1 Step Forward...2 Steps Back

[DaisyFace]

Good Morning All--

Forgive me for venting here...

Seemed like difficult child had been making good progress...the therapist felt that she improved so much on the Celexa that there was really no more need for weekly sessions (and just as well since Medicaid is dropping coverage of weekly counseling sessions...) and it felt like things had settled down at home...less anger...much more cooperation.

Then yesterday, she arrived home from school in such a black mood because she had to go to the principal's office today for hitting a girl in the face during gym class. difficult child is angry because she feels the hit was "just part of basketball" and the other girl should have 'sucked it up' and not been so upset about getting hit..."I mean, it's not like I punched her as hard as I could" she said. So now difficult child has to go to Saturday detention.

AND because she is already angry...now every little thing is a big problem. Upset during dinner...can't get homework done...can't get chores done...can't take a shower...can't get to bed on time...and then still cranky and upset this morning.

And this is one of those situations where it feels like everything just goes right out the window. Her anger completely dominates--and there is no negotiating, or talking it out, or reward/punishment...and if she's not gonna do something, she's not gonna do it. So she went to school looking like a rag and without her homework (and she'll be picked on and have consequences for missing work)...and so she will be in a foul mood when she gets home again today.



--DaisyF

 

[TerryJ2]

Oh, I'm so sorry.
been there done that.
Usually, our difficult child gets over it after he has to apologize or otherwise address the issue. If he doesn't, he will be a monster for days and days and days.
Is there any way for her to resolve the issue?
Do you think it will be resolved in her mind after she finishes detention?
with-our difficult child, I always make a statement like, "Well, I know you're glad that's overwith. Now you can get on with your life."
It seems to create a definite begining and ending, Know what I mean??
Especially because Aspies are so literal.

 

[Josie]

Are you sure she is taking the Celexa? My difficult child took Lexapro which is the 2nd generation Celexa and she was always at her worst if we forgot to give it to her.

She also had to keep increasing the dose to get the same results.

 

[DaisyFace]

Are you sure she is taking the Celexa? My difficult child took Lexapro which is the 2nd generation Celexa and she was always at her worst if we forgot to give it to her.

She also had to keep increasing the dose to get the same results.

You bring up a good point...and we have evidence that she has skipped a few doses here and there. If we are not right on top of her in the morning, she will not take it. So that is an issue.

And yes, I noticed that the medication seemed to have a big effect when whe first started it--but now after a little more than two months we are seeing more and more of the anger issues coming back.

 

[compassion]

It takes so-ooo much patientce!!! My difficult child is crashed out today:trying hard to do her academics with her. It is day 65. Coompassion

 

[DaisyFace]

Oh, I'm so sorry.
been there done that.
Usually, our difficult child gets over it after he has to apologize or otherwise address the issue. If he doesn't, he will be a monster for days and days and days.
Is there any way for her to resolve the issue?
Do you think it will be resolved in her mind after she finishes detention?
with-our difficult child, I always make a statement like, "Well, I know you're glad that's overwith. Now you can get on with your life."
It seems to create a definite begining and ending, Know what I mean??
Especially because Aspies are so literal.

Yes...I think you are right. She will stew over it until she feels that it is resolved....probably after detention.

In the meantime, we have been trying to help her gain an understanding of why she might be in trouble for this in the first place. We've been trying to explain that the coach would not have sent her to the office just to be mean--and the coach must have felt that the hit was NOT just part of the game--and the other girl must have been hurt when she was hit and was probably in some pain etc. etc.

Right now, though, it does not seem to be sinking in.

 

[DaisyFace]

It takes so-ooo much patientce!!! . Coompassion

You are so right...and I feel like I right out of mine sooo quickly.

 

[smallworld]

Daisy, how much Celexa is she taking?

When you say the anger issues are coming back, are they worse than before she started Celexa or about the same as before she started Celexa?

 

[DaisyFace]

Daisy, how much Celexa is she taking?

When you say the anger issues are coming back, are they worse than before she started Celexa or about the same as before she started Celexa?

The psychiatric hospital started her on 10mg once per day and then upped it to 20mg per day upon discharge (mid-November).

Before hospitalization...she had what I would call a "hair-trigger temper". She was always irritable and it wouldn't take much to set her off into a full-blown rage. She as been this way for years and was diagnosed as ADD/ODD. However, as she has been getting older the rages have been getting more intense and she had been talking about killing herself or her family or both. It was the threat of suicide that got her admitted to the psychiatric hospital, where she was diagnosis with depression and anxiety.

The effect of the Celexa was dramatic--no anger at all...and kind of a new awareness of what was going on around her. It was different--but good!

But now we are seeing what I would call "breaking through". It's as if the "angry personality" is breaking through the Celexa haze. I will see it come across her face all of a sudden--and then I think "Uh-Oh! Here we go...".

 

[smallworld]

Daisy, how are you going to figure out if she has Aspergers? That, to me, would be a key to undertstanding what kind of treatment she truly needs.

That said, it sounds as if she really does suffer from anxiety and depression, and the Celexa has helped. But it's not a "cure." She may well still need therapy and interventions to help her regulate her emotional lability. Even though my kids are "stable," they still need therapy to work on how to cope with their intense feelings.

