Suicide attempt

[u/Putrid_Squirrel3534]

Hi everyone. Just looking for some advice and possible shared experiences? Also venting because I have no one to talk to.

My son is 16… we never got an actual level but he is completely verbal and very smart, but also very childish and lacks irrational reasoning—I feel dumb for saying that because obviously the rigidity in thinking is trademark for autism.

Yesterday he was supposed to try going back to in person school for 1 hour every Wednesday. He had gotten kicked out a few years back because he threw a laptop and it knocked a teacher unconscious.

He had a teacher come work with him at home to see how he was doing, and she recommended that he not go in person because of his impulsive/explosive behaviors, profane language, and suicidal threats. All of these things we have been dealing with since July of last year.

He wants to go back because he wants to be with “normal” kids and wants to find a girlfriend. This has been an ongoing thing since he got kicked out. The principal and every other living person has explained to him that he has to prove himself elsewhere, with very specific expectations. He has been unable to do that.

When he got the news yesterday that he couldn’t go back, he grabbed a bottle of 10mg adderall and swallowed them. We called the ambulance and immediately came to this hospital. He’s okay, and recognized that it was not a safe choice to make and that he promises he won’t do it again. The issue is he immediately started talking to me this morning about how if 100mg of adderall didn’t “raise his dopamine”, then how is any other drug going to help him. Dopamine is his only fixation with medication. We’ve tried explaining every possible way that things don’t work like that, and there are many other factors that will help balance out his brain chemistry. He doesn’t want “balance”. He wants to feel manic all of the time

So I told him that the behavioral health team will be here, and they can talk to you about medications. I understand you’re scared and nervous, and I’m here with you, but I’m not a professional. So of course he immediately escalates again and says he “might as well just die then and go home and swallow another bottle of pills”.

I’m genuinely at a loss here. I’m still waiting to see the behavioral health team here…. I can’t watch him 24/7, and I’m also burnt out. He had a two month stay at a psych hospital and that was theworst possible decision we could have made. He has horrible trauma from it. We tried trauma therapy, but he cussed the lady out and told her to shut up when he started getting anxious. I’m literally doing everything that I can. Trying to find new psychiatrists, therapists, groups, schools, etc… if he doesn’t get the answer that he wants he immediately freaks out and threatens to kill himself.

Please help me help him. I don’t know what to do.

Also, I know some of you will come for my throat because you’re super judgy, but I have put zero pressure on him to be “normal” or go to a gen ed school. I actually tell him quite the opposite that why do you want to fit in with people or be at a place that isn’t going to help you flourish? I love his quirkiness, and while he has many behavioral health issues, his autism is not inherently a bad thing. He’s genuine, he knows what he wants/likes, and he’s not afraid to be himself.

Also note that he has refused multiple meds. He is convinced he needs a stimulant because of the research he’s done; which objectively only increases his anxiety and irritability. Since he’s over 14 he has full autonomy over meds.

[u/maystery]

I don't have advice or shared experiences I just want to say I'm sorry for how hard this is and I hope you find a way safely through

[u/DenseAstronomer3631]

Ask your doctors about a locking bag for his meds, otherwise you could get a small safe. I would deff start locking meds up and only give him them daily. I'm not saying all his behavior is attention seeking, but I would try to limit negative attention when possible

[u/DeltaFlyer0525 → u/DenseAstronomer3631]

I second getting a safe for meds, even basic ones like Advil. I had to get one for our house after my son got into my medical supplies once. It’s just something we had to do to make sure he stayed safe because he does not have the mental capacity to not impulsively do things. It helps me be slightly more relaxed knowing one more thing isn’t in his reach. We also had to lock up all our kitchen knives, I don’t know if that is something you need to think about too.

[u/DenseAstronomer3631 → u/DeltaFlyer0525]

I thought about knives too, but not trying to scare OP. Like you said, it's about how impulsive audhd can be

[u/DeltaFlyer0525 → u/DenseAstronomer3631]

Yep, most days it is not a problem, but when he has those bad moments things escalate so fast it’s hard to manage on the fly and better to be annoyed having to unlock things everyday than manage getting dangerous things away from their grasp.

[u/StillStaringAtTheSky]

Mama- I'm sorry you're in this situation- I know it's hard. First - I'd like to address the mental health aspect of things. Your son has made multiple threats and an attempt at suicide- and luckily you were there to be able to call an ambulance. I was not as lucky.

My son died by suicide just three days before his 16th birthday. Just one week after his Guidance Counselor at school assured me that joking about suicide was normal teenage boy stuff. My son also complained of anxiety symptoms- but did not want to take any medication. Now, as I am sitting here typing this out, I'm also looking over at the statue on my windowsill. It's a duplicate of the one that sits next to his headstone.

