DD1 is really scaring me I need insights PLEASE

[keista]

Brief background

DD1 was pretty stable on Wellbutrin and paxil. Then she started having depressive episodes once a month, then it was one every two weeks for 6 weeks and then BAM! 2-3 per week. Episodes would last a few hours with crying, feelings of hopelessness, helplessness and thoughts of death. As they got more frequent they got more intense with more talk of actual suicide as opposed to wishing she were dead. She had been out of counseling for a while, so I got her back in, and went to get medications tweaked. psychiatrist suggested removing Wellbutrin and adding Abilify, but if ins wasn't gonna pay (and they didn't) she got risperdal. First 5 days on half dose were fine, but then she had a "creepy" episode. It was essentially her depressed episode, but no crying, no sadness, just matter of factly stating that she was stupid, she should be dead, how she planned to achieve that goal.etal. I wanted to stop the new medications then and there, but we weren't into full dose yet. Turns out full dose made her need at least 13hrs of sleep. Brought her home from school because she was actually snoring at her desk. OK done. In the meantime, I switched her insurance plan to one I knew would pay for Abilify (son is on it and worked great) So she gets Abilify and the Paxil is also upped from 10-20mg The first evening on Abilify she had an episode that scared the living s*** out of me It was very similar to the "creepy" episode but she got aggressive as well. This time she eventually "snapped out of it" and went into depressed, crying, why did I do that? She could not remember everything that happened and said that while it was happening it was as if she were in a trance. It took a while to console her and calm her down. Afterwards she apologized (without prompting) for 'that' behavior and thanked me for being an awesome Mom. So maybe Abilify won't be good for her, but should give it at least a few more days. Next day she flipped from creepy to normal to depressed several times over the course of 2hrs and was normal again by bedtime. (by the way all of these episodes were happening after 6pm including the earlier depressive ones) After that everything seemed to be great. Better than any normal we had experienced before - until tonight. Only two weeks.

Detailed description of the latest type of "episode"
Everything seems fine. Getting dinner plated for the girls and DD1 has her feet on DD2's chair.
DD2: Can you get your feet off the chair?
DD1: no
DD2: Can you get your feet off the chair?
DD1: no
DD2: Mom can you ask her to move her feet?
Me: Sweetie can you please get your feet off the chair?
DD1: no
I didn't even have to turn and look, just form that one word, I heard the change in her voice, flat, monotone, emotionless. I turned to look at her and her eyes are dilated, flat, dead, like dolls eyes (thanks Jaws for a good description) I move around the table to physically move the feet off the chair and then just suggest to DD2 to sit in the other seat.
DD1: **** that means I have to look at her now.
Me: If you moved your feet you wouldn't have to, so now you gotta live with it. So, what do you girls want to drink?
DD2: Tropical juice
DD1: Stupid juice
Me: Huh?
DD1: You heard me, stupid juice
Me: That doesn't help. We haven't designated any liquid in this house as stupid.
DD1: Water
DD2: Why is water stupid?
DD1: Because it's for ppl that are to stupid to pick a flavor
I pour the juice, then just look at her with my mind racing
Me: Sweetie, are you OK? (I know she's not)
DD1: You stupid
There have only been a handful of these episodes so far but I've learned (praying I'm right) that if I can manage to get hugging on her I can get her to "snap out of it" sooner rather than later, so I walk around the table and give her a hug.
Me: Oh sweetie I love you
I start giving her nonstop kisses on the cheek and forehead
DD1: What is that?
Me: Kisses, because I love you
DD1: No you don't, you hate me
I stop the kisses, and am just hugging her and looking into her eyes and face.
DD1: You f*****g stupid
I gently grabbed her face. It was gentle, but definitely a grab
Me: DD1 you know that language is not acceptable
She picks up her fork and fists it as if to stab me with it. After staring right at the fork (it was level with my eyes) for a few seconds, I turned my head behind hers, and hugged harder. She dropped the fork, went almost limp and burst into tears
DD1: Why am I doing this? (through her sobs)

I assured her I loved her, she said it back, and I told her to finish her dinner. She did so with tears in her eyes. Whole thing lasted 5 maybe 10 minutes. When I got her alone, I started asking her about it. Was it the same as last time? Yes. Did she "feel" it coming on this time? No. She didn't want to talk about it. I went into the usual spiel of how I understand it's tough, but the more information we can get from her the better we can help her. So I finally asked a question that it never occurred to me to ask: WHY don't you want to talk about it? "It scares me"

So to nip some questions in the bud:

The girls usually get along FABULOUSLY. Sure, they will have some disagreements, but they are really good friends.
DD1's voice was flat and monotonal the whole time. No indication of any emotions.
I was calm and sweet - you may have thought Florence Henderson had possessed me.
Under normal circumstances (if she were angry) I would have immediately shut her down for her attitude and choice of words. I’m almost not sure which is creepier – her “creepy” episodes or how calmly and patiently I dealt with it.

So, does anybody recognize/identify with this? What is this?
There’s a cynical, distrusting voice in the back of my head suggesting that she’s making this up. Playing me, manipulating me, seeing what she can get away with. But then I remember that it’s not just me. The episode when trying risperdal, she was talking with her brother. I was just observing – she didn’t even know I was there. The extended episode on the first night of Abilify, her brother “babysat” for a few minutes so I could go to the bathroom, fall apart, and collect myself again to see it through. As I relieved him, he was like, “It’s as if she has that multiple personality thing” I assured him she doesn’t but it sure is similar.

