We don't know what to think....

[waytootired]

Have have posted about a couple of these issues before but now I need big input...please.

When difficult child was three he showed signs of "Big Time" stubbornness, frustration and anger issues. If he was sent to his room for time out, he would push over his book case, tear the sheets off his bed and throw his toys around the room. We had to hold the door closed so he wouldn't come out into the rest of the house and destroy it. He usually fell a sleep in front of his door. He often would hit his head on the floor when frustrated to try to get our sympathy. We started behavioral therapy at age three and it helped for awhile.....He wanted to “always” be the one in control. My husband and I went to sessions too to learn how to deal with his behaviors.

About age seven or so, some of the behaviors were back and worse. difficult child just seemed crabby & irritable alllll the time, very negative and unhappy. It was suggested to us at that point to see a Pediatric Psychiatrist. He started difficult child on an antidepressant. We finally found an antidepressant that he could tolerate without side effects. The medication really took the negative edge off for about two years.

Gradually his behaviors worsened and were becoming HUGE, verbally abusive & violent towards my 13 year-old-son, my husband & myself. It was really ugly!! Very negative self-talk, " I hate myself" " I want to kill myself"" This family ", even cussed at us. There were times when he would turn over furniture, throw things at us, hit, kick and bite us. He has gone after us with steak knives, to where we have had to hold him down, lay on top of him and pry then out of his hands. We have locked him in his room with one of us sitting in front of his door (inside with him to make sure he doesn't hurt himself) while he destroys his room and says to me..."If you didn't weigh 800 pounds I could get out the door!" I sat and read a magazine and ignored what ever he said or did. I was very hard to just sit there, but that's what we had to do. There were times when we were very near calling the police.

Mood swings were huge! One minute he was angry at something that triggered an episode or rage and awhile later he was fine to be around, happy & silly... "cycling" right? He is very dramatic. Little things can become huge & serious. He could trip over something very small but the way he reacts you would think someone cut off his head. He is can be sensitive to loud noises that startle him. He is also very smart, above average in academics, can be very silly, funny, helpful and loving.

About a year ago we took him off his antidepressants and started him on a mood stabilizer. Going off the antidepressant, Effexor, was horrible!!! The worst withdrawal EVER. My poor baby was delusional, in pain, violent and out of control. It was so hard to see him go through it. It lasted a week. We had to send our oldest son to my sister’s house.

******* I know that if your child is bipolar, antidepressants should never be prescribed by themselves. It should be with a mood stabilizer. Antidepressants can make children with Bipolar worse!!!!! ******

His trigger are: When he hasn't eaten in awhile, when he is tired, or if there is a lot of commotion going on. He hasn’t been able to be on a team sport because he gets too frustrated with the competition and teammates, he gets to angry when playing shooting games on Xbox and Game Cube (we don’t let him anymore). We also get into trouble if he becomes board, he needs to be busy & stay busy all day. Routine is really good for him.

difficult child did well on the medication Risperdal, only after trying Depakote which wasn't a good medication for him. His behavior on the Risperdal was very manageable. We saw a big difference and he was able to control himself and his anger outbursts. Unfortunately after a year, his triglycerides and cholesterol became too high we had to go off.

As of a month ago, difficult child is not on any medications...Yikes !!!!. We and the doctor wanted to give his body a break from medication. He was experiencing a strange leg sensation towards the end of the Risperdal and I thought it was the medication & the doctor thought it was a behavior issue. Much to our surprise.....difficult child is doing quite well "Off" all medication !!!! He still has some behavior issues, quick to fire when frustrated, but no violence and a couple other little things but we are choosing to manage him without medications for now and go back to behavioral therapy. But..... if the" Wheels fall off the cart", we will not hesitate to try another mood stabilizer. He still has some of the leg sensations but they are not as bad. Maybe restless leg syndrome......

So of course now I'm thinking.....is he truly Bipolar? Maybe just borderline? Was it the antidepressants that caused him to become so out of control? Antidepressants and some mood stabilizers can cause children to have the opposite effect of what they are suppose to help...maybe he just has a mood disorder ?......So my husband are in a state of mind that we don't know what to think. We are just going day-by-day at this point and well see what happens.

I do need to say that all of these negative behaviors are only at home, for us, around close family members and only a few instances for us around family friends. Not at school...his teachers are shocked when we tell them he has been on medication. I hear that interesting enough that is common in bipolar kids. They hold it together at school but then let go at home...lucky us!

Forgive me...this is soooo long......sorry !

