Where to start.....

Discussion in 'General Parenting' started by sherden24, Oct 7, 2011.

  1. sherden24

    sherden24 New Member

    I just found this site tonight and I am really hoping it can be of use for me.....and my family.

    I have a 9.5 year old daughter who is the only child to myself and my husband. We are a pretty stable family. We both work and she goes to a wonderful elementary school. My husband is a pastor, I am a social worker. We both have Master's degrees in counseling.

    I know this sounds strange but when I had her via C-section, the dr. had to really dig into my stomach to get her because she was so content! They laughed and said "oh, this baby is MAD to come out of her momma". And she was. She has always been a little "wild", to say the least. She was diagnosed with ADHD when she was in K (which I knew even before she went to school, there were issues). She was always having issues with crying and being aggressive in Pre K, church, etc...She started taking Focalin and Abilify. We have off and on the past 4 -5 years, have wanted to take her off the Abilify because she has gained SO much weight. Probably around 60-80 pounds. She is 9 years old and weighs about 125-130 pounds. When we take her off, she has these aggressive thoughts and she will yell and run away or cry and stomp or hit, etc... However, today, she even threw a fit when her daddy would not buy her a candy bar and tried to leave the store.

    Her pedatrician is so good to her but she is unable to do much "psychological" medication adjustment as she is not a psychatrist. The psychatrist that saw her in the past took her off the Abilify and then gave her some of the Intuiv which worked for about 3 weeks till she because psychotic one night and almost ran into the street. Her daddy grabbed her and she bit him and I had to grab her arm and pinch her to get her off of him she was in such a rage.

    I just feel that this disease is taking my baby from me. I feel all the joy that I had for her disappering. I have no idea how to help her. She is currently on the Abilify 15 mg 1 x' day and Focalin XR 15 mg in the am. She also at times, takes Focalin 5mg in the afternoon. I just don't know what else to do but we feel really really strong that we need to get her off the Abilify.

    Does anyone have any ideas how to help me? I don't have any support here. I know that the child does not have Bipolar. She is way to young, it's not diagnosed until really, age 18 however, there are tendecies earlier. We do not have a strong family tie of anyone with Bipolar. The only thing that we have overall is that the women on my side of the family have depression. I have it, my momma has it, etc... She does get sad a lot. She has horrible personal hygiene. She has a 152 IQ but fails her tests because she does not want to study. I just am so lost. Thanks so much for listening.
  2. susiestar

    susiestar Roll With It

    Welcome! this is the right place. First off, she is NOT too young for bipolar. PLEASE PLEASE PLEASE get a copy of "the bipolar child" by Papalous and read it. It really gives a great picture of early onset bipolar (eopb) and how it works in the brain and how it can be treated and what medications will and won't work.

    Start keeping track of her moods, when she rages, etc.... Also consider that food allergies can cause some of this. It isn't that hard to do a gluten free/casein free diet for a few weeks, our allergest said to do it for at least a month and pref 6 weeks and then add a small amt of either gluten or casein back for a week and see if her behavior changes with it. there are parents here who have had HUGE changes when they removed these from their children's and their own diet. I can't say it is the most or least probable cause, but it IS something you can do with-o a psychiatrist (psychiatrist). It is not that hard now because it is far more mainstream than it ever was before.

    We also urge you to read "The Explosive Child" by Ross Greene and "What your Explosive Child is Trying to Tell you" by doug Riley. If you search this board for the 2nd of those books, the author has come here and posted about it to get some opinions on it and give some of his own. I am pretty sure his name is doug riley. SOrry about the capitalization, my hands aer not working very well tonight.

    As for medications, there are others that they can try if you want her off of abilify. What exams and tests has she had? We recommend seeing a neuropsychologist for a complete battery of tests as well as seeing an Occupational Therapist (OT) for possible sensory issues (I have a lot of them and they can totally drive you out of your mind.), audiologist and speech pathologist for issues in those areas. It is a bit of a nuisance to get all the tests done, but she needs them and tehy will help figure out what the problem really is and how to help her learn to cope. Does she have an IEP at school? in my opinion that would be a very good thing.

    Again, Welcome! Others will post soon, I am sure!
  3. keista

    keista New Member

    Welcome to the board!

    You gave a very good introduction, but as always there are more questions.

    Who diagnosed(diagnosed) her? What other dxes does she have besides the ADHD? Does she have an IEP in school?

    I understand your concern with the weight gain on Abilify. I have such concerns for my children as well, but sometimes we have to deal with that kind of "minor" side effect to get the best help. There are other similar medicines to try, but most of them also cause weight gain. risperdal and Seroquel are two I know off the top of my head.

