He just can't help it!

Discussion in 'General Parenting' started by Christy, Jun 12, 2009.

  1. Christy

    Christy New Member

    Now how do we help him?

    I am not one to make excuses for my difficult child. In fact, I am probably harder on him than anyone else but I also realize how much he wants to do the right thisng but just can't control his anger.

    We have a sweet, good hearted kid who is friendly and wants to do well UNTIL he becomes upset. He then goes into a violent rage. He is currently at psychiatric hospital (EP'd by the police for an episode at school) , fourth psychiatric hospital visit this year. If fact he had only been out of psychiatric hospital for 5 days when this episode occured ((new psychiatric hospital this time). Has been on practically every mood stabalizer and atypical antipsychotic medication available. Does not tolerate any stimulants or antidepreessent medication. His behaviors fit a bipolar diagnosis but he also has many sign of Pervasive Developmental Disorder (PDD) or high functioning autism. He had a neuropsychologist done at a Children's Hospital two years ago that did not place him on the spectrum and while it was a thorough evaluation of several hours over several days, it did not have a component in which difficult child was observed with other children and this is where he tends to fall apart socially. All of his psychiatric hospital visits resulted in a queston of Pervasive Developmental Disorder (PDD)-not otherwise specified or other form of autism in addition to BiPolar (BP). I am trying to get him on the neuropsychological unit of his current psychiatric hospital and they say he is too high functioning. His total IQ is in the low average range, 83, but he has high and low subtests, verbal comprehension 102, working memory 70, processing speed 73. Significant speech language needs, Occupational Therapist (OT) needs, and learning disabilities. He is already in a specialized theraputic school setting in the public school and receives intensive behavioral support services through a local agency. Seeking another neuropsychologist on my own, I'm given a wait time of over a year. His psychiatrist does not feel that seeking more nero info or actually getting a diagnosis on the autism spectrum will help with his situation. She says it his unregualted moods that cause him the problems YET we can not get a medication combo that works. This is a kid who feels badly for how he behaves. He know what to do and can tell you when he is calm. He's had a great deal of therapy and behavioral support and in my mom-who-lives-with-him-everyday opinion, he is not having these outbursts on purpose and he wants to do well. Everytime he says, "I'll never do that again", he believes himself and it breaks my heart because he is also resigned to the consequences when he has had an episode and takes personal responsibility but truly feels that he has no control over his anger. Residential Treatment Center (RTC) has been mentioned and I know it might come to that someday if things don't improve but I am not willing to go down that road yet. I can't seem to find a facility that will keep him long enough to do a thorough inpatient evaluation, everything is short term crisis management.

    Where do I go from here? Do I seek out a pediatric neurologist? Who do I contact to rule out a seizure disorder or other organic problem. What am I asking for when I call? Little is known about his birth parents history. He was removed due to neglect and no history of drug or alcohol abuse was noted. I do know tht he as premature and that his birth mom smoked during pregency. It was suspected that she had a mental illness though refuse treatment and her records stated that she was mildly metally retarded. Not much know about the birth dad.

    Thank you for reading this and any advice you may have.
  2. DaisyFace

    DaisyFace Love me...Love me not


    What a tough, terrible heart-breaking situation!

    I am wondering if there is "anger-management" or some sort of therapy that could help him practice some skills for managing his emotions?

  3. house of cards

    house of cards New Member

    My advice is to just keep believing in him. You know there is a great kid inside, let him know as often as you can. Don't you wish everyone would see him as you do? See my post "are we having fun yet" and you'll see you are not alone. I do think this improves some with maturity. Anger management can't hurt but if he is like my kid, he could teach the class but not apply it.
  4. Josie

    Josie Active Member

    Have you ever tried to modify his diet? Some kids on the autism spectrum do well on the girlfriend/CF diet. My kids are on the girlfriend/CF diet even though they don't have autism, but one of them isn't even a difficult child any more if she stays on it. Her problem used to be uncontrollable anger. She took Lexapro but needed increasing doses for it to work. At the end, we were going to have to add an AP. Instead, we changed her diet and she was able to stop taking any medications. I am convinced that as long as she was eating gluten and milk, no medications would have helped.

    I have only had to give up gluten, not casein, but I feel much better emotionally on the girlfriend diet. I used to be irritable and anxious, but not to the extent of our difficult child's.

    I know it sounds both extremely difficult and too good to be true. It has worked for us, though.
  5. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    My advice is to trust your Mommy gut, which sounds like it's telling you that the Pervasive Developmental Disorder (PDD) is a huge part of the problem. Why give up on that just because this psychiatrist says it's not? I found that our psychiatrist was wrong. Yes, they can be wrong.

    I would get that neuropsychologist evaluation. Sometimes a second neuropsychologist evaluation is very valuable. Remember that psychiatrists are not experts on Pervasive Developmental Disorder (PDD)--it's not their field, so they tend to favor treating things like bipolar (and sometimes they are even wrong when they diagnose!).

    Do what YOU feel is right. If the medications aren't helping that much, then maybe it's not medications that are what will help him the most and maybe bipolar isn't the main problem at all. Autism Spectrum Disorders (ASD) makes kids very volitile.

    (((Hugs))) and good luck with your hard decisions. NEVER let ANY doctor limit what you feel you should do for your child. THEY CAN BE WRONG!
  6. susiestar

    susiestar Roll With It

    He is adopted, correct? What are the odds his biomom stayed totally away from alcohol and drugs during her pregnancy? Has he ever been evaluated for Fetal Alcohol Syndrime or fetal Alcohol effects (Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE) respectively)???

    The Pervasive Developmental Disorder (PDD) does sound like a major contributor to the problems. As for not wanting to pursue a diagnosis with more testing, the psychiatrist is an idiot. Not saying psychiatrist is not good at her job, but she sure doesn't get the insurance system. The diagnosis, or label, is how insurance companies, schools, doctors, etc... all determine what kind of help he can have.

    I would keep pushing to see if you can get more ideas. Listen to your mommy instincts. They are there to protect your young.

    I would do some research into Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE) and maybe see if there is a clinic in your area that can do evaluations of your difficult child with that in mind.
  7. Christy

    Christy New Member

    Thanks for the advice. I've made an appointment with a neurologist and we are on the waiting list for a neuropsychologist at a local reasearch hospital but they are scheduliong appointment for next May! I hope we can get him home from psychiatric hospital soon and in a decent place. The doctor is actually weaning him off one of his medications. He seemed to be doing well today but too soon to tell.