New diagnosis for 14yr old...ugh

[Loony Smurf]

After so many problems with this kid....we Finally got a neuropsychologist evaluation done. They also did a speech and Occupational Therapist (OT) evaluation. The results were a bit unexpected. We were thinking possibly Autism Spectrum Disorders (ASD), maybe ASPD. Apparently between his CBT therapist, the pediatrician. neuropsychologist, and the Occupational Therapist (OT) and speech folks, they unanimously agree he has Other specified schizophrenia spectrum and psychotic disorder. On top of his Bipolar II and writing issues.

We won't get the full report for a few weeks. But thinking about it and reading up on it...it really does fit. We've chosen not to tell him the d simply because we feel he'd use it to get away with stuff and say he can't help it, and he'd also tell everyone. I doubt that would be a good thing. So we're going on the theory that bipolar can show psychotic features and going to educate him on that so he's aware of the possibility. He won't recognize it himself but if he starts showing symptoms he'll probably be more open to treatment if he's already aware of the possibility.

So now we're applying for SSDI, and something called an ICG grant here in IL. I'm currently waiting on a call back on what exactly that helps with.

I also read that stressful situations will make it worse, and that it isn't reversible. And that these next few years are the most critical. Problem is that he's Such a problem at home, everyone hates him. He gets bullied, told to shut up, nobody wants to hear you, called names, etc. To be fair he is super annoying, his comments are often rude and out of left field. He isn't grounded in reality and has no reality testing ability. He gets ideas in his head that make no sense, and you just can't convince him otherwise. So we talked with the older 3 and explained the situation to them. my 18 yr old is going to be the issue there I think, he absolutely can't stand him, and has a very deeply ingrained pattern of abuse towards him. I made clear if they can't change their behavior towards him they will have to move out because that sort of behavior will actually mentally break him worse than he is and it can't be fixed.

I don't really know how much or what to tell other people like schools, etc. No idea what kinds of things to change at home and school and church to help him, or how to help others deal with him.

For a change, this year he has Not gotten in trouble at school, at all! He's becoming a problem in getting out the door and all the way to school though. we live 6 blocks from the school, but sometimes he messes around on the way so much that it takes him over an hour to get there. I'm thinking it's time to ask for the Sped bus to pick him up and drop him off again. Considering that he shows he can't be left unsupervised anymore...*sigh*

So, I'm open for suggestions, experiences, advice.

Thanks for always being here when I need it...lol I'm like a bad penny I guess.

 

[DDD]

I am sincerely sending supportive thoughts and prayers your way. It is so hard to accept a more "severe" diagnosis for our difficult child's...plus the label leads to sleepless nights and expanded fears. It is so hard to face an uncertain future but you are a Warrior Mom and I believe you will find the best path to follow. Hugs DDD

 

[BusynMember]

For such a serious diagnosis, I'd definitely take my kid to a psychiatrist for another opinion. I'd want a second, fresh person with qualifications to look at my child and a psychiatrist is more familiar with schizophrenia than a CBT therapist or even a neuropsychologist. An Occupational Therapist (OT) would not be qualified to diagnose schizophrenia at all...he is not in the mental health field.

If you get another "affirmative" on the schizophrenia then I'd take t he family to counseling to hear from a professional how to best deal with it. As long as your child is not violent, he should be treated respectfully. If he gets violent, and he is violent due to his illness, also I do not believe he should be treated with disrespect. He should not be ridiculed, abused or ridiculed for having a serious brain disorder. Does he hallucinate? Does he have weird thoughts, like the radio or television are beaming messages to him? Did they tell you why they feel he has this disorder?

I'm big on second opinions. You want to make sure that this particular diagnosis, which will require serious medication for a lifetime, is correct. You don't want it to just be a person's best guess.

I am very honest with my kids. Your child is already fourteen. If he does have a thought disorder which is as distorting as schizophrenia, I wouldn't keep it from him and would definitely tell the school. And he wouldn't be USING it as an excuse. It is an excuse, a REAL excuse that makes sense. Schizophrenia interferes with every faction of one's life, until the person is stable. It would be a valid excuse for his acting bizarre, possibly being unable to do school work that he could once have done (it can cause cognitive problems) and makes people think things that are not true so that they may blurt out nonsense.

But make sure he really has it. Hugs and I'm sorry.