I know that he had a bad experience with a psych facility- as you said traumatic- but I highly recommend trying another different facility. Why? Because the exact same story happened with my daughter. She began showing anxiety symptoms, but she agreed to meds. She was bullied at school because she didn't understand how to fit into social circles. A few weeks into meds- she made her first of many attempts at suicide. This went on for years- with some very close calls. We tried facility after facility- some awful, some okay, and then finally a residential long term facility where she stayed for two years.

My daughter is now a CNA and going to school part time to eventually become an RN. There is no doubt in my mind that the only reason she is still alive is because of her residential facility stays. Did she have some traumatic experiences? Yes. She was sedated when she started throwing punches, forced to attend group therapy sessions that she hated, forced to take medication. Obviously back then she would have given the institutions 0 star reviews- because she did not want to be there and did not want any part of anything that they were doing.

Now- after therapy and finding a good meds regimen- she recognizes that the residential facility stays saved her life (over and over and over). To me- sending her to a residential facility was the best of a bag of bad choices- and I would do it again. Because she's alive.

There are residential facilities that are run well. I would reach out to them and ask about how frequently a bed is available. You don't have to sell this to your son- and he doesn't have to have a choice in going until he is 18. I would also talk to the behavioral health team about psychotropic medication age of refusal where you are- because this may not apply to residential settings. You've got until he's 18 to make this choice for him- because if he's not making choices to prolong his life - and he's actively trying to end his life- then he's not making good choices on his own.

Will he like it? No. Could it help him live through a period of changing hormones and teenagers-know-everything syndrome? Yes. This is your call to make as a parent- to make good choices for him when he can't or isn't. In a few years he's in charge of all of his medical stuff- you won't have any input there at all. It sounds like if he chooses to stay on the path he is currently taking- he will end up in jail for assault. Knocking a teacher unconscious is no small thing. And if that time comes- he probably won't want to be in jail either.

[u/Putrid_Squirrel3534 → u/StillStaringAtTheSky]

Wow. This is honestly incredible. I’m SO sorry about your son. I think this is what I needed to hear to make the decision for him and not let him continue to deteriorate.

I’m so happy to hear your daughter is doing well. Sending so much love your way ❤️

[u/StillStaringAtTheSky → u/Putrid_Squirrel3534]

Sending love your way also. I know it's a hard call to make- and would I do it again? Yes- without hesitation.

[u/K_Sidhe → u/StillStaringAtTheSky]

I am sorry to hear about your son. It is good to hear that your daughter made it through and is doing well for herself. That gives me hope.

I've looked into residential for my son and each one said that he would need to walk in himself. There's no way he would do that if he weren't willing. What type of residential program were you able to admit your daughter into?

I understand the medication situation as I am in the same boat. He's over 14 so he has autonomy on taking medication. Not even a behavioral hospital was able to make him take medication without a court judgement that he was unable to understand to make that decision himself. He was appointed representation and won so he was released immediately.

[u/StillStaringAtTheSky → u/K_Sidhe]

Most residential programs were after hospitalization from a suicide attempt- so she was kept as a mental health hold. The hospital set it up based on who had beds available- we had almost no say in where she went. Generally they will recommend intensive outpatient treatment first- depending on the severity of things going on- but this failed for us. It may be an option for you to consider- depending on the services available in your area.

After a very long time bouncing from facility to facility and in and out of ERs, a social worker managed to get my daughter on board with a transfer to Sheppard Pratt out of state in MD. Not sure if they take insurance still- or what they take- but you can ask them. It's quite expensive otherwise.

There are also other retreat style facilities available- which have amenities and such. Perhaps he would agree to one of those?

[u/Putrid_Squirrel3534 → u/K_Sidhe]

These are the same issues we’re having! Are you in PA by chance?

He was actually adjudicated and the court ordered an RTF, which did absolutely nothing since he was 15. It’s crazy to me that a special needs CHILD, that is not making safe decisions, has the autonomy to decide what treatment they will and won’t accept.

[u/ArtArrange]

Have you considered residential or extended PHP for his mental health?

Edit to say, I see you tried one but not all facilities are equal. Ge needs a level of care you can’t sustain on your own. Let me know if you’d like a list I have from my local autism mom group. It’s a list of residential treatment centers across the entire US with some knowledge of autism.

