Conduct Disorder - Is there any hope?

JJJ

Active Member
This just keeps getting better...now in addition to everything else I have to be worried about an incorrect diagnosis.

Since he is only 10, you will likely go through many diagnosis before the psychiatrists finally figure out what is actually the main one. I would consider any diagnosis a working theory and if the medications and therapy for that diagnosis help your son, great. If they don't help, then keep pushing the psychiatrists for more testing and ideas.

My son Eeyore was diagnosis with Conduct Disorder at age 6. My mommy gut completely rejected that diagnosis (although I am grateful for it because it led me here). Many of our kids that are servere enough to lead us to this forum are way more severe than the typical patient seen by most psychiatrists and tdocs. in my humble opinion they tend to either overreact (giving young children diagnosis of Conduct Disorder) or under-react (giving a homicidal, psychotic girl the diagnosis of depression).

You are doing the right thing in asking for more testing and a second opinion.
 

susiestar

Roll With It
Welcome!! Others have given you awesome info. You are at the start of a truly amazing journey. You will learn more about your child, your husband and yourself than you ever knew it was possible to know. One MAJOR, very important, incredibly serious piece of advice is to start seeing a therapist now to strengthen your marriage. A huge number of marriages does not survive having a difficult child. You and husband are going to have to work, and work HARD, to stay together in a healthy way. A divorce will pile even more problems onto difficult child and onto both of you. Right now you can probably agree that your plate is already overfull of problems.

Make a pact with husband that you will set up a list of behaviors and consequences. Post it on the walls in a few places. Make these consequences set in stone until you and husband TOGETHER decide to change them. Agree that neither you nor husband will put ANY stock in ANYTHING that comes out of difficult child's mouth that would make you upset or angry with each other. Save that reaction until you can speak calmly about it with each other. You will be astounded by the ways your difficult child will try to triangulate you. You MUST stick together and present a united front to him. You are all each other has in this battle. If he can get you upset with each other, he wins.

Almost all difficult children lie. There are some notable exceptions like Totoro's daughter and Marg's son, but even they can misinterpret a situation so what they say isn't the truth or the whole truth. In their case it is a mistake in perception. In most cases though, difficult children lie more than rugs. Many of us have meant the old joke - How do you know when my difficult child is lying? His mouth is moving. In my case there were several years where we could not catch my difficult child telling the truth and neither could his teachers and therapist!! We worked hard to "catch" him telling the truth so that we could reward him for it. He would still lie over the biggest stuff, the stupidest stuff and everything in between.

I have a link in my signature to a Parent Report. Years ago some of the warrior moms here put together an outline for a report about our kids. It is immensely helpful because it keeps ALL of the info about difficult child in ONE binder. Copies of all or part of it can be given to people you are working with, filling out those endless forms for doctor visits is much easier because you have all the answers in your report. I strongly encourage you to start one ASAP. do not expect to finish it in one session, it seems to be more complete if you work on it in several chunks of time.

The Explosive Child by Ross Greene is a truly amazing, life changing book. Most of us have gotten great results by using the methods from the book. I also suggest you check out the various books on the Love and Logic website (www.loveandlogic.com). The methods in it are wonderful. L&L stresses logical consequences administered in a way that nurtures a loving parent-child bond. It truly is amazing. Not to mention that it tends to lead to a vastly calmer home, at least on the parents' part.

I looked at the list of behaviors you posted. One of my mom's friends has a daughter with severe adult onset bipolar. At one time or another she has exhibited every single one of the things on that list. ALL of them. Usually only when she is on the wrong medications or more likely goes off her medications do these things appear, but she has done ALL of them. She does NOT have CD. When she is off her medications she tends to sink into psychosis fairly quickly. At that point she has done many of the listed things she is unable to control much of what is going on because of the delusions and hallucinations.

Medications can make a huge difference for a child, esp with problems like bipolar which cannot be helped with therapy and accommodations alone. Some problems, esp bipolar, are made worse (MUCH worse) by certain medications. If bipolar is suspected it is best to start with medications that would help bipolar. If trials of several different medications are not helpful then you can move on to other medications. If you start with medications for depression or adhd it is possible that the patient will never achieve mood stability until those medications are out of the system and mood stabilizers and antipsychotics are at therapeutic doses. To know if the medications are going to work the patient may need to titrate up to a therapeutic level and be at that level for 6-7 weeks. medications are not easy but they CAN make a huge difference.

I am not saying your son is bipolar, or that he isn't. He could have a combination of several problems. I know at one point I truly thought my son was going to grow up to be a predator. One social worker who evaluated him called and told me she was afraid to go back to the psychiatric hospital he was in because he was going to be the "next Hannibal Lector". He was in the psychiatric hospital for trying to kill his sister in her sleep. Now he is a normal, healthy 19yo who is working and going to college while living across town with my parents. He has changed dramatically and has a wonderful relationship with his little sister, brother, and us. He is on medication for depression, adhd (a component of his Aspergers), and a sleep disorder. The medications did not cause the change in him, they allowed him to work to make the changes. with-o the medications he is so depressed that he wants to kill himself and everyone else, he gets less than 3 hours of sleep a night for weeks on end, and he is so hyper he cannot follow anything for more than 15 seconds unless it is a video game.