Oh, there is some comic relief to this story:

After we were all calm and back to “normal” I had to go next door to fix the neighbor’s computer. She came with me because she wanted to play with the dogs. Yeah, I wasn’t leaving her home alone with son and DD2 at that point anyway. So I’m at the computer, and I didn’t notice her enter the room. In my frustration with the easy child I blurted out, “What the H***?” from behind me, comes this sweet voice, “Ah, Mom, the H word.” (the kids always correct me even on the mild words – if they can’t use them then I shouldn’t either) I just busted out laughing! She didn’t get it. She asked why I was laughing, and I reminded her about dinner. She still didn’t get it. “Remember? You, the F bomb?” “Mom, I have no clue what you’re talking about” I had to start laughing again or I was gonna burst into tears.


Insights, comments, musings are all welcome. I've run the gamut of emotions dealing with all three of my kids, but I've never been this scared.

 

[Hound dog]

Hmmmm.

I think my first question would be.........how long has she been on paxil? There are some people the medication just doesn't work well for over all.

I'd have a call in to psychiatrist over the suicidal thoughts and remarks for sure.

But Nichole did the same sort of things unstable. That girl's mood changed so fast that I couldn't keep up with it. It was like someone was inside her brain flipping a switch on and off. And I have to admit that I also had times when I had a nagging voice wondering if I was being played, but I knew I wasn't. Once we found the right medication combo at the right dose such episodes decreased and eventually stopped. It has been a long time since the last one.

I'm with you though, it's a scary thing to watch happen.

((hugs))

 

[Rainbird]

Does she have an official diagnosis? To me, the way you are describing her actions, it sounds similar to multiple personalities. If it were my child and she was experiencing this degree of pain/mental illness I would be looking at inpatient mental help. Just my two cents. I have Bipolar myself.

 

[susiestar]

Is she sleepy after these episodes? Do you think it is mood cycling that maybe produces this or produces a mixed state - meaning stuck not depressed or manic but sort of both at the same time, often this includes a lot of anger and aggression, at least it has in the few kids I have seen go through this?

My other thought is seizures. Has she ever had an EEG? That is the test of brain function - they put electrical leads onto the scalp and record what is going on to look for abnormal activity. You would need a pediatrician neuro to do this. If you get it done at a hospital, such as through the ER be SURE it is a pediatric ER and they are trained in how to do this with kids. Seizures do not just cause the stereotypical behavior where someone drops to the ground shaking, bites through their tongue, etc... Reality is that seizures can and do produce almost every behavior under the sun. EEGs are the test we have that best shows them, but they only show seizures on the surface of the brain. So about 80% of the time no seizures are caught even though they are happening.

What does her psychiatrist say about these creepy times? Is she dissociating? Atypical antipsychotics like risperdal and abilify can cause sedation, but I don't know that they would cause what you are seeing as a part of sedation. They are supposed to reduce aggression, so her holding the fork in a threatening way is not at all typical.

Paxil is a problematic drug in kids. All ssri/snri drugs are. They made my daughter higher than a kite - she ltierally acted drunk on the starting dose. People with mood disorders can also act this way on them. they can trigger manic episodes that are very hard to stop. Some people grow out of this and are not bipolar, just couldn't tolerate the medication as kids. Others are bipolar and react that way because of that. For many people with bipolar, antidepressants are not medications they can take because they trigger mood cycling.

Are you aware that there is a medication protocol recommended by the board that certifies psychiatrists? It is recommended for patients with bipolar and other mood disorders (those that may have bipolar but they don't want to call it that yet). I have long not understood why so many psychiatrists do not follow this and not one has ever had a good answer for not following the protocol. In fact, 3 psychiatrists either refused to answer or changed the subject. The medication protocol is in the book, The Bipolar Child by Papalous, and is probably also on the bpkids.com website. It calls for first giving mood stabilizers at a therapeutic level - one or even two different ones given at the same time, and an atypical antipsychotic. These are to stabilize moods. Once moods are stable many patients do not have symptoms that need further treatment. For those who do still have symptoms that need help, stimulants (for adhd symptoms) or antidepressants like paxil, welbutrin, etc... for depression are given in very small amounts. If the newer medications trigger cycling of moods then they are backed off, moods are again stabilized and something else is tried.

We have had many adults with bipolar, and parents with kids with the disorder, who swore that lexapro, paxil, or antoher antidepressant was dealing with all the problems. Then eventually they wind up on mood stabilizers instead and are shocked at how much better things are. They tehn realize how the antidepressants, esp ssri/snri medications, were causing problems for them.

One problem with mood stabilizers is that they are SLOW. Plus they often need other tests done to make sure other health problems are not happening (liver function, EKG, etc...), just like atypical antipsychotics do. Mood stabilizers need to be at the therapeutic level for about six weeks before they are fully effective. When your child is having daily or weekly crisis, this is a LOOOOOOOONG time. With many of them you have to slowly titrate up to the therapeutic level and regularly check the level of medications in the blood.