 

[smallworld]

Kids with BiPolar (BP) frequently have bad reactions to antidepressants. But a bad reaction to an antidepressant does not in and of itself lead to a diagnosis of BiPolar (BP). Kids without BiPolar (BP) can also have very bad reactions to antidepressants.

by the way, Risperdal is not a mood stabilizer; it is an atypical antipsychotic used for the short term treatment of mania. It also helps with anxiety and aggression. The first-line mood stabilizers prescribed to treat BiPolar (BP) are Lithium, Depakote, Lamictal, Trileptal and Tegretol.

Has your difficult child ever had a neuropsychological evaluation? That might give you valuable information on what's really going on.

 

[waytootired]

SmallWorld,

No he has never has a neuropsychologist evaluation. I've been thinking that's what I need to do. I can just hear my husband now "Why? He's fine right now,we can handle it." I am not one to wait for the Rage's to set in again !

 

[Sara PA]

He could have had antidepressant induced bipolar. Usually withdrawal from the antidepressant is the cure though chronic withdrawal can last months, as you probably learned if you did any research about Effexor withdrawal. (Yes, along with Paxil, it is considered the worst to withdraw from.) Or he could have bipolar which was made worse by the antidepressant.

by the way, Risperdal is not a mood stabilizer nor are any of the antipsychotic (aka "major tranquilziers"). It is approved for the treatment of, among other things, manic episodes of bipolar but it is not a long term maintenance treat to prevent or reduce the number of swings into mania and depression. Mood stabilizers are lithium, Depakote, Lamictal and Tegretol.

ETA: I didn't mean to repeat what smallword said. For some reason her post wasn't visable when I first read the thread

 

[busywend]

waytootired, I agree with husband. Hold off on any more intervention until you see a problem. Sometimes these kids get angry because of the dr appts and medications. It makes them feel so different than other kids. So, unless you see something that is impacting his quality of life - I would do the wait and see approach. Just my opinion.

 

[BusynMember]

I want to warn that it may NOT be bipolar. My son was misdiagnosed with bipolar for three years, and he also had a manicky like reaction to antidepressants. You don't have to be bipolar to have a bad reaction to antidepressants. Anyone can. My son is on the autism spectrum and does better off medications. He is doing great now, but we had to put interventions in place to help him with the "different way" he sees the world. If we hadn't taken him to a neuropsychologist, I don't think we would have shaken the bipolar label, although hub and I didn't really think he fit the bill (the kid was not really moody and medications made him more lethargic than anything). It is very hard to know for sure what you are dealing with. I highly recommend a Neuropscych evaulation. Yes, I know it's tiring and you've seen a hundred psychiatrists (so had we), but I do think it's worth checking everything out and leaving no stone unturned and coming as close as you can to knowing what is wrong with the child. My son was on at least ten medications--he had bad reactions to many and, four years later, is still very overweight from poor eating when he'd been on hunger-inducing medication. Your child MAY have bipolar, but I'd want a fresh perspective and another opinion because so many disorders look the same--ADHD/bipolar/autism spectrum disorder. (((Hugs))) I know how hard it is. Been there, done that. Do what your mom gut tells you--that will help you more than us. in my opinion, it's better to be safe than sorry. You know your son will eventually erupt again. I'd rather see somebody before it happens. The kids, in my opinion, already know they are different--they may not like it, but it's not a surprise to them. Good luck!

 

[Janna]

His trigger are: When he hasn't eaten in awhile, when he is tired, or if there is a lot of commotion going on. He hasn’t been able to be on a team sport because he gets too frustrated with the competition and teammates, he gets to angry when playing shooting games on Xbox and Game Cube (we don’t let him anymore). We also get into trouble if he becomes board, he needs to be busy & stay busy all day. Routine is really good for him.

Yeah, I was kinda thinking, this sounds more Autism type related than Bipolar. My son has both (lucky me), and when he is tired or if there is alot going on, stimulation city. He gets so out of control.

The difference between his inability to cope with stimulation and his manic episodes is that, his mania can strike even when there is nothing going on. He can be sitting, watching TV, lights off, quiet in the house, then all of a sudden have the urge to get up and dance, can't sit still, talk to himself, to anyone willing to listen, etc.

When he's in the classroom, say, or out in the community and alot of people are around, he gets more hyper, overstimulated, but it's a different kid of hyper.

I guess it's hard for me to explain.

Check out this website:

http://www.childbrain.com

It's got alot of Autism info on it. Not saying your difficult child has it, but maybe it's something to look into anyway.

 

[waytootired]

I never even considered that my difficult child would be considered Autistic. What make you think he might be? He has no delays of any kind..speech or any other .

Can you eplain?

