Back to the psychiatrist we go....

[welcometowitsend]

So I am kind of between General Parenting and Parent Emeritus right now. husband and I felt we had no alternative but to ask difficult child to move out. Long story short: He backed us up so far we only had 3 rules left - go to school, don't tell me to f off or call me names, come home on school nights. He couldn't/wouldn't follow them. We told him he could stay here until he found a place but he is gone and seems to be quite happy to be gone.

Anyway, I picked him up yesterday to go to the pediatrician to get his Wellbutrin prescription refilled. difficult child proceeds to tell the pediatrician. stories about how horrible I am and how he is responsible and tries to do everything right but if he isn't perfect I go nuts on him and freak out. Huh? This from the kid who skipped every day last week and told me to f off and told me I was a b**** numerous times.

Don't know if I told you this but the school had the police take him to hospital at the end of September and he was admitted to the psychiatric ward for 6 days for suicidal thoughts. Went over that with the pediatrician. and he asked what the psychiatrist at the hospital said.... difficult child is immature, takes no responsibility for himself and has a huge sense of entitlement - and he's depressed. He got suspended for 2 weeks form school because when the police apprehended him he had a knife on him. So now he has a 'safety plan' at school.

pediatrician. suggests that we go back to the psychiatrist and get another assessment for him. I had called her the week before he went to the hospital with concerns and she didn't think it was necessary to see him again - obviously I was right and she was wrong there. So, we are getting another appointment. for him with the psychiatrist. I'd love to speak to her alone and let her know my thoughts on his behaviour.

I can not understand why he twists things so much. He'll take a normal conversation and tell everyone that I was screeching at him or that I was verbally vicious. He lies all the time - about everything and nothing, things that don't even matter. I asked him if he truly believed what was coming out of his mouth and he said he did. Either way his thinking seems very distorted - I'm just not sure if he is making stuff up or if he really sees things that way.

Here is an example: He missed the bus a couple of weeks ago so I said I would drive him to school. He told me he was going to a friends that night and I said he would need to take the bus home. His response - well, I just won't come home then. I said that wasn't acceptable and he went off on me. "Why are you such a b? It's your fault I slept in, it's your fault you have to drive me to school. etc." I told him if he didn't stop I'd let him off at the nearest bus stop and he could take public transportation to school. He didn't stop so I left him at the bus stop. It was not cold out, he knew where he was and had bus tickets that I'd bought for him. He tells everyone (including me) that I freaked out on him (I never even raised my voice), left him stranded in the freezing cold to wait 1.5 hrs for a bus. Ok, so he exaggerated the situation. But after telling this story several times he changed it yesterday and said he had to hitchhike to school. Told me he didn't have any bus tickets left. So now he is lying about taking the bus or hitchhiking. He is also lying about the bus tickets because he told me a couple of days ago that he still had 1 bus ticket left of the ones I'd bought him. Ugh. There was just no point in lying about it but he does it anyway - this happens all the time. When confronted with the lies he denies or changes the subject - there is no acknowledgement that it doesn't even make sense.

So tired of running around in circles and not getting answers or solutions. So, ADHD, Tourette's for sure. psychiatrist ruled out autism and aspergers and says he is depressed, possibly bipolar. pediatrician says his is ODD. Ugh!

 

[InsaneCdn]

It is NOT "ODD". That just describes the behavior, not the reason.
Ever had a comprehensive evaluation? A really, REALLY detailed one?
This could be all sorts of things.
ADHD is... a strange diagnosis, in that there are very few people who have ADHD and nothing else.
The rest who get the ADHD label are either... ADHD plus a raft of other things (Developmental Coordination Disorder (DCD), Auditory Processing Disorders (APD), Learning Disability (LD), mood disorders, etc.), OR... they are something else entirely (Aspie, and BiPolar (BP), being two that I'm aware of).

There is something ELSE going on... having gone through 10 years of (stuff I can't write or I'd be censored)... we are getting answers, but... I know what it's like to get the run-around.

 

[TerryJ2]

HOly cow!

I agree, there is something else going on. Would he go with-you for a long day of testing? (When we went, I took my son to McDonald's, his fave restaurant at the time.)

Did the psychiatric hospital only give you the ADHD/ODD diagnosis? That's not helpful at all. Arrgh!

So where will he live? Will you subsidize an apt? Are there grandparents or cousins?