I know many drug co reps tell docs that their medications are faster/better for treating bipolar than mood stabilizers. They often will tell docs almost anything to get the doctor to rx their drug. For years neurontin was marketed to doctors as working as a mood stabilizer in spite of the fact that the company knew that it did NOT work that way. They were eventually taken to court over this. I went to school with quite a few people who became drug co reps and the stories about what they are "authorized" to tell a doctor are horrifying - many times it includes lies and half truths phrased in such a way as to make docs and the public believe they do many things that they do NOT do. It is one reason I went searching for medication protocols for various disorders years ago - I realized that many docs are so rushed for time that they don't have time to really read the literature and drug info, so they believe what they are told in the big print by the drug co and at lunches and seminars by the reps.

Anyway, sorry I got off topic. Have you asked her doctor why she is not on mood stabilizers if she has a mood disorder?

Is it possible for you to set up a camera or use your phone to record how she is when she has a creepy episode? Docs often react better to symptoms they can see and kids don't just pull these behaviors out wehn the doctor is around. I often wished mine would, but the doctor never gets to really see the problems. Then it becomes a matter of how well the doctor listens and if he thinks you are exaggerating or making things up. (I know you are not, but docs do get parents and patients who do, plus they often just don't believe anything they cannot see. It drives me crazy!) So capturing this on video may be crucial to getting her the help she needs.

I don't know of any foods that would cause this. I wondered because you say it happens in the evenings, but it just doesn't seem like that kind of reaction. How many hours past her doses of each medication is it?

You should start a journal where you record her mood, symptoms, what she did taht day, etc.... Include the time that any rages, creepy episodes, etc... happen. This can really help you (and the doctor) find patterns in what is going on.

I am really sorry that you are going through this. From her reaction afterwards, and her fear, I do not think she is pretending. If you haven't called her doctor, that should be done asap. Also, it may be helpful to get her to the ER for evaluation if she is planning to hurt herself or others. Some of this depends on how long the episodes last. If it is an hour or more, try to get her to the ER to be evaluated. If if is shorter, chances are she would be fine when you get there and they would be less than helpful.

 

[BusynMember]

I have, among other things, a bad depressive disorder so I need to be on medications. It's a necessity, trust me, or I would not use them. It took me almost ten years to find medications that didn't cause side effects and worked. Before I'd look for another diagnosis, I'd wean the medications and see if she comes back to earth.

One medication (amitripytlene) gave me auditory and visual hallucinations and I continued to have them for three days AFTER I stopped the medication (I was in the hospital because I needed to be watched coming off of them). I also had physical symptoms such as akathesia and not being able to swallow. It was very frightening. The doctors said that this kind of reaction is similar to being on LSD.

My daughter tried to kill herself after three weeks on 20 mgs. of Prozac, a cousin of Paxil. They can help or harm...we never know which until we see. Maybe she is having a bad reaction to either Paxil or Abilify or both. Call your psychiatrist f irst thing in the morning!


Many hugs, prayers, good thoughts to you!

 

[keista]

Thanks so much everyone! . I had more of her background written out, but it ended up ridiculously LONG so I cut it. In a nutshell:

At 8yo started Prozac. Prozac was no good. Within a month she became more agitaed even though actual depression symptoms had eased. A few upped doses and arguments with psychiatrist later, we changed docs and put her on Zoloft. Side effect of fatigue. She was just too tired to feel or do anything. Switched to Wellbutrin. Moods seemed better, no agitation or 'tantrums' psychiatrist leaving practice so we switch again. Moods/depression seems to be stable for some time but she still gets anxious and continues to respond inappropriately to anxiety triggers - essentially she "freaks out" It's not a tantrum or a rage, but there is screaming, but all just in fear, Like what are you afraid of? Snakes, mice, spiders? That scream you let out when you see one of those, but also more complicated. OK, eg: Leaches are in the water on the shoreline. She's PETRIFIED of leaches. But she wants to be in the water. There are boogie boards she can use to float in the deep water with the big kids. EVERYONE assures her that there are no leaches in the deep water. She goes out on a board and is happy. Boys will be boys, and she gets knocked off her board. Starts screaming bloody murder, 3 dads instantly jump in to save her thinking maybe she got bit by a snake or something. Get her to shore, get her calm, no more water. Lesson learned - NOT Next day she wants to be right back out there. Try talking her out of it, 'casuse she might get knocked off again, yadda, yadda, yadda "No mom, I'm fine. It'll be alright" OK, Mom, gotta 'let go' UHG it all happens again.
Anyway, after these stories, the psychiatrist added Paxil 10mg It was Sept 2010. Worked like a charm! She was less anxious about everything, anxiety with her peers seemed to completely disappear. November she had one depressive episode 2-3 hr duration. She's full on into puberty, so I start tracking to see if it will be a monthly thing possibly indicating menstruation starting soon. Dec one episode, Jan 2 episodes.And now we're caught up to what I wrote above

