depressive episodes?

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My son J (6) is awaiting his diagnosis. He's generally a happy little boy, but this weekend he's gone completely the other way. Saturday evening he was really upset - not loud/angry, but just utterly depressed, with slow tears dripping from his eyes. He said that he was bad, he was naughty, that every bad thing that happens in the world is his fault, that if the other kids are bad it is really him. It took a very long time to settle him down enough that he would sleep, and I had to swaddle him in fleece (he's a very tactile-calmed child) to get him to calm down enough to nod off. All explanations, however sensible, that I gave him of how he couldn't possibly be responsible for all the bad things in the world were argued against. He even tried justifying how he could be responsible for famine and murder

He woke up yesterday a bit brighter, still a bit quiet and low, but not as noticeably depressed. However by after lunch things went down hill again. We needed to pop to the shops and he started in the shop saying how stupid he is, how he is an idiot, how he doesn't want any of his toys any more and wants to sell them/give them away and just sit in a heap, he wants to be bored. At one point he went so far as to say he wanted to light a fire, wondered what it would be like to burn, and then said that he wants to burn to death.

I really am at a complete loss as to what to do to help him. He has gone to school today seeming quiet but ok, and I've let his teacher know to keep an eye on him. I've spoken briefly to the GP, who said to try and keep things as normal as possible today and bring him in asap - so we've got an appointment booked for 9:30am tomorrow.

Has anyone else had any problems like this with their little one? I'm really worried about him.

Thanks.

Both my kids have said this at one time or another.

S1, who was recently diagnosed with HFA at age 13, used to say this after major meltdowns, because he felt horrible about himself for having them. Like your son, his reasoning was illogical, and he could not be persuaded otherwise. He would cry it out while I held him, then he would go to sleep, and then be better the next day. However, his meltdowns and subsequent suicidal ideation were so bad, we ended up putting him on medication. This was even before we had an official diagnosis. Now that we have a definitive answer as to why he has meltdowns, we hoping to work on better ways to deal with them, and possibly eliminate or reduce medication. You should know that when we started medication he was in the late tween stage. I don't know what they would have done if he was younger.

S2 used to say this before we put him on medication for ADHD, because he felt horrible about himself for his inability to behave appropriately in kindergarten. He is now 10, and has not had such episodes since he's been on medication for ADHD.

I commiserate with you. It's heartbreaking to see your child struggle like this. I hope that you can find some solutions.

Thank you for your reply. It is reassuring in a way to know that other children have felt this way, but it is also utterly heartbreaking to know that they do. I hope that we will be able to get a diagnosis soon and work through things without needing to put him on medication, however if he is suffering and it will help, then so be it! I hope that your S1 is able to start to understand himself better now that he has his diagnosis.

Here's hoping that the gp tomorrow is able to put us onto the right road...

I wonder what triggered it. Maybe a kid said something to him, and he is taking it out of proportion. My son is a very catastrophic type thinker. We haven't gotten anything in that vein (at this point, anyway) but my son will ask things like what will happen if he fills the world with tears. I think it is a similar type thing. Hyperbole and catastrophic thinking. Maybe a kid told your child he did something bad or wrong and he just leaped to that kind of thinking in his mind.

I don't know what the doc will recommend. You could try some at-home simulated CBT. If you find out what is troubling him, you can try to teach him what is a proportional emotion/reaction and what is not. I don't think I would try to drill for information right now or he could start perseverating again. I would wait to talk to the doctor.

These are things DS has also said. He also talks about running away when he is upset. It's very upsetting, and hard to know whether he always feels this way or only sometimes. Most of the time he seems happy, but when he's unhappy he says some really extreme things. I wish I had some advice for you, but all I can do is commiserate.

How much does he understand about this process? I know when we were schlepping my son hither and yon to try to figure out what was going on with him, this was definitely a way he responded. He could not understand the difference between behavior that was out of his control and purposeful behavior (no wonder - we didn't know at the time that meltdowns weren't purposeful, etc. It is one of my major regrets in life that we used to punish him for behavior that we found out after diagnosis was not in his control.) Even if you didn't do this, it's likely that someone somewhere did - people are very hard on kids' behavior these days and getting glares from strangers is sometimes worse for a kid than punishment.

DS didn't have a frame for his behavior any more than we did - all he knew is that behavior could be "good" or "bad" and he knew that many of the things he did qualified as "bad." It's very logical if you think about it.

Another aspect of the disability is a limited awareness of how you can affect others (if you don't communicate well, and don't know what to look for to learn by observation, how else would you find out?) DS also had that strange globalization of ways he was "bad," and sometimes irrational explanations for it (there was an unpleasant dog that shared his name, DS was convinced that all things named with his name were "bad" or "evil.")

Have you talked to your son about the diagnostic process and what you think is going on with him? Eventually, after DS was getting a decent diagnosis and I'd found WrongPlanet, this problem was solved for us with the book "All Cats Have Asperger's Syndrome." (which may or may not be pertinent to your son.) We were able to show him that if cats behave like him, and cats are OK, then he must also be OK.

