New to board looking for help

[earthprowler]

Hi there, I'm Tamy, i'm 38, husband is 36. difficult child is going to be 8 in a few weeks and daughter will be 15 this summer.

anyway, difficult child has been diagnosed with Adhd and comorbity but psychiatrist says he is bipolar. new counselor says she hasn't jumped on the bandwagon of bipolar and he's probably more ODD with Adhd. he's constantly in trouble at school and at home, he gets in moods where he's mean to everyone in his path and then it's over. there are days where his mood swings happen so frequently my head spins. his usual target is his older sister which he's gone after her with butcher knives in the past (put them up), last week he got mad at her and told her he was going to set a pen on fire and stick it in her eye. i have no idea where he gets these things or why she's his main target, otherwise they get along perfect. it's caused so many problems on the home front it's not funny. my husband and i have fought over it many times. difficult child sees a neurologis, psychiatris and counselor. he's been in a behavior hospital once this year so far. he's on a coctail of medications that some days don't seem to work at all but other days work perfect.

his newest anger spell got me a nasty phone call from a mom down the street. he told her son that she was a fat cow (her son and mine were fighting) and she reacted like an 8 year old and got nasty with him. i understand where she was coming from but she called me and told me that if things didn't change in my house that she was going to call cps on me. i've talked to her in the past and told her all that we are doing for him, it's not like i'm not trying! difficult child had gotten mad at her again after she talked to him about calling her a fat cow because she told him he was not allowed down there for a couple of days and he rode by and called them all p****'s. i know it's not right, but he did it because he was mad. he's constantly in trouble for cussing, hitting other people, defiantly disobeying adults, arguing and destruction.

i'm exhausted and don't know what else i can do and it doesn't help when people expect him to change and behave like their kids do. we do have an iep set up at school, but they are pretty much worthless about following up on it. he's set up to be evaluated through the school here in the next month also. i've done everything i can think of to do and it' s just not good enough for most people when they don't walk in your shoes or live in your house. i'm glad i found this forum so i have people that understand where i'm coming from and understand. thanks for listening to me babble.

 

[smallworld]

Welcome! I'm glad you found us.

What medications/doses is he taking? Are they making things better, worse or about the same?

When you get a chance, please click on UserCP at the top lefthand side of this page and create a signature like mine below. It helps us keep everyone on the board straight.

We recommend reading The Explosive Child by Ross Greene. It has helped many of us parent our extra-challenging children.

Again, welcome.

 

[earthprowler]

thanks. he's been on a coctail since February.

he takes: focalin 2.5 mg for the ADHD three times a day
Prozac .5 mg once a day
Lithium 600 mg a day

he'd been on Abilify for two and a half months and it worked great! but then it slowly stopped working and they had to take him off of it, he was too small to up the dosage. after that it seemed like they switched his medications every other week till he went in the hospital. a week before he went in there, he threatened to kill me and his sister. he was on Risperdal then but obviously it made him too aggressive.

hopefully my signature shows up, i did do it.

 

[smallworld]

If your son truly has bipolar disorder, it's important to treat him with mood stabilizers and sometimes an atypical antipsychotic. Both stimulants like Focalin XR and SSRIs like Prozac (and I suspect you mean 5 mg because it's almost impossible to make a dose of 0.5 mg even with liquid Prozac) can make kids with BiPolar (BP) much worse. Lithium is a mood stabilizer, but it can't always work its magic against the bad side effects of Focalin and Prozac.

You won't really know how Lithium is working unless you ditch the Focalin and Prozac plus get a blood test to see if he's in the therapeutic window to treat BiPolar (BP). Furthermore, kids with BiPolar (BP) frequently need to be stabilized with two mood stabilizers plus an atypical antipsychotic. It's a very hard balancing act to get the medications right.

Has your difficult child undergone any neuropsychological testing? Can you get a second opinion with a psychiatrist who is experienced with treating pediatric bipolar disorder? Without an accurate diagnosis and the proper interventions, you're going to continue to spin your wheels in the sand.