I've reported all of this to psychiatrist. She did mention that if the depressive episodes get more frequent or severe, we will have to consider inpatient treatment. I CAN deal with that thought, BUT (insert Mom anxiety here) Truly, at the height (Low?) of her depressive episodes, I hold her in my arms to comfort her, and ultimately she pulls herself out of it enough to go to sleep and be fine the next day. So if I "send her away" when she feels the least loved.....oh just seems so counter intuitive. She's never tried to hurt herself, not even really threatened, just wishing and dreaming for now. If it does come down to real crisis, I will admit her. Unfortunately, the children's psychiatric hospital is almost an hour away, so going there during an episode probably won't work, and also ads to the mom anxiety of admitting her "too soon"

Susiestar, No, I did not know there was a protocol. All the research I've done only yields 2 medications FDA approved for kids for depression, and just a handful more for BiPolar (BP) and anxiety. Also I thought Abilify WAS a mood stabilizer. That's what my psychiatrist calls it. Since I have the "good" insurance plan for her now including a registered nurse as her caseworker, I will be exploring more doctors and evaluations and options.

I have the battery for my camera charging right now. Haven't used it since I first tried it out since it didn't come with editing software, and then what's the point, but for these purposes, i don't need to edit anything.

MWM, sorry about your daughter. Mine was on Prozac too many months too long. The psychiatrist at the time kept dismissing all her NEW symptoms as ODD, and my parenting needed to be tweaked, and maybe I should come to his workshops, by the way there's a $50 registration fee for each one. Ironic thing is that I have in the past considered that she was ODD - just not so sever a degree as the stories I read online. But I also knew that I hadn't considered it as a diagnosis for her for a whole year before she started on the Prozac.

Rainbird Yeah, it does almost sound like multiple personality, but I'm 99.9% sure it is not. If it turns out to be, it would certainly be one for the record books since she hasn't had any kind of serious trauma to trigger it. I've learned never to say never, though.

Hound dog Thanks for the support. While reading your post I started thinking about what I had written of the day DD1 kept "flipping" around. I also realized that that day, she and I kept walking around, and as always when we're walking, my arm goes around her, then drops away to do stuff, then the arm is around her again. If I'm right about those hugs "getting her out", then it's feasible that I was actually flipping her switch that day. Hmmmmm

by the way, yes I'm always hugging on my girls (would also be on my son but he hasn't let me since he was 5 - ah an Aspie) I grew up hug deprived. I'm convinced that's at least part of what made me promiscuous in my teens and early twenties - I was DESPERATE for human contact, so if that's something I can try to "nip in the bud" I will.

 

[ski10]

I have, among other things, a bad depressive disorder so I need to be on medications. It's a necessity, trust me, or I would not use them. It took me almost ten years to find medications that didn't cause side effects and worked.

(((Before I'd look for another diagnosis, I'd wean the medications and see if she comes back to earth. ))))

One medication (amitripytlene) gave me auditory and visual hallucinations and I continued to have them for three days AFTER I stopped the medication (I was in the hospital because I needed to be watched coming off of them). I also had physical symptoms such as akathesia and not being able to swallow. It was very frightening. The doctors said that this kind of reaction is similar to being on LSD.

QUOTE]

I agree with the above.

I was diagnosed with a severe depressive disorder, (one diagnosis was bi-polar but then they changed their minds...? because I seemed to more down than "up") I need to take AD's or I would not be here, that's the truth, I have to take them, tried so many medications and Prozac sent me suicidal, another, can't remember the name of it had me almost comatose, I could hardly keep my eyes open and felt nothing.

I'd change from feeling almost normal, whatever that is, to a few hours later in a severe depression, then later in the day back up a little again, this would go on and on.

 

[Steely]

I would put her inpatient, the next time she has an episode, take her to phosph, ASAP.
Then have the phosph do a medwash and go from there on what medications they recommend.

She was on TWO SSRIs when some of this happened, which it A LOT for a child. That can cause all sorts of crazy behavior. Wellbutrin is known to cause anxiety and agitation, not a first choice for our types of kids. And Paxil is known to cause inhibition. If she has mood instability than in my opinion she should be on a mood stab.

Abilify is an anti-psychotic, and it can help in mood stab, however, it differs for each person. Abilify made my son over the top crazy, manic..........so you have to trial these medications in the liberty of an environment that is secure, thus inpatient. In addition while inpatient they can get her an EEG, schedule a NeuroPscyh, and other things to try and diagnosis and figure out what is going on.

Sounds scary, I know - but it will be OK. It sounds like she is having severe mood swings. Matt has these. Sometimes, when I ask Matt if he remembered what he said, he says that he doesn't remember, yet he does. He just didn't feel like himself when having them, therefore he felt out of body. He still talks about feeling this way.

by the way, your profile doesn't say how old she is???

Get some intensive medical help asap - hugs.

 

[seriously]

rule out seizure disorder would be at the top of my list I think. That fast a transition suggests to me it should be at least considered.

 

[keista]

Tomorrow I get to do the insurance intake interview. This will also enable me to get more information on evaluations (yes, I will be asking for neuropsychologist evaluation) and changes it treatment and psychiatric hospital options (if we can go out of county, etc) So, YAY!

