difficult child refuses to do anything we say, sneaks out, etc

[weatheringthestorm]

I'm new to this site and have never tried a support group type thing. I'm really at my wits end. When my difficult child's mood swings into the mean version of him he explodes, argues over everything, hits things, etc. What frustrates me most is when he refuses to follow any direction. He won't even go into his room to cool off because we tell him to. On top of this he's left the house after being told not to several times. Tonight we had another big blow up. He wouldn't follow any direction and snuck out of the house. I don't know what to do with him. I can't make him do any of the things he refuses to do. He has 9 inches and almost 100 lbs on me. His dad can physically remove him, but that would likely turn into a major physical fight. In these situations he has complete power and he knows it.

We've had limited success with anything we've tried. The good behavior allowance worked the best but was far from perfect. He also used the money he got from us to start smoking. So we have that issue to deal with as well. He's on medications and they help to some extent. His moods have been so bad lately that the doctor is upping his dose. He wouldn't cooperate in therapy and now refuses to go at all. I can't get him into the car.

I'm just feeling really beaten down. The stress is taking it's toll on everyone, including his little brother. He was so upset by tonights episode that he had an asthma attack.

Does anyone have any advice?

 

[flutterbee]

Hello and welcome to the board. This is a wonderful place for parents in our situation.

First a couple of questions...what medications is he taking? Is he receiving therapy or any other kinds of interventions?

Second, I recommend reading The Explosive Child by Ross Greene. It really helps us understand the way our kiddos' minds work and gives useful strategies to deal with the behavior.

When my easy child was younger he was diagnosis'd with severe depression and there was *a lot* of hostility and anger. I can understand your concerns/fears because if he was exhibiting the anger now that he was at 10, I would be afraid for my safety. As it was, my daughter wasn't safe with him and I couldn't leave them alone for a second. I got a punching bag and hung it in the basement. It helped tremendously. After making the suggestion to use it the first couple of times - when I could see he was going over the edge, so to speak - he would just head straight to it when he could feel himself losing control. It was used on a regular basis for a couple of years. And at ten years old, the entire house shook when he used it. It hung without being used for probably another year, then we took it down and stored it in the basement corner. We just got rid of it...as in 2 weeks ago. I was hesitant to for so long just in case a need arose for it again.

More will be along in the morning to offer the advice and support.

Make sure to take time for you. We have to take care of ourselves before we can take care of our kids.

Welcome, again.

 

[Marguerite]

It's really hard when you can see him doing the wrong thing. All you can do is say, "You shouldn't be doing that," but do not add the "or else" because you have already learnt you cannot give him consequences that you can follow through on.

Basically, don't start a fight with him that you can't be certain of winning.

That's in the short-term. In the long term, you need to find a way, fast, of turning this around. I know, a tall order. But every time you tell him to not do this, or that, and he does it - you have lost that much more authority over him. You need to stop entirely. Let him know that if he chooses to go his own way, you aren't going to be the one to stop him. But you WILL call the cops on him if he is breaking the law.

Hugs and hang in there. There will be others along to give you more advice. Your days of trying to physically restrain him are long gone. Take a deep breath and be relieved. It's time to find a new angle, one you CAN enforce. One to consider - the things you do for him. Make your own private list - you cook, you clean, you do his laundry, you probably do other things. If he stops being cooperative, what will happen if you stop doing your bits for him? Food is usually the biggest leverage we can use. Often our kids don't care if what they're wearing is ragged, dirty or smelly. But a rumbling belly will send a strong message that he has to cook for himself (or find somewhere else to live) if he won't follow house rules.

Think again - if he were not your son, but instead were a flatmate, what would you do? How would you communicate your concerns? What would you expect from him and what would you expect you would be doing for him?

Often as they go into their teens our kids want to be treated as adults (even when they're behaving like children). Since we will put up with a lot more than a flatmate would, this can be good practice for the big wide world.

