At the end of my rope - what should I do?

Discussion in 'General Parenting' started by frustratedbyODD, Mar 21, 2007.

  1. frustratedbyODD

    frustratedbyODD New Member

    I have a difficult child who is almost 11 years old and diagnosis with ODD and ADHD. He takes Concerta 36mg and Ritalin (as a booster) 10mg.

    I think that it is the ODD that is kicking me in the backside - but I am not sure. We cannot seem to have a single day go by where there is not an all-out fight, yelling match, or tears coming from difficult children younger siblings.

    I cannot get him to concentrate on anything school related, although about 2/3 of the time, he will go to his swim practice in the evening without fight and incidence, although it is hit or miss as to whether he will actually swim as he capable of doing.

    My husband has completely given up on difficult child - he does not know what to do and it frustrates the heck out of him so he just makes me deal with it.

    difficult child spends so much time "grounded" that is doesn't even make any difference anymore and he definitely gets a kick out of picking/pushing peoples buttons (even the 16 year old neighbour girl who helps me take care of my kids). His language is getting more and more profane and I am finding that I am having to hold my son down on the floor when he really starts going off.

    His medication never really "works" - it just lessens the effects of his disorders. I am at the end of my rope and do not know what to do - I have never been one to like the idea of medicating my child or admitting that I am not able to handle him - but it is definitely getting to that point. There are days (and nights) that I think I should be having him committed). He is not under the care of a PDR - due to the fact that he swears he won't talk to them and our insurance sucks - but I don't think we qualify for any type of assistance as we "make too much $$" (too bad we don't see it due to 3 step PCs from husband first marriage).

    He claims that his life is so rough and that no one loves him or even cares about him. All of the kids at school pick on him one moment and then are his best friends another. He says that he is depressed and is going to run away. He hates me.

    Worst thing about all of this is that I have 2 PCs - easy child 1(M) is almost 5 and easy child 2(F) is almost 3 - I am so worried that they are going to do the same things that difficult child does because of how much they look up to him.

    We have another "medication check" on Friday - does anyone have any input on what we should be pursuing next?
  2. Wiped Out

    Wiped Out Well-Known Member Staff Member

    Welcome to our corner of the world. I'm sorry you are struggling so much-you are definitely in the right placce. I can understand your frustration when you say it feels like never a day goes by without some incident. I often feel like that. It sounds like he may need a more complete evaluations. I also recommend you get the book The Explosive Child. It is a book that many of us have found very helpful. Again welcome-you have found a safe, supportive place to be.
  3. thestormyjourney

    thestormyjourney New Member

    I am so sorry you are going through this, wow I feel like I am reding my own story!! I have had bite marks and been in pools of sweat from holding down my difficult child 2 and it just kills you having to do that. My difficult child 1 has just started seeing a psychiatric and I didnt think I would bother either coz he just spits at them and wont talk to them but what I found was a psychiatric whois also a child play therapist, so they play with any of the thousands of toys she has in her room, all sorts of gross things that boys like plus a sand pit and many other things, and she can tell so much from the way they play , the dialogue that goes on and also they talka lot more and they don;t even realise it. He actually respects her and he has no respect for anyone, as her only rules are, respect her and respect her toys, apart from that they can do anything. And suprisingly enough they do! My difficult child 1 also spend so much time without his things too that it doesnt make a difference, man I know exactly how you feel. Unfortunatly apart from Play Therapy, I am only new here myself and theres not much else I can suggest apart from taking one hour at a time and know that we are all here for you!!


  4. smallworld

    smallworld Moderator

    Welcome! I'm glad you found us.

    Sharon gave you some good info. I will add to it by saying that when medications don't work, it's generally one of three options: the dose is wrong, the medication is wrong or the diagnosis is wrong. If your difficult child has not been evaluated by both a neuropsychologist and a child psychiatrist, I would start there to make sure you are dealing with just ADHD. The symptoms of many disorders mimic each other, and it's important to figure out what is what so you can put the proper interventions into place.

