New.... does this sound "normal"?

[klnsc]

Hi

I'm new here and have been lurking for a few weeks. I've learned a lot and appreciate everyone's shares. My son just turned 11 and for the last year, I've taken him to psychiatrists, therapists, occupational therapists, the emergency room and even had him hospitalized for a few days because of threatening behavior towards me. Last year he started taking Prozac (didn't work), then went on Abilify (didn't work), Lexapro (didn't work) and he is currently on Lamictal (we are slowly increasing the dosage--50mg. but I don't see any results). He tried Vyvance recently for a few days but was up until 12am every night so we stopped that. He was diagnosed with- Mood Disorder not otherwise specified, ADHD, ODD and possible CD. His psychiatrist is concerned because none of the medications have worked and thinks he is going to end up in the Juvenille Justice System. His therapist does not think anything is wrong with- him... that he's just making bad choices and that I need to be more consistent with- my parenting. I have a masters degree in couseling and work with- lots of children and have a high success rate, but can't seem to get a handle on my own child. I feel overwhelmed, frustrated, guilty, exhausted and at times, hopeless. I feel like I'm spinning my wheels, running all over the place trying to "fix" the situation (myself included) and nothing is working. At what point do you slow things down and face the reality that they don't care about what's happening and have no desire to change? I can only change myself and provide him the opportunity to get help but he's not getting it! I even started going to Al Anon to work on boundaries with- him and try not to allow him to get to me every day. My life has become one big crisis and this is all I'm focused on.

Here are some things he does... some on a daily (if not hourly) basis......

• Constantly asks for things (buy him a cell phone, to go to his favorite store--if I say no to one store, he'll ask about 5 others, go out to lunch, buy this, that, etc.) ALL DAY--as if he has a sense of entitlement.
• Throws temper tantrums if he doesn't get his way
• Has tantrums (crying & violent) fits at least 3-4 times each day
• Refuses to do chores (even though he doesn't have many to do)
• Challenges everything I say; does not take no for an answer
• Tries to bargain with- me and make deals ("I'll mow the lawn if you do ____")
• Hates his teacher, therapist, doctor, anyone in authority
• Never takes responsibility for his own behavior; can't see his part; blames others for everything
• Has gone through my room and closets and taken things
• Has stolen from his brother (money) and several friends (their ipods and video games--then traded them into Gamestop for money and more games)
• Was suspected to have hacked the computer system at school and deleted a teacher's files
• Seems to have several different personalities (real sweet and loving when he wants something and if I say no he flips out and says he hates me, I make him sick, etc.; calls his dad to tell him how mean I am and acts like he's sad and depressed--his dad always buys into it!)
• He can be terribly disrespectful all day and at the end of the night, he will cry hysterically and say he's so sorry, that he loves me and doesn't know why he's so mean to me.
• A few weeks ago he became violent in the house (overtured a coffee table, banging chairs, kicking walls) and I called the police. He was taken to the er but I chose not to admit him. Several weeks later he did the same thing and I had him admitted. He was out within 3 days because he was a model patient.
• He is very bright (turns everything I say around) and can be very charming when he wants something
• Seems to hate me and think I'm against him and "set him up" to get in trouble. I am his target and if his teachers knew about his behavior at home, they would be shocked. In fact, I just started telling my family (for more support) and they are in shock be/c he comes across as this loving little boy.

I can go on and on. I realize that some of you experience these issues with your children as well. I'm wondering where to go from here. His therapist told me today that I need to work on being more consistent and following through with- what I say. He thinks my son doesn't know how to express himself and I am his target because I'm safe. He put my son in group with- Asburgers children and is using him as the Typical Peer and wants me to work on my parenting and consistency. The therapist doesn't think he needs medications, especially since non have worked so far. He thinks my son is depressed and has low self esteem but has learned to manipulate and get his way to the point of throwing temper tantrums in order to get what he wants.

I know I'm rambling now... I just wanted to share. Any thoughts would be greatly appreciated... and if anyone has any answers or a solution, I will gladly pay you!