 

[earthprowler]

If your son truly has bipolar disorder, it's important to treat him with mood stabilizers and sometimes an atypical antipsychotic. Both stimulants like Focalin XR and SSRIs like Prozac (and I suspect you mean 5 mg because it's almost impossible to make a dose of 0.5 mg even with liquid Prozac) can make kids with BiPolar (BP) much worse. Lithium is a mood stabilizer, but it can't always work its magic against the bad side effects of Focalin and Prozac.

You won't really know how Lithium is working unless you ditch the Focalin and Prozac plus get a blood test to see if he's in the therapeutic window to treat BiPolar (BP). Furthermore, kids with BiPolar (BP) frequently need to be stabilized with two mood stabilizers plus an atypical antipsychotic. It's a very hard balancing act to get the medications right.

Has your difficult child undergone any neuropsychological testing? Can you get a second opinion with a psychiatrist who is experienced with treating pediatric bipolar disorder? Without an accurate diagnosis and the proper interventions, you're going to continue to spin your wheels in the sand.

he has seen a neurologist who said he was ADHD with comorbidity after taking a two hour test. the list is very long of what they came up with. right now he's seeing the most sought after psychiatrist in our town and he's been in psyciatric medicine since the 70's. he's the one that's been prescribing all the bipolar medications and that's been since October. i'm already worried about the long term effects of the medications not to mention if he's not bipolar and has been treated with medications like he is, i'll blow a gasket. i know the medications can't treat it all, he has to learn to control his emotions as well. the counselor he is seeing right now deals with children and he will be going there for at least 3 months and she'll be able to also make the call whether he's bipolar or not. we see the psychiatrist again in a couple of weeks and i'll ask about the medications. thanks for your help, i would have never known that.

 

[Lothlorien]

I see the medications he's on and in my opinion, if he's adhd, the Prozac is going to make him super hyper. That was a terrible drug for my difficult child. She was on it for a few weeks and she was completely out of her mind.

What was the dose of Abilify? Seems like the docs don't want to go up high enough on the Abilify. Missy was only on 5mg and it fizzled out in a couple of weeks. She's on 7.5 now and they will probable increase to 10 when I go in next. The abilify is supposed to help with the hypomania or mania.

I also would second the opinion of smallworld that you may need to look into a mood stabilizer. How long ago was he diagnosed with bipolar? Is that why he's on the Lithium?

 

[smallworld]

You might want to check out the following links about BiPolar (BP) in children:

www.bipolarchild.com
www.bpchildresearch.org

 

[smallworld]

Lothlorien is right -- Abilify is not dosed by age or weight. It is dosed by clinical response. Sometimes APs like Abilify work and then fizzle out so the dose needs to be increased over time or the child needs to be switched to another AP. But again, not much will work in a child with BiPolar (BP) if stimulants and SSRIs are also present.

 

[Steely]

Welcome to our board. Your son sounds just like mine at that age - and oh boy - is it horrible. We almost has to move, probably should have moved, because of the reputation he created in our neighborhood.

Just a few things.
-The medications he is on, are probably not the right ones. Both Focalin and Prozac can increase impulsivity.
- In my experience, many times, the most sought after psychiatrists are the worst. They become too conditioned to treat the main streamed kids, and our difficult children are not. When I finally found a psychiatrist right out of medical school, who was creative, and innovative, and full of new knowledge, things finally turned around.
- A neuropsychologist exam should be at least 8 hours long. After which they can rule out things like Aspergers, Learning Disabilities, or any neurological deficits. They can also guess on mood issues, but it is still not an exact science, and many of these diagnosis can only come in time. I knew my son was bi-polar since he was little, his moods were all over the place. He would go from happy to sad in seconds. However, it took time for the illness to form enough of a cycle, that doctors could actually diagnosis it.

Welcome to our board. You have found the most informed group of people I know, not to mention the most compassionate.