    I will also tell you that you should take talk of depression seriously. Concerta over the long haul can depress (it happened to my difficult child 1). Furthermore, mood issues like anxiety and depression can fuel many of the oppositional behaviors you have posted about.

    Again, welcome.
  5. mattsmum

    mattsmum New Member

    Just wondering....

    My son is on Concerta and Straterra. The Concerta is a stimulant and the Straterra is a mood stabilizer. In October, they increased just the dosage of Concerta. It worked okay for about a month and a half. Then he became angry and a lot of negative behaviors surfaced.

    So, they told me that the stimulant might be causing irritability and they increased the Straterra to balance it. We have seen an improvement.

    Have they every mentioned the possibility of two prescriptions? They only gave my son two after my suggestion...and I read it on another website as well.

    Just trying to help...
  6. smallworld

    smallworld Moderator

    Mattsmum, with all due respect, Strattera is not a mood stabilizer. It is an SNRI antidepressant often prescribed to treat ADHD. It is actually highly unusual to need both Concerta and Strattera together. Usually, one or the other is prescribed for straight ADHD. I see your difficult child doesn't have straight ADHD, however, which may account for the use of both medications.
  7. oceans

    oceans New Member

    I agree with what was said... if the medications are not working then something is wrong. We went through this for years. Get another evaluation...maybe there is something wrong that has not been picked up on yet. If a higher dosage of the medications do not work, or if they make things worse, than perhaps they are the wrong medications. Do get a copy of the explosive child by Ross helps. I don't know where you live, but he also does evaluations for collaborative problem solving in the Boston area. If you go to the website there is an email link and you get see if there are any Dr's trained in the CPS method in your area.
  8. TerryJ2

    TerryJ2 Well-Known Member

    Frustrated, so sorry you are going through this. Sounds familiar! You've gotten some good ideas here already.
    I am SO glad that our easy child is the oldest... difficult child looks up to her, as you said your younger kids do with-your difficult child. That is really hard. You'll have to spend time with-ea of them, alone, and make sure they have positive role models.
    I looked up to my sisters, but they were pretty wild, too, and I never did the things they did because I didn't want the punishment. So you never know... they may catch on.
    by the way, we rarely ground any more. It wasn't working well. We found other triggers. I'd suggest watching your difficult child closely to see what he values... football cards, computer time, etc. and take those away instead. Plus, grounding keeps him underfoot and then he drives you crazy. YOU aren't the one being punished, right? :wink:
  9. frustratedbyODD

    frustratedbyODD New Member

    TerryJ2 -

    "Grounding" in my house does mean taking items he values away - not physically locking him in the house. Usually it is all of the video games and the TV - which are already the main things that set him off. He goes into La La Land when he watches TV or plays games and asking anything else of him is out of the question.
  10. frustratedbyODD

    frustratedbyODD New Member

    All --

    Thanks for the sincere welcomes and all of the wonderful suggestions. I am glad I have finally found a place where I can get advice and hopefully eventually I will be the one who can help some of the other newbies who join the site.

    I have read alot of your stories and am flabbergasted at how common ODD and ADHD seem to be. I grew up in small town Alberta, Canada and no one ever talked of ADD, ADHD, ODD or any of the psychiatric inflictions that I have read about over the last few months on the internet and now on this site.

    My difficult child was diagnosed late last year after my frantic desire not to admit anything was wrong with my difficult child came to a halting end, so I am still very new at this.

    Today started off really bad (yelling obscenities at me and the babysitter) and once my difficult child had taken his medication, miraculously improved (it was 180 degrees today). This is normally not the case - but I am glad that I got one day of recluse.
  11. neednewtechnique

    neednewtechnique New Member


    One very important question you should ask your psychiatrist when you go for your medication check is WHY ON EARTH they are giving your ODD child a STIMULANT to treat his ADHD when STIMULANTS make the ODD worse!!!!! We have been dealing with this EXACT problem for quite some time now, and our psychiatrist refused to make any changes, so we have found a new psychiatrist. The new doctor wants to REMOVE the Concerta completely, try the Straterra by itself for the ADHD because it is a NON stimulant, and then if necessary, and a mood stabilizer for the ODD. We will be seeing her in only a few short weeks (thank goodness, the time has come!)

