I think I need to send my son away...........

Discussion in 'General Parenting' started by ggluvbug, Jan 12, 2008.

  1. ggluvbug

    ggluvbug New Member

    I don't know what to do. My son is getting more and more out of control. He was in the hospital in November. He got out and was more stable, but his ODD seemed to be worse than ever. He is just escalating more and more. He left the school campus twice last week. He has done no school work since Christmas break. He is violent. He tells me that he hates me and wants to go to foster care. He is constantly running out of the house. He ran away and the police had to bring him home today.

    I know some may say that the medications still arent right, but this is not BiPolar (BP) behavior> i know when my son is cycling or manic. This is different. He has always been defiant, but things are escalating to a new level.

    I don't know what to do. My insurance won't pay for anymore inpatient days for 12 months. His therapist thinks he needs to see someone else because she can't get him to participate.

    I am at my wit's end, and I dont' know which way to turn. My house is a living hell, and there are days that I wish his had never been born! I can't live like this forever. I don't really know what my options are, and I can't seem to find any encouraging information because residential treatment is so expensive.

    Any ideas?
  2. smallworld

    smallworld Moderator

    What about his behavior makes you think this isn't related to BiPolar (BP)? My son has a BiPolar (BP)-like mood disorder, and when he's not stable, he doesn't do his schoolwork, says he hates us and is violent at times. From your description, I'd wager his medications aren't right. Are you seeing a board-certified child psychiatrist?
  3. ggluvbug

    ggluvbug New Member

    He just had his medications adjusted and was in the hospital for 9 days. I know what his BiPolar (BP) looks like. What he is doing right now he is in complete control over. He can turn it on and off like a switch. He will tell me that he wishes I was dead with one breath and in the next, he can smile at someone like he is in complete control. He has been manipulating and lying as well. Which he doesnt' do when his medications are off.
    Yes, he sees a board cert. child psychiatrist. She is the head of the children's unit at the local hospital.
    He has been diagnosed with BiPolar (BP) and ODD. What I am seeing more of lately is the ODD.
  4. klmno

    klmno Active Member

    Well, I could be very wrong because I'm trying to decipher all this for my difficult child, myself. But, it does sound like my difficult child's more extreme, erratic behavior, which I do think is manic. There are many times I think my terminology is different from others, including psychiatrist, so I'm not sure. All I know is that there are times when difficult child is a different person and no punishment works. It's not just disobeying- it's self-destructive and sometimes self-harming. Only medications- certain medications- seem to work. And I'm not even sure it's medications at this point- it could be happening on it's own. In either case, it is more than clear to me that sometimes he's one way and sometimes he's another. As frustrating as this is, it does reinforce to me, at least, that there is something going on that he's not in control of. My difficult child is also very intelligent in some areas but has intermittent memory problems, has a questionable BiPolar (BP) diagnosis and started acting erratic about the time he turned 11- although there was a clear trigger that first started a very major depression. I'm almost certain of tell-tale signs at this point and from the holidays until around spring break, he's going to be a different person. He's on 2 mood stabilizers and they are making, maybe, a fraction of a difference, but they sure aren't solving the problem. In between these "cycles" he is a typical kid- not perfect, but discipline works, he tries, he's normal- Know what I mean?? He doesn't need "extra" accommodations, at home or school.

    I hope I haven't made you feel worse- really what I want to suggest is that this does sound like it could be mania to me. When I read various lists of symptons for adolescents, it amazes me and otherwise, I would have been too ashamed to tell, unfortunately. Sometimes I think it is hard to acknowledge when the difficult child is in the middle of it- have you seen this in your difficult child before?
  5. klmno

    klmno Active Member

    Another thing I'd like to mention- if you want to call my difficult child's changes "cycling", then I have to say that being on his current medications have changed his typical cycling pattern. If your difficult child just had a medication change, I wonder if this could be happening with him. Also, I am definetly no expert, but I do think the process of puberty and the season can effect the pattern we are used to seeing.

