Tuesday, April 2, 2019

Admission

Most of 2018 was pretty good - just full of small ups and downs.  N held his weight high, but shifted into an "I-don't-care-about-anything" mode.  By the end of the year, he had to drop several classes because he was failing.  He was sleeping all the time and seemed to be showing increased markers for depression.  He met with his primary care doctor who told him to start keto.   That did not go over well with me and I made it pretty clear.  However, the doctor insisted that his objective was to help N control his insulin spikes, not for weight loss.  He's an adult now and despite my objections the decision was made to carry on.  They also put him on adderall, increased his sertraline dose and eventually added olanzapine to the mix. 

Of course, N's weight plummeted.  I insisted upon a weight line that he wouldn't cross.  It started as 215, but then he dropped below that weight.  He hovered right below 200 lbs. for a while.  He was okay - OCD not totally flaring, but it was there in the background.  The olanzapine was a good addition to the mix because it usually causes some weight gain, but unfortunately it also causes him to sleep.  His mental health was declining.  He was having relationship problems with a girlfriend.  Things were not good.

The last week of February as we prepared to go to a family funeral, I contacted him to make sure he was coming.  He asked if I had gotten his texts.  No.  He spent the night at the ER for a suicide evaluation, but was doing okay.  We had no idea.  A week later, I took him to the hospital where he was admitted for a three day stay in the psych unit. 

While in the hospital, he had access to a great psychiatrist who slightly adjusted his meds and halved his olanzapine.  Some additional mental-health evals showed high anxiety, but not so much depression.  That same weekend I had a work training on anxiety and was surprised how much it can look like depression when it gets bad - but needs slightly different approaches to treat. 

Up until now, he has been resistant to getting help from a therapist.  At one point, his dad walked him over to our university mental health crisis center only to be asked by the receptionist if they could come back tomorrow (crazy, right?).  This further entrenched him in his resistance to get help.  I was thrilled that one of the requirements of his release was making sure he had ongoing mental-health services lined up.  However, there is such a back-up of mental-health care in the valley and unfortunately, not even the hospital could make arrangements for a therapist.  We were released with a referral to return to the same university mental health services (which had previously turned him away).

Thankfully, we were able to find a new (not fully licensed yet) therapist to see him.  N wouldn't make the call so my husband dialed the number and handed him the phone.  Waits have been three weeks or more.   He's only been seen once and his next appointment isn't until next week  He's not making any progress yet because of care availability.  He also missed his scheduled psychiatrist appointment.  I feel like he's doing better in some ways, but there is still so far to go. 


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