At a loss

Discussion in 'General Parenting' started by klmno, May 25, 2008.

  1. klmno

    klmno Active Member

    difficult child tells me today that he wants to drink or smoke or something because he doesn't feel the way he should. OK, so I tell him this means the medications are not right yet and we need to discuss this with psychiatrist. I asked if he had been doing anything- he said sneaking and smoking cigarettes sometimes. I say that needs to stop. I asked about pot or anything like that- he said no. (He gets random drug tests through PO so I think this is true.) Drinking- he said he tried a sip of my beer once (which I did not know) and he hated it- it was disgusting. But, he said he talked to his therapist about this and his desire to do something along these lines and that I had been telling him not to ever drink or do drugs because not only is it illegal, and bad for him, but it can mess up his prescription medications. He said his therapist told him not to tell anyone but, a little smoking and drinking would not mess up the effect of his prescription medications.

    Here I am again wondering if it is just me not getting with the program or what but I cannot imagine telling a 13yo who has not yet started down this path but is contemplating it and having urges ANYTHING that could be interpreted as "ok, it wouldn't be that bad".

    And how do I handle this with difficult child? I'm glad he told me, but what can I say to him that I already haven't said?

    Oh- he also told me he hated his life and sometimes thought about taking a bunch of his medications or doing something else very risky so that maybe he would just die. So, now I am wondering, how much of mania was really mania. Could the psychiatrists have been correct the first year when he was diagnosis'd as unipolar depression and been wrong this past year? If that was the case, wood being on mood stabilizers if you really shouldn't be cause side effects that mimic hypomania and/or cycling?

    Needless to say, I'll be keeping a very close eye on him-
  2. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Get rid of that therapist ASAP. That is insane advice.
    Unfortunately new, trendy therapists can do more harm than good and I'd never let my child see a therapist who condoned even a little smoking and drinking...he's THIRTEEN. And YES they screw up prescription medications. Is he nuts? Jeesh. Kick thy to the curb! JMO one who has had both unipolar and bipolar diagnosis., I can tell you right off that is VERY hard to tell which it is. Unless he has had an obvious manic episode, it's very difficult to tell if he has hypomanic. It does sound like the medications aren't working. I wish I could help you more, but it took me three decades to find medications that helped me. It's better now, but a lot of it is trial and error.
    Mood stabilizers requires eight full weeks on a therapeutic dosage to work. These are the major mood stabilizers in my preferred order (just MY opinion) of how good they work: Lithium, Lamictal, Depakote, Triileptal Tegretal medications like Risperdal, Seroquel, Geodon, Abilify and Zyprexa and antipsycotics, not mood stabilizers. They are used for short-term mood stabilization or with a major mood stabilizer. Standing alone they tend not to be as effective as a mood stabilizer for the long run. It would help us if you listed the medications your child is taking.
    I know how frustrating it is--I know first hand. Keep trying and hang in there. Something will work...good luck.
  3. Sara PA

    Sara PA New Member

    We should know the drugs and the doses.

    And yeah, you don't need a therapist who tells a 13 year old that one can smoke and drink without messing up the medications. His only response should have been that 13 year olds shouldn't smoke or drink, medications or not.
  4. Wiped Out

    Wiped Out Well-Known Member Staff Member

    I would so get rid of that therapist and be complaining to someone about it!!

    I'm sorry he is struggling so much right now. I don't know the answer about the mood stabilizers causing mania.

    Gentle hugs.
  5. klmno

    klmno Active Member

    Thanks so much, MM. I am just devestated that my son feels this way- at the same time, I am so glad he told me.

    He is currently on 1200mg lithobid, 500mg depakote er, and titrating up on risperdal- he's been taking 1/2 pill (I think that is .5mg) each day.

    I remember that the psychiatrist on MDE team (very reputable in mood disorders area) last Oct., recommended a mood stabilizer plus being put back on prozac. We haven't tried that- regular psychiatrist and I both were a little reluctant to because last year when prozac was doubled, he went on the spree and set a brush fire- I am re-thinking that now.
  6. witzend

    witzend Well-Known Member

    Sat what?

