Appts with- psychiatrist and therapist = disappointing

Discussion in 'General Parenting' started by Jules71, Oct 8, 2010.

  1. Jules71

    Jules71 Warrior Mom since 2007

    A little background.... difficult child has been increasingly more aggressive, in fights with friends, stole money, pinching and shoving people in music, problems at recess, major blowups/meltdowns at home, etc.

    I met with the psychiatrist yesterday and felt completely let down when I walked out of there. I guess because we are at the breaking point. I had my hopes up that he would make a change in difficult child's medication and we would have some relief. That didn't happen. I spent the time re-catching him up on everything and everything we have done and tried and all the medications and side effects, etc. and then time was up! So we have another appointment next week, in which he said we can talk more about the medications. Ugggh! I know it's only a week, but it feels like a lifetime to me.

    I met with the counselor in that same office today. Spent an hour getting her up to speed on difficult child, his issues, our concerns, medications, etc. All with my 3 year old in tow, because husband couldn't leave work today and we do not have child care or anyone near by who can help. It went ok, but I just don't see counseling working for difficult child right now. She wants to see difficult child next week too. So we see the psychiatrist Wed morning, and the therapist Wed night. That's going to be quite a day!

    So now... what to do in the meantime??? Give him everything he wants to avoid a blow up? I have had a headache for days and I feel like I've been run over by a bus. I am stressed out and not looking forward to the ticking time bomb this weekend.

    I also talked to the pediatrician today - she finally called me back. She said she consulted with the other doctor in her office and she felt like we never increased the stimulants to the proper dose because we thought it was causing side effect when maybe it really was just all the other stuff going on. She said if he was still in charge, she would have increased his Concerta from 27 to 36 mg. Hmmm! She also said the other doctor in her office said when x, y, or z doesn't work in boys, you need to look at the autistic spectrum piece. pediatrician doesn't see it in difficult child. I have looked at that many times and maybe can see a little, but not too much.

    My poor kid needs a break and needs to feel better. I hate this! I am really thinking the stimulants need to go. It's been almost 3 years and things are only getting worse, not better.

    Thanks for listening!

    Oh - and pediatrician doesn't think we need a referral for a neuropsychologist evaluation. She says to work with the psychiatrist and therapist.
  2. smallworld

    smallworld Moderator

    If you've tried stimulants for three years and they haven't worked, then maybe it's time to look at other medications or other disorders. What doesn't the pediatrician understand about that?

    Do you need a referral to a neuropsychologist, or can you just make the appointment yourself?

    Did you check out the link I sent you in the PM earlier this week?
  3. Jules71

    Jules71 Warrior Mom since 2007

    I agree about the stims! Geeez, you would think the professionals would want to try something else. As far as the referral, I don't think we need it for our insurance company, but the hospital says to have your pediatrician make a referral. Yes, I checked that one out and one in Tacoma.
  4. timer lady

    timer lady Queen of Hearts

    As to surviving the next week I would encourage you to pick your battles wisely. In the tweedle household medications & safety were non-negotiable. If the tweedles were in high anxiety or manic mode I'd give them lots of choices, but only choices I could live with.

    AND rather than stopping the world over various issues (except safety) I learned the fine art of redirection. No talking or trying to reason - just redirect to another activity including television or video games if that's what needed to be done.

    Jules, sending positive thoughts for you during the upcoming week. Medications & young difficult children is an art form - it takes time to find the exact medication for your difficult child. The same with therapy.
  5. Jules71

    Jules71 Warrior Mom since 2007

    Thanks Timer Lady. I understand about picking my battles. The thing is, if we let him use the computer to play games all day - for the most part he will have an ok day. If we say no to anything or tell him to do something he doesn't want to (pick up stuff, take dishes into kitchen, etc.) then he will flip out. So if he is able to function ok - as long as we tip toe around and he gets his own way, then is it in his control and more of a discipline problem, or could there still be some underlying issue?

    The psychiatrist makes me feel like we just aren't disciplining him properly. He asked me the question - so what is his consequence after he beats up his friend and then has a major meltdown which results in husband having to restrain him for an hour. My answer was - uh, well.... uh.... we are all traumatized and need to go lick our wounds so to speak, then when all the excitement has settled down and difficult child is calm and is able to function fine and I guess we don't punish him. The natural consequence of his action is he can't play with his friend anymore. Isn't that enough? Or are we supposed to then lecture him and punish him further? I just don't like someone sitting across from me thinking we are the ones screwing up. We've tried everything - we didn't set out to be crappy parents. The complete difficulty of parenting him has altered how we envisioned we would raise our son.