 

[AnnieO]

First... Welcome! Glad to have you here though sorry you have to be here - if that makes any sense at all.

I'll be honest I don't have a magic wand (closest I've got is a giant Pixy Stix, but that doesn't work very well). Nor do I have a fix-it pill or even many answers. What I do have is experience... You could be talking about my Onyxx.

His therapist does not think anything is wrong with- him... that he's just making bad choices and that I need to be more consistent with- my parenting.

Ya know, I have heard variations on this so many times it's not even funny. It's almost impossible to be consistent with parenting when you cannot foresee everything that's going to happen. You can try all you like, but unless you're FORCING the child to made the bad decisions (yeah, SURE you are), he has to learn accountability sometime. And ya know what? His own bad decisions will result in consequences. I'm still trying to wrap my mind around the fact that Onyxx doesn't GET why it is bad to just TAKE what she wants from anyone else... And why she doesn't GET that she spent a week in juvie because she FAILED A DRUG TEST while on probation! She has bugged us repeatedly to call her PO to get her off house arrest. If it were up to me, she'd be in treatment RIGHT NOW.

So... I know others who know more than me will be along, but I wanted to welcome you to the family!

 

[JJJ]

(((Hugs))) and Welcome.

Your mommy instinct sound right on. That is not a list of 'normal' behaviors.

Has your son ever had a neuropsychologist evaluation including IQ testing, language testing, reality testing, etc? Did the Occupational Therapist (OT) assess for sensory issues?

How is your son's behavior at school? his academics? Does he have an IEP?

Is there a history of mental illness, substance abuse or criminal activty on either side of the family? (birthfamily if he is adopted)

It is not unusual to go through many, many medications without success before finding one that works. If mood disorder is the primary diagnosis, many of those drugs should not have been trialed without getting a modd stabilizer on board first.

Any therapist that gives up an 11 year old kid (and that is what 'blame the parent' does) need to not be the therapist anymore. Can you find a new one?

Our "fee" for advice is simple. Stick around, share the journey as we all do our best to raise our 'hard to parent' difficult child children.

 

[tictoc]

Welcome to the forum. I second the opinion that you need a new therapist. I don't think the fact that medications haven't helped means that your difficult child's behavior is "normal." Many of us here have had the experience of going from one medication to the next, still hoping to find what works. That certainly doesn't mean that nothing is going on with our kids. We just haven't found the answer, yet.

Good luck.

 

[klnsc]

Thanks for your replies. JJJ-- I was considering having some psychological testing done but the p-doctor said we already know what he has and that the testing/results would not change the treatment. I had an appointment last week to meet with- the psychologist alone but cancelled after speaking to the p-doctor. Is a therapist the therapist? I feel like the therapist is good and is aware of my son's manipulative behavior, but it's the psychiatrist who says during most visits that the medications are not changing his behaior, that he's going to end up in jail, has all the characteristics of the kids he sees in the detention centers and has told me to call the police several times. I have thought about changing since I feel like he's given up hope (and we only started seeing him in January). The therapist thinks he's a good kid but that we have to catch this before he gets any older and is giving me tips on how to be more consistent.

His test scores are in the 98th percentile nationally and has always gotten high 90's until this year (5th grade) where his grades have dropped to low 80's/high 70's. There has never been a need to get the school involved, so there is no IEP. The Occupational Therapist (OT) said he has Sensory Processing D/O and we went to Occupational Therapist (OT) 2x/week for 6 months. They said he could be acting out be/c he was so frustrated with- the processing issues, but that did not work. His Occupational Therapist (OT) was a nice young guy and I kept him there just to have that positive connection but we've since stopped.

We have mood disorders in the family as well as substance abuse issues (although the person has been in recovery for 30 years). We are pretty wacky and for years I've been going to counseling and other programs to help with- my issues and have tried to change my behavior. We have never had any criminal behaviors or domestic violence in the family (or even active alcoholism). I believe his dad has Narcissistic Personality D/O and can not really relate to or connect with- people. He's not a bad person but extremely self absorbed. My son has a lot of his traits (not that I'm perfect by any means) and knows what, how and when to say the right thing to get what he wants.

