PLEASE HELP BUT WHO NEEDS THE HELP

We need help, but I don't even know what kind of help to ask for. Five years ago, I was the 22 year-old August bride of a 23 year old guy that I met in college. We had just graduated with degrees in business (marketing and human resource management), had new jobs in a Pittsburgh-based corporation with a terrific career-ladder, good starting salaries, excellent benefits, and what appeared to be lifetime job security. Based on this, we decided to buy a house and have our children right away.  My parents loaned us enough for a down payment and we bought a split entry house on two-acres of land near a Penn State exhibition farm about 25 miles from downtown Pittsburgh. Our first child, Bella, was born the day before our first wedding anniversary. Her brother, Liam, was born fifteen months later (NAMES CHANGED TO PROTECT CONFIDENTIALITY).   Up until this point, we felt like we were living the dream… 

We used a daycare center in Pittsburgh for Bella, but found that it was too difficult (and expensive) to transport both children to the daycare center when my maternity leave for Liam was up. We tried three different nannies during Liam’s first year, but none of them worked out very well for us. Finally, I negotiated a leave of absence from work so that I could stay home and care for the children, knowing that I would be giving up a position I really enjoyed to be hired back into whatever was available when I wanted to return.  Our perfect life turned into a nightmare at this point. 

 Both Bella and Liam are very intense, strong-willed, highly active children who don’t focus their attention on any kind of play activity for more than a few minutes. The house is a continuous mess with toys everywhere. I thought I would enjoy being a stay-at-home-mother, but they don’t listen to me and sometimes don’t even seem to like me very much. I’m alone with the kids for a few days most weeks because my husband's job requires travel. We are barely making ends meet financially, and my parents are upset because we haven’t even started to pay them back for the money they loaned us on the house. 

I find myself crying every day. I feel like the marriage and family are starting to fall apart, but my husband just acts as though everything is normal. My parents and his father (his mother died when he was a teen-ager) say that things will get better when the kids get older, but I don’t see this happening. Last night, in desperation, I literally walked out of the house when my husband came home and just disappeared in the woods surrounding the property for about six hours. I fell asleep sitting up under a tree and didn’t even wake-up until after 11 p.m. No one seemed to care. When I finally found my way home, my husband and the kids were asleep and the mess was left for me to clean-up this morning. At breakfast, I got the "deep-freeze" treatment from my husband. When I called my mother, she said that he never even called them and that she didn't know I had walked out. She asked me if I was having PMS and suggested that I talk to my doctor about an antidepressant!!!!

So who needs help here? Am I crazy or hormonal? Is there something wrong with my husband or my kids? I really do love them dearly. Is this the "problem-that-has-no-name" that Betty Friedan wrote about when the feminist movement was relaunched in the mid-1960's? Please help because I'm afraid of what I might do if nothing changes (and I'm the only one who seems to think that things need to change).

Samantha (NAME CHANGED TO PROTECT CONFIDENTIALITY

Striking Out On My Own

My name is Todd, and I’m hoping someone will read this and give me some advice. I’m 17, and I currently live in Montana. I recently moved here to get as far away from my old life as possible. When I arrived in Montana I had nothing. I was lucky to find a job working at a family run Italian restaurant in the town where I arrived. I’m lucky to have a great boss (Brad). The owner of the restaurant is renting me a room on the second floor of the building, and charges me a very reasonable rate. He also lets me eat 2 meals per day at the restaurant for free. When I was 12, I was sexually assaulted by an acquaintance of my mother’s. My mom worked at a local fast food restaurant. The owner took a liking to me, and asked if I could help out around the restaurant. He offered to improve my mom’s schedule and increase her pay if she would let me “help out”. The assault happened after the first (and only) time that I was dropped off at the restaurant to help the man. When I arrived, the guy offered me a Pepsi, and I don’t remember much of what happened after that. I’m told that I was quite confused about the day and time when my mom picked me up. I was also in a lot of pain. It turns out that the man drugged me and assaulted me during the time that I was supposed to be helping him around the restaurant. When I told my mom about the pain, she initially acted unconcerned. I had a ton of rage ever since I discovered what had happened to me. My mother was never very supportive, and she denies having any idea that the man would do this. The man was arrested, but I was terrified of testifying in front of him, and so he’s since been released. By the time I reached 17, I could no longer stand looking at my mom, or the town where this happened. I just wanted to get as far away as I possibly could, so I hitchhiked across the country to Montana. I’m very lucky to have found Brad. When I came into the restaurant to get lunch, all I had was 5 dollars, and I probably looked like a mess. Brad saw my condition and took an interest in me. We struck up a conversation and he offered me a job at the restaurant. While working at Brad’s eatery, I’ve discovered that I really like working in the food industry. I’d love to become a chef, or maybe even a dietician. I figure that I’ll need to go to school to do this. If I get my GED, will I be able to get into college? What’s the best way for me to go about getting a college degree? Do you think that I'll be able to handle college better than high school, because now I'm away from where all this happened?