We have a household of mostly young adults - and us (throw in difficult child 3). The other adults - we all take turns washing up. At the moment I do most of the cooking, with husband helping, but at any time I can call on the others to lend a hand. We work as a team to keep the household running - if someone is putting on a load of washing, they will ask around to see if there's anything else, to make up a load. We all keep an eye on the washing line to be ready to bring in the washing if it starts to rain. There's no point being lazy about that one, and then complaining that you've run out of shirts because they are still wet on the line after being rained on.
We answer the phone, we take messages (and pass them on), we sort the mail and make sure it gets to the person it's intended for. These are all things we just do, as the need arises. We help each other with transport and car-pooling (another area where you can go on strike). We even lend each other our cars (also another area you can go on strike). Whatever you choose to do to limit his rudeness, you need to have a logical consequences reason. For example, "I'm not lending you my car because you have been drinking and I always said, I will never let you into my car if you drive while intoxicated." Or, "I'm not lending you my car because I need it myself."

There are ways, and we often have to make big adjustments when our kids force us to look at them and their management in different ways.

Marg

 

[TerryJ2]

I agree. At that age, you still control the house,the car, the phones, and his clothing. That gives you a lot of leverage.
Natural consquences work well. That hard part is staying cool and walking away to let him have his meltdown by himself.
Since the good behavior allowance worked to a point, I would revisit that and tweak it.
Also, is he leaving the house at 2 a.m.? or in the middle of the afternoon? You should be able to negotiate his leaving after he does some chores. In the beginning they can be fairly simple--a load of wash, getting junk off of his bedroom floor--things that won't take all day and emotonally overwhelm him.

You may want to just tackle one behavior at a time so it doesn't become overwhelming for all of you.

The hard part is finding something good, when you are at your wits end. Like "Thank you for giving me that message," or "Thankyou for holding open that door," "You did a nice job negotiating that corner where the semi didnt' see you."

Good luck.

 

[BusynMember]

Hi. Is he on any medications?
Unfortunately, out of control teens with mood disorders or drug problems (are you sure he's not experimenting?) will NOT listen and there isn't always much you can do. I speak from experience. My daughter used drugs and if I told her to stay in the house, she climbed out her window when we were sleeping, and this went on until the cops brought her home because it was after curfew. She'd go to work and do a good job there (while high) then get into trouble afterwards. She managed to get into trouble when we took the car, her license, all her electronics etc. In the end, we had to make her leave when she turned eighteen and she turned it around and is doing great. Don't blame yourself. Teens are a different animal from little guys and they are big and strong. And creative. I tell you to watch for drugs because we had no idea the depth of drug use my daughter was involved in until after she was clean and told us all about it. In detail. She was usually able to act moody, but fairly normal, at least around us.

I suggest maybe a second opinion on any medications your son is taking because he is still moodswinging so badly. Whatever he is taking isn't working right now. You can't really "discipline" bipolar away (I have it) since it is a medical condition. Also, you may want to do a surprise drug test on him, even if it makes him mad. At his age, and since he has a disorder that would make him vulnerable to drug use, and any recreational drugs he uses (or if he drinks)--that can screw up any medications he is taking to stabilize him. Good luck and welcome!

 

[gottaloveem]

I also was going to ask if he is doing drugs. MidwestMom mentioned that she didn't know the depth of her daughters drug use. We also didn't realize our son had turned to hard drugs. His behavior got worse and worse, until he admitted his drug use. As you can see by my signature below, we lost our son Alex to a drug overdose last year. I know what you are going through, it is awful when a kid is creating such havoc in a home (even if the havoc is not the result of drug use)

Definitely surprise drug test him, make sure you get the kits that checks for up to six drugs, not just the one that tests for marijuana.

MidwestMom gave good advice, if he is drugging, that is probably really messing up the prescription drugs he is prescribed.

I'm sorry you had to find us, but I am glad you did. You will get great advice here, we all understand your pain and frustration. There are many wise moms who have been through it all here. They can help you walk through this mess.