 

[Loony Smurf]

As part of the ICG grant were applying for his psychiatrist must agree with the diagnosis. The neuropsychologist is already sending there report and supporting evidence to him, and he has an appointment with the psychiatrist on the 5th.

This kid is perfectly smart enough to look up erosivity what this diagnosis means and then do things he shouldn't and say he can't help it, he has this disorder, same way he says he has ADD so he Can't focus so we shouldn't ask him to. I can see him trying to use it to get away with stuff that isn't really a problem for him. The problem with this is that mental illness or no, he'd still get in double, and land in court again. He doesn't realize that when he's lying, he's actually horrible at it since his lies have no connections to reality. Think of the 2 he old caught with a cookie in his hand, in his mouth, and then saying it was his brother and his brother must have put it in his mouth while he was sleeping. Or I said he could, and I just forgot. I mean really... Things just magically fall in his pockets, the car must have chewed that head sized hole in his dresser.. That's the kind of stuff he comes up with.

He admits hearing voices also. He shows all but I think 2 of the criteria for the disorder. The only reason it wasn't caught before is other things were making it because they were so bad. Now those are mostly under control and we see more what's underneath.

This is the same neuro psychiatric that did his WBAL a couple years ago, when he just refused to do a big portion of the testing, and she had less time and no other input than her 6 hours with him.
She's significantly concerned with the things she sees now.

 

[BackintheSaddle]

Sorry to hear about all of this....MWM is right that you should get a 2nd opinion from a psychological expert (none of those you mention have that training which is critical in a case like this)-- usually it's the psychologists who do the tests to diagnose psychological disorders unless there's a physical brain disorder involved where MRIs or scans can help diagnose-- ...what they are saying is his diagnosis falls within a family of disorders called Other specified schizophrenia spectrum-- it's a relatively new classification of which schizophrenia itself is one of several options, so don't assume this is a schizophrenia diagnosis....this is the list of possibilities (below) based on what they're saying and usually professionals classify a diagnosis as 'other' (I bolded the one they told you) because the patient is demonstrating an array of symptoms that fall somewhat in one or more of the other disorders (but in none of them entirely)-- for something this serious, you really need a psychiatric professional in the mix-- a psychiatrist (MD trained) prescribes medications and gives the diagnosis based on input from the psychologist (PhD trained)-- based on your signature line, I'm probably telling you a lot you already know but I did want to encourage you that what is wrong isn't necessarily full-blown schizophrenia (which I know is as scary to some as hearing the word 'cancer')-- keep in mind that some bipolar patients experience delusions and hallucinations (psychotic breaks) and he already has that diagnosis so you need help teasing out what the issues are that can be treated with medications (maybe a different combination-- Risperdal, for example, has worked wonders on my son for delusions, racing thoughts) and which ones will need other forms of treatment (but family counseling to help everyone cope with the path ahead is a great idea from MWM):


Schizophrenia Spectrum and Other Psychotic Disorders
Schizotypal (Personality) Disorder
Delusional Disorder
Brief Psychotic Disorder
Schizophreniform Disorder
Schizophrenia
Schizoaffective Disorder
Substance/Medication-Induced Psychotic Disorder
Psychotic Disorder Due to Another Medical Condition
Catatonia
Catatonia Associated With Another Mental Disorder (Catatonia Specifier)
Catatonic Disorder Due to Another Medical Condition
Unspecified Catatonia
Other Specified Schizophrenia Spectrum and Other Psychotic Disorder
Unspecified Schizophrenia Spectrum and Other Psychotic Disorder

 

[helpangel]

I would recommend a second opinion, looking at those medications it just doesn't match the diagnosis. I understand Depakote (mood stabilizer) for bipolar but I've also heard to stabilize the bipolar before adding stimulants or antidepressants and if that's his diagnosis where is the antipsychotic medication? I'm not prescribing medications over the internet just saying that combo of medications would cause both of my girls to have psychosis. Please get this reevaluated by a qualified mental health professional.

