Help with severe meltdowns/rage? (Bipolar? And other questions)

[pattyb]

Hi all! I am so relieved to re-find this forum since I actually posted here 4 years ago - http://www.conductdisorders.com/com...g-rigid-finger-positions.46455/#axzz4BzRU1yq1 - looking for advice about my son. He is now 8 and hasn't been fully evaluated in a few years, but his behaviors are seriously escalating we are trying to find a place to have him seen and we're looking for advice in the meantime.

He has been diagnosed in the past with anxiety disorder, mood disorder and autism but all of these were around age 4 and 5. His first few years of school went extremely well, even though we still had meltdowns and behavior issues at home. This whole year has been a different story, getting much much worse after we sold our home and have had to stay in two short-term rentals while waiting to move into the house we bought (finally moving to the permanent house next month). His behaviors at home and school have been getting very bad, escalating to where we've almost taken him to the ER out of desperation multiple times. We think all the moving/transition has a lot to do with the escalation of his behaviors.

He is not taking any medication, he gets school services like social work and sensory breaks, and he recently started seeing a psychologist. He acts like a typically developing kid probably 90 percent of the time - extremely sweet, curious, witty, has a variety of interests, plays sports, has friends and plays normally with them, normal speech and about average academics, etc. Maybe 9 percent of the time he is out of control - it usually starts when he has to go somewhere he doesn't want to go, or stop doing something he likes (mainly playing Minecraft or having screen time), or something minor like his brother says something that annoys him. He gets angry, irritable, destructive, even becoming aggressive, being unsafe (like walking out into a parking lot without looking when he's mad and trying to get away, etc.). He is almost not himself during these fits - he'll say extreme things like he'd rather die than do (whatever it is he doesn't want to do), or that we don't deserve to live, why do we abuse him, why can't he have loving parents, etc. He will never accept blame or responsibility for anything he did (like hitting or causing the conflict in the first place) - during or after the tantrum. We can get him to apologize after, usually, but if we press him too much or try to get him to explain or accept what he did wrong, the meltdown could even start over). But he will become totally sweet and happy once he calms down and then it's like nothing happened. We're also suddenly getting calls from school to pick him up early because he refuses to work or is threatening to leave, even pushing his teacher, etc. The other 1 percent of the time would be behaviors that seem just a little "off" - the hand-posturing I mentioned in my post 4 years ago is now gone, but he does still get in "baby mode" sometimes/rarely - like in social situations where he doesn't know how to act or when he's super excited/happy to see a parent or relative, he just gets a little immature/babyish in a way that I don't see other kids doing.

I'm wondering if anyone can relate to these behaviors? Does it sound like childhood bipolar? Any advice on how to handle the meltdowns during them or tips to end them quicker? The psychologist says to NOT try to reason with him, but with some of this violent speech I feel like I have to try. Has anyone had success dealing with these sort of extreme/aggressive behaviors without medication? Thanks so much for any advice!

 

[GoingNorth]

Actually, I'm seeing some red flags for Autistic Spectrum Disorder or A.S.D. Combine even high functioning A.S.D with its difficulty with transitions and fixations, with the current unstable living situations, and you've got fertile ground for rages.

My suggestion is to get this child in for a full neuropsychological evaluation (8 hours or so) asap. If he is autistic, or even bipolar, interventions MUST be started asap.

Treating Bipolar requires medications, usually heavy duty medications. There is no medication that cures Autism, but some medications are used in autistics to deal with the overwhelming anxiety many of us feel just from dealing with what you, as a neurotypical person, find to be normal and not even worthy of consideration.

Best of luck. Do keep in touch and keep us posted on how your son is doing. We are a wealth of info though know our limits. You will find many parents who have gone through what you are going through and I'm sure, after the weekend (it's slow then), several folks will stop by. We also have strong shoulders and warm hearts.

In the meantime, do create a signature that lists your son's (supposed) disorders, what medications he is on, and anything else that you think would help us keep track of you and him.

Also, many of us are in the 40-65 age range. That means our eyesight isn't what it used to be (mine has always been awful) and walls of text are hard to read.

Could you please break up your future posts into smaller paragraphs? It makes it easier for us older folks to read your posts.

 

[BusynMember]

I also thought autism and was going to suggest a neuropsychological evaluation. I would definitely update the older evaluation. It has been a while. in my opinion, at least in the U.S. neuropsychiologists do the the best, most thorough evaluations.