    As for Bipolar, it absolutely can be diagnosed in children. Generally it does not present with the same time criteria for manic and depressive episodes in children as it does for adults. However, there is a "lesser" bipolar type disorder called cyclothymia which according to DSM criteria can be diagnosed in children. This one would seem to fit children more since it doesn't have time criteria for the length of manic or depressive episodes, since children tend to cycle rapidly.
  4. Liahona

    Liahona Guest

    Just wanted to add my welcome.
  5. InsaneCdn

    InsaneCdn Well-Known Member


    This is a complex child. If it were simple, you'd have found answers already.

    Therefore... I second the need for a comprehensive evaluation. In fact, get every evaluation that even remotely makes sense. Because... there are many hidden things that can cause huge problems.

    You mention ADHD - its a diagnosis that can come with a LOT of baggage in the form of co-morbid conditions... learning disabilities and Developmental Coordination Disorder (DCD) are very common. But its also a diagnosis that can in fact be "something else". For example, many kids who are Asperger's or Autism Spectrum Disorders (ASD) have strong ADHD traits. If its "just ADHD", then common ADHD interventions work (basic medications, and a few accommodations at school) - and yes, a kid can be "just ADHD" - I have one like that. Yours is not... and I have one like that, too.

    Mood disorders are tricky. First, there's the whole primary/secondary situation... some, like Bi-polar, are not secondary disorders. But depression and anxiety can be either primary or secondary. Its kind of like the chicken or the egg question... which came first? If the mood disorders came first, they can cause all sorts of other issues especially if interventions are not working. BUT all kinds of other issues, especially if not caught or interventions are not working... can definitely cause severe anxiety and/or depression. And it will NOT necessarily be obvious which came first.

    This is why the comprehensive evaluation is so important. This is the opportunity to go digging for "other things" that may also be a problem. If there are none (possible, but not as likely), then at least you've answered the chicken-or-egg question. If there ARE other things, then you go after those (we'll teach you how to be a warrior mom) and deal with everything possible... including trying to handle the moods.

    Please start a parent report - its not called exactly that, but its easy to find in Site Help and Resources. Its a great way to pull together everything you already know, in a format that is useful to everyone who has to evaluate your child.

    I'm curious... did her problems get worse when she started school? and worse again with starting grade 4? If so... the probability of motor skills issues and learning disabilities is VERY high. In which case, try and get an Occupational Therapist (OT) evaluation done as well - and before the comprehansive, if possible. Info from the Occupational Therapist (OT) testing will be useful to the one doing the comprehensive evaluation.
  6. oldmama

    oldmama New Member

    whoa, my son was born almost exactly like your daughter! he was almost 3 weeks late and when they tried to induce labor he got stuck so they did an emergency c-section and had to pull and pull to get him out... he was 10 pounds!

    when they placed him in my arms I felt his anger almost immediately... I said, "Whoa, this kid is really ****** off" he had what we called his "boo-boo lip" for several years. always pouting and in a foul mood.. angry at teh world.

    as he got older he threw this tremendous temper tantrums.. he would get red in the face and start destroying everything in his path... i would hold him and wrap my legs around him and tell him "I'm not letting go until you scream!" he would fight and fight and then finally scream or cry or both and then at that point his body would relax and he would cry and cry as I cuddled him and I would try to explain, "when you get mad it's okay to yell or scream. Just let it out."

    It was if he didn't know how to be angry? But several years of this and he learned how to yell and tell me off whenever he was angry.

    I never put him on drugs but maybe i should have? I don't know if any of this is useful but just sharing my experience with you. I don't think i would say your daughter is bipolar but maybe just doesn't know how to express her anger?

    you know best because you are around her obviously but just wanted to share what happened to me...

    Good luck and god bless you and your daughter :)
  7. crazymama30

    crazymama30 Active Member

    You have received some great advice, just wanted to add my welcome.
  8. I am both sorry and glad that you are here, if that makes sense. These folks are wonderful. I have no advice, only prayer and commiseration. I do want to second what susiestar said. My difficult child has a lot of intolerance to food and a lot of vitamin and mineral deficiency. We had them tested when he was young.
    Age 5 he was barely verbal...couldn't do more than echo what we said. He also wasn't toilet trained, to speak of. He also whacked things and destroyed things a lot. We did gluten-free, casein-free diet and within two weeks, he was speaking in sentences and was completely toilet trained, and was a lot more calm. He still had issues but this was amazing to us. We are still gluten-free, casein-free. We did a lot of other interventions, including testing for allergies and metabolic issues, and we addressed them at the time, and saw results.