HOW DO YOU KEEP AN OLDER MAN SAFE AND STILL LET HIM MAKE HIS OWN DECISIONS?

My brother and I are the legal next of kin for my paternal grandfather who is going through a rough time. I’m trying to convince my grandfather that he and his wife should sell the house and land to me or to both my brother and I because neither of them can manage all the work that goes with it, and things are really beginning to fall apart. If they sell the house and land to one or both of us, we will make sure that they continue to have the right to live in the house for as long as they want.

Grandpa is in his late 70’s and was told that he was in the early stage of Alzheimer’s disease.  His wife is an LPN and she insists that she will be able to take care of him and the land, no matter what happens with the Alzheimer’s disease. We don’t think so! Both of my parents are deceased so it is up to my younger brother and I to look after him. He and our grandmother were always there for us when we were growing up.  My wife and his roommate have already expressed their willingness to help.

                Grandpa is a 275 lb. former marine who has been in outstanding health throughout his life. In addition to the training he got in the marines, he grew up on this land and has raised cattle on it throughout his lifetime. He can wrestle and tie down a bull, and no one is ever going to be able to manage him if his Alzheimer’s gets any worse. Right now, he only has some occasional episodes of it and then it clears and he is his normal self, but if it gets worse…. His wife is in her fifties and she is a very small, petite woman.

                Grandpa is a hunter as well as a farmer/rancher. Two days ago, his wife called and asked if my brother and I would go looking for him. She was worried because he had one of his Alzheimer’s episodes last week and wasn’t completely back to normal yet. She noticed that his hunting rifle and some ammo were also missing so she figured that he must have taken it with him. He hadn’t said anything about going hunting that day, but he wasn’t in the house when she woke up and she couldn’t find him anywhere on the land. He must have left during the night because none of the morning farm work was done. That’s when she went looking for his rifle and the ammo. He had been said that it was time to go hunting again about a week before this happened, even though it’s not really legal right now. He would never break the law if he was in his right mind.

                My brother and I searched the parts of the woods he normally hunts in and couldn’t find any sign of him. When it got dark, we thought about calling the police but decided to just wait until morning to see if he showed up during the night. This would not be unusual for him. He loves being outdoors and knows every inch of the woods by heart. Sure enough, at about six a.m., he came home hungry and thirsty, saying he had been out hunting, but he didn’t have his gun with him. He couldn’t remember where he left it, but assured us that it was  “in a safe place” and that he would go out to get it later. (There is no such thing as a safe place for a hunting rifle in a wooded area where kids might be playing or exploring.)  He does things like this on impulse without thinking about the consequences a lot now. This is so different from how he used to be when my grandmother was alive. She died three years ago and he never really went through any grieving even though they had been together since high school.

The woman he married right after she died was one of the people who came into the house to help take care of her when she was sick. She’s a nice lady, but doesn’t know anything about farming or raising cattle. There is no way that she will be able to care for him if he gets any worse with the Alzheimer’s, and there is no way that she will ever be able to manage the farm chores or even the complexity of selling it all. Grandpa always said that he wanted one or both of us to take over the farm someday, but we both went to college and ended up with jobs that paid better. Still, we don’t want to see the farm deteriorate. We could hire someone to manage it and we both know enough about farming to help with the work, but ever since Grandpa remarried, he seems more and more distant from us and less communicative about what he is planning to do with the farm as he ages.