Wishing you lots of luck, whichever path you choose.

 

[InsaneCdn]

Any advice on how to handle the meltdowns during them or tips to end them quicker?

In my experience, the only way to handle meltdowns is to prevent them in the first place.
And yes, that does mean totally re-arranging your life. And yes, it's a major challenge to do so.

The rages are more likely related to Autism Spectrum Disorders (ASD) than to childhood bi-polar. Autism Spectrum Disorders (ASD) kids do best with absolute consistency. Bed time the same seven days a week. Breakfast, lunch and supper at the same time, seven days a week. Be prepared to pull out of new experiences if he gets overwhelmed. Learn how to see him getting overwhelmed before he gets to meltdown - there are signs, but sometimes not obvious unless you know what to look for.

The approaches that work for parenting most kids, do not work with Autism Spectrum Disorders (ASD) kids. Fortunately, neurotypical kids seem to do just fine with the approaches that work for Autism Spectrum Disorders (ASD) kids.

Do you have support outside of your nuclear family? Uncles and aunts, grandparents, older cousins - people who can help share the load, both with this kid, and to give your other kids a break?

 

[Praecepta]

Ask his psychologist what you CAN do. Listen to his advice.

 

[Sister's Keeper]

I have no experience with Autism Spectrum Disorders (ASD), but my, now, 6 year old was a tantrumer. He has grown out of it, thank dog.

Anyway, the only thing I can suggest is 1) don't reason with him, don't feed into the tantrum, just ignore it as long as he isn't harming himself or anyone else. They aren't logical at that point.

The other thing I found helpful is to let him know what to expect before it happens. My friend has a son who has Autism Spectrum Disorders (ASD) and she explains a lot before hand and uses electronic devices as timers so he knows what to expect. Just an example: Minecraft. Tell him he is allowed to play Minecraft for 1 hour (or whatever) explain to him that the 1st timer alarm to go off means that he has 5 more minutes to play. The 2nd timer means he has to put the game away and do whatever. (she uses 2 different alarm tones on her phone) He seems to do well when he knows what to anticipate. She does this for a lot of things. It seems to help with transitions.

 

[Frieda]

My son has high functioning autism and what you described sounds a lot like him (only that your kid seems to do better overall, my son rarely appears typical) We moved across country when my son was 7 and it took him a good 3 month to find his footing again after we moved into our permanent house. He had a lot of tantrum and a lot of really out-of-it behaviors. School got pretty bad for a while too. This kind of change really deregulates kids on the spectrum. Keep his schedule as consistent as possible, give him advance warning for changes and don't expect him to do well when the unexpected happens. As far as what you do mid tantrum -nothing other than minimize sensory input. Don't talk too much in a meltdown, keep yourself even and just give short supportive directives. You can talk about what happened later. Mid tantrum it will only push his anxiety higher. It looks like aggression but it comes from anxiety. At this time he needs structure and understanding, consequences (as in punishment) are not helpful for these kind of tantrums. To me he sounds like a good kid on the spectrum who struggles while his life is out of whack. It does not sound like bipolar to me. Of course if there is a history of bipolar in the family you would have to keep that in mind.

 

[Night Owl Mama]

He sounds just like my oldest, who was finally diagnosed with autism at the age of 13. We had him in for evaluations starting at 4 for rage episodes triggered by random events, frequently related to transitions in activities. He is high functioning and seems "normal" at first. The random rage does look like bipolar sometimes. And frankly it can be both. Comorbid conditions are very common in these kids.

My son's official diagnosis is Autism Spectrum Disorders (ASD), Bipolar not otherwise specified, ADHD, and anxiety/depression. He is absolutely not able to function without medications. He functions best with a mood stabilizer, an antidepressant, and a long acting stimulant for ADHD. He can get away with just taking an antidepressant but he does better when on all three. I am a very natural minded mama and it was hard accepting my son needed all these medications but it really is no different than medication for a child with diabetes or asthma orchronic migraines. Brain based illness need treatment too. All of my special needs kids took a real turn for the worse between ages 9-12 and I suspect the hormones as the body revs up for puberty really do a number on their brain chemistry/function. You do not want to wait until then to stabilize him, believe me.

 

[Michele223]

My son with Aspergers tourettes ADHD and mood disorder had a rage yesterday that resulted in the house being destroyed and him attacking us and breaking electronics and personal items. He was hospitalized in psychiatric he tried to cut himself and said he took some pills. No clue what to do next. This keeps happening every few months. But every day he is irritable and difficult to deal with. He is very inappropriate and hyper sexual. What's next? How do you find residential help?

