When t Worry about a teen?

I don't think you quite understand the complexity of this situation.   If a kid is depressed and his only lifeline is a few teens he chats with on-line or a tv show he treasures, cutting that off might be disastrous. Yes, he has been modified in his time allowed and he now goes to extra help at school for 2 afternoons a week but I don't think taking everything away is the solution here. Nor do I think it would even work- I think I've said before he just doesn't care, right?    He'd literally say "ok" and go downstairs and sleep (and has done just that when this was attempted). 

dave said:

Cut the TV and Internet until his grades are above a C.    Doesn't like it?  Boohoo. 

And you have applied this method with success how many times?

tjohn said:

dave said:

Cut the TV and Internet until his grades are above a C.    Doesn't like it?  Boohoo. 

And you have applied this method with success how many times?

+1.  This situation is complex - your proposed solution is far too simplistic and potentially dangerous.

conandrob240 said:

I don't think you quite understand the complexity of this situation.   If a kid is depressed and his only lifeline is a few teens he chats with on-line or a tv show he treasures, cutting that off might be disastrous. Yes, he has been modified in his time allowed and he now goes to extra help at school for 2 afternoons a week but I don't think taking everything away is the solution here. Nor do I think it would even work- I think I've said before he just doesn't care, right?    He'd literally say "ok" and go downstairs and sleep (and has done just that when this was attempted). 

I am wondering why he is still not evaluated or treated for depression, which I am almost positive he has, since he has mimicked my son's development and habits almost identically, for years now.   Honestly, things can get better with a little talk therapy and some meds.

Well, I am not his parent so I don't really have any control over his medical life.  First off, he did try therapy and as I said, it was a disaster.  he refused to engage at all.  Second, his parents seem to think he is fine and are more interested in their own silly, shallow lives. Third, I don't see him as often anymore but on my last two interactions with him over the past 6 weeks or so, my gut tells me something deeper is wrong and spurred my post. He's also really hard to read as he is super-quiet and has always been disengaged and disinterested with few interests or friends. And I have never been the parent of a teen so I am doing my best to get a sense of what is "normal" teen stuff, "normal" for him (low engagement) vs what is more worrysome and a potential red flag.  That's what I was asking.  Now that there seems to be agreement that this is more in the "worrysome" zone than normal teen stuff zone, I want to find a way to help.  I can try doing some of the things here and I will also be telling his parents I think he is may be depressed and strongly encouraging another try at therapy and a physician's visit.  If I feel he is firmly in that danger zone and nothing above is happening, I will step in even more.

I know, it's just that he is the mirror image of my son and I wanted to let you know that it could be something that can be turned around.

that makes me very happy. I am sick over what's to come for him. 

I feel like his parents have just given up on him and he has too- why not, right? If they don't value him, why should he?

Try not to feel hopeless about it.  It's sad but he likely is more resilient about it than you think.  But he does need to enjoy his life and feel comfortable.

What comes to mind is, if money and time are not an object, take him to Mexico, or Guatemala, Belize or Peru, stay in a nice place but venture out of the tourist zones.  Show him how kids not as privileged as he actually live. Or take him to northern Maine or New Hampshire, or just have him work or visit less affluent neighborhoods and learn how lucky he is.

springgreen2 said:

What comes to mind is, if money and time are not an object, take him to Mexico, or Guatemala, Belize or Peru, stay in a nice place but venture out of the tourist zones.  Show him how kids not as privileged as he actually live. Or take him to northern Maine or New Hampshire, or just have him work or visit less affluent neighborhoods and learn how lucky he is.

.......and if he doesn't clean his plate, tell him about the starving children in South Sudan.  Works every time......

Not.

mjh said:

springgreen2 said:

What comes to mind is, if money and time are not an object, take him to Mexico, or Guatemala, Belize or Peru, stay in a nice place but venture out of the tourist zones.  Show him how kids not as privileged as he actually live. Or take him to northern Maine or New Hampshire, or just have him work or visit less affluent neighborhoods and learn how lucky he is.

.......and if he doesn't clean his plate, tell him about the starving children in South Sudan.  Works every time......

Not.

Telling him doesn't work. 

Showing him might help, along with treatment for depression, of course. Do a working vacation. 

@mjh: my suggestion is not stupid enough to warrant your profoundly discourteous remark.

I agree with you that he sounds depressed. BTW one session with a therapist is not adequate. It is a therapist's job to understand this kid is going to be slow to open up. That is normal for any number of teens. You need someone who is willing to spend many sessions just hoping to get the kid to engage. Sometimes it starts with simple yes or no type questions. Wondering about interests. Talking about those interests can be a possible way in. But it can be very slow going. The question really is whether his parents are willing to get him the kind of help he needs. Seems like to me the hardest thing is that there is a limited amount that you can do. And, you seem to be doing it. 

it wasn't a one time therapy session but agreed maybe another therapist would have more luck.