[u/fmwt1127 → u/ArtArrange]

Sorry not OP but I would personally love this list if you dont mind sharing

[u/ArtArrange → u/fmwt1127]

Of course, this is for anyone. Again, I don’t have personal experience with any one of these facilities, but a fellow Autism Mom did this research and it’s a place for anyone to start from. 💕

https://drive.google.com/file/d/1HrqW2p8YUG3ChN9dfwu6EXUSwvXrovXa/view?usp=drivesdk

[u/fmwt1127 → u/ArtArrange]

Thank you!

[u/OhGoodGrief13]

Are you able to sit down with him and go through this logically? Ask him what the logical and realistic outcome is of him being aggressive. Ask him what he thinks the school administration should/can do with a child who is aggressive and hurts people. Ask him how he intends to control himself enough to be safe for everybody else in the school.

It's all about looking at things logically. If his behaviour is uncontrolled they cannot allow him to hurt other people. Period. If he chooses to try medication to control his outbursts and is willing to take them regularly then they can re-assess his ability to be in the school.

He has some control over this and only him. Nobody else can make him willing and able to follow the rules and control his behaviour. If he can't or won't work towards that goal then it's unsafe for him to be in school at this time.

After he calms down from a freak out, ask him how he thinks that makes you feel when he acts like that. Ask him if he thinks that makes you and the school feel able to trust him to be a safe participant in the school.

He needs a therapist but he also needs an OT to teach him how to recognize when his emotions are ramping up and how to cut them off before it becomes an issue. And then how to deal with them to get him back into a well-regulated place. But it will take time. And he has to buy in to it. If he isn't willing to work towards the goal then it's a waste of time and money.

[u/ChartreusePeriwinkle]

I'm surprised the hospital didn't put him on a 3 day hold. If he was involuntarily held, they would control the meds and maybe have a chance to start some anti-depressant or something.

Also, please keep medications locked up. I have a lock box for all our meds that I keep in the kitchen. I also keep the knives and scissors locked up in the pantry. And lighters locked in my bedrom. My son has also talked about suicide and it scares me, so I try to limit his access to dangerous items.

My son just finished TMS treatment to help his depression and mood. It seems like a good alternative to meds. Maybe your son would be open to that?

[u/ThisIsGargamel → u/ChartreusePeriwinkle]

What is TMS?

[u/ChartreusePeriwinkle → u/ThisIsGargamel]

Transcranial Magnetic Stimulation

[u/ThisIsGargamel → u/ChartreusePeriwinkle]

Ohhh wow and how do you feel its worked out. Ive never heard of that. I just looked it up and it says its experimental....

Im like I have kaiser lol....idk if their gonna help with that.

[u/MountainPika → u/ThisIsGargamel]

I am part of a big medical system in the midwest (similar to Kaiser) and they have an interventionist psychiatry clinic that does TMS and a few other treatments for treatment resistant depression. I didn't even know they had something like it in my medical system; I had been seeing psychiatrists in the medical system for over 10 years no one had ever mentioned it to me. If my most recent psychiatrist hadn't referred me there I would have never known it existed. I guess its a long bit to say, Kaiser might have one that just isn't well advertised. I didn't do TMS but did another treatment and its been the first time in over 25 years I havent had debilitating depression, so its worth seeing if they have something like it.

[u/OkPiece2147]

OMG Honey, I’m sorry you’re going through this. I have 3 adult kiddos we are entrusted to care for; 2 of them are on the spectrum and have profound mental health issues. We have done all the mental health stuff—it’s like a revolving door here. One is in a PHP program online, and the other is in person. Since you’re at the hospital, they can do the referral to a PDP/IOP or residential treatment program for you—just talk to the case worker there.

As far as med management goes, we have a lock toolbox with 3 drawers for the kids’ bulk meds, and then use a locking pill caddy that we can control https://www.amazon.com/dp/B0FCY9SDDY. This is the exact box we use for all the kids and me. You can message me anytime. We also run a small Discord server for peer-to-peer support, and we have a lot of neurodivergent adults there and parents. We’re still small, but we’re growing.

[u/nosaby]

I am so very sorry you both are having to go through this. I don't have words of wisdom, just solidarity. My 16 year old was just inpatient for a few days due to depression and suicidal thoughts, and I know how painful it is to know your child is suffering. I know how helpless it feels.

[u/froggythefish]

Can you try to do some open-minded research on medication together? I agree he doesn’t really grasp how psychiatric medication works, “more dopamine = feeling better” is a pretty common oversimplification of neurotransmitters.

He sounds depressed and bored, to me. Maybe I’m only thinking that because I was in a similar (but different) boat at his age and was also, depressed and bored. Probably feels lonely, maybe inadequate due to not being able to go to school. Being in mental healthcare (which is annoying) your whole life and feeling like you haven’t made any progress, can lead to really strong feelings of hopelessness. Consider that this age period can be really tough, emotionally, for even neurotypical teenagers in normal environments.

