Hypothetically speaking...

[klmno]

Well, let's just say this is hypothetical anyway....

If a difficult child who had previously expressed temptations to hurt his mom, then seemed to get over that quickly after a talk and seemed to be doing very well for a while, suddenly became angry one night- to the point of being violent and causing some physical injury (not to the point of requiring medical care- but close) and expressing stronger feelings about his Mom- how could a Mom know or tell if this was psychosis, mania, change in medications, manipulative threats because he thinks he can end up taking control of the house, or if he's really walking around all the time believing that there is no problem other than his Mom and if he gets her out of his life his problems are solved- like he's bought into everything a family member had previously said to him?

So- those answers would lead to- then, should the mother take the difficult child to a psychiatric hospital, call police which leads to difficult child arrested (which would lead to long-term stay in detention), seek some means of therapuetic living environment- which would fail because difficult child can't get that in difficult child's state and difficult child would end up in long term detention or with that other family member mentioned above, or other (please offer any "other" you can think of here)?

Just curious...

 

[DammitJanet]

Honey....I think you are "hypothetically" over your head here. In my experience, teen boys that age need a really strong male figure in their lives that will let them know in no uncertain terms exactly what will happen if they cross that huge boundary. With all that my son has done...and he has pulled some doozies...he has never laid a hand on me in anger. He knows better. In his words "he would wake up dead." That is no idle threat either. If his dad didnt kill him, his brothers would. And I pity the fool outside this family who ever laid a hand on me!

Do you have a strong male friend or family member who could have a serious come to Jesus talk with him...hypothetically speaking. Would you like to have me arrange to have you meet up with Jamie for a chat? Jamie is 6'5 and can be really intimidating if you want him to be. Rule number one is you dont hit or disrespect Yo Momma! Jamie is really this big old teddy bear but he IS a Marine and a cop so he can be mean looking if that is what is needed.

I think right now you need to look less into the diagnosis and take back your authority because in the real world no one cares if he is sick...they just care that he is acting like a jerk. That is what will get him in trouble and keep him there.

Just my two cents.

 

[smallworld]

I would uncategorically recommend an evaluation at a psychiatric hospital. You need a medical professional to assess exactly what's going on. Without knowing your difficult child's psychological state, you can't make long-term decisions about what is in his best interests.

 

[Sara PA]

When my son was violent towards me, I racked my brain trying to figure out where there was help. He had already been in a phos and the resutls were underwhelming. After discussing it with his new psychiatrist and considering other facilities including one on the other side of the state, I saw no point in doing that again. I couldn't figure out what help the juvenile justice system could be. If they had answers they would gladly hand them over to the public just so they wouldn't be dealing with all these kids with neurological conditions. But they have no answers either.

My concern was less for my own safety and more for my son's care. I really didn't see that anyone had more answers than I did or that he would have gotten better care anywhere else. That's not to say I knew it all or was the greatest caregiver, just that I didn't see that anyone else had answers. In fact, I felt that all the options open to him ...or me....would likely make things worse. I couldn't get past wondering what is suppose to change if I put him in a phos? What could they do there that couldn't have been done outpatient over the previous two years? After hours of doctor's appointments, after spending thousands of dollars, after he took hundreds of pills, he was worse than when we started. Did that mean I should hand him over to the doctors full time? And he was sick, not a criminal. Why would I want him in jail/juvy? We fought hard to keep him out of the juvenile justice system simply because it we would have lost some control, forcing us to limit our options.

I slept wearing my glasses in clothing I could wear in public, my car keys and cell phone in my pocket in case I was forced to flee. I told my best friend and my dear aunt that if my son killed me, to make sure people knew he was sick, not evil. I bore the brunt of his rages while treating him with the respect that I would treat any ill person. I was scared but I knew my real son loved and respected me despite how he treated me in those psychotic rages.

