difficult child had his psychiatrist appointment and has a diagnosis - finally

[SuZir]

I'm sitting here totally dumbstruck. difficult child just called and told about his appointment with psychiatrist this morning. After all these years of psychiatrists, neurologists, neuropsychs, psychologists etc. and hearing how he has traits and symptoms of this and that but not enough or severe enough or not impairing his functioning enough for a diagnosis, he finally got one now. Certainly not the one that would explain all his problems, more like something that has developed partly because he does have problems. And to be honest, rather devastating and guilt producing for me (I think I can already warn you that I will likely be whining and wallowing in guilt a lot over this here in future.) But still, it is a name for some of his problems.

psychiatrist had evaluations which the psychologist/mental coach my son works with had done, neurologists opinion from earlier spring and of course he talked with difficult child. She thinks that while not very severe case, difficult child does have a PTSD, mostly resulted of being severely bullied most of his life in school. She recommends therapy as a primary treatment. Medication can be considered but right now it seems that may not be needed (and difficult child is against it anyway, he is concerned of side effects.) difficult child was given further appointments with psychiatric nurse and later with the psychiatrist to discuss and consider his treatment options. difficult child is not sure if he wants to have intensive therapy or not. He promised me to be open to all options and really discuss a matter during these appointments but I'm not sure if he is ready for it now.

Funding will also be a question if difficult child decides to go with intensive therapy option. Supportive therapy will be available very cheaply for him but intensive therapy is more tricky. We have rather similar health care system as for example Canada. There is a public side and private side. Everything very serious is treated in public side and for that, it works well. Co-pays for patients are very affordable and if you are low income, you get social security for them. With less serious things you often have to wait or be inconvenienced for public treatment and that is where private side comes to play. If your kid for example start to have symptoms of ear infection in Friday night, your options are to go ER and wait till they have time to treat it (and of course all the more serious issues go first so you may end up sitting there for hours) or have an appointment to private doctor that night or for Saturday morning. To get a timed appointment to public side you would have to wait till Monday morning in most places. Or if that same kid has ear infections often and doctor suggests tubes, you will often have to wait for example three months to get them in public hospital and in private side you can get them in week or two. So many parents do take an insurance to cover also private care for their kid to avoid waiting and inconvenience. Because it is mostly for those minor stuff, they are not expensive, usually less than 300 dollars a year. When they came to market, there was very little limitations on them but now the new ones often don't cover therapies etc. Luckily difficult child has one of the old ones with very few limitations and we have kept it even when he grew out of children stuff. So it may cover also intensive therapy but it is little iffy and depends totally from insurance company doctors opinions. For public funding for intensive therapy you either have to have your ability to work or study to be in danger and therapy should be able to restore it and you get a funding from source that funds rehab, or you has to be really sick and funding comes from different source. difficult child is certainly not sick enough to get a funding from latter source, but it is also a question if his function is endangered enough for rehab funding. These appointments that are now lined up for him are also requisite for rehab funding so at least they put the process in movement if he does to go for therapy route. But it will be a question if difficult child situation is serious enough to get him those public funds either. He is after all functioning well right now, but psychiatrist had said him that if she plays up the addiction and behavioural issues side of difficult child's problems it may be enough. But that will be seen.

If those funding options fail, it is possible that difficult child's team may help at least on some of it, but we don't have any guarantee or clear cut promise to do so. Just some vague talk about making it work out somehow. We did discuss about this with husband already before difficult child had his psychiatrist appointment and decided that we would pick up the bill, if it comes to that and if difficult child really wants it, but it will be expensive and I'm not looking forward to that.

Sorry that I'm rambling but I really have my feelings and thoughts all over the place over this.

 

[dashcat]

It's a start, and a long time coming. I can relate to your feelings about this. Finally having a name for this must be a huge relief, yet there are still so many quesitons ahead. One day at a time. Hang in there.
Dash

 

[Hound dog]

I can understand how you're feeling right now. We worked so very hard getting Travis diagnosed properly, but when those dxes suddenly came pouring in.....it knocked me off my feet temporarily.

Then I realized, he's the same kid, with the same issues, those issues just now have a name. And it's the same way for your son. He still has his issues, but they now have at least one name....and now he can get help for that part and maybe it will lead to help for other areas. So it is a good thing, a very good thing.

As far as Mom Guilt, we all get/have it on some level until we manage to work through it. It's normal. Life happens and we all just do the best we can with what we know at the time.

(((hugs)))

 

[buddy]

I agree, it can knock you off your feet to actually hear the name. You have said that you think he has problems from that before and you were hearing more about the bullying now...but there is NO WAY you could have known how awful it was. It is not your fault. And, I'm no PTSD expert, but I suspect you are right, it doesn't account for all of it, maybe there is an impulsive or executive functioning thing going on too? One bright side is there are more treatments for this now and some that are very good. Some here have had their difficult child's go through some of the treatments and I think I've heard some of the parents say they have too.

