difficult child refuses medications

Discussion in 'General Parenting' started by Stella, Mar 12, 2009.

  1. Stella

    Stella New Member

    My difficult child had a complete melt down last night. Her Obsessive Compulsive Disorder (OCD) seems to be getting worse. The meltdown last night was due to the fact that I lost one of her toys (her tamagochie). She asked for it before she went to bed and when i couldn't find it anywhere she became hysterical. This went on for about an hour and at 10pm last night she ran out onto the road on our cul-de-sac, screaming hysterically. The neighbours were looking out their windows but nobody dared to come over and offer help or ask what was wrong. I eventually had to put her in the car and bring her to my mothers who lives ten minutes away from me but she was hysterical there too. Anyway to cut a long story short I eventually got her to bed (at 11.45pm) but she warned me that If i didn't find it before she work up i was "dead" and I would regret it, and she would make my life hell the next day - all her own words. Also when she goes to bed, she has a ritual wherein I must sit in the same place, say same thing to her etc etc but not only now do i have to say the same thing to her every night i.e. "goodnight petal, love you" -last night and night before she started screaming hysterically because i didn't say it fast enough or i was saying it too fast so I had to say it at least ten times before she was satisfied with how i said it before she went to bed!!! I really can't live like this anymore. I am being terrorised by own daughter and she is getting bigger and stronger, scarier and she is not afraid to hurt me!!

    She was prescribed Risperdal a few months ago when i first brought her to the psychiatric but she point blank refuses to take it and he can't seem to offer any alternative solution!! I really can't cope with her aggresive outbursts any more and feel she needs the medications. Does anyone have any tips on how i get her to take her medications!!! I can't live like this and honestly I cannot even look any of my neighbours in the eyes anymore. I reckon they think i am slaughtering her with the screams that come out of our house - I am very surprised that none of them have every rang the police (I have rang them myself but they did nothing). Now I have another night of it ahead if i don't find her toy. I am filled with DREAD!!
     
  2. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    I'm thinking that she's getting so out of control that maybe she needs the hospital. I know it's hard to get a child admitted though. So the first thing I'd do, is schedule her for a neuropsychologist appointment. in my opinion you need a second opinion on what's wrong with her and her medication (once the report is done you can take it to a psychiatrist). Maybe once she is calmed down she will not fight the medications. To me it sounds less like control issues and more like Obsessive Compulsive Disorder (OCD) ritual problems, which are anxiety based. She needs everything to always be the same or she flips out. And, yes, it seems to be accelerating. My oldest son has horrible Obsessive Compulsive Disorder (OCD) and he didn't rage, but his rituals started taking over to the point where he couldn't function. He had to drop out of college because he couldn't stop counting the words that everyone said to him, so he couldn't understand anything, and he developed insomnia and a nervous disorder and he was a mess. Also, you do want to check and see if your child is on the Autism Spectrum Disorders (ASD) spectrum because those kids are VERY Obsessive Compulsive Disorder (OCD) and can rage sometimes over very small changes and frustrations. Some psychiatrists don't understand Autism Spectrum Disorders (ASD)--that's why I recommended a neuropsychologist evaluation. They do intensive testing for everything.
    Until then, I'd try to get her into this psychiatrist ASAP. She does seem to need medications and if she won't take them for you, maybe psychiatrist can talk her into it. Is she afraid of the medications?
     
  3. Stella

    Stella New Member

    Neuropschy's are very few and far between around here but I will do my utmost to track one down!! by psychiatrist do you mean her pshychiatrist?? She is still going to him on a weekly basis and recently he did tell me that he suspects autisic spectrum disoder. I have called him this morning and am awaiting a call back from him. I don't think he will be able to convince her to take medications - once she had made up her mind about something, that's it. She is VERY rigid. I think she won't take any medications because she doesn't want to beleive there is anything wrong with her. I tried to put cod-liver oil into her cereal once and she found out and went beserk and ever since that she wont take any type of medications at all and is very suspicious and untrusting of me and anyone who works in the clinic where I bring her. She absolutely refuses to sit in any of the seats at the clinic so all her sessions are conducted with her standing. She is the same when her tutor comes to the house on a monday, she just refuses to sit down and has to do her lessons standing up!!

    oh, and last night I was on the verge of calling for an ambulance but the only reason I didn't is that last time we did that she was taken to a mainstream children's hospital who didn't have a clue what to do with her and she came out worse than what she was going in. She even developed a tic disorder while she was in there due the anxiety and i couldn't put her through that again.
     