And, for us, it worked out. I was fortunate, in this respect, that he is an only child and that my ex supported us financially, though not emotionally, through it all. I didn't have to work. My choices and options would have been quite different if those two things hadn't been true.

klmo, there are no answers. It's a different balancing act for each of us. And everything is constantly changing. We do the best we can to make the right choices for our children and ourselves. We do the best we can. That's all we can do. That and hope/pray we are making the right choices.

 

[witzend]

In hindsight, violence or the threat of violence once is natural. When it is repeated, I don't know that it matters why. The question is, knowing his nature and his abilities, what is going to help him get past it, which will work best? Does he respect police? Does he respect therapy? What about a private school or camp?

Whatever it is, he has to know that violence will not be tolerated. Whether he has to stop it out of fear for where he will end up, or because it's the right thing to do, I guess you know better than anyone.

 

[klmno]

Wow, Sara- your experience summarizes exactly how I feel.

He was saying things completely out of character during that time period. Not just ranting and raving like some of us do when we are angry, but things like "you made a big mistake when you decided I was bipolar", "I wouldn't get rid of you now, because then everyone would just say I was crazy, I have to let everyone know what kind of person you are and what is wrong with you first, so they'll know I'm not sick" or something like that.

He had been doing more than just "ok"- he had been doing great- and I had told him so. I had fussed at him in a major way for something the 3rd day he was home from detention (alomst 2 weeks ago), then he straightened up- there was no indicator of becoming physical through that. Then yesterday, I fussed at him for eating ALL the snacks that I had bought in bulk last weekend that were supposed to last 2 weeks. I fussed- but not as much as I had before- I just told him that he wouldn't have as much to take with him to day camp next week because he should have saved some of them. I told him I was very upset with him about it.

Things like that happen occasionaly- it doesn't always trigger him into a a rage. Rages don't normally turn into physical confrontations. I don't know- but I can definietely relate to what Sara said. I'm sure I'm not always handling things the best way with him and have room for improvement, but I don't think sending him to live with someone who tells him that it IS all his mom's fault is going to improve things for anyone.

I feel like I have failed him- not because I think I deserved that or that it's my fault this is happening, but because I don't know the solution. And, I'm starting to wonder if and how much of a connection there is to a certain side of his father that would come out periodically. That scares me horribly. His father never became physicaly violent with me, but there were times I was afraid of him. Have you ever met a person who was as nice as could be unless they drank or got high, then they were not rational and seemed to be a different person - so much so that they were frighterning? The father is that way- exccept he didn't drink or do drugs. "It" just came out peridicaly- and now I'm not so sure if that was just a manipulation technique like I used to think. Seeing difficult child do this, when difficult child has never had ANY knowledge or idea that his father did this makes me think there might be more going in inside his head than I thought.

He was taken off his risperdal 1 week ago to use it only PRN. I wonder if that had anything to do with it.

by the way- I do realize that I can't get so caught up into analyzing the cause that I don't address a solution. But I'm still a little shocked and stymied right now and trying to mull all this over and, like Sara said, weigh what direction to go in about it. I SOOO wish that we had people in our Department of Juvenile Justice who actually could help and not just "put" the kids places that almost always make them worse and don't address the problems they have.

 

[smallworld]

If he stopped Risperdal in the last week and is making statements that seem "off" and "out of character," it could absolutely be the removal of the Risperdal. Can you talk to the psychiatrist about this?

 

[klmno]

Yes- I can start him back on the risperdal and we have an appointment with psychiatrist later next week.

Do you (or anyone with risperdal experience) think this is a temporary symptom of coming off it (meaning he should stay off of it) or an obvious sign that he needs to go back on right away?

Actually- since it had changed to prn, I gave him one last night, but it was shortly after this all happened and he was still cooling off and I was upseet so I can't guarantee that he took it- I just handed it to him with a glass of water and walked off.

 

[slsh]

My thoughts, when dealing with a difficult child, are this - voicing violent thoughts are one thing, not to be ignored but not necessarily requiring immediate evaluation. When the line is crossed to actually committing violent acts (close to requiring medical care!! OMG!), then the genie is out of the bottle, not to be returned easily.