There CAN be hope, but it takes a lot of work and advocacy and sheer stubbornness on your part. You are going to have to push your difficult child, his therapists, and a whole group of doctors to figure out what is going on and why and how best to get him to change.

You are NOT alone anymore. We are here with you, anytime you need us!
 
Hi Jenn,
Welcome. You've already got some state-of-the-art advice. I thought I'd throw in my 2cents -- most of the "diagnoses" evolve over time. Ten years old is young for a concrete diagnosis. And as many have mentioned, I've never heard of a ten yr old being diagnosis with CD. Too young.

We've just been looking at a CD diagnosis for our older son, but most of it's turning out to be neurobiological. For more on CD, there's a good article in the archives called the Chandler Papers in the archives (sorry if mentioned already -- ADD). It's pretty hopeful about CD.

But more patterns have to be observed in your little guy over time. Write them down in a little journal -- just a few words about the day. Read up on some of the diagnoses until something clicks in your gut.
For me it was an article called "Rage Attacks" on Leslie Packer's site about Tourette's about 10 years ago. It didn't help me diagnose my kid. But it fit.

Some of the symptoms you mentioned could have different reasons, as others have suggested. Like hitting - he may not know how hard he's hitting or throwing (sensory issue). He may be getting too much or not enough sensory input, so he's dysregulated and isn't successful in self-regulating. Impulsivity, poor judgment can stem for a number of reasons in different areas of the brain. That's where a neuropsychologist evaluation would be helpful -- it looks like a bunch of esoteric academic tests (to me anyway), but it's actually a blueprint of how his brain is working.

A few more questions to ask yourself, not sure if they were already mentioned. Any birth trauma (sorry so personal). Head trauma? Separation from you in the early years due to illness? These are very personal questions, please don't even think of answering me. Do you have any thoughts about his setting fires and hurting animals? If a child is traumatized or stressed early on (for whatever reason) he can get stuck in a state of hyperarousal and cortisol (stress hormone) keeps flooding his brain.

There's probably a very specific reason he's not self-regulating. It's unclear now.

by the way if you do behavior mod and it involves an area of his brain that isn't up to speed, his behavior will worsen because he can't do it. Keep notes on what he can and can't do, or specific things that enrage him. That will show you what part of the brain he's relying on (maybe over-reliance) and what part of the brain he's not using. Rational decisions are made in the frontal lobe. Pre-frontal cortex. Fight or flight: amygdala I think. Oh how I hate the word amygdala and wish I had never ever heard it.

Hope I don't sound preachy -- this is basically just a little summary of my own journey with our older son.

Good luck. Keep posting. Bag the guilt and use that energy to take good care of yourself. You're doing a great job for your son and for your daughter too. Regarding the anger towards your son -- normal. I'd be wondering what's wrong with you if you weren't angry. I've gone far beyond anger all the way to rage. EEK! Better now though. I hate rage. Yuck! Underneath rage --- grief. Yuck! That's even worse. Got to be faced though.

Good luck, keep posting, do some things you enjoy and that define you as a person.
 
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susiestar

Roll With It
Barney'smom has great suggestions. I had forgotten about the Chandler Papers. They are very informative!!

One thing I want to add is that YOU are the expert on your child. The various doctor and professionals are experts about fields of medicine, study, etc... They spend precious little time with our kids, some as little as 5-10 minutes every 3-4 months!! That is less than an hour a year!!! You have been there every single day of your child's existence!! If you are his birth mom you were there for 40 weeks before he was born too! You spent more time with him before he was born than any doctor will in his lifetime. How is that for putting things in perspective as to who is an expert on what???When that was pointed out to me I was shocked. It is such a different way to think about it, isn't it? Yet it is a very logical way to look at it.

Don't get me wrong, the docs and experts are necessary. They just do not have the final say. They will interpret things differently and can give you a different point of view on things.

On example- My 15yo daughter, Jess, has what looks like a movement disorder. Her body will shake uncontrollably for hours at a time. The muscles contract and relax all on their own. The docs have seen that when she talks the shaking stops. They conclude that it is anxiety related and if we keep her busy she won't shake. They are dead WRONG. She can suppress the shaking for short periods of time. If she wants to eat, drink, or talk she MUST suppress the shaking. Otherwise she cannot control her vocal cords and the muscles that are used in speech. I have worked with her on this for the last year, since it started. She simply is unable to speak, to get food or drink to her mouth or to swallow unless she stops the shaking. Of course the docs ALL think they know everything and have told me I am making excuses for her. Her therapist wants to go shoot them, lol! The therapist sees anxiety there, but it is largely caused by the disorder and the migraines she has 3-4 times a week.