Just keep on "weatheringthestorm", and with us by your side, you will pull through.

(((((HUGS)))))

 

[weatheringthestorm]

Thank you for all the responses. In response to some of the questions....

His doctor just changed his medications to Buproprian 200mg twice a day, Seraquel 25mg twice a day, Adderall 25mg once a day. He also takes Allegra and a multi-vitamin daily. He has an Albuterol inhaler as needed.

He had been doing rather well on his medications. However, his moods have been changing very quickly and are more severe than usual. The defiance has greatly increased. He's in a big downward spiral. We've been working with his doctor to adjust the medications. He's extremely resistant to taking medications of any sort, but especially these. We have to go slowly because the minute he feels any side effects he won't take them. He won't admit that he has a mental illness or any behavior problems. Everything is our fault.

He's not in counseling right now as he refuses to go. He is EXTREMELY sensitive to the anyone "knowing his business". He went weekly all of this last spring and summer. His cooperation was minimal. The therapist still got him to talk and open up some. He began doing really well. Then only problems we were having was the weekly fight to get him there. Since he was doing well and hated going so much we (in agreement with the therapist) discontinued treatment. Now I can't get him into the car to go back. His doctor is considering putting him a day program at a Residential Treatment Facility (RTF).


I don't think he's doing any drugs, but I really can't be sure. He recently passed a drug test that the doctor snuck in with some other blood and urnine tests. I do know he is smoking cigarettes. We supported him in his first attempt to quit - made a plan with the doctor, bought the patches, etc. We would have also supported him in his second attempt, but he has stated he doesn't want to quit. I do keep drug use in mind. I really worry that all of the emotional problems will encourage self medication. I'd like to think I know what he's up to, but I really don't. I can't even keep him home when he doesn't want to be.

He hasn't snuck out during the night (that I know of). He usually only leaves without permission when he's had a meltdown and / or gets into trouble. When we tell him he's grounded he's taken to leaving, either blatently or sneaking. This usually comes after he's refused to stop screaming, swearing, hitting (in the last year he's broken his hand several times) and throwing things, etc. Then he refuses to go to his room. Then he decides he should be allowed to leave. When he can't convince us by screaming and swearing he leaves. This is usually in the evening and he comes home by curfew.

This morning he tried not speaking to me. Then he began the yelling and swearing. He left for school telling me that he's not doing any of his projects, etc. He does this periodically too,and he means it. He doesn't do anything. He had just raised his grades up so that he is passing all of his classes.

It really feels as if he is the one in controll. He goes out when he's not supposed to, he decides when to come home, he smokes, his behavior determines what can and cannot be done every evening, etc.


On top of all this I'm dealing with some pain issues from an injury in '06. I'm taking my youngest and myself to physical therapy twice a week. I have after school programs that I work the other 2 - 3 days a week.

I'm dreading when he comes home as he needs to have consequences for his actions and he'll likely just refuse to comply.

Thanks for the info on the book. I'm ordering it!

 

[smallworld]

Welcome!

Your difficult child is not really on medications that treat bipolar disorder. Buproprian (brand name is Wellbutrin) is a stimulatory antidepresant that can cause mania and mood swings in kids with BiPolar (BP). Adderall, which is prescribed for ADHD, can increase anger and aggression. Seroquel is an atypical antipsychotic that is used to calm anxiety, anger and aggression in kids with BiPolar (BP), but the dose your difficult child is taking is very low and likely not to counter the bad side effects of the other two medications.

How long has he been on these medications? Is there any way you can talk to the psychiatrist about appropriate treatment of BiPolar (BP) (check out the treatment guidelines on the website http://www.thebalancedmind.org/ ) If not, is there any way you can get a second opinion about the medications? I'm afraid this psychiatrist is not doing your difficult child any favors.

 

[DadRich]

BOY does this sound familiar.

WOW.