Mothers (and other family members) have the absolute right to be safe in their home. Any violent act, in my humble opinion, requires very swift action. In our home, it resulted in a 911 call requesting transport of a psychiatric pt to the hospital for evaluation. I was always very specific in my request because probably half the time we needed the backup of the police as well.

I have to be honest - my thinking on this has changed a lot over the years. If it's the result of psychosis, you're going to know it because... well, in my experience with thank you, psychosis is hard to miss. Bizarre thought patterns and speech, etc. Psychosis = hospital evaluation always in my book.

As thank you has gotten older, and probably because we've done over 2 dozen admissions to this point, I lean more towards police intervention now. thank you is 17. Yes, he's definitely mentally ill. But not so ill that any judge is going to not hold him accountable for his actions. He *is* responsible. I think, consciously or not, he's gotten the message over the years that if he assaults someone, he's just going to get a free ride in a hospital for a couple of weeks. I think we've actually reinforced his violence, in his twisted mind.

I know it bites to have our kids involved in the juvenile system (ok, I don't *know* it personally, yet). We want to protect our kids from their poor choices. But sometimes I wonder if we're doing a disservice ultimately to our kids by worrying about the potential consequences they face for *their* actions. I think some of our kids are only going to learn by facing the music - and unfortunately I think some of our kids are going to have to do it many times before they get the message.

Just my 2 cents - but regardless of which path (police/hospital) you choose, absolutely without question or hesitation, he needs to be removed from the home.

I hope you're ok hon.

 

[smallworld]

I can't tell you for certain. I do know that many kids with BiPolar (BP) symptoms require two mood stabilizers and an atypical antipsychotic for full symptom relief.

I can also relate my daughter's experience with Zyprexa (same family as Risperdal), which was prescribed to treat her phobia about eating. She was on Zyprexa for a year when her psychiatrist recommended that we wean her because she seemed to be doing so well with her eating. As we started to go down from 7.5 mg to 2.5 mg last summer, her eating disorder returned with a vengeance. So we immediately added back Zyprexa and her symtpoms disappeared. We are considering trying to get her off Zyprexa again this fall.

My son has been on Seroquel (again, same family as Risperdal) since January for depression and mania. We have successfully reduced his dose, but we haven't yet felt comfortable taking him off entirely. He is not through puberty yet so I think it will take a little more time before we consider discontinuing Seroquel.

 

[slsh]

Sorry - was writing my novel when you posted about the Risperdal and his comments. That changes my response about 180 degrees, LOL. So in this situation with the recent change in medications and his comments to you, 911 for ambulance transport to hospital for evaluation.

 

[klmno]

Thanks, Sue. Yes, I'm ok physically- emotionally, I'm broken hearted. I am having thoughts about where is the "line of enabling" here, too. But I am sure that I don't want him thrown in a situation that can never do more than make him worse for 2 years then let him out into society again and expect him to do better than before.

When he expressed temptations about this, it was about 3 mos ago and I had fussed at him for something. He became angry and started to rage. I agreed with those here that said maybe it was a fight or flight response because it was shortly before a court date and we pretty much knew he'd have to do some time in detention. Anyway, after we had been in separate rooms for a little while, he came to me and said that maybe I should take him to psychiatric hospital because he was having thoughts and temptations to hurt me. We talked about it and his fear and stress about the detention. He was on risperdal at the time, I think.

But shoot, I can deal with him coming to me and discussing these thoughts, as everyone has said- it is different when he takes action. I wonder now if the risperdal helped him to stop before he took action. I'll guarantee you this- if he tells me that again, I will take him to psychiatric hospital and make sure they understand that he probably is serious about trying to prevent something bad.

 

[klmno]

by the way, Janet and Witz- I didn't overlook your responses either. I'm still mulling over that offer about a "religious" talk from Jamie, LOL! (Just to make sure difficult child makes every effort to handle things a different way in the future!