 

[nvts]

Some autism doesn't show as a delay that is obvious to people. My difficult child 1 and difficult child 2 both have Asperger's syndrome which is considered to be on the autistic spectrum.

difficult child 1 spoke in tiny sentences by the end of his 9th month (I want that). He was holding entire conversations with everyone clearly and intelligently way before the age of 2 (telling my husband that a chrysallis is "just a caterpillars cacoon" and that it would mature in a few weeks" - - he was 1yr 10mos.). He was "creepy smart". But not get his way - BBBOOOOOOOMMMMMM!!!!!
The quirks started really showing up to us by the time he was 2.5 yrs old, but his doctor, teachers, preschool aids, etc. just thought he was hyper.

difficult child 2 had a speech delay so bad that most people still have trouble understanding him and his sentence structure is a nightmare! But he's a funloving, easy going kid who only wants to make people happy.

The point is: autism has more faces than you could ever imagine. Get a neuropsyche done by a neuropsychologist and keep your mind open to different diagnosis. It could be a "mind-blowing" experience and could possibly change the way things are done!

Good luck!
Beth

 

[TerryJ2]

Our son has a lot of similarities to yours. He is 10 now. For yrs, people thought I was exaggerating, told me "He's ALL boy."
When we put him in Time Out, he'd destroy his room just as you described. We reversed the doorknob so the lock faced outward. Sounds awful but it was safer for him. I'd always unlock it at night after he fell asleep. Right now he only has a mattress and bookcase in his room. (Oh, and by age 8 he figured out how to disassemble the lock mechanism so we had to come up with-another strategy to keep him in his room. I can explain it if you're interested.)

I had my difficult child tested for Asperger's, a form of autism, because of lack of eye contact, insistence on exact quotations in speaking and time, strict adherance to routine, and lack of creative thought. We took him to a neurpsych., who said all he saw was ADHD and other issues that must be handled in counseling.
Same thing with-the speech path that he referred us to.
The speech path did caution, however, that he only tests for glaring deficits, and if there is anything subtle going on, we'd have to figure that out some other way.
Our difficult child falls through the cracks when it comes to diagnosis.

He, like your son, has overstimulation triggers with-video games. It has to do with-the speed of movement and how it is processed through his eyes to his brain.
I have learned to hate PS2 and any and all computer games. Unfortunately, he cannot judge for himself when he is overstimulated ... he just continues on until he has a meltdown, which is why we ban most computer stuff.
He is highly allergic to wheat, which gives him ADHD symptoms. That in turn creates ODD. He's stubborn anyway (I've met his bparents and there's a definite genetic component there) but he's unbelievably defiant.
He's also allergic to red and yellow dyes and milk. We're still doing some food elimiations and it's time consuming.

Still, 99% of his acting out is at home, just as you describe.

I would wait on the medications, since you seem to be doing so well. Your difficult child is older now, and as you go through the diagnosis with-diff doctors, you may come up with-other ideas. And this way, when he rages, you'll have a much better idea of the cause, since you will have ruled out medications.

by the way, everyone is different, but our son's rages have improved immensely since he's been on Adderal. When he's off of it for a cpl days, it's like every little thing makes him angry. Especially me! He hears my voice and he whips around and immediately yells, "I KNOW! Quit bugging me!" 20 min. later, the medications kick in, he apologizes, and things calm down.

I definitely recommend The Explosive Child by Ross Greene. Most everyone here has had good luck with-it. The key is to figure out exactly what your difficult child's triggers are, and work with-them. What we did was deliberately recreate some of the triggers, such as unpredictability, and deliberately cause a meltdown, and he learned over the months and yrs that 1st of all, he's not in charge of our lives and schedules, and 2nd, since he can't control us, he'll have to control himself. (I can look up my old notes if you want to know more about that, too.)

I also bought The Out of Sync Child, which I recommend. It may help you, too, since your son may have sensory issues.

It's still possible that my son is bipolar, but it's pretty mild compared to others I've seen.

He's been tested as Learning Disability (LD) but is catching up (there are diff types and his is nothing permanent ... he's just very slow in sequencing, fine motor control, some cognition issues, and emotional development). Those test results helped a lot. Knowing he was developmentally behind made me more patient and taught me that he was not always deliberately digging in his heels; sometimes he just fell apart because he was overwhelmed.

We have made a lot of progress, despite the fact he's neither "here" nor "there," so we just work with-what we have.
Compared to 6 mo's ago, things are much better.

 

[waytootired]

The video game thing is if he's losing a competion or having trouble getting to a higher level he gets very frustrated. If he gets shot in a war game and dies than he gets angry. Whether he is frustrated or angry the bad language starts and has been known to throw the game controllers. He is very limited on what games he can play now. If its another kind of mellow game he is perfectly fine.

His hyperness is just annoying stuff..examlpe: repeating the same stupid phrases from Spongbob over & over while tapping pencils like drumsticks in the coffee table.

I am going to do some reading on Autism, probably more Aspergers than the others?

