How to respond to an obsessive-behavior request?

[Sanity101]

Background: My 12 year old son has been on Concerta 27mg. I was happy that we had finally found a medication that worked without stopping his appetite during the day (he's small for his age by natural and respiratory steroid reasons). We went through a lot of medications in early elementary years. Then, I quit all medications for a couple of years. During that time, the major issue was anger. We saw a counselor for that. Focus was becoming a big issue again at school, so before middle school this year, we thought we'd give medications a try again. Focalin 10mg made him too sedate. Focalin 5mg was like candy - nothing. Concerta 27mg seemed to work for awhile. Now after talking with the pharmacist because I can't get a hold of the doctor, I'm finding that our new side effects are on the call your doctor and change dose or change medications list of side effects.

Last week, we determined that on the days he took his medicine, he was developing a headache and an irrational response to noise levels. His two youngest siblings would be playing in a barely above a whisper, very reasonable manner in a single room. He would be so bothered by their "noise" that he'd go around yelling at them to shut up, even going into their room and shouting at/hitting them saying they were being loud on purpose to annoy him. This was TOTALLY not the case.

Today - I did not give him his medications. I was going to call the doctor back again, but found they are out due to holiday today. GRRR. He got off the bus and had obviously been asleep on the bus. He came in the door and I politely requested for him to watch his hyper level and behavior since he did not take his pill. He calmly asked if he could go to Wendy's. That's out of the blue. It turned into a discussion that what he really wanted was a chili hot dog. We have hot dogs, but are out of chili. For 30-45 minutes, he was violently demanding that I take him to get a chili hot dog. I made a simple request without acknowledging that I would or would not take him, to put his game down and do his 2 chores. He proceeded to bang doors and kick stuff instead of following directions. It is my opinion that I should not give into a violent behavior request, probably even after all is calmed down? Because wouldn't that just be teaching him that throwing the fit before following the instructions was ok? As of right now, he is finally calmed down without medications, but has not followed instructions yet either. During the fit, I did take his game from him and he does not have it back yet.

Is there anything else I should try? In addition? Instead? What about his request? I have a coupon for a Buy 1 get 1 free chili dog at Sonic. I would gladly have taken him out for a one-on-one night to get it had he simply followed instructions without going into a rage. I feel like he could benefit from that one-on-one time, but don't like for it to follow explosive behavior too often in case he learns to further demand expectations.

Now that he is calm, is it "giving in" or "bribery" to try to repeat the directions explaining that if he follows the instructions without rage or delay, we can go out tonight? Or should I stick to just expecting him to follow the instructions. He's to the point these days where if there's not something in it for him, he refuses to do it. That's not how we raised him to be. It's a fairly recent, new behavior. I'm just not sure what to do about it.

PS - we do have hot dogs, so I could just run to the store to pick up a can of hot dog chili, too. I just don't want to spend gas to do that if it will further promote this behavior.

Thanks

 

[meowbunny]

He lost his game as a consequence for the kicking and banging. That's fair and reasonable.

So, my vote is that if he does his two chores, off to Sonic you two go and hope you have a good time.

 

[hearts and roses]

I agree with meowbunny. However, I would point out where things went awry and how it could have gone better and easier, without all the violence and meltdown stuff, Know what I mean??

 

[hearts and roses]

by the way - WELCOME!!!! :bravo:

 

[susiestar]

So sorry you are having trouble with the medications. I think you need to follow your instincts. When he is calm, if all chores are done, it is not unreasonable to go out for the chilidog. Esp if it provides some bonding time. Often that will help in future rages.

This is a difficult thing. I am so sorry. If the rages are really bad, and he is a danger to himself or others, please have him transported to a hospital for evaluation.

Hugs

Susie

 

[Marguerite]

If he was used to having to manage without medications, he would have at least partly adapted to knowing how short his fuse is; but when he's suddenly unmedicated when on previous days he HAS been medicated, his ability to control his temper is much reduced.

Still, I agree you don't want to reinforce bad behaviour. What you need to do is try to head off bad behaviour before it happens (tall order, I know) and try to defuse it as soon as you can.

If you had said, "I'll take you to Wendys, you WILL get your chilli dog, but some tasks must be done first. We will be done quicker (and get to Wendy's sooner) if you help by doing x and y," you might still have gotten the rolled eyes and an outburst, but you would have lowered his anxiety to a point where he could see that you are trying to help him get what he wants, and he needs to do to get. It puts the teamwork and the mutual support back in.

Instead, he perceives that he has just handed you some ammunition against him, something you can use against him for your own amusement, like holding a bone to a dog but keeping on lifting it higher to make the dog jump, but never giving the bone to the dog.