 

[Christy]

Sorry for what you are going through. You're in the right place, welcome!

I feel your pain when it comes to neighbors. We try to keep our son in the backyard because when he plays with the other kids in the cul de sac it's a disaster. Partly due to his temper and partly because they get their kicks from pushing his buttons.

My son is also ADHD and bi-polar and stimulents like foccalin make him incredibly agressive. Check with your psychiatrist this could be causing a lot of the problem.

Good luck and keep us posted.
Christy

 

[Marguerite]

I've got a few concerns about the labels also. It's wrong, but I think you need to educate yourself as much as possible, on medical terminology. I mean, we shouldn't have to do it, but doctors sometimes use medical terms far too loosely and it can mislead us. They don't necessarily intend to mislead us, it's just tat it happens unless we read almost enough to qualify as doctors ourselves!

For example, you have been told he's got ADHD with comorbidity. But "comorbid" just means he's got something else in there too. The doctor just hasn't specified exactly what. But he may have, in his conversations with you. Were you talking bipolar at the time?

Also, Pervasive Developmental Disorder (PDD) needs to be ruled out. It often gets misdiagnosed as BiPolar (BP) (and vice versa) as well as ADHD. Two hours is good, but often not enough on its own to really nail down a diagnosis. You often need other specialists to each put in their oar and together, all the information should point to something more specific.

Right now it seems they're playing guessing games with the medications. "Give him this, see if it helps, and that should also give us some guide as to what it is that's wrong with him."
It may sound crazy, but there are a number of medical conditions which get treated this way routinely, at least by some doctors.

Also, check out "The Explosive Child" by Ross Greene. It could give you some practical help NOW in dealing with him. You can also use the same techniques on PCs. Hey, you can even apply it to the immature neighbour!

I'm also wondering why his sister is a target - it could be quite simple. She is much older than him, but not old enough to justify (in his eyes) her taking on a parental/disciplinary role. I've seen almost exactly the same thing in our house - difficult child 1 would attack his older sister (took a screwdriver to her once) and they fought at times like Kilkenny cats. And now difficult child 3 gets very upset with easy child 2/difficult child 2, whose sometimes shrill insistence on him doing everything exactly right (by HER definition) annoys me, too, because she's trying to discipline him like a parent and often undermining what I'm trying to do. People looking on could wonder if she is his mother, not me. I suspect your daughter isn't anywhere near as bad as easy child 2/difficult child 2, but it really doesn't take much at all.

My Pervasive Developmental Disorder (PDD) son became very aggressive towards people he felt didn't like him or who he felt were not being fair to him. He would use whatever language he picked up, that had previously been directed at him. Generally it was from other kids at school taunting him. So we would hear phrases coming out of difficult child 3 such as "dummy", "retard", and others which the site would definitely censor. They were exactly the sort of labels tat would get thrown at a kid like difficult child 3, who all these kids knew was slow to learn to talk (not all Pervasive Developmental Disorder (PDD) kids are slow to talk, however).

If your son is feeling frustrated and angry, but lacks the social skills to handle it, what you are getting now is the result. And there can be many possible reasons for this, BiPolar (BP) is just one possibility. ADHD is another. Pervasive Developmental Disorder (PDD) is yet one more. And again - many more.

Sometimes we look for a specific label and thing, "That explains everything," when it actually doesn't. What we are dealing with, by the time a few years have passed, is no longer the problem they were born with, it's been compounded by the social overlay caused by all the negativity, unpleasantness, aggression, bullying etc that goes on. For every failure, every mistake, every harsh word, there is a negative consequence on the child's behaviour.

Please be aware - I am not blaming anyone here. This is just what happens to all of us. We are all a product of our upbringing and our environment. This in turn is affected by what we already brought to the table in our genetic lottery. Think - what was Helen Keller like, before Annie Sullivan came into her life? Again, she was the product of her own nature plus her environment, which was indulgent but directionless. As a result, she was a wild, angry creature. When you can really get inside the head of someone who has problems, you can begin to see why they are angry, frustrated, depressed and therefore lashing out. And when you can se this you stand a better chance of changing the direction of where they are going.