    EDITED: My difficult child is on lithobid and depakote. Depakote was added second to lithobid. As he was titrating up on depkaote to a "typical" dosage, he did become a VERY different, violent looking and acting person- much more liike a person on street drugs than mania or his typical raging. If this is what is happening with your difficult child, I'd put an emergency call into the psychiatrist or call a pharmicist so you might be able to safely taper him back down a little. My difficult child still takes it, but it's lower than the "typical" dosage.
  6. ggluvbug

    ggluvbug New Member

    My son has been diagnosis'd since he was 6. He has been hospitalized 3 times for mania. It looks different than this. Honestly, I was doing some reading the other day, and on that particular day, he exhibited every ODD symptom listed....all in the same day.

    I am really open about my son's illness because I have to be able to talk about it. Everyone who knows him has noticed a tremendous change lately. And everyone I have talked to seems to think it is deliberate defiance as well.

    When his medications are unstable, he is extremely anxious, irritable, cries all the time, throws tantrums, and is overly apologetic. Right now, he is mean and hateful. He is trying to deliberately instigate fights with people, running away from home and school, throwing things, being verbally abusive.

    I should say too that his therapist seems to think that the medications are where they should be, and she seems to think his actions are very manipulative and deliberate as well. She thinks her sessions are unproductive because he is so unwilling to participate.
  7. ggluvbug

    ggluvbug New Member

    His medications were increased not changed, but I do know what you mean about that.

    I think puberty is affecting him as well--my theory is that the puberty thing is exacerbating the ODD.

    One thing I should mention to is this: My son, for all of his faults, has been sweet underneath. He would be considerate and loving and wouldn't be ugly to me. But that sweetness is replaced by something else in his eyes. He looks at me differently know. It is almost like he looks at me in contempt all the time. It is really hard to explain, but there is such a feeling of forboding in my house because of him that I have resorted to taking sleeping pills just to get to bed at night. This is no way to live.
  8. ggluvbug

    ggluvbug New Member

    His Depakote was upped by 250. He had been cheeking his pills so his levels were super low. We finally got them in a theraputic range.
  9. smallworld

    smallworld Moderator

    Right before Thanksgiving my son completely shut down at school and refused to do any classwork or homework. It looked a lot like willful oppositional behavior. His school insisted we get him treatment before he be allowed to return (it's a private school). He has been in a day treatment program at a local psychiatric hospital since December 12.

    His attending psychiatrist at the day treatment program is reputed to be one of the best psychopharmacologists in our area. He made several points to us: First, the medications have to be right or you're not going to make any progress with BiPolar (BP). The key is stability, and your son doesn't sound stable. Second, oppositional behavior is a symptom of the illness. When the illness is treated, the oppositional behavior subsides. Third, my son was smirking every time he was oppositional. The psychiatrist said this is a symptom of mania.

    My son's medications have been completely revamped, and he is slowly improving. But it's a slow road to recovery. He will be in day treatment for several more weeks, and he may not be able to return to a mainstream school. We just don't know yet.

    One other point: Depakote made my son and daughter irritable and depressed at high doses. I'm wondering if that's a consideration in your son's case.

    Sorry things are so rough. Hang in there.
  10. Steely

    Steely Active Member

    I just wanted to send you a hug. I know how hard this all is. :frown:

    Lately my son has been more ODD than anything else. I know his medications are stable, because I have seen him unstable. This is just outright ugliness. I know exactly what you mean.

    There is no medication sometimes that will help these kids 100%........sometimes we have to step in with a behavior modification of some kind. If he is threatening and somewhat willing to go away, I think I would take this opp to find residential treatment for him. The state, and this board are a plethora of resources for this kind of thing, if you decide to seriously research it.

    Hang in there........and keep fighting the good fight.
  11. klmno

    klmno Active Member

    Well, taking a shot in the dark- it has to be one of 3 things- 1) maybe she's right (I don't think so , but could be), 2) she's the wrong therapist for him for whatever reason and she does sound frustrated (maybe he's just of an age that he needs a male- this happened with my difficult child), or 3) it's the medications-- read my edited post for a possibility (not neccessarily YOUR RIGHT answer). And, it vould be a combination. How long has he been going to this therapist? Did things change about the time of the medication change or a sign of puberty taking place?

