Mood Disorder?

Discussion in 'General Parenting' started by rolleroaster, Jul 4, 2015.

  1. rolleroaster

    rolleroaster New Member


    This is my first post. My 10 year old daughter was diagnosed with Aspergers a few years ago. She is now also diagnosed with ADHD but possibly a mood disorder. Her reactions to medications point to possible mood disorder, not necessarily Bipolar, but maybe. She has ALWAYS been inflexible and defiant. She is extremely bright but over the last couple of years has more school work refusal issues. Also, over the past year or so she gets mad at us when we ask her to do anything that will cause the slightest discomfort.....take a shower, pick up a mess, stop watching TV, stop playing a video game etc. She will tell us to shut up or she tells us she hates us. When things are going well (she is having fun) then she seems fine. She seems sort of Aspie-like, but does not have too much awkwardness. She presents sort of in between Aspie and neurotypical. But when there is a problem (stress) and she is inflexible and defiant, she looks more Aspie.

    The issue now is that she is so moody, it looks like more than Asperger's is going on here. She can't seem to deal with the slightest demand, she is mean to us, she says hurtful things all the time, she doesn't seem very sorry about any of it either, which is very concerning. Things will be good and she will be happy but the minute something doesn't go her way a switch flips and she is hateful.

    She doesn't have moods that last very long. She goes back and forth several times a day. She is impulsive so she may hit or kick but I would't say she is "violent", she hasn't actually hurt anyone. So there is some physical aggression and a lot of verbal aggression. Like I said sometimes she is fine and fully functional.

    Does this sound familiar to anyone? We do see lots of docs who are all trying to figure her out. She has a very stable home and no one in the household/immediate family has any mental illnesses, though Bipolar does run in the family, as does depression.

    Thanks for listening, please feel free to ask questions!
  2. ChiefDramatist

    ChiefDramatist New Member

    Hi RollerCoaster, and {{hugs}}.

    Wow, this sounds familiar. My Difficult Child was first diagnosed with Obsessive Compulsive Disorder (OCD) at age 7, and then shortly thereafter with bipolar (although it manifested much differently at age 7 than it did at ages 8, 9, 10, and 11). Her next diagnosis was anxiety disorder (when she had an anaphylacTOID reaction to stress over the third grade state testing). Her final, and most surprising, was low spectrum Aspergers when she was 10. I don't see it, but her psychiatric does.

    But I would say that my daughter's behavior is an exact mirror of yours. Hearing "no" is simply not an option to her.

    Again, BIG BIG {{hugs}}. Please bring your concerns to a psychiatrist. Even if bipolar is disqualified, her doctor needs to know.
  3. HMBgal

    HMBgal Active Member

    Yep. Very similar to my grandson. No firm diagnosis aside from ADHD, which isn't even the main thing. Hang with this group; they get it, they rock.
  4. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Actually, Rollercoaster, your daughter sounds almost exactly like my Autism Spectrum Disorders (ASD) son at that age. They ARE moody, but they get over it faster than mood disordered kids, of which I was one (and my moods...well, I was usually depressed and it didn't lift). Defiance is common in Autism Spectrum Disorders (ASD) because the ASDers are inflexible and almost panic when they have to transition or change what they are doing or do it another way. My son was not violent in any way, but neither was I (with the mood disorder as a kid). That can go with either one.

    ADHD behavior is the rule with Aspergers. They are impulsive and hyperactive. medications often do not work or make ASDers worse. They are sensitive to son can't take any medications. He does better off of them.

    Nobody can prove a diagnosis yet. Psychiatry and certain disorders in neurology (Autism Spectrum Disorders (ASD)/ADHD) can not be verified by blood tests. I'm beginning to think, in hindsight, that it is best to treat the behaviors and use Autism Spectrum Disorders (ASD) interventions, if there is any chance of that because it won't hurt any kid to have them, but it WILL hurt an ASDer to skip the Autism Spectrum Disorders (ASD) interventions as the child gets older.