In his situation, if he can get appropriate treatment and maybe some social skills support as he is now (he has learned some inappropriate coping skills and needs help to learn better still, and he does seem to respond to very direct teaching and methods because he is motivated).... he might not need them. The trial and error thing with medications is tough anyway, and given his addictive personality it might not be a good idea to try, even beyond the side effects that could affect his sport. But if it comes to quality of life, or any kind of life, at some point he may need to try something. As long as he is making progress though, it actually seems reasonable to try therapy first, just MHO of course.

Big caring hug for you, and please be kind to yourself. I do have lots of regrets about things like stopping a certain therapy or not pushing hard enough to know what was going on in school etc. But we do what we do with what we know at those moments. My heart breaks for him. (Q just told me in the last month that he is gonna act like a bully since that is what they all did to him, I knew one boy was rough on him but had no idea and now that he is gone from that school, the stories are coming out....SOOO frustrating). Of course I wish I had investigated that and could have protected him. But I didn't know. He was supposed to have had adults around him at all times. yet.............. it was nothing so severe as what your difficult child has said happened. So I can only imagine. you are a very caring and supportive mom, CLEARLY! He is likely doing as well as he is because of the support from his family through some terrible situations. None of us are mind readers nor perfect. But no doubts, you are a wonderful mom.

 

[InsaneCdn]

When layers of problems get added to the picture, sometimes we have to work backwards and peel off the layers. Sounds like PTSD is the "top" layer, and if that can be dealt with, the other issues may come into focus so they can be dealt with later.

 

[SuZir]

Hound dog: I do try to keep in mind he is indeed the same kid, he has always been and I did remind also himself about that. He did call me again later and confessed that he had not told about psychiatrist appointment to his girlfriend beforehand and he was nervous telling her this. They have special event this coming weekend and I advised him to consider waiting over the weekend before telling about it. Reminded him that girlfriend knows him already, has seen some symptoms, having a name to that doesn't change him and girlfriend is likely to understand that. But that it could be smart to tell girlfriend that PTSD is usually not quite as dramatic in reality than in TV and share reading material psychiatrist gave him with girlfriend. And that he should expect girlfriend to be angry and hurt for him keeping things from her, not because he is now having this label.

buddy: I checked local recommendations for treatment of PTSD and in them the therapy seems to be the first line treatment and medications are added, if needed. They may be needed in some point also with difficult child but I too feel it may not be now. He is not depressed so he doesn't need medications for that and his anxiety is not bad enough/frequent enough to really need medications. And difficult child doesn't want to try anything now. I can understand that. There has been a lot of media attention locally about how SSRIs are currently over-prescribed and doctors don't take side effects seriously enough. Most attention has been given to weight gain and sexual dysfunctions in these discussions. To be honest I think the side effects difficult child is dreading are the sexual ones. He did talk something vague about dizziness etc. and then about 'the other side effects.' I could bet he was meaning the sexual dysfunctions and I can totally see why. He is a young guy who just moved to live together with girlfriend, I think it is perfectly normal he doesn't want anything messing his libido or to have any other adverse sexual effects from medications. And if he is not really needing them right now...

For me guilt is something I probably need to get a handle first. While I did try my best with difficult child, my best wasn't always good enough and he pays the price. Of course perfect parents don't exist and my best was the best I could do and difficult child certainly is not perfect son himself so we just have to deal with it. I do have an inkling that there may be a time when difficult child will need to pour all this onto me and I would like to be in place there I could take it without becoming defensive or desperate and instead be strong for him. Now he is being very careful not to make me feel guilty. When he told what had happened to him he several times told how he hadn't told us, how we could not had done anything to prevent it etc. That was very nice of him, he can indeed be very sweet boy at times.

Overall I have been very impressed with his attitude lately. He really is motivated and wants to work out his issues. He really tries. And he has mostly been very mature. I'm very proud of him. And think his attitude is a huge thing. With his stubbornness and intensity there is no stopping him, when he really puts his mind onto something. I do hope that principle works also in this.