 

[TerryJ2]

The Spongebob repetition and pencil tapping sounds like ADHD.
What sorts of appts. do you have scheduled?

 

[ML]

My son does this too. We've broken controllers. He gets sooo angry and upset and cries and calls himself stupid and says things like "I never do anything right". All because of a stupid video game! And of course what does he want for his 9th birthday next month. A WII. And this pushover/shouldknowbetter mom is thinking about it.

As far as diagnosis, mine has ADHD and anxiety but has underlying shades of bipolar mixed with autism spectrum. They just get frustrated so easily.

TC

 

[kymomof3]

WOW! Your household sounds like mine! I mean it was like reading what goes on at my house only with someone else writing it. My difficult child has been having agressiong problems since about 18 mos. old. There has never been a DR, teacher, preschool worker, anyone that wanted to help me with his behavior issues. I just keep getting "hes all boy" from everyone. Well, as we speak, hes in a behavior hospital. I think its just more than all boy.

Until I found this site yesterday, I was beginning to think we were the only family with such a difficult child. Now, I see we aren't. Which helps my sanity.

difficult child is just starting to take risperdal, this will be his first day, today. He is in a behavioral health hospital atm. He does get to come home today. I have been praying and praying the risperdal will help. Im keeping fingers, legs, eyes crossed that it works.

 

[Kjs]

been there done that with video games. Thought he would outgrown that. Nope. 12.5 years old and still yells, throws controller, cries, shuts if off if someone is beating him. AGHHHH. He has PS2, xbox and Wii. guess what he asked for this Christmas? Xbox 360! Between the games he plays online with the computer, and the game systems he has now (plus the new little gameboy) he's not getting another game system. Especially when those cost about $500.

 

[Mrs Smith]

Mine still does it at 14yo. It has gotten slightly better though. He actually turned off the game on his own.

 

[nvts]

How are all of us fitting in one house? It seems everyone is having the same situation surrounding video games!

And our neurologist RECOMMENDED them for his eye/hand coordination (difficult child 1).

Here's what helped here:

1. invest in 2 cheap-o kitchen timers

2. set a time that they can play (I limit mine to 1/2 hour : anything more than that and he gets overstimulated)

3. set one timer and leave it in front of him and set the other and keep it in your pocket (so if more time gets added "mysteriously" you're aware of it)

4. spell out the rules EXACTLY! DO NOT LEAVE ROOM FOR THE "YOU DIDN'T SAY THAT, YOU SAID....

5. your rules need to include: length of time, touching the timer will result in losing the rest of your time, you can break the time up in incriments (say he wants to play one game on the computer and one on his x-box - and you allow 1hr total for all games, he can do 20 mins on 1 and 40 on another), ANY meltdowns will result in losing ALL of the time left over from the second the meltdown starts, if they start to feel frustrated they can turn off the game and give it a shot in a little while (then remind him frustration is that feeling when you're a little bit angry and you get that "icky" feeling in your head and/or stomach), as he shows more patience he can earn extra time over the course of time, ANY cursing results in the game being taken away and you'll make him watch teletubbies for a week (lol - that works here!)

What you're trying to do is teach him to identify frustration and the appropriate way to handle it by putting HIM in control. (that's why he has his own timer). Once you've handed him the responsibility, you go from "meanie" to Mommy/coach. It's working around here (darn! I probably just jinxed it!). Right now they're all trying to earn back the computer priviledges by speaking nicely to one another, it's been a week, but we're starting to see some improvement! :smile:

Hope this helps!
Beth

 

[TerryJ2]

I've heard you can buy programs that will shut off the games at a certain time. Can't find one, though. As it turned out, difficult child's computer overheated a lot and shut itself off, so we achieved our goal that way, LOL! The best part was that it took the blame off of me. :smile: And it absolutely helped him with-his transitioning issues. Hey, whatever works!

 

[TerryJ2]

Yes, there are some games that will help ADHD issues. We took difficult child to a biofeedback place and they gave him a game that was very slow, and helped him focus on one thing at a time. Very different from the fast-paced, shoot 'em up garbage he loves.

 

[waytootired]

To answer your question Terry, we don't have any appointments set up for now. We are doing the wait and see thing! I know..Yikes...We want to see what kind of behaviors stay and what goes away now that he is NOT on any medication. If we need to we will net make a neuro-psychiatric appointment next. I'm tired of leaving this to one psychiatrist. I'll bring in the "big guns" .....

My almost easy child has Xbox and difficult child has playstation2 & a wii. There are days when difficult child will throw a game or a controller in frustration, break it and then and turn around and want an XBOX360!!What!? Are you kidding me!? He just looks at me like, "Well..how about it!" Those kinds of thoughts,or lack of, just kill me.......