HUGE Blowup tonight

[wintak]

And was so close to having to call 911...man, it's like he KNOWS where the line is and he will NOT cross it. It took a lot of people convincing me (once someone TOLD me that was even on option) that it was ok to call 911 if he should become a threat to himself or others..and I finally have told myself..ok, I'll do it. But he just won't cross that line. And I know many of you will tell me I should be HAPPY that he can control himself to NOT cross that line.

I did get the other 2 in my room, did manage to lock the door and stood behind it while he threatened to call the police (please do) and/or break down the door (again, please do) but then he finally went away and became calm. And like I said, I should be thankful that he is at least giving up (whereas 2 years ago these went on for an hour or so) at 10 minutes it's still scary to have to run down the hall, downstairs, get the youngest one away from what he's doing, run back up the stairs into my room and lock it before difficult child can do too much.

Won't go into details but man, it's exhausting.

 

[pepperidge]

Sorry , I have forgotten your story. What's his diagnosis? Has the concerta helped--is this a reaction when it wears off? Would it help to give more Rispderal or give it on a PRN basis? When was he adopted? What do you know about birth history, etc? Could it be Reactive Attachment Disorder (RAD)?

Take heart we had times just like what you are describing but that part of our life is now pretty much over. Maturity, medications, less reactive parenting, all have helped.
It is truly draining and exhausting and you can't imagine how you are going to go on and raise this kid 10 more years.

 

[TerryJ2]

It is exhausting, for sure.
Interesting that he gets just to the edge and then ... doesn't follow through.
Sounds like a tiny bit of progress, despite the blowup.
I hope you get some sleep and calm this evening.

 

[wintak]

thanks ladies...yes, exhausting BUT...I didn't raise my voice once. NOT ONCE. Just calmly asked him to leave my room as this was MY room and yelling in my room is not permitted (notice I am following therapy rules...I did not put this on him..I used generic terms so I don't offend him or verbally point fingers...I COULD have said leave my room because you are yelling, but I am seriously trying to follow rules and jump through hoops) and didn't engage in his arguments or threats. SO for ONCE kudos should go to the parent!

Pepper ...Concerta is for the ADHD not the moods, or that's what the dr is telling me. Adopted at 10 mos, no hx at all on birth, birthmother or 0-10 mos care other than in a foster home. WE've asked about Reactive Attachment Disorder (RAD) but pretty much been dismissed with that. Dr has actually told me to 1/2 the risperdal due to side effects.

So these start to subside with age? I do know they are less than when he was 4-6 years old...

 

[HaoZi]

Is there something in the air right now? Even with the medications going up, mine is ramping it up with her behavior and has gone back to the "I want to die/kill myself" instead of saying "I'm very angry, too angry to express myself properly."

 

[wintak]

it's not a full moon, yet...is it?

 

[InsaneCdn]

Concerta... could be affecting his moods. It is short-acting - in a long-release format, but it's still short-acting. So, if he takes it at 8 in the morning, then he has "rebound-effect" about 8 in the evening...

At least, that's what we've been told. If the blow-ups are usually more than 10 hours after taking Concerta, then maybe its time to re-visit the rx... non-stimulant? advantage there is 24hr coverage and no rebound, but we haven't been able to get there yet.

 

[wintak]

I don't understand what you mean InsaneCdn....how can it be short acting? I know it's the long release formula. our doctor told us that although it's SUPPOSED to be good for 10 hours, realistically it's more like 6-8 hrs.

I"m pretty sure it started because he couldn't have the last piece of his brothers birthday cake and it went downhill from there. It's the whole "no, you can't" put more delicately "it is the last piece of your baby brothers cake so he is going to eat it". And then it progressed to other issues and like I said..went downhill from there.

But now everyone is asleep. Peace in the house. Best time of day is after 9pm and before 6:30am

 

[InsaneCdn]

Short acting... Concerta is based on the same chemical composition as Ritalin. It has a "half-life" of about 4 hours... which means its totally gone from your system in 8 hours.

As opposed to, say, Stratera, which takes 2-4 weeks or more to build up in your system, and all of that or longer to work your way of the drug, because it is "persistent".

So, to explain the Concerta effect: 54mg of Concerta is not the same as 54mg of Ritalin... if you took 54 mg of Ritalin in the morning, you'd have WAY too much in your system for at least the first 4 hours... but, 8 hours after you took it, it would be "gone". When you take 54mg of Concerta, it releases an immediate start-up dose, and then (because its designed to disolve very slowly in the gut) deliveres staged doses for the rest of the "day"... how long Concerta lasts for a particular individual depends on the dose, what kind of a day they had, and physical things like metabolic rate and age. So... while Concerta is advertised as lasting "12 hours", its usually "10-12" and sometimes less.

Concerta does not affect mood directly. But (when it works, as in - if its the right drug for this person), it does affect ADHD, including impulsivity. What I'm seeing in your posts on this thread is that...
- Concerta has worn off
- he has some spur-of-the-moment impulse
- then something happens (in this case, being told he couldn't have the last piece...)
- at this point, his mood issues kick in... anger/frustration/whatever else, and
- BOOM! the mood thing blows up.

What time does this kid go to bed? If you have at least a 4 hour window from "normal Concerta wear-off" (as in normal for this kid), ask the psychiatrist about a small dose of Ritalin (comes in generic, as low as 5mg tabs) to be taken after school, so there's something in his system for the evening? While you're at it, ask about whether another medication might work better.

