Dealing with adult son with mental health: Parents want to share?

Hi,
Thanks for your reply,
He is currently taking as of June 2024 - I need to double check
Medications : Once daily at bedtime
3 mg Vraylar (anti psychotic) 3 mg
20 mg Lexapro (depression) 20 mg
1 mg Cogentin (twitching side affects)1 mg (I think this was removed )
Lamictal XR (dissociation , you don’t feel real, derealization ) 50 mg
His blood pressure was too high so he’s started taking Zestril 10 mg per day.
I too have been interested in the monthly, or three month injections.
I also learned of a new medication - Cobenfy
https://www.psychiatrictimes.com/view/fda-approves-cobenfy-for-schizophrenia
He spoke to his Psychiatrist about it and is waiting until it is released as well as if it would be a better medication fit. I doubt it is injectable being so new.
M

I cannot offer any diagnoses as I haven’t met your son. Is there any substance use that you know of or suspect?
It must be very painful to see your son suffering. It would be a good idea to see him in his own environment and (I know he resists) to get involved with his care.
Does he have a support network where he lives?
Most of the time with serious mental illness patients lack insight into the truth that they are sick. It’s part of the disease process and not them being stubborn or ignorant.
I hope you can re establish your relationship with your son and gingerly help him. I say gingerly as he seems like a proud guy not wanting his mom’s help. But sometimes, more often than not, adult kids need them for support.

Good luck to you. Take care of yourself.

To @meri and @briarrose

There are many laid from the typical class and atypicals.
Most of my patients are on them. It provides coverage for a month which is very essential in patients who are non adherent to med regimens. It’s not being stubborn or difficult when a pt refuses meds it’s lack of insight which is part of the disease. That’s why the injectables have been a game changer. Best to you both

Thank you for your response hwange. I believe you know how extremely difficult this situation is. I know he abused Adderall in his senior, last semester of college to get through it due to the stress of divorcing parents.
When he was living and working in Italy for 3 1/2 years at age 25-28, I accidentally discovered he was using cocaine. I had a terrible physical reaction to it - which frightened him - and he told me he was no longer using it. Now at age 39? It's anyone's guess what he is doing. He is so secretive.
I wanted to fly up to his condo for his 40th birthday next month but he discouraged it - due to my anxiety disorder and fear of flying alone. But I would do it for him. He is suppose to come to visit me for his 40th birthday now. Will he? Who knows. He could have been sincere in his worries about me but I can't help that he simply didn't want me in his condo.
He has no support network. Only his psychiatrist. His former therapist got a new position and he was reassigned a new therapist but, no surprise, didn't like him so he has nobody now.
He cut off all ties with friends. He was a son that called his mother all the time. Now, it is one excuse after another as to why he can't call when he texts me. I always respond with understanding. It is always "we will try tomorrow". He has spoken to his father, less than he speak with me which is not saying much. I last saw him in August. His father has not seen him in one year. I will be calling NAMI today...and will speak with my own psychiatric nurse practitioner as well.
My fear is as his behavior continues to go unchecked, he will get worse and worse.
An intervention has to be done. But what? He is not getting the right medications nor seeing the right psychiatrist. My guess is he is not disclosing his true mental status to him and the doctor is in the dark.
Thank you again...it is so ironic, the psychiatric nurse - who treated many patients under my care successfully for 25+ years - can not help my own son.

Hi briarrose

Here in Louisiana we have a thing called an order of protective custody in which a family member can reach out to (at least here in LA) the coroner stating why they think there loved one is a threat to self others or gravely disabled. It’s a try at least. If it is approved local authorities will do their best to find the person and they are mandated to be evaluated in psychiatric ED or regular ED.
As I write this I must say that I don’t know if he is even any of those things at all. Getting info from those who see him on a daily basis would help greatly. I hope this helps

