difficult child 1 becoming more hostile

Discussion in 'General Parenting' started by gcvmom, Jan 31, 2010.

  1. gcvmom

    gcvmom Here we go again!

    We've been having a lot of problems with difficult child 1's behavior the past few months. He provokes his sibs verbally and physically (name calling, poking, spitting, threatening to hit, etc.) and then when they react he gets violent. He is argumentative with both husband and I and gets confrontational and sometimes violent with us.

    At first we thought it was medication rebound because the worst of his episodes happened at night.

    husband was at the psychiatrist's last week and mentioned the winter break incident where difficult child 1 was so out of control with us late one night he was fearful for his own safety and was yelling for me to call the police. We managed to diffuse the situation on our own, but psychiatrist was very disturbed by this information. He said it sounded like difficult child 1's emotions were being made raw by the stimulant (this is NOT typical teen behavior) and he told husband that we should reduce difficult child 1's stimulant to 1/2 of a 30mg Daytrana patch instead of our usual 3/4 patch.

    Well, I waited until finals were over on Thursday, and so Friday, yesterday and today difficult child 1 has only had 1/2 a patch. And it does not seem to be helping much.

    This morning he was his usuall PITA self until his Focalin kicked in. Then he was great! Cooperative, helpful, but as the Focalin started to wear off and the patch kicked in (he puts the patch on about an hour or two after he takes the Focalin because the patch takes a couple hours to start working) he started getting bossy and irritable and annoying.

    After lunch he got into it with easy child outside by spitting on her and when she reacted, he started dragging her around the yard on her back (really soiling her favorite shirt badly) which infuriated her further so she started hitting him. He had on his lacrosse gloves and his stick was in his hands. She said he was poke checking her in the side, back and on her shins, and she apparently then started slapping and hitting him back. She got him on the ground and he thought it was funny and was sort of laughing about it, then he got the upper hand and sat on her and started to choke her with the lacrosse stick. I didn't see what was happening until she was hitting him and I hollered from the house for them to stop fighting. Of course, that was like trying to break up a dog fight by singing a lullabye. difficult child 1 was already on top of her by the time I got outside and difficult child 2 was a few steps ahead of me thinking he would come to easy child's rescue, which only inflamed difficult child 1 more.

    So I got it broken up and sent everyone in to separate rooms. Then went to talk to easy child to find out what happened. difficult child 1 came out of his room about 5 minutes later and I asked for his side, which completely left out his role in the situation. I asked him if what easy child said was true, and after a few seconds of reflection (he was still quite agitated) he admitted that he had started it all by spitting on her. I got him to apologize (and not too sincerely at that) and told him that there was no way on earth he could ever justify what he did to his sister and that if he wants to continue living under my roof, he's going to have to figure out a solution to his aggressive behavior. And so he's grounded in there for the rest of the day.

    Then after I had a good cry in the bathroom (over easy child getting the brunt of this, difficult child 1 not getting it, and easy child feeling like I let her down and let him get away with it) I called the psychiatrist and left a message about what happened. Hopefully he'll call back tomorrow morning and we can get some help with this.

    I'm starting to wonder if he needs something like Risperdal. Or if the citalopram is not the right AD for him. Or if he needs something like Lamictal. Or even Tenex. But something definitely has to change.

    I'll update when I hear back from the psychiatrist. Hopefully the drama is done for today. He just came out of his room and gave me a loud, exasperated sigh when I told him he was in his room for the rest of the day. We'll see how he handles this as the patch wears off this evening...
    Last edited: Jan 31, 2010
  2. DazedandConfused

    DazedandConfused Active Member

    Hey gcvmom,

    I feel your pain. Son has been a MAJOR PITA. I wrote about it in my thread I posted last night.

    Now, his psychiatrist is out (presumably sick) for a long time or even for good.

    So, what I have to offer is sympathetic and understanding ((hugs)).
  3. tiredmommy

    tiredmommy Site Moderator

    Sending a big {{{hug}}} to you and easy child. I'm sorry difficult child 1 is so out of control. I hate to say this, but... maybe it's time for an inpatient medication wash. I'm really concerned about the level of violence in your home. Does easy child have a lock on her door? How about difficult child 2?
  4. gcvmom

    gcvmom Here we go again!

    Thank you, Dazed... it's just good to know you all know what this is like.

