difficult child back in behavioral hospital

Discussion in 'General Parenting' started by earthprowler, Apr 11, 2008.

  1. earthprowler

    earthprowler New Member

    Tuesday difficult child got throwing rocks at cars pulling up to the school and other people, laughing about it and not caring he was caught. he was also caught doing girating movements to other kids which they thought was gross by what the teacher says but he found hilarious.
    After other things he's done in the past week alone (telling his sister he was going to light a pen on fire and stick it in her eye) his p-doctor told me to take him back to the hospital to be evaluated. He didn't want to go and all but destroyed the backseat of the car trying to get away on the way there, ripping up homework the teacher had sent and throwing anything in reach around and screaming at the top of his lungs. Once we got there he settled down like nothing was wrong although i thought i was going to need help getting him out of the car at first.
    Since the beginning of the year when he started the prozac, lithium and focalin his grades have gone down. He still threatens his sister alot of the time. He says he just doesn't like her and she's mean to him, he makes up stories about things she wouldn't do (having a jumping contest on his bed and she kicked him which is why he doesn't like her) to tell why he hates her so.
    The p-doctor has switched his medications again and added one and i'm hoping something will work along with the therapy we'd been going to, something's got to change! I don't understand why he's so violent even with the bipolarism, we try to work with him and explain things so he can understand them that he has to work on NOT doing things that he does (calling the neighbor a fat cow and a pe*** because she won't let him play at he house), hitting other kids; he just doesn't understand why everyone gets mad at him.
    Is it tough love? Do we crack down on him so hard that he breaks and break his spirit? Or is it just a disability that he has trouble controlling? This is the second year in a row that he's acted like this, his history shows the same things over and over from the school. I just don't know what to do right now, any suggestions? Or am i just making excuses for him?
     
  2. susiestar

    susiestar Roll With It

    First of all, welcome. This is a hard situation for your family. Your son is sick. It is NOT something tough love will fix. NO amount of spanking or beating will change this. Many of us have learned that physical discipline like spanking makes our difficult kids worse, NOT better.

    Breaking his spirit will not help. I strongly advice that you remember he is actually more fragile than most children, emotionally.

    Have you read The Bipolar Child by papalous? It is a wonderful resource. We also recommend The Explosive Child by Ross Greene. It is very very helpful, no matter what diagnosis you have.

    You say your child is on prozac, lithium, focalin and another medication? First off, if he is bipolar the moods should be stabilized BEFORE anything else is treated. It is a long road, and a tough one. Prozac is an SSRI antidepressant. It makes many children manic, and tends to make those with bipolar cycle even more rapidly. Lithium is a mood stabilizer. This is going to make the moods more even, and cycle less. This is the "gold standard" of mood stabilizers.

    Focalin is for ADHD. this is another medication that can make those with bipolar worse.

    Many with bipolar say they need time on a mood stabilizer only, or even 2 mood stabilizers and an antipsychotic (risperdal, geodon, trileptal, zyprexa) to make them have stable moods. All of htese medications are serious, and you should read as much as you can on them.

    Another thing that is important is to check to see if seizures can be part of the mix. You need a neurologist to do a sleep deprived EEG. This iwll let htem see how his brain is working, if it is seizing. Seizures can cause many types of behaviors, and many medications can make seizures worse.

    Is it possible to ask the psychiatrist to wean your child off hte prozac and focalin to see if the lithium will work? You can't just stop these medications, and most docs taper them off much faster than many of us find successful. I tend to taper medications off much slower than the doctor says.

    This IS a disability. You MUST work for his rights, and protect him while setting appropriate limits and keeping him from hurting others. It is hard to do.

    Please get your 14yo some counselling. This is going to be hard on her, and on your marriage. It is important to remember that if mom and dad are not happy and stable, then the kids and whole family will suffer. It is easy to focus onlhy on the sick child, but this is really bad for the marriage and family, as well as the individuals who make up the family.

    Sending hugs,

    Susie

    ps. I am NOT a doctor, so my advice is simply advice from a parent. don't change medications with-o talking Occupational Therapist (OT) the doctor. It is also good to make 1 medication change at a time, not a bunch of changes at once. IT can take 6 weeks to see if a medication will work.
     