    You know, as a general rule, that is probably so. But how exactly is a 13 year old supposed to know how much is enough and how much is too much? I would be having a private session with this idiot explaining why difficult child should not be seeing him any longer. That might be something you say to a reasonably responsible 40 year old. It's not something you say to a 13 year old who is discussing a desire for self-destructive behavior!

    I'd also think about writing a letter to his governing body in your state.
  7. Sara PA

    Sara PA New Member

    Did these urges start since the Risperdal was added? The antipsychotics dull some of the senory parts of the brain. I would susupect that just like kids craving food and not being able to feel full, they could crave other things that go into the mouth.

    There is a study that found cocaine and amphetamine cravings were reduced after discontinuing typical antipsychotics. Risperdal is an atypical but recent studies have found there really isn't that much difference in the typicals and the atypicals.
  8. flutterbee

    flutterbee Guest

    What does he mean exactly by not feeling the way he should? It is possible that it can be something different to you than it does to him.

    A fairly high percentage of people with bipolar disorder self medicate. One of the reasons is that hypomania can become addicting-like and the self medicating is to get that again. Now I'm going to have to go find the book I read that in...I think it was Night Falls Fast written by a psychiatry professor who also suffers from BiPolar (BP)...but I'll have to double check.

    Definitely dump the therapist and report him as witz suggested.

    And definitely keep a close eye on him. Call to or an appointment with a psychiatrist is in order.
  9. Sara PA

    Sara PA New Member

    If he's on the depressive side, why isn't he on Lamictal instead of Depakote or even the Lithobid? Depakote is an antimania mood stabilizer.

    And Risperdal is a major tranquilizer.

    Has in only manic episode been while on the antidepressant?
  10. DammitJanet

    DammitJanet Well-Known Member Staff Member

    Im going to play devils advocate here. Did you actually hear the therapist say that to your son or is your son just telling you he said that? I mean lets all face it...if a 13 year old says he wants to drink and smoke but knows you dont think he should but wants to tell you that he has talked it over with his therapist well then wouldnt it behoove him to tell you that therapist said that a little wouldnt be all that bad?
  11. Sara PA

    Sara PA New Member

    Good point, Janet. I guess because we had one of those tdocs who wanted to be friends with the patients, I jumped to the conclusion that this guy was like that too.
  12. klmno

    klmno Active Member

    Ok, let me see if I can get the questions answered before I need to check on him again. If I have to post in mid-sentence, I'll be back later!

    He says things started feeling wierd when the zyprexa was added. That would have been a couple of months ago (it was then switched to seroquel in psychiatric hospital - I took him there due to major cycling and resulting behavior). The seroquel was switched to risperdal this past week. He says he hasn'tr felt wierd this week. I can't quite get from him what he means by "wierd". I have to handle this questioning carefully. Now, he has been on a really low dose of risperdal this week, so that might make a difference. He brought up again that the zyprexa and seroquell just left him sleepy all the time.

    I asked again about thoughts about doing risky stuff that could make him die and not wanting to live. He said he wasn't going to do anything, please don't take it that way. I said that I understood, he wasn't taking action on these thoughts right now, but he was still having the thoughts. I'll have to broach this subject again to get any further with him.

    Sara, you may be onto someething regarding AP's and cravings. We tried lamictol last summer- now difficult child was not sleeping and seemed more hypomanic when we tried it so I don't know if that makes a ddifference, but lamictol made it worse- he was awake for 30+ hours straight, bouncing off the walls, and telling me he would do what he needed to do. So, we went to lithium and anytime we try to switch lithobid out, raging and trouble sleeping comes back. Although, it came back a couple of months ago, even while on lithobid. He was wild (for lack of better term) and not himself for a about 2-3 mos in late winter/early spring of 2006. At the time, that was determined to be a reaction to depression, which he had clearly shown sserious signs of, and suicidal tendencies. He had not been on any medications until then- and that is when prozac was started. After last year, we thought it was mania. He was taken off prozac and left off medications for about 6 weeks. He exhibited signs of hypomania at that time. I had never seen signs like that in him before.

    Lithobid took care of raging and sleeplessness, but there were still signs of hypomania. Or, I have also wondered if these weren't a result of AD and mood stabilizers. I just don't know if that can happen. Anyway, that is why depakote was added. The wierd thing to me- my sone only exhibited signs of full-blown mania in laate winter or spring. All these medications didn't sstop that from happening this year either.