 

[Concerned parent]

Hi all! I am so relieved to re-find this forum since I actually posted here 4 years ago - http://www.conductdisorders.com/com...g-rigid-finger-positions.46455/#axzz4BzRU1yq1 - looking for advice about my son. He is now 8 and hasn't been fully evaluated in a few years, but his behaviors are seriously escalating we are trying to find a place to have him seen and we're looking for advice in the meantime.

He has been diagnosed in the past with anxiety disorder, mood disorder and autism but all of these were around age 4 and 5. His first few years of school went extremely well, even though we still had meltdowns and behavior issues at home. This whole year has been a different story, getting much much worse after we sold our home and have had to stay in two short-term rentals while waiting to move into the house we bought (finally moving to the permanent house next month). His behaviors at home and school have been getting very bad, escalating to where we've almost taken him to the ER out of desperation multiple times. We think all the moving/transition has a lot to do with the escalation of his behaviors.

He is not taking any medication, he gets school services like social work and sensory breaks, and he recently started seeing a psychologist. He acts like a typically developing kid probably 90 percent of the time - extremely sweet, curious, witty, has a variety of interests, plays sports, has friends and plays normally with them, normal speech and about average academics, etc. Maybe 9 percent of the time he is out of control - it usually starts when he has to go somewhere he doesn't want to go, or stop doing something he likes (mainly playing Minecraft or having screen time), or something minor like his brother says something that annoys him. He gets angry, irritable, destructive, even becoming aggressive, being unsafe (like walking out into a parking lot without looking when he's mad and trying to get away, etc.). He is almost not himself during these fits - he'll say extreme things like he'd rather die than do (whatever it is he doesn't want to do), or that we don't deserve to live, why do we abuse him, why can't he have loving parents, etc. He will never accept blame or responsibility for anything he did (like hitting or causing the conflict in the first place) - during or after the tantrum. We can get him to apologize after, usually, but if we press him too much or try to get him to explain or accept what he did wrong, the meltdown could even start over). But he will become totally sweet and happy once he calms down and then it's like nothing happened. We're also suddenly getting calls from school to pick him up early because he refuses to work or is threatening to leave, even pushing his teacher, etc. The other 1 percent of the time would be behaviors that seem just a little "off" - the hand-posturing I mentioned in my post 4 years ago is now gone, but he does still get in "baby mode" sometimes/rarely - like in social situations where he doesn't know how to act or when he's super excited/happy to see a parent or relative, he just gets a little immature/babyish in a way that I don't see other kids doing.

I'm wondering if anyone can relate to these behaviors? Does it sound like childhood bipolar? Any advice on how to handle the meltdowns during them or tips to end them quicker? The psychologist says to NOT try to reason with him, but with some of this violent speech I feel like I have to try. Has anyone had success dealing with these sort of extreme/aggressive behaviors without medication? Thanks so much for any advice!

I am not a psychologist, but simply a parent of a teen who exhibited some of these some traits as a younger child. This is just my two cents, but I would be hesitant to go with a diagnosis of bipolar disorder at such a young age. His brain is still developing.


This sounds more like autism spectrum to me (again, I have no formal training or expertise) perhaps and/or a combination of ADD and autism. When our son has been in one of his rages, my husband and I found that trying to talk to him while it was happening simply agitated him more.


Words streaming in while he is raging may be sensory overload and can just escalate matters. Not always easy, or successful, but we would say "I hear that you are upset (or angry or disappointed) and we will talk about this when you are able to be calmer. ". Then later, we would try to brainstorm strategies he might use in the future to help himself.

I know this all sounds so logical and easy on paper, but we we were clear at a later time (when we knew he was well rested and well fed) that having feelings is normal and human, but expressing them in constructive ways is the rule. When our son was really young, sometimes we could interrupt the rage by coming in to his room, gently asking him to have eye contact with us and telling him it was "time to stop now." Sometimes he would and fall into his father's arms and cry. He is a teenager now, so that does not work, and our challenges are a bit different.

The fact that the majority of the time he is able function well suggests that this rages are a byproduct of stress, change, sensory overload, transitions that happen too quickly, etc. Again, just saying this from my very limited experence as a parent.

I would get him evaluated too.

 

[BusynMember]

This is an old thread.