New and in need of advice 9yo ADHD

[Tarheelcpl]

I am new to site but in desperate need of advice. My 9yr old son has ADHD and adolescent anxiety. He has been on medications since he was aprox. 5 yrs old. We have had our ups and downs but last night all I could feel was fear. Little after 8pm told him it was bed time. About 10 min later he goes running into the bathroom screaming. He was bleeding from his hand. He had gotten a pair of scissors from the sewing closet. And was cutting his bedding up, his blinds, and the tip of his thumb. He has done something like this once before... as far as cutting things up. But never hurting himself like this before.
I don't know what to do. I have called his doctor.. he is on vac. So i sit here waiting to hear from the person filling in for our reg. doctor. I am open to any and all advice..
EARS ARE OPEN HERE

 

[BusynMember]

Hi there.
My first thought is that they diagnosed him wrong and that much more is wrong than ADHD. In fact, the ADHD medications obviously are not working. I would take him for a complete neuropsychologist evaluation. ADHD does not make kids cut themselves. I would be thinking either mood disorder or somewhere on the autism spectrum. How was his early development--speech, eye contact, ability to transition, socialization with peers? Or do you have mood disorders or substance abuse on either side of the family tree?
I'd definitely want a neuropsychologist evaluation. They are the most intensive and best by far, in my opinion. Has he ever seen a neuropsychologist? Why kind of doctor is taking care of him? ADHD is often the first diagnosis. and often NOT the last one.

 

[susiestar]

Midwest mom echoed my thoughts. I do think most of us hear ADHD as the first diagnosis. If you feel that your son is a danger to himself or others, please take him to the ER or call the police for transport to a mental hospital.

It really really sounds like MUCH more than ADHD and anxiety. I am sorry.

 

[Tarheelcpl]

He is currently seeing a Child/Adolescent Psychiatrist. And yes there are mood disorders in the family. At this point I feel like I need to start from scratch cause you are right this isnt working. I have never in my life felt so helpless

 

[smallworld]

Welcome to the board.

What medications is your son taking? And at what doses?

ADHD medications can exacerbate anxiety and cause depression. They can also make kids with mood disorders worse.

Is there another psychiatrist covering for your psychiatrist while he is on vacation? If so, you need to get in touch with that doctor ASAP to figure out what should be done.

When you get a chance, please click on "User CP" at the top lefthand side of this page and create a signature similar to mine. It helps us keep everyone on the board straight.

Again, welcome.

 

[Tarheelcpl]

He is currently on focalin 40mg and prozac 20mg a day.
Right now that is the only dr he is seeing. Which I am learning it is soooooooooo time for a change

 

[Steely]

Hi and welcome.
Personally I would take him to get an evaluation at the local hospital. Whenever a child injures himself, that is a huge cause of concern, and needs to treated immediately before it escalates.

I am sure he will be fine, my son has done similar things, but he needs to be checked into a hospital for a couple of days so he can get evaluated and on the proper medications.

Good luck - we have all walked in your shoes - and we do get through to the other side.
PS
The medication combo he is on can exacerbate and escalate some mood conditions. Whenever a stimulant is combined with an anti-depressant you run the risk of it elevating and activating certain children with certain mood disorders.

 

[smallworld]

When you call your psychiatrist's office number, is there another psychiatrist listed to contact in case of emergency? Your son's episode counts as an emergency, and you should contact your psychiatrist's coverage.

If that doesn't work, I agree with Steely's assessment that your son should be evaluated at a local hospital. That hospital should have a pediatric psychiatric unit, if possible (children's or university teaching hospitals should be looked into). I would hope that a good psychiatrist would see the need to wean your son from these medications because they seem to be making him worse instead of better.

My son's first diagnosis was ADHD and anxiety. He now has a diagnosis of bipolar disorder because both ADHD stimulants (like Focalin) and antidepressants (like Prozac) destabilized his mood. It is something you definitely need to consider.

I hope you are able to get some help today.

 

[SRL]

I agree that you need to push for an evaluation at a pediatric psychiatric unit. None of us can tell you if your son is misdiagnosed, is having a medication reaction, or any number of other things, but this should be taken as an urgent matter. Prozac has been implicated in increased suicide risk in children.

We can talk you through diagnosis and evaluations later but this needs immediate attention.

 

[Andy]

Did you tell the doctor staff that this was urgent and that you are afraid? When I called to get a sooner initial appointment with my son's psychiatrist when he was feeling like jumping from the third floor of a shopping mall balcony, I was advised to take him to the ER. I felt that we could handle this without going to an ER 3 -4 hours away from home. When we did get into the psychiatric a few days later, he explained how to get the next level of help (day treatment or hospitalization) if we felt we needed it. He stated to 1. go to an ER where the evaluation can be done and referral to the peds Residential Treatment Center (RTC) or 2. call the peds Residential Treatment Center (RTC) and ask for an appointment to come in for an evaluation.

I am so glad we didn't go to ER in the cities, I don't think they would have let me take him home even with the promise to get him hospitalized closer to home - he would have been admitted to a hospital too far from home. I think that the ER route also helps with insurance payments - if this is documented as an emergency, better payment.

I do understand calling ahead, however, we were only one block away and I figured we would just walk in and ask for an appointment. They noticed how upset my son was (threw up in the entry in a waste basket) and knew what was best for him was to get help NOW.

If you have not heard from your doctor's back up by now, call the Residential Treatment Center (RTC) direct and ask for their advice. Go ahead and let them know your feelings and hear your desperation. I think sometimes we try to hold too much in. We need to learn to get our urgency out without showing loss of control.

How is your son today? This has to be extremely scary for him. My son told me on vacation he didn't feel safe at home because he knew where the scissors and hammer were. He felt is was too hard to continue fighting his body trying to make him hurt himself. The hospitalization was the best thing we did - he felt so safe there, nothing available to use to hurt himself, and learned skills to use when these bad feelings arouse. I believe part of the hospitalization decision was because he was afraid of doing something when I was asleep and wouldn't know to help stop.

 

[tryinghard]

I just wanted to send you my warmest thoughts for you and your difficult child. We are here for support..please post when ever you need to. Gentle hugs....

 

[TerryJ2]

A friend's son did something similar but he used his bare hands to rip up the sheets, and create a sort of jungle playhouse in his bedroom. They freaked when they saw it and that was a moment of change for all of them. He has Asperger's and ADHD and I don't know what else. He is very high functioning and on grade level, drives, does volunteer work, etc.

I would not want a child that young on Prozac. It is experimental with-kids.
Also, remember that if your son is ADHD, impulse control is the name of the game, so grabbing a scissors and cutting apart sheets probably sounded like a cool project, and he got so carried away he just missed the sheet and got himself. I mean, he didn't stab himself, he was doing a "project" that was ill planned, right?

Best of luck with-your challenging child, and finding new docs.

 

[smallworld]

FYI, Prozac is the only SSRI antidepressant approved by the FDA for the treatment of depression in children. However, all SSRI antidepressants carry a warning of increased aggression and hostility plus suidical and homicidal ideation.