pdoc gave parial asberger's dx, but reluctant to give any bipolar dx. change in meds

[ryzgal]

there's 7 days in a week, so my odds of having one of them be a good day are pretty good right? today is not one of them ok, that was extremely pessimistic.


Years ago, I tried bringing up the Asbergers with other pdocs, and reg doc. Kept getting told his symptoms were ADD. I've never believed my son had ADD ever! Today, while going over his symptoms again, the pdoc says she believes he has Asberger tendencies. Because he does well on tests (??) she doesn't feel he falls directily into it however. She does feel his other symptoms fall under his ODD and OCD, and not bipolar. So he now has a dx of OCD, ODD, GAD, and mild Asberger's.
They changed his meds to Lexapro 20 mg, and upped his Abilify to 10 mg. She (the pdoc) feels very confident that the combination will help significantly with his delusional thoughts (both OCD delusions, and anger delusions). She said we should see a difference in about a week. After the last couple days, that week can't come quick enough.
My gfg admitted today he has thoughts of punching us (his dad, sister, and I) in the face and other various violent reactions, frequently. I was beyond shocked! We are a family of yellers, screamers, cussers etc, (man that makes us sound like lunatics lol, we really are actually a close fun loving family I swear ) but not a physical violent family at all. I can't figure out where that comes from???
So, I'm wanting to crawl in bed and hide under the covers (except it's too damn hot here in AZ!) Been having an anxiety attack all day. Going to break down and take a half of a Xanax and try to cope! Gfg is completing his chore list, and is on grounding for the day for being verbally abusive to me this morning, so I know I have an uphill climb to get through the day.

[ryzgal]

oops, asperger's not asberger's...

[Fran]

Funny how mom's have a sense of what's going on with their own gfg.
I always feel very uncomfortable with thoughts of physical violence in our kids. Hopefully, he will have some therapy and they can find out why he is thinking that way and how he should deal with his impulses.
I hope you have a better day tomorrow.

[TerryJ2]

My gfg admitted today he has thoughts of punching us (his dad, sister, and I) in the face and other various violent reactions, frequently. I was beyond shocked! We are a family of yellers, screamers, cussers etc, (man that makes us sound like lunatics lol, we really are actually a close fun loving family I swear ) but not a physical violent family at all. I can't figure out where that comes from???

That's the ADD/ADHD part, assuming he acts on it.
We all think weird, odd, violent things once in a while. We don't act on our notions, though. Some people, like professional novelists and film makers, actually make money off of it.
I know the dx issue is troubling. There are sometimes no definitive answers. Or sometimes you get a good dx when your kid is an adult, and you can armchair quarterback.
Fingers crossed that the meds work in a week. Lord knows, you can all use a break.

[MidwestMom]

I have an Aspie son. To be honest, he may have some symptoms of Aspergers, but he doesn't sound primarily Aspergers to me. Violence and thoughts of hurting are not usually part of Aspergers alone...any violence prompted by Aspies is usually frustration with life.

Has he ever had a NeuroPsych evaluation? That may be th e best way to try to diagnose a complicated kid (and he, like my kid, sounds complicated). They do very intensisve testing for all disorders, not just educational evaluations, which can be pretty meaningless. I'm a little leery of your doctor because I'm NOT a doctor (and don't play one on TV) and even I know that Lexapro takes at least four-six weeks to work. Abilify may work right away...I never took it...but the primary treatment for Aspergers isn't meds anyway. I have to wonder if this doctor really understands Aspergers or even knows what he is doing. I've been through a lot of psychiatrists, psychologists and therapists in my life (for me AND my son) and I'd say more are bad than good...you really need to kiss a lot of frogs to find a prince, so to speak.

Good luck. It's not your fault...he is just wired differently. Don't blame yourself at all.

[ML]

My kid (also on the spectrum) used to have scary thoughts that he would do something violent. It wasn't that he had the urge to do it, more that his thoughts would go sort of haywire and he was scared of what would happen IF he did something like that. He also had thoughts of OBL (Osama) coming to kill his family after 911. If it helps, this aspect of his symptom profile has has gotten much better. He's dx with anxiety, ocd, adhd, TS AND Aspergers. Talk about complex!

[TerryJ2]

Interesting, ML.
My son used to ask who was real and who wasn't ... most kids go through that, but I think w/Aspies it's larger than life, because they tend to think in such b&w terms. We NTs take for granted our ability to know that I Love Lucy reruns feature people who have mostly passed away, and that the plots are all fiction. An Aspie often has to be told, not just about the series, but every single show.
So when 9/11 happened, my son kind of blew it off, assuming it was fiction, until we all went berserk and did nothing but stare at the TV for days. He had no clue, the immensity of what had happened. (Some of that may be due to watching violent TV shows ... I'd be curious to know how many NTs didn't get it, either.) There is a very famous photo of OBL smiling, holding an AK47 and petting it like a kitten (I think it's a still taken from a video) and gfg was amazed that such a gentle looking man was behind so much violence. He asked over and over again if we had the right person. He was expecting a Hollywood gangster type, 5 o'clock shadow, crazed eyes, hair sticking out all over.
He has a hard time w/shows that are based on real people, such as James Bond, and wants to know exactly which scenes are based on real events. When we say none of them, just the fact that there was an English spy and gadabout, he can hardly stand it. Now that he's entering 7th gr and has had to write his own fiction for English, he is beginning to grasp extrapolation, imagination and metaphor but it's been a long road.