WHAT IS HAPPENING TO MY FRIEND?

 I feel like I need to do something to help my friend, but I don’t know where to turn.  My name is Sarah (NAME CHANGED TO PROTECT CONFIDENTIALITY), I’m 17, and I’m entering my senior year of high school.  During my freshman year I met a girl named Jen (NAME CHANGED TO PROTECT CONFIDENTIALITY).  Jen quickly became one of my closest friends.  Jen had a great sense of humor, and we both shared a love of romantic movies and boy bands.  We started hanging out after school on a regular basis.  Initially we would hang out at her house and watch sappy movies or go to the mall.  Jen had some other friends that she introduced me to, and eventually we started drinking and partying with them.  Before I met Jen I had never tried any drugs or alcohol.  Jen and her friends knew of some good hangout spots in the woods around town, and we started spending time there.  It wasn’t long after that that we began smoking cigarettes and drinking alcohol.  Shortly after that one of Jen’s friends brought us some weed, and then the partying began.

We did a lot of partying during my sophomore and junior year.  Jen became more and more involved in the party scene.  She stopped wanting to hang out at her house or mine, and only wanted to drink and smoke. She started spending alot of time with strange guys as well.    I went along with all the partying over the past two years, but I feel like things are starting to get out of hand now.  I'm tired of being pressured to "hook up" with guys at the parties.  I never wanted to try anything more than weed, but Jen is more adventurous than I am.  She started taking acid and then Ecstasy.  I lost track of what she was into after that, as I often saw her popping different pain pills and other drugs when we were hanging out.  When we go to parties now, she often stays long after I leave.  She frequently leaves me and disappears with other guys during parties, and  I've heard that she often spends the night at these parties too.  I saw her with a couple guys who were doing cocaine one time, but I don’t know if she tried any or not. 

When we first met, Jen’s parents were really nice.  They frequently had me over for dinner, and Jen’s dad had a really cool boat which we sometimes went out on.  During my junior year, I was shocked to find out that Jen’s mom got diagnosed with lymphoma.  To make matters worse, she told me that her dad was recently laid off, and spends most of his time at the bar or in front of the TV now.  We don’t go over to her parent’s anymore now.  Over the summer we mostly partied in the woods and at other people’s houses.  With the start of my senior year I’m concerned about getting into college.  The partying was fun, but I’ve decided to grow up.  I want to get into a good college, and I need to improve my grades.  I've also met a really nice guy who I've been spending time with.  Jen does not seem to feel this way though. 

I noticed over the summer that Jen seems to be changing.  She’s losing a great deal of weight.  Her eyes are always bloodshot and kind of wild looking, and I rarely see her sober.  Sometimes she has bruises on her arms, and one time she had a bruise on her cheek.  She also dresses different.  She wears incredibly tight pants and short skirts now, and I've noticed that a lot of the jocks pay much more attention to her.   She still hasn’t gotten her driver’s license, and she has no interest in getting a job.  I’m not sure how she gets her money for drugs and alcohol, but she always seems to have a pocketful.  Back in August I told her that she should stop partying so much.  She doesn’t talk about her family or grades much, but I’m pretty sure that she failed a lot of classes over her junior year.  She laughed at me when I suggested that maybe we should just go see a movie (sober) or go shopping at the mall like we used to.  She's become increasingly distant now that I’ve stopped partying.  She also wasn’t interested in talking about college, or what’s going on with her parents. 

I'm worried about Jen.  I feel like she needs help, but don’t know where to turn.  I'm afraid to talk to the guidance counselor about Jen; I don't want her to be mad at me.  I’m afraid of losing her all together.  Who can I talk to about this?

-Sarah

What has happened to my wife?