  4. smallworld

    smallworld Moderator

    I agree with MWM that Obsessive Compulsive Disorder (OCD), which is a form of anxiety, is fueling your daughter's behavior. Your daughter is not terrorizing you on purpose; her Obsessive Compulsive Disorder (OCD) is terrorizing her, which is turn causes her to escalate.

    Have you asked her why she won't take Risperdal? Perhaps it makes her feel funny, and it's not the right medication. While Risperdal treats anger and aggression, it is not necessarily going to target her Obsessive Compulsive Disorder (OCD). The SSRIs Prozac, Zoloft and Luvox as well as the tricyclic AD Anafranil are FDA-approved to treat Obsessive Compulsive Disorder (OCD) in children. You might want to talk to the psychiatrist about starting one of those medications.

    When our kids went on medications, we told them (in a quiet moment) they had a lot of choices in their life, but taking medications was not of them. We also told them they could always tell us and their psychiatrist whether the medications made them feel bad and we would look at different options if the side effects were too awful to live with. We made them partners in their own treatment.

    If we got to a time when they refused their medications, we sometimes offered a choice that didn't affect the final outcome -- Do you want to take your medications at 8 am or 9 am? Do you want to go bike riding or take the dog for a walk after you take your medications? Or we would "stop the world" -- no TV, computer, video games, going anywhere, etc -- until the medication was taken.

    Good luck.
     
  5. Janna

    Janna New Member

    So, the reason she won't take the medications is because she doesn't trust you because once you put the oil in her cereal and she freaked out. Now she doesn't trust you or any medications? Is that what you're thinking? (it's early if I read that wrong I'm so sorry lol).

    I have really no medication help, Stella. D's always been pretty good about taking whatever - but there's that trust between him and I, and he's not apprehensive about it. Maybe you could find a kid's book about taking medications - look at CABF, they have a huge list of kids books there - maybe that might help.

    You could stuff it in something, piece of bread or whatever, but then there's that problem that's going to give you PTSD - if she catches it, the trust factor goes down less - because you didn't tell her.

    How did she do on the Risperdal? Is it possible it gave her some weird side effect and it scared her? D hallucinated on it once - another time it caused severe constipation - wasn't a good medication for him. Might be that?

    I know what you mean about the Obsessive Compulsive Disorder (OCD) bedtime stuff. We have it here. D brushes teeth and pees, then gets to his room. He has to, in order - put lotion on his hands, chap stick on his lips, cross off the day on his calendar, prop his door just right, feel the bedsheets (because he wets, and even though he KNOWS I check EVERY DAY and it's clean EVERY NIGHT, still gotta check), climbs in. Then I have to rub his back for THREE minutes (don't worry, there's a TIMER in there), kiss him and tell him good night. The nightlight MUST be on, if I forget that - it's over. It's exhausting, but, in the end, if I take that 15 minutes, he goes right to sleep.

    I guess I don't have anything valuable to offer, just know I've been there done that and you're not alone. I really think MWM had a good suggestion with the hospital - or do you have Crisis? You could call them - here they come out to the house, do an evaluation and if they feel the child needs phospitalization, they take them. Or, maybe she needs an Residential Treatment Facility (RTF) environment.

    I hope today is better. I'm sorry.
     
  6. Stella

    Stella New Member

    Thanks so much for your replies. The thing is she has never even TRIED any medications. So he has never taken the Risperdal in her life!! She has to date had no help at all as far as medication in concerned. I have seen what a negative impact putting the cod liver oil in her cereal has had - she really has lost all trust in me so i'm not prepared to do it behind her back again but I just don't know what else to do.