Since he has actually done violent things and feels remorse, he still has scary, very sad thoughts about his past and I'm going to ask him if he ever worries about his actions in the future. (Highly doubtful, given that he had no idea why he blew up when I picked him up from camp last mo, but was fine this weekend. Not big into self-examination.)

[Marguerite]

Interesting points, Terry. With 9/11, we had to shield GFG3 from the news coverage. It was sadly easy. Then a few years later when he was 11, his class at school were being taught about it and I had to explain to the teacher that GFG3 was likely to get freaked out by that level of deliberate violence against innocent people, perpetrated in such a shocking way. We have to shield him against a lot of this sort of thing, including the tsunami that happened a year later and a lot of the war coverage that was also happening.

Over the next few years GFG3 has been able to cope with the knowledge, but possibly a bit easier when it hasn't happened just a few days previously. We still need to shield him against really bad, very recent news.

As for fantasy & reality - to GFG3, it was all real. We didn't realise just how bad it was, we had done our best to show him a lot of the special effects and "making of..." segments on DVDs (including the detailed stuff on LOTR) and we thought he was finally understanding about movie magic.
Then we took him to the village film night where we watched "Mars Attacks!". We thought it would be so obviously over the top that GFG3 would have no trouble believing it was not real.
Then after the film, which he had watched wide-eyed, GFG3 came to me asking for reassurance. "I know it wasn't real, it was just a story," he said. But did they put all those buildings back together after they wrecked them? The White House? The Sydney Opera House? I know it's back in one piece because we drove past it last week, but how did they wreck everything and then rebuild it? It must cost a lot of money to do all that. An what about the people? Were they able to bring the people back to life after the ray gun disintegrated them and turned them into green skeletons? And what about that lady whose had was put on her dog? How did they do that, and then put her back together again?"

Poor kid. He was trying to enjoy the movie (or the concept of the movie) but all he was concerned about was the trauma that people must have gone through, to be disintegrated/dissected/dismembered and blown up, purely to put on a show for other people's enjoyment. I felt awful, I imagine how the ancient Romans must have felt when trying to indoctrinate their children to enjoy gladiators being torn apart by lions purely for public enjoyment.

We did our best to explain (again!) that movies really are not real.

He didn't get it until he got his own chance to be in a movie. We'd already been in a small special effects movie we'd made ourselves at the museum, he had the chance to see how it was done (we did green screen stuff a lot as well as other trick stuff where voices were changed and other things distorted) and we had to do this over and over, and were still never sure exactly what it was that helped him finally work it out.

He was still trying to please us though, by making an effort to accept that we wanted him to watch the movie, even though in his heart he believed he was really watching people being killed and dismembered.

Just think - if our kids really did see someone dismembered in front of them, if we as parents actually sat them down to watch this happen for entertainment, wouldn't we expect some level of PTSD in the child as a result? it's not necessarily what they actually see tat is the problem, it is what they believe they see. And for GFG3, he was (and still is in ways we can't always know) being traumatised by everyday living.

No wonder life is so difficult for them sometimes.

Marg

[ryzgal]

interesting, thanks for sharing

my son has a hard time with different things. he had a very very very hard time with nazis and hitler specifically. for a very long time he obsessed on it and he couldn't get the thought out of his head that he was going to grow up to be a killer because to him hitler was the worst person he could think of, and if he had thoughts of him, then in his mind that meant he must "like" him and therefore was going to "be" him. It makes no logical sense, but in his head, that's how it works out. It was very difficult. At school, he couldn't hear that part of history without it causing all sorts of anxiety that manifested in odd ways, that of course no one knew anything about (which for awhile, neither did we).
When 9/11 happened, it was very traumatic. At that time, my son was very obsessed with being poisoned, hurt, killed etc anyway, so this was a whole new thing being thrown into the mix. One day we were playing a video game and the game died. He jumped up and immediately asked 'is there a killer on the roof coming to get us?'. He had equated the game dying, with the power going out, and that to him equated to someone (a killer) coming to get us. It must be very scary to be in that head somedays.

Right now, he excels at learning history. I have explained that the only way to not fear something is to learn everything about it, so he really trys hard to do that. I wish we could apply that to other aspects in our lives right now!

Hugs
Stac

FYI side note- my sons thoughts used to be "what if" as in what if I suddenly went crazy and did violent things, but now he gets upset and thinks I want to punch mom, dad, sis etc in the face...very frightening indeed

[Marguerite]

Cognitive behaviour therapy can help, but it sounds like the therapist would need to have a really good handle on what is happening in his head. He needs to understand that there is a huge difference between the thoughts, and the action; that a lot of us at times want to hit someone but when we choose not to, it is because we are good people inside, despite those odd thoughts.

As he gets older it should get easier for him to manage those thoughts, but he needs help to learn some techniques as well as to learn what is not uncommon for other people too.

It's a matter of degree as well as learning how to understand oneself.

Marg