The most pig-headed person in the world

Discussion in 'General Parenting' started by somerset, Dec 26, 2011.

  1. somerset

    somerset Member

    difficult child has a history of insomnia (insists there is no problem now) and of waking up on school mornings feeling sick. She's missed a huge amount of school in the last few years and was off for a whole month before Christmas vacation for various ailments. She has failed the entire first semester of high school.

    It is my belief that she needs to stay on a strict sleep schedule - getting up early and going to bed early - even on non-school days. She always has more trouble after Xmas and Spring breaks - I think because she gets used to sleeping late and then suddenly she has to get up at 6:30 am and it feels like I'm waking her up in the middle of the night. She has two weeks before school starts again, and I talked to her AGAIN about it. But I forgot - I'm always wrong. She insists it doesn't make any difference and if she tries to go to sleep earlier she won't be able to, and it's better for her to sleep late and get as much sleep as possible now so she'll be recharged when school starts. And stop trying to talk to her about it all the time because it's really upsetting her and I am WRONG. And it's vacation! so she should be able to sleep late. I told her that's for people who haven't already spent the last month and the whole summer in bed. By the way, I'm taking two weeks off starting next week, and I am prepared and willing to get up early to wake her up on my vacation, if that's what it takes.

    She just refuses to change any habits that I know from experience hold her back physically and mentally, and to me, this is a person who seems unwilling to lift a finger to get better. But to her, I'm just wrong. She says she's trying, but to an outsider it sure wouldn't look like it.

    She is the most pig-headed person I've ever met. You can't make her do anything. Rewards, punishments, nothing affects her, but if you pressure her too much, she crumbles and stops functioning at all.

    At least she's taking the medications and going to therapy without complaint now. We just went up from 10mg to 20 on Celexa and I think I see a little change.
     
  2. tiredmommy

    tiredmommy Site Moderator

    What does she do when she is up late? Perhaps removing those things (or limiting them to a reasonable hour) may help. Also, you may want to try having her wind back the clock in increments; so if she's up intil 2AM, she now has lights out at 1:30AM for three days, then 1AM for three days, etc. Just curious: does your difficult child have a mood disorder?
     
  3. somerset

    somerset Member

    Yes, she has depression and Generalized Anxiety Disorder (GAD). Right now, she's going to bed before midnight. I would love it if she at least was willing to gradually change her sleep patterns, but she completely refuses. After I posted, I started thinking that maybe it's not willfulness but fear and anxiety that make her so rigid. Maybe she's afraid of changing anything in her life or of being out of control.
     
  4. InsaneCdn

    InsaneCdn Well-Known Member

    I was going to suggest that, based on your first post... and then came to your second post.
    She has at least three issues - that is, she has three that you know about. There may be more. This would not be uncommon.

    Meanwhile - the three that you do know about, work against each other.

    Depression exaggerates the tiredness - even without a sleep problem.
    Anxiety is a well-known sleep killer.
    And sleep problems... multiply every other problem in life.

    Catch 22. You can't really solve one of these, without finding answers to all of them.

    Glad she's open to medications and therapy... probably the only long-term solution.
    Hopefully the therapist is also looking for "other things" - hidden LDs and other issues, that may have stayed below the radar...
     
  5. somerset

    somerset Member

    THe therapist and psychiatrist aren't looking for anything else. Kaiser psychiatrists seem content with very general diagnoses and their evaluations are not deep at all. I'm sure we could find a better therapist, but I don't know how - it's so hit or miss. I think she does have other problems. For example, for years she's been saying she has trouble with her eyesight at school, but optometrists always find her vision normal. I wonder if it's a processing issue. Problem is, I have no money for evaluations and have never found school cooperative. I guess you really have to push for those things. Trouble is, she always wants to fly under the radar at school, so she's uncomfortable with me having meetings with teachers, etc.
     
  6. DammitJanet

    DammitJanet Well-Known Member Staff Member

    Insomnia is a killer. I have awful insomnia and it really doesnt go away no matter what I do. medications help somewhat if I can catch them at their ideal window for falling asleep but sometimes I miss that window and they wont work.

    You might want to talk to her doctor about trialing either a very low dose of seroquel or some thing like trazadone for sleep. For seroquel, a dose of as low as 25 mgs can be very sedating.