I can share with you the one we used, and she is amazing.  Message me if you like.

he lives on Long Island but I do appreciate the offer.

conandrob240 said:

Will do. I am going to see him weekend after next (he says he wants to join me and his uncle for overnight in NYC for my birthday) so we'll have some time then. My biggest concern right now is whether this is "normal" or is he suffering from depression so I want to convince his parents to take him to a doc for some diagnosis.

I am going to say something very strong. 

You don't need to, nor should you, unpack this yourself. Don't address each new behavior or stage piecemeal. Go forth with the presumption that he has multiple, complex problems due to the environment he is growing up in, which you have described in detail many times, and get him ongoing professional help. 

Trips, summer college programs, etc. are wonderful, but they do not treat the psychological damage of growing up in a highly dysfunctional household. They are nice and may lift his mood, but it is an indirect, piecemeal approach. Reminds me of when my mother decided to enroll one of my siblings in ballet to address her significant speech impediment. 

Get this kid to a therapist. Anything else is just a distraction. 

When the medical piece is sonewhat out of my hands, I'll do the parts that are within my control. No one said that was the only or optimal solution.

Now, what is the first part of diagnosis? Meaning, who to see? Is this a physician/ pediatrician thing? Or is the first stop a psychiatrist? If the latter, where can I find resources for a psychiatrist that specializes in teen depression on Long Island. Suffolk County?

and it needs to be psychiatrist not therapist, I assume because of the potential need for medication? I'd rather not seek both right now. One stop - kid is going to be resistant so two counsellors isn't going to cut it right now.

Psychiatrist for diagnosis and for medication (if needed).  Therapist for talk therapy (if you can get him to go).

so, psychiatrist is first stop or pediatrician? Not sure if their insurance requires referral ( I guess that might matter?)

I want to get them to address immediate medical need first and then therapy can be discussed again.

conandrob240 said:

so, psychiatrist is first stop or pediatrician? Not sure if their insurance requires referral ( I guess that might matter?)

I want to get them to address immediate medical need first and then therapy can be discussed again.

Referral is often required, so I guess I'd agree with pediatrician first.  It might be possible to get the referral with a phone call rather than a visit, but YMMV depending on the doc.  

Best case scenario is that prescription treatment improves his mood enough that he becomes more open to talk therapy.  

okay, I'll find out if they need a referral.

Resource for teen psychiatrist in Suffolk county? I guess pediatrician might be able to help

He will need close and careful monitoring. Teens are at higher risk for suicidal ideation which is a risk for anyone when starting anti-depressants. Will the parents let you go to Dr appt with him so you can ask questions, etc? Not to alarm you, but he needs a lot of attention from all quarters to get through this, especially if it is clinical depression that requires medication. It can be a very scary time, more scary if it isn't taken seriously by his parents.

Pediatrician can refer, or the psychiatry department at the nearest hospital. The search engine at Psychology Today is a blunt instrument but helpful if you have no personal contacts. Best to be prepared with several alternatives as the wait for appointments can be shockingly long. (A ped referral may help in that case.)

https://psychiatrists.psychologytoday.com/rms/prof_results.php?county=Suffolk&state=NY&spec=326

thanks. Sister received a very troubling text from a teacher today about her being worried about his disengagement & lack of effort so, while sad, this has sparked the discussion to get him help. 

I can't even think about the suicide piece right now but thanks for the warning. He lacks supervision right now so we'll have to add that to things we'll have to change

Good teen psychiatrists often don't take insurance.  Just to make sure you are aware.  So, Aunt helping with those costs might be more important than paying for summer classes etc right now.  All depends on what you are able to do.  Also, he is old enough that you do have to have some buy in from him.  Antidepressants have some side effects that some people refuse to tolerate if they don't see the need for them.  

First stop does not necessarily need to be a psychiatrist. Could be a psychologist. If the psychologist believes meds  might be helpful, he will refer to a psychiatrist he works with. In fact, diagnosis could take several visits, so a psychologist can handle that. 

That said, I happen to know an excellent, board-certified child/adolescent psychiatrist on Long Island. He is one of the rare psychiatrists who does therapy. If you want his name, let me know. 

Yes, I want his name! I am trying to avoid multiple stops for a kid who is already completely disengaged but I understand that might happen. If I can start with a psychiatrist, all the better.  Their insurance is excellent (father is postal employee) but I don't know the specifics around mental health

Yes, if there is a cost, of course that will be a priority. 

I also understand he has to buy in.  We cant hold a 17 yr old down and make him take medication and we cant make him talk to a psychiatrist.  But we are certainly going to try.

Con-I am PMing you. Definitely get the referral from Shoshannah above if there is a great MD near him on LI--there is likely to be a wait for an appointment.