  3. Wiped Out

    Wiped Out Well-Known Member Staff Member

    Earthprowler,

    I'm sorry he is struggling so much. You must be absolutely exhausted. I remember a time when difficult child was like that-at about that age. The part where he doesn't care if he gets caught sounds so familiar from that time. Mine still struggles but has come to care a bit what others think and does have a bit more control at times.

    Does he have an IEP that deals with his behaviors? Sounds like he certainly needs a BIP.

    I'm sorry he is in the hospital but it sounds like it is where he needs to be. Until he is stabilized he will have a hard time being able to control his actions. I hope the new medication combo works and he is able to be more stable. Gentle hugs to your weary heart.
     
  4. earthprowler

    earthprowler New Member

    thank you for you nice words of wisdom. it is so hard some days, i'd love to crawl inside his head to find out what makes him think the way he does. the impulsivity is the worst one to deal with next to the temper tantrums! last week instead of coming through the door he climbed in through the window and ripped all my curtains down! don't know why.

    i am concerned about all the medications he's on and can see the cycles in slower motion now, he's like a ping pong ball on freeze frame most of the time.......mad, sad, sorry, hateful, laughing, it's such a vicious cycle.

    He does have an IEP and the behavioral dicipline they had working quit working because he stopped caring about gaining anything good, he knows he can do it so he just won't do what they want at all. He has also been evaluated by the school and is a good candidate for ED which will probably start next year with a new school and a fresh start hopefully for him.

    I know they are checking his blood every other day in the hospital to check the medication levels and his p-doctor is trying to crawl inside of him to find out why he's acting the way he does.

    Trust me, i know a whole lot more than i did a year ago when they thought it was just ADHD and i'm trying to do everything i can for him!

    Right now he's already told the hospital therapist that he's being good because he wants to go home, but they want to see him in action. he's just not going to give them what they want because he wants to be at home. he had one kid punch him in the nose and another kick him in the privates (which they were reprimanded for) and he now knows what it feels like to be on the receiving end of what he dishes out to the other kids at school and in the neighborhood but he didn't flinch and controled him self very well and did not hit back because he knew he'd get in trouble.
     
  5. klmno

    klmno Active Member

    Hi, Prowler! I want to respond and send you a link that someone from the board had sent me but I don't have much time right now- finally have difficult child at school and I need to go to work for a while. I will respond more this afternoon. Hang in there- there is hope!!
     
  6. klmno

    klmno Active Member

    I recommend The Explosive Child, at least the concept, and you can tweak it however it works best for you and difficult child.

    Hang in there and remember- there are people here to help with questions, read our vents, and just offer a little humor or shoulder to lean on sometimes. I think you are on the right track and doing everything you can for difficult child- is just might not seem like it right now. Keep us posted.
     
  7. Steely

    Steely Active Member

    I might suggest that while he is at the phosph they do a medication wash of the Prozac and Focalin. Those are 2 medications that only make the mania worse. After they d/c those, they can determine if he would need another mood stab like Depakote - but only after those 2 stimulating medications are removed are you going to have an accurate picture of your sons baseline moods.

    Hugs. Spring is the beginning of the end for my difficult child most every year.
     
  8. smallworld

    smallworld Moderator

    I recommend checking out this link on treatment guidelines for Pediatric Bipolar Disorder:

    http://www.thebalancedmind.org/sites/default/files/treatment_guidelines.pdf

    I agree that Focalin and Prozac could be making your difficult child worse, and mood-stabilizing medications have a hard time working their magic if stimulants and antidepressants are present. A group of child psychiatrists developed the guidelines mentioned above by reviewing medical literature and forming a consensus on the best treatment for children with BiPolar (BP). You might want to share this article (originally published in the Journal of the Academy of Child and Adolescent Psychiatrists) with your difficult child's psychiatric hospital psychiatrist.
     
  9. Sara PA

    Sara PA New Member

    Antidepressants can cause behaviors which are collectively called "hostility" in children and adolescents. Those behaviors include anger, aggression, violence and even homicidal ideation.