One of my big frustrations is that she does not seem "textbook" on anything - at least not anything I'm coming across. It reminds me of when I was first told, in not so many words, that there was something wrong with my son. I researched every keyword on his IEP and lots of things kinda fit, but it just didn't seem right. It took another year and a half, a verbal mention by a psychiatrist that he was on the border of Autism (that had never been documented for some reason - might be in the files they NEVER let parents see where they say how the parents a nutty too lol), a different state and two different schools, for Aspergers to emerge - perfect fit! So needless to say when I'm researching for DD1 I go exploring on every possible tangent I can and I'm just not finding her fit.

So, I watched her with new eyes tonight, while praying "creepy" didn't show up.
After school today, she:
Went for a bike ride
Came with me on 3 quick errands including the library and she got two books (wanted 3, but the more she gets the less she actually reads)
Went for another bike ride to find friends
Didn't find friends, went next door to play with dogs
Wanted to go shopping for fabric, I found her some fabric here, she started on two pillow patterns
Asked if she could have early dinner (she'll make it herself)
Played with her Ice cream making kit - toy kit uses bags and ice, not a machine
Asked if I'd teach her to use the sewing machine 100 times (I told her tomorrow, since I'm still sick and exhausted from just doing the necessary stuff)
Painted with gel paints
Convinced her sister to finally try carrots and they ate them for "dessert" like chips in front of the TV for 10 minutes
Asked her brother to cnvince me to teach her to use the sewing machine
Decided brother should get the machine out of storage for her and she could find instructions on internet.
Harassed brother about her idea for 15 minutes.
Asked me to give her something to do (this used to be the standard with her, and no matter how many suggestions I made, they were ALL boring. When I would physically direct her to a task that she seemed excited/interested in, her interest would only last 5 minutes. This was LONG before she started on any medications. So now my standard reply is to suggest one chore, and one fun activity and I'm done suggesting)
played on computer
Asked me to give her something to do
Crocheted for 5 mins
FINALLY it was bedtime.
She took her melatonin, brushed her teeth, washed up, and said goodnight.
10 minutes later, she came out telling me she didn't want to go to bed because she still had a lot of things to do. Of course, I told her she could have done them when when she was asking me to tell her what to do. She fell to the floor and started to weep - depressive episode here we are.

So, I've never seen her exactly like this. It was more often just the boredom stuff like explained above. Is this mania/hypomania? My gut is saying YES! Again, I've NEVER seen her like this before - similar but not quite.

So the next frustration is deciphering everything. the medications could be causing this, but not necessarily because she's behaved similarly in the past, but she's growing and changing, so this could be something 'emerging' that was more subtle in the past. Same with "creepy". That started showing it's face while she was on medications she had been on for 8 months. Continued to show it's face through medication changes, and showed again after being "stable" on a regimen for 2 wks. Or it could be all due to medications. UHG I am so in information overload.

Steely Medwash sounds very appealing right about now. I have to get more info on phosps. She's only 10, and the only one I know of around here (45 mins away) is usually filled with teens on involuntary commitments - that increases the mom anxiety factor when she's not in imminent or even "I think she just may do something this time" danger. by the way thanks for asking her age - I've now added that.

 

[TerryJ2]

Goodness, I have no suggestions other than the medications she's on are not working.
Fingers crossed for all of you!

 

[Hound dog]

Hmmm.

You're gong to have to forgive me, but I don't have enough background to go on. You may have posted it, but I missed it.

Was difficult children behavior anything like this before she was put on medications? (thinking the last two posts here, doesn't have to be exactly the same but similar?)

If not could you give me a short example? Because medications can be masking some behaviors and triggering others.

Did she even have a complete evaluation done for ADD? The behavior in the last post reminds me more of ADD than mania........of course it could still be mania.....but that is what popped into my head as I read it. I was diagnosed ADD/ADHD as a child......and spent most of my childhood like that 2nd post. Good days and bad days of course, but still. lol

And I'm looking at her dxes........Generalized Anxiety Disorder (GAD), Obsessive Compulsive Disorder (OCD), Hoarder........and can hop around from activity to activity......and a sibling who is on the autism spectrum. I'm not saying she's autistic.......but I am saying if I were her parent I'd want her to be evaled to see if she is. Autism is a spectrum disorder, it's possible she could be higher up or lower down on that spectrum. Not all autistic kids are the same or display all the traits. Travis does well with adults and very young children, anything other than that and he flounders terribly. (adults are more understanding and very young children don't notice he has social issues) Yet because he does well with adults.....it made getting his diagnosis tricky until we found someone who specialized in autistic spectrum and tourettes.

If her diagnosis is not correct, and she wouldn't be the first child who has been diagnosed wrong, the medications are not going to work properly and it would make sense that you're seeing new disturbing behavior.

Getting a neuropsychologist evaluation is probably the best thing you can do. in my opinion it would be even better if it could be done when she's had a medication wash (preferably in hospital) so medications aren't masking behavior or causing behavior that without them wouldn't be present.

At 10 I understand your worry over the psychiatric hospital. The one Nichole was in was set up great. The children were separated by age groups, and teens were off in their own unit. I would call and ask how the set up is for the different age groups ect.

Hugs

 

[TerryJ2]

I would call and ask how the set up is for the different age groups ect.

I agree.

 

[susiestar]

It is hard to send your child to a hospital, esp a psychiatric one where you cannot be with the child all day. Surprisingly to us moms, our kids usually do quite well there - even if they cry and scream and beg us not to leave them. Many kids actually prefer the structure of the psychiatric hospital, odd as that sounds. I would definitely call and ask how the different age groups are handled.