I'm going to continue to give Lamical a chance and start searching for a new psychiatrist who has a more positive attitude towards my son.

 

[klmno]

Hi and welcome!!~

I read many familiar things in your post and unfortunately, my son is now in the juvenile justice system and has been for several years. He is 15yo but started having issues similiar to what you describe at 11yo. I believe he does have a mood disorder, they run in my family. However, the current people in control of our lives- courts and parole officer (his, I haven't broken the law), and the psychiatrist at his last juvenile facility do not. Never mind that two state expert psychiatrists felt he needs mental health treatment, along with staff at a private psychiatric hospital.

I would strongly agree and urge you to get a multi-discipline evaluation done (usually in concurrence with or right after neuropsychological testing) at the best place you can find before he does get in the juvenile system. For one, if he ends up in the system this can help push for appropriate sanctions, and 2) once in that system, these people can take over so much that it will not be as easy to get the evaluation or follow the recommendations resulting from it.

 

[JJJ]

Your psychiatrist sounds less than qualified to help your son. If his tx was WORKING for your son then I would agree that the label didn't matter. But the fact is that your psychiatrist has been unsuccessful in treating your son and is actively discouraging you from getting a second opinion.

You need a neuropsychologist, not a regular pysch. They have additional training on testing. If you need to have your son hospitalized again, that is often the quickest way to get the testing done. All of Kanga's neuropsychologist testing was done inpatient. We were never able to access it as an outpatient due to cost ($3,000 for outpatient yet fully covered as an inpatient).

Having mental health issues on both sides of the family does indicate the likelihood that he has a genetically based mental illness and supports that it is NOT a poor parenting issue.

If he is doing well at school, I would count your blessings and leave them out of it for now, except for possibly sending them a letter stating that he has been diagnosis with xxx and that while you do not feel that it is having a negative impact on his education, you want them to be aware of it in case of future concerns. (This will provide him with some protections for behaviors related to his disability.)

 

[gcvmom]

In my opinion, you need to find a new psychiatrist for starters.

Second, I would question whether or not the various medications have been given a sufficient amount of time and/or been taken to a therapeutic level to do the job. If you read the prescribing info for Lamictal, for example, http://us.gsk.com/products/assets/us_lamictal.pdf you'll see in Table 5 that the peak level targeted after a titration period is 200mg/day. You may very well not see much of a change until you get to a higher dose. Furthermore, the upper limits of a medication's recommended dosage is often just that -- recommended. Sometimes a psychiatrist, in their extensive experience and judgement, will base dosing on patient response rather than a recommended limit.

There are likely multiple issues going on with your difficult child that are causing the rages, the violence, the lack of impulse control, etc. I would focus on the rage/violence first and get those under control before worrying about the impulse control problems.

 

[Andy]

Hi! I agree that a neuropscyh exam is what you need. Testing and possibly medications will help a great deal. However, your son also has a job to do. He has to make the choices to make his own life easier. If other people are not seeing this negative behavior, that is a sign that he is cabable of making good choices. It also sounds like he can be a bit manipulative with you. You say you work successfully with other kids. The thing that is different here with your own child is "emotions". Yours to be exact. You are emotionally involved with your son. You are personally hurt by his behavior. "How can MY son be like this?" (I have been there). And my diva would throw it back in my face with an "I can do whatever I want" attitude.

A book that helped me is "The Manipulative Child". It helped me to remove my emotions from the equation in a situation and keep the focus on the issue at hand. It showed me that my child's anger toward me was a manipulation. Our kids know that we want them to be happy and healthy so if we are not agreeing on something, they think showing another emotion such as sadness or anger will kick in our want to give in to keep the peace and bring happiness into their lives. My diva is the world's pro at making EVERYTHING under the sun MY fault. I could be hours away but for some reason, negative things are my fault and she tries to give her problems to me by proving that I did wrong. That is manipulation to get out of trouble.