Yes, having worked in mental health I know I can do that. It would actually be easier for him and his parents IF he was in such a dire condition and we would get him into the psych ER very easily. But he has not reached that point yet so I don't want to put those wheels in motion unless absolutely necessary. But having said that, you know as well as I, we are often "fooled" by those harboring self-harm or harm to others intent...until the deed is done. He gives me no indication of harm to others...nor active suicidal ideation. But who knows what is in his mind? No one. My psychiatric nurse practitioner feels he hasn't hit "rock bottom" yet. He continues to work at his high paying job (he has a MBA from a prestigious international business school) and do what he needs to do to "get by" but all is in total isolation and complete distrust of all. People I trust in our field are telling me to simply support and love him. Don't challenge him as it will get me nowhere. Just be there for him. I am but I see he is not improving, going down that rabbit hole further and further with the WRONG psychiatric treatment. I will ask him if he would give his consent for me to talk to his psychiatrist. But with his high level of paranoia how can the answer be "yes"? Please honestly tell me your thoughts on this plan I have set in place: I made a "video" appointment with his psychiatrist for this Friday Nov. 1. We have different last names - my son and I. I will tell his doctor "I know all about HIPPA, I expect you to say nothing to me, I will do all the talking". I will ask him "do you have to tell my son I have contacted you this way? If so, I will immediately end the session. Do you think this is right or it will be "ambushing" his doctor? And, therefore, cause a major problem (as if there aren't enough already) with our relationship? Do I run the chance of completely severing all ties to my son? I would barely be living if that happens...he is my only child and throughout his entire life up to age 37 1/2 was simply a wonderful, loving, supportive and caring son to me in every way. My husband (his step-dad) tells me simply to "accept" what he is right now and don't give up hope...it's possible he will "get out of this". If I were your patient and I told you all this about what I am going through with my son, what would be your honest advice to me? Should I try my plan with his doctor...is it appropriate? I need your professional opinion and complete honesty right now...I am probably not seeing the forest from the trees. It's too personal for me.
Thank you ever so kindly.

Hi,
A thought. The Dr cannot talk to you..however u can write to him & tell him your concerns & he can read at his leisure. Tell the Dr all of your concerns & recent episodes. It helps the Dr help the patient. Let him know u understand he cannot converse w/ u but u want him to be aware. I volunteer w/ NAMI- NATIONAL Alliance for Mental Illness. Are u aware of them? Very good classes to help family. It sounds like you have a good idea of your son's issues. It sounds exactly like my nephew. Do you see a counselor? It would be a good thing to help you. Also look up your local NAMI. U could probably look on the web page.
No one really understands mental health unless they have a loved one that suffers w/ it.
Hope this is helpful. Your son will call.. he needs you. 🤍

Thank you so kindly for your understanding thoughts. I am aware of HIPPA and know he can not talk to me b/c of confidentiality and the laws. I have thought of writing to his psychiatrist but afraid he will tell my son and read my letter to him. At this point, I know my son will not be happy in the least and very angry when he hears what I believe to be happening to him...further straining our relationship and very shaky trust. So I feel stuck...if I knew FOR SURE my son what not know the contents of my letter to his physician I would most certainly write it. But I believe he must tell him he received a letter from me. I think?? I might be wrong??
Yes, I am seeing a therapist for the sole reason of getting support to deal and cope with my son. Not to change him, but to change me. My therapist feels I am "enmeshed" with him. But this is how I am - when my immediate love ones suffer, I suffer. And when I know there is clearly a solution to an issue and no one listens to me - I find it very stressful and it weighs heavily on my mind always. Especially when it is a physical or mental health issue as I am a former RN (& the last 25 years worked in mental health ironically). I have been dealing with his complete 360 in life for 2 1/2 years now - and he is not improving at all. Yes, I certainly know of NAMI and a chapter is a bit always from me and was recommended by them to come to their family meetings. I have no doubt it is supportive...the meetings are held at night and my husband (my son's stepfather) is not keen on driving at night especially along the back roads of where we live in PA. We are both seniors...but must bite the bullet here. My husband will do this for me. It is all so sad for me. I think of what he was...completely, fully & happily engaged in life in every way and now he completely isolated himself and trusts no one. Yes, he suffered 2 major losses, one professional and one personal in the last 2 years But I knew my son to always "bounce back" from the hits in life. I suppose these losses were simply too much for him to bare...and triggered a chain of mental events he can not escape from despite being under the care of this psychiatrist all this time. And he no longer has a therapist...he left and he didn't like the new one assigned to him. He also needs a grief counselor and he tells me "I will go" but he never does. Anything he says, I suppose to appease me, he never does. And clearly he knows therapy could help me yet he doesn't do it...he is very bright and highly educated in the best schools. Another frustration for me, on top of so many. I even did a search in Chicago for him...looking for therapists, came up with some names but my son always has an excuse as to "why" he is not seeing them...it always "I will" but that time never comes.
Thank you again for your kindness and understanding thoughts.
And you are so right. I found this again and again when I worked as a Psychiatric Nurse - no one truly understands mental illness until one is in such shoes or they have a love one suffering from it.
Sometimes I think losing one's mind is worse than a physical illness...it can be so devastating in so many ways.

Seeing your son go through such a difficult period and feeling so cut off from him must be quite difficult. Since you've always been so close, the changes in his conduct must be extremely distressing.To help you navigate this circumstance, you might choose to consult a therapist. Continue to be loving and compassionate, but during this trying time, remember to look after yourself.

I’m so sorry that you’re going through this. Wish I had some advice but we have a son “living his dream” in Hollywood. His dad and I are in constant contact with him though it’s very difficult…🙏