It is EASY to get confused about what is going on, and to let the docs convince you that they are correct. You have instincts about your kids, very powerful ones. If someone suggests something that your instincts scream is wrong, or you see a symptom that instincts tell you is serious, go with those instincts. EVERY SINGLE TIME. Most of us here admit that the biggest, most awful mistakes we have made as parents have come about because we did what an expert was sure needed to happen even though our instincts screamed the opposite. It can be hard to stand up against the experts. Esp if your spouse or another family member thinks you are dead wrong. It is still important to follow your instincts.

You will make mistakes. We ALL do. Our kids learn that we are not infallible, and that it is okay to make mistakes. The important thing is to not beat yourself up when you do mess things up. Also to not let your kid beat you up with guilt because you made a mistake!

Many of us have found that diet can make a BIG difference in our children's behavior. Some of our kids have food allergies or sensitivities that result in terrible rages and behavior. Wiz becomes terribly MEAN when he eats a lot of sugar on an empty stomach. He truly becomes Mr. Hyde. As long as he has enough protein in his diet he is fine with a reasonable amount of sugar. We have found that those protein bars are wonderful to have on hand. They satisfy his sweet tooth and don't send him into the sugar meanies. Others have kids who don't handle gluten or casein well. The diet is called a girlfriend/cg diet, meaning gluten free/casein free. Gluten is a protein in grains like wheat and casein is a protein found in dairy. The diets can be pretty hard at first because gluten and casein are in all sorts of things that you wouldn't think of, but for some kids it makes all the difference in the world. Allergy testing sometimes shows these problems, as do tests for celiac disease (gluten is not digested properly and causes enormous problems). Some kids show no signs of celiac disease or other allergies and still have problems if they eat certain foods.

If at all possible, it is helpful to keep a journal of difficult child's moods, behavior, and what he eats. You may see some links after a couple of weeks of recording this stuff.

Has your son ever been evaluated for sensory integration disorder? Sensory Integration Disorder (SID) happens when the brain does not process sensory input properly. It is a problem thought to be in how the brain is wired. That is why people have asked about if tags on clothes bother your son, if certain textures, colors, tastes, etc... are problems. It can cause drastic problems including tactile defensiveness. Wiz has had a lot of problems with that. Even a very light touch might make him take a swing at you. He flinched from every touch, sometimes even from his clothing if it brushed his skin. Some kids avoid stimulation and others seek it out. Your son should be evaluated by a private Occupational Therapist. Here in the US our school have Occupational Therapist (OT)'s on staff but they only evaluate for how Sensory Integration Disorder (SID) impacts academics. Private OTs look for how it impacts every facet of his life. Sensory Integration Disorder (SID) is a very hopeful diagnosis. One of the primary therapies is brushing. A very soft brush, like a surgical scrub brush, is used to brush the body in a certain pattern and is followed by very gentle joint compressions. It is proven that this actually forms new pathways in the brain to handle sensory input!! And it involves NOTHING invasive!! Many kids enjoy the therapy and it can be done under or over clothing. The brushing and compressions take us less than 2 minutes to complete even taking our time - my son timed us with a stopwatch, lol. Do NOT try to figure out the brushing yourself. It must be taught by an Occupational Therapist (OT) because you can create more problems if it is not done correctly. To learn more, read The Out of Sync Child and The Out of Sync Child Has Fun by Carol Kranowitz.

I hope I haven't overwhelmed you. If I have I am sorry. I don't know what services are available to you and wanted to offer a variety of suggestions. Most important of all, keep coming back here!!! We truly care. We have walked (and ran, rolled, wallowed, fallen, etc...) in your shoes and we truly understand. We will NOT judge you and we won't be upset if you just want to vent and ignore suggestions. We know not all suggestions work for every family.

(((((hugs)))))

Susie
 

DammitJanet

Well-Known Member
Welcome!

I found this board when my youngest son was 12 and he will be 24 this week! Gosh how time flies. A psychiatrist told me back then that I might as well just forget about even attempting to help him because he was a sociopath. Little did I know she was probably right...lol. I was so mad at her I grabbed my kid by the hand at ran from her office convinced I could fix him somehow. Blah. I dont think anything we did made a difference really. He has just grown up.

He never really acted out sexually in public. At home? Ahhh,...yeah! King of the 'oh look what I have found" ...lol. Until he found girls.

He has been arrested several times. On probation now. Stole from me. I turned him in. He also gave me my most precious gift. My oldest granddaughter.

I dont know if Cory is CD or not. Maybe. I know he loves me. I know he would kill for his dtr. He is a very good daddy. She adores him. She has learned a new song. K.E.Y.A.N.A ......keyana......D.A.D.D.Y.....daddy ...spells LOVE!
 
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