It's not only me who feels guilt ridden right now in our house. My husband has even worse case of guilt over this. There was a time when we really tried everything to fight difficult child's stubborn truancy. One thing we tried was to very consistently and harshly punish him on that. First with other methods, but later in our desperation also with spankings. That only made difficult child worse and he was incredibly provocative about it. Laughed in husband's face during the spanking etc. Or maybe I should say whipping, husband was harsh with him to begin with and due frustration and difficult child being very provocative it escalated till it was truly abusive. We were well over the line when we finally understood what we were doing and deserted corporal punishment. it only made difficult child worse and husband was starting to really hurt and do some damage to him. We felt awfully guilty at that time, when we understood what we were doing and it isn't any easier now, when it seems apparent that difficult child refused school because bullying made it pure torture for him. So the poor kid was skipping school to avoid being beaten at school only to be beaten at home. What a situation for him. Thinking of that is also the reason that keeps me awake now even though I should have been sleeping hours already. My heart just keeps breaking over difficult child again and again

 

[InsaneCdn]

For me guilt is something I probably need to get a handle first. While I did try my best with difficult child, my best wasn't always good enough and he pays the price. Of course perfect parents don't exist and my best was the best I could do and difficult child certainly is not perfect son himself so we just have to deal with it.

Go easy on yourself. It's not like YOU dropped him on his head or something...
Perfect parents don't exist... but neither do perfect teachers or perfect schools... and so, there'a whole lot more to the equation than just you.

On top of that? difficult child may well be right that there was little you could have done.

In our case... WE knew from part way through kindergarten that there were serious issues. ONE issue got attention in grade 1. The rest didn't get diagnosed and/or properly accommodated until HIGH SCHOOL. And there wasn't a thing I could have done to make that different. It turns out that the testing he needed to have done, to reveal the needed dxes... simply wasn't known or available in our part of the world.

So... it's PTSD due to bullying and such. The best you can do now is be supportive as he works his way through it... which is likely all you could have really done in the first place, but it would have happened sooner...

 

[buddy]

It is making me cry too. I read a great book a woman wrote about her experience being severely bullied and if I find it in this move I'll pass it on because as awful as it was ...I mean rocks thrown at her head assaults...it is a story of overcoming. What kills me is that this has made your whole family victims of the bullies. husband, you, easy child and difficult child.

It is an understatement to say your difficult child is impressive. Look, the energy our difficult children need to get through days is more than most of us can appreciate. Any of us who has ever tried to change a behavior from minor to major ....eating better, quitting smoking, overcoming depression, stopping impulse buys, quitting swearing .....gosh anything.....it can be so hard. He is working to change things that may be actually related to his hard wiring, to chemical issues related to trauma and still he soldiers on. Of course he is a kid, may always have a certain level of personality quirks but how many adults could handle the humility and determination he needs to improve?

Sneak him a hug for me. One for you too. It won't be easy but as they say admitting the problem is half the battle.

 

[DammitJanet]

Im glad you now have a diagnosis. I also have PTSD as one of my diagnosis's. It can be a hard diagnosis to work on but it can be done. I know you have guilt because like the other posters said, all parents have guilt or we wouldnt be here. There are some good books and workbooks that you might want to look into for both of you about this issue. When I did a small group for survivors of childhood sexual abuse we used a book and workbook along with a therapist but it was one that could have been done alone.

 

[SuZir]

It is an understatement to say your difficult child is impressive. Look, the energy our difficult children need to get through days is more than most of us can appreciate. Any of us who has ever tried to change a behavior from minor to major ....eating better, quitting smoking, overcoming depression, stopping impulse buys, quitting swearing .....gosh anything.....it can be so hard. He is working to change things that may be actually related to his hard wiring, to chemical issues related to trauma and still he soldiers on. Of course he is a kid, may always have a certain level of personality quirks but how many adults could handle the humility and determination he needs to improve?

This is something I find to be one of difficult child's greatest strength. While he is hard press to show responsibility or be accountable in many things, when he is motivated, it really changes and he can really take criticism and correction well and work with it. It doesn't crush him and make him hopeless, he just takes it in and tries his best to correct himself. I don't think I could do that anywhere as well as he does. I thank mostly sports of this skill. difficult child's position in his sport is such that he has always gotten a lot of individual attention, teaching and correction in it. And because he loved the game he was really trying to take it in from the beginning. He was also lucky to have coaches that were good at reading kids and giving them just a right amount of correction and reassurance. I think taking criticism is one of the greatest skills sports and music teach kids. Because kids are usually motivated to do well in those and like them, they can take harder criticism than in school or from parents. And they are learning to take it and also learn that being corrected is not that bad and can lead to good things. Whenever my kids' sport careers will end, this is maybe the most important skill they have both learned from it and I'm sure will serve them well their whole life.

 

[welcometowitsend]

Suz - I know how difficult it is to not feel guilty about things that happen to our children but hindsight is 20/20. You are both loving parents who wanted the best for your child and have done everything you could to the best of your ability at the time that you did it. Did you make mistakes? Absolutely, but they weren't mistakes to intentionally harm your child - either physically or emotionally. You only ever wanted to help him. If that help was sometimes misguided that only proves you are humans who make mistakes with the best of intentions.