I’m writing this post on behalf of my wife Brandy; I don’t know how to help her…..Brandy and I have been married for 10 years.  We met when we were both enlisted in the army.  After several years of working as a mechanic, I left the army when my contract expired, but Brandy has remained enlisted.  We live on a local army base.  We have 2 children…Sarah and Todd.  Sarah is 6 and Todd is 3.  Recently I’ve been noticing that Brandy seems less attentive, both to the kids and me.  Brandy just returned from a 6 month tour from an area where there is still some minor combat occurring. She arrived back on base roughly 2 weeks ago.  She’s been reluctant to discuss any details of the trip with me, instead changing the subject or asking about the kids when I bring it up.



I first noticed that something was amiss at night.  About 10 days ago I woke up at night to find Brandy writing and moaning in the sheets.  She was quite pale and sweaty, and looked at me with wild eyes when I woke her up; she seemed to hardly recognize me for several seconds.  This is becoming somewhat common now, as she seems to have nightmares and/or disruptive dreams almost every night.  I’m a light sleeper so this frequently wakes me up.  Things had been relatively normal during the day until this past week.  On Saturday night we were making dinner.  Brandy was chopping celery for a salad and I was boiling pasta.  I heard the rhythmic sound of the vegetable chopping stop while I had my back turned and was putting pasta into the pan.  I turned around to ask Brandy if she was done with the celery and saw that she was still holding the knife and the celery, but was staring straight ahead at the kitchen wall; she had her back to me.  I watched her for about 30 seconds, during which time she didn’t move at all.  This struck me as especially odd.  I finally called out to her, and when I called her name a second time she suddenly flinched and turned around, like I’d surprised her.  She looked completely disoriented, and I remember noticing that she had a tear running from her left eye.  I asked her what was wrong and she ignored me and went back to chopping the celery.



Over these past several days she has become increasingly distant.  Sarah told me the other day that she forgot to make them breakfast after I left for work.  I asked her about this when I got home and she snapped at me telling me that she wasn’t “their servant” and then stomping out of the room.  I was completely shocked.  When I get home from work now and try and give her a kiss, she often turns her head, and it seems like she avoids eye contact with me.  Her dreams at night are getting worse than ever.  It seems like my beautiful sweet wife has undergone a sudden personality change.  I don’t know what could be happening to her.  She refuses to talk to anyone involved with the military or VA about this, and also refuses to talk with our family doctor, saying that she'll get over it and be okay if we just give her some time. She also insists that I not disclose what is going on to anyone in the family or to anyone who might know her. How is a husband supposed to handle something like this?

Trauma or ADHD?

The following request for information came in from Southwestern PA. Please respond if you have any recommendations.

We live in a house that my husband and father-in-law built on a corner of his family's farm. My seven-year old son loves it here, as do we. The problem is that my in-laws have 6 horses in various pastures who roam a large portion of the land freely and they are not about to get rid of them or keep them in a smaller confined area. Several years ago one of the horses kicked my son when he walked up behind it and he was thrown several feet.  Luckily he didn't have any internal injuries, but he was thrown several feet into some fencing and ended up having to have a number of stitches on his forehead and around his left eye. His vision was fine, but the plastic surgeon wanted him awake while he was stitching the eye. The scars are very minor, but because he was awake he was very frightened. He knows that the horse didn't mean to hurt him and that the kick was the result of its instinct.  Now he respects the horses more and keeps a distance from them. Nonetheless, whenever he hears one whinny or sees one nearby,  he seems to lose his ability to focus his attention and becomes really hyper. He is also a huge risk-taker in other ways. His first grade teacher suggested that he might have ADHD, but when he wants to focus his attention, he can, as long as there are no horses around or anything that reminds him of horses. He also gets hyper and distracted when he hears any kind of siren or when there is any talk about hospitals or injuries. Could his on-and-off problems focusing attention in school and at home simply be due to the trauma he went through from being kicked by the horse and getting stitches, or does ADHD come and go the way his distractability and hyperactivity do? What kind of expertise do we need here? His teacher is recommending a local family practitioner who has provided ADHD medication for other children in her class, but I'm not comfortable with this. The chiropractic we use said that he is developing normally for a child his age and that most seven-year old boys aren't really ready to sit still and focus their attention all day in school. I trust him, but worry that a "wait-and-see" approach might cause us to lose valuable time in treating his problem--if it really needs any kind of treatment.

Why don't I feel right?

