Any advice please, my 13 year old son is suicidal

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Desperately needing some advice! My 13 year old Asperger's son, was put on medication a couple of months ago for suicidal thoughts. He started with Prozac but suffered constant nausea and headaches, so after 2 weeks they changed it to sertraline which he's now been taking for 9 weeks. He also takes melatonin, which has definitely helped him sleep better.
His thoughts are just as intense and over the last couple of weeks has begged me to understand that "he can't do this anymore" (live).
I suppose I always knew and was told it was highly likely Matthew would suffer suicidal tendencies. He was 6 the first time he told me he wanted to kill himself, then when he was 11 we had a long in-depth conversation, his emotional detachment makes it impossible for him to understand how devastating this would be for us.
It was only through the school counsellor I found out how low he was and that he was suicidal. We left my partner my children's father last year, after years of suffering, controlling verbal abuse. All 3 of my children have issues because of him, hence seeing the counsellor. I have no doubt he also has Asperger's.
He was to start cognitive therapy, but after spending time with the psychiatrist she said his thoughts were to intense and advanced. He has only recently started speaking to me about how he feels. He told the counsellor last week that he's still going to do it, he just has to wait for the right time. At home we are vigilant, nothing in his room he could potentially hurt himself with, all medication locked and hidden. He has said he plans to overdose. Originally he was going to hang himself but.... he said "that could fail the first time, and when I do it, it can't and I won't fail". He has basically researched "the best way to kill yourself".
I have no idea if there is anything I can do to help him! I am heartbroken he feels this way!
If anyone can give me advice, it would be so appreciated. I'm sure there are many who have been where Matthew is just now. What helped you get through? Was there anything, that could help me, help him?
Thank you for taking the time to read this. And thank you for any advice in advance.

This is horrible I can remember how much I hated school at that age and only got through it by regular breaks from it and the option to be out occasionally I also had a strong attachment to remaining living.
I wish I could offer practical help, teenage years are probably the grimmest in our lives learning that one can take responsibility as an adult is the light at the end of the tunnel.
you have my sympathy and best wishes

I am very sorry that your son is going through this. I have had suicidal tendencies before, so I know how he feels. The thing that stopped me from being suicidal was my religion. I was taught that if you kill yourself, it's a sin and you will go to hell, because there is no second chances when you die before you can ask forgiveness from your sins. Even though I still occasionally think about suicide, in the end my fear of hell is what stops me from attempting it. But I don't know if you or your son are religious, so talk of fire and brimstone may not work with him.

Sometimes when I get suicidal, there is talk of me being committed to the psychiatric hospital. I hate to be the one to suggest this, but maybe that would be the best option for your son right now. If he truly is that determined to take his own life, then putting him in a psych ward where he will be safe and doctors can figure out the best combination of meds for him sounds like the best plan. But ultimately, the decision has to be yours.

The good news is that if he truly wanted to kill himself, he would be dead now and he's not.

I'm going to second the pysch ward idea, just temporary voluntary admission so they can work things out for him.

I'll third the psych ward idea, it's the safest place if someone has intent, it's not pleasant but medication can be worked out in a safe environment

It can take a long time to find a med that works for him, and you need to listen to what he says it's doing to him. Some of these meds can have some very nasty mental and physical side effects. While a psych ward may sound good, it's only a very short-term solution. Usually they just drug them up with a cocktail that seems to work, but don't keep them there long enough to properly test it or listen to his feedback on side effects.

My advice is to make the home as safe for him as possible and to try to get him treatment. Doctors nowadays often avoid SSRI's for kids because they can cause suicidal thoughts or worsen them if you get the wrong one, and instead try other meds. The problem is that, in doing so, they ignore a class of meds that are normally very effective and may be what he needs.

What is it exactly that is making him feel suicidal?

Is it the fact that he has Asperger's?

Is he being bullied at school?

Is the forced routine of being made to go to school too much with his brain to cope with?

Is it loneliness?

Is it sensory overload?

Whatever it is, you need to find out what it is that's making him feel this desperate, and change it. Obviously if it's just the fact that he has Asperger's you can't change that. He's stuck with it. However, if it's bullying, or being unable to cope with a school environment, you could pull him out of school and home educate him instead. If it's loneliness, you could try and look for some clubs or contact groups where he could interact with fellow Asperger's people who were more likely to want to be his friends than the "normal" people are.

I just think that when a child that young is feeling suicidal there is a problem that needs addressing. Rather than addressing the symptoms, and giving him counselling and medication, you should treat the CAUSE. Find out what is making him so desperate, and try to solve it so he gets relief. His suicidal feelings are being caused by some huge big emotional something, and you need to find out what it is and eliminate it. It's unlikely that they are being caused by your ex partner, if he has now left the scene. It's far more likely that his suicidal thoughts are being caused by something that is CURRENT in his life, so you need to find out what it is and try to fix it.