He feels like the dog, only smarter because he gets frustrated faster in the belief you will never give him 'the bone'. He then loses perspective and cannot be reasoned with, because his mind is whirling on one topic - "Chilli dog - NOW!" and he's simply not hearing anything else and with the prospect of his treat evaporating, he is feeling, "Why try?"

You might find that when you get in the car, he calms down. THAT is when you can talk to him and make it clear, he is getting his treat in spite of his behaviour, you do not value the problems you had.

But without his medications, he is not going to be able to hold things together anywhere near as well as he normally does. And he shouldn't be punished for what he can't handle. He just needs to know he's not being rewarded for it, either.

Marg

Marg

 

[BusynMember]

I would have him re-evaluated if he gets that violent. in my opinion it sounds like more than ADHD to me. I'd take him to a neuropsychologist.
I used to rage and it isn't really in your control once you're into your rage and I don't recall planning a rage either. It kind of overtook me in a split second and then all control was lost. I'd question the type of medications and treatment. I'm not convinced he can "learn" not to rage until he is stable. I think he needs a different type of medication--maybe a mood stabilizer. JMO

 

[susiestar]

I think Marge has some good points about putting teamwork in and the certainty of knowing he would get what he fixed on, but not right this minute.

This may be a way to approach problems that is cooperative, rather than antagonistic or punitive (in HIS mind).

http://www.loveandlogic.com has some wonderful ideas and principle. It really helped with my son's rages and obsessions.

Has anyone evaluated him thoroughly for Aspergers or Autism Spectrum Disorders? He just reminds me SO MUCH of my son when on concerta only.

And learning to work with him on obsessions/fixations that would not hurt any of us was important.

We also had to cope with obsessions that would hurt someone. Knowing we would work with him on the safe obsessions made it easier for him (and us) to deal with the unsafe ones.

He really will have a much harder time when he has to handle school with-o his concerta.

I think a medication evaluation is due. It sounds like his medications are just not doing what he needs.

Hugs, I know how hard this is.

Susie

 

[Sanity101]

He lost his game as a consequence for the kicking and banging. That's fair and reasonable.

So, my vote is that if he does his two chores, off to Sonic you two go and hope you have a good time.

Thanks. As with other areas of my life, I have learned that it helps to have objective input from outside. Even if you have known before what to do or of course that age old "hind sight is 20/20", you can still miss the objective when in the heat of frustration. Thank you for pointing out the separation of these 2 areas. It was muddled together in my view earlier.

He has calmed down now and begun to work on his two chores (with a little hyperness, but not anger). He ended up asking me to make the Hamburger Helper for supper instead, proving that he was in an impulsive moment of "I've gotta have what I think I want and right now!". I had already started cooking that when I read the responses. However, over supper, I talked to him about setting up a chili dog night on another night this week - still expecting the daily chores without rage.

Thanks for the helpful insight.

 

[TerryJ2]

Hi, welcome!

I agree, chores and a chili dog. I know the craving, LOL!

He sounds a lot like my son. We only use Adderal. The meltdowns have gotten a lot better but boy, can you tell when the medications wear off every day!
These kids do not seem to understand cause and effect, particularly when they cause the effects. They have to slow down and calm down.
(I probably sound like a broken record. Sorry.)
We have to be very, very consistent. It's hard. You have to have nerves of steel.

Good luck!

:warrior:

 

[Sanity101]

I can't tell you how many times I have mentioned I think it is something other than ADHD going on with the anger/rage.

One of you hit the nail on the head with his type rage. It is not in his control. I have learned not to deal with "the issue" DURING the rage. A lot of his behavior, he doesn't even remember doing afterward. He has broken the swing set's slide before. He has flipped the swing set over before. He has broken the back window of our old car with a thrown object before. Stepdad's current car has a cracked windshield from a thrown toy. He has run out into the middle of the road in the dark before (wanna talk about scared).

I don't think he plans his rages. He knows the drill of all the things to do when he feels himself getting angry. However, what we've noticed is a lack of that "warming up" time. He can go straight from fine to a rage like the snap of a finger! Once in that rage, reminding him of anger control techniques only makes him madder. NO INTERCHANGE has been the best thing for calming his rages lately. I do LISTEN to everything he says while raging. But, I reserve responses for a calm discussion after the rage has passed.

The biggest thing is to not engage in the fit. It will simmer down faster if no one is feeding it with responses. I have asked about Bipolar and Schizophrenia before. The current psyche (who hasn't returned my call) has mentioned a possibility of the Intermittent Rage Disorder. I think that's probably the same as Intermittent Explosive Disorder (IED) on the shortcuts list.