 

[Sara PA]

I've noticed over the years that it seems for some kids it can be very hard to remove an antipsychotic. Like with antidepressants, the problems aren't necessarily related to the condition for which the drug was originally prescibed. There seems to be an element of violence involved for some people. When I first noticed that a number of parents were reporting problems trying to stop AP, I was reminded about the newspaper articles where a person with schizophrenia "stopped taking his medication" and commited some violent crime even though the person had no history of violence before.

These drugs cause physical changes in the brains. There is very little research about exactly what those changes are and what happens when the drug that causes the change is removed.

 

[OpenWindow]

Have you ever met a person who was as nice as could be unless they drank or got high, then they were not rational and seemed to be a different person - so much so that they were frighterning? The father is that way- exccept he didn't drink or do drugs. "It" just came out peridicaly

Yes, I have - my husband. And just recently I realized it is the same thing I see in my son, and it scared the cr*p out of me. With husband everything is fine for a few months and then he just explodes, usually at me. He's never gotten physical but says horrible, cruel things. I am so afraid difficult child isn't going to learn how to control his anger and will grow up to treat people this way, or worse.

In your difficult child's case, quitting Risperdal may very possibly have been the cause. At the very least I'd be calling his psychiatrist immediately, but a trip to the psychiatric hospital would be the best option (although I have to admit I've never taken that step myself when I probably should have).

Linda

 

[alongfortheride]

Klmo -

My son stopped taking his medications unbeknowst to me (apparently, an erection is more important than mental health to a 17 year old) The violence that ensued was horrible. He stopped the seroquel and AD abruptly...a definite no-no. Not only did the psychosis come back but it wasn't the benign thoughts that were there prior to the medications. Anyway, a psychiatric hospital stay was in order and I think he learned a difficult lesson. Always keep yourself safe for your benefit and for his, because if you think his thoughts are screwed up now adding the guilt that he did harm to his mother really pushes them over the edge.

 

[TerryJ2]

klmno, so sorry you're all going through this. I don't have any experience with-those medications, but I'm glad you've gotten ideas and advice from people here who do have experience.
All I can offer is support.

 

[Steely]

klmno.........sorry I am coming into this late. But of course I had to offer my 2 cents

OK.........so here it is. Popular or not.

A) Start him back on the Risperdal ASAP. Yes, it absolutely can be a side effect from stopping the medication.

B)Yes, it can also be from bro planting ideas and confusion in his head. Bio dad does this to difficult child all of the time, and it messes with him more than anything. Here we are, their moms, their sole providers, care takers, and only loving connection in life - and someone else they are supposed to love and respect is telling them we are cr@p. I know for my difficult child anytime he spent with his dad, afterwards he became aggressive and threatening towards me. Still to this day, do not know exactly why - but it is enough of a pattern it has validity.

C) For me, sending my difficult child away long term was never, ever an option. I was sent away when I was 16 and it altered me in a way that can never be repaired. I was not ever going to do that to my kid. Now that may make me an irrational mom, or one who is not practicing tough love - but it was what I had to adhere to in terms of my moral compass. So when difficult child would get so out of control that he physically threatened me, or tried to hurt me - I had limited myself in options. One day, when he got in my face - I looked at him, with the resolve of the biggest bad a@@ is the world, and just stared him down. He was taller than me, stronger than me - but that is what he needed - to know, that I was internally stronger than anything he could think of, or act on. He looked the other way, and went on about his business. I know he felt my resolve that I would not be victimized by my kid. Kids like these prey upon weakness, and they never ever need to see us weak. So to tie this and bro together - bro made difficult child think you are weak - and difficult child needs to test this.

Now, I do not advocate this for everyone, or even you - I am just sharing my story - not advice. Perhaps in retrospect I should have called the police. But I didn't, and long term this has worked. He has been violence free for awhile now. Knock on wood.

So many, many hugs klmno. I think of you often.