Here's what I would do to handle the not getting in the car thing:

1. "Time for your appointment son. Let's go or we will be late.
"

2. Refuses to go.

3. "OK, you have a CHOICE to make. You can get in the car and go to appointment or I will have the police take you to the appointment."

4. Follow through with whatever he chooses to do.

The local PD WILL support you through this and when a point is made that way (and sometimes it has to) your son will 'get it' or not. That, too, is his choice. I am very interested to hear how this comes out.......

 

[smallworld]

With all due respect, I'm not sure it's appropriate to involve (or waste the resources of) the police in forcing a child to attend a doctor's appointment. I know our county police department would not take kindly to being used in this way.

 

[DadRich]

Our is.

Sometimes parents need to parent. Enforcing their own decisions using whatever means is necessary and available is sometimes what it takes.

When one of mine would throw a fit about doing something, I would either put them in the car physically (if possible) or let the law help me. When the local Sheriff showed up, I had a VERY cooperative kid, or one who was hauled away is handcuffs for being physically uncooperative (and abusive). A round through JDC can sometimes (oftentimes) provide a whole new perspective.

 

[smallworld]

Being physically abusive is different from quietly refusing to attend a doctor's appointment. I have told my son that if he physically comes after me, I will in no uncertain terms call 911. But if he passively refuses to attend a doctor's appointment, I would not feel justified in bothering the police. There are real emergencies out there that they need to tend to.

by the way, because we live in a major metropolitan area, there's no such thing as a local sherriff. The kind of police help available does depend somewhat on where you live.

 

[flutterbee]

I've had several therapist's tell me, both for my son and my daughter, if they don't want to come, don't force them. I may very well get the police to help get my child in the car, but there is no way anyone can make them participate in therapy unless they want to. It's just going to end up making the child even more resentful and even less willing to participate.

When easy child was 10, I forced him to go to a therapist appointment (no police involvement). I couldn't get him out of the car at the office. His therapist and I met for 45 minutes before we saw easy child get out of the car and run. He was so beside himself with anger that he almost ran right into oncoming traffic. It took his therapist and I another 45 minutes to get him safely back to the car. He was like a scared deer...we couldn't even get close to him.

My difficult child has refused to participate in therapy. She also refused medications. It is my job to help her understand the need for these things; that, yeah, it's not fair and it stinks, but some people need these things just like a diabetic needs insulin. If she were a serious threat to herself I wouldn't hesitate to have her transported to the ER. But, the rest of the time I just keep plugging away at helping her understand - that she has to do this for herself, that I can't do it for her no matter how much I want to. It has to become her decision. I could force these things on her, but doing that is not going to make her actively participate. Her active participation is required in order for her to get better.

And even if I succeed in forcing these things on her now, what happens when she turns 18? These problems don't miraculously go away. They are there for a lifetime. She needs to learn now, while she has me as her safety net, that she is the only one who can help herself. I can only provide the resources; she has to do the work.

 

[Nancy]

While I have not used the police to get my child in the car for a dr appointment, I have used them numerous times when she has snuck out, not come home, refused to come home from a friend's house or been verbally or physically abusive. They have told me numerous times to call them whenever I needed, but that was because we had established a working relationship with them and they understood the situation.

My daughter went through a similar phase when she was 14-15, very defiant and just refused to do anything she didn't want to do. The big incentive for her was driving. She turned 16 and did not even have her temp although all her friends go theirs when they were 15 1/2. We have made it clear that she does not drive until she is trustworthy and is following rules and keeping her grades up. It's finally made an impact. She is now carrying all A's and B's when last year she has C's and D's.

You will have to draw the line in the sand at some point and will probably have to involve the police if he becomes more defiant and escalates his behavior. We also had her medications changed during this time, I think that is common at this age.