The suddenness of her episodes are what made me think of seizures. I would definitely want to have them ruled out.

If you do not have a copy of The Bipolar Child, it is a resource that you NEED, in my opinion. Parts are very technical, but not all of it. It has a whole lot of excellent info that can help the whole family. I found it invaluable because it helped me rule out bipolar for my child. Many tdocs, psychiatrists, teachers and others wanted to give him a bipolar diagnosis and it jsut does NOT fit him. When I had the book and would go through the list of symptoms with them, they were all able to see this with-o me pointing out specific things for each of the diagnostic criteria. I just asked if that seemed to fit him for each one. A couple of psychiatrists tried to insist, but they did NOT want to follow the protocol for medications so they stopped bringing it up. This was after we were sure he did not have that disorder. they each wanted to create their own special medication regime to treat bipolar and I found out later that the psychiatrists who did this were all writing papers on how to treat bipolar in kids and wanted to be able to say that they had a practice that specialized in kids with bipolar. But they wanted to achieve this by giving every child that diagnosis, whic is NOT the way to do it with MY kids.

I do think that having your daughter evaluated for autistic spectrum disorders is a good thing. Girls are esp hard to diagnosis because they do NOT show the disorders in the "typical" ways. Girls are more aware of social behavior and they are often inclined to mimic what others are doing even if they don't know why. Sensory issues are also something to have evaluated - treatment for this can be super helpful in helping a child learn to handle anxiety and life in general.

 

[seriously]

That sounds like Bipolar Mania with ADHD thrown in to spice things up. But it could just be mania. Or neither one - not a doctor and she absolutely needs a doctor.

But it sounds similar to what we see here at times. If that's what it is, then it sounds like she has the kind of sudden drop into depression that difficult child 2 gets as part of the mood swing. It is profound but usually brief - lasts at most 2 or 3 hours and then he usually falls asleep and wakes up relatively OK. Often insists that none of the things he did just before the drop happened - it's as if they've been wiped from his memory. Swoop up, switch from flight of ideas (rapidly switching between activities/focus) to extreme irritability to raging with threats to others, defiance, fixation on a goal that puts him in direct conflict with everyone else, may peak with actual attempts to injure others or himself or damage property and then wham - sobbing, life is not worth living, I am a terrible person...

If that's what you're seeing then I think it's bipolar or drug-induced bipolar. Could be other issues layered on top which makes it really hard to diagnosis. Most complex cases take years of observation and various treatment attempts to sort out all the strands and find what works. That includes pretty much all our difficult child's. It's nobody's fault it's just the way it is.

You are going to have to be patient, keep good records if you can of what medications are tried and what changes are seen, who's given what diagnosis and why. And then focus on figuring out what triggers her, how to reduce the triggers and how to help her recover.

However, regardless of the diagnosis, the behavior has to be managed appropriately. And I have some strong opinions on that subject. Take them FWIW and use what works for you, toss the rest.

I didn't have time to give much input last time but I have to tell you that I do not think you should stare her in the eye or give her lots of kisses in the face etc. if she's threatening you with a fork or other sharp object.

When he's combative, angry and agitated (mania + depressed mood = mixed mood) difficult child 2 can be very dangerous and we handle him with kid gloves. If he crosses the line and we feel he or others are no longer safe then we have hospitalized him or called the police for help. His first hospitalization was at age 10 after he tried to use a wrought iron curtain rod to beat me. His twin sister was here and saw it all. If you had asked me if my son would ever tear the drapes down in his room, take out the heavy curtain rod and try to attack me with it - I would have told you NO.

You owe it to your daughter, your family and yourself to take her threatening behavior at face value and take action.

If she actually hurts you - if she'd used the fork - she could have blinded or seriously injured you. What then? She would have to live with that the rest of her long life. Do you want to burden a 10 year old with that grief and guilt?

Your other child would have witnessed her sister attack and seriously injure you. Do you think her relationship with her sister would survive that?

And you would be unable to take care of her while she endured the aftermath of that assault, live in fear of her along with the tremendous consequences of the physical injury.

I know she would never hurt you in a million years - when she's in her right mind. But she is NOT in her right mind when she is like that and it is really dangerous not to take that seriously.

If she is having that level of agitation and oddity of behavior she needs to be hospitalized in my humble opinion. Take it FWIW but when she is in that much distress, I think she needs the kind of help she can (hopefully) get at a psychiatric hospital and can't get at home, no matter how much you love her and try to help her.

And she is in distress.

She may not realize everything she's doing but she knows enough to be frightened and to know that you cannot stop it from happening. If you put yourself in her shoes, would you want people to stand by and let you act that way - including threatening people you love with forks - and do nothing but offer you kisses? Kisses are very important - don't get me wrong. But they are not enough and will not make this go away.

I am so very sorry that you and she are going through this. It is terrifying. I hope you find answers and that things get better quickly.

Peace

 

[keista]

Thanks again for insights.