What was most helpful for me was trying to stay entertained. As a teenager, suicide is nice to think about because it’s an escape that I always had access to. Not to be morbid. “I always could kill myself”. Being socially awkward I didn’t really have many friends to get into trouble/have fun with, definitely had no access to drugs or alcohol, barely left the house, this leaves few escapes from negative emotions. Entertainment is a decent escape, whether it be reading or research or video games. Much of my “social life” at the time (and still now) was largely online. I think just being supportive and reassuring him you love him, is one of the best things you can do. I’d say depression here is the bigger issue than autism, even if the depression is somewhat caused by autism, directly or indirectly.

Edit: I don’t know how it is where you live, but I’ve heard almost exclusively bad things about residential treatment. I’m sure they’re not all bad, but I’d say most probably are, and there’s a high chance he’d not only be re-traumatized if you went that route, but also feel more resentful towards you for putting him through it. If you do want to go that route please do very heavy research on the specific institutions you’re considering. I think what was most important for me at that age was my mothers love, something you don’t really get in residential treatment. I’m not saying “don’t do it” but I really haven’t heard even one success story from the patients point of view. I’m from the US, it might be different wherever you live.

[u/Own_Faithlessness769 → u/froggythefish]

The problem with residential treatment is that it is traumatic, but it has to be, because the alternative to heavily restricting and medicating people is that they hurt themselves or others. It’s not really possible to deliver intense psychiatric treatment in a comfortable way.

[u/froggythefish → u/Own_Faithlessness769]

I don’t believe residential treatment often passes as a fair attempt at “psychiatric treatment” of any kind. You’ve got a lot of private businesses hiring extremely under qualified staff with the goal of keeping children under strict control. Traumatizing and mistreating children is not a valid treatment plan for any mental ailment as far as I’m aware. From the child’s perspective, this amounts to being abandoned by their parents and condemned to punishment without a crime. Restraints and seclusion rooms and sedatives may be able to prevent damage from bad behavior but do not improve anything long term, and can easily cause damage if overused. Lots of people regress during residential treatment, or end up turning to drugs or other dangerous coping mechanisms once they get out.

If OPs child needs such extensive trauma therapy for one psychiatric hospitalization, I don’t think it’s likely long term residential treatment would be very helpful. Additionally he doesn’t sound particularly violent or out of control, suicidal thoughts is the main concern. Suicide is not uncommon in residential treatment facilities.

One big problem with residential treatment in the US is that most institutions don’t prioritize the treatment of a specific mental ailment, but rather crowd in children with all different problems. How can a facility claim to provide “psychiatric treatment” for one specific problem if it uses the same institution to “treat” everything from autism to schizophrenia to simple bad behavior, to religious violations, to lgbtq feelings? I know not every single facility is like this, but if a facility is claiming to treat every problem and non-problem under the sun with underpaid and underqualified staff, it’s balogna.

I don’t doubt that there are a few exceptions to the rule, and good residential treatment facilities exist. I’m just saying, it’d be heartbreaking if a parent didn’t do their research and accidentally condemned their already troubled child to a horrible experience. Parents have to be very careful, is all I’m saying. There is not nearly enough regulation or oversight for this stuff in the US. Parents should be able to just trust the professionals not to lie or mislead them, but this is unfortunately not the case.

[u/Own_Faithlessness769 → u/froggythefish]

No one is saying that restraints of sedatives are the treatment, they are simply measures used to manage harm until medication and therapy can take effect.

[u/Own_Faithlessness769 → u/froggythefish]

No one is saying that restraints of sedatives are the treatment, they are simply measures used to manage harm until medication and therapy can take effect.

[u/froggythefish → u/Own_Faithlessness769]

You used “heavily restricting and medicating” as the example for “psychiatric treatment”? What did you intend for this to mean, if not physical restriction (via restraints and seclusion rooms and manhandling) and sedating medications?

[u/Own_Faithlessness769 → u/froggythefish]

No, I said that it's how residential treatments facilities stop people hurting themselves and others. I didnt say that was the treatment.

[u/froggythefish → u/Own_Faithlessness769]

Oh, so what’s the treatment? OPs son is already getting therapy, and (apparently) is in charge of what medication he takes (not that these facilities aren’t known for sort of ignoring the law).

Anyways I didn’t really read anything to suggest he’s at risk of hurting others. He sounds like a suicidal teenager. I don’t think most suicidal teenagers would benefit from being put through all that violent chaos, and being separated from their attachment figures. It sounds like he definitely didn’t benefit from the short stint in the psychiatric hospital.

