KATHY MITCHELL AND MARCY SUGAR \ ANNIE'S MAILBOX 'Zach's' visions may be sign of medical problem

Dear Annie: I am very close to my 12-year-old grandson, "Zach." He says I give good advice. I felt confident guiding him, until now.
Last night, Zach confided that for several months, he has been having "visions." One is of a man, whom he described in detail. The second is a dog, and the last is an animal that he says resembles a polar bear. Zach says the visions last only a second before disappearing. He doesn't hear voices or anything like that.
My grandson is articulate, intelligent, sociable and not prone to exaggeration. He has no extraordinary problems at school or at home, and he doesn't exhibit any symptoms of a medical problem.
Zach asked me not to tell anyone, and I don't want to lose his trust. But I don't want to ignore something potentially serious. What should I do? Worried Grandma
Dear Worried: You are a caring and loving grandmother. We spoke with Dr. Carrie Freedheim, a child and adolescent psychiatrist in Tucson, Ariz. Here is her reply:
Visual hallucinations can be associated with serious psychiatric disorders in children. However, from your description of your grandson, his overall functioning remains good. He is socially adept and not showing any other symptoms, which means he most likely does not have a serious psychiatric disorder such as childhood onset schizophrenia.
Frequently, visual hallucinations are associated with medical problems -- primarily neurological disorders. Despite your desire to keep this quiet, Zach needs to be seen by his primary care physician and likely by a neurologist as well. Approach him about this as a medical necessity, not as if he is having a "mental" problem.
Dear Annie: I have been married to "Barry" for 20 years. Our marriage is a loving and supportive partnership, except when it comes to his mother.
Mom's passive-aggressive behavior toward me is the cause of most of our arguments. For years I've wanted to confront her about it, but Barry has asked me to put up with it and essentially shut up. He doesn't have the courage to confront her himself. The problem is, I cannot get beyond the fairness factor, and that infuriates me. How can I discuss this with my mother-in-law without alienating myself from the family? Tired of the Cheap Shots in Madison, Wis.
Dear Tired: First ask yourself what you will accomplish by confronting the woman, other than letting off steam. Do you expect her suddenly to realize how poorly she's treated you and do a complete about-face? That sounds unrealistic to us, with the end result being more hostility, not less.
It would help if your husband told his mother to knock it off, or if you could ignore her barbs. Since he won't, however, and you can't, please consider consulting a counselor who will work with you on effective ways to deflect Mom's mental torture.
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