He has apparently had a suicidal ideation for a longtime and it started out very young. I would guess some of it is him having a hardwired reaction to things, but I agree with the other posters that if you could find out what is currently upsetting him this much, there might be a way to get him out of the ideation so that you can work on giving him coping strategies and if need be changes in meds. Of course he may need changes in meds now in addition to getting him away from his specific trigger to get him out of the ideation, too.

What do his doctors say?

Most likely it's the brutal conformist nature of junior high. It's not that he misperceives the social situation. It's probably that he perceives the social situation all too correctly.

Now, I was very lucky when I was a teenager in that we lived right next to the school boundary line and my boy scout troop was in the other school district. And so, all my social eggs were not in the one basket of "school." And that was huge. When school was going badly, boy scouts was kind of going okay, and vice versa. Plus, I had my judo team which was also partially in the other school district.

He needs something real and he needs something right now. As one example, I know Atlantic City and some other communities have Cat Action Team (CAT) which practices capture, spay, release in an effort to help feral cats. And the practice itself and some of the details are controversial and that's a good thing, for it helps to keep it real. Or, your son might be interested in swimming, baseball, tennis, all of which are arguably examples of an individual sport in a team context. At the university level, five tennis matches go to a team score, so when your son does well, it helps the team.

You might also sell your son on the idea that nerds are becoming more accepted. Or, like years ago, gay people were excluded and treated appallingly bad, and now most people are pretty matter-of-fact about a person being gay. And I really think that's coming for those of us on the Asperger's-Autism Spectrum, and the UK is ahead of where we are now in the U.S. Of course, the possibility of future improvement is probably thin consolation to your son right now, and he might not want to at all hear an analogy about gay people (even though what this is about is the right of people to be authentically themselves). There are lists of famous celebrities who are Aspie or probably Aspie. The actress Daryl Hannah is one example. This can be a trap too, for it's telling your son that he needs to be famous or big time. Not necessarily, he just needs to be himself.

He mainly needs right now positives. The opportunity to build a team and be part of a team, now, not at some indefinite time in the future. Plus, continuing to tinker with the medication till you, your son, and the medical professional working together get the right one and the right dosage.

Please note: I AM NOT A PARENT. I am a person who lives life on the spectrum and I try to be a pretty good guy.

I agree to. Medications are there to help you through the time, until you found out, whats really bothering you, but its absolutely no solution. Whyever he is feeling down, the medication wont solve the problem. They can just help him to endure the time, until he really finds a solution.

The second problem for me is, that i have the feeling, that you do not understand him really. So your kids so down, that he wanna to die. And all that comes up to your mind is to tell him, that he shall not kill yourself because YOUR life would be sadened because of this? O_o So thats the best reason on your mind, why he shall decide to live. So you are not unhappy? O_o

What about finding reasons for HIM not to kill himself instead of adding to his miserable life allegations about how self-centered suicide would be, so that he can feel even more miserable? O_o

Find reasons for him to live. I also tried to kill myself, and the only cause why i live is pure luck that the medication i took, wasn´t enough. And there is no arguing about, that this would be silly or useless or anything. At this time, there was absolute no cause for me to live for, so you can argue around as long as you want, but as long as there is no reason to live suicide is the right and logic option.

So start to change that and find reasons for HIM to want to be living. (And no "Mummy will be sooooo sad." isn´t. Thats only making it worse. I know that this situation IS really hard for you and that you would be really sad, but it still gives him no reason to live on. And its also not logic: "So you shall endure your terrible life that is so horrible that you just cant stand it anymore, because if not my life would be a bit hardened. No not so much, that i wanted to kill myself too, but because i would be sooo sad, you shall live on in terror and sadness your whole life long. -.- Nope, no logic inside.)

Find him a therapy or councelor, and you can use the medication to help him to endure this time until he found out, whats really responsible for him to feel no reason or fun in live. But medications is no solution and the more effective they are, the more side effects the have and none of them i would consider as healthy.