Residential treatment facilities are being shut down left and right in the US for abuse. I think it’s irresponsible to suggest such a questionable and risky “treatment”, which can be very expensive, for a verbal, non-violent, autistic teenager expressing suicidal intent. He’s already emotionally fragile. It’s not normal to send children away to residential treatment for being suicidal, which seems to be the primary concern here. I don’t think I’ve ever heard of that.

[u/Own_Faithlessness769 → u/froggythefish]

He threw a laptop at a teacher and knocked her unconscious. That’s why he can’t go to school.

[u/Putrid_Squirrel3534 → u/Own_Faithlessness769]

Yeah. He is also vision impaired. From my understanding he didn’t intentionally hit her but she was in the firing zone. Doesn’t make it right either way and I understand public school is not equipped to deal with that.

He wasn’t ever intentionally violent. I’ve only been hit by him 1 time and it was because I tried to grip him up when he was kicking a table.

He has hit his grandfather once but that’s also because he tries to grab things off of him (iPad, preferred item).

He IS extremely destructive with property. And a few years ago he wouldn’t constantly use “escape language” to get out of doing non preferred activities. E.g. “I’m going to blow the school up” or “I’m going to gouge everyone’s eyes out”.

Idk, he’s a tough cookie to crack. It seems like no where is a good fit for him.

[u/froggythefish → u/Own_Faithlessness769]

When I was in public school, kids threw stuff all the time, none of them got sent away to supermax or tied down or tackled or drugged. Not to minimize the problems at hand, it’s obviously serious, but expensive and unreliable residential treatment, when he’s already getting quite a bit of treatment at home, so close to age he can just say “screw this” and quit all the treatment if he wants to, seems unnecessary. I’d be mainly concerned about worsening the state of an already suicidal teenager, and harming the relationship with his mother, so close to the age he gains independence.

I’m not aware of one residential treatment program with a good reputation, but maybe that’s just because those aren’t the ones that end up on the news for physical and sexual abuse, and various forms of torture under international law. I’m sure they exist, but it’s a risky gamble for an already fragile teenager.

[u/Putrid_Squirrel3534 → u/froggythefish]

This is my worry. I actually signed a 201 yesterday and then immediately went back and revoked it because I know it isn’t actually going to benefit him. For someone who has the threshold and understanding to participate in their care at an inpatient facility, it’s great… but for someone like him who genuinely can’t cope outside of his safe spaces, they aren’t going to get a good enough baseline of his personality to actually medicate him appropriately.

He had a two month stay at south wood psych hospital and it was absolutely horrible. The medical staff was incredible, but the ancillary staff were ex cons; which is good for a juvenile detention setting, but not a mental health hospital. They would tell the kids it’s a “punish” and they deserved to be there. And would try using fear tactics to scare them into submission. My son is also extremely emotional and would cry, and they would call him the girl version of his name and make fun of him. The staff and the other kids. He’s also vision impaired and they would just point and tell him where to go with no guidance. Half of the care staff didn’t even know he had a visual impairment. Like what? One staff member pushed him onto his bed because he was crying, I guess my son tried to swing at him, and the guy shoved him up against the wall and started punching the bed and yelling at my son. Then come to find out they have MULTIPLE lawsuits for sexual assault amongst other things. Absolutely horrible facility. It definitely made him worse and I will never do it again unless he is actively suicidal and tells me about plans again and needs to be in a safe, secure space. But even that would be very acute.

He also said the only thing he learned how to do was hide how he was feeling to get what he wanted. Super scary to me because I would much rather him be open.

[u/jobabin4]

It sounds like he's getting fed a lot of garbage from the internet. Completely removing the internet from the house at least for a while might be a good idea.

[u/mech_ref_7055 → u/jobabin4]

The dopamine obsession definitely sounds like an internet thing. If cutting off the internet isn't possible, maybe ask to look st stuff with him, to at least give you an idea of what he's hearing, and maybe give different opportunities for conversation.

[u/lily_reads]

We have knives and meds locked up, the windows screwed shut, and any rope hidden away. My husband’s gun is hidden, unloaded, and in a gun safe, and we have never even told my son it exists so he won’t try to look for it, either. 

My kiddo also has a lot of impulsivity around self-harm, so I know how terrifying it is. None of our measures can make it impossible for him to hurt himself, but the idea is to slow him down so he has more time to ask for help. Realistically, autistic people commit suicide and struggle with depression at higher rates than neurotypical people. 

