Is this where I should post??

[dago]

Really not sure where to begin without completely boring all of you. I stumbled on to this site while trying to figure out why our 13 y o was becoming worse to discipline, talk to, be in the same room with, etc. I am in desperate need of advice, maybe even comfort from other parents/moms who live with this type of behavior on a daily basis. I have found that if one is not surrounded by an emotionally/mentally ill child there is absolutely no compassion for either the mom or the child (adolescent). So here I am looking for help, or maybe even a boot in the out of here telling me that there is nothing wrong with Makala and I need to merely tighten the reigns. Her favorite game is ‘conquer and divide’ she wins a gold medal EVERY time she plays, sometimes we think manipulation is her middle name.
Some of her negative characteristics are as follows: nail biting (both hands and feet), chews on EVERTYHING (paper, pencils, pens and pen tops, Nintendo stylus pens, staples, paperclips, to name a few) knuckle cracking (all the time) more so when we are conversing with her ~she knows it annoys the heck out of me~ deliberately does things she knows are unacceptable, then lies about them, annoys the heck out of her sisters starts arguments with them, she will walk by them and kick at them or skims the top of their heads, taps the 4 y o’s head, will throw her unwanted things (whatever they may be) into the 9y o’s room, disrespectful of her things and ours, homework will not get finished until she is ready to finish it or until I stop EVERYTHING I am doing and sit with her (most of the time up to 2 hours) and walk her through the material step by step, by now everyone is in an uproar cause mom is preoccupied, will sit down at the supper table and announce ‘this is disgusting, people in jail eat better than this!’ Extremely non empathetic, one questions we ask her often is ‘Makala if I were to do that to you how would that make you feel?’ or ‘how would you feel if someone says that to you?’ 90% of the time she will not, cannot, or just blatantly refuse to answer! Oh, one of her ultimate answers is ‘don’t know, don’t care!!’
A little bit, not much, background ~~ I will answer ANY questions and fill in any blanks if and or when asked. Makala is an intelligent, big hearted, adventurous, clever, not so ordinary 13 year old adolescent. Her biological father and I separated, after close to one year of bi-monthly counseling, before she was 1. He packed up and moved to Arizona, we live in Indiana. I remarried a long lost sweet heart (Tony), a man I had been a platonic friend with all through high school. Makala was 18 months when we started dating and 3 when we married. From the time she was infant she and my dad had an inseparable bond, she was basically the 1st born (I do have a 22 year old daughter ~ Christa ~ who I placed for adoption in 1984, we were reunited in Nov. of 2004). We lost him to cancer at age 57, only 5 years ago. I am sure that by now you may see a possible “abandonment” problem.
My dad was an insightful, intelligent, understanding man, a Hero if you will…He used to say her (Makala) imagination is, ‘out of this world’, ‘send her to Hollywood, her drama is outstanding’, ‘she is gonna give you all the troubles you gave your mom and I’. Well let me tell you I NEVER imagined he would be right (again) or that he would leave me to pick up the pieces over and over and over again.
Makala’s Pediatrician has given the diagnosis of bi-polar/depression/ADD ~ however he goes on to say that there is such a fine line between bi-polar and ODD we will monitor, could be either or maybe both. She has been on a variety of medications as well as a combination of them, some are as follows: depakote, ambilify, concerta, wellbutrin, to name a few that come to mind with out looking them up. She is now on trileptal 1200 mg., celexa 40 mg., and adderall 25mg. Often times she opts not to take her medications, says they, “do not help, my friends say I do not need them, I do not care how I feel or what I do…”
Moving on ~ we have seen behavioral challenges with Mak for 10 years now. We have been to 4 different counselors; the last one telling us that she was not qualified enough to work with Mak any further. She gave us a paper with referrals on it.
We went to see a new child’s psychiatric yesterday Tuesday the 8th we were in the office for close to 2 hours, literally. She was able to put on her perfect charm at first, then we switched to the ‘poor me, if mom and dad would understand I am just a teenager they would not be so mean to me.’ After some talking we went to the ‘I am such a bad kid, my mom and dad are good parents and they should not have such a ‘bad kid’ song and dance. The dr. left the room came back in told me, ‘Children’s Hospital has one of the best psychiatric wards and they will be waiting for you, can you be there in an hour?’ Oh my goodness, I could not believe what was going on. Needless to say, I told him that had been considered, but was my ABSOLUTE last choice. He gave me 3 different phone numbers, a new medication, geodon, and 2 other appointments this week, 1 tomorrow with the adolescent therapist and 1 Friday with him.
I will stop here and hope that I have not completely bored ALL of you who took the time to read this and pray some of you may be able to help me help my family as well as understand Makala.
PS~I would like some help on the acronyms in the forum(s)
Thanks for reading (listening)

 

[oceans]

It sounds like she is a difficult patient to figure out, and it is going to take trial and error to get the right medication combination. Hospitalization is not a bad idea. She will get psychological testing and medication trials. It sounds like she needs a good evaluation. I guess if you don't want to hospitalize her, the first place I would think about starting is with a very thorough evaluation at a good teaching hospital.