    Smallworld has been reminding us that antidepressants can also cause disinhibition which often results in sexual behavior.

    There is no medication you can add that will stop an adverse psychiatric reaction to an antidepressant.
     
  10. susiestar

    susiestar Roll With It

    It is hard to treat behaviors they do not see. I have been there done that.

    With my son they wanted to send him home from the psychiatric hospital and he was a danger to us.

    I thought long and hard about what to do. I then went into the therapy session and triggered him. I pushed every single button he had. I felt horrible doing it. My difficult child was a danger to my younger 2 children. He had honeymooned for 6 weeks at that point. I let the therapist know what I intended to do. She didn't disagree, they were all very frustrated because he clearly had some problems, and he was the only child there with family willing/able to be there every single week for visits and therapy.

    We found out a LOT, it was a hideously rough day, and after that he was his "real" self in the psychiatric hospital. This is NOT magic. I did NOT receive any recommendations to do this from anyone. I was simply at my wits end and terrified he would kill one of us if the psychiatric hospital couldn't help him. I realize you are NOT at that place. But I watned to let you know what I did. It was a HUGE risk, I truly did NOT know how he would react. I owuld NEVER do that normally.

    Susie
     
  11. earthprowler

    earthprowler New Member

    thanks everyone! difficult child got released from the hospital yesterday with new medications. now he takes:
    20 mg Geodon twice daily
    5 mg focalin 3 times a day
    300 mg lithium twice a day

    the Geodon causes really bad stomach aches but they told him that he has to try so i'm hoping its a side effect, i'm giving him a tums for upset stomach now. he's happy to be home and we got him coloring books because he said that calms him down and it keeps him busy for a couple of hours. i also have him on omega 3 dha & epa vitamin gummies.......are those good? hopefully. i'm just trying to do the best i can, guess my lesson here is to learn all i can about ADHD and bipolar and try to become an expert without a degree, i have read that most of the things that happen with the ADHD stems from fear. he has always been afraid, i always asked my husband "how can someone be afraid of everything and not be afraid of anything"?
     
  12. klmno

    klmno Active Member

    Hey! I'm glad he's home now! FWIW- my son always gets stomach problems the first 3-5 days of Lithium increases/changes. One dosage kept him sick for 3 weeks- he never adjusted to it- so we switched to lithobid (the time release version) and this stopped the stomach problems.

    Oh, you'll become an expert- and don't be surprised if you end up learning things that many with the degree don't know. For my difficult child, most things that escalate BiPolar (BP) episodes stem from stress- that probably doesn't apply to all, but just wanted to let you know another thing you might want to watch for (sorry, you probably have a laundry list of things like that right now.)
     
  13. Fran

    Fran Former Site Owner

    It's so difficult to see our kids in the hospital. I'm sure you are very sad that your child can't keep his behavior in check.
    I think the advice about the medication wash is a good one. Maybe starting from scratch is a better alternative.

    As far as broken spirits...... I don't believe any of us warrior mom's have met a difficult child with a broken spirit. Despite any and all treatments. Truthfully, our kids tend to have a surplus of spirit and emotion.

    Our job as parents is to raise a child who will be a functional, tax paying, responsible adult with character who is able to be as independent as possible. Any other positive attributes are gravy.

    I hope difficult child learns self control and is able to handle school but it's obvious that he isn't able to at present. Poor guy. Poor you.
     
  14. earthprowler

    earthprowler New Member

    the last two days have been quietly different. a nurse i know said that's an interesting combination they've put him on and it just might work. he's been pleasently quiet and contently playing, putting together his puzzles we got and coloring. his sister has been gone all weekend and most of his friends were not home so there's been no one to play with.

    yesterday he was complaining of his stomach hurting and last night he was horribly sick. he was afraid to take his medications, we think he had a touch of the flu that's going around, he's better this morning. i think he's excited and nervous about going back to school tomorrow, he doesn't want to be in trouble. we've talked about behavior and what to do if certain things come up, hopefully the teachers will follow through on their end instead of just seeing him as a problem child the way they've been doing. only 6 more weeks of school and he can have a break from all of it! we go back to see the p-doctor next week and will start his play therapy up again this week.
     
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