Symptoms familiar to anyone?

[oceans]

My difficult child had been diagnosed with major depressive disorder. Up until now nothing has helped his depression. With his hospitalization he
ended up on zoloft, wellbutrin and lamictal. His depression is now under control, but he is still having several other symptoms. Now that he is not depressed, his ODD has gone away, and he is talking about his other problems.

One of the issues is that he is now in a different hospital and since they never saw the depression, they don't believe he was ever depressed. They keep wanting to remove his medications. It is time to titrate up the Lamictal and they do not want to. It has been a constant argument about the fact that this combination is actually helping.

difficult child says he still has the following problems.

He reporting that he is flooded with thoughts and this causes him to have shut downs. He reports getting opposing thoughts and having sensitivity to over stimuli. He is unable to relax mentally. It is like there are too many programs running at the same time. He reports that two parts of his brain seem to be fighting with each other. He states that he can talk to people, but can't relate to them. He often feels misunderstood. He says that it is hard for him to understand what people are saying when he makes eye contact, because it is too much information for him. He says that he only gets 20 % of information if he makes eye contact.

The psychiatrist at this hospital says that this is probably why in the past he got an ADD diagnoses, but she does not believe he has ADD. She says it might be something else that is evolving that we can't diagnose yet. She thinks something is wrong with his thinking and that he might also be Pervasive Developmental Disorder (PDD)-not otherwise specified.

She started him on Zyprexa to see if it will improve any of the symptoms and if it does switch him to abilify. She still keeps wanting to remove the other medications. difficult child does not want them removed because he is finally not feeling depressed after many horrible years.

Any opinion of all of this? I know that you can't make diagnoses....just curious what you all think, or if you have seen any of these symptoms before in your difficult child's that have different diagnoses.

 

[Liahona]

On one of our visits psychiatrist recognized that difficult child 1's thoughts race and he is very destractable. So while his attention is all over the place his mind is racing. Its a wonder he learns anything in school at all. difficult child 1 is bipolar and ADHD and anxiety.

The eye contact thing reminds me of the autism spectrum.

Just my thoughts and I'm not a doctor and don't as much experiance as others here. I'm glad your son got the medications to help the depression.

 

[Fran]

Sounds like your son is similar to many of our kids in that there isn't one clear diagnosis of what's going on.
Has his mind always raced or is that since put on a new medication?
I understand completely about him sharing that he can only process 20% of what he is hearing because of his racing brain and his over stimulation.
My difficult child is very similar,although he has evolved out of the hypersensitivity and is appropriate with eye contact.
My husband studied with the radio on. It's as if he found a way to keep the other half of his brain busy so he could study. My difficult child never learned to accomodate his obstacles. (husband is not like difficult child in terms of function but has some of the thinking patterns)

The fact that he is talking and sharing will help him sort out what issues to advocate. If he doesn't want medications stopped I would definitely involve the prescribing physician to weigh in on what should be done.

We had a situation where a program wanted to discontinue difficult child's medications because he would be too drowsy. This was before they met him. It didn't happen because I stopped it. They were allowed to change medications only with approval of prescribing physician and myself. My difficult child hadn't had a drowsy day in his life.

The depression is like a blanket over all the other issues. You almost can't see them through that depression but once it lightens up there are other things that pop out at your difficult child as well as you.

I know how worrisome this all is because kids like ours just defy any common treatment plan. If it were a straight up diagnosis you could follow the plan but our kids don't fit in any one environment or school or medication.

 

[BusynMember]

My son had most of the symptoms, minus the racing thoughts. He has Pervasive Developmental Disorder (PDD)-not otherwise specified. I'd take him to a neuropsychologist to have him evaluated. They really do a bang up job of testing and can look for ADHD,Autism Spectrum Disorders (ASD) and beyond. If it's not a psychiatric problem, treating it like one won't help. Autism Spectrum Disorders (ASD) requires a different type of interventions and, yes, these kids neither understand people nor feel understood. Aspergers is the Spectrum disorder that does not include a speech deficit. Here's an online test you can take. It's not definitive, but it points in a certain direction. I found it accurate.

http://www.childbrain.com/pddassess.html

 

[TerryJ2]

I'd agree... a bit of autism in there, highly functioning, and ADHD, with-the racing thoughts. ODD is usually a byproduct of other things, but not always.
What a mess, that you have to argue your way through this,
Oceans! I wish it could be easier for you.

 

[DammitJanet]

Well Im glad that he can feel his depression lifting.

I really am not too sure about anything else. Personally I would want to allow him to be on the current medications long enough to see how he does and get him to therapeutic dose on the lamictal before talking about d/cing anything.

 

[Hound dog]

I think I'd give current medications more time, too. Then see where you're at.

But as for what he's saying, N has alot of the same complaints. But she also had them before the depression went away.