    In hindsight again, my now twenty-one year old son was misdiagnosed with bipolar because he could be defiant when he was younger and had meltdowns, but the medications doped him up, made him gain thirty pounds (he is still obese) and he didn't HAVE bipolar. The doctor, a certified child plsychiatrist, was wrong in his diagnosis. Our son is Autism Spectrum Disorders (ASD) and is doing quite well after Autism Spectrum Disorders (ASD) interventions. He is now healthy, even-temptered, happy, medication-free and living on his own with some minor adult supports. With the way he regulates his moods now there is NO WAY he had a mood disorder.

    As parents we have to be careful. Psychiatry is in it's infancy and diagnoses criteria changes all the time. Be careful of the "flavor of the day" too. Use your mom gut and be firm with diagnosticians.
  5. rolleroaster

    rolleroaster New Member

    Thank you for the replies.

    SWOT, we have always felt the Asperger's diagnosed fit pretty well, although she does not have any gross or fine motor difficulties, she is a great writer, and has a great imagination. But the rest fit fairly well (especially the inflexibility!). It is the hatefulness that is disturbing now. She was not hateful like this before. She blames everyone for everything, she takes no responsibility. I think she is well aware of other people's feelings, she just doesn't care about them. She cannot deal with the slightest stress. Her moods change very quickly. She does get sort of silly/hyper with rapid speech. Other times she zones out into a game or TV and when we try to talk to her she tells us to shut up no matter what we say. She goes from being really nice to 8 year old sister but tries to control her. The minute sister doesn't do what she says she tells her she hates her and wishes she didn't exist. It is so not fair for an 8 year old to be on this roller coaster :(

    A low dose of Zoloft has been better than nothing, but other antidepressant, a stimulant, and non-stimulant ADHD medication have all been disasters. I know we are headed toward a mood stabilizer. A year ago or even 6 months ago it didn't even cross our minds. Now, something has got to change! We've done play therapy, CBT, she now sees a psychiatrist. I feel like we have tried so much and she has had several doctors eyes on her for years, but things just get worse.
  6. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Well, be careful. I personanlly don't like bipolar diagnoses in little kids as t here are no studies that support that these kids grow up to have full blown bipolar and I was unhappy with the amount of weight gain, hunger and fatigue my son had on mood stablizers. They have serious side effects and, in the end, he didn't have a mood do your homework about medications and don't just trust the doctor. It's best to be informed.

    My son was never mean to anybody and is one of the nicest people you will ever meet, but even with Aspergers all kids have their own personalities and it affects everyone differently. I think the best diagnosticians are neuropsychologists rather than psychiatrists. My son's doctor, a certified and popular psychiatrist around here, told us my son "couldn't" have Autism Spectrum Disorders (ASD) because he could go from one room to another a nd not freak out. I just stared at him, thinking that I knew more about autistic spectrum than he did. Did he not know that higher functioning autistics are perfectly capable of going from room to room? I was shocked at his ignorance. The man was a doctor of Psychiatry. Shame on him. I'm just glad that I knew better than him, although I had never even gone to college. Scary.

    That's when we took him to a neuropsychologist and his life turned around after that and he got off the medications and, frankly, was better off of them.

    Psychiatrists do not always understand autistic spectrum disorder because it is really a neurological difference, not a psychiatric disorder, which is why I prefer neuropsychologists, who understand both and test for both. It's always smart to get a second opinion anyway before starting psychotrophic medication. These are nothing to play around with and some psychiatrists hand them out like candy.

    I've been a psychiatric patient since I have been 23 and I am 61 now and I learned that pspychitry is not an exact science and that if you don't speak up for yourself or your child, they could be used as guinea pigs. Nobody is sure what your child has and nobody is certain if she should be on particular medications. He is taking a guess. Before you allow him t o give her anything very strong, look it up and know your stuff. Ask about side effects. My son had one on Risperdal AND Zyprexa which could have become permanent called tardive dystonia. And for what? He didn't HAVE bipolar.They are automatic movements which can not be controlled. Also, while on Lithium he wet his bed every night after having never done it since being potty trained. As soon as he went off of it, he stopped. Found out later that's a side effect too. These drugs are NOT and should not, in my opinion, be experimented with, but they are. On adults too. Again, read up and know your stuff. Although my son is better off medications, I NEED medications to not feel suicidal and have been on them since 23. I am not anti-medication at all. Mine saved my life. But I was an adult when I started taking them and also it took ten years to find medications that really worked for me and I was very involved in my treatment.

