Incredibly worried about the treatment being given to ds (17) - please can someone give me some advice on how to deal with this?

[DayDreamingAway]

Ds has always been troubled. He was always a bit emotionally immature, he was always a bit anxious. When he got to secondary school he started self harming and being a lot more unhappy so i reached out to get help for him. When he was around 15, he had 10 sessions with a counsellor that i paid for privately and I thought it made a difference to him and I naively thought the problem had been addressed (and ds said it had).

I went away for work around 6 months ago and left ds and elder dd together (which I have done before) and came back and found ds in a state because he had self harmed again (badly). He then told me the counselling had made no difference, he had continued to be very unhappy and he didn't know what to do.

I arranged for him to see a psychiatrist as at this point, I felt he needed some sort of diagnosis.

Since then, it's like I've lost my child :(. The psychiatrist won't talk to me as he says he only has to inform me if ds is in danger and ds now doesn't talk to me (when he did before) because he says he's been told he doesn't have to tell me anything (which is true I know).

he's told me they have put him on medication - he's on the highest does of fluoxetine possible which is making him completely exhausted. In addition, this week, they have added an antipsychotic which is making him like a complete and utter zombie. I actually have no idea how he is going to go back to school on Wednesday. I've asked him and he says he is 'fine' and he will be 'fine' for school. I've suggested he gets a haircut for school and he's said 'he will tell me when he's ready to have his haircut not when I say he needs one'.

I honestly don't know what to do. I asked, gently, why he was on an antipsychotic (he told me immediately when they prescribed it) and he says it's to get rid of the sad feelings. I've checked the dose he's taking and it's massive! Apparently the psychiatrist told him to start on one tablet twice a day but to increase up to 3 twice a day if the feelings were still there so that's what he's done.

I am honestly despairing today. I'm sat at work but I could cry :(. I wish the medical system would just let me know what is going on with him - I understand that once they are a certain age, they don't have to tell you but this is a child still, living under my roof, dependent on me, and I have absolutely no idea what is going on!

and what worries me even more is that he wants to go to university next year. This is apparently a good thing because it shows he has future ambitions but I am really concerned how he is going to manage when he is so mentally unwell that a psychiatrist is having to put him on the maximum dose of 2 types of medication! And then no doctors will tell me what is going on or fill me in if things are going wrong while he's away!

How does your DS feel about the MH team talking to you? Legally they are not allowed to disclose patient information unless the patient expressly gives consent, and as your DS is 17 he will be deemed old enough to decide.

Having said that, he is living with you and you are, effectively, his carer so if he is agreeable to the MH professionals discussing whatever he feels happy for them to discuss with you,. this shouldn't be an issue.

Do you know which antipsychotic he is taking? Many of them are dual use so can be for anxiety, a mood stabilizer etc. However to go straight on to the highest dose rather than see if there is any improvement at a lower dose does seem to be overkill. The medication can take a long period of time to work so is normally titrated up gradually to a therapeutic dose. I guess the main thing is that your son is happy with the psychiatrist and trusts him?

@RatherBeRiding he likes the psychiatrist a lot. He has specifically instructed him not to speak to me (or exh) (which makes me feel awful if I'm honest :( ).

I did make an appointment and go and see him (the psychiatrist) myself because I was so concerned about ds specifically asking for me not to know (I wanted to know if I was doing something wrong). And he said that I shouldn't worry and there wasn't anything i was doing that was making it worse but that ds was a very private person and he wanted to keep all the information to himself. He said he had advised ds that he would prefer to communicate with me but that ds had said he does not want me to know (and even though ds has told me about the medication, he is refusing to let me tell exh). But I saw him months ago, so this was before all the medication.

oranges the antipsychotic is quetiapine

I had a look at it and it seems to be used when depression is hard to treat - but tbh he hasn't been on the fluoxetine that long, maybe 2-3 months? I don't know if that's long enough for them to determine its efficacy. Or why they didn't change that one first. I just don't know :(

Quetiapine is often used in addition to an antidepressant, it tends to help improve sleep as well if that is an issue and has a generally calming affect. Does he seem overly sedated with it? If it was increased rapidly I would be surprised if he wasn't quite drowsy. Do you think it is depression he has been diagnosed with, if he is no longer willing to discuss it, do you think there may be more to it?

that's interesting, thanks Oranges, as he has always, even as a young child, had problems with his sleep

he does seem completely over sedated with it. He seems like a total zombie. I went to speak to him this morning before I went to work and he asked me to make him a bowl of cereal and I went to the loo, popped my head in the door and said 'I'll make you that bowl of cereal now' and he said 'what bowl of cereal'.

I think he has definitely been diagnosed with depression. And when I met the psychiatrist, i told him there was a strong history of mental illness in my family (bipolar disorder) - I'm lucky enough not to have it but my mother and one of my siblings have it very severely. So I wonder if that's something they are exploring?

I'm just so concerned as he appears aggressive to me now and he wasn't before he was on these medications. I might be reading too much into it but his personality really appears different to me since he's been taking the drugs.

I'm just not sure where to go because if I speak to the psychiatrist, they can't give me any answers. All I can do is give them information about how ds appears to me. And if they speak to ds, it may well betray the little trust he has left in me. I mean at least he is telling me what is going on now.

I have just sent you a private message

In my opinion, having mh issues myself anxiety leading to depression
Like you it’s in my family.

When gp referred me to psych, I thought that’s all she wanted to do to get to better was throw meds at me.
Now I’m 62!, but was in such a mess I said ok
They gave me. Promazine, quitiapine, had bad se with both that scared me to death.
These drugs are so powerful, and I personally don’t think they give your body enough time to get used to one dose before there moving it to the next dose. Everything seems to rush you to the therapeutic dose or higher. When sometimes it’s just time.

I’m so sorry you have no idea or input into your sons care that must be terrifying.
Just wondering why his change of heart. Happy at the beginning, now almost resentful of you knowing.

He should be having therapy as well as meds, meds do help but you need to have an understanding of why. Is he having any therapy, I’d of thought psych would of suggested something.

thanks for sharing your experience granada. He is getting therapy too which does appear to be working this time. It's just being in the dark that I find so hard but it really helps hearing from other people.

What about suggesting a family counselling session OP with the both of you and this or another counsellor, to help improve your relationship and communication skills?