 

[Marguerite]

Do the online questionnaire that MWM posted for you. It really is a useful tool.

Also, just to point out - depression often goes with Pervasive Developmental Disorder (PDD) in various forms. Especially with difficult child 1, the over-exposure to too much stimulation has been a huge issue for him.

A lot of autistic people avoid eye contact when conversing, because they hear the person more clearly if they DON'T also look at them. Making eye contact often makes it harder for them to listen effectively.

Marg

 

[oceans]

Thanks- difficult child always had these symptoms..even before medications. He would only tell me about them and refuse to tell the doctors. I think he is feeling better and more accepting of help right now because the depression is lifted and more able to tell others.

What I really want to do is to titrate up the lamictal and keep the combination longer.

The problem is that he is in a state hosptial, and I don't seem to have much choice in the matter. The Dr did not want to increase the lamictal when I suggested it. She thinks his thinking is off base, and has already added the Zyprexia. She wants to decrease the Wellbutrin next. She seems to think that any changes he had is due to the structure he has there, even though he had the same structure at the other hospital for 3 weeks, but still had the depression. She never saw the depression that the other hospital and doctors saw, and is reluctant to believe it...even though everyone else she talked to told her that he had been severely depressed.

I know he needs the therapeutic help and structured setting the hospital is providing right now, and that he will learn new skills that he needs, but I am scared to death that she is going to destabelize him with medication changes and he is going to spiral downward again.

I did not want to do the anti psychotic again and told her so, but she really pushed me into at least giving it a trial to see what would happen. I finally agreed to a trial. The only way to get him with his outpatient psychiatrist (who would keep the medications and increase the lamictal) is to fight to get him out of there...and on other levels I know he is not ready for home yet.

We tried Risperdal before and after an initial good effect that lasted a few months it totally stopped working. When the dose was increased his mood cycled wildly up and down. He had gone up to 200 lbs on it, and I felt that in the long run it did more harm than good. I hate to have to see him go through something similar again....

I want him to remain stable like he is right now. I don't know what to do. This psychiatrist scares me.

 

[givnmegryhr]

Funny when I was reading your post ADHD and anxiety came to mind. Then I go on to read emily's and she said thats what her son has.So does mine although, I'm not too sure about the ADHD part. Does he say he gets anxious when talking to people and looking them in the eye? Just thinking logically, if he is anxious talking to them along with the racing thoughts(possible ADHD), that would explain why he wouldn't comprehend what they are saying. Has he seen a neurologist to count out anything physically wrong? Good luck , hope he is feeling better soon.

 

[rejectedmom]

I tend to agree with the doctor. To me (although I am not expert)it sounds like an Autisim spectrum disorder. Aspergers maybe? some of the drugs prescribed for mood disorder and ADD can actually relieve some of the symptoms of autism so I am not surprised about you noticing a difference. -RM

 

[oceans]

His first diagnoses was depression and ADD and we tried lots of stimulants and they never helped....actually seemed to make things worse. I was thinking that if he stayed stable on the Lamictal then adding back a stimulant might help. He is not anxious for the most part. I do not see anxiety and he says he does not feel anxiety. I can't see adding another antipsychotic when he is already on the Lamictal and that can stabilize the mood. Especially with the short lived effects of the Risperdal. I also feel he might very well be on the sprectrum,

 

[DammitJanet]

Ok...do you want my take as an adult with the more depressive end of bipolar?

I have been trialed on a couple of AP's and I dont like them. They tried Geoden and Seroquel on me. I wont take the others because of the massive weight gain potential. Seroquel was bad enough.

The AP's simply dont help me. I do have an anxiety component to my illness but I like an antianxiety medication better than anything else. It works, that is what it was made for and I have never had to increase my dose. Getting state docs to understand this is like talking to a brick wall. They are very set in their way of thinking and have a set agenda of what medication regimen they want to use for what disorder.

Try getting the notes from the other hospital showing his depression or see if that hospital would speak with that psychiatrist about what they saw as depression.

I will be honest...I would worry about him being on both zoloft and wellbutrin at the same time because of something called Seretonin Syndrome. Im not completely sure if lamictal would increase the chance of it or not but I tried to take lamictal and wellbutrin together to stop smoking and got incredibly sick. Of course, Im on a much higher dose of lamictal but SS is bad. Read up on it online. That may be what the doctor is worried about.

If you really dont like the course of treatment, then do some research and find out what you think he should be on and take it in. I have pitched fits before and finally got my way.

 

[oceans]

Thank you Janet. I guess I need to gather some information and become an advocate again.

I saw him today and he was not doing well. He said that he does not like how the Zyprexia is making him feel. He said that he feels like his is shrinking in his skin or that he is a tennis ball inside a basket ball. He feels withdrawn and down. He stares into space but does not have any thought as all. He wants his thoughts back again. He wants to feel how he did before this medication was started.

I need to help him to get off this...