    TM, it's so inconsistent. He's fine, then he's not, then he is. Something does need to change, and I'm pretty confident we can handle this transition at home just fine, but it really has to change now. Can't continue on this way at all. And yes, all kids have locks on their doors, though they are the push-button kind so easy to "pick". Maybe it's time to get the keyed kind. :(
  5. smallworld

    smallworld Moderator

    We had definitely reached this point with J and stimulants a couple of years before he left for Residential Treatment Center (RTC). They worked, but there was far too much variability in his mood to continue to use them.

    I'm curious, though -- you said difficult child 1 does well on Focalin. Have you ever tried him on Focalin XR instead of Daytrana? Focalin is refined Ritalin so the side effects are supposed to be lessened. I'm wondering if it would be better for difficult child 1.

    I'm also wondering if difficult child 1 has ever tried Wellbutrin. It is a stimulatory AD that helps with ADHD symptoms. It doesn't have the rebound effect of stimulants. This is the only medication J is on right now, and his mood is very even. Just a thought.

    I hope the psychiatrist is able to offer some good suggestions for you tomorrow.
  6. ThreeShadows

    ThreeShadows Quid me anxia?

    I'm so sorry about this turmoil in your home. I hate how much our children suffer. It's painful just reading about this. My three would rub against each other like flint trying to start a fire.
  7. ML

    ML Guest

    Just adding my hugs. What a rough day for everyone! Love, ML
  8. pepperidge

    pepperidge New Member

    We have had some similar issues.

    Adderall works really really well, but rebound is definitely not pretty and didn't seem to deal iwth underlying depression.

    Lamictal really helped, and a small dose of Risperdal seems to have helped the aggression and rebound.

    My child would be lost with the stimulant, but he really needed something else. You can tell when the stimulant kicks in---cooperative, talkative, pleasant...

    good luck. some medication changes might help.
  9. flutterby

    flutterby Fly away!

    I'm so sorry. :(

    When easy child was 10 and severely depressed and very hostile, I couldn't leave him and difficult child alone at all. After he choked her and she had red marks on her neck, I let him know, at 10 years old, that if he touched her again I would call the police. That was hard.

    Had he been older, I would have been afraid for my safety.

    I hope you're able to find a solution quickly.

  10. crazymama30

    crazymama30 Active Member

    I was wondering the same as sm, would focalin xr be better than the daytrana?

    I would really wonder if the ad is causing some of the problems? Maybe a different one or go to Lamictal, he sounds like he might be moving into a bit of a cyclic mood disorder. I have really been impressed with Lamictal with difficult child. Didn't do anything for husband--he takes tegretol, but for difficult child it is great. Hugs.
  11. gcvmom

    gcvmom Here we go again!

    SW, that's a very good point about the two different medications. I don't think he's been on Focalin XR, although difficult child 2 has. Before we switched to Daytrana he had been on Concerta and doing well, except at the time we found out he had an intestinal stricture from the Crohn's and there was concern about the Concerta capsule not dissolve completely and the potential for a blockage because of that.

    It's certainly worth looking into... heck, I may even still have some old Focalin XR on hand somewhere... I need to look.

    3S, the metaphor is perfect. I kept difficult child 1 in his room all day today and it was AMAZING how quiet and peaceful things were. easy child and difficult child 2 played so nicely together both in and outside the house today. The minute difficult child 1 came out and tried to interact with them, voices started raising and there was trouble within a very short time. My heart hurts for all of them.

    ML, thank you.

    Pepperidge, we had horrible rebound with Adderall when he was younger. The aggression was very bad on it. I think of Lamictal because I know what it did for his dad and he sometimes has the same irritability and depressive anger husband had.

    Yup, Heather, it truly bites when your kids make you afraid for your safety and that of the rest of the family. I hate this.

    CM, the only reason we put him on an AD was to address the anxiety that was getting out of control with him shortly after his Crohn's diagnosis. He's always been an anxious kid, and it got really bad then. And even before then, when he was on imipramine for bedwetting, I noticed an improvement in his mood when he was on that in the first grade.

