Can Anyone Relate to This Behavior in Their difficult child's?

[jal]

Our difficult child is 7. Current diagnosis is ADHD/ADD combined type with Mood Dis not otherwise specified. He takes Seroquel and Prozac and is in a therapeutic school program. Stimulants have never helped, only made things worse. He has always had some anxiety even though earlier doctors said he didn't. Last week difficult child was to go to an event and he looked forward to it all day. Throughout the day he could not sit still, could not occupy himself. Kept looking at the time and telling us exactly how long it would be until it was time to go. We know that with him we usually have to wait to tell him about places, things otherwise we go through this all the time, but in this instance he knew ahead of time.

Asked him to calm down, provided alternatives, but nothing worked. The kid was crawling out of his skin with excitement. I'd never seen it so bad before. He even said he knew he couldn't calm down. As time drew near he has a meltdown in regards to dinner. He really lost it. Not physical, just a total emotional meltdown. Now we decided we weren't going to go because we didn't want to reward him for the behavior, but then this outing was a chance for him to meet up with a friend and he doesn't have any, so we relented and took him.

We got there and he did fine and had a nice time, but once or twice I needed him to listen to me and he would get angry and just try to go on his way. He gets so scattered in a large group. His mind is on something and you can't get him to stray from it, or he has several things on his mind and can't make concrete decisions. Later, when we got home he gave us some trouble about getting into the shower and brushing his teeth. Things he was told ahead of time would need to be done. They were done eventually and uneventfully, but I guess I just don't see any gratitude from him. I would think that at his age now he should be able to show a little of that. (That he went to the outing inspite of the tantrum). It's just that he never seems to take others feelings into consideration. It's all about him all the time and it made me quite a bit mad honestly. Now I know he is only 7 and probably emotionally younger than that and maybe I am expecting too much?

I guess I don't know really what I am asking. We have an appointment today with a new psychiatrist. I am wondering if it's time to try stims or clonodine again to see if we can't get the ADHD and impulsivity under control. difficult child has recently begun to get sticky fingers at school and is taking food at home without asking. He is never deprived anything, we just want him to ask and not just take. We've had to put a lock on one cabinet as he'll get up before us on the weekend and eat what he wants. He knows the appropriate choices for breakfast and has access to all of them, but of course he gets into other things. I think I know have to get a lock for the fridge now as he got into the ice cream Sunday am, UGH.

We have also just received results from an austim consortium that we were part of. It didn't come with an official diagnosis, which was disappointing, but did point out that he does exhibit some tendencies (not great eye contact, very hard to have a back and forth converstion with for any length of time). He was tested independently for Asperger's and was found not to be on the spectrum then.

Thanks for listening.

 

[JJJ]

I'm glad you let him go. I think our kids lose out on so much. I don't think you'll see gratitude for letting him go in spite of the meltdown because he doesn't see a connection between the meltdown and the activity (which is exactly why 'punishing' him by missing the activity would not have worked because he can't connect the consequence with the behavior.

I'd suggest reading The Explosive Child and Lost At School (the techniques can be used very well at home) both by Ross Greene.

Stimulants are awful for my son. We finally have some control. It took time. At 7, he sounded just like your son. He is now 10 and doing so much better.

Here is what worked for us:

1. Medication (clonodine, depakote, seroquel)
2. gluten-free, casein-free All-Natural Diet
3. Time (just maturing)


I cannot stress enough how much the gluten-free, casein-free All-Natural diet improved our lives. Both of my sons are so much better. I just had a meeting with Eeyore's school and it felt so good to see "no behavior problems" "great kid who tries hard" on all the paperwork

 

[smallworld]

This does not sound like ADHD to me. It sounds like anticipatory anxiety and emotional reactivity. This is JMHO, but I believe stimulants don't work for your difficult child because they make pre-exisiting anxiety worse.

What are his Seroquel and Prozac doses?

 

[jal]

Thank you JJJ. I do have The Explosive Child and I'll check into the other one. I am glad we let him go too, because you're right, they do miss out on so much. difficult child has been on clonodine before with-no improvement and he also had been on Depakote with no improvement. We've been through the medication wringer.

Hi Smallworld-Seroquel 100mg am/50mg afternoon/25mg pm and 20mg Prozac in am only.
He definately appears to have ADHD (always has), a lot if inattention and focus at times, but I agree that was exhibited yesterday was definately related to anxiety.

 

[smallworld]

My daughter M was diagnosed with ADHD (inattentive) by a neuropsychologist, but we don't really think she has it. We really do believe her severe anxiety makes her inattentive. Just something to consider.

I personally wouldn't recommend going higher on the Prozac because it can cause disinhibition on higher doses. But Seroquel is also good for anxiety. You have lots of room to go higher. It's something you might want to discuss with the new psychiatrist.

 

[smallworld]

Forgot to add: A psychiatrist recently told me that a tiny dose of Abilify (1 mg) is often good for inattention.

