BiPolar (BP) rage, control

[miles2go]

Any comments on the following: the medication (abilify 7mg) keeps things quite wonderful (except for some excess weight) most of the time but once every few days, when he's tired, he'll go into a mode where he wants to control everyone completely and then of course is frustrated and lashes out in a more and more violent way -- bite, hit, picked up a stick. When confined to his room, busts out a wire screen, goes outside, cools off and then is contrite as can be and swears 'never again' and obviously means it. Is this common for BiPolar (BP)? Does that mean I need to up medications again? The outbursts haven't been in school, so its not nearly as bad as it used to be.
Me: dad almost 50
difficult child: 8 y.o. boy, BiPolar (BP), abilify
Wife, other kids, animals, in-laws......

 

[BusynMember]

It's common for unstable BiPolar (BP).
And in my opinion your son needs a mood stabilizer on top of the Abilify. That's not a real mood stabilizer.

 

[klmno]

I'd report this to psychiatrist right away. Yes, it's normal for unstable BiPolar (BP) but the right medication combo could improve it. My son didn't do well on abilify and I've heard of other similar stories- it makes some kids worse in the rage department. Also, I think (but am not sure) that if abilify is going to be an asset, it needs to be used with another MS.

 

[smallworld]

First, this behavior is common for kids with BiPolar (BP).

Second, even though things are better, your son doesn't sound stable. He's still on a relatively low dose of Abilify, and he might need a first-line mood stabilizer (Lithium, Depakote, Lamictal, Trileptal, Tegretol) for full stabilization.

You should have a discussion with the psychiatrist about what you're observing. It would help the psychiatrist decide what needs to be done if you keep a log of behaviors -- time of day, duration of rage, trigger, what actually occurred, etc.

Good luck.

 

[miles2go]

Thanks all. We have an appointment with psychiatrist early June.
I also notice, when he gets into his tense mode but way before any outburst may or may not happen, he starts talking through clenched teeth. Mood, all else fine, but teeth clenched. Seen anything like that?

 

[klmno]

That sounds like he's trying to hold his agitation in before exploding- it could be anxiety related. All this can be associated with BiPolar (BP), or he could be misdiagnosed. Our difficult child's usually need extra help learning good coping skills- actually I'm not so sure that this is not the root of difficult child'ness. It's hard to find a therapist to actually teach them good coping skills, though in my humble opinion- most of them just wwant to deal with rewards and consequences. Anyway, I don't think it would hurt to go ahead and put a call into psychiatrist before the appointment.

 

[Christy]

I'd recommend keeping a journal so that you can show the psychiatrist exactly what is happening and how often. I hope you can find the right combination of medications to help stabilize your son. Good luck.

 

[miles2go]

smallworld -- 7 mg is small? what is your information on abilify dosage? I hear some opposing views (may be stemming from the fact that adult dosages are not too much bigger than children's?)
ok, I'll keep a journal y'all -- I do rely on my memory too much at times.

 

[gcvmom]

We had some similar behaviors with difficult child 2 when he was not stable. Especially the controlling and obsessiveness. He would have nuclear meltdowns when things didn't go the way he wanted -- and he was very rigid about what he wanted. It was like his life depended on it -- almost a desperate quality. It got much better when we added a mood stabilizer (in our case, Depakote) to the antipsychotic medication.

 

[SearchingForRainbows]

I agree with the others. The behavior you're describing sounds like your difficult child isn't properly medicated and is still unstable.

difficult child 1 currently takes Trileptal (generic) and Abilify. This combination has worked well for him. He started the Trileptal (mood stabilizer) before he was put on the Abilify. I think he is going to need a medication "tweak" because of the amount of stress he is under (all caused by his own poor choices), but that is off topic.

As far as your difficult child is concerned, I'm glad you have a psychiatrist appointment soon. Things should get easier once your difficult child is on the combination of drugs that is right for him.

Thinking of you - I know how hard it is to live with an unstable, raging difficult child. WFEN