I’m posting this because I’m not sure who else to talk to about this. My name is Terry and I’m a 26 year old male. I'm a computer programmer and I often work long hours and frequent overtime.  I've been fairly successful in my career so far, but  I don't have many friends, and have always been somewhat socially awkward.  I'm currently dating a girl I met online, and this is my first serious relationship. 

 I've recently begun to experience episodes of dizziness. These episodes are starting to make me really nervous, because they happen at random times.      My last episode occurred yesterday morning after I had just finished my morning can of Red Bull.  I was coming back from the bathroom when all of a sudden I became quite dizzy.  I started to see spots in my vision so I sat down.  After about 1 minute I felt normal again.  I was talking to my older brother about this several days ago and he mentioned that he used to get panic attacks that felt similar before his wedding.

This has been occurring several times per day now for about 2 weeks.  Sometimes I get really sweaty during these episodes, and my stomach will feel really funny like I’m free falling.  I’ve never fainted, but I did have to pull over one time when I was driving and I started to see more spots in my vision than usual. I never have any pain when this happens.  I’m starting to worry that I’m eventually going to pass out while driving or doing something important. I’m starting to get really nervous about this, and lately I’ve been cancelling plans with friends and just staying home or at the office because I never know what will cause these episodes.  Does this sound like a panic attack? If so, What is the best way to stop it? My schedule is so packed with work and finding time to spend with my girlfriend that I just don't have time for all the counseling my brother went through with his panic attacks. Also, I'm really opposed to taking any kind of anxiety meds.

Autism and Antidepressants

Hey, here's a new post from Allison, a mother who is asking some questions that have relevance for so many other parents of disabled children.

 I'm asking for help because I have a 11 year old son, Joe, who was diagnosed as having autism when he was four-years old. Needless to say, I was devastated at the time, but also kind of relieved because, for three years, I had been telling both my husband and Joe's pediatrician that something was wrong. I had noticed that Joe often had very little interest in interacting with other kids when I set up play dates.  He also had certain routines, and would have major emotional outbursts if I didn't follow them, such as making him exactly 2 pancakes for breakfast every morning.  Joe's diagnosis was delayed because his speech developed normally for the first two years, but then it simply stopped developing and he actually lost some of his language. I was angry--really angry--that we missed out on three years of early intervention because of the delayed diagnosis. Why didn't anyone listen to me when I said there was something wrong with my child? I have talked with other mothers of children on the spectrum who were treated the same way.

Somehow, when I expressed my anger about the delayed diagnosis to Joe's pediatrician , I ended up being labeled as having depression and was referred to my PCP for an anti-depressant. I let my husband convince me that I shouldn't initiate legal action against the pediatrician who missed the diagnosis. I've been on the anti-depressant ever since and, although it helps me feel better and keep my anger under control, I'm worried about the long-term effect of using this type of medication. I've noticed that my hands have started to shake recently, and I'm also gaining weight. Is there a trade-off in terms of a shorter lifespan in exchange for artificially feeling good most of the time? 

My husband spends most of his time with our two older sons who play baseball for their high school team.  When we occasionally all have dinner together, the conversation always turns to baseball.  Nobody ever asks Joe about his day, or what he's been up to lately.  No one else in the family really spends much time with Joe. They ignore Joe as much as my husband does. It's obvious that I am the only one who really cares about Joe's future. I need to stay alive as long as possible to oversee Joe's  care when he is an adult. I don't think that there are any services for adults with autism in our small town community and I hate to think of his being sent off to some unfamiliar environment. He knows his way around here and functions pretty well at home and in the neighborhood. His school district has been fantastic in helping him with his language and behavior, but he still can't really read or do enough math to be able to manage money. What happens to autistic children when they age-out of the public school system?