There are also some small trivial things you can easily do for him, so a professional therapy has better chances. First is healthy eating: So you dont have to bother about hyper special diet plans and so on, just try to get him to average healthy eating. You should avoid blood sugar spikes, caffeine and such stuff, so there will be enough hard work to do in the therapy, so you should not make that even harder for the doctor because of such trivialities caused of wrong eating. Then try to get your boy out every day. Sunlight (even when there are clouds) has a great responsibility for the production of "Happy-hormones", so when your boy has great problems with that anyway, at least try not to enlarge the problem. If he has got depression, he will have less physical energy so making small walks or so will be just ok. If he likes to do more its ok, but normally people with depression dont have much energy and overexert would only make it worse. Third is sleep: Its complete normal, even for healthy people, to get more and more depressed, when they cannot sleep enough until they even get suicidal thoughts. So getting back a normal sleep rythm is a huge advantage, when fighting against depression. So i avoided medication while my therapy as much as i could, but some soft sleeping pills really made a big chance within two weeks, when i really was on my limit. Before i could rarely sleep 3-4 hours a day for months, because whenever i went to bed my thoughts about my problems were running wild, so i couldnt sleep, so to endure the day was even more harder for me, so my problems got bigger, so i couldnt sleep.... When you cant sleep, your energy depots are dropping to zero, and with zero energy you also have no energy for therapy or trivial fun or hobbies and so on...

These things might seem trivial according to the problems, but at first day of therapy, these have been my homework and it was really a help for the therapy. Just a small part, but at least a part that can be acchieved really easily without any professional medical knowlegde, so your doctor has more time to focus on the real issues which need professional treatment.

Just so you know you aren't alone, there is a section in the Parenting Index on Self-harm and suicidal ideation that may help you as well.

Many of us have been through this - and when combined with autism, it's difficult to figure out whether your child is having difficulty expressing himself, whether he actually plans to harm himself, or whether you have some combination of the two. I would make sure, first and foremost, that you find a professional who works with kids on the spectrum (preferably a pediatric neuropsychologist or a developmental pediatrician) and work with them.

I would agree that you need to find out what is going on underneath the suicidal language. Even though we are now fairly confident that my son did not plan to harm himself (which is not to say that this isn't a very real possibility and at the time we took it seriously and would if we had to do it over again,) we did find out he was being regularly bullied at school, and that he was terrified that having AS meant he was crazy and worthless. We had to deal with these two issues in order for him to improve.

Also, make sure the medications aren't part of the problem. Get a second and third opinion. I am not anti-medicating, but they do add variables to an already complicated situation - if they aren't fine-tuned correctly they can exacerbate suicidal feelings and thoughts. Make sure your doctor can get the meds where they need to be in order for them to be part of the solution and not part of the problem. (DO NOT try to take him off meds without the guidance of a professional; there is a process you need to follow to take someone off meds if you decide meds are not the way to go.)

I am so sorry all this is happening to you, and I hope things improve for you soon! I will say that I was terrified for my son, too - but after figuring out what it was about, we are much more stable and all of us - my son included - are better able to handle things when they go badly.

I'm so sorry I've not replied before now. And Thank you for all your comments, they are without doubt appreciated.

Matthew still has these thoughts, although not as intense as they were. Whether the medication has anything to do with that, I'm unsure?

I am now thinking the root of the problem is school. His mood lifted and he seemed quite 'chilled' during the xmas break. He's been back at school a couple of weeks now, he is definitely more moody and I can see him slipping back to being low again. I have to say the school (main stream) Matthew attends are very good and they have a unit within the school for kids on the spectrum. Although Matthew won't go to the unit, as he doesn't want to be seen to be different, they do have a care plan in place to help him manage.

Yes, I am looking at getting a referral for another opinion. I agree with comments that his consultant should be looking at other ways to help him. I'm also wondering how many kids she has dealt with, who have felt the way he does? It's our local hospital, but, not on a large scale in comparison to others.

His social worker may have found a befriender through NAS who I'm meeting tomorrow. Young lad who is at University who sounds like someone Matthew would like and has interests in common with. So, see how that goes.

Again, sorry for not replying sooner and Thank you so much for all your comments

Thanks very much for checking in, it is always good to hear when things are going well.

My son's problem was in large part due to school: he had an undiagnosed pragmatic language deficit and basically, without anyone knowing because he hid it so well, was only understanding about 70% of every interaction. This meant he was constantly making assumptions about what other people meant and that frequently those assumptions were wrong - therefore, although he knew he was being bullied, he'd completely miss the actual moments of bullying, or he would lash out at totally innocent kids who bumped into him accidentally. This meant that school was nothing short of torture for him until we got it worked out (things are significantly better now.)

Pragmatics can be tested at school by the speech therapist; basically it means the social aspects of communication. My son had a near college-level of vocabulary when we got him tested for AS, when the neuropsychologist suggested speech I thought she was crazy...but I was able to observe the test and it was incredibly enlightening.

AS needs a specialist; we'd seen numerous psychologists, social workers, counselors, even the school and didn't get answers until we went to a multi-disciplinary unit at a local hospital (I should really put this in my signature, I write it so often - but for us it was the key) that specialized in developmental issues. It was headed by a pediatric neuropsychologist and a developmental pediatrician - those are the disciplines to look out for.