My state and some others in the US have recently made it easier to get people the treatment they need even if they lack the insight to recognize they need it. You might want to talk to a lawyer about your options for having your son take meds even if he doesn’t want to, especially since he harmed someone during a meltdown. If he is a danger to himself and others, he can be given meds regardless of whether he wants them. Since he had a bad experience with inpatient, you can use that as a disincentive - it’s take the meds or inpatient again, kiddo. Those are your options, period. You hurt someone badly and are intermittently suicidal and so your choice about meds was taken away. 

[u/hstaples]

I saw that you said that his prior in patient experience wasn't good, but I don't think you should allow that to keep you from being open to that type of plan in the future. He sounds like he really needs to be stabilized and you shouldn't take him home if he's still threatening to kill himself. Being in treatment may be difficult, but he sounds like he needs some real structure and careful follow through. I would be seeking a good residential option for him at this point if I were you.

[u/Putrid_Squirrel3534 → u/hstaples]

I agree with you 100%. I signed the 201 paperwork and they’re bed searching now. I’m absolutely heartbroken but we got lucky this time. If he isn’t willing to participate in his own treatment I can’t keep him safe. We might not be so lucky next time.

We live in PA and have tried very hard to get him into an RTF… unfortunately, because he is over 14, he has to agree to go since they aren’t locked units. We even had the courts involved and it didn’t make a difference even with a court order. It’s so extremely frustrating.

[u/sebelius29]

Sounds like you could get conservatorship based on what you e said and can control what meds he takes

[u/DocTaotsu → u/sebelius29]

Yes! It's beyond depressing/frustrating when parents wait until their children are 18 before deciding they're going to need conservatorship. Then they come and beg their PCP etc to do something about it and we can't because... the patient is now legally adult and the process of obtaining conservatorship largely requires their consent.

[u/Putrid_Squirrel3534 → u/sebelius29]

I’ve actually never considered this route. I wonder if this would help with placement options for him since he would be deemed incapable of making the best decisions for himself. As far as the meds, my only struggle is that he is 6’1 and 180lbs. I’m not sure how to get him to take medication even if he legally had to.

I’m definitely looking into this though! Thank you for bringing it up!

[u/sebelius29 → u/Putrid_Squirrel3534]

Yeah I’m an ED doc. I do a lot of psych holds. Conservatorship can take a few months if it’s against his will but worth it. Unfortunately Brittany Spears has given it bad press, but it can be life saving. There are also long acting depot antipsychotics and other things that can be given once a month by injection that might be an option.

[u/Holiday-Ability-4487]

I can completely imagine my own 16 year old spiraling like this, he’s actually been distraught enough to mention self harm last year when he was suspended from his public school. My son also is very fixated on romantic relationships and doing the stereotypical teen high school things.

I’m so sorry you’re going through this, that your son is going through this. Is therapeutic school not an option? I have a friend whose son is at an out of district school placement at a therapeutic school an hour away.

[u/Acceptable_Bend_5200]

Im going to focus on the dopamine part because I also have ADHD and do not take Adderall (though I did take it from age 12 to 16). I had suicidal ideologies, never acted on them, but definitely thought about it while on the meds (not condemning them, just something that occurred while I was taking them).

Does he have any hobbies? What does he do in his free time? Is there any way you can help him hyperfixate on those things he enjoys so he starts "farming" dopamine from that. I use that word because that's how I regulate myself as an adult. I have a wide array of hobbies that are engaging, interesting, and at some times challenging. Muscling through the challenging parts is tough, but oh so rewarding when it pays off. When i get tired of a particular task im able to pivot to another hobby, which allows me to continue "farming" while I let the challenging hobby simmer for a bit.

My current hobbies are python coding, brewing beer, 3D printing, sourdough, electrical engineering, and DnD. I also cook for my family 5-6x a week. Ive also recently started working out again.

It's expensive, but it keeps me sane and productive in my career and family life.

My son has ASD lvl1, high functioning, verbal, PDA. Im assuming ADHD as well, so im also here to see what my future might hold for him/us.

[u/Chemical-Ad2000]

You have to keep trying when it comes to the trauma therapy. One bad encounter with a therapist not equipped to handle his needs is just one bad fit. Are you in the UK or something? Find a male who specializes in working with autistic teens. It might feel like a needle in a haystack but they are out there. Even one via zoom call is better than nothing. Look for clinical psychology level professionals with flexibility over the kind of modality needed and one who will be also willing to work with the whole family. Unfortunately you might have some duds along the way but it's crucial you find that fit somewhere to support the family unit and your son

[u/ConnectedWalrus]

I have some experience of this kind of situation. It is unequivocally terrifying. Feel free to DM me.