 

[BusynMember]

Has she ever seen a neuropsychologist for a battery of tests? Sounds to me like she could be (not saying she is) on the autism spectrum, especially with the nailbiting fingers AND toes, and throwing stuff, and not able to answer "how do you feel?" I'd certainly want a full neuropsychologist exam. Something is going on that, in my opinion, makes your child "different" and I'm not convinced it's defiance. NeuroPsychs can test intensively to spot problem areas and often come up with helpful diagnosis. that can get your child help. I would skip the talk therapists and go to the neuropsychologist for an evaluation. Most therapists, including regular psycologists, do not tend to do testing to spot difficulties. They just sort of talk about it and, from our long experience, often can't tell by just talking and jump to wrong conclusions. My son is on the spectrum and communication is a big problem for him. He can not explain how he feels and has trouble with give and take conversations, yet he will go into long monologues about his own interests, without a break for a breath...lol. He used to love to touch things to see how they feel and throw things to watch how they land. It could have been misconstrued as defiance, but we saw more into it and persevered. He is doing GREAT now. Note: High-Functioning Autism (HFA) is often mistaken for mental illness--even psychiatrists can get it wrong because neurological testing is not their field. Interventions were the key. Good luck :smile:

 

[slsh]

Hi Michaele and welcome. Gotta love teens with- issues. :wink: Forgive me, but I giggled over the knuckle cracking thing - my son does the exact same thing and it drives me out of my *tree*!! Almost as bad as fingernails on a chalkboard. Most of the time I bite my tongue and just bear it but every once in a while I forget and tell him to knock it off. He's clueless. :wink:

I would strongly recommend reading "The Explosive Child". I'm not a fan of self-help books at all, but in addition to being highly amusing (I'm warped, but I just giggled as he described child after child who was *so* like my own son - could there possibly be more than 1 of him?) it also helped me prioritize what behaviors were really important as opposed to annoying. We can't address everything without losing our minds (baskets A, B, and C - basket A being nonnegotiable things, B being mid priority, and C being things that can slide for right now).

Some things I would let slide - the chewing on stuff, the complaining about meals (she can either eat or not, but complaining isn't going to change anything). In my home, the physical contact with- sibs would be a priority. But priorities are different in each home and I don't think there's a "right" answer.

How is she doing in school?

I understand your hesitation about hospitalization. I would see if the psychiatrist (psychiatrist, as opposed to "therapist" which is the therapist) could do testing on an outpatient basis? But there can be advantages to inpatient evaluation, especially if they're going to be changing medications. We've been through many hospitalizations with thank you, but I really do understand not wanting to go that route if it can be avoided.

If you check out the FAQ (top of screen, on the right) you'll get a run down of the abbreviations and other helpful info.

Again, welcome. :smile:

 

[timer lady]

Hi & welcome,

I'm impressed that psychiatrist had such a quick response to your difficult children issues & was willing to hospitalize. That is not the usual route for many of us here - we have to beg.

Having said that, I can understand your reluctance to go this route. You will know when & if your difficult child needs to be hospitalized. Good luck in the evaluations & medication tweaks.

Again - welcome.

 

[Just keep swimming]

Hi and welcome!

Oh the medication Merry-Go-Round! UGH! Not fun, I know.

Just an aside: You said psychiatrist gave your daughter a new Rx Geodon, right? Please, please watch her very carefully. It was about this time last year that my difficult child was put on Geodon. Within about 3 days she was drooling, unable to move her left side, was actually barely able to walk. We rushed her into the ER, they put her on IV Benadryl and Ativan and then the next day she had to be hospitalized for suicidal ideation. She had what was called a "Dystonic Reaction" to the Geodon.

Not trying to scare you, but that medication set my difficult child back months and months treatment-wise. Just watch for all the possible side effects.

Welcome and please visit here often!!