    Even if I can manage to get to sleep at a reasonable hour, I definitely need a full 8 to 9 hours of sleep. I simply cannot run on less. Cant. My eyes will close on their own and I cant even pay attention to something that I desperately want to see. I cannot imagine trying to sit in a classroom and learn something in that state. I would be asleep on the desk. I think I would try to get her day to start a bit later in the day and have it written into an IEP or 504 if she doesnt have an IEP. Get a doctor's note.
     
  7. soapbox

    soapbox Member

    If therapist and psychiatrist aren't looking and school isn't cooperating... mind if I dig a bit?

    Can you tell us a bit about how she is doing in school? What does she find easy, what does she find hard, what does she hate - or refuse - to do?
    How are her motor skills? both gross (clumsy?) and fine (writing, dressing, etc.)
    Does she prefer one-on-one teaching? complain about the classroom being noisy?
    Does she have trouble trying to focus in class?

    If we can map a bit of a pattern, then there are ways to FORCE the school to do certain evaluations (you're fortunate... we don't have that level here!).

    I could dump the details of where I'm going with this right here, but I'll wait until I know a bit more about your daughter.
     
  8. somerset

    somerset Member

    She hates having to write by hand, doing any school work outside of school, math. She likes English and has favorite books, although she doesn't read very much but manga. She likes making up stories, but doesn't want to write them down. She's never been taught one on one. Her motor skills are good. Last year, when I was trying to get a 504 for her, her teachers said she was always attentive in class and she seemed just fine to them. (Of course she was fine - when she wasn't fine she'd be at home.) I guess they didn't notice the times she fell asleep in class. She doesn't have problems learning the material and is capable of getting good grades, but she missed so much class time and usually doesn't make up assignments, so she failed all her classes. She never complains about noise. She does daydream in class. I do remember that she wrote letters and numbers backwards sometimes way longer than I thought she should, but her teachers thought it was normal.

    She says she's sleeping ok now, and I haven't seen any signs she's been up in the middle of the night, like I used to. RIght now I'm just concerned about the timing of her sleep, because it will be a big change when she goes back to school. She was taking trazodone, but it didn't seem to make her sleepy and she wanted to stop taking it. Before that, she was on Remeron and it helped, but she stopped taking it without telling me, and when she tried to go back on, she had a bad reaction to it. Now she's on Celexa only, and I give it to her at night. She seems to need 10 hours of sleep.
     
  9. HaoZi

    HaoZi Guest

    She definitely needs to stay on a steady and do-able sleep schedule. If she's afraid of lack of control being tired all day won't help matters. At her age I had few rules about bedtime: 1) I had better not keep anyone else up, and 2) I had to get up and get to school on time. I learned what time I needed to be in bed by for my own good. If I wasn't "well enough" to go to school, I wasn't "well enough" to go anywhere that weekend, either (or have anyone over). I could be sick Monday morning and not allowed to go anywhere that weekend no matter how much better I was, so if I stayed home sick it was because I was *really* sick.
     
  10. soapbox

    soapbox Member

    Here's some things you may want to think about - because it sounds to me like there is more going on.

    Some of the red flags are:
    - Sleep - yes, quantity is an issue... both ways. She "needs" 10 hours. Why? OR... maybe she is getting quantity but not quality of sleep, which would also be a problem. Don't rule out other sleep problems yet.
    - Writing problems = huge school issues.
    - Not really a "reader"...
    - Daydreaming in class.

    The fact that she doesn't like writing, isn't really reading, and had trouble with letter formation... sounds like it could be one of several things... or ALL of them. She needs multiple evaluations.
    1) Dyslexia - affects both reading and writing
    2) Dysgraphia - reading isn't a problem, but can't really do written (or typed) output
    3) Developmental Coordination Disorder (DCD) - developmental coordination disorder, affecting fine motor skills - this has to do with the physical/neuro-motor aspects of writing. People with this disorder may be able to write just fine - except if they have to think and write at the same time, or listen and write - because it takes so much brain power just to recall and form each letter that the flow gets lost, plus mental fatigue sets in quickly. Others, just can't master the whole mechanics of writing. Either way, accommodations help: scribe, note-taker, access to computer for written work...
    Any of these are going to feed anxiety. And the approach teachers usually take, just makes it worse. ("You can if you want to - you just aren't trying")