I understand the concern and the possibility that DD1 has an Autism Spectrum Disorders (ASD), but she is soooooo NOT on the AS. DD2 and I are closer to the AS than DD1. However, 2 psychiatrists also suggested it, mostly because she never warmed up to them, and in her stranger anxiety state, she def looks like she might be on the AS. She was screened and evaluated for Autism Spectrum Disorders (ASD) when we did her (supposedly) full psychiatric evaluation. Nope. She was also screened and tested for ADD/ADHD, and got a negatory there as well.

I also was thinking that yesterdays activities seemed very ADHD like, but again, that wasn't a normal state for her. Today she's done quite a few things, but certainly not as active as yesterday. Might be dubbing it her "ADHD episode" LOL Difficult yes, but more preferable to the "creepy episodes"

Started thinking about what Hound dog said about comparing symptoms/behaviors. Her next therapist session will actually be for me, to discuss her whole symptom progression. Just by really thinking about it, I came to realize that her symptoms/behaviors haven't really "changed" per se. Differences in the way they present and intensity and frequency, sure. Planning to plot it all out on a spreadsheet.

Researched phosps and it so does not look good. The one in this county has 16 beds and is mostly for involuntary commits. It's called the Baker Act here, and it doesn't take much at all to get anyone "Baker Acted" My son was Baker Acted at the beginning of middle school. The exact words that got him there were, "I have two choices, either be in jail or six feet under" It was said in a conversational tone, but to the school resource officer (regular cop).Anyway, the other psychiatric hospital is the next county over, same distance from my house, but has two Yellow Pages reviews and they aren't good. Investigations of violent/inappropriate behavior by staff members. But the new "good" insurance would probably stay in county anyway.

So, this new "good" insurance isn't as good as I thought it was, but still better than the old plan. Covers Abilify without batting an eyelash, no copays, easy referrals. Might not be as easy to get the neuropsychologist evaluation as I thought it would be, but also probably not as tough as with other plans.

Ah the sensory issue I always forget about. Loud noises bug her - especially crowds - lots of different loud nises converging into one. My dilemma here is what do I check first, sensory or auditory. Son has the same thing. Their hearing is REALLY good, so is it just good hearing or something more? Neither have had any ear infections that caused pain or required medication - don't know if it's relevant or related. This issue is always on the back burner because we manage to manage the obvious effects easily enough, but I guess there could be effects and issues in the not so obvious settings. Any thoughts on which to explore first would be appreciated.

Did some research on seizures. Had pretty good background knowledge since my GM had both petit and gran mal seizures. Never heard of partial brain seizures until yesterday, but again, it just kinda fit - not "textbook" - so will explore that avenue as well.

******* WTH was that???????????***************

So I've been composing this for about 2 hrs. taking breaks to smoke, hang with the kids, play a game, etc. Got up to get the girls ready for bed at 7:50 they took their melatonin (yea, should add that in my signature) DD2 is hugging on me, playing a few silly talking games, we play the last one and I send her off to brush and wash up. Less than 5 mins later she's back in the kitchen, only it's not her, it's "creepy". "it" tells me it will sit there waiting for death, so I put myself between her and the knife drawers. So I start hugging and tickling, and making light of the situation - trying to banish "creepy". In the midst of the tickling, she cracked a smile, and I could SWEAR that her pupils constricted back to normal, but then her her face got tense again and the pupils dilated, and it was "creepy" So, maybe I didn't see the pupil thing and she really is playing me????????????She goes outside to sit in the middle of the road. OH DEAR LORD! I had to do it, risked 10 seconds to run in to get the camera. By the time I got back, she was back in the driveway crying. Yay! NOT! When she sees me she starts yelling through her tears for me to get away and why would anyone want to live with a monster like her? I keep approaching her and she walks to the street, turns and keeps on walking. I start recording with her periodically turning around saying she's a monster, I assure her I love her no matter what, repeat repeat repeat. She turned the corner and when turned around again, she asked if I was recording this? I told her yes, and she started to run. Just a few yards to get some more distance between us. So now I'm thinking I have to figure out how to call the cops. The good thought was that she already took the melatonin and will be getting very tired, very soon. So I'm hoping a neighbor is out and about, or someone has visible lights on inside so I can knock real fast and have them call for me, when she turns around and sits down. She's back! I sit down with her and she turns to let me cradle her.

So we talk a few minutes. i assure her that we will do everyhting we can to figure this out and get the help she needs. She asked why I filmed her and I tell her it's do the doctors can see better what I'm talking about. She apologizes, and thanks me for following her. Then we starte getting up and she asks why I was crying - I lover her and I'm scared too, and I just want to keep her safe.

On the walk home she tells me she stopped because she realized that she didn't know where she was going and she didn't know where she would sleep or what she would eat. As we approached our house she asked if I would PLEASE post the video on FaceBook. (WTH??) Why? So her family could see it. Told her I would never post it to FB because that's not just family. Then she asked if I would email it to them. WHY? Maybe they will have some ideas of how to help.

"Normal" DD1 knows what she should do, how she should act, and how she should respond to zillions of situations. For that, therapy is useless for her and that's why she was out of it for a year. I'm hoping this latest therapist can get her cracked open about these episodes. I'm currently on a waiting list for in home therapy - hoping someone else can see this with me.

So we get inside, and she wants to sleep on the couch and I let her. I'm thinking it's
8:45 or later. Nope. It was 8:24 when I sat down to this computer. She was asleep by 8:35 The whole ordeal from start to finish was about 30 min.