Smallworld, I'm not sure if you were on the board when Dadrich first came. His methods work for him, his style works for him, and others. I happen to like his style although I am not as strong as he is. I agree that we are the parent and they are the children. I'm sure there are many police depts who don't want to help kids and therefore would object to being called into these situations. I am veeeeeery fortunate that my police dept acually want to help parents help their kids. And he is right, a weekend stay in detention does wonders. They told me I needed a paper trail and a paper trail is what I got. I started out making an appointment with our juvenile officer and taking her in to have a talk. That established the relationship and from that point on I got excellent backup.

Nancy

 

[DadRich]

Hi Nancy!

Please keep in mind when I share my 'forceful' opinion, those who know me also know that I NEVER raise my voice or be a part of the 'anger' that goes with some of the difficult child's out there.

Everything I say during a potentially physical confrontation is kept at a low tone (very low) but very matter of factly. Our Sheriff's Dept. is large (we are in a suburb of St. Paul, MN) and they too know me and the kids I have raised (sadly!)

Years ago, I gave Tim a choice (he was one of my worst). He could comply with some request (basic) or he could choose to be oppositional. He immediately became physically aggressive and the police were called. He was hauled away. BAD choice but it is one HE made. After another 'try' or two, he found himself in a similar situation. This time he chose to cool off and comply, knowing full well the consequences of his choice could be significant.

Tim (who is Reactive Attachment Disorder (RAD)) turned out an adult sociopath, however, he was given the tools to keep himself out of trouble with the law. That basic 1+1 = 2 logic is something he now has.

By the way, things with this group did occaisionally involve local law enforcement. I started that by sitting down with the cops, at their office, and explaning to them what I was up against saying "Boy I think your help is warranted here". They agreed and have been there for me ever since although I am happy to report, that other than hauling Chris to the hospital during a mental crisis, they havent had much need to come here anymore!!!!

 

[weatheringthestorm]

Thanks for all the responses. I wasn't sure I'd get any response. While he's always had issues his BiPolar (BP), odd diagnosis is new and we're still learning.

Smallworld, thanks for the website, I've found it very helpful. We were aware of the possible increase in hypomania from the medications. His psychiatrist doesn't think this is likely for him as he's had these same problems long before the medications and they had improved on them. However, even she says anything is possible and she's monitoring it closely. I have read on several sites that the Wellbutrin - Seraquel combo is frequently used in BiPolar (BP) kids. He was on Wellbutrin and Abilify for a while. I felt that worked the best but he couldn't handle the side effects. Taking him off almost brought me to tears. He's very medication adverse and allergic to many. He'd been on Lexapro with the Seraquel which didn't seem to work any better than this. His psychiatrist and pediatrician switched him to Wellbutrin to help him quit smoking as it's supposed to be good for that. I did email his psychiatrist to raise the medications question. Thanks again.

After posting my first and second time I realized how far this had gone. He had gained total control. We had reached the point where we couldn't even give him consequences because he'd just leave. He just couldn't handle himself at home. So we made him go and stay at his grandma's house. He'll be there until at least Christmas Eve. It's that or the day program at the hospital. I'd like to try to avoid that, but if this doesn't work he'll be going there. Anyway, we told him that to stay at home he had to follow the rules - only leaving with permission, being decent to us, etc. He really didn't want to go but it serves two purposes. One he is removed from his biggest trigger (home) and can calm down and two it's the only way (aside from the police or the psychiatric hospital) that we can exert some control over him and let him know that he's not in charge. It's almost like a work program with all the chores he'll end up with (they're remodeling their home and have no shortage of tasks). He also has limited access to his friends. It's almost like being grounded. This is kind of the last attempt to avoid the hospital.

As far as using the police goes.... we've let him know in no uncertain terms that the next time he leaves without permission, won't come home, etc we'll call the police and they'll deal with him. Apparently around here that usually leads to a trip to the det center. If he were to come at any of us we'd call 911 without hesitation. We'll also call them if he refuses to go to school,or he needs to go to the hospital and we can't get him there. I don't think I'll use them to go to the therapist as he won't participate and it will likely make him even more determined to not cooperate. We do have a couple of really good youth officers at our PD whom he knows both from DARE and his minor run ins with the law (none related to his illness as much as just goofy boy stuff). We also know many of the other police from the haunted house that my whole family participates in every year (the police monitor the crowd, etc)so he's at least met many of them on good terms.

