Friday, January 16, 2015

Is It Time To Stop?

Yesterday was Thomas's day with Dr. N., his psychiatrist, and I was really curious to see how it was going to go. Thomas has been doing so well lately that I thought Dr. N. might try again to decrease his meds. Strangely enough a part of me was totally ready for that decision and I decided that I would support that choice if it were to be made. Thomas is only newly stable and perhaps it's not the smartest thing to be messing with his meds but I personally was feeling really good about the changes in Thomas I have seen lately.

As usual Thomas went in first and talked to Dr. N.. I was called in shortly thereafter which surprised me. Dr. N. usually likes to take more time with Thomas but that wasn't the case this time. When I got in there and sat down I found out that Thomas had already filled him in about his heavy depression he had at work the other night but he had omitted (because he forgot) the story about him watching the scary video and coming to me shaking and needing a hug. I told that story to Dr. N. because I felt that it was worth mentioning because I felt like Thomas got far too involved in the video and had crossed a line from an average person watching a video to someone who was caught up in it and losing touch with reality. That whole incident pointed out to me that Thomas is still struggling with reality and as such I felt like it was worth mentioning.

Dr. N. really seemed on his game yesterday and really listened to both of us. He agreed that Thomas seemed to be doing better over all and then surprisingly said that he wasn't going to touch the meds.

I was relieved.

Even though part of me had previously been feeling okay about changing them there, apparently, had been a part of me that was scared to see those changes take place. Dr. N. told us that he felt that Thomas should be SOLIDLY stable for 4-5 months before we make any changes.

Whew. And YAY!!

I had a timeline now. With Thomas doing so well, I feel like we could expect, now, to look forward to 4-5 months of stability before we shake things up a little. Even then, Dr. N. said that he'll try to decrease meds after those months have passed but if Thomas sees ANY negative changes then he's going to put Thomas right back up on the meds. We're not going to mess around. Always in the back of my mind is the fact that untreated psychosis only gets worse and once it's being treated it takes a long time for it to stabilize and if you treat psychosis successfully and then stop the meds and the person becomes psychotic again then it's harder to treat and stabilize it the next time and so on and so forth. So I asked Dr. N. to explain the science behind how meds work in the brain.

He had a very poetic way of looking at it. He said that a psychotic brain is a lot like trees in winter. The dendrites etc. have no "leaves" and the branches are bare. As you begin to treat psychosis and it gets better, the trees begin to look like trees in spring with little leaves and buds on them. Then a healthy brain looks like a healthy tree, strong and covered in leaves. I liked that analogy. I figure Thomas is in the very beginnings of "spring". That thought excites me. I love spring. I love when you can see those little buds on the trees, the flowers are pushing up out of the ground and are barely peeking above the soil.


(insert the rush of a warm spring breeze here)

I did also mention how Thomas has heard me calling him lately and Dr. N. sat up and took notice but said we would just keep an eye on it. That's fine with me since me calling Thomas is hardly anything to worry about seriously but it's still an auditory hallucination nonetheless.

Then I said something about how I felt, based on the changes I have seen in Thomas lately, that he has probably been depressed for years. To that Dr. N. said,

"Well then it makes a person wonder if his psychosis has been as a result of (psychotic) depression and not schizophrenia."

This stopped me for a minute. Could he be saying he thinks Thomas doesn't actually have schizophrenia? The thing is, though, I know psychotic depression well. I had been there before during a 2 year stint with heavy, chronic depression. At one point I found myself just this side of being hospitalized and I was paranoid and hearing things. The thing was, though, it took a heck of a lot to get me to that point. A LONG time of chronic, heavy depression.

In the car on the way home Thomas and I talked about his depression. In the end we agreed that he hasn't been "depressed for years" like I had stated. I remember him before he got sick. He was not a depressed kid. I also remember him as he got sick for the first time and he wasn't depressed then either. Schizophrenia had worked its magic just as it should with its garden variety psychotic break and subsequent struggles. So, together, Thomas and I ruled out psychotic depression as a possibility for what he struggles with.

All in all the appointment went well. We drove over to the next town to Thomas's favorite restaurant and he had his bacon cheeseburger. Interestingly, because of a recent tragic multiple homicide in that town, I found myself a bit uncomfortable and a touch paranoid about being in a public place like the restaurant. The shootings in the town had begun in an Arby's and that fact made me feel like it could happen in any fast food restaurant like the one we were in. It was then, though, that the student became the teacher so-to-speak. Thomas picked up on my uncomfortableness and asked me if I was feeling unsafe in the restaurant. It was quite a momentous occasion as I realized my child living with schizophrenia wasn't the least bit concerned nor paranoid about being in a public place in a town that had just seen horrific gun violence and tragedy.

I had to smile. There's no better way to ground myself than to have my previously seriously paranoid son comforting me through a situation that really didn't warrant the kind of feelings I was having.

He's actually, really, doing better!

I love that kid!!

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