I'm so tired.

 

[keista]

Hound Dog, thanks for your comparative story and wake up call. Only read your post after completing my latest.

The fork thing was in no way a starting contest. As soon as the danger registered in my brain, was when I turned my head. The danger did register, but never the thoughts and consequences you continued to post - 10Q for letting me see through your experienced eyes.

 

[TerryJ2]

Wow. Tired is an understatement. Get some sleep!

 

[Hound dog]

Wow. I'm glad you were able to catch at least some of the odd behavior on tape.

And you said she has no memory of what she's said and done during what you term "creepy" episodes?

As far as those episodes are concerned.......I'm talking the real far out ones that are scaring you.........I'm thinking you need to look into seizure activity. Now I'm going to tell you why. Back when Travis was about 13 (this is what brought me to the board in desperation) his behavior suddenly became very strange.....and yes, creepy. All his life he's had the autistic behaviors, the tourettes thing, and his other issues, and while he was a difficult child........this was totally different. Out of the blue he began to "zone out" and would literally walk into walls, repeatedly, like a wind up toy that goes to a wall and gets hung up. Other times he'd be walking and suddenly land on his face. Then there were the really scary creep you out times when he'd get up in your face, eyes glazed over, expressionless / vacant.....saying off the wall things that made no sense to what had been going on.......worse was when he did it and would grab me by the arms. Now if you'd ever been latched on to by a brain damaged person......well they often have unusual strength.....and he really has it. He'd not let go until I'd see the light come back into his eyes. There were many other odd creepy behaviors.

Now my posts I'm sure were as freaked out and desperate as yours, understandably so. Well, some wise person here suggested I call his neurologist and inform them of the behavior and have him seen. (he'd been diagnosed with absence seizures the year before....although had had them all his life) I don't recall who it was now, it's been too many years. But I took their advice, thinking what the heck did I have to lose, while also thinking the doctor was going to tell me I was asking the wrong doctor. lol But neuro saw him right away. We did a medication dose change of his carbatrol. And be darned if all those creepy behaviors didn't vanish. He was having atypical seizures or temperal lobe seizures and they were displaying as the "creepy" behavior. And poor Travis.......didn't remember any of it and it scared him.

Now up until coming to the board I knew all about petit mal and grand mal seizures. But turns out they don't teach much on atypical seizures in nursing school. I had never heard of absence seizures until he was diagnosed with them, either. But due to the absence ones.....it made it easier to accept and sort of understand the other types.

Again, I'm not saying your daughter is having seizures. I'm saying it is a possibility. When a child is having such disturbing behavior it's always important to look at all possible causes. The whole not remembering the episodes sent up the flag for possible seizure.

Since ADD/ADHD and AS have been ruled out, you know to look in another direction. Which is why I asked if they'd looked at those already.

Until you can get in to see a doctor, be it the neuropsychologist, neurologist, whom ever, I'd start keeping (if you're not already) a detailed journal of her daily behavior. I'd also write up behaviors you've seen at different stages as she's progressed through childhood. Sort of gives the doctor a background to work from. You should've seen the ones I'd hand over to neuro's and such. lol But Travis was complicated from the get go and it was just too much information to sit and talk to them about during a visit. Much easier to write in a report style and let them browse through it or sit and read it then ask me specific questions. I even offered to bring in videos......as his behavior was often caught on tape even when we weren't trying.

I wish you luck in helping her with this. It was a horrific and scary time for me with Travis, and I can imagine it is for you too. She's a lucky little girl to have such a great warrior mom.

Hugs

 

[keista]

yay. We actually got through without a serious episode today.

I was on eggshells all evening, and then I realized bed time was an hour later on weekends! UHG. At 9, it seemed like creepy was trying to creep out. DD1 was getting a bit oppositional about her bed time - she RARELY does that, but it seemed like it was half her and half 'creepy', or maybe even switching back and forth really fast? or maybe "playing" me? Anyway, I chose not to pick that battle, and even though she was shooting for 10, she crashed a 9:30 WITHOUT
melatonin. Might try cutting that out since I've read it can cause/exacerbate mental health issues during the day. She had started it in the first place because even though original medications were helping with depression symptoms during the day, she'd still have intrusive and obsessive thoughts once her head hit the pillow. It would take her hours to fall asleep no matter what time she went to bed.

Hound dog, it's not like she doesn't remember anything at all. It kind of like remembering a dream. Fuzzy around the edges. Your story sounds a lot more like the partial brain seizures I read about. Again, DD1 kinda fits the description, but not quite. She's coherent and "logical", and gross motor looks perfectly fine. However, tone and timbre of her voice change, speech and language pattern changes from her norm, and of course the eye thing. I will be exploring the possibility of seizures as well as anything else I can think of.

Got an "emergency" appointment with her psychiatrist on Monday. Talked to nurse about emergency psychiatric hospital protocol. I was distressed to find out that if I do have to get her down there this weekend, they won't even contact her psychiatrist until discharge. WTH????? Really????? On the bright side, It's all the same organization so they should have access to her files - I hope. Unless included in the files are several notations saying "by the way Mom's crazy as a loon!"