help please

[losthorizons]

my difficult child is 12 and has been seeing doctors for years over being ADHD, BiPolar, Turrets, and conduct disorder. He has been in a special school (Washington State) for kids who have mental and behavioral disabilities. He was recently in a hospital for 9 days (our insurance would only cover for that amount of time) and the hospital got no where with him. He hits and acts out violently. He managed to head a nurse in the hospital and break her nose. He runs from the school when he goes outside, leaving the school personel to chase after him. He ended up in the hospital for damaging school property. Was arrested, but the juvenile courts would not keep him because he was only 12. We make over the limit to qualify for state/S.S. funds and don't make enough to pay our dr bills! The only residential treatment facilities here are for people who recieve state help. How do I go about getting him put into a state run facility when we don't qualify to get the help we need for him? Our home is in turmoil whenever he starts acting up. He has a younger sister (7) who cries all the time for fear of him. Hubby and I sleep at night with one eye open and it is very scary. Can anyone give me any insight as to what to do? How do I get him into a residential facility to live?

 

[smallworld]

Welcome!

I'm sorry I don't have any experience with residential treatment facilities, but I have a few questions for you. Your answers may help us point you in the right direction for help.

What kind of doctor diagnosed your difficult child? What kind of doctor is treating him? Is he in therapy?
When was the last time he was evaluated? Has he ever undergone neuropsychological testing?
Is he taking any medication? If so, what?
I assume he has an IEP for school? Have you tried to get him placed in a residential treatment center through the IEP process? Have you tried to locate an advocate to help you with this process?

Again, welcome. Weekends tend to be quiet around here, but others will be along shortly to offer their advice.

 

[timer lady]

It's time to apply for medical assistance along with whatever your state determines a disability. For us, we had to go through the state medical review board for the tweedles.

In the meantime, have you called county mental health for resources? Contacted your local chapter of NAMI? Sometimes you can find help through those contacts.

by the way, welcome.

 

[flutterbee]

I just wanted to add my welcome. :salute:

 

[hearts and roses]

Hugs losthorizonz. I'm sorry that your family is going through this and very sorry that your is acting out the way he is. Hard as it is to believe, he probably has a place in his heart that hates when he behaves this was as well.

The above posters have asked really good questions. Hopefully you will post more so you can get some more support and answers.

I hope you're able to get him the help he needs so he can feel better and in turn you can have a more peaceful family life.

 

[DammitJanet]

Welcome to the board but sorry you have to find us.

In answer to your specific questions, I am unsure exactly how your specific state works but most states do have some form of waiver for kids with disabilities through the medicaid program so they can access funds to help pay for catastrophic medical care.

You might also want to check into having him placed into the state psychiatric hospital in their teen unit. That is usually income based and they do a thorough job of testing and can recommend a long term residential placement if they think it is needed. If he has to go into residential, he can qualify for SSI on his own and then he would get medicaid which would help pay for the treatment.

You can also contact the local mental health departments and ask for help from them.

These are all the avenues that I would contact immediately in trying to access care. It takes banging on doors when a child is completely out of control.

 

[losthorizons]

thank you all for some insight. He is on Depakote, Saraquel (sp?) Remeron and Effexor. He just got out of a psychiatric hospital for kids and was in there for 9 days. They pretty much told me that they couldn't help him and that I had their sympathy. Go figure. While he was in there he broke a nurse's nose and she was still in the hospital after 9 days. I will contact our mental health departments and see what is our next step. He has also been diagnosed as possibly having a personality disorder as well as the other things. I have tried the medical from the state and get turned down repeatedly. I have a meeting at his school on Thursday so will let you all know what they say. (over his IEP) The school he goes to is a complete lockdown, but still is agressive towards staff and does hit them as well.

 

[losthorizons]

I also forgot to mention that he does she a child psychiatrist who does specialize with children who have disorders. He was also evalutated less than two weeks ago, but originally he has been diagnosed since he was 5. He has not undergone any neurological pysch testing. Not even sure what that is as no one has ever mentioned it before to me. I am going to contact Nami tomorrow morning to see if they can put me in touch with someone who can help out. I am so glad that I found this forum, you guys are a light at the end of my tunnel. :smile:

 

[smallworld]

Children with bipolar disorder frequently can't handle antidepressants like Effexor and Remeron. These ADs can make them aggressive and violent, even with a mood stabilizer like Depakote and an atypical antipsychotic like Seroquel on board. My difficult child 1 became aggressive on Effexor after taking it for just 8 days, and he was on Depakote at the time (we immediately discontinued Effexor). Have you talked to a child psychiatrist about your difficult child's medications? Before you assume that he can't be helped and he may have a personality disorder, you really have to take a good hard look at his medications. The wrong medication combo could be the key to his aggression.

The book The Bipolar Child by Demitri and Janice Papalos is very helpful.

Good luck.

 

[losthorizons]

Thank you. We have tried (at least in my mind) sooo many different medication combo's that I am at a loss. The pysch dr's in the hospital are the ones that gave him the latest ones. He can be such a sweet loveable little boy, but it is has been very rare that I see that in him nowdays. For the last few months, everything has gone downhill. He seems to be getting worse than better.

 

[smallworld]

When did he start Effexor and Remeron? Is that when things started to get worse?