    On a good note, he slept in his own bed all night last night! (he did that for the 15 days he took Intuniv and then once we stopped it, he went back to sleeping in my bed)

    Have a good weekend!
  6. shellyd67

    shellyd67 Active Member

    Ahhhh Jules I feel your pain darling ! It is such a long and windy road with medications.... Since we increased our difficult child to 36mgs things have been better. I won't say MUCH better, or great, wonderful or that Concerta has been a miracle, yada, yada, yada.... It took over a year to find the proper dose. In reading your post, I noticed you said the an associate in the psychiatrist's office said that is x,y,and z do not work that difficult child may be on the autism spectrum. The thought has crossed my mind with our difficult child many, many times. We had an independent evaluation and a neuropysch evaluation (both cost us big bucks, but worth EVERY penny) and they both concluded he was not on the spectrum. When I read or respond to posts on the forum many people have said to me my difficult child sounds like an aspie. Frankly, some of the parents on this site have more experience that psychiatrist,tdocs, etc.... they have been down this tough and long road and for lack of a better term, been there done that. My difficult child has never had any major school issues (fingers crossed) he does of course display ADHD behaviors at school with focus and attention but never any ODD behaviors. We are just doing what works for difficult child and our family. I wish you luck but hang in there. You will find the right mix soon!
  7. Jules71

    Jules71 Warrior Mom since 2007

    Thanks Shelly! You said your private evaluation and neuropsychologist evaluation were worth every penny - Did they tell you something you didn't already know? And I do agree with you, that some parents have more experience than the professionals.

    The psychiatrist asked me to chart difficult child's moods. I think I will start a new thread because I am a very detailed person and have spreadsheets and lists and calendars, logs, etc - but I am finding it very difficult to use this chart he gave me. It's made for bi-polar disorder and you mark highs and lows for the day - I think it is hard for me because he seems high low all over the place each hour of the day! Maybe I need to do one that breaks up the day into chunks. Plus it is hard for me to know if he is for example depressed/sad - or just quiet and reflective at that moment.
  8. Bunny

    Bunny Guest

    For getting through the next week, how does your difficult child do with choices? I know that my difficult child does much better with things if we preface it as choice. Would you like to take your shower tonight or tomorrow morning? Would you like to wear the red shirt or the blue shirt? He still has to take a shower and get dressed, but he gets to choose when he does it and what he wears, and feels like he he has control over the situation. I know a week can seem like forever. I've had weeks like that, too. Try to hang in there. And I agree with what someone else posted. If difficult child has been on the same types of medications for three years and there has been no imporvement, then it's time to think about a different type of medication.

  9. Josie

    Josie Active Member

    This is how my difficult child used to be, too. I tried to use The Explosive Child method but we never really got to do Basket B things. We had to let go of our expectations and try to maintain some calm in the house. If we added a consequence after the explosion, it made things worse.

    I am not sure we handled everything properly, at the time, but we did what we had to to get by. I will tell you that once she was stable, we can impose consequences and require chores, etc. without those explosions occurring. There was an underlying problem causing that defiance and moodiness even though it only displayed itself at home.

    I know there are lots here who would disagree, but I think a kid who has had a 1 hour meltdown requiring a restraint has already had a consequence. That wasn't fun for them either, and I believe if they could control it, they would.

    I don't mean you have to act like nothing happened. That sad, upset atmosphere in the house is another consequence.
  10. smallworld

    smallworld Moderator

    I agree 100 percent with Hope. What you need to work on right now is getting to the underlying cause. Once you identify and treat the underlying cause, the frustration, meltdowns and oppositional behaviors improve. And then you can work with your child in a more productive manner. All the consequences, rewards and punishments are not going to changes the types of behaviors you're dealing with right now.

    Hang in there -- it can be very tough to find the right mental health professional to diagnose and treat your child appropriately, but it can be done.
  11. Jules71

    Jules71 Warrior Mom since 2007

    Thanks Hope and SW. I completely agree with both of you. The restraint and the sad upset atmosphere were the other consequences.

    And SW you are right - all the rewards, consequences, and punishments aren't going to do a thing - which is why NOTHING has worked over the years.

    I really hope we can get to the bottom of this. Yesterday was a doozy! He had 3 or more separate meltdowns throughout the day. It was bad. Lots of crying.... He just got up and it has already started - refusing his pill, screaming and demanding, and bothering his brother, running all over the house. He's been up for 7 minutes.