    This is one of my chief complaints and if you look back through my previous posts, you will see that this has been the thing that has frustrated me the most since our difficult child came to live with us. ADHD and ODD is SUCH a COMMON combination, one would THINK that the psychiatristS would know how to handle it, or at least have some ideas, but most of them act completely CLUELESS!! They prescribe these stimulants to treat ADHD and act like they don't know what you are talking about when you call them, wondering why your already out of control child has taken a turn for the worse. Do me a favor, look up the side effects of Concerta online. You will see all the warnings they put out about how Concerta can cause agression, violent behavior, and "fits of rage" as they call it...and they HIGHLY caution the use of this medication in children who already demonstrate these types of behavior.

    And not to mention, a child with ANY mood disorder comorbid with ADHD....give me a break, I think the behavior/mood disorder takes precedence over the ADHD and would like to see the ADHD put on the back burner until the behavioral and mood issues are treated properly. Because now, not only is your difficult child's medication not helping anything, but it is in effect, working AGAINST you!!!!

    Sorry, this is me venting because once again, I find that this is SUCH a common problem and the psychiatristS act completely CLUELESS!!!!

    Maybe I should back up though, becuase I have never heard of using Concerta and Straterra at the same time, so I don't know what benefits your difficult child should be getting from the combination. But it is my understanding that Straterra is HIGHLY recommended for treating ADHD in children that have a comorbid behavior/mood disorder because Straterra is NON stimulant, so it doesn't cause the adverse side effects such as the agression, violent behavior, rapid mood swings, and "fits of rage". For example, our difficult child went on a two hour rage fit the other day because we had the wrong brand of margarine in our refrigerator.

    Anyway, best of luck, I hope things go good with the psychiatrist. When you get an opportunity to discuss your difficult child's medications with them, the first thing you want to find out is what the benefits are from using the Straterra AND Concerta together. in my opinion, you should also come right out and ask if the side effects of the Concerta are making the ODD behaviors worse??? You don't want to go in there and try to tell them they are doing everything wrong, that would not be good, but you should never be afraid to voice your concerns about a medication combo, or if they are on something they shouldn't be, or if you think they need something they aren't getting. There is a difference between trying to do their job for them, and trying to voice your concerns or ideas regarding your child's treatment. After all, you are the one that lives with them everyday and knows how their behavior is. If you truly have a good psychiatrist, they will welcome your concerns and ideas (that doesn't mean they will do whatever you say) but a truly good one will always consider the parent's opinion!!!

    I will keep you and your difficult child in my prayers!!!
  12. Mikey

    Mikey Psycho Gorilla Dad

    Hi. I'm new to the board (soon to post my own story about my difficult child), but I'd say make sure you have the right medications, i.e. check with your doctor. My difficult child son and I both have ADD, and react very badly to most ADD medications. Adderal makes us homicidal - literally. Antidepressants (like WellButrin) make us suicidal. My difficult child literally tried everything, but eventually suffered from the same side effect.

    Fortunately (or unfortunately), difficult child is also a pot smoker and experiments with other drugs. He told me about something he tried called Focalin - which is a form of Ritalin where the part with most of the side effects have been removed. After four years, it turned out to be the only thing he could take that didn't make him any worse than he already was. Never thought I'd see anything "positive" from my son being a drug addict, but I guess you take good stuff when you can, regardless of how it comes to you....

    Alas, he now refuses to take it (ODD as well as ADD). He's 17, big, strong, and defiant (I think the right word might be "oppositional"). However, when he DID take Focalin it worked well without side effects (i.e. he didn't put his fist through walls and act like the second coming of Charles Manson).

