looking for advice about medications

[sjexpress]

HI- I usually just lurk here but have posted before as you can see. Just lurking makes me feel so not alone in my isolated world due to difficult child's behaviors. Anyway, difficult child just turned 11 and although I have tried to get a neuropsychologist evaluation ( it was not covered by ins.) and tried to get difficult child to see a psychiatrist (he refuses to go after yrs of counselors, psychologists, anger management classes) I am still determined to try to help him.
difficult child does great in school. Great grades, great reports from teachers, even won a big county wide award for citizenship/ leadership/athletics this year but at home or outside of school, it is a different story. It's like our own personal he** the way he treats us and carries on when things don't go his way. Like many of you, we have had our share of more than embarrasing scenes in public.
Our biggest problems (we have others) arises during sports. difficult child is an amazing athlete. Has skills beyond his years but when things don't go right in a game, he just loses it in seconds! He begins to cry and scream about what the umpire or ref did wrong or worse he starts yelling about what a teamate did wrong. Of course it is only if the action of others affects him someway like if he gets called out on strikes in baseball or if he is pitching and one of the other kids makes an error in the field or if in basketball or soccer, another player does something wrong against him and the ref misses the call. difficult child does not yell at the ref, ump, or other child, but directs his anger at husband or I but he is so out of control that he is screaming loudly about it and then when we try to calm him or walk further away, he gets aggressive and starts shoving us away for not listening or agreeing with him (many times difficult child is wrong but just doesn't like the call against him). We are less than popular with other parents due to difficult child behavior. I am sure we are the topic of discussion after a game quite frequently.
The coaches have many times benched difficult child or even suspended him a game but still, difficult child can not control himself so there is no lesson learned and it happens again. We have spoken to all his coaches about his problems but still, they have a team to run and other kids to worry about so eventually, difficult child will get himself kicked off a team and there is nothing we can do about it. difficult child wants to try out for some other teams but he a has such a reputation that even thought the coaches say he is a great athlete, they can't have such behavior on their sidelines. I get it but difficult child loves sports so much and has so much to offer when he is not angry, it breaks my heart to see these things happen to him.
We have never gotten an official diagnosis of difficult child but I am sure he has anxiety, the ever popular ODD, and possibly a mood disorder because he can be fine one minute and out of control the next. Once a natural doctor we tried said he had more the emotional/behavior issues of adhd caused by a chemical imbalance in his brain. We have no known mental illness in the family although I have heard stories that my grandfather on my dad's side was verbally and at times physically abusive to his children and wife.
Now, my question. husband and I have never wanted to put difficult child on medications. We do have weeks when things are fine and only isolated problems but then we have days in a row when things are awful and of course there is our sports issues. Is there really any medications that can help keep difficult child calmer and maybe not make difficult child lose it so quickly when he is frustrated? I know we can not change the intensity of who he is but it would be nice to see him get thru a game without such problems. I definitly have to be careful of any medications that can increase aggression as difficult child can at times hit us at his worst. Of course then we would still have the battle of getting difficult child back to a specialist and then just to take the medications but like I said, I can't give up on him. Thanks for any input you can offer and for reading my long post.

Jan

 

[seriously]

What are you going to do when he's 14 or 15 and bigger and stronger than you (if he's not already)?

I'm glad you stopped lurking but I am going to be blunt. You have not done anyone any favors letting him push you around let alone hit you. You are going to have to take strong measures if you really want to help him. You must focus on the long term goal - to produce a functional adult - and not let yourself feel sorry for him in the present. When he turns 18 and gets out of control - the police and other adults are not going to care that he had these problems all his life. They will care about his assaulting another person and will arrest him.

You don't mention whether he is remorseful after these episodes. If he is not remorseful then I am really concerned for your safety with him.

I am not a psychiatrist or psychologist and would never dream of trying to diagnose your child via a forum post or say whether medications are appropriate. That is what doctors do.