    Daydreaming in class, falling asleep in class, general fatigue... these can be any number of things. If something like Developmental Coordination Disorder (DCD) is in the equation, that alone can generate significant fatigue. Also, it leads to subtle bullying... by both teachers and peers. But, it could also be Central Auditory Processing Disorder (CAPD) or Auditory Processing Disorders (APD) - an auditory processing disorder. Central Auditory Processing Disorder (CAPD) is less likely, but not impossible... it isn't bad enough for her language capability to be markedly behind, or it would be noticable. There are other APDs, though. One is "auditory figure ground": difficulty following the "primary" or "important" sounds, in the presence of background noise. Classrooms are notoriously noisy (teachers say they aren't!). Even a mild Auditory Processing Disorders (APD) can make it difficult to focus on the teacher's voice, get the right instructions. After a while, you just tune out - its too much effort. And yes, it adds to mental fatigue. This would begin with an Speech Language Pathologist (SLP) evaluation - but specifically push for "auditory figure ground" testing.

    The other possibility, which would be a subject for discussion with the therapist, is Obsessive Compulsive Disorder (OCD) - obsessive compulsive disorder. One of the forms of this is "perfectionism". Taken to excess, it can be paralyzing. If this exists in conjunction with other writing-related issues, it can compound quickly.

    Its possible that none of these apply to your daughter. Just wanted to toss them out in case they might fit. Because if the do... getting the right accommodations and interventions can make a world of difference.
     
  11. susiestar

    susiestar Roll With It

    Your daughter NEEDS a sleep study. Get her to a doctor (primary care would be the easiest and is FINE for this part) and get him to order the study. She will go to a place in the evening, have a bunch of things hooked up to her, then be allowed to sleep at a certain time, and they will see what is going on with her sleep. in my opinion is this HUGELY IMPORTANT. Sleep issues can destroy the rest of your life.

    Then she will meet with the sleep doctor (yes, there are docs who just study sleep, in my opinion it gets patients that can't argue, KIDDING!) and the doctor will tell her ALL about good sleep hygeine. All the stuff that is totally WRONG when Mom says it just might be RIGHT if the doctor says it. Even if that doesn't happen, you will be able to figure out how best to help her sleep problems.

    Is there a reason she cannot do some/all of her classes online for high school? Most states have that for free and it doesn't MATTER what time you do lessons unless you need help from the on-call teacher. She does need to be tested for learning disabilities esp dysgraphia (handwriting problem - brain glitch between thought and hand) and can get accommodations for that. Many with dysgraphia do very well with keyboards. I have it and I have 2 sons with it, and it can actually HURT to write a lot. Testing can get treatment that can help her overcome the awkward feeling of holding a pen or pencil and it can help her not have her hands hurt so much. MOST IMPORTANT, in my opinion, the testing can show that she IS NOT lazy or a waste or any other awful things she has been told or told herself. It will show she has a problem that can be helped and is as much to be ashamed of as having a cold it.

    Why can't the school have her do classes on campus in the afternoon and online in the evening? in my opinion it seems quite logical. Most states have an online school for kids up to 12 grade and surelyh seh could do that?
     
  12. DaisyFace

    DaisyFace Love me...Love me not

    Somerset--

    When my daughter was taking Celexa...she had a hard time settling down to sleep at night, too. So she switched to taking the Celexa before bed, instead of in the morning, and that seemed to help. Maybe worth a try?
     
  13. exhausted

    exhausted Active Member

    We found Celexa to be our best choice of the SRI's but sleep problems as well. We did dose her at night but ended up with trazedone that she takes only when she knows she is over stimulated and wont sleep. We tried melatonin to no avail.. Sleep is key. It causes major health issues and yes psychiatric problems when they dont get enough. Could be anxiety (thats when a lot of us don't sleep). I agree that a sleep study would be good if your insurance will cover it. It will give peace of mind. I will also warn that some of my girls sleep patterns were disturbed as she began to talk to older people in the night when we were asleep and also I believe buy marijuana. This started at age 14. I don't want to be an alarmist, just sharing experience.
     
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