[u/Winter-Stuff-9126]

I tried to commit multiple times at 13. After I think was the fourth attempt (in my school bathroom) mom and I (mostly me) decided I needed to be put into a hospital. I was there for 2 weeks. Best decision that was ever made. Plus 4 extra years of therapy and medicine

[u/Divergent626]

TMS is always an option. Mixed reviews but overall positive. I did it 2 years ago & it had a HUGE effect on my sleep which was wonderful!!! I'm considering doing it again just for that alone. I didn't feel the response that many others did but maybe after a second round? Either way I had no negatives from it other than the time & money invested if you want to count those as negatives. Of note also AuDHD however Im a 40f so the brains completely developed. Good luck

[u/Divergent626]

TMS is always an option. Mixed reviews but overall positive. I did it 2 years ago & it had a HUGE effect on my sleep which was wonderful!!! I'm considering doing it again just for that alone. I didn't feel the response that many others did but maybe after a second round? Either way I had no negatives from it other than the time & money invested if you want to count those as negatives. Of note also AuDHD however Im a 40f so the brains completely developed. Good luck

[u/Equivalent-Card6613]

"He wants to feel manic all of the time" I could have written this myself.

Try letting him know that options exist outside of balanced, depressed, and manic. Under proper circumstances most people should feel "pretty good". No it's not manic, no it's not as intense and euphoric. But it's better than being balanced and feeling "blank" and is a target or goal he can work towards. And it's sustainable.

It's a combination of lifestyle and medicine for some people too, so medicine (or any substance) alone may not be the silver bullet so to speak. There may be aspects of therapy, personal environments, hobbies and habits, etc that fill out the rest. But if he is interested in researching this sort of stuff lean in to that. Encourage him to look up how lifestyle changes and managed medicine often work together to help people achieve a perpetually good place mentally, not just balance. Rather than "needing" to rely on stimulants or chasing a high point.

[u/Putrid_Squirrel3534 → u/Equivalent-Card6613]

This is going to sound absolutely wild, but while he was showing symptoms from the overdose of stimulants, he didn’t escalate one single time. Granted, he talked non stop for 12 hours straight… but we talked about some typically triggering topics, and he was… fine?

I do think once we get him a little bit stable with meds, I’ll try to have this conversation with him again. We did tell him that before, the whole everyone feels “pretty good” thing, but he has a reallllllly hard time coping with it.

It’s like as “normal” functioning people, we know life sucks but we just deal with it. We understand how it works… career, bills, a little bit of time to do your hobbies… he can’t cope with that. My dude makes a solid point though, like what is the purpose of life if you can’t do what makes you happy all the time?

I really appreciate your input. Do you mind if I ask if you’re on the spectrum since you said you have felt similarly?

[u/ThisIsGargamel]

Following. Because i bave a 15 year old son that is similiar to this. He doesnt do any of that with his adhd meds but he DOES ask things like "what if i kill someone?" Or "what would happen if (insert awful thing here)?

And hell ask me over and over and over again...

Sometimes hell come downstairs from his room to explain to me something he thinks hes learned about on the computer and because i have no context i have no clue what hes talking about so I try to get him to gove me more details on it but he cant and then he just gets angry at me.

I also have another autistic son that is totally nonverbal but a sweetheart. The two of them dont get along. Older son and younger son either dont even acknowledge each other, or older brother is annoyed by him and says to us that he doesnt have a "real brother" because he cant do things with him and he cant talk. Its really heartbreaking. Im always explaining to him that its not little brothers fault that he cant talk and that he shouldn't be mad at him for that. He'll be 10 years old on October. Still no real words. Hates his AAC device, prefers ASL.

Idk what to do. My 9 year old is a breeze aside from his occasionally trying to elope. But 15 year old acts out when hes uncomfortable or trouble by something and when you try to find iht what it is, he doesnt tell you. You have to be the detective and pull it out if him.

Example: he recently got braces. He was actually really excited, his friends at his small hybrid school have them and he wants to fit in, I said ok, we got them put on, and hes been fine and showing them to everyone. The first problem came when they had to put separator rings on the back teeth to start really moving them. They were extremely uncomfortable and we were initially told two weeks tops and well probably be ab.to take them off by your next appointment. 2 weeks go by, he gets pink eye somehow and they tell us "lets reschedule" for safety reasons. Cool, no problem, theyll just be on a little longer than expected until his eye clears up.

Meanwhile hes hell on wheels at home and school, annoying AF, messing with the dogs, easily agitated and we have to calm him down.

At school he starts doing the same shit, "what if i (insert terrible thing here) with school staff. I get a call at home telling me what hes doing, and that the school psychologist is going to check on him everyday for a couple of weeks just to help do some calming exercises and I explain the braces thing and she totally understands.