    Get some rest this weekend, take a deep breath, is difficult child stable enough that you could spend a little time alone with him asking what he thinks happened? Really, it appears to me that something- therapist, puberty, medications, something triggered this at a time when he hadn't reached complete stability to start with.

    Others will come along with other opinios- just try to relax and see what seems to hit your gut as a possibility!

    Keep us informed, and post just to vent if you need to!!

  12. ggluvbug

    ggluvbug New Member

    I will have to ask the doctor about the Depakote. He has been on it for a year and a half and for a long time was doing well. However, even when he was stable, he will still oppositional. I think he has two seperate issues....the ODD and the BiPolar (BP). The BiPolar (BP) makes the ODD worse, but I think it is two things that need to be addressed.

    Plus, how do I get medication adjustments done when I have no insurance left for hospital stays? I would be afraid of trying to change anything outpatient.

    I really feel like I just wouldn't have to wake up some days. It is that bad. I feel like he has beat me down so much that I just can't feel happy much anymore. I am so tired.
  13. ggluvbug

    ggluvbug New Member

    Thanks for the support. Unfortunately, I live in Mississippi. There isn't any kind of state help here that I can find. Is Residential Treatment Center (RTC) expensive?
  14. ggluvbug

    ggluvbug New Member

    He has been with his psychiatrist since august of 'o6 and his therapist since june of '07.

    He has been showing a few signs of puberty for about a year now. My theory was that his BiPolar (BP) was making him unstable. So those sypmtoms seemed to be worse than anything else. Once that got under control, all of these other things that were on the back burner (they have always been there--just to a lesser degree) seemed to come to the forefront. Probably crazy idea, but that is what it seems like.
    I do appreciate your input.
  15. klmno

    klmno Active Member

    Did I understand correctly that you're only tweaking medications when he is inpatient?
  16. ggluvbug

    ggluvbug New Member

    The last time he was in the hospital we found out he had been spitting his medications in his drink at the house. I never thought to check the bottom of the cup. He usually took them with soda or something. Anyway, he went in, his levels were low so they increased and added another medication. But he had a violent reaction to the Welbutrin they gave him so they took him back off of the Wel. and upped the Abilify by 5 mg and the depakote by 250mg.
  17. klmno

    klmno Active Member

    I think it's a medication problem- if he'd been taking only part of the medications, it's hard to tell which day of medications were reflected in the blood draw. I'd say other things are playing into it, but I don't think medications are where they should be, in my humble opinion- can you get an appointment with a psychiatrist soon- or a neurologist or his pediatrician?
  18. smallworld

    smallworld Moderator

    Sometimes it's a matter of changing the medications entirely. Very often kids with BiPolar (BP) need two mood stabilizers with an atypical antipsychotic. See my post above.

    We have always done medication changes at home. You just need to titrate the old medications down slowly, one at a time, and then titrate the new medications up slowly, one at a time. This is the only way you're going to know what's working and what's not.
  19. DDD

    DDD Well-Known Member

    I am no expert so I hesitate to input on your post. These are
    some things I know from experience. You probably need to make an
    appointment for yourself and see if your MD thinks temporarily
    taking an Rx would ease your stress. There is no doubt that your
    stress is real and not likely to end quickly, so based on many
    years experience I believe you may need help to cope. I took this same advice from another CD family member this past year
    (even though I never dreamed I'd need to) and it made a really
    remarkable difference.

    Being gifted, been there done that, triggers some kids to creatively challenge
    authority "because they can". It is hard to judge if there is or
    is not any correlation between giftedness and GFGness.

    It is normal for you to wish he would just disappear for awhile
    so you could fall back and regroup. It's similar to being in the
    midst of a disaster and you keep dealing in an emergency mode
    with no chance to exhale. Most of us have been there. I hope
    you can find a way to put some space between you all.

    You've found a great place for support. Welcome. DDD
  20. Lostfan108

    Lostfan108 New Member

    is there any way you can apply for CMO services through your state (Crisis Management Orginazation) I know in NJ you can only really get them if the school or child welfare services recommends them. I am in the process of being approved and through CMO you would receive an in home therapist and he or she would be able to make the determination if your son should be placed in a residential program or not and if so it would be payed for by CMO.