 

[BusynMember]

This is my LONG LONG and EXTENSIVE experience on antidepressants (since 23 years old and I'm 55). Some start out making you feel better, BUT the real effect doesn't kick in for six weeks, at which time you either can start feeling worse (if it is either the wrong medication for you OR if it starts making you manicky) or you can start feeling wonderful, normal!!! Unfortunately, the first happens more often. It took me until almost 35 to find the right antidepressant that makes me a normal person...lol (well, some would dispute the normal). Anger can actually accelerate on any antidepressant, and a very fast, good start on any antidepressant isn't really a good sign. It's supposed to take six weeks to kick in. The person who has a very early "kick" is at risk for angry mania as the drug builds up in the system (yeah, I've been told this over and over again by various psychiatrists throughout my life because I am a 'fast starter.'). If your daughter is threatening suicide it COULD be the medication, but it could also be emerging bipolar disorder (which has a high suicide rate as opposed to ADHD, which does not). Or it could be both. I hope this helps, even though I can't offer any solution. It took me a long time to get stable and sometimes I felt like a guinia pig. As an aside, if I miss even one day of antidepressant, I am intolerable to myself and others. And antidepressants ARE addictive and have a withdrawal effect. And no doctor ever tells us that, which ticks me off.

 

[DaisyFace]

Daisy, how are you going to figure out if she has Aspergers? That, to me, would be a key to undertstanding what kind of treatment she truly needs.

We are in limbo on that for the moment. The pediatrician referred her to the county's mental health center (who felt that difficult child didn't need any kind of treatment or therapy at all)...then the pediatrician referred her to the psychiatric hospital....who then referred her back to county. I have been asking whether any of the doctors did any kind of thorough evaluation at all on difficult child--and it sounds like none of them did. So I asked the therapist about how I would set up a neuropsychologist evaluation...and the answer was that they are not allowed to give me that sort of information and that I need to go back to the pediatrician.

Meanwhile, Medicaid is implementing all kinds of cuts on mental health services starting Feb 1st--so county is every-which-way about what difficult child needs and whether it will be covered or whether they need to get a new 'diagnosis code' in order to continue weekly therapy under Medicaid's new rules. But it looks like I will have to go outside of county, anyway, in order to have her really evaluated. The closest children's hospital is about 50 miles away, but it is in the next state...and the Medicaid coverage does not always extend to out-of-state specialists. So--I am kind of stuck waiting to see how the new insurance coverage rules go so that I know where I can go with this next.

 

[DaisyFace]

Anger can actually accelerate on any antidepressant, and a very fast, good start on any antidepressant isn't really a good sign. It's supposed to take six weeks to kick in. The person who has a very early "kick" is at risk for angry mania as the drug builds up in the system (yeah, I've been told this over and over again by various psychiatrists throughout my life because I am a 'fast starter.'). If your daughter is threatening suicide it COULD be the medication, but it could also be emerging bipolar disorder (which has a high suicide rate as opposed to ADHD, which does not). Or it could be both.

And antidepressants ARE addictive and have a withdrawal effect. And no doctor ever tells us that, which ticks me off.

Wow!

Thanks, MW, for sharing this...this is information that we definitely did not have. If the Celexa really will begin to cause "angry mania"--then we are headed for a train wreck!!

I am not sure about bi-polar, because we never see upswings in her emotional state...without Celexa she just goes from irritated to angry to angrier. I would think that with a bi-polar disorder, we would being seeing "high" points--where she is very manic and overly excitable about everything and then then "low" points where she is depressed and down and feels upset.

But perhaps I have a misunderstanding of 'bi-polar'?

 

[robinm1922]

Hi Daisy,
I know how you feel about one step forward ... two steps back! My difficult child is also on Celexa 20mg for depression / anxiety and Obsessive Compulsive Disorder (OCD) tendencies. She was switched from Zoloft a little over two months ago, we are now just really seeing the effects. Maybe that is a good thing now! With the Zoloft it was an immediate change, this one has been gradual. I don't think she is all the way there yet, she still naps every day and not focusing right at school.
Like your difficult child mine has anger issues to, she hasn't been violent but boy when she gets mad it is like she has been taken by an alien! I can only describe it as a really mean look! It is such a shame that they change plans (medicaid) that so many people depend on especially the ones that affect the children.
I don't have anything to offer other than my support (I am still new at this too)! I sure do know how you feel and my heart goes out to you!
I would keep an eye on her and how she is acting, to be on the safe side you may want to give her the Celexa every day yourself for a while. At least that way you know she took it.
That is the one thing my difficult child has a hard time remembering to do!
Best of luck!

 

[TerryJ2]

DaisyFace, when all else fails, there's always the phonebook. I spent a cpl hrs one day doing that. I also used info from local moms and teachers.
Best of luck! I know you want to pull your hair out.

 

[compassion]

I know the frustaration of teen girl difficult child who willnot own responsiblity for her part. Currently, she is sitll trying to blame everyone for her impulsivity and poor judgment. My part is being able to stand up thorugh her threats and fits to enforce the boundaries. She took off last night, said she was goig to a movie but did not , I called and cled an dclled the freind she was with , and E-Mailed him and no reply. I need the courage to enforce the consewuence of no going out the Friday. She also is not cooperating much with acadmeics. She ahs doen less than an hour the past 2 days. She wants to blame her chice to have sex with a 19 year old and the resulting her freind no longer wants to be freinds with her as thery are racist nad picking on her. Compassion

 

[Wiped Out]

Just wanted to send some supportive hugs your way. My easy child had an almost immediate reaction to Zoloft and is also starting to downslide but just a bit. I've heard that with some ADs some people can have good immediate results.