    I am meeting with a social worker from Family Support on Friday to tell her our story and as far as I know they arrange someone to come out to my house a couple of days a week. Not sure exactly what is is they do yet but i'll take any help i can get!!!
     
  7. smallworld

    smallworld Moderator

    Again in a quiet moment, you could ask your daughter what would make it easier for her to take her medications. Brainstorm a lot of ideas and then have her choose something that she can try. To build trust again, you need to make her an active participant in her treatment.
     
  8. Janna

    Janna New Member

    I know charts are lame, and nobody likes them - but how about one just for the medications.

    You could try it, let her do it. Take her to the Dollar Store - get construction paper, stickers, markers, glitter glue, whatever, and make a small chart on a piece of paper (let her do it) for every day and medications.

    Give her the carrot. What does she like? D used to LOVE CD's, so if he'd do XYZ and/or earn so many stickers or checks or whatever - he'd get a CD. Get her more Tamagachi stuff. Fill a bucket with toys.

    At this point, if she HAS to have the medications, you want to do whatever you can do to get them into her. She is still young enough the charts could work for that.

    I'd also do the talk like SW said. She has to be able to trust you. I have always told D with every medication if there's something he doesn't like to tell me. And, out of 30 medication trials, he's only ever denied one. He trusts me.

    I will tell you, if this was us, I'd definately be doing the Stop The World thing. medication refusal here, it's just not tolerated, they already just know it. You wouldn't be doing ANYTHING if you're not gonna take em. Period. What's she gonna do? Throw a tantrum. She's already doing that....


    I hope you find a way, Stella.
     
  9. Andy

    Andy Active Member

    Do you have a child's psychiatric hospital nearby? You can try taking her directly there instead of the ER when she has an episode like last nights. The ER should have directed her to a psychiatric hospital, not a mainstream medical hospital. If they will not take her to one, then you can.
     
  10. Stella

    Stella New Member

    I know what you are saying about sitting down and talking to her but it's not as easy as that with difficult child. She refuses to talk about anything. She never shows any remorse for any ofher actions and the only way she seems to be able to express herself is through anger. Any time i have tried to sit her down and talk to her she covers her ears and starts screaming over me and next thing I know she's smashing up the house. She never tells me how she feels about anything. It's like she has the emotional maturity of a two year old. Honestly she is exactly like a two year old having a tantrum, only she is bigger and stronger. I feel like i'm banging my head off a brick wall. She won't open up the the psychiatric either. She has never opened up to anyone about how she is feeling. To complete strangers that she meets, she comes across as incredibly shy, she will whisper a reply if asked a question and has very poor eye contact. The more familar she is with someone the more likely she is to rage in front of them.

    I have tried charts etc but to no avail. Still awaiting call back from psychiatrist so will see if he can offer any suggestions! I'm in work now, totally exhausted and feel like I'm about to break into tears any give minute. I'm afraid i'm starting to become depressed and I've never suffered from depression in my life!!:sad-very:
     
  11. Stella

    Stella New Member

    Andy, there is only one children's psychiatric hospital in the whole county with only 8 beds in it! If it happens again I would probably have to bring her to a mainstream hospital and refuse to leave until they transfer her. I'd probably be waiting a long time though!
     
  12. Stef

    Stef Dazed and Confused

    Hi,

    My difficult child pulled the old refuse the medication on us a few times. We have more ammo now than in the past to get him to take it if he gets wise about it though. The ammo consists of a previous hospital (Residential Treatment Center (RTC)) stay, "wanna go back?", crisis lines, and a probation officer. Increased Community Service doesn't sit well with the lad, so he calms down and takes the medication. Before these things were in place, he'd tell us to "F" off, or worse, and not take the medication. We'd wait for him to calm down, usually when he got tired, then try again. At that point he would tend to be more accommodating- usually. An Residential Treatment Center (RTC) may be in your future, it can't hurt. You'll be sick about it, and hate yourself for doing it, but in the end it is worth it. We have seen improvement, although it is transitional. He has good and bad days, but it seems he stops to think things through a bit more now, as opposed to just going off the deep end. That alone is worth the effort's you'll expend. A good Residential Treatment Center (RTC) program will involve the parents to some extent as well. It will set up guidelines for the warring parties to live my via a signed contract. Not to say it always works, but it is a start, and they give you ideas of what to do when it doesn't. Our Residential Treatment Center (RTC) also consisted of 3 months of Outpatient (once a week) psychological treatment in the home. They come to you. The program is run by Centegra Hospital.

