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

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Bit worried and looking for advice really. DS14 has ADHD and anxiety, but I’ve suspected autism for a while too. He’s been really low recently, doesn’t seem himself at all, and I think he might be depressed on top of everything else.

He’s been struggling since last year with school refusal, barely managing to go in at all, and things have just got worse. We’re still waiting on CAMHS — been on the list for months and feels like we’re getting nowhere.

Today he’s just been completely flat. Barely said a word all day, wouldn’t eat anything til mid afternoon, just pacing or lying on the sofa staring at the ceiling. Snapped at DP earlier for turning the telly on too loud which isn’t like him. Said he feels weird and can’t explain why. Looks totally worn out but still can’t settle or sleep.

Sleep’s been a nightmare – he’s only had 4hrs the last two nights. He napped for an hour or so yesterday but hasn’t really rested properly. He’s started saying he can see bugs in his room, swore something flew at him last night but there was nothing there when DP checked. He was really freaked out.

He’s exhausted, anxious, not himself at all. I’m not sure if this is sensory stuff or something else but it’s starting to scare me a bit. Would you take him to A&E? I don’t want to overreact but also don’t want to ignore it if something’s properly wrong.

Others have given good advice — also, make sure he is drinking water and not dehydrated!

Just echoing what pps have said; is it possible he’s dehydrated? Not sure whereabouts you are but temps are high 20’s and climbing and it’s also warm overnight and getting hotter over the next couple of days.

I had heatstroke as a child of the 70’s and saw bugs & spider’s everywhere until I was cooled and got adequate fluids in me.

Get him seen

But it sounds like he needs sleep.

You said he hadn't had much sleep the last few days.
Whatever the reason you need to make sure he gets enough sleep the next few days.

My son hallucinated when he suffered a bout of insomnia as an older teen. Insomnia is absolutely awful. My son looked like he had been in a fight.
You haven’t mentioned it so assume it’s not an issue but does your son take any recreational drugs?

My first thought would be sleep deprivation and dehydration causing eye floaters, rather than a psychotic episode. My child sees fast moving dots, particularly when tired, and it's entirely optical rather than psychological. I hope your son is ok x

Another one saying google Voice Collective. Incredibly helpful organisation.

I was in the exact same situation as your DS at 14, I also remember the first time I saw bugs crawling, I was sat in the bath and suddenly saw them all crawling. I’m now in my mid 20’s and when I’m very very sleep deprived or having a bad depressive episode I will often see things.
dont hesitate to call 111, i know as a parent its so scary watching your child suffer like this and I know as someone who’s been in his shoes that its absolutely awful. Hope you are all okay OP

Sorry this isn't really accurate. Symptoms like flatness/depression, fixed staring, pacing, etc aren't uncommon features of a psychotic illness. Depression is called a 'negative' symptom. Source: I'm a mental health nurse

Anyway OP, I'd ring 111. It sounds like he may be having some hallucinations induced by sleep deprivation. If these are new symptoms, it's also important to have bloods done/MSU as things like UTI can cause delirium, though it's more common in the elderly.

For delirium, follow pinch me:
P- is he in any pain
I- infection markers
N- is he eating well
C- any issues with bowels
H- is he drinking well
M- new medications
E- recent changes to environment
S- how is sleep

It's possible it was a hypnagogic hallucination, harmless although they don't seem it at the time and quite frightening when you're in the middle of one.
Unfortunately I still get them occasionally now and I'm late 40's!

Hi op,

Was your son ill at all before all this started? Please look into Pans/pandas and see if his behaviour matches at all.
How is he today?

A comment on the " bug " part of this ( I appreciate there is a lot more going on here and I do hope you have managed to get some support for your son) - we have clothes moths in our house, at a low level.
They appear from nowhere,son and I leap up trying to squash them, they vanish. They are little,flitty, definitely sometimes fly "at you" and the chances of your husband seeing one that your son had seen in his room even a little bit earlier are minimal.
And if your son is moth phobic that would be a distressing experience for him.(When we see them I have a deep clean as there will be the cocoons in a corner,skirting board edge,or under something....)

Hopefully you are getting it checked out, OP. There could be a really simple explanation.

Floaters in his vision, for example. I’m on a medication that causes me to have them and I often think I see birds or bugs places. It’s not, it’s just because I have spots in my vision. It’s worth getting his vision checked.

Dd (now 12) had a really scary incident a few years ago, which we think was a migraine (Dh gets migraines). She kept seeing lights everywhere and scary faces and weird floating shapes. She literally drew for me what she could see (it was bizarre and very surreal) and she was genuinely really frightened. I think it was triggered by poor sleep. We managed to get her a good night of sleep and it went away in the morning. She has not had another one since.

Hope he’s doing okay this morning and you can soon get an answer.

Nothing to add, except sending a hand hold. Having a teen with mental health issues is exhausting and terrifying. Please look after yourself too 💐

Yep me too, fairly normal and is worsened with anxiety, sleep deprivation and worry.

There are many possible causes, you need to seek immediate medical advice I would think. Call 111 immediately, unless he is very unwell when A and E/ambulance depending on how severe. Is he definitely not overheated or have temperature? If hallucinating with with temperature or possible heat stroke I would think is urgent. Good advice here around heat stroke if you have not seen it: https://www.nhs.uk/conditions/heat-exhaustion-heatstroke/