Sorry for the dissertation...having one of those wordy days...

Thanks The words reply made a lot of sense. He doesn't know much about the referral yet as we are still waiting for appointments and so haven't actually been seen by anyone yet. We saw the gp this morning and he went really hyper and silly during the appointment, i assume as a reaction to the stress and new situation. The gp is putting through an urgent referral to the paediatric psychologists, so hopefully it won't take too long to be seen by them.

I am trying very hard to not label any behaviours as bad/naughty etc, but it is really difficult sometimes not to let the words slip out, or when other people don't understand and make comments, even his little brother is guilty of this at times - it is very hard to explain to a 4yr old that his brother is ok to behave in one way but he isn't!

I understand how J can feel that he is innately bad/naughty/stupid based on the reactions of others to his behviour, and perhapse realising that he can't control his own behaviour.

I've spoken to him about how he felt at the weekend and he says he doesn't know why he felt so sad, that he just gets random bursts of being really sad or grumpy. I really hope we can help him learn and understand why he feels like this and help him to feel better.

Has his mood improved substantially since the weekend? Not sure about children, but I seem to recall that for adults the dx of a major depressive episode requires that the symptoms are present for at least two weeks. I hope that referral to the specialist comes through quickly for you.

First, don't feel bad about yourself: it's normal, we're all socialized to label behaviors (and sometimes it's accurate, right?) and it is impossible to control yourself 100% of the time. Just work towards the mindset that his behavior is the way he communicates his needs when he can't figure out another way.

Also, he has probably figured out something is up even if you haven't told him you're seeking diagnosis. It's often recommended here that people disclose a diagnosis to their kids (not saying it's appropriate here pre-diagnosis and with such a young child - each case is individual) because kids often label themselves something significantly worse than what is actually going on - and it sounds like that's what your son is doing.

I suggest (and I'm not a doctor, so think about whether this sounds reasonable in your case) you sit him down and explain you are taking him to the doctor in terms he can understand.

For instance, he seems to know there are behaviors he thinks he can't control and things he doesn't understand clearly: explain that you see that he's confused and frustrated. Say that you think there are ways to help make his life easier, and you know that X doctor helps kids figure out how to do that.

Try to find out if he thinks there is something "wrong with him" (this is something kids often pick up on; he will have his own language for it) and if so, explain that all people are different, everybody has things that come easily to them, and everybody has things that are hard for them (if he's got some gifts, this is the time to bring them up.) Be matter-of-fact, and help him re-frame "something is wrong with me" to "some things are hard for me, and it's OK to get help."

His mood is still quite low, he isn't himself at all, though he isn't repeating the same remarks as frequently thankfully. His behaviour in general, the meltdowns and stimming, are definitely more pronounced as well, it looks like something is bothering him but he can't verbalise what.

Since the weekend I have tried to sit and explain to him about the aspergers. His little brother is colourblind, so we sometimes refer to him as having special/magic eyes that help him see things differently. Because the kids all understand this, I have explained to J that we think he has a special/magic brain that helps him understand things differently, and that sometimes that means he thinks of things in ways that mummy needs to try and understand better so that we can help him get less upset. He seemed to be quite happy with this idea, and now knows that seeing the gp (and the paediatricians once the appointment comes through) is to find out just how special/magic his brain is and help me understand him better.

He did very well at the school concert yesterday and managed to last through his class performance. The whole school bits are too much for him, but his teachers were showering praise on him for doing so well with the bits he felt able to participate in. I'm so glad they understand and are being so supportive towards him.

Sounds like you are on the right track and it will take him some time to process everything. There are several threads on this board about disclosure that may give you some ideas on how to move forward once he has a formal diagnosis and you know what "pieces" of the autism puzzle are a fit for him. I'm glad that the school is supportive - make sure they also get him the services he needs!

One caution I ran into later (my son wasn't appropriately diagnosed until he was 10.) Autism, the way we define it clinically, is a disability - meaning that if you qualify for a diagnosis, you have aspects of AS that are disabling in some way. We started out by explaining it only as a difference, as "special" (which it is, too) and then realized we were doing my son a disservice - he didn't understand that he had work to do to compensate for the disabling aspects of his difference and wanted the world to change around him instead.

Part of the problem is that our society has a very screwed-up view of disability. There's nothing wrong with being disabled, and we shouldn't associate the word "disabled" with "bad" or "weak."

So, in Middle School we changed our tactic: we explained to DS that while AS gave him some great gifts (which it did) it also gives him some challenges, and those he needs to work to minimize and also to learn to ask for help and advocate for himself when it's needed.

Your son is obviously too little for this kind of nuance, but it's something to keep in mind for later, but as you get further into the diagnosis you might think about approaching it more like a yin/yang thing, e.g. some things are easier, some things are harder.