If your son refuses to be evaluated by a psychiatrist then you are going to be faced with coming up with a plan to get him there by either negative or positive motivation (or a combo). For example, he loses all his electronics the next time he is aggressive or violent. He gets something back for the rest of the day after going to an appointment. Then you take it back until he can show that he will not be violent for 2 days.

No matter what, you must decide that there is zero tolerance for physical aggression regardless of the reason for his anger. You have to stand up to him, even if it means calling the police for help. If you don't - it will only get uglier and uglier in my experience.

And you absolutely need to be in couples or family therapy with someone who can help you figure out how you got to where you are and what you are going to do differently now.

You could try looking at Ross Greene's book The Explosive Child and see if there's anything there that is helpful to you.

I would be refusing to enroll him in ANY kind of team sports as long as he is behaving this way. If he doesn't like it then he needs to change his behavior. Believe me, even people who are extremely mentally ill, usually have some degree of control over their behavior. Maybe all they can do is isolate or retreat from other people - but they do it if they are not completely psychotic. That means there is no excuse for those behaviors once he has been taught skills to help him manage his emotions AND you have consistently enforced limits that make him use those skills.

Keep posting and everyone will be glad to help you problem solve or keep your resolve when you find yourself giving in or feeling sorry for him. It will get worse before it gets better but if you will stand up to him it is almost certainly going to get better. If you don't stand up to him - I can guarantee you that it will get much worse.

Good luck

 

[BusynMember]

Hi there.
I have to agree with zero tolerance for violence. Also, he needs to be evaluated whether he likes it or not. He is ten years old. He's not the boss, you are, even if he makes that difficult How about no evaluation, no sports. Even if he doesn't cooperate with the evaluator, his behavior will cue the professional into what may be going on (I think it sounds different than just ADHD). I would take him for a neuropsychologist evaluation to maybe pinpoint why he has such a fast trigger. He could have hidden d disabilities that only an intensive evaluation will pick up. It's hard to help somebody if you don't know the devil you face. That is especially true if you are considering medication. Medication for WHAT???

A few questions that will help us help you:

1/Any psychiatric or neurological problems on either side of his genetic family tree? This is important since things can be inherited.

2/Does he know how to interact appropriately with his same age peers? Does he get teased? Is HE a bully? Does he hang around with other kids after school? Any family problems?

 

[keista]

tried to get difficult child to see a psychiatrist (he refuses to go after yrs of counselors, psychologists, anger management classes) I am still determined to try to help him.

Hi, glad you posted. While every thing you/he have tried so far is great for first steps, they do involve lots of time and effort on both your and his part. If it doesn't seem to help, I can understand why he'd be less than enthused to try something else, but have you tried explaining that if you do find the right medicine for him, all that other work he's done in the past, and may continue in the future might make more sense and become easier? Like Seriously mentioned, if he has/shows remorse, he might be more receptive to the idea, but if he doesn't then it's more than time for you to get really tough with him.

It's very interesting that the anger gets pointed at you and your husband, even when clearly someone else's fault. What happens when you aren't around? Where does it get directed then? It makes sense that he would do this since you are SAFE, you are not going anywhere, and that's the way it's supposed to be. We all lash out more to the ppl we are closest to and feel most secure with.

Gotta get him to a psychiatrist for any medication recommendation. What works for one child may be poison for another. You and psychiatrist need to decide what to try and monitor if it's working or not. I think dangling the next sports sign up as a reward for going to psychiatrist is a great idea. He's not a little kid anymore and more than ever needs to learn to monitor himself and accept responsibility for his actions. The younger this is done, the "easier" I think it can be. No, it will never be easy, but we can hope and pray and do our best to get our kids the help they need.

 

[KTMom91]

Definitely zero tolerance for violence. The rest of the world could care less about your son's ongoing issues once the violence is directed at them, as seriously said, especially after he gets older.

Whether or not he's a good athlete is really irrelevant if he can't demonstrate sportsman-like behavior, as you stated, the coaches won't want to deal with him, nor should they have to.

medications may or may not help, depending on the diagnosis, but he's 10. It's not his call. He isn't the one in charge. You are. Get him assessed first, and go from there.