He has ALWAYS had trouble getting to sleep at night. YEARS ago, we found melatonin. He has to take that EVERY night and it is the difference between sleep and NO sleep. He literally can stay up ALL night. He does go through spurts of helpful obsessions. I didn't think it was healthy to go overboard on the chore spectrum either. He has literally done MANY chores in one day when in the mood to do so.

I bring sleep up, because he has had sleep studies done. They removed his tonsils after one, but ruled they don't see any other causes after that. His sleep has not changed before/after the T&A surgery.

He IS having 6th grade insecurity self esteem issues at school, of which we have been communicating about. He also talks to his school-based counselor about. He's not even in puberty yet and it is already getting scary. I do plan to find the book on The Explosive Child and read the referred website, both of which I learned about on these forums. I am glad I found this resource.

I am not sure what would happen if I take him to the hospital and that scares me away from taking him. I had panic attacks back when I was going through my divorce from his dad. I was committed for a couple of days involuntarily due to a misunderstanding of my panic attack. I was freaking out about all those palmetto bugs flying around in the strange house where I was alone and it was bedtime. I was already in an agitated state of mind. They claim that I threatened suicide. I remember no such occurence. So, that's the foundation to my lack of trust. Yes, I have holes in my walls. There is a difference between his "hyperactivity" and his "anger/rage". I think they are separate issues. It's breaking my heart.

I'm going to reread all the advice on here and take notes. His previous counselor included me in parts of his sessions. It does take teamwork to deal with all this. Now that he's in middle school, he sees their school-based counselor during the school day.

He's good in school! He's very smart, but also unfocused and unorganized. He does have an Learning Disability (LD) in reading, but excels in Math/Science. The social side of school has him asking to be home-schooled. I don't think we could successfully homeschool with these rage issues going on.

Thanks again

 

[Sanity101]

but boy, can you tell when the medications wear off every day!

That's a big reason why we have gone through trying a LOT of medications. He has a HIGH metabolism and the long-actings were no such thing as long-acting! They wore off LONG before the doctors said they should have. Right now, I need to probably get the dose changed and add a short-acting medication (pharmacist suggestion) BEFORE the wearing off period. Concerta really was helping for a couple of months. With all of the issues. I can't get my ex to give him his medications while he is over there every other weekend. So, imagine what every other Sunday looks like over here. They also let him play games 24-7 (yes, all night, too).

 

[Sheila]

Wanted to say hello and welcome. :smile:

 

[hopeful]

A side bar on the medications... When my daughter began taking ridlin the doctor told us she would be on it for a long time and to reduce the risk of kidney damage to take her off of it on weekends and holidays, it was just for school. (you see the family didn't need her to be calm, just the school did... but thats another story) Anyhow, I noticed two things, after school she would have a big emotional crash, it was associated with the medications so we fiddled with smaller doses, twice a day to avoid this. Also, the weekend days she didn't take her medications, she experienced alot of irritability. This was back in 1996. We found out later that the ups and downs are terribly hard on their psyche and that it is better to use less medication regularly than have them go on and off. This may be contributing to some of the "new" behavior. Also, when she experienced a growth spurt we would go through another adjustment period.

Not related to the chili dog, but knowing these things helped me with anxiety and assisted me in not personalizing the behavior. Our family saying was, "If she had no legs, we wouldn't expect her to run..." this is kind of crass but I had to find a way to explain her outbursts, irrationality to her three siblings and they could understand this. The explanation didn't start out like this, it was her brother's six year old rendition of my grand explanation about mental health, judgment and expectation! lol lol

 

[waytootired]

With these rages, once they start, there is no quickly snapping them out of them. They have to just peter out. Don't fight him or argue with him during, it will only make is worse. Try best you can to ignore it but pay enough attention to keep him and yourself safe from harm(flying objects or abuse). Call the Doctor first thing Tuesday and get some help. I recommend a neuropsychologist evaluation..best thing we ever did for my son and our whole family. We now exactly what we are dealing with and what treatments are in our sons best interest.

My heart goes out to you...been there done that

Hugs... :flower:

 

[hopeful]

On this I can subject I can relate. My daughter is unable to do anything but rage when she is angry. If I react, we engage in the dance and it serves no one. If I do not engage, she acts it out, moves through it and when the rage passes she is generally quite lucid and thoughtful. If she is engaged, the "memory" of the rage is skewed and onesided, her side of course.