 

[witzend]

Klmo -

My son stopped taking his medications unbeknowst to me (apparently, an erection is more important than mental health to a 17 year old)

Well, DUH!

Sorry, I couldn't resist. I was going to say that when M was on one of his medications and stopped, he got so much worse. I can't remember what it was, but it was an AD. We tried getting him back on that one, but it never worked the way it did before he stopped. We talked to the psychiatrist about it, and he said that it is possible for chemical changes to occur after use, and after stopping, that make it less effective if you try to stop it again. It's been some time, so I'm probably not explaining it as well as I could. But, I think it's right on to be concerned about the medications change, and I wouldn't let my guard down just because he was back on the medications. It may not help him the way it did before. That's one reason I am against taking kids off of medications in the summer or weekends. They can totally lose their effectiveness when restarted.

AFTR makes some very good observations. Do what you have to to get him stablized ASAP. For right now, the why doesn't matter. Although it would probably be helpful to know, if you can figure it out...

 

[klmno]

Thanks everyone- as always- I don't know what I would do without you! I talked to him about it today and reminded him about what had happened a few months ago when he had feelings like that but he didn't act on them- he came and talked to me instead. He said it wasn't like that last night. (I'm not convinced- I think in HIS mind it wasn't the same because it was impulsive and a few months ago he was able to recognize a tempataion before he acted impulsively.) Anyway- right now I tend to think it will take a combination of things to reel this in from getting worse. That opinion could change as I learn more and we see what transpires, but I think medications and psychiatrist need to be involved, but punishment needs to be involved too. Not punishment like our Department of Juvenile Justice has though- mainly because they don't have anything other than lock them up with no rehabilitation.

They have no boot camp type program or work program in our county. They have nothing but short -term detention, the program that the judge wanted but difficult child is too young for , and the state commitment. The judge's program would be the best of those three but it still doesn't do much. I asked the attny about the state and was even considering it for difficult child, but the attny said I needed to fight with all my might against that because here, that is like sticking a kid in an adult prison. He stressed to me that difficult child is way too young and not hardened (I don't remember his exact words)- but he said difficult child should NOT be in there and that he would be hurt.

I tend to think- at least today, and lord knows I have spent the past 24 hours pretty emotionally shaken, that difficult child does have issues and problems but they can be helped, but they aren't helped by doing what people did with my bro. They might require therapy and medications, but they don't require permission to keep pushing those boundaries to limits beyond belief. I cannot solve this problem by allowing my son to develop the same sense of entitlement that my bro has. Not just for my or my son's sake, but for any future wife and grandbaby's sake, too, Know what I mean??

That being said, I'm not so sure that I'm knowledgable enough at this point to know if he's psychotic sometimes. I'm still learning a lot of this and I'm not sure I have the correct definitions. Clearly- he had distorted thinking last night. But I really do not know if it was distorted like my bro's sense of entitlement and fantasy land where no one counts but him, or if it was hallucinations (as in hearing voices telling him to do something) or if difficult child had thoughts that I was some enemy. The profs sometimes (ok- most of the time) jump to such conclusions before they know half the facts or history that it scares me more to talk to them. I mean if they are talking about forcing a solution on us when I KNOW they don't know 1/4 of the story, how can I have much faith in their solution?

Anyway, I'm trying not to put all the eggs in one basket, so to speak, as far as what to do. Maybe because I'm not sure and maybe because I think there is no one miraculous cure and it will take a combination of things. So, I don't want to call anyone in who will make it a "this is the only solution" situation. I have given him a few punishments- I guess they are lame for what he has done. He has been irritable all day and pushed limits a little- just making noise and banging things when I told him to put something in the shed. I went and stood up to him (not all in his face) and told him that he had pushed enough- he's lucky that he's sleeping in this house tonight.

I try to think back things (approaches) that have worked with him. I am trying hard to stay focused on those methods. Even though, no counselor seems to be supporting that. All I can say is that I want to find what gives him the best hope- not just for today or this year, but for the rest of his life. and he cannot grow up to abuse women or children.