Seeing things?

[DeepWaterSwimmer]

NC. I'm supporting a teen boy (17) at the moment. He has disclosed that, for a year or two, possibly linked to difficult times at school, he has been feeling very down and struggling with a number of issues including distressing intrusive thoughts, suicidal feelings, (but not intentions), and outbursts of anger. Sometimes he copes with this by hurting himself. There is no suggestion of drug or alcohol use. Perhaps the most distressing and disturbing thing to him is that he has started to see demon-like images at home - for example coming out of a wall or sitting in a room when he walks in - and this is accompanied with deep feelings of fear and dread. I would be grateful for advice on the aspect of him seeing things in particular.

He needs to see a dr urgently

As above, contact the gp urgently to discuss mental health assessment, medication and referral to MH services

Hello. Yes, he needs to see his GP as soon as possible. Offer to take him and sit in with him if he doesn’t have any other support. If you feel comfortable that is.

Agree with everyone else - he needs to see a Dr urgently.

Thank you pps. Does anyone know why he might be seeing these awful images, what it might be a part of, how it might progress and what his prognosis might be? How common it is, especially at his age, and how serious it is? Also how best to support him and approach it with him?

There are many reasons why, this is a really worruing scenario. If you can,get this lad to a dr please

So far he is not willing to speak to anyone else, so I am struggling a little bit.

See if you can find any information online about the Early Intervention in Psychosis (EIP) team for your local mental health service. Your GP can make the referral but some trusts you can access directly as well.

The concern with hallucinations is that he may become psychotic. It can be very difficult for people with invasive visual or auditory hallucinations - whatever the cause - to distinguish between what is real and what is not, and sometimes this leads them to act in an unsafe way out of fear (more often unsafe towards themselves rather than others, but that is also a risk). For example, I know of a young man who tragically died because he jumped out of a top floor window in an attempt to escape a devil that he could ‘see’ that thought was trying to kill him.

Psychotic thoughts can be well managed with the right medication but it’s important that he sees someone very soon. The longer this goes on the worse it may get. He is at a very vulnerable age in terms of psychotic disorders (eg schizophrenia) which most commonly develop in late adolescence.

youngminds.org.uk/find-help/conditions/psychosis/

Thank you pps. That sort of information will help me understand a little more, which is what I think I need if I am going to better help him. For background, he is very bright and articulate, doing A Levels, hoping to go to Uni after that and from a loving, stable family. He has a girlfriend and a small number of friends, (although not able to see them at the moment with online lessons and lockdown).

EIP team or GP (as pp said) NOW. Call them today, or get someone else to call for him.
Psychosis is no joke. I had a psychotic break last summer, it's not the same because it was caused by stress, but the psychosis was real. He needs help very, very quickly.

School has been particularly stressful for him for the last 3 years or so after a change and his mental and physical health seems to have increasingly suffered from then on. He describes being aware from quite a young age of some habits which now sound a little like OCD and having had an overwhelming 'bad feeling' at times. Intrusive thoughts or voices and now seeing these things seem to have taken the place of that early bad feeling.

I would call his GP first thing this morning and tell the receptionist it’s urgent.

As per others have said, he needs to see a doctor now with an immediate referral to a psychosis intervention team. This could escalate very quickly. It could be caused by lack of sleep so they may prescribe a short dose of tranquillisers before he can be seen by an MH specialist. If he won’t go, request a home visit.

Another MH professional here saying your son needs referral to your local early intervention in psychosis team. The earlier professionals intervene on this scenario, the far better the outcome is likely to be. The good news for your family is that this is one area of MH that seems to be well resourced right now. He's likely to get two years of care/monitoring. Please don't hesitate to get him seen. Stamp your feet and absolutely insist this happens.

Also just wanted to add as I read your post about your sons life and hopes for the future etc....please don't think that involvement with mental health services now will prevent any of that. They won't; they will increase it by ensuring he is well enough to do all the things he hopes to.

Although this is happening and there are mood swings, including angry outbursts and withdrawal, he also seems very in touch with reality. I am very reluctant to breach trust and take decisions out of his control.

I really appreciate the advice pps and link. I am hoping that the more I understand the better I can help and keep a watchful eye on him in the meantime, and guide him towards getting the right help.

One particular question is how exactly to respond to him about what he has seen - to listen, obviously, but what to say to him and what should he do in the moment they are happening and afterwards? I have reassured him that he is not alone, he can talk to me and said that I think they are hallucinations because of how stressed and down he has been feeling for a while. I think he is largely accepting of this but also has a small fear that they are somehow linked to his (fairly quietly/low key Christian) faith - not the devil exactly, but maleficent/evil - he mentioned he had been looking that up on the internet, which I have advised him against doing more of.

I totally understand your trust concerns here, but the best help you can give him is through medical professionals. You can’t talk someone out of psychosis, it is a chemical imbalance. Bitter & painful experiences of my son’s psychotic episode 3 years ago when he was 17.

I have similar hallucinations and can tell you don't hang about. Get him to his GP as a matter of urgency. He is going into psychoses and anything could happen.

There are various causes of psychosis, and prognosis will depend on the ultimate cause, but as others have said you won’t be able to reason him out of his hallucinations, he needs proper mental health assessment and medication. The sooner the better. These type of hallucinations are very frightening for the person having them, as they believe they are real demons.

www.mindcharity.co.uk/wp-content/uploads/2015/10/are_you_worried_about_someones_mental_health_factsheet.pdf

You can talk about what his beliefs about what these things he sees are, accept what he thinks but it’s ok to say you don’t believe the same thing. Treat is as a difference of opinion rather than real/not real. Ask about how he feels when it happens. Focus on feelings rather than experiences. Aim to move the conversation on to what he wants to do about it, what solutions there might be, ask how could he help himself, ask how he wants you to support him.

Encourage him to talk to GP or directly to mental health services if that is possible in your area - find all that information out for him. Ask about why he’s reluctant to do that and try to reassure him about any concerns he has that is preventing him seeking proper support.

He’s incredibly vulnerable right now. If he absolutely refuses to seek proper help himself then personally I would still contact services on his behalf, they will be very used to dealing with people who don’t want intervention and be able to advise what is and isn’t appropriate to do.

The most important thing is that he sees a doctor today. You are doing the very best for this young man if you can help him get an appointment.If you feel that you don't want to collude with him when he talks about seeing things you could say " I believe you are seeing xyz and that must be very scary for you." Nobody on here can give you a diagnosis other than to say it sounds like psychosis. But don't get ahead of yourself, it doesn't have to mean his life's over. I hope it goes ok today, op.

I agree he needs to see a doctor urgently but is he by any chance on an antidepressant? When I used to take Citalopram I had hallucinations. As soon as I came off it they stopped within weeks.

Might be worth checking any medication he takes and looking up side effects as I had a terrible time on SSRI antidepressants. Citalopram I was having conversations with customers who weren't there and seeing Green dots on me and others (like you get from rifles) and Paroxetine I had these awful dark violent thoughts. I stood in primark and this child was whinging and I imagined grabbing him hair and smashing his face into the railing over and over, it was horrible. And I couldn't block the thoughts out. Again they stopped when the meds did and never recurred.