A lot of time. My son's stay in the hospital may have been helpful for him. Maybe it was most helpful for us. He was in for about 10 days. It was far from home (about 90 minutes driving, in traffic). He definitely hit bottom some time around his stay.
During visiting hours once, a new child was admitted. As all patients do, he arrived restrained on a stretcher. Once inside the secure facility, he was released and made his way to the common room where he awaited intake. He sat quietly and ate a snack. My son approached him and asked the equivalent of "What are you in for?" The boy said, "Attempted suicide". My son didn't understand the word "suicide" and the non-comprehension registered on his face. The boy then reworded his response. "I tried to kill myself." My son was obviously confused and flustered by such a response - after all he wanted to live forever! He said, with obvious mental clarity and confusion "What did you try to do that for?!?!?!" The boy was taken aback. He thought a little and said, meekly, "I had a bad day." My son thought a little about that and said, "I hope you have a better day, tomorrow."
When my son came home, he was stable. Still a little on edge and sometimes still violent. He was on Risperdal, Remeron and Wellbutrin. We had Benadryl available. He started out at his old school for a couple of weeks while we located a new placement. The new placement was a life skills facility where each student had a one-on-one aide. No academics, some vocational work. Lots of behavioral support. Maybe the best placement given that his behavior stood in the way of any progress on any front.
Whether it was the passage of time, the behavioral support, the new drugs, the new placement or all of those things...or something else entirely, slowly but surely my son began to "come back". He re-engaged with life as he lived it before. He began speaking, riding his bike, conversing with neighbors, spending too much time on facebook, doing little self-motivated community service projects and grooming. He started talking on the phone, re-engaging in social activities and Tae-Kwan-Do. He showers, again, toilets and cares about his hygiene. We have tapered off the Remeron and then the Risperdal. The behavioral specialist who were engaged to get him to control the violent outbursts saw that behavior maybe for three weeks. Now they are focused on such mild behavioral issues such as "reading with correct vocal inflection".
We started ramping up the Concerta again to see if we get better impulse control or attention. We are back to worrying about his social disabilities and his lack of a close friend.
I still sometimes see mannerisms or gestures or hear words that trigger my fears of a slide back into the abyss but these appear to be fleeting, random actions and not indications of regression. Knock on wood.
Now I have a lot of time to reflect on the 18 month "dark period". What is most difficult for me is my wife's family's reaction. My mother visited us twice, my sister 3 times. While my mother was not really helpful, and was mostly upset, her presence was extremely supportive. My sister who has a background in special education came with boxes of tricks - that were mostly useless - but she came and tried. That was good.
My wife's family, on the other hand, who always talk about the strength and enduring nature of familial bonds and the value of family, basically abandoned us. Her mother stopped visiting us. None of her brothers or sisters offered any assistance. No uncles. No aunts. When her mother called, the last thing she wanted to hear about was her grandson. I am angry about that. I didn't really notice or care until now - that I can reflect on it.
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