    Best Regards!
     
    Last edited: Mar 12, 2009
  13. Stella

    Stella New Member

    Thanks. yes, I think an in-patient stay somewhere is defintely in the future. I just spoke to difficult child's psychiatrist and now he's telling me he doesn't think she has an Austic Spectrum Disorder as she is able to go to gymnastics, swimming, ballet, tennis etc and that behaviourally she's fine in school!!! He said he thinks a lot of the problem is my relationship with her and how she has percevied me over the years. (she has two very involved grandmothers) a case of too many primary caregivers etc etc. I said I understand the family therapy element of all of this and what he is saying but that she has been showing behaviours since the age of 2 and I first asked for a referreal to the clinic when she was aged 4 as she was showing signs of Obsessive Compulsive Disorder (OCD). I said that i have heard of other kids on the spectrum who are social and he said that it's not possible and that if she did have Autism Spectrum Disorders (ASD) that the clinic where he is would not be the place for her. I said how am i meant to know the best place for her if i can't get a diagnosis!! He also said that if she had Autism Spectrum Disorders (ASD) there's no medication for it anyway!!

    He agreed to get in touch with the psychiatric hospital regarding a referral for an in patient stay. He couldn't offer any suggestions on how to get her to take medications but said he would prescribe some if i wanted.

    I'm so confused and upset right now. Is it true that she couldn't be Autism Spectrum Disorders (ASD) because of the extra cirricular activites she does? At present she does swimming, gymnastics, tennis, ballet, dancing drama and singing and she loves going to all of them!
     
  14. hearts and roses

    hearts and roses Mind Reader

    Hi Steph, My difficult child didn't refuse medications till she was a teen, so it was slightly different, though just as difficult to make her understand that it was one of those 'no choice' rules for living together. She eventually went off her medications almost 2 years ago. I personally think she could use an AD, but she won't even discuss it with me - treats the idea as if I'm trying to poison her.

    Any chance you could have the prescribing DR speak with her alone about taking her medications? Perhaps she would not have a meltdown with him/her and without you present to 'perform' for. Just a thought. I know that when my difficult child was that age she would go out of her way to outperform herself in front of others if I was present. However, if I was not in the room and a controversial topic of conversation came up, she was less apt to act up.

    Risperdal was a lifesaver for us for years. I hope it's not side effects/reactions she is having a hard time with because it's a good medication.

    Sending hugs & support~
     
  15. KTMom91

    KTMom91 Well-Known Member

    Wish I had some advice for you. Taking/not taking medications was never an option for Miss KT. I do understand what you mean about the neighbors...and the horrible noises coming from your house. Miss KT used to scream that I was killing her, usually when we had the screen door open so everyone could hear her. Risperdal has been very good for Miss KT...no more holes punched in walls, and a lot less screaming.
     
  16. Janna

    Janna New Member

    The thing about Autism is, it's a spectrum. So, what 10 kids may or may not do, doesn't mean the other 1 or 2 kids may or may not do the same.

    There is no question, anywhere, that D is on the spectrum. He is FIRMLY Pervasive Developmental Disorder (PDD)-not otherwise specified, questions of Aspergers - doesn't really matter. I can tell you that, for my son, ANY type of social group (we tried karate, for example) was a nightmare for him. Not only did the anxiety overtake him, but being around others, interacting with peers, has ALWAYS been a challenge. At 12, he still does not have one friend. He has aquaintances, peers he may tolerate for brief moments, but they all cause an issue one way or the other. It's either because he doesn't get sarcasm with them, or he takes things personally, cannot read body language, etc. He has the social interaction of a 4 year old. Because, that is what Autism is. It's developmental delays.

