP. We have a beautiful, highly intellegent girl who is just being assessed for AS. A lot of the behaviours you've described could be just "normal kid having a tough time" or they could point to something like AS or other conditions.
To most people & school DD seems like a bright, intellegent, polite girl, (which she is!), but only us, grandparents and VERY close friends see the effect that maintaining this effort has on her: anxiety, depression, fear of everyday situations etc. Although the process has been long and at times hard, both myself and DH have greatly appreciated the advice & support given by CAMHS and other professionals. I think that we are better at meeting her needs and fighting her corner than we were 12 months ago.
You are the expert on your DS, trust your instincts. Good Luck.

Someone earlier mentioned Young Minds - they have advisers specifically for parents in your position. I'd have a word with them first before your GP appointment, so you have some ideas and info beforehand, particularly as in some areas CAHMS have a 6 month waiting list and then you may only be offered a group session. But might be a lot better in your area. My GP could not help at all as she had no experience of mental health issues in young children, CAHMS was 6 months+ wait so in the end I had to pay for a child psychologist privately, luckily I could, and that helped in buckets. Hope you get something sorted out soon.

I was suicidal at the age of 10, so it's certainly not impossible. You are doing the right thing taking this seriously, OP.