It doesn't help matters that Dad is not seeing the big picture. Your son has a "safe haven" to avoid his responisibilities.

I don't have any answers. Read the book and know that therapy, testing, possible medications and your son's own choices need to work together to make his life happier.

My difficult child was 11 years old when we started having problems. We had some pretty intense moments but not nearly what you are going through. I would do a lot of talking with him rehashing the day's events. I always asked him what kind of person he wants to become and if those behaviors fit that mold. I also told him that it was up to him to make the right choice no matter how hard it was. I tried not to tell him that what he did was wrong but tried to lead him into seeing how his behaviors hurt himself and others.

 

[susiestar]

Hi and welcome!!! You sure have a full plate, don't you??

I completely agree that you NEED a new psychiatrist. Any time a doctor discourages you from seeking a second opinion it is a GIANT red flag. I have health issues and have NEVER had a reputable doctor discourage me from getting a second opinion. A couple of docs have required it before some surgical procedures. psychiatrists, esp, should NEVER discourage a second opinion. Psychiatry is packed with disorders that have similar symptoms and you could go to six psychiatrists and get completely different diagnosis's from each of them. It is actually rather normal to have several psychiatrists each have different ideas about what is going on. Having another psychiatrist tell you exactly what the first one did would be an experience that very few of us have ever had. We couldn't even get three psychiatrists who worked at the same psychiatric hospital to give the same diagnosis's (diagnoses) for my son. I was surprised because they all saw him with-in a three day window.

If you have trialed all of those medications since January I would bet that not only has the doctor not gotten the medications up to the therapeutic range, they have not been in his system at that level for long enough to have a clue as to whether they work or not. The stimulant (vyvanse) is quick in/quick out. You would see results within hours if it was going to work. It would be out of his system within hours also. The other medications need to be at a therapeutic level for as long as six weeks (yes, six WEEKS) before you would know if they were having an effect and what it would be.

If you have been lurking you have likely seen us recommend The Explosive Child by Ross Greene. Regardless of your son's diagnosis, it may be helpful to you. You also may find help in the various Love and Logic books. You can learn about the various books at www.loveandlogic.com . I also strongly recommend you read The Bipolar Child by Papalous. It will explain a LOT about mood disorders. Pay special attention to the parts about medications as many rx and OTC medications can make mood disorders MUCh worse.

While you do all of that (as if you had spare time before you started here, LOL!) it would be incredibly helpful if you could keep a diary of his moods, outbursts, etc... If you can identify a trigger for the rage be sure to note it down. In a few weeks you may be able to start seeing patterns in his behavior. MOST people are creatures of habit, it is just the nature of the beast.

I also suggest you start a Parent Report. Years ago some moms here worked out an outline to keep all the info on a difficult child in one binder. That way you have the info when you get those forms about health history, you can give a doctor a section of the report to let him have the family history (rather than relying on his notes after you give the history orally).The outline is in the FAQ/Board Help section under the title Parent Input/Multi-Disciplinary Evaluation. Here is a link: http://www.conductdisorders.com/forum/f7/parent-input-multi-disciplinary-evaluation-10/

I am glad you joined us and spoke up out of "lurkdom", though I wish you didn't need us!

{{{{{hugs}}}}}

 

[klnsc]

Thank you all so much! What wonderful advice you have given me. My first mission is to find a new psychiatrist and set up an appointment. I do have a name of a good one that our therapist mentioned in the past but did not want to switch again and have my son meet a new professional but it looks like we need a new approach. I have read The Explosive Child, The Bipolar Child and several of the Love and Logic books (and many more). I am currently reading Your Defiant Child: 8 Steps to Better Behavior and will get The Manipulative Child next.

I love the idea about the Parent Report. I usually carry a bag with- lots of folders and important information to all our appointments but it's a great idea to have it organized in a binder with- sleeves and several copies of each document. Great idea!

I will also reschedule my appointment with- the psychologist to discuss the testing options. That was a very good point that if the treatment was WORKING then a label would not matter. Obviously, something is not working so I need to take a different route.

Thank you all so much. Have a peaceful weekend.