    My only point is that the wrong medications can really make things worse, so like the other posters here have said, be sure you're working closely with your doctor and don't be afraid to be pushy. We had push for him to Rx Focalin, and we had to fight our insurance co. to pay for it.

    Not sure this helps, but hope it does. Best wishes and prayers for you from someone who understands.

  13. frustratedbyODD

    frustratedbyODD New Member

    NeedNewTechnique -

    Thanks for the advice - I will take what you said to heart when I go into the doctors tomorrow. However, it is not my child who is on Strattera and Concerta. My son is only on Concerta and Ritalin (for booster).

    I am going to suggest us trying Concerta because I do not think that the Concerta is cutting it...
  14. neednewtechnique

    neednewtechnique New Member

    I apologize, I must have skipped someone's post because I noticed conversation about Straterra and it all got jumbled together!!!! Either way, you are talking about stimulant medication in a behaviorally unstable child (I don't say that to offend anyone, but that is in essence what most of our difficult child's are). And that has a great tendency to make things worse. Again, I hope I wasn't too harsh, I wasn't out to offend anyone, it is just the number one "big thing" that has bugged me since our difficult child was placed in our home. I am pretty sure that this is due to a not so great psychiatrist though, and we have remedied that, so hopefully I will not be as frustrated a few weeks from now...

    I noticed you mention that your son doesn't see a psychiatrist right now for several different reasons, and one of the things that I thought to mention to you is, that if you can convince your regular doctor to listen to your concerns regarding behavior, a lot of times they will monitor the medications for you so you don't have to see someone else. However, if a psychiatrist becomes necessary, you should check with your county's local mental health center. They usually have programs for patients that will help alleviate some of the cost that insurance doesn't cover. I don't know what state you are in, but I know that our state offers medicaid to just about anyone... it is just that if your income is higher, they put you on a "pay plan". For instance, since our difficult child is technically placed in our home by CPS, her Medicaid is free. However, our easy child's are my children and we make too much money to qualify for regular medicaid services, but we still have a medicaid plan. It is set up that we pay 25 dollars per month for the card, we pay a 15 dollar copay at Docs, and medications are 10 dollars for name brand, and 5 dollars for generics. I don't know if all states offer this program, but I have found it to be extremely helpful, and since we have regular insurance too, we only use the medicaid to help get through the deductibles on the regular insurance, plus the percentage that regular insurance doesn't cover. It makes a nice supplement to our "sucky" insurance that sounds a lot like yours. You might check into it and see if your state offers the "pay programs". The nice thing is, that once you hit the income bracket that you start paying, the amounts they give you are still based on your income, but they also take into account your expenses, which is something that most government assistance programs don't do....
  15. TerryJ2

    TerryJ2 Well-Known Member

    Ah, different definitions! :redface:Grounding here means difficult child can't play with-friends outside. Sometimes if he's been grounded too long and needs to exercise, he's grounded to the yard.
    Taking away things he values is is just called, um... taking things away. :crazy2:
    Yeah, our difficult child goes into lala land, too, so we restrict video games. No GameBoy, nothing except Backyard Football or Backyard Basketball using only a mouse, not controllers. I set the microwave timer to go off to time him.
    Good luck with-your difficult child.
    Let us know how the medication check goes tomorrow. :cool:
  16. mattsmum

    mattsmum New Member

    Sorry if I gave the wrong info....the person who prescribes Matthew's medications told me it was a mood stabilizer and that the two medications together were a good combination and not unusual. difficult child does have anger issues/ODD on top of the maybe that is why he is on both-like you said.

    I am still trying to figure it all out....
  17. Marguerite

    Marguerite Active Member

    A few things concern me. You say that the discipline just doesn't seem to be making an impact any more - this should tell you that this discipline method is not working. And if it's not working - then don't do it.