    Good luck!!! :)
    Last edited: Jul 4, 2015
  7. InsaneCdn

    InsaneCdn Well-Known Member

    Hi, rollercoaster.

    It is not unusual for a person on the autism spectrum to have other co-morbid conditions. But that doesn't mean that there ARE co-morbid conditions in this particular case. It's... tricky.

    Different perspective, given that we're talking about a 10 year old here.
    She's into the second phase of school - the grades 4/5/6 are tricky. The kids move into a whole different level of subtlety in social interaction, rules for games become much more complex AND more flexible, and teachers expectations multiply faster than skills can be caught up on. Yes, my family's experience with schools has been nothing short of disaster.

    it's entirely possible that this is just an Aspie kid in an impossible situation. Accommodations and interventions may not be enough to make school work for her. As others have suggested, I'd also be looking for an Occupational Therapist (OT) evaluation for sensory and motor skills issues, if it hasn't been done yet. I know, you said she doesn't have motor skills issues... get her tested anyway, it's amazing how a subtle gap in skills can really trip them up at school.

    I wish we had pulled my kids out of school by grade 4. Both of them. (only one is extremely difficult) School was highly toxic for them, and has left lasting damage.

    I'd be looking at all sorts of other things long before I'd be looking at a mental illness diagnosis. If other interventions and significant changes to schooling do not correct things, then by age 14/15 maybe I'd consider looking into mental illness as an option.
  8. rolleroaster

    rolleroaster New Member

    Yes InsaneCdn, you hit the nail on the head with school. 4th grade became a complete disaster. I can understand how she would fall apart at school, we actually pulled her out of there and have a new placement lined up for next year. But she has gone downhill AT HOME. We place very little demands on her (take a shower every couple of days, wake up in the morning, go to bed at night, be kind to others). I would like her summer days to have more structure, but it's tough. The pool is great when the weather is good and she wants to go. Other than that she watches a lot of TV, youtube videos, and plays video games. She swings from nice to hateful with her sister, and it is really starting to affect her sister in a bad way.

    SWOT- Alot of kids with Aspergers are really kind and not hateful. Many have meltdowns but then feel really bad about it and apologize. In the moment they only think of themselves but in the end they are sweet. My daughter, upon reflection after an issue, she continues on about how she hates us. She really does not care how we feel. It is like she will be nice just to get what she wants, not because she is genuine. This is what is SO concerning. Take away her hatefulness and we are back to how she has been the last several years, and no I would not consider any type of mood stabilizing medication for her. But right now, something has got to change. Even the CBT said right now my daughter is just not available to be helped, maybe we need to see a psychiatrist.....which we did.

    But I am with you about psychiatry not being an exact science. And no I do not want to put her on a mood stabilizer. We also cannot go on living this way. I feel like I am being verbally abused everyday. I watch my other daughter cry because she is treated on and off like a piece of trash.

    You would think my daughter would want to feel better, you would think she would want to not feel miserable on and off day in and day out. You would think she would get tired of us getting upset with her. But she really doesn't seem to care. The last medication we tried she refused to take after a few days. It takes a while to work and she wasn't having side effects but she refused to take it, said she doesn't want to change. I don't get it.

    I know this is more than Aspergers.
  9. InsaneCdn

    InsaneCdn Well-Known Member

    Second take:
    Do you actually know all of the reasons 4th grade became a complete disaster? Because... it could be MORE than school - as in, school being a huge problem and then some other huge problem added. And I'm still not thinking mental illness here. More like... trauma.

    Aspie kids are very vulnerable to bullying... and to abuse. It could be a teacher, another older kid at school, or just someone in the neighborhood. But it would be another explanation for her behavior. And kids who have been sexually abused at any level are often NOT initially open to talking to anyone about it. Often, they will have been fed lies about what will happen if they tell, so that they won't tell - and it can unfortunately be quite effective.
  10. rolleroaster

    rolleroaster New Member

    Hi InsaneCdn,

    Yes we know the reasons why she fell apart at school. There were peer issues among other things where the school did not support her. I do not want to be too specific because this is an open forum, but yes there were reasons. But no, no sexual abuse. She doesn't go off roaming the neighborhood. The playdates she has had have been with girls her age with a mom at home, no older brothers or anything like that. She is pretty much always with us besides the occasional playdate. Things definitely went downhill at school after a peer issue and she was accused of bullying when it was another student starting it. She is very sensitive when she thinks kids don't like her--and she started to feel like most kids hated her. Her behavior got worse and then less kids wanted to be around her. She has low self-esteem. Even though she is extremely bright she thinks she is dumb and will do nothing in life except live at home and do nothing. It is quite sad. Of course if you really think you are going to live with your parents your whole life, wouldn't you treat them nicely!!!