    When he was in 2nd and 3rd grade he was always out at recess alone, by a tree, singing somewhere. in my opinion, if a child is normally social, that would really rule out Autism Spectrum Disorders (ASD). But, I'm not a doctor and I think you should really see a neuropsychologist with her.
     
  17. Stella

    Stella New Member

    Yep i'd really love an appointment with one of these neuropsychologist's!!!! he did say that the only piece that doesn't fit with her having Autism Spectrum Disorders (ASD) is that she is social. She has friends and is actually at her happiest when she is with her peers.

    She defintely has sensory problems and always has done, along with ODD and Obsessive Compulsive Disorder (OCD) and she has learning difficulties and is bottom of the class in all subjects. So if it's not Autism Spectrum Disorders (ASD) what is it?? aaaaaaah i'm so frustrated!!!:faint:
     
  18. AnnieO

    AnnieO Shooting from the Hip

    I think you may want to look at a second opinion there. If he is more interested in blaming you than in looking at all the possibilities, that's a red flag right there. At one point we changed difficult child 2's primary care doctor because when biomom had him put on Concerta, husband went to see doctor to find out whatever he could. doctor literally screamed at husband and told him it was his fault that easy child had severe ADHD and that he needed to stop beating his son. (Last I checked, that doesn't cause ADHD and he doesn't do it in any case... Interesting.) The same doctor is difficult child 1's primary care, but that situation is a lot different (although he keeps telling us that we need to discipline her - I'd like to see him try). difficult child 1 will complain that she doesn't feel well, but if a doctor visit is in the cards she will do whatever she can to prove she's fine. She got to the point last summer with a stomach virus that we had to do the Urgent Care thing and she got a shot. She won't do that again anytime soon.

    However - in your case - there are so many possibilities and possible combinations of said possibilities that anyone flat refusing to consider them is just scary. You can't live like that.

    Regarding the refusal to take medications... difficult child 1 has done that, several times. The first one, the Risperdone, she said was because she didn't want to depend on them for the rest of her life. We discussed what they're for - certainly not a forever thing, just to get her over the hump so she could learn how to deal with her anger, and then we'd reassess the situation. No problems after that, until they put her on bupropion - AKA Wellbutrin. She got real bad about refusing this (but not the Seroquel). After a few fights she finally screamed, "It's making my hallucinations worse!"

    AHA.

    psychiatrist agreed we needed to take her off.

    Hallucinations are down to a dull roar now, tolerable for us all.

    However if your difficult child has never taken it, something will need to be done. And if you have to hide the medications, so be it. I would say try the normal way every day, and have a backup plan handy. How did she find out about the cod liver oil? I'd refuse that, too. If her medications are soluble in water, drop the darn thing into chocolate milk (the chocolate covers up a lot, I've discovered).

    And good luck. I am sending you hugs and all the extra luck I can spare!
     
  19. Stella

    Stella New Member

    Thanks so much for the hugs, i really need them today! I agree that if he it is scary that he is ruling out not giving a diagnosis and putting it down to family dynamics. I KNOW there is more to it than that.

    difficult child found out about the cod liver oil when she took a mouthful of cereal and tasted it. lol She hasn't eaten a cereal since unless it is new and she is the one to open it. I have tried the mini variety pack cereals but she will only eat the chocolately ones and leave the rest!!! The cod liver oil incident really was a lot more damaging than i realised at the time as she is paranoid ever since that i am putting tablets in all of her food and even in her bath!! (that's why she wont bath anymore).She's convinced i'm trying to put medications in everything!! God give me strength!
     
  20. AnnieO

    AnnieO Shooting from the Hip

    OK - dumb question - what was the cod liver oil for?

    At one point, several years back, difficult child 1 was prescribed antibiotics that my Mom always called "horse pills". We had to crush them and put them in something - hence the chocolate milk. Nice thing about this is, if you put enough chocolate mix in it, the kids are ecstatic (my parents never put enough in for me as a child), so it's a thought...
     
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