After calming down a bit and stepping back and looking at it, here's what happened regarding medications: Oct.- difficult child was majorly depressed, psychiatrist said we could try adding an AD and raising depakote to compensate. This was a concern for both psychiatrist and myself because difficult child apparently went manic due to an AD before and that's why he raised depakote, however, when difficult child first was titrating up on depkaote a year ago, that higher dose turned him into a person I never wanted to see again so it was immediately lowered back. psychiatrist said we could try this- maybe it would be different this time.
Then, difficult child got physically ill shortly after ( a few days) these medication changes and was rx'd other medications that can potentially cause agitation/stimulation, etc- ie, a potential trigger for mania. After being on all those medications a few days, difficult child started becoming agressive, so I put the ones psychiatrist rx's back where they were while difficult child finished his ones for the physical illness. I told psychiatrist about it and he was fine with that. Then, he said to try again, starting depakote first so we can see if it is the depakote causing the agression. If that goes ok, then start the AD and we'll see if he has any reaction to that. That was about 11 days ago.
Between ending the physical medications and talking with psychiatrist about trialing this new medication combo again, difficult child started cutting himself. About 3 days after raising depakote again, I had difficult child tdo'd for an inpatient evaluation. He was not violent at that time. The psychiatric hospital was aware of all this and chose to keep the depakote at the higher dose but not add the AD yet. yesterday, of course, I see the violence again. I think it is worth it to put the depakote back where it was and see if the violence and agression decrease.
Given that I see this in difficult child when moods aren't adequately regulated but not when they are, I agree that the correct medication mix will help the most. And, that's why I want him to be somewhere where he can get help. If the medicaid waiver comes thru, that will be at least a possibility and I should at least be able to get someone lined up to come and help deal with things when they reach crisis mode at home but don't meet psychiatric hospital's and insurance co's definition of acute.