Go easy on yourselves. You have done your best and I know that you will continue to do so - we get better as we learn from the mistakes that we make.

 

[SuZir]

Thank you all for your kind words. They are much appreciated. This thing really rattles foundations of my life. These kids who bullied difficult child are no strangers for me, I have known them most of their life, I know their parents, many cases I know their grandparents some of their brothers and sisters are close friends of my easy child. These are people we are friendly with. We meet often around neighbourhood, we have get-togehters etc. We are a tight community. And just now I have a really hard time relating to the kids who bullied difficult child and even their parents.

Luckily difficult child seems to be doing okay. He did tell about diagnosis to his girlfriend and she didn't get too spooked. That is a very good thing. While I don't really believe the longevity of this relationship, I do hope that difficult child is more stable, when they break up. So I really much hope they stay together at least a year or more. Don't get me wrong, I have nothing against difficult child's girlfriend, she seems like a nice girl and she is certainly good for him, but they are just so young and I don't really see any long term attraction between them. Of course I could be wrong, but I suspect that big part of difficult child's attractiveness for this girl is him being a well-known athlete in that small town. I don't believe that she would had looked him twice, if he would had been just another engineering student (there is a big engineering college in the town...) And to be honest, I also think that when difficult child matures, he may be attracted on little different type of girl than his girlfriend. Girlfriend is a type of girl he certainly thinks he should be attracted, but when he learns to be more true to himself, that may change. difficult child's girlfriend is a type of girl I could see my easy child marrying, but I have an inkling that difficult child's life partner may be a little different type of person in the end. Of course I may be wrong and they may stay together rest of their lives or difficult child's will end up marrying other pretty, popular, preppy and perky cheerleader type girl and easy child will be the one who marries a quirky goth punk rocker with twenty safety pins on her (or his) face. Who knows?

Just now I'm happy that difficult child is together with this girl, who I think is very good for him. She is very popular and social, has lots of friends and likes to spend time with them. And she takes difficult child with her and her friends do include difficult child to their activities. And that is something that does a world of good for difficult child in so many ways. It makes it easier for him, that he is having troubles with his team mates, he doesn't need to feel alone in the town he knows few people, and he has opportunities to observe, model and train appropriate social skills. And it likely does wonders to his self-esteem that he is included. Of course he is likely to be smart enough to understand, that being a pro-athlete and some perks that come with it are part of the reason, they want to hang out with him (for example he can get them to the night clubs that don't usually accept customers as young as they are etc.) but still it is positive experience for him.

If difficult child will consider therapy as an option is still very much in the air, but at least he is willing to talk it out with the psychiatric nurse and psychiatrist.

 

[InsaneCdn]

If difficult child will consider therapy as an option is still very much in the air, but at least he is willing to talk it out with the psychiatric nurse and psychiatrist.

Does it really matter what label the professional he IS talking to, has? Because... "talking it out" IS therapy... and we had very good success with a psychiatric nurse who was trained and experienced in dealing with "difficult child" kids...

 

[SuZir]

Does it really matter what label the professional he IS talking to, has? Because... "talking it out" IS therapy... and we had very good success with a psychiatric nurse who was trained and experienced in dealing with "difficult child" kids...

Label of the professional certainly doesn't matter. But the goal of these talks with psychiatric nurse is to map out his current situation and to discuss treatment options and help difficult child make an informed decision of the treatment. One of the treatment options (and one that psychiatrist recommended) was intensive psychotherapy. Apparently there are few trauma focused therapists on the area (both EMDR therapists and some other form of trauma focused CBTs) and that would be psychiatrists recommendation. But intensive therapy can be very hard and stressful and difficult child has to decide if he is ready and willing to start that. His other options are less intense supportive therapy or skipping therapy all together in this time. And of curse medications can be added to any of this options if needed. So the current talks with psychiatric nurse are meant to be advisory and the treatment will be a separate part.

 

[SuZir]

I have been reading a lot about PTSD during the last week. I'm like that, when I encounter a problem, especially if it makes me anxious, I just have to find out all the facts, so I have spend my beautiful midsummer week reading studies and thesis about PTSD and I'm not sure if it has helped at all. Seems like really indefinite diagnosis, or maybe even more so prognosis. May do this or that or may not, this or that treatment can be tried but no real studies about efficiency of different approaches. Well it is, what it is and luckily at least right now difficult child is functioning reasonable well and has motivation and resources to work with his problems. And he also has so much positive going on in his life.

Now I just have to discipline myself to keep my mouth shut and not try to dictate or advice too much about what he should be doing. I know that would backfire big time but it always feels like managing his own life is just too important thing to be left for him to do, if you know what I mean. Mommy would know soooooooo much better...