Nancy

 

[Loony Smurf]

See the thing is that he's had huge issues from the time he was 2-3 when there was a lot of traumatic stuff happen in his life. At first it was chalked up to environment, moving, terrible two's, preschool, then ADHD...but ADHD medications sent him manic, so he started seroquel. His oddness still remained, and his outlandishly scary behavior, impulsivity, inability to actually internalize any lessons. medications changed. behavior still worsened. Therapists, counselors, psychiatrists. different medications. IEPs behaviour plans. Hospitalizations. First for mania like behaviors, including playing on the top of a 3 story house, and trying to stab his brother. then he got extremely depressed, ended up in the hospital again (first time we heard of him hearing things), when we added prozac. Obsessive Compulsive Disorder (OCD) behavior got to be an even bigger problem than before, we raised the dose. depression even worse, added lexapro. then he had what we thought was a bipolar mania last year. got in trouble nearly every day at school, suspended repeatedly, stealing tickets, and while suspended he got in even more trouble. His behavior got more and more outrageous and bizarre. Raised the depakote dose. then he had an episode at school where he was found staring at the mirror in the bathroom, then when sent back to school, a few minutes later he was found with wet pants standing a few inches from the wall staring at it, fairly incoherent. He wasnt giving rational responses. We took him to the ER. they did blood tests, his stress hormone level was high, his depakote was too. They ordered an EEG just to make sure, it was negative. We cut back on the depakote. and since, his moods are stable. his behavior has improved. but his thought process...nope. He seriously lacks the link to the real world the rest of us live in. it affects everything. He is not capable of having a rational conversation. He doesnt have a clue when he's really clueless. Social skills...not really there either. Despite the classes, the groups, the therapy. It doesnt sink in. He can give all the right answers, but he doesnt realize that he actually lives in the same wold as the rest of us and should follow the same rules of life. This isn't just a passing psychosis, he LIVES in this state. He has since he was little. Just now that behavior isnt as much of an issue, and moods stable, they no longer explain the continuous bizarreness.

He has several other issues too, including a really low processing speed which combined with a high IQ...well, it's interesting to say the least.

I know you guys are used to second guessing. And i'm not Just going along with it without questioning it. I am taking it to the next level in taking the stuff to the psychiatrist. In the mean time, I'm rooting out as much info as I can.

 

[BusynMember]

I don't remember if he is adopted or had chaotic early years, but to me it sounds more like antisocial disorder traits and perhaps attachment disorder (in which they don't make sense, but they don't think the television is talking to them either). They have more erratic, out-there behavior that is more breaking of societal norms than schizophrenic total thought breakdowns and fantasy world. Of course I'm no expert by any means, but I have been in a psychiatric hospital...lol...and have seen schizophrenics and they are usually harmless, if not rather sedate. I am wondering if the medication made your son psychotic breifly. Both stimulands and antidepressants did a number on me so I know that alone can cause psychosis on a temporary basis.

I would definitely take this to the big guy with the MD, a Psychiatrist. He would know schizophrenia more than anyone. Unfortunately, if he has attachment disorder issues, a psychiatrist would probably miss that (any professional could miss that), however he could identify schizophrenia from impending conduct disorder (antisocial personality disorder).Did he have drugs or alcohol in his system before birth?

For such a serious, lifelong diagnosis, I would not trust anyone but a psychiatrist and maybe two of them who don't know one another. Being overly defiant and not learning from his mistakes is more antisocial than schizophrenic (again I'm NOT a doctor, of course), but I'd check it out. He sounds complicated, like he may have a cluster of problems that are not clear-cut.

A pediatrician and an Occupational Therapist (OT) have no right trying to diagnose anyone. It is not what a pediatrician is trained to know and an Occupational Therapist (OT) is no more qualified to diagnose schizophrenia as you and me.They are Occupational Therapists, not psychiatrists or even mental health professionals.

Just throwing out ideas. Hate for your kid to get that diagnosis and not really have it. He MAY have it, but if this were my kid, I'd want it verified by a psychiatrist and not just by a psychiatrist seeing notes. I would want him to see my child several times.

As our neuropsychologist from Mayo Clinic told us, "Professionals misdiagnose ALL THE TIME, even at Mayo." It is not an exact science.

Good luck, whatever you decide to do

 

[Loony Smurf]

He's my bio son. No problems with pregnancy or birth. No drugs or alcohol. He was the perfect child till he was about 2 1/2...and he's my 4th kid so I have a pretty good comparison there i think lol.

He's been seeing the same psychiatrist for a few years now, but the guy only sees him for about 30 minutes every 6-8 weeks. They have had some good conversations though. The lady that gave this diagnosis is a licensed clinical psychologist, Pediatric neuropsychologist. not a pediatrician.

 

[BusynMember]

I'm so sorry then. I'd still get a psychiatrist's assessment. He really IS the guy with the medical knowledge to know.

I wish you so much luck in your journey and sending lots of love and hugs.