The book helps. While you wait for doctors to actually DO something helpful, this is something you can do NOW.

There is some discussion of this book in Early Childhood, or you can Google it for more info. There is a sample chapter online. Your library probably has a copy.

But you need us. We can help. And remember, we are generally parents just like you, but some of us are a bit further down the road and can share with you our mistakes so you can avoid them where possible.

get your husband to lurk/post here too, if he has the time. it can make a huge difference in your communication with each other. And especially with difficult children, you need to be on the same page.

Welcome.

Marg

 

[earthprowler]

Thanks to everyone! wow! i don't get this much help from the doctors!

Marguerite: thank you, no when he took the test it was because i had met with the neurologist and she suggested it. we knew he was ADHD but none of those medications were working for him at all and he'd been on about 6 in a year. we weren't talking bi polar at all but it was easier to take test results to the psychiatrist, counselor, psychologist, who ever instead of trying to explain to each and every one what was going on and not get it right each time. it wasn't until i finally asked the psychiatists assistant "what is wrong with him?" they told me that he was bipolar. "oh"..........well they know best i thought. but things keep going at the same speed as they always have just not the level. you never know what's coming next with him. and if he's behaving, it's wonderful but then he goes to play out side and i get a phone call from someone saying "difficult child said this or he did this"..........ugggh.....the kids are even starting to call me!

i will look into the book, i got some books friday on defiant kids.

From Defiance to Cooperation
Your defiant child, 8 steps to better behavior
Facing ADHD
the explosive child was checked out so i will try to get that one soon.

Smallworld: thank you! i've been to all of those sites and am registered on two of them.

So the drug combination that he's on presently, from what most of you are saying that would be why he bounces one minute, explodes the next and then is calm, cool and collected and acts like there's nothing wrong. is that about right? that's what happens. he's like a golf ball. he's wound so tight in the middle (rubber bands) that if you bounce him too hard he'll explode, but if you are nice and gentle it's going to take a while but he'll still explode, you just don't know when it's going to happen or why. i'm tired of all the drugs he has to take, i feel so bad for him, he hates taking them especially the prozac, it breaks up and tastes nasty. he takes more medications than my husband with diabetes almost. but with out the medication, it's 100% worse! especially at school. and the lies he tells are rediculous! you aren't sure when he's telling the truth and when he's lying, he almost has to stand on his head to get you to believe him because of being caught in so many lies. And he's already labled at school as a trouble maker. when ever something happens, they single out difficult child as the one that did it, even if they have no proof. i've seen them take the word of a first grader (no lie!) over an adult because they are convinced difficult child did what ever it was. am i babbling? sorry. i tend to go off into a rant.

anyway, i'm hoping that the new psychologist can help shed light on what's going on with difficult child with play therapy which he loves. we just started it last week, so we'll see how things progress with it and what she says.

have any of you ever heard of any of the kids going up against females but not males? he normally won't push the limits when there's a male around, but will act up for girls, women even the ones he doesn't know! just thought i'd ask.

Thanks again to everyone, i wish i'd found this site sooner!!!!!!

 

[Lothlorien]

So the drug combination that he's on presently, from what most of you are saying that would be why he bounces one minute, explodes the next and then is calm, cool and collected and acts like there's nothing wrong.

That's probably exactly right. I don't know anything about focalin, but from the things that you are saying, I don't think he's on the right medications....especially that Prozac. You seem to be on the right track with this new doctor and psychologist. They are waiting it out before giving a definitive diagnosis, which I think is probably best. But you really should talk to them about the medications that he's on and making the adjustments.

Before you d/c the Prozac, if that's what you decide to do....make sure that you do it with the doctor and at levels. Completing d/c'ing Prozac can have some serious negative side effects.