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Worried we're approaching crisis time
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<blockquote data-quote="rlsnights" data-source="post: 309627" data-attributes="member: 7948"><p>Thanks for all the ideas and well wishes.</p><p></p><p>Fortunately, the psychiatrist, therapist and I are all on the same page. difficult child 2 was clearly close to manic if not all the way by last night. I think the psychiatrist is now ready to call him rapid cycling and get more aggressive in treating him as bipolar. Up til now she's been kind of on the fence about a bipolar diagnosis.</p><p></p><p>We are waiting on the blood test results and, if they're OK, will be increasing his Lamictal to 200 and his Abilify to 10 possibly adding Geodon if that's not enough pretty quick.</p><p></p><p>One good thing from all this has been a real reversal with his new therapist. The guy told me today that he feels very strongly that difficult child 2 is bipolar based on the events of the past 3 weeks and that needs to be addressed ASAP. No more advice to send him for a walk to calm down so he can do his chores. Today he said that behavioral approaches weren't appropriate with difficult child 2 and we won't know if they are until we get him stabilized. My thoughts precisely.</p><p></p><p>I guess I wouldn't describe what we do as threatening to call the cops. Rather we apply the house rules to a given situation and then say to him "if this happens/doesn't happen then calling the cops is what will happen after that." We don't treat it as a threat but rather as a reminder to him and a strange sort of lifeline for him to grab. </p><p></p><p>We have called the cops in the past and will call them again under certain conditions and he knows it. So we are very willing and able to follow through if it is clear to us that calling the cops is necessary. I guess you could say it's our way of asking him to show us if that's what really needs to happen.</p><p></p><p>We can count on one hand the number of times we have used that phrase to reach him in a rage. The one time it didn't work he was taken to ER in the back of a squad car. For us it is a way to measure just how far gone he is - if he can't respond to that then he absolutely needs psychiatric hospital.</p><p></p><p>One of the things that's scary is that we have had to use that reminder with him 3 times in the past 2 weeks. So far it has worked to break through to him. All the professionals we are working with (2 tdocs who specialize in working with adolescents, 1 case manager from the psychosis early intervention program, and our child psychiatrist) have told us what we are doing is appropriate and they feel we are handling him really well. None of us want to see him in the psychiatric hospital unless it's absolutely necessary. </p><p></p><p>About the blood draws. I understand your perspective on this and many times that is exactly the approach I take. But my son has a serious chronic autoimmune disorder that requires frequent (as in 20+ times a year) blood draws. That's when things are going well. The repeated trauma of this over the past 3 years means that there are times when he is simply too emotionally fragile to handle a blood draw - not so much because of that day's blood draw but because of the accumulated trauma of years of blood draws.</p><p></p><p>Because we must do this (and other invasive medical procedures like sub-cutaneous injections at home) so often I have found that I cannot do battle with him or issue ultimatums too often. Instead I must sometimes work with him at a more adult level and use persuasion or logic to get him on board.</p></blockquote><p></p>
[QUOTE="rlsnights, post: 309627, member: 7948"] Thanks for all the ideas and well wishes. Fortunately, the psychiatrist, therapist and I are all on the same page. difficult child 2 was clearly close to manic if not all the way by last night. I think the psychiatrist is now ready to call him rapid cycling and get more aggressive in treating him as bipolar. Up til now she's been kind of on the fence about a bipolar diagnosis. We are waiting on the blood test results and, if they're OK, will be increasing his Lamictal to 200 and his Abilify to 10 possibly adding Geodon if that's not enough pretty quick. One good thing from all this has been a real reversal with his new therapist. The guy told me today that he feels very strongly that difficult child 2 is bipolar based on the events of the past 3 weeks and that needs to be addressed ASAP. No more advice to send him for a walk to calm down so he can do his chores. Today he said that behavioral approaches weren't appropriate with difficult child 2 and we won't know if they are until we get him stabilized. My thoughts precisely. I guess I wouldn't describe what we do as threatening to call the cops. Rather we apply the house rules to a given situation and then say to him "if this happens/doesn't happen then calling the cops is what will happen after that." We don't treat it as a threat but rather as a reminder to him and a strange sort of lifeline for him to grab. We have called the cops in the past and will call them again under certain conditions and he knows it. So we are very willing and able to follow through if it is clear to us that calling the cops is necessary. I guess you could say it's our way of asking him to show us if that's what really needs to happen. We can count on one hand the number of times we have used that phrase to reach him in a rage. The one time it didn't work he was taken to ER in the back of a squad car. For us it is a way to measure just how far gone he is - if he can't respond to that then he absolutely needs psychiatric hospital. One of the things that's scary is that we have had to use that reminder with him 3 times in the past 2 weeks. So far it has worked to break through to him. All the professionals we are working with (2 tdocs who specialize in working with adolescents, 1 case manager from the psychosis early intervention program, and our child psychiatrist) have told us what we are doing is appropriate and they feel we are handling him really well. None of us want to see him in the psychiatric hospital unless it's absolutely necessary. About the blood draws. I understand your perspective on this and many times that is exactly the approach I take. But my son has a serious chronic autoimmune disorder that requires frequent (as in 20+ times a year) blood draws. That's when things are going well. The repeated trauma of this over the past 3 years means that there are times when he is simply too emotionally fragile to handle a blood draw - not so much because of that day's blood draw but because of the accumulated trauma of years of blood draws. Because we must do this (and other invasive medical procedures like sub-cutaneous injections at home) so often I have found that I cannot do battle with him or issue ultimatums too often. Instead I must sometimes work with him at a more adult level and use persuasion or logic to get him on board. [/QUOTE]
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