Things are tough right now.

[idohope]

difficult child had been doing better. She started building a relationship with therapist. We dealt with school refusal by driving her to school everyday. Still some bad mornings but nothing like when we tried to put her on the bus. Then therapist moved and we could not see therapist anymore but difficult child was still pretty stable. Tantrums were infrequent and when they occurred they were shorter and less severe.



Then she got a stomach virus and was home from school for 3 days. She had a very hard time returning to school and separating from me. In the subsequent weeks there was a minor sports injury and a family vacation and this has sent her reeling to where we have been back to nearly daily tantrums, which have at times included her slapping me on the arms and kicking me or threatening herself with scissors etc.


She can also get very fixated. She was going to a sports event and was tantruming and insisted that I walk out the front door a certain way and was screaming at me and I had to come back in the house 5 times and walk out again until it was "right". We then went to the sports thing and she joined her team and performed amazingly. No one there would ever guess what we went thru that morning to get out of the house.


I have called multiple new tdocs that have been recommended to us. None are taking new patients. We are one month into a 5 month wait list for a neuropsychologist exam. I went to this practice because of a specific neuropsychologist that was recommended to me but they will not guarantee that I will be able to have the evaluation done by the doctor that I want.


husband cannot tolerate difficult children behavior. He cannot be calm when she tantrums. husband did not follow the majority of the tdocs advice when we were working with one. He wants to put difficult child out of house and screamed that at her during a recent tantrum.


The PCs are struggling. easy child 1 says I hate this family. easy child 2’s teacher has noticed that he is crying almost every day in K.


My plan is to identify a new therapist and a psychiatrist. We have not tried medications yet because difficult child has been so adamant about refusing to see a doctor and husband has been reluctant. I also feel that we have not gotten a valid diagnosis and I am hopeful that the neuropsychologist exam will provide some information. If difficult child continues to refuse to work with therapist or to take medications then I agree that we will need to consider placing her out of the home. But that to be fair to her we need to at least have her evaluated and try therapy/medications that are actually addressing the issues that she is dealing with.



I have started seeing a therapist for me so that I can cope with all of this and therapist has said it is a titanic situation. I cannot save everyone and difficult child, the PCs, and the whole family is suffering. But I am the mom. I feel have to save all the kids. I know from this site that sometime a Residential Treatment Center (RTC) is the way to do that but as you know it is a hard step to take. And I don’t know what to do when one parent says I can not live with and this she has to go (husband) and the other one feels that as her parents we need to step up the plate and that there are more options (e.g therapy and medications) that have to be tried first (me).


Thanks for listening...

 

[jal]

Has anyone diagnosis'd Obsessive Compulsive Disorder (OCD)?

She had her world turned upside down (losing therapist, illness, vacation). She is exerting control and putting that anxiety onto you. The demand for you to walk "right" out of the house struck me, because my husband has Obsessive Compulsive Disorder (OCD) and has to walk up the stairs to our home in a "certain way" or he does it again and again and sometimes again!

 

[idohope]

The only one who has "diagnosed" difficult child with Obsessive Compulsive Disorder (OCD) has been me. There have been other examples that I have seen that have made me think it. We have worked with three tdocs in the past. #1 did not diagnose difficult child at all. #2 said working diagnosis was mood disorder not otherwise specified and extreme anxiety. #3 said ODD. But no formal testing was done by any of these individuals. I am hoping that these issues will be better examined during the neuropsychologist evaluation (if we ever get off the wait list).

 

[Josie]

The making you walk in the door the "right" way struck me as Obsessive Compulsive Disorder (OCD), too.

There is a book by Aureen Pinto Wagner called "What to Do When Your Child has Obsessive Compulsive Disorder (OCD)" that is very helpful. You might look at that to see if you think she does have Obsessive Compulsive Disorder (OCD). If so, the book is very specific about what to do.

I "diagnosed" my daughter with Obsessive Compulsive Disorder (OCD), too, then I took her to an Obsessive Compulsive Disorder (OCD) specialist for confirmation and treatment. In my experience, not every therapist will recognize it and even fewer will know how to treat it.

My daughter had 2 neuropsychologist exams. I am not sure either of them could have uncovered an Obsessive Compulsive Disorder (OCD) diagnosis. They were more focused on cognitive functioning.