I'm kind of rambling on here but it is because I can't find anything about the long-term health consequences of using antidepressant medication or about what happens to autistic kids when they are too old for services through the public school system. The antidepressant takes the edge off my worry, but I don't want to lose any more valuable time delaying decisions related to Joe's autism and needs. Like I said, no one in my family really cares about Joe and his future except me. My husband and other two sons just put all their energy into baseball and having fun while I'm having to do all the caregiving and worrying myself. Even the relatives organize their lives around the baseball games, ignore Joe, and take it for granted that I'll be the one to stay home taking care of him while they are all off having a good time together. Joe is at an age now where he could really enjoy doing things with them, and I know that I would enjoy it. Joe is outgrowing the at-home activities that I use to keep him happy and occupied. Also, he is almost as tall as I am. What happens when he gets too big or strong for me to manage his outbursts?

Welcome!

Welcome to the ASSESS blog. The letters in ASSESS stand for the blog’s real name, “About Special Services, Expertise and Social Support.” We developed this blog to introduce you to a network of mental health, behavioral health, public health and educational professionals who believe that it is individuals, parents, caregivers, and employers who are the real experts when it comes to identifying the need for special services. They are also the ones who are best at identifying unique symptoms and strengths that experts have to know about when they conduct an assessment or develop an intervention plan.

In other words, when it comes to solving problems, we can all learn from each other. The last two letters in ASSESS stand for “social support,” something that we all need when we are trying to solve problems and address the challenges that get in the way of optimal development and quality of life.

Who is this blog for? It is for anyone seeking information about special services for those who have special needs. It is also a blog for those who are either looking for experts or who consider themselves experts in caring for people with special needs. A special need can refer to anything from severe developmental delay to giftedness and exceptional talent.  A special need can also refer to mental and behavioral health conditions such as Attention Deficit Disorders (ADD and ADHD), Autism Spectrum Disorders, Adjustment Disorders, Attachment Disorders, Anxiety Disorders, Brain Injury, Conduct Disorders, Communication Disorders, Depression, Mood Disorder, Post Traumatic Stress Disorder, Phobias and just about anything else listed in the DSM-V. Last, but not least, a special need can refer to the needs of families, organizations and communities. Our network includes professionals who work in the areas of marriage and family counseling, public health, employee assistance, and court-related assessments related to adoption, custody, conflict resolution and mediation. We will do our best to share some of the things that we know with you and, in return, we ask that you share what you know or want to know with us.

How to care for my husband at home...

Hello, my name is Mary.  I’m 72 and recently retired from my job as a bank teller.  I live with my husband George, who is 83.  We have 2 daughters who are married with children of their own and they both live out of state.  We live in a rural suburb in a 2 story home on 15 acres.  We love the peace and quiet; our nearest neighbor is ½ mile down the road.

George was diagnosed with Prostate Cancer about 12 years ago.  He was treated with medication and with radiation therapy.  George beat the cancer and we thanked god and put the whole ordeal behind us (or so we thought).  About 2 years ago we started to notice that George had blood in his urine.  We took him to the hospital, and they told us he has “radiation induced hemorrhagic cystitis secondary to soft tissue radionecrosis”.  They gave George some kind of injection and the bleeding went away.  George’s doctor has also informed me that George is beginning to display early signs of dementia.
2 weeks ago George began to bleed again.  He went back into the hospital and stayed for several days.  During this time they ran fluids into his bladder to wash the blood out and tried several different treatments.  They told us that the treatments had helped, but not to be surprised if there was still some bleeding at home. 

Over the past several days George has been bleeding intermittently throughout the day (and night).  He’s losing the ability to control his bladder, and often has pain and trouble peeing when he’s bleeding. We’ve since gone to the local ER and talked to his PCP, and we were told that this was normal.  I was told that we should return if he begins to “demonstrate substantial hemorrhaging, expel significant clots, or experience total obstruction”.  I have no idea what any of this means…George is quite frustrated with the healthcare system at this point and he blames his suffering on the radiation therapy.  He’s also starting to get confused at night.  I’ve been up every night with him for the past 4 days; neither of us have gotten much sleep.  To make matters worse, George almost fell last night while he was in the bathroom.  I got under his arm to help him keep his balance, but I almost fell too, and today my back hurts.  We are both also completely exhausted.
I feel like I need help taking care of George.  With both of our daughters out of state, we don’t have anybody to help us.  When they discharged George from the hospital they rushed us out the door and didn’t really answer my questions about how to take care of him. I’m frustrated and feel like I’m in all alone.