 

[jal]

Thank you smallworld. difficult child has also been on Abilify, but at the time could not move from 5mg to 7.5mg at all. I will definately discuss with-psychiatrist today. difficult child learns, as in school and is doing well academically, but always just seems to be all over the place. Can't do anything for more than a few moments unless it's tv or video games. The other night he was so excited to carve the pumpkin. He covered the dining table in newspaper, got the carving kit and everything ready. He chose the design and as soon as I started to cut the lid off, he was over watching tv and was done with it.

 

[smallworld]

The psychiatrist I was talking with recommended higher Seroquel dose augmented by tiny Abilify dose (1 mg) for brighter affect and attention.

 

[totoro]

Just wanted to let you know that he sounds just like K in so many ways.

I have to have HUGE charts because she is so easily distracted, I have to redirect her within minutes.
She also can not be told about any event prior to the event. I also would have let her go.
If by chance she is told, UGH, I have to try to figure out any way possible to distract her until the event.
What works at times for me is to set up Legos in front of the TV and then sit with her and force her to build with me until the event.
This makes it hard for me to get anything done. I will run away for a minute here and there to help N or get dressed etc.
I also will slowly get her ready.
"OK, let's get your shirt on" then go back and play Lego's... things like this.
"Go check and tell me if I left my purse in the car?" (wink-wink)
I will hide it and let her know we can't leave until we find it!!!
Have her wash out her travel cup and put water in it for the road...

I also let my rules of not making a huge mess kind of go, I will ask her to make a project with glue and what ever...

Otherwise there is tears, screaming, banging head on the wall all of the fun things! Multiple times.

medications I have not idea? We are still searching. K has been diagnosis'd with severe combo type ADHD, by every one that has seen her.
Anxiety as well. So who knows. I can see the difference in different situations but the medications have been a struggle.

Good luck it is so hard.

 

[pepperidge]

I can relate.

Prozac caused a great deal of disinhibition in both my kids, on lower doses than even your kiddo is on. Sticky fingers was one of the definite results of that disinhibition. My oldest who has depression/anxiety has gotten some relief from his combo of Lamictal and low dose of Risperdal. He is not a typical BiPolar (BP) kid but definitely has some mood disorder issues.

My youngest did get some significant relief on ADHD type symptoms (impulisivity and inattention) on a low dose of abilify (2.5 mg). We recently took him off it and could definitely see the difference.


You might want to discuss medication changes with psychiatrist.

Good luck .

 

[smallworld]

Jal, has your difficult child ever trialed Lamictal? My three kids take it, and like Pepperidge's don't have full-blown BiPolar (BP) dxes. But Lamictal has definitely helped with meltdowns, emotional reactivity and mood regulation. The psychiatrist at my son's Residential Treatment Center (RTC) said Lamictal can also help with anxiety.

 

[klmno]

I'm wondering about the prozac- I have heard that if stims serve to activate a child, sometimes they won't do well on SSRI's either. I'm not an expert but I'm thinking more like SW- maybe a mood stabilizer would be more effective.

 

[BusynMember]

I know I'm late in the game, but it sounds like he may be having a bad reaction to Prozac, which can cause akathesia (the feeling of jumping out of your own skin). You can't sit still, can't focus, can't do anything...and SSRIs can cause it. Actually, any psychiatric medication can including Seroquel, but Prozac is far more likely. It was hell for me when I had akethesia...and very different from anything I'd experienced...very icky. I had to go off the medication (Zoloft) right away. It was the night of my two son's eighth grade graduation and the only way I could sit through their ceremony was (per doctor) to take one 5 mg. Valium every single hour. Otherwise, I was an adult who was climbing the walls like a difficult child.

I wouldn't do stimulants with him acting this way, ADHD or not. It doesn't sound like ADHD to me right now. It sounds to me like a medication reaction. Prozac can take several months to amp up a sensitive person because the drug builds up in the system. For me it took two weeks. I'm an adult and was only on 10 mgs. of Zoloft when it made me crazy. I ended up in ER. The doctor told me it couldn't be the Zoloft. Well, it went away a few days after the Zoloft and never came back. Um, psychiatrist was wrong and fired.

Good luck, whatever route you take!

 

[trinityroyal]

Jal, you've already had some good input from others but I thought I'd add my $0.02 as well.

This behaviour sounds just like that of my difficult child, before we got his medications straightened out. He has Asperger's and bipolar disorder. Stims were a nightmare for him. They did give him the ability to focus, but at great cost as they exacerbated his anxiety, caused issues with extreme weight loss (in an already underweight child), and led to paranoia. When we added an SSRI into the mix (in his case, Paxil), he had severe akathesia and disinhibition.

Your difficult child's behaviour sounds like it fits the autistic spectrum to me. Dual diagnoses are always so difficult to pin down. Mood disorder mania looks just like the hyperactivity of ADHD, etc. so it's difficult at first to tell which it is.

I'm not qualified to diagnose by any means, but I thought I'd mention my difficult child's experience as it sounds so much like what you're dealing with.

Trinity