    We have since stopped over the past few years, with the exception of the diet, and we will be revisiting all of that orthomolecular treatment now, as he currently has problems, and intolerable side effects to the few medications we have tried. I am not trying to push an agenda in any way, just adding something else to the long list of things you will probably be reading about.

  9. buddy

    buddy New Member

    Welcome, so glad you found this board. I wish I would have found it 10 years ago! My only advice really is to stick with this group because even if you receive posts that dont fit, you will receive posts! People here really care and it has been a life line for the past couple of weeks that I have been here.

    I would second the re-evaluation/complete evaluation suggestion. For sure there is childhood bi-polar and it can look very different from the adult form. I am no expert, just have had students and friends dealing with it. My son has mood swing issues and for him it is a brain trauma thing. medications are super tricky.

    When it comes to chaning medications, do what you feel is right for her but many of us have some little routines to do it....Like for me, he will never have a medication CHANGE during school time unless it is an emergency. I wait for long breaks. If it includes going off a medication and starting another I wait till summer (again, if not an emergency). If it is an increase or decrease, I do it on the weekends... you get the idea. I wouldn't have thought it such a big idea until my son had a psychotic reaction to a medication. This has happened once since about 7 years after the first. Found out he has an enzyme issue and can't process many medications so I am ultra careful and only stick with very conservative docs when it comes to dosing.

    You sound like a really great family. She is lucky to have you.
  10. TerryJ2

    TerryJ2 Well-Known Member

    I second (or third) the idea for a better evaluation. Something more in-depth.
    I am so sorry about the weight gain. I have heard that from other people.
    Wish I had more to offer, except hugs. :notalone:
  11. sherden24

    sherden24 New Member

    Thanks so much for the warm welcome. Several questions were asked. She was evaluated by a wonderful psychatrist who did a complete and indepth evaluation. He stated that she is the smartest child he has ever seen. He also said he has the worse case of ADHD that he has ever seen. I do understand a lot of the co-morbidites of the ADHD diagnosis and I know that Bi-Polar is very common however, there usually has to be some sort of famial history for it. We just can't find anything as far as Bi-polar on any side of the family. She does seem to have a strong case of depression.

    She does not have an IEP. We may need to do that. I am not sure. She just seems so "normal" at times and then when she has these fits, so angry. I am going to look at some of these resources to see what I can find out. Thanks so much for the warm welcome.
  12. keista

    keista New Member

    It is possible that the depression you are aware of is misdiagnosed bipolar. Not all bipolar goes into sever manic mode. Even with bipolar II, the hypomania is not always pronounced enough to cause a problem and therefore is not considered a symptom by the patient. In fact it feels like extreme well being. in my opinion this is why SSRI's have all these crazy opposing side effects. In ppl diagnosed with depression who actually have bipolar, these medications can spell serious trouble.

    AND bipolar is not necessarily genetic. It can skip a generation or two and it can just come out of nowhere. It's just more likely if there is bipolar in the family tree.
  13. InsaneCdn

    InsaneCdn Well-Known Member

    I held off posting at first - needed to get a little feel of the situation before responding.

    There are multiple possibilities here - and its not obvious which it might be.
    Do you mind if I toss some more possibilities out there?

    1) It could be ADHD plus other stuff. The list of co-morbid dxes is quite long - and most lists are incomplete. In particular, I'd be looking for motor skills issues - even subtle ones expecially on the fine motor side, can cause huge school issues... and the huge school issues can cause secondary anxiety and secondary depression. Developmental Coordination Disorder (DCD) is just starting to hit the radar in North America - more well known in some parts of Europe, and in Aus/NZ.

    2) The list of red flags for ADHD mimics very closely the list of red flags for Auditory Processing Disorders. If you're really dealing with an Auditory Processing Disorders (APD), then all the things that help ADHD go out the window... EXCEPT... Auditory Processing Disorders (APD) and ADHD can be (often are) co-morbid. There are a whole range of possible issues here - not just classical Central Auditory Processing Disorder (CAPD). One of the newest on the list, is also very subtle AND very destructive, because it makes school torture: sometimes referred to as any of... auditory filtering, auditory focus, or auditory discrimination. Result: can't make sense of what the teacher is saying, because of the background noise in the classroom. And don't let anyone tell you these are quiet classrooms. If you have Auditory Processing Disorders (APD) - the noise levels are beyond coping. Most people filter out that background noise and don't "notice" it... but it IS there. One common thing that you will see with this particular issue, is that the student does much better one-on-one in a quiet, separate environment. There are accommodations that make a huge diff in-class.

    She's at an age where the focus of school work is starting to change - from learning basic skills, to using them. If she's had trouble with the basics... she may be reaching the limits of her resources, and literally "screaming" for help.