 

[BeachPeace]

I do not have any input on the diagnosis - that will have to be something teased out by his doctors. But...you did ask if there were any medications that could help him - my answer is a big YES.
My son Blue with the right combo of medication is a happy, functional child that can sit through church and go to a restaurant. Oh do we have our days still....but it is 90% better with the correct medication.
He has a seizure disorder - but takes 2 medications for aggression/meltdown behavior (abilify and risperdal) - the medications did not change him or his personality - they just seem to keep him from crossing the line of anger/tired/irrritable - to banging his head on the floor violent meltdown most of the time.
This week with the added stress of transitioning out of school - he has had a few good tantrums so medications are not 100% perfect.
Also - the other posters are correct .... as my son has progressed to 85 pounds it just gets harder to manage the anger - the bigger and older they get.
We have a good neurologist that manages his medications since my sons problems are mostly due to brain damage than a psychiatric diagnosis.
Hope things get better {{hugs}}

 

[Marguerite]

I emphasise now, we do not diagnose on this site.

BUT - your son sounds like my son. And he does not have a mood disorder, he has autism.

What I am trying to say - there cane be a wider range of possible reasons for your son's behaviour, and simply asking for medications for a mood disorder is too simplistic. He needs an evaluation and you CAN talk him into this. Assuming you need to talk him into anything, you are the parent, HE is the child. But I find your reaction to him interesting, in light of my own experience. In fact, it is your reaction to his violence that makes me think even more, that autism in some form needs to be assessed for, before anything else. Because basically, despite the violence, the aggression, the sudden and seemingly mysterious mood swings - there is always a reason that makes sense to the child, which is why, although autism can resemble a mood disorder, it is not. But it is often misdiagnosed as one, often to the detriment and longer neglect of the child.

Now, you may be right and I may be wrong, it may be a mood disorder primarily. But you will never never know if you never never go - to a neuropsychologist.

You can 'sell' him on this by pointing out that the aim of the exercise is to confirm once and for all exactly HOW smart he is. We know he's smart, because he does well in school. Knowing how smart he is can help him get better access to special extension programs and a fast-track to a really great career. Use that on him. Because it is true, although it is only part of the truth.

As for the rest of it, tha tantrums when things don't go his way in a game - ths sort of games he is playing, are well-defined with strict rules. Rules are something I suspect he understands well, and when rules aren't followed to his liking, he loses it. But the umpire's word is what goes, not his. He would one day make a very good umpire, by the way. But tis need for rules and dependence on them above all, is also a common finding in Asperger's (which is what I think needs to be considered). Also they have a keen sense of injustice. The smarter the kid, the more inclined they are to some level of autism (even mildly), the more you get these rage reactions to perceived injustice.

Now, your son does well at school but not at home. We get that a lot. These kids try really hard to be good (and I think you perceive this in him - he's a good kid who is basically honest, decent and fair most of the time) but can't hold it together all the time. Also at the end of the day, they get tired, hungry, cranky and just less able to keep in control.

Do read up on "The Explosive Child" as a matter of urgent priority. It will give you a different perspective on your son as well as give you tools to cope. it is not a cure for him, it is a management tool for you.

But you do have to begin to take control back. However, do it the right way, use the book. Don't just step in and say, "I'm the parent, you will do as I say," because he has been in control at home for years (I suspect you found this was the best way for you - I frankly don't blame you, if my unqualified suspicions as to diagnosis are right). The book shows you how you can use the child's own determination and drive to give him the sense of control he needs, but for you to get what you want. And if you need more help, we are here.

So, instructions in brief - Read "Explosive Child". Get him to a neuropsychologist. Then, over time and using the book, get his cooperation in his own diagnosis and treatment. He has done well so far, but soon far more will be expected of him than he can give.

Oh, and the above instructions will work even if your suspicions of mood disorder are correct. As for ODD - don't go there, it is not helpful. Deal with the underlying problems and follow the book and the ODD you observe will reduce by itself.

Marg