 

[Wiped Out]

I'm sorry things are so rough right now. I think seeing a psychiatrist is also a good idea. I'm glad you are seeing someone to help you deal with all of this. Be sure to keep taking care of you.

 

[smallworld]

I would skip the neuropsychologist testing at this point and get her into a psychiatrist and a therapist who specializes in Obsessive Compulsive Disorder (OCD). She needs therapy and medications. If you put together a good team treating her, they may be able to convince her to take medications.

Hang in there.

 

[JJJ]

Obsessive Compulsive Disorder (OCD) or maybe a Pervasive Developmental Disorder (PDD)-spectrum

Tigger use to insist the whole family stand just so before he could take his medications.

 

[Andy]

Smallworld, I don't know all that neurospychs test for. Would their tests reveal the Obsessive Compulsive Disorder (OCD)? I am thinking if it does that idohope should keep that plan going but still lower the priority of it as she puts all her focus on finding a psychiatrist and therapist that specializes in the treatment. My reasoning is that if she has not found a specialist by then and the neurospych confirms this diagnosis or anything else going on, then she might have the help of the neurospych staff in locating a specialist?

Also, if the therapist or psychiatrist would like her to have the exam, it is still on the books - no waiting another 5 months or more?

Idohope, My recommendation would be is to beef up the search for a psychiatrist and therapist but still keep that exam date. Do NOT wait for that exam or result of it in your search for further help for your child. However, Smallworld knows tons more than I do in this process so weigh her input heavier than mine.

 

[Marguerite]

Gee, I don't know about an out of home placement for difficult child. Not until you've tried one for husband first.

He HAS to learn how to behave in front of his kids. How can the kids learn to not throw tantrums, if dad screams at them?

Marg

 

[smallworld]

A neuropsychologist could diagnosis an Autistic Spectrum Disorder, as JJJ suggests.

A neuropsychologist would only pick up on Obsessive Compulsive Disorder (OCD) if he/she did projective/personality testing, and not all of them do. You have to ask for it and pay extra for it.

My younger daughter has severe anxiety with Obsessive Compulsive Disorder (OCD) tendencies, and she was treated with positive results by a psychiatrist (medication management and weekly therapy) for two years. We only did neuropsychologist testing at that point because my daughter began to have some difficulties in school. But we didn't need the testing for diagnosis at all. The psychiatrist nailed it.

 

[idohope]

Thank you so much for all the valuable feedback. After calling 5 tdocs I have a consult with someone this week to see if therapist would be a good fit. This therapist does not specialize in Obsessive Compulsive Disorder (OCD) but I will go talk to her and also continue to pursue other options.



It is complex. As we were leaving for vacation difficult child was clearly in high anxiety. She insisted that the seat in the car where she would sit be a specific way, which made fitting in the luggage impossible. But she would not get in the car or buckle if she perceived (princess and the pea like) that a suitcase was pushing on the back of her seat or if we moved or folded a seat to make room. So is it anxiety, is it sensory, it is Obsessive Compulsive Disorder (OCD), is it defiance? Is it all of them or something else?


Also after years of the school telling us that it is a parenting issue her teacher this year (who had her last year as well; looping class) said that she is worried about difficult child and that her highs and lows are too dramatic and at times have interfered with her academics, she sees her as a child at risk for behavior such as cutting and she thinks she has executive function issues.


I am not sure how a psychiatrist would evaluate what medication to prescribe. I thought that the neuropsychologist would be important to have done before medications to identify the right medications. But some of the responses suggest that may not be the way to go. I will keep on the wait list for the neuropsychologist but also pursue a psychiatrist appointment separately and more immediately.