 

[BusynMember]

Hi there. First off, he's on a lot of medications, even for bipolar. Secondly, if he has bipolar at all, even with co-morbid ADHD, antidepressants can worsen his condition significantly--even one antidepressant, and he's on two of them. ADHD medications can also worsen bipolar. Lots of parents of BiPolar (BP) kids treat the bipolar and let the ADHD symptoms go, sometimes they are a symptom of childhood mania. Has he ever been on simply a mood stabilizer or has he always also been on an antidepressant or stimulant too?
There is a Katie Beckett law in many states--help for kids with psychiatric problems. You should see if your state participates in this. Also, if you get disability for your child, you also automatically get Medical Assistance, despite your monetary status. Each state is different though.

 

[waytootired]

Hi and Welcome... I am so sorry you are having such a rough time. My 11 yr. old difficult child is Bipolar and was on an antidepresant....He was put on Effexor before we knew he was Bipolar. In time he got to the point where he was so out of control, raging & violent we had to go to a mood stablizer. We learned that bipolar children should not be treated with antidepressants, it makes them worse. If you should at some point take him off the Effexor, PLEASED BE WARNED !!!!!! Many people I know,adults & children, including my son, had horrible experiences going off Effexor(even going off a bit at a time) Delusions, manic episodes, violent outbusts & extremely mean. If you take your difficult child off the Effexor, I highly suggest doing it in-house, at a hospital. We had to send our older easy child to his cousin's for a week to keep him safe and away from the whole experience. We couldn't leave our difficult child alone for a minute. It was the worst experience we had with him since his onsettwo yrs ago. Now he is only talking a mood stablizer and he is going great. He still has his moments, but nothing like while on or going off the Effexor. I wish you all the best and I am pulling for you.

Oh! One more thing....Go online to NAMI.org (National Alliance for Mental Illness). You will find a contact person for your State and County. They will be a huge help in finding local services for you and your difficult child. They also put on a great class called "Family to Family" you learn so much about the different mental illnesses including Bipolar. Lots of great info.on statagies for dealing with and commiucation with your ill relative. Plus great info. on all the medications out there.
I highly recommend taking this class for anyone with a realtive with a major mental illness.

 

[wakeupcall]

You sound like you're going through what I was with my difficult child a few months ago. It turned out it was the DEPAKOTE!!!! He had a reaction to it that made him SO violent that I couldn't believe it was my son. He was on few medications at the time, so I knew exactly which one was causing it. I read the "side effects" of Depakote and violence/aggression was one of the rare and uncommon side effects. Please make a call to your child's doctor and do it soon...

 

[losthorizons]

he has been on effexor for depression. (he was having thoughts of suicide) as far as the remeron goes, he started getting that about 2 months ago. His actions have progressively gotten worse over the last 2 yrs.

 

[losthorizons]

He just started the Depakote about 2 weeks ago and his anger episodes have been an ongoing thing since he could walk. When he was first learning to walk he would heat things with his head. His last fit of hurting someone was head butting the nurse at the hospital and breaking her nose. When he was in the hospital it took 7 people to contain him. (he is little, only 4'11 and 78 pounds) but he is a wirey little guy.

 

[smallworld]

Depakote takes 6 to 8 weeks AT A THERAPEUTIC DOSE to work. A therapeutic dose is measured by a blood draw. As we said earlier, the Depakote may not be able to counter the bad side effects of the antidepressants Effexor and Remeron if they are causing aggression and violence.

How much Depakote is he taking? Is he having blood draws?

 

[losthorizons]

he hasn't started doing any blood draws as he as only been on Depakote for about 2 weeks. The remeron he gets in the morning and only started taking it about 1 month ago. His moods were alot worse before he started taking the remeron or Depakote. Yes, he did break a nurse's nose in the hospital, but that was before he started taking the Depakote. Before he started on either medications, hubby and I used to go to bed sleeping with one eye open. I have had knives to me that he had threatened me with in the past, I have been punched in the face, in the back (when I least expected it) and been pinned down where the only thing I could do was bite him to get him to free me. Even after biting him, he didn't even feel it or complain. (I feel like a horrible mother for doing that too, but was left with no choice) I know he has rapid mood swings and a personality disorder. When he gets violent he has no memory of it what so every. Its like he gets to a heightened sense and does not recall anything that happened or when he escalated.

 

[smallworld]

Has he ever been evaluated by a neurologist for seizures?

Effexor can cause the kind of rage reactions you're describing. It can cause homicidal ideation as a side effect.

Blood draws can be done 6 days after every dose increase (that's how long it takes for a steady level to build up in the blood stream).

 

[Babbs]

My heart goes out to you - it sounds like you've been through a lot. The only extended care residential pysch hospital for teenagers that I'm familiar with in Washington is Ryther - unfortunately the student needs to be a ward of the state to enter it, it's run by DSHS. 9 days in an acute ward is not nearly enough time for any pscyhiatrist to get medications stabilized.

Having had experienced adverse reactions to mood stabilizers (both Lexapro and Effexor) I can definitely understand if the increased aggression is caused by the medications. I only had to put up with it for 2 weeks but orignially my physician decided I was bipolar which was why I was reacting the way I did (which I'm not)and tossed some heavy duty psychotropics at me to counteract the Effexor. I would certainly seriously question the prescribing physicians regarding possible adverse reactions to his medications.