May 1, 2012

Tuesday May 1, 2012

Brian and I just left an appointment with Tyler's counselor Scott. He used a lot of negative terminology. I was wondering why Tyler's recent appointments have been running so short - yesterday's lasted 20 minutes. When I asked Tyler about it, he said they didn't have anything more to talk about. Scott said 20 minutes was all Tyler could handle. He sees Tyler growing fidgety and his eyes dart around the room. Tyler said he sees bugs crawling on the walls. His brain shuts off and anything said over the 20 minutes goes in one ear and directly out the other. At least he told Scott about the voices telling him to cut himself last week. He tells Scott he wants to die. He told him about the gun facebook post. He said Brian has been a huge help to him, helping him deal with things. I'm glad one of us can.

Scott used words like "severely psychotic" and "extremely mentally ill". He said that Tyler was the most schizophrenic teenager he has ever seen. He voiced his very strong doubts that Tyler will ever be able to hold a job for very long. He said he needs to work with other people, and not by himself making pizzas. Tyler told him he couldn't handle that job because the pizzas were talking to him. Tyler told him he snorted the Xanax a few weeks ago. OH. Now it makes sense. Now I understand why Ty didn't reach the peak effect and his condition kept worsening. It's called First-Pass Effect, and he bypassed that. The drugs went straight to his brain without going through his stomach and being metabolized in the liver as in a normal situation, so the drugs had a much stronger effect.

I don't want Tyler to know that he probably won't be able to hold a job. I don't want Tyler to know the severity that Scott sees. I want him to have hopes and dreams. I want him to have a 'normal' life with a career and a family and a steady job. I am not ready to give that up. I will fight for these things with all of my being. I will do anything for my son. I will drop everything if he needs me. I will give up everything for him. I cannot accept that my son will not be normal. I won't accept it.

I needed to know when to get intervention. This is why I made the appointment with Scott. I needed to find out his opinion of Tyler's mental state, and what he thinks he's capable of. He helped put into perspective that Tyler has never hurt anyone beside himself. He is not violent, despite what the voices tell him to do. Tyler is not a criminal. He self-harms because he doesn't know what else to do. Ty said he would go to Brian when he hears voices telling him to do something, and say "Hey, is this okay?" and Brian can direct him. He has already begun doing this, which is very good.

Scott says Tyler is extremely bright, and he has a good grasp on what is happening to him, but he does not have a good grasp on reality. He said Tyler doesn't want to kill himself. He may say, "I want to die" but he doesn't want to do it. That was encouraging for me to hear. Scott said we can't treat Tyler like a normal teen who may be suicidal. If you have a normal boy who cut himself up and wrote a death poem and says he wants to blow his brains out, then yes, have him committed. But Ty is not a normal teen. This behavior is common place with Tyler. He gave the acronym of SLAP. S is for specific - does Tyler say "I'm going to get a knife from the kitchen and cut my wrists this way, and that's how I'm going to die". L is for lethality - did he harm himself so badly that he needs medical attention? A is for Availability - is he making himself available to others and being social, or is he hiding in his room and not responding to anyone? P is for proximity - how close is Tyler's support system, and is there one in place?

This was very helpful to me. I need constant reminding to put things into perspective. I get caught up in the moment that is happening right now, and I start bawling. "Don't you think about what this would do to me? I won't be able to take it if you kill yourself" are the things I usually say to him to try to understand the reason WHY. Each time I have asked Tyler questions like this, he has a flat effect on his face, and he tells me he doesn't care how I feel about it, and he doesn't care what it would do to his loved ones.

Flat effect is very common with schizophrenics. When things become too hard to handle, the emotion center of their brain shuts off, and they show nothing. They feel nothing. Scott advised me that when this happens, I need to be flat also. Don't cry or scream or try to get through to him with emotions. Ha! Yeah right. But I have to try. Tell Tyler that if he kills himself, "I will miss you" - very flat. When I leave the room, then I can breakdown. I have to respond as if I was talking to a patient. Explain things shortly and in a simple manner, while being supportive.

I can't accept all of this. This is not normal. This is not my son. I don't think of 'my son the schizophrenic'. I think of 'my son the wonderful, bright, funny little boy I've always known'. This is all new to me. I don't know where it came from. From day to day, I don't know where it's going. Scott says we haven't hit the bottom of this yet, but keep my chin up. Tyler is not criminally minded, and he is not violent to others. He just needs help dealing with what's going on in his head, and I don't know the half-of the half-of-it. I have to focus on today, and today only. Is my son alive? Yes? Good. Deep breath. Keep going.