    And of course she has lots of good times when everything is going smoothly, she seems happy, and almost just typical. Since she is not really too awkward, when things are going well she does appear typical, maybe just a tad quirky. When things are not going well she seems, well, like there is something seriously wrong with her. Aspergers and ADHD or some mood disorder, we don't know and we really need to know. IF she actually has a mood disorder then I guess we would have to try medication? Can you have a mood disorder and not be on medications?
  11. InsaneCdn

    InsaneCdn Well-Known Member

    Technically, yes.
    Depends on which mood disorder. And on whether you can find a medication that works for the condition and doesn't interfere with other medications or other parts of their life... for some kids, no medications work.
    Depression, for example, often can be treated with just talk therapy, IF the person really wants to work the program AND isn't actively self-harming.

    You can't use medications to diagnose a disorder. You have to get a really SOLID diagnosis. Mood stabilizers are brutal - lots of side effects, some permanent. You really don't want to go there unless it is really necessary.
  12. rolleroaster

    rolleroaster New Member

    The atypical ones don't SEEM to have AS bad of side effects.....but of course they can have bad side effects. Even if there is a 1% chance of something bad happening, it is 100% if it happens to you or your child.

    Who tends to be the best diagnosticians? We have seen many doctors, no one is ever certain of what is going on. They all buy the Asperger diagnosis (with anxiety) but the psychiatrist who has only seen her twice is not sure. He thinks ADHD for sure. Maybe Aspergers but maybe something underlying.
  13. InsaneCdn

    InsaneCdn Well-Known Member

    Depends on where you are. There are multiple ways to get a comprehensive evaluation. The key is to get a COMPREHENSIVE evaluation... the ones that take 6-10 hours of direct one-to-one involvement between evaluator and patient (usually with forms and interviews for parents and others...). Some sources include Neuro-psychologists, PhD-level Psychologists with a specialty in testing and diagnosis, or a child developmental/behavioral evaluation team at a children's hospital.
  14. rolleroaster

    rolleroaster New Member

    We have done the developmental pediatrician at a major children's hospital complete with ADOS and ADI and continue to follow up with them. We might try a neuro-psychiatric, we just need to make sure we get a really good one. They are not created equal. Often the BEST around here do not perform the testing, they only do the analysis.
  15. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    A neuropsychologist from a university hospital would be my first choice. Even if you have to travel. A neuropsychologist is NOT a neurologist. They are two different animals. They are psychologists with extra training in the brain. Our neuropsychologist was very good and tested my son for ten hours. Also we had to fill out many forms and so did the school. He used a lot of observation with Sonic and tested him in many ways. He did a computerized test for ADHD, which Sonic actually passed. Although he does have trouble on and off focusing, it is not all the time, like it is with ADHD...he can also hyperfocus or have normal focus.

    At any rate, he is doing well and medication did nothing for him at all. We tried a lot of medications.He got most of his interventions through his IEP at school...Occupational Therapist (OT), PT, social skills classes and also an aide. He stopped being a behavior problem and is a very sweet young man now, but he is still neurologically different in his interests and the way he thinks. But everyone likes him. Most of all, he likes himself. That makes me happy :)
  16. rolleroaster

    rolleroaster New Member

    Thanks SWOT. Our other daughter had neuropsychological testing. It was a full day long, lots of testing, and yes I completed many forms. I found the neuropsychologist did pretty much what the school did, plus a little bit more. The neuropsychologist diagnosed ADHD and a specific learning disability which the school did not but they totally agreed. So yes the neuropsychological evaluation was helpful in proving what we already knew. But it took the neuropsychologist evaluation to make the school really jump.

    For my very difficult child, I also think it will be beneficial, but I think I want to go with someone even better, someone even more thorough. So the search is on!

    I am glad your son is doing so well :)