Marg: The husband issue is huge. We were on the verge of divorce a year ago. There are other issues but his response to difficult child’s trantrums and his refusal to carry out what therapist suggest (when he agreed to it in the office) was the final straw for me. But we have not divorced yet and have been in weekly marriage counseling for about 6 months now. He is saying the right things about difficult child in counseling but cannot do it in practice. There are many days that I think we would be better off without him in the home but if we divorce he wants 50% custody, possibly splitting up the 3 kids. Each day I am weighing what is better, overall, staying married where I am there for the kids every day or divorcing and having the kids be alone with him. He is an involved Dad, maybe more involved than some in terms of say being at the bus stop 2 days a week etc, but he provides almost no structure and limited discipline but then explodes when it gets too much. But after discussion with a divorce lawyer and some comments from my counselor, my sense is that he would have a very good chance of the custody that he seeks. He does not hit the kids. We would be gone if he did. He has grabbed the front of their shirt and yelled in their face on a couple of occasions. Former therapist spoke to him very pointedly about what is allowed by CPS and what is not. He has a good stable job and is viewed by the world as a funny, laid back guy. But those limited people who have seen him get angry do not forget it. But yelling and even cursing at your kids does not preclude custody from an involved parent as far as I can tell.





Thank you again for all your input.

 

[Andy]

psychiatrists do have ways to evaluate how to medicate without using the neuropysch results. My difficult child was on medications for two years before we did a neuropsychologist. The medications he has been prescribed were perfect for him. They turned his life around (a long with tools that the therapist taught him). Our psychiatrist also took my concerns into account when prescribing. I was afraid of a certain medication because of things I had heard about it so he stayed away from that one. I was concerned about difficult child loosing his appetite so he was put on dosage times that would not interfere with meals.

We only did the neurospych to try to diagnos why he was still struggling in school. His anxiety was definetly under control but something was still going on. Up until the neuro, we did not think there was any ADD - however, the neuro did pinpoint a level of ADD. So, a medication for that has been added and now school is NOT a problem anymore. Grades have improved as well as his attitude to go to school.

Our psychiatrist gathered information from the school, history and current as well as medical and therapist records. He also had my difficult child do some testing on computer.

It is also my stumbling block when I think, "How can that person help?" I don't know how the professional operates or what information/tests are done so I too easily dismiss their importance.

I believe you will be surprised at how much the right psychiatrist and therapist can do. And if you are as lucky as I am, you will find two that work as a great team. The neuropsychologist may still be needed but be assured that things can be done outside of it.

 

[Andy]

P.S. Follow your mommy instinct. You know your child much better than the psychiatrist and therapist. Make sure they hear your concerns and understand anything you are hesitant about. They are human, they can easily overlook a red flag that comes up to you. An example was my son is not one that can loose weight so I spoke up and made it clear that I didn't feel the medication that could cause loss of appetite would be good. I just could not live with that side effect. So psychiatrist gave us a way around it in dosing times. Instead of an 8 hr dose that would affect lunch time, we go with two 4 hour doses that will be out of the system for meal time. If it doesn't feel right, follow your instincts until the doctor can explain it. Our psychiatrist had difficult child start EVERY medication at the lowest dose even if he thought it would be bumped up within a day. That also helped me. Each child is different and you don't know how yours will react to a medication. psychiatrist would say, "Start with this and if you feel a need to, you can bump it up to this." Always call psychiatrist's office if a medication is not going the way you think it should or you do not think difficult child should go through whatever side effects that may pop up.

 

[crazymama30]

Just an fyi, my husband and difficult child both have cyclic mood disorders. Both of them have some Obsessive Compulsive Disorder (OCD) tendencies that get better with treatment. husband used to count the stairs while he walked up them, for example. I would be careful and make sure you get good evaluations, the medications for one condition can worsen another. You are doing the right thing, get her evaluated.

As for husband? That is a hard one. If he is making the situation worse and shining everyone on and YOU do not want to be married anymore, you need to seriously think about what you want. You cannot change him, and you can only help those who want help.

 

[flutterby]

Obsessive Compulsive Disorder (OCD) falls under the anxiety umbrella. With severe anxiety, medications are going to have to be a factor.

 

[LittleDudesMom]

And looking for a psychiatrist in this situation will be more helpful than a therapist. I'm a big believer in "talk therapy" because it made a huge difference with my difficult child. But in this situation, a psychiatrist would be a better first fit.

Sharon

 

[idohope]

Thank you all so much! Much food for thought.

I am happy to say difficult child had a pretty good weekend and that is always a relief. Maybe with the vacation behind us things will improve a bit. I will work on identifying a psychiatrist.

Thanks again,