    With discipline, the main aim is to teach the child the right way to behave. There can be a number of problems here -

    1) The child may be incapable of behaving or learning right and wrong, in this area. For example, you may be smacking a newborn baby for having a dirty nappy. Will this work? Not for a few years, at least.

    2) The child may know what is wrong but be unable to stop himself behaving impulsively. In this situation, the discipline can't change the impulsivity, but is it teaching the child what is right and what is wrong. probably. But the child may already know this, and still be unable to comply because on the spur of the moment he can't help himself.

    3) The child may simply not be getting the message that this behaviour is wrong, and that it is this behaviour that is leading to the punishment. Basically, the punishment and crime are not connecting in the child's mind. An example here from difficult child 3 - his school would put him on detention after two infractions written down in the discipline book, over a 6 month period. At that time he was barely capable of hearing and understanding what was said to him, especially if it was in a noisy, crowded environment. He was also impulsive. The detention was not immediate; it began the next convenient Monday.As a result he may have had a period of good behaviour, but the detention would still take place. In his mind he was being punished simply for who he was, since he could not make any other possible connection.

    Another problem can be if you are trying to correct too much at once. If your child is totally undisciplined at meal times, runs and jumps on the furniture, eats with his hands and throws food, then the last thing you should chide him for is talking with his mouth full.
    You should prioritise what behaviours are most urgent to deal with, and only deal with those.

    And a brief word on the subject of medicating ADHD etc - this medication will not necessarily make ODD worse. In fact, if the ODD is linked to the ADHD, medicating the ADHD may improve the ODD problems. It all depends on what works for your child. If you try something and it's a miserable failure, then don't do it again unless you've worked out why it didn't work, and fixed it. Similarly, if you try something and it works in unexpected ways, don't take him off it while you question why, just count your blessings. While it is claimed that ODD can occur with no other co-morbid condition, it is far more often seen hand in hand with other conditions which, when treated, can produce an improvement in the ODD.

    One thing about ODD that seems to stand out - it seems to be a case where discipline methods which may have worked like a charm on other kids in the family, especially strict discipline, can make these kids' behaviours worse, not better. And if a discipline method isn't working, why persist? You go in search of a better technique that may work, instead of using the one which you know does not.

    If you haven't already, look up Ross Greene's "The Explosive Child" and read it. If you want a quick idea of what it's like, there is some good discussion on this book in the Early Childhood forum. It's turned our life around, difficult child 3 has gone from undiagnosed but classic ODD to a pleasant, cooperative but still strong-willed young man. We keep having to work at it but he no longer sees us as the enemy to fight against - instead, he now sees us as his helpers. Changing that mind-set of his was the biggest breakthrough and we did it by changing how we dealt with him and not coming down hard on him all the time. It had turned into a tug-of-war, where each opponent tugs in the opposite direction. But when you begin to slack off YOUR pull, so does your opponent, until neither is pulling (or you're now both pulling in the same direction).
    Example - you are shopping with your wilful toddler. Toddler is on a baby harness with leash. baby sees a puppy and wants to look, but you're in a hurry and want to continue to the grocery store. baby is pulling hard towards the puppy and is about to throw a tantrum. You could:
    a) assert your greater mass and parenthood and insist you go to the store - after all, you are the parent and your will must prevail; or
    b) give way for a short while, let the toddler pat the puppy, show the toddler the right way to approach the puppy, take a few minutes, and THEN it's easier to say, "bye-bye, puppy" and take a now cooperative toddler to the store, while you both talk about the puppy on the way.

    While the second option may make you slightly late for the store, fighting a screaming toddler in the first option won't help your schedule either.

    I know that is simplistic, but sometimes you need to look at everything with your child's behaviour in just such a simplistic way, one piece of the puzzle at a time.

    There is no medication for ODD. There are medications for some possible underlying disorders. There IS behavioural modification options for ODD, as well as other disorders. These techniques also work well on 'normal' kids, so you don't have to have different rules for different members of the family.

    Good luck!