 

[Bunny]

In some ways that sounds ALOT like my difficult child. The swearing, calling me every name in the book (and some that I didn't even know existed), the lying, telling me that everything is my fault (if I hadn't made him angry he would not have had to punch a hole in easy child's door. I just don't understand that logic).

Whne you take him in to see the psychiatrist does she talk to you alone at all? If not, request that. The psychiatrist that difficult child sees always talks to me alone before he talks to difficult child so that he can get a true guage of what is going on in the home. If she won't do that see if you can e-mail her before the appointment and tell her what is happening. She needs to know so that she can make a thorough evaluation of what he needs.

Good luck. I hope they listen to you.

 

[Calamity Jane]

WWE,
I was in practically the same boat as you 2 yrs. ago. difficult child's behavior was abominable, he lied, cut school, showed up late for school, cursed us out, even told his teacher I made death threats against him, and they had to call CPS to investigate. He was lying, stealing, you name it. However, he was on drugs, too....don't know if that's an issue at all for your difficult child.
Anyway, at that time, the HS mandated that he be seen by a psychiatrist who was sanctioned by the school, and who turned out to be terrific. Unfortunately, once difficult child spewed all that venom to the psychiatrist about us, which the psychiatrist didn't believe, difficult child lost all interest in going and basically sat there mute through the sessions which cost us $350/50 minutes. psychiatrist said difficult child had no intention to stop using drugs, and that he had abandonment issues related to adoption. He said to be patient, wait things out, consequences were bound to affect him, and don't escalate or even respond to the lies and accusations...it's just their way of deflecting responsibility for their destructive choices.
Since difficult child doesn't live with you anymore, is he interested in seeing the psychiatrist? Would he participate? If so, that could be a very good thing. I'd rule out drug use, too, if possible.

 

[welcometowitsend]

Insane - The last time he had a really really indepth evaluation was at age 9 when he was diagnosed with Tourette's and ADHD. The psychiatrist initially agreed with the original diagnosis and added Moderate Depression and possibly bipolar. And I agree with you about the ODD.

There is a lot of personality disorder stuff in my family. Of course nothing that has been diagnosed but there are very obvious signs from several aunts, uncles and cousins as well.

Terry - I think he would go for the testing. I think he would go because he likes the attention it brings him. He can go back to his friends, school, etc and he has 'proof' that he has problems. He absolutely loved the attention he got after being in the hospital psychiatric ward. He didn't care who knew about it. One would think that it would be the opposite but not with difficult child. He has a friend who called him an attention wh**re last year and she truly hit the nail on the head.

Right now he is couch surfing with a friend. Apparently he has a lead on a shared accommodation. We have agreed to sell his dirtbike and give him the money for first and last. If he works enough part-time shifts at his job he should be able to get by ok. He makes $10 an hour so if he works 20-25 hours a week he will make $800-$1000 a month. He should be able to get those hours if he asks for them. The rent on this place he is looking at is $400/month. If he actually puts for the effort and maintains a place for himself and is looking like he is headed in the right direction then husband and I would have no problem buying him some new clothes when needed, supplying groceries, that kind of thing - but I will not give him actual $$.

My parents have texted him a few times over the last couple of weeks - he doesn't even bother to respond to them.
Bunny - Yes, our difficult child's sound a lot alike. He tried to get my husband out of the house last year by accusing him of abuse. It didn't work but I think he wanted to be able to bully me without husband around to protect me. He's never hit me but he uses his size to intimidate me.

Thank you for the idea of emailing the information to the psychiatrist. That might work and that way she will have the information before the next appointment. Trying to talk to her with difficult child there will be difficult because of the lies and he absolutely refuses to listen - he has to talk talk talk over top of people so you can't get a word in.

Calamity - Unless he has started abusing drugs within the last month then he is not on drugs. I had him tested last March and again in early August and the hospital tested him at the end of September when he was admitted.

I think there is something deeper going on here. I pulled difficult child out of school when he was in Kindergarten because he was having problems. Small things like not asking permission to go to the bathroom, not following directions well, etc.. I thought his teacher was being too hard on him because I'd never really had any abnormal issues with his behaviour at home - just terrible 2's that kind of thing. He did get into a physical fight with a boy in JK and got sent home for the day. I look back at some behaviour and when he was about 8 or 9 my mom bought him a little pocket knife at a yard sale (I know - my mother is a difficult child). I kept it in a drawer for him to use with Daddy in the garage or outside. He snuck the knife out and told his little friend that he could kill him with it if he wanted to. In hindsight that is scary but at the time I just thought difficult child meant that knives could be dangerous and was showing off, you know? Maybe I"m reading too much into this. He certainly was never cruel to animals - at least not that I ever knew of or witnessed and we had a very loving and stable home for him.

