DD hospitalized again

[BioAdoptMom3]

DD14 was hospitalized (crisis stabilization) 3 weeks ago, for severe depression and suicidal thoughts, and is back again - same behavioral center, only one for kids in our community.  The last time the psych there (not our psychiatrist) took her off of Prozac and Abilfy after 2 years and put her on Risperdal!  For the past 2 weeks she has complained of dizziness and been very weepy, moody, etc. Last night she was having suicidal thoughts and asked on her own if she could be admitted.  We took her in, they did feel the need to admit her.  Tonight at visiting time she was crying the entire time, said she didn't feel well, didn't get her meds and had to sit in the social isolation desk all afternoon!  When I questioned the nurse I was told it was the doctor's policy to put them in isolation if they returned too soon as an inpatient because obviously they hadn't done a good job with their goals and need more thinking time (the child already has social anxiety and isolates herself way too much).  Are you kidding me?  :)epression is an ILLNESS and they are the ones who changed her meds  !  As for the meds, she said the doctor ASKED her, a 14 y/o, if she wanted to continue with them and SHE said no.  Since when is that a decision to be made by an unstable 14 y/o?  When DH and I got in the car to leave I called the nurse and tactfully, but forcefully told her our concerns which she said she would express to the doctor.  Is this normal for a behavioral center to treat kids like this?  By the way, DD has NEVER in any way, shape or form, had behavior issues.  Its just been depression, anxiety, self-harm, eating disorders and problems maintaining peer relationships.  

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[crazedncrazymom]

Wow!  I'd be livid too!  I'm so sorry your dd is back in the hospital. How are you holding up?   I think it was really brave of your dd to admit that she was having a problem.  You must be really proud of her.

My dd has been hospitalized several times and the doctors have always asked my permission to change her medication.  It's great that he asked your dd if she wanted a change but he also needs to seek parental permission.

As far as the isolation goes; many kids, especially those with BPD use the hospital as a way to escape situations.  If a doctor suspects this is the case (or it could just be standard protocol without looking at individual cases) they will make being at the hospital unpleasant.  This is not necessarily a bad thing although it is painful to see our children unhappy.

[lbjnltx]

Oh my!  I'm sorry that your d is having these thoughts and feelings.  It is so difficult to know our children are in that much pain.

I can see that the isolation would be a good thing in that exposing her to peers who are also suicidal could make things worse for her.  I can also see the other side of the situation in that teens are hungry for acceptance amongst their group.  Having the opportunity to identify with others around her age could ease the feelings of shame/being alone/enigma.

Policies are hard to get past in the medical world.  I think any long term exposure to them needs to be a good fit for the individual.  Flexibility can cover a multitude of scenarios and patient needs.  The goal of the facility is to keep your d safe from herself.  I guess they accomplish that so there is value there.  How they accomplish it may be questionable for some of their patients.

Making the hospital experience unpleasant to discourage using them as an escape makes sense.  This could also backfire in that the next time a patient is suicidal they will not speak /ask for help because they don't want to repeat an unpleasant experience at the hospital.

Most choices have both good and bad consequences.  Keeping the overall picture in mind... .not losing sight of the goal at hand... .can be difficult in times of crisis and even day to day.  You made the best choice with the resources available to you BioAdoptmom3. 

Regarding asking a young person's desires for medication is a good thing I believe.  Helping them is something we want to do with them... .not to them.  It is also true that asking an unstable/mentally ill person to make decisions about their meds or professional care is a risky venture no matter what their age.  It defies logic and reason and there is little that can be done against their will past a certain age (depending on where you live).  The laws hold us accountable for them while the law ties our hands behind our backs to help them.  What a conundrum.

Remaining calm and firm with the professionals, listening to the reasoning for their policies and validating the value of those policies before presenting to them the other side (your personal opinions) may affect positive change or may not.  It is out of your control. 

Have you read this information?

Depression and Suicidal Ideation

TOOLS: Dealing with threats of Suicide and Suicide Attempts

I hope that you find something there that can help you and your family.

Knowing prior to crisis what your options are and how to calmly respond is vital for everyone's well being and making wise choices in the moment.

Let us know how you and your d14 are doing.

lbjnltx

[jdtm]

By the way, DD has NEVER in any way, shape or form, had behavior issues.  Its just been depression, anxiety, self-harm, eating disorders and problems maintaining peer relationships.   

I posted a couple of days ago re the use of Risperidone.  I'm wondering again - it appears that bipolar, autism and schizophrenia are not what ails your daughter (or the reaction to Risperidone would not have been so drastic).  I also question BPD being a viable "excuse".  And no, I'm not in the medical field so my observations could be way out in left field; but your description reminds me (somewhat) of our teen-aged granddaughter.  I also thought a few years ago (about the time she became a teenager) that she might have inherited a personality disorder from her maternal side of the family.  But, it is beginning to seem that she suffers from severe, severe anxiety and I'm wondering if that is the issue with your daughter.  Research has discovered (rather recently, I believe) that anger (both repressed and expressed) is the hidden emotion in severe anxiety.  I also wonder if the issue of "suicide" might be the result of your daughter's anxiety and depression brought on by the removal of Prozac. 

The medical doctor has taken our granddaughter off of her SSRI - been two weeks now - she is feeling irritable and angry and weepy; not sure about suicidal thoughts (sure hope not); she is also in a monitored residential center.  It's scary but severe anxiety can be the issue.  I suspect strongly that is the main issue in our granddaughter's situation.

So no answers here - just some nagging thoughts ... .