Advice needed: when to push and when to step back? Low mood in teen with ASC

[BladeOfMiquella]

DS 15 is struggling with low mood and anxiety. He’s refusing to go to school and I’ve not been forcing him since I found out he was self harming and has thoughts of suicide - I’m reluctant to push him into something that’s clearing impacting him so adversely. I’m very worried about him.

He’s very complex and so I struggle to know what to do for the best. It can be challenging to understand what he’s thinking and feeling, communication is difficult due to him being autistic.

School have a different approach and think I need to do whatever it takes to get him into school. They think he is fine when in school and that he is ‘pushing my buttons’.

How can I know what is best to do?

Anyone?

Just thought might be helpful to add he is currently under CAMHS. Has been on Fluoxetine for a couple of years but hasn’t seemed to help. Fluoxetine was recently increased but then decreased a few weeks later as he became worse (self harmed). Recently prescribed promethazine - just seems to make him sleep. At last appointment CAMHS did suggest might be best to look at switching Fluoxetine to something else.

And just to add I absolutely don’t think he’s pushing my buttons. Over the last year he has lost interest in everything, he rarely if ever wants to leave the house and has no interest in recreational activities or hobbies. Over the past few weeks he is also eating very little as he has no appetite.

He hides the self harm but I spotted it and I was only alerted to his suicidal feelings by school after he told another pupil. It’s not like he’s using it as a threat, he doesn’t want to discuss it.

Sorry to hear you’re both going through this. I hope some one will be along soon who has been in the same situation and can offer advice. I wouldn’t push him to go to school, you know your own son, trust your instinct. Are you able to get him out for a walk at all? My husband and eldest daughter suffer with their mental health at times and getting out for a walk in the woods regularly helps.

Caveat: I don't know your son so am speaking of my experience of parenting mine ... He's not 'pushing your buttons' he is experiencing MH challenges. He needs to feel in control, rested, calm. Things rarely available in secondary school. Regular nutritious food, regular short walks outside, plus short periods of his preferred activity. Education can be accessed throughout his life. If he's self harming & has had suicidal ideation then I'd not push him.

Some anti depressants in teens can make them worse and suicidal.

In your shoes I would consider changing meds fairly urgently.

I've had a teen in your situation. Ignore school. Their mental health is far more important. Education can be picked up again (mine dropped out of a-levels and did an access course. She was a lot happier at college rather than school.)

I took mine out of school. The change in his mental health had been astonishing. He still had a lot of struggles but removing the pressure of school was a huge release

He's exhibiting emotion based school refusal which is very common in ASD. There are many resources online you can have a look at. Some LA's (if you're in England) often have their own guidance. Check it out.
Does he have an ehcp?

Are you able to access DBT for teens? Even privately? This is effective for suicidal feelings and also for people w asd / autistic ppl.

I’ve not heard of DBT - I’ll look into that thanks

He does have an EHCP, he’s only doing maths and science GCSE and he’s predicted a grade 2

My gut is telling me not to push him, I feel very worried about him. It’s not just school he refuses, it’s like he’s refusing life - he has no interests, no hobbies, very little social interaction, won’t leave the house.

Forcing DS to attend is likely to cause further trauma.

You need an early review of the EHCP because it needs amending to better meet DS’s needs. On their website, IPSEA has a model letter you can use. Does the EHCP currently include any therapeutic provision? The benefit of an EHCP is it can include therapies DC wouldn’t otherwise receive and therapies more frequently than they would otherwise have access to and without the need to sit on the normal waiting lists. Although you may have to appeal. You could look at an EOTAS package, which doesn’t have to include formal education if that isn’t suitable for DS. Does DS game?

In the meantime, if DS can’t attend school the LA must ensure he receives a suitable full-time education. Or if full-time is not appropriate in any form as much as DS can cope with.

If he has an ehcp I would request home tuition package as a stepping stone to increasing his engagement with education.

Ok, if his academic ability is such that he's only doing 2 GCSEs and they don't expect him to pass I would totally ignore school.

Start playing the long game.

Think to yourself - what did he used to like? Was he sporty? Did he like board games? Music?

Then maybe say to him that in January as a New Year's resolution you're going to get out and try new things. Try and drag him with you to try stuff.

Maybe once a week, or once a fortnight if that is too much. Do a cooking class. Do a new sport. Just try stuff and try your find something that sparks a response.