    At first he was on Lexapro for the post-Crohn's diagnosis anxiety, and that did great for him. Then about two years later he started with IBS problems, and his GI rx'd Elavil/amitriptyline for that (in addition to the Lexapor) with psychiatrist's blessing. But it was right around then his anger problems started to get out of control. psychiatrist switched him to Celexa, and I couldn't really tell if there was any change, plus it's hard to tell if it was puberty or the medications or what. Then last year I took him off the Elavil and for a long time he was a lot better. But then over winter break it's like things are getting more frequently out of control for him now. He's just obnoxious and annoying off the stimulant -- and then he's nasty and irritable when it's wearing off.

    And because he's so immature he doesn't even know how to deal with my disapproval and his dad's disapproval. husband tries the soft approach, and I tend to be the hardliner. difficult child 1 just throws it back in husband's face and with me he just tries to provoke a reaction. Tonight he kept coming out of his room and doing things to both annoy me and get my attention: throwing pretzels at me, standing right behind the couch where I was sitting and swinging a smal dumbbell over my head (I have to admit, I was both nervous and angry but trying not to react to him), then trying to hug and hang onto me, or take the sleeping cat from my lap, making faces at me from behind (I could see his reflection in the TV). You'd think he was 8 or 9, not almost 15 1/2.

    So I'm taking my notes on the medication suggestions and we'll see what we can come up with in the morning. Hopefully we can find a way to sort out the medications and help him redeem himself in this family before things get much worse.
  12. timer lady

    timer lady Queen of Hearts

    What a fun day (said tongue in cheek & ducking quickly) ;)

    The tweedles have the attention span of a gnat - sometimes the stims worked; mostly they didn't so they were discontinued. Too much aggression for my taste.

    wm has been on risperdal since he was 9. I have to tell you that medication has been the best thing to lessen his physical aggression. We attempted to take him off of risperdal ~ puberty hit & that was the end of the story. wm still rages but to my knowledge no longer lashes out physically.

    My heart goes out to you, chicken lady. Sending you positive thoughts for a quiet day today & a phone call from psychiatrist.

  13. Wiped Out

    Wiped Out Well-Known Member Staff Member

    Sending gentle hugs your way-the physical violence really stinks. I hope they are able to figure something out medication wise that will help your difficult child.
  14. house of cards

    house of cards New Member

    Major also does the raw nerve, I'm going to get my siblings in trouble because everyone is out to get me stuff, he truly just doesn't see reality correctly at those times. It is so upsetting to everyone and zaps the happiness out of the home so quickly.Separtating them is the only thing I found helpful as well...and time.

    Huge hugs, bubble bath, a massage and anything else you can think of to help you. I am another that likes Lamictal alot. We simply say it gave Major his smile back. Now if I could get psychiatrist to up it just a bit.
  15. gcvmom

    gcvmom Here we go again!

    Again, thank you ladies for the encouragement and support. :)

    I checked my old stash of discontinued medications and unfortunately, the old Focalin XR expired in early '07. Don't think I want to try something THAT old on him... if it exp'd last year, I'd consider it.

    Anyway, stay tuned! I'm sure this will get more interesting as the week unfolds! :rolleyes:
  16. DaisyFace

    DaisyFace Love me...Love me not


    I don't know enough about medications to offer any advice....but I do hope things get straightened out soon. His behavior sounds very scary right now.

  17. pepperidge

    pepperidge New Member

    Hi GCV mom

    Wasn't suggesting that you switch to adderall only using my son's experience to say that sometimes stims have big benefits and drawbacks and that if you address the drawbacks sometimes you can keep the stims on board.

    Lamictal had a big influence on the whole irritablity component. My son was on Prozac and lexapro--neither of which did anything positive at all for irritability or anxiety. And worked counter to stims. Risperdal has also had a big impact on aggression and rage.

    Good luck with medication discussions.
  18. gcvmom

    gcvmom Here we go again!

    Pepper, I didn't take it that way. Just wanted to let you know how Adderall had (not) worked for him in the past :)
  19. tiredmommy

    tiredmommy Site Moderator

    How's it going today?
  20. gcvmom

    gcvmom Here we go again!

    Thanks for asking TM. No word yet from the psychiatrist, and I left a follow-up message this morning asking about trying a different stimulant.

    difficult child 1 had a good morning and got off to school without incident. After school he started getting a bit squirrely around 4pm, and said he felt "crazy" and didn't like the way he felt, but couldn't elaborate beyond that. Now he's in his room working on assignments. We'll see how the evening hours wind down.