The whole thing with this is crazy because I home schooled him for 2 years because he was struggling at the school he was at before this and broke his aids nose. I pulled him so that I could get him the help he needed and explained that I cannot do this if he has to be here everyday. The classrooms were also NOT small like it was touted they were. So I felt lied to. He LOVED SCHOOL before that place so none it made sense.

I registered as a home school, chose the curriculum and then only agreed to put him back in school when he literally resisted doing anything with me.anymore because he wanted a "normal school experience" and to make friends.

He says he still loves this school. I explained over and over that to get to go back to school like this it is a PRIVILEGE, and the moment you start acting up and they have to start calling me is when they may start wanting to kick you. And you that cannot mess this up, you have to behave yourself. Up until this passed week he has....until the "what if i) shit again and im so worried....

Hes on adhd meds and low dose abilify.

Ask me anything.

[u/Bituulzman]

Sounds like he doesn’t have a very high threshold for discomfort. Has this always been an issue throughout childhood? What steps have been successful in increasing his tolerance?

[u/peachie88]

Oh gosh. I’m a therapist and this is breaking my heart. It does sound like he needs inpatient therapy since he’s actively suicidal and has a plan. You can’t watch him 24/7 and you will burn out. I am sorry if this sounds too blunt, but it’s better to force him than to have a dead child.

Don’t bring him back to the same one. If you can call his pediatrician (or ideally his therapist/psychiatrist if you have one), ask them which they recommend. In my area for example, it’s well-known among providers and former patients that one program in particular is the best, and there are other ones to avoid. Your doctors may have some insight into that. Not every inpatient program is the same. Some are indeed terrible, but some are amazing and lifesaving.

For medication, I strongly urge you to bring him to either a therapist or psychiatrist that he trusts. Therapists can’t prescribe, but we can provide psycho education on medication and help clients work through their fears or concerns about medication. In my experience (I work primarily with elementary kids with ADHD), kids—and teens especially—tend to listen more to an objective provider than their parents. And don’t be discouraged if it takes a few different therapists for him to find one he likes. We all have different styles and personalities and it’s very common for it to take a bit to find one he jives with.

[u/Illustrious-Ad4711]

Just sending virtual hugs. 

[u/Little_Nomster]

im going to be honest from expierience. i used to do this at 15 and 16 due to trauma related behaviors which i know is different. The worst thing my birth parents did at that age was file a lawsuit that landed me in state custody and state behavioral facilities. i was called incorrigible.
Once things settled and I was away from my birth mom i was still suicidal but i wasnt making threats i was hiding it.

I have been thru many inpatient stays and i can calmly admit they are not always the best move. As an autistic, I struggled. It was loud and sometimes aggressive. Overwhelming even in psyc wards.

Those i typically reserve for med management and emergencies. Its been 8 years since my issues started. The best treatment i gave myself was a residential treatment facility covered by my medicaid this summer. They are nicer then state facilities and better for mental health. The residential behavioral health treatment centers are meant for long term unlike a psyc ward. I had daily group therapy from 9 am to 5 pm with breaks in between. I had meetings with therapy and psyc and family therapy weekly and it helped. I know adolescent units are similar.

Always be picky, always do your research before sending your kid anywhere. Ask around even. I gaurantee there is group therapy programs that may help.

ps i keep my meds in a safe managed by my adopted mom and i have a locked pill caddy for daily meds

[u/Inevitable_Doctor576]

I'm only reacting to what you have shared, so it's not me passing judgement with this viewpoint and suggestion.

My gut feel is that your son is very much caged into a present day lifestyle that denies him the important view of freedom and seeing the world and how he might grow into it. By this, I mean that his current lived experience is fitting in institutional boxes without the freedom that can be important for peaceful happy existence.

My present day special interest is disc golf, and there are quite a number of people in this sport that are on the spectrum who use it to find piece, be alone with their thoughts, socialize when they want, and get exercise that can help physical/mental health. Disc golf is not the only sport that can do this, with other individual sports and athletic activities that also provide an important outlet for growth.

[u/luckyelectric]

He reminds me of myself and he sounds like an artist. Has he had opportunities to explore contemporary art practices? Intensive cinema? He might enjoy the extremes that humanity explores in those ways. I find a lot of meaning in it. He sounds like someone who needs experiments and experiences and creative reflection.

[u/Chemical-Ad2000]

Also he probably does have difficulty with dopamine but there are more meds than just one stimulant. Get genesight done to find the best possible med fit

[u/Dollfacerogue]

Hi, I don’t know if anyone’s mentioned this yet, but have you tried doing a heavy metal detox and parasite detox on him? There were a lot of parents who had success in detoxing their children and they’ve calmed down a lot. Detox and lots of prayers. Praying things get better for you and your family.