Hugs,
Vickie

 

[Sara PA]

You don't have to be around here for long before you realize that I am uncomfortable with children and adolescents being on SSRI antidepressants, especially if their behavior isn't getting better or is getting worse. Your daughter's diagnosis is either bipolar or ODD, according to the psychiatrist. Celexa is not recommended or approved for either disorder or for us by children or adolescents. While the side effect of suicidal ideation has gotten most of the attention, hostility under a variety of names is a fairly common side effect for SSRI/SSRI antidepressants. Anger, aggression, agitation, violence, anxiety and akethesia (inner restlessness) can all be adverse reactions to the Celexa.* My son eventually went psychotic on half the dose that your daughter is taking. And finally, there is a disorder called antidepressant induced mania/bipolar. The only appropriate treatment is discontinuation of the antidepressant.

The Adderall dose is on the high side of the recommended dose (30 mg) and could be causing rebound aggression when it wears off each day. Adderall would be appropriate only with a diagnosis of ADD.

On the other hand, the Trileptal is likely not at a therapeutic dose unless your daughter is an extreemly small (50-60 pound) 13 year old. However no amount of any mood stabilizer will control adverse reactions to antidepressants.


*On a highly personal level, when my son was suffering from the adverse reactions to the Celexa his perceptions of what people were saying and doing were not based in reality. He totally misread EVERYTHING and EVERYBODY.

 

[lizinmd]

Hi Michaele - thanks for taking the time to share with us what's going on with you. I definitely agree with the need for a neuropsychologist evaluation ... it sounds like a lot has been going on with your girl, and I always worry with mine that something new is emerging. You will be amazed at what information a good evaluation can bring to the fore. Good luck and hang in there!
Liz

 

[Wiped Out]

Just popping in to add my welcome-nothing new to add but wanted to say hi and that you've found a very supportive place to be. Hugs.

 

[busywend]

Welcome! Glad you found us. It is helpful to use more paragraphs - just easier on the eyes.

It is my opinion that your regular pediatrician is not the one to be prescribing medications for your daughter. There are so many side effects to look for. I believe there should be a 24 hour service that people should have to check in on every other day or so.

Psychiatrist should be the one to prescribe the medications and monitor the reactions. It is usually the case that a regular doctor just is not familiar enough to know what to warn you about.

 

[hearts and roses]

HI and welcome. Nothing to add but wanted to offer my support!

 

[Marguerite]

Hi, Michaele. Welcome. Help is at hand!

Get the book. "The Explosive Child" by Ross Greene. Whether she's BiPolar (BP) or ODD or both - or High-Functioning Autism (HFA) or whatever. The book helps you get under HER skin the way she gets under yours, and work to turn the problem behaviour around, generally with a lot less effort than you're expending right now. But you do need to READ it first - it's not heavy enough to hit her over the head with (hey, my attempt at some humour).

You mentioned her rudeness over what you put on the table - I immediately visualised that wonderful scene in "Sister Act" when Whoopi Goldberg is rude about the food and Mother Superior immediately puts her on a fast. Something like, "OK, if it's that bad then I will feed yours to someone else, you can go without." Of course, an oppositional kid will then try to get food in some other way, but if she ends up organising her own meal then at least she's not being rude about your cooking. You might need to limit what food is available, though - no junk food in the house, for example.
For us, dessert is only permitted when the main course has been completely eaten. If for whatever reason (not hungry enough, don't like it when they normally eat it, too impatient, genuinely unwell) the main course doesn't get finished, then no dessert. "You can't have any ice cream because you're too full/you haven't eaten a balanced meal/you haven't time/you're not well."

Biting her toenails! MWM is right, this could be an indicator for Obsessive Compulsive Disorder (OCD) in some form which is often found in high-functioning autism - in which case, it's hard to change the habit so don't try. Basket C. If she's doing it to annoy you, don't get angry. STILL Basket C! I would just congratulate her on still being flexible enough to bite her toenails, and move on. She won't be doing it when she's an office worker - got to take off the stilettos and pantyhose first, to bite toenails. And the boss might get the wrong idea if you do that.

Trying to assess for high-functioning autism is tricky as they're older, especially if they're bright. They don't mean to be deceptive but they Do adapt to trying to fit in. They teach themselves some rudimentary social skills, for example, so a lot of the deficits seen in younger High-Functioning Autism (HFA) kids are masked or resolved when they're older. This doesn't mean they're cured - it just means they have made allowances. Life for them is still very stressful and confusing.

Anyway, welcome aboard, looking forward to hearing more from you. by the way, difficult child means Gift From God (the reason we're on this site). easy child means Perfect Child. husband means Darling Husband, sometimes with tongue firmly in cheek. DEX - Darling ex (DEFINITELY with tongue in cheek!). There is a page somewhere with all the acronyms or you can do what I did - learn as you go.

Marg