    Janet- it could be a lie, that is true. Lord knows, my son lies when he is not stable. The reason that I tend to believe him on this one is that there have been other signs that this guy is a quack. And, a couple of weeks ago, difficult child told him he had cheeked his medications. The therapist did tell me after I pulled him aside and asked. But, he had also told difficult child something casual like "well, do you think maybe you should take them if you are getting ready to go to court". I thought it should have been something a little more like- "because you have to have them- court or no court". Then, there have been a couple of things this therapist has done that were just dishonest in my book and left me thinking he didn't know as much as he claimed to. The therapist is supposed to call me this week- I will definitely be getting his side of this, but, knowing difficult child and the way he told me about this, I tend to believe him. For one thing, difficult child has always loved going to this therapist, and I already had the impression that the guy was just telling difficult child whatever he wanted to hear. I haven't completely ruled out that difficult child is lying, but right now, I am giving him the benefit of the doubt- until I talk to therapist. Oh- then before- difficult child had told me about therapist bring in games for them to play that were rated M, which difficult child knows I don't let him play and therapist should have known a 13 yo should not be playing, in my humble opinion.

    Thanks to all of you for the support and advice!!!
  13. Sara PA

    Sara PA New Member

    I would have to wonder if an antipsychotic isn't the best choice for him.

    Was he on the Prozac when the antipsychotics were started? Or had the Prozac been removed at the time the Zyprexa was started?
  14. DammitJanet

    DammitJanet Well-Known Member Staff Member

    APs can make you feel weird but then so can any of these medications. I have been on low dose seroquel for sleep, tried geoden but it was yucky...refused resperdal and zyprexa. If I had to go on one it would be abilify I think.

    Now I think lamictal is the easiest "feeling" mood stabilizer. You titrate up so slowly and I honestly cannot feel anything on it. I really am on a boatload of medications and I dont think Im sedated in the least.
  15. klmno

    klmno Active Member

    He hasn't been on prozac since March, 2007- after the 2 hour spree with- brush fire (7 legal charges- 2 felonies).
  16. klmno

    klmno Active Member

    What is it that the AP is really supposed to be doing for BiPolar (BP) that lithobid and depakote wouldn't or shouldn't be doing?
  17. TerryJ2

    TerryJ2 Well-Known Member

    Im going to play devils advocate here. Did you actually hear the therapist say that to your son or is your son just telling you he said that? I mean lets all face it...if a 13 year old says he wants to drink and smoke but knows you dont think he should but wants to tell you that he has talked it over with his therapist well then wouldnt it behoove him to tell you that therapist said that a little wouldnt be all that bad?

    Ahhh, I'm so glad I read to this point. I was thinking the exact same thing. It sounds exactly like something both our easy child and difficult child would tell one of us, about the other. When husband and I talk, alone, we compare the exact phrases, and find that the actual conversation was distorted ... in favor of what the child wanted it to be.

    Tread carefully.
  18. TerryJ2

    TerryJ2 Well-Known Member

    He said he wasn't going to do anything, please don't take it that way.

    That's a great clarification. He sounds like he's really trying, and open to talking to you.
    Take care.
  19. klmno

    klmno Active Member

    Here's how the therapist statement came out-

    He was telling me about all these urges to get into the smoking, drugs, etc. I was saying why this was not the answer. He said "well, you know, medications just don't take care of everything and sometimes, things still feel strange, no matter what medications I have been on". I said "no, medications won't take care of it all, that is why we are seeing tdocs" (we are seeing 2) Then, he says "well, what good is that doing, all XX (his individual therapist) has told me is that it won't mess up my medications if I only do a little- so you (meaning me) lied to me". Now, given that there have already been some doubts I have had about this therapist, how would you take this?

    on the other hand, my difficult child is a very crafty lier at times when he is in this "mode".

    Another thought about what Sara or Janet one said- I do think he is starting to like hypomania. He also mentioned that he felt pretty energetic today and was glad because he had been tired for so long on the other medications. I think this is because his dose of risperdal is still low. I was going to leave it at a half, but I went ahead and raised it to one tonight because I am worried. He had been sleeping fine and acting fairly well on 1/2. Now, I just hope this doesn't zonk him out so he feels worse again.
  20. Sara PA

    Sara PA New Member