Before she was 10-11 home was scheduled, manageable and organized. We all knew what to do to maintain. She would simply storm to her room to "calm down", once in a while I would check in and she would shout at me "I'm not done yet!" and continue trashing her room, punching her bed etc. In school, peer pressure had little impact and her teachers sighed in relief when she moved on to another class. The kids couldn't engage with her because if she got mad, she was verbally abusive. When she wasn't mad she was sweet and funny, they couldn't handle the chaos. In fact, school was our personal battleground, taking medications, (she would hide them under her tongue and spit them out, refuse to take them..)getting dressed, she often undressed while I was getting her brother ready and I would always be late... I got over that eventually, but most mornings after leaving her at her class I would wander to the car and cry.

We had many successes but the road was long. So, puberty... a very trying and dangerous time. I don't know if mental health in the states offers it but through mental health in Canada we were assigned a conduct disorder clinician. This amazing gal meets with my daughter every week, takes her for lunch, just connects with her and does solid tool building sessions with her. If we had this in place when she was 12 it would have saved us all so much grief.

I suggest reaching out to see if this is available, the school counselors are a comfort but there is specific supports needed especially at this time and the other service they provided was someone for me to talk to. She "knows" that I love my daughter and she can hear my frustration or fears without judgment. It really helps me... She also has connections to other supports that I couldn't access without her, for free!

Food for thought.

 

[flutterbee]

I wanted to add my welcome to the board. :flower: I'm always happy to see new members.

When my difficult child is raging, I send her to her room. When she was younger I had to carry her to her room and sit outside her door holding it shut, but at least now I can get her to go to her room on her own. It of course entails STOMP, STOMP, STOMP....SLAM!!! but at least she's not controlling the house. Once she's done, we can talk about it. When she's in that mode, she is not capable of rational thought. Any attempt at it just added fuel to the fire.

A bit of a hijack here...those palmetto bugs would cause me to have a panic attack without going through a divorce and being in a strange house. (Lisa, if you're reading this the palmetto bugs are the flying roaches. *shiver*)

I know you'll find lots of support here.

 

[Marguerite]

With giving kids a break from medication - I'm beginning to think that idea was never really tested "in the field" before they told us to go do it. difficult child 1's rebound whenever he came off ritalin (or was between doses during the day) included some spectacular rages.

And about rages - while there may be a specific disorder to account for it, sometimes kids just rage, especially if there is something else wrong. When you're a difficult child life is much harder than for other kids, raging is often a reaction to "I can't cope, nothing is going right for me."
difficult child 3 rages a lot. So does easy child 2/difficult child 2. While these days I can see a trigger most times, especially with that wonderful 20:20 hindsight, the actual time interval between the trigger and the rage onset can be less than 2 seconds. Mostly, the trigger is something someone says or does, to apparently 'block' either one of them. And yes, there is no point trying to discuss it while they are raging. We just ride out the storm and THEN try to talk, as far as we can (which may not be that far). It IS something we're trying to sort for easy child 2/difficult child 2, with counselling.

But with both of them - I feel it's part of their Pervasive Developmental Disorder (PDD), nothing else.

Marg

 

[Big Bad Kitty]

Hiya,

Wanted to pop in and offer a welcome and my support. You got some great advice, and it looks like you handled it very well.

I also wanted to say that I think it is FANTASTIC to see the newer members chiming in on these threads and offering their opinions and wisdom. New to the board does NOT mean new to parenting a difficult child!

 

[Sanity101]

Quick update: I didn't just call. I got to the office at opening time this morning. There were NO doctors on site (pediatric psychs). His doctor was in another offsite office, so the lady I talked to called him. He just said to stop the medications and he'll review tomorrow (Wednesday) when he's back in the office. That leaves me to expect and deal with another rage tonight and I have two meetings to go to. I'm just going to have to pray all day today. Have ya'll ever heard the song "He's My Son" by Mark Shultz? It's not about my son, but I sure relate to it big time - every time I hear it. I always cry by the end of it.

I asked them on the way out what I was supposed to do about this evening and she said that it seems I have control of the situation and he should be safe. GRRR. OK, I'll wait one more day if that means we can try something that works. I think he did have a growth spurt in height, so I wonder if he just needs a new dose of this, plus the Ritalin for after school? He doesn't get off the bus until ~4:20pm. He wakes up at 6:30am, takes his medications with breakfast and gets on the bus by 7:10am.

I'm definitely going to bookmark this site. My husband is his stepdad, so I've already seen discussions that can get me an inroad into him being more understanding/cooperative. How his daddy raised him ain't gonna work on everybody. He accuses me of "coddling" the kids when I use positive reinforcement techniques of parenting.

I also have the book "Creative Correction" by Lisa Whelchel (former actress from Facts of Life). I've used it for years.

Thanks