So, difficult child was homeschooled through Grade 8 and so this is only his 3rd year in school. Grade 9 - great, glowing reviews from teachers, good grades, no skipping. Grade 10 - by November we were having serious problems. Grades slipping, some skipping, really bad attitude at home, pornography on his phone, etc.. - by March - grades in the toilet, skipping all the time, left home to live with girlfriend. - by June - back home, still having problems at school, almost failed everything, found more porn on computer (incestuous and beastiality porn as well as regular stuff), extremely unpredicatble, explosive, irrational (once left his house at 11pm and rode his back to several different towns all night) and his thinking is so distorted. Now he has progressed where he can't/won't follow a single rule and I think the only reason he takes his medications is because they make him happy and they give him some sort of 'status' among his friends and teachers(as in there is something wrong with him). He likes to be pitied.

Is it possible that this behaviour is only coming out now because he was homeschooled for so long? Or is it hormone related? I'm just grasping at straws trying to figure it out.

He told me in September that he would be quite happy to live on someone else's couch for the rest of his life. huh?

Another example of his distorted thinking - my cousin invited him to her sons birthday party. difficult child said "I'll bring my guitar." Cousin said "OK, you can if you want. But you don't have to, I'd just like to have you here." difficult child tells me that cousin wants him to come to the birthday party and play songs for the kids and be the entertainment. He literally turned "OK, you can bring it if you want." into a gig. And I think he believed it.

Sorry, now I'm rambling. I hope the psychiatrist listens and can give me some insight into this. Hopefully she does another really in depth analysis of him seeing as so much has changed since the last one. When we saw he rin August we spent a couple of hours with her but she didn't use any of the actual DSM-IV forms except the aspergers one which he didn't fit - except for the higher than normal iq category.

 

[InsaneCdn]

My head is spinning.
This difficult child was homeschooled for 8 years?
I'm not anti-home-schooling, but... it really masks a lot of problems, because they are not exposed to school. For example... many difficult child kids learn better one-on-one in a quiet environment, which is the polar opposite of school. He may have been far enough ahead of the game for grade 9 that he could coast, but as he reached the end of his prior knowledge... he just can't keep up, can't learn in school?

There could be all sorts of reasons for this - anything from MI to developmental challenges (aspie, Autism Spectrum Disorders (ASD), etc.) to Auditory Processing Disorders (APD) to who knows what else. But all HE knows is that he IS a failure and there's no point in being at school. Because THAT is what he learned in school. (and no, schools do NOT admit this, but we've been there done that)

 

[welcometowitsend]

Insane - I would agree that for my difficult child the home environment was better. When the docs that did his Tourettes and ADHD testing found out he was homeschooled they were happy to hear he was in that environment and encouraged us to continue on that path for as long as we could. Before we put him in school we did academic testing and he tested overall at Grade 11.5. His grammar skills were slightly below grade level (not his ability to write but his ability to diagram sentences), math was a little above grade level and everything else was very high, especially spelling and understanding the meaning of words (college level). When he was in school in JK he was academically ahead of his peers as well.

I have gone back and forth on the Aspie/Autism Spectrum Disorders (ASD) thing because my nephew is on the scale but we did the DSM-IV test for it and he doesn't fit the mold - and he's very charming, makes friends easily, is outgoing, a ladies man (too much so but that's another story). He did have some strong interests as a kid but not that he wasn't distractable from. He told me once that he used to talk about things like a favourite video game or lego and go on and on not because he couldn't stop talking about it but just to see how long I'd tolerate it before asking him to change the subject. So that looks aspie but then based on what he said he was aware that it was annoying but he'd do it just to see how long I'd put up with it.