 

[pepperidge]

Hi--we ended up having to give our child an afternoon dose of Adderall because of the rebound effect. Though after we got him onto Lamictal the blowouts seemed to diminish since he wasn't so irritable all the time. Also Risperdal in the late afternoon helped. What seemed to provoke a lot of the blowouts was our trying to get him to do too much, and then denying him privileges. LIke doing homework at home or no TV. When we let go of some of the homework battles, the blowouts seemed to diminish. But really for him it was the correct cocktail of medications that seemed to turn things around alot. Though not completely. But that's another story.

as for other child, Strattera and Tenex were not good. At all. Abilify helped for a while with both focus and moods. What we have learned with him is to be very black and white. Write down the list of exactly what he has to do each night to get TV privileges and keep to the same general schedule. Sounds simple but took us a long time to learn it.

There was a news post recently about emotional dysregulation. I think many of our children suffer from that. They just lack the capacity to regulate their moods and over react to everything. I think with the kind of low emotion calm reactions you are modeling that you will make progress over time. Slow, but progress none the less.

 

[TeDo]

it's not a full moon, yet...is it?

Official full moon is tomorrow. Funny you should as that as I was just thinking the same thing.

 

[BusynMember]

What kind of doctor is he seeing? Does he have any clue about Reactive Attachment Disorder (RAD) or adopted children? Bad stuff may have happened to your son in those ten months in foster care and, sadly, those infant years require one caregiver and lots of nurturing. Are you convinced that this doctor knows what he is doing? Do you think it may be a good idea to go for a second opinion?

I forgot, but has he ever seen a neuropsychologist?

It is very hard when you have no history on your child's genetics. I know this first-hand. There is no point of reference...but we have to keep trying. (((Hugs))).

 

[JJJ]

If he is out of control enough that you are locked in your room for safety, he has crossed the line, call 911.

Why the heck the doctors put a kid with suspected mood disorder on a stimulant without the protectition of a mood stabilizer, I will never get!!! I agree with all of the others, the Concerta can be a factor in this. That rebound effect can be tough.

Does he see a child psychiatrist? or is your pediatricain winging it?

 

[TerryJ2]

Better today?

 

[wintak]

I do have 5mg of Ritalin that I can give him after school but I truly never see a difference when I give it to him. If anything he seems BOUNCIER if that can possibly be. I don't give it to him regularly (and had not given it to him yesterday). I had already reduced the risperdal mainly cuz I spaced it and ran out. SO Sunday he had 0 risperdal and Monday he only had .5 mg of it. So maybe it was doing more good than I thought it was. Or maybe it was the full moon, or maybe he had a tough day at school. But the counselor at school said he seemed agitated in the afternoon in his seat.

We are seeing the director of psychiatric at the childrens hospital. She is a psychiatrist, not a neuro and I will be seeing her and his therapist today and tomorrow and might bring this up.

I say good night around 8pm and let him turn his light off.

as for this a.m....I'm bracing myself cuz I can tell it might be a tough night again. He's in one of his "moods" to a point. Ugh. Maybe I should track the moon cycle and his moods.

 

[ready2run]

mine has similar explosions and has all along. he is only six but he is dangerous. i don't hide from him though, i may have to when he is a bit older. i get him into his room and lock him in there, that way he can wreck his own stuff and only one room gets destroyed. our psychiatric. also told us to call 911 if he is hitting himself or hurting other people. i have yet to follow through on it because i don't want to have to explain why i can't handle a six year old. i did call CAS on him once and they would not take him which was when he tried to smother my littlest son for not giving him a toy. i am with everyone else on the whole i can't imagine how i can do this for another 10 years.....sigh. glad they can be sent out on their own at 16 not 18 where i live. be careful with the risperidol. that stuff can be harmful. ours was on risperidone and he is now having heart problems because of it which after reading online seems to be more of a problem then they admit it to be. we are having a great time having him off his medications now... my mother phoned and heard about ten minutes of him going back and forth again and again between loving me, i'm so sorry momma and hating me saying he's gonna cut my head right off. i wish i had known beforehand what i was getting into, that's for sure.

 

[HaoZi]

Mine was even worse today. Major blow-up at school to the point that I had to pick her up early.
*headdesk*
*repeat*

 

[TiredSoul]

It's funny the comments about the full moon - because seriously I have noticed this for years! Same thing with changes in weather and when it is windy. Bizarre. My difficult child has been the same the past few days even with an increase in his Intuniv.

Also, I finally took all the advice awhile back when difficult child was really raging in the evenings and called 911 and they were useless! They made me feel like I was an idiot to call and commented in a condescending tone to me something like 'well what do you want us to do, it's not like we can arrest him or anything he's a kid.' I will not do that again. I too worry about when he gets older - right now I can overpower him - but I just wish this all would go away - as I am sure everyone here thinks.

 

[ready2run]

It's funny the comments about the full moon - because seriously I have noticed this for years! Same thing with changes in weather and when it is windy. Bizarre. My difficult child has been the same the past few days even with an increase in his Intuniv.

Also, I finally took all the advice awhile back when difficult child was really raging in the evenings and called 911 and they were useless! They made me feel like I was an idiot to call and commented in a condescending tone to me something like 'well what do you want us to do, it's not like we can arrest him or anything he's a kid.' I will not do that again. I too worry about when he gets older - right now I can overpower him - but I just wish this all would go away - as I am sure everyone here thinks.

they are supposed to be brought by ambulance to the psychiatric ward to be evaluated while they are still acting out, and then possibly have their medications adjusted and be held for (48 or 72, i forget) hours.

 

[HaoZi]

they are supposed to be brought by ambulance to the psychiatric ward to be evaluated while they are still acting out, and then possibly have their medications adjusted and be held for (48 or 72, i forget) hours.

In theory, hon, in theory. Reality in the U.S.? Many emergency services are overworked and underfunded.