I hope his medications will help him get to a point that he'll actually accept the fact that he is BiPolar (BP) and that therapy is part of what will help him. Until then I don't really think that forcing this particular issue will help. It's so hard to see him so miserable.

 

[TerryJ2]

Weathering, you've made some big choices and big changes.
Way To Go!
Good luck with-the holidays. And good luck to his grandma! She must be a great person.

 

[weatheringthestorm]

We went to visit my son at my mom's house yesterday. Since he won't coopertate in any kind of counseling we decided to give it a try with my mom as the moderator. Figured it was better than nothing. We even included my easy child who in the past hadn't participated with the counselor, etc. Since the stress of difficult child seems to be wearing on him and they fight all the time we included him.

Anyway, we tried having everyone discuss what they and others could do to "keep the peace". Everyone was really cooperative except, of course, difficult child. He went right into being really angry, yelling, had nothing constructive to say, etc. It really didn't go that well. And to think he's coming home in 8 days.

Despite that we did have a break through from him, though it's far from encouraging. He finally came out and admitted that even though in his mind he knew that we, as parents, had to be the boss that he couldn't stand it. He can't stand having anyone be in charge of him or have any power over him. And... he's not willing to work on that in therapy. He doesn't think this will effect him one bit when he begins working, out in the real world, etc. It's impossible to reason with him. He feels he's all grown up, can make all the right decisions, and should be allowed to do whatever he wishes. This was really discouraging because witout him working on the problem I don't see many things changing. I think this is the root of many of our problems. I guess I just keep hoping that we'll finally get the right medications and his mind will clear.

Happy Holidays to all!

 

[smallworld]

What you're talking about may be a symptom of mania (as in bipolar mania). From an article written by my son's psychiatrist: "Grandiose children see themslves as being of a higher order -- being an 'adult.' This puts perspective on their defiance and lack of willingness to follow directions such as when parents ask the question, 'Who do you think you are?'"

I'm guessing the fact that your difficult child is not on a mood stabilizer and is on antidepressants is contributing to the mania. Counseling isn't going to solve the problem; proper medical treatment will. I hope you will find a board-certified child/adolescent psychiatrist who will help you get your son the help he needs.

Good luck.

 

[Sara PA]

Originally Posted By: weatheringthestorm
We were aware of the possible increase in hypomania from the medications. His psychiatrist doesn't think this is likely for him as he's had these same problems long before the medications and they had improved on them. However, even she says anything is possible and she's monitoring it closely. I have read on several sites that the Wellbutrin - Seraquel combo is frequently used in BiPolar (BP) kids. He was on Wellbutrin and Abilify for a while.

Having the problems before, then having them improve when first taking an antidepressant, than have them swing into being worse is pretty much the way it works much of the time when there is a psychiatric adverse reaction to the medication.

Is your son better now or before he took medication? Before medications is the baseline to which you should compare his current behavior, not how he was when he first started the medications.

While the combo of an antidepressant and an antipsychotic might be used to treat people with bipolar, it is not what is recommended by the American Psychiatric Association guidelines for treating bipolar. A first line mood stabilizer (lithium, Lamictal, Depokote, Tegretol/Trileptal) and, if needed for short term treatment of manic or depressed phases, an antipsychotic or an antidepressan. It is recommended that when the mood stabilizer is working, the antipsychotic or antidepressant be weaned back or removed.

Mania is not the only psychiatric side effect for antidepressants. Hostility is another as are anger, aggression, anxiety and mood swings.

The criminal justice system is no cure for neurobiological disorders. It would be quicker, easier, cheaper if we could all just send our kids to jail for a bit instead of treating their malfunctioning brains. Unfortunately that isn't the case.