He wasn't failing in school because he couldn't do the work he was failing in school because he wouldn't do the work and didn't show up for his classes. I think part of that was the depression on top of all the behavioural issues and the fact that he moved out and had no parental supervision did not help at all. He is very smart and can easily work around his ADHD issues as far as focus at school goes. He does have a problem with Executive Function and I think that has been the cause of some issues - can't get himself out of bed in the morning, misses the bus, lack of time management skills, keeping track of assignments (but still managing to get them done and handed in on time in Gr 9 and first half of Gr 10). I have tried to help him with these things but he doesn't see that he has a problem and refuses to try anything that is suggested to him. He'd rather muddle through and do crisis management - that said - he is smart enough that he can get away with crisis management at school. Despite everything that happened last year he didn't fail any classes - he pulled high enough grades cramming for exams that he passed everything.

I do think we need to do some very thorough testing with him to see what comes up. I mean, I can go round and round and guess and think but that's not going to do any good.

 

[TerryJ2]

I agree with-Insane, that homeschooling masks a lot of problems. It was the right thing to do for your difficult child, since he is clearly "different" and I would venture to guess that with-your attention and the leeway he got, not to mention comfortable surroundings, he learned a heck of a lot more than he would have otherwise.

This jumped out at me: Another example of his distorted thinking

Until he sees a psychiatrist and therapist and is thoroughly tested, I do not see how anything will change. Just my humble opinion.

I know how worried you are. Many hugs.

Many hugs.

 

[welcometowitsend]

Thanks Terry - I am going to push the psychiatrist to do a full DSM-IV testing on him for behavioural and for educational assessment as well. If she won't do it then I'll have to pay to have it done privately. Psychiatrists are covered under our health plan, psychologists are not. We had a psychologist to do the testing for Learning Disability (LD)'s on easy child.

I am going to call their office today and see if I can find out what is happening with getting an appointment.

 

[trinityroyal]

WTWE, your difficult child's behaviour and thinking reminds me of my difficult child. He's both BiPolar (BP) and Aspie (with Obsessive Compulsive Disorder (OCD), Anxiety and a bunch of other stuff that goes along).

For a very long time, tdocs, psychiatrists and paediatricians had him diagnosed as ADHD/ODD and were prescribing stimulants and SSRIs. Once a very good forensic psychiatrist did a full workup and pinpointed the BiPolar (BP), everything fell into place. The hyperactivity of mania can look just like the hyperactivity of ADHD, but the stimulant medications can send someone with BiPolar (BP) right over the top. Add in the SSRIs, and it can just go straight to H-E-*-* in a handbasket.

The distorted thinking is a real challenge. I once corrected difficult child about something minor, where he misinterpreted my words. He got very upset with me, so I asked him: "Tell me exactly what I just said to you that got you so upset." He replied that I had just told him he was stupid, and he wasn't stupid. So my, "That's not really what I meant" was translated in his mind as "You're stupid." Knowing that really helped me to better understand that communicating with my difficult child by talking to him just wasn't going to work well. So much noise and interference that the verbal input just wasn't getting through.

Now we communicate much more in writing (e-mail, text message, even scribbled notes), and much less through talking. It has really helped us to clear up so many misunderstandings. AND it seems to help difficult child not take things to personally. It's no longer, "Mom's being a B, she told me to Blah". It's, well "The rules say I'm supposed to Blah. I guess I'd better Blah."

I'm not sure why it works -- something to do with auditory vs. visual processing of information, but it really makes a huge difference for us.

Maybe this is something you can try out with your difficult child? Just a thought. Another tool that might work for you.

 

[welcometowitsend]

Trinity - Thank you. The psychiatrist and myself both suspect BiPolar (BP) based on his behaviour over the past year. If he is BiPolar (BP) then his manic episodes are agitated and angry - not happy. He is not a high energy person - he's actually very lazy for the most part but he is fidgety and the more agitated he is the more fidgety he is.

I thank you for your description of your son and how you overcame the misunderstandings. My difficult child is like that. He misinterprets things, remembers conversations and events completely differently than his dad and I do. The only way I can describe it is distorted but maybe there is some auditory processing stuff going on there. I know Insane has suggested it before and I'm going to ask the psychiatrist about it as well. I did some internet research on Auditory Processing Disorders (APD) and it didn't sound like difficult child but he doesn't really fit the internet description of a BiPolar (BP) person either.

We just have to keep looking for answers until we find the right ones for our difficult child's.

Something he said yesterday when speaking to my cousin is he is chronically thirsty lately. Can't get enough to drink. I am going to get hold of him and make an appointment with our family doctor as well to get that checked out. It could be a side effect of the Wellbutrin but it could be something else as well - like diabetes. He has lost some weight lately too but that is also a side effect of Wellbutrin. Not taking any chances though.