What are our options - major rage going on

[TiredSoul]

I need to know what are options are when difficult child is having a full blown rage. husband is having to restrain him which always scares me because he is not trained to do that and difficult child can get hurt. This atmosphere is not good for any of us, including my 3 year old son who does not understand what is going on.

So what can we do? Do we call his psychiatrist? His therapist? Take him to the ER? Call a crisis line? What have you done in situations like this and what worked?

I just don't know what to do. I wish I could shoot him in the butt with a tranquilizer gun.

 

[smallworld]

You can do any of the options you stated -- psychiatrist, therapist, crisis line or head to the ER if the rage is serious enough. One of you should take your younger child to a safe place away from the action so he's not exposed to the rage (physically or emotionally).

After this rage is over (say on Monday morning), you need to call your psychiatrist and ask for a safety plan. It may include a PRN medication, a place to bring difficult child when he's raging, a place to call, etc. The psychiatrist should give you specific steps to take when your son rages.

Hang in there, Jules. We're here for you if you need us.

 

[tiredmommy]

I agree with Smallworld... it sounds like you need to to set up a formal safety action plan with the psychiatrist. Also, you both need to be trained on how to do a restraint properly and set up a safe area for easy child to go to during a rage. Chances are he's old enough to go to a room and close the door behind himself if there is something fun such as a special book or toy.

 

[TiredSoul]

Thanks you two. What is a PRN? The 3 year old jumps in and starts hitting and kicking Dad because he thinks he is hurting difficult child, he won't go to a safe place. I have lately been taking him in the car and driving somewhere. He usually falls asleep in the car - poor baby. I am drained and am going to try to get some sleep. Can you give me an idea of what a safety plan would look like? Also who does the training on how to properly restrain?

Thanks again.

by the way, you guys are awesome. I mean it, and thank you.

 

[smallworld]

PRN is an as-needed medication that can be prescribed by the psychiatrist to be used for rages. Examples are melt-tab Risperdal or oral-disintegrating Zyprexa Zydis. Both dissolve in the mouth and work quickly.

Every safety plan looks different. It depends on the resources available in your community and what the psychiatrist thinks your difficult child needs.

 

[slsh]

Training on restraints for us was done by our therapist. Your psychiatrist might also be able to. You need to make sure that *both* of you are trained and that it is documented in your son's chart that training was done.

I think you actually need to have 2 safety plans - 1 for which both of you are there and 1 for when only 1 parent is present. Most of the time around here, I was the only parent in the home. Up until thank you was about 9, the safety plan consisted of my youngest son taking my daughter, going into my bedroom (which had a TV and toys just for these occasions), and locking the bedroom door. His cue was simply me saying "Wee, get Diva and go." I would roll oldest into kitchen, since most of the fun and games happened in the living room or his and thank you's room. I would keep phone nearby in case things got insanely out of control, and I would restrain thank you. If he didn't chill out in a reasonable amt of time (10-15 mins), or if he was in one his mega-rages where it was impossible to restrain him, I would call 911 and request an ambulance to transport a mentally ill child. I *always* made sure to tell them it was a mentally ill child. I'd usually end up with- 2 or 3 police cars, the ambulance, and the head of EMT services for our village here. They got to know us pretty well very quickly, so they knew what to expect.

I would never try to transport a raging kid to a hospital by myself, or even with husband in the car. We had 1 incident where the meltdown started in the car with both husband and I in it. I ended up having to pull over because it was simply impossible for husband to manage thank you and protect the other kids by himself (and he's 6'5", 275 pounds).

For the few months thank you lived at home after age 9 (3 months at 12 and then 3 more months at 14), the safety plan changed. He was bigger than me and there was no way either husband or I could restrain him safely. Plan was call 911 and request ambulance, period.

I know 3 seems really young, but I would work with him on removing himself in case it's only 1 parent in the home during a rage. Diva was about 2-1/2 when thank you left for his first Residential Treatment Center (RTC), but even at that young age, she understood enough to go to my bedroom and at least close the door when I told her to go and thank you was raging. Plus, the flying objects were pretty scary, so she did get it.

I think which option you choose (calling therapist/psychiatrist/crisis line/911) has to depend on how unsafe the situation is. If you are able to contain difficult child, then the first 3 options are reasonable. If he's continuing to escalate or trying to engage in unsafe behaviors (knives and jumping out windows were the biggies when thank you was younger - when he was older he started taking swings at me and that was equally unsafe in my book), then you need to call 911, in my humble opinion.

Hang in there.

 

[TerryJ2]

I wish I could shoot him in the butt with a tranquilizer gun.

I LIKE that idea!

Since the others responded to a safety plan and what to during a rage, I'd like to respond to what you could do before a rage.

What happens just b4 a rage? Does someone use the word "no"? Is difficult child told to do a task? Is difficult child transitioning from TV to dinner or something?
Watch very closely for signs that difficult child is ramping up--foot tapping, pencil tapping, rapid fire speech, etc. Eventually, you'll be able to see it coming and then can give the PRN medication asap.

No diagnosis at this point other than ADHD and ODD? Any dr leaning toward Asperger's or bipolar?

 

[TiredSoul]

Thanks everyone! I will ask the psychiatrist about a PRN, a safety plan, and proper restraint techniques. I will also work with little brother to go to my room and lock the door when I/we give the command.

Terry, you asked what happens just before a rage - he has several triggers which include being told no, being told to do something he doesn't want to do, a friend leaving, etc - this one was because he lost chips (not real money) in an online poker game, and then I told him he could no longer play. I gave him chances to get it together and to control himself and he could not do that, so I signed him out and cut off his access. He went ballistic. He is like a wild animal with super strength. He only weighs 62 pounds but man is he ever strong. He will throw things, kick things, lift up furniture, etc. When husband holds him, he keeps going crazy, gets completely drenched with sweat, fights and struggles and doesn't give up for more than an hour. Usually when he is done, that's it and he is calm. Last night he remained so upset that he could not go to sleep and ended up crying himself to sleep in his bed at 1:30 am.

The psychiatrist that diagnosis'd him in 2007 mentioned a possible mood disorder but he was not diagnosis'ing bipolar at that time. I have looked at Aspergers many times and he just doesn't fit all of the criteria but he does some. He has poor social skills, bad eye contact (at times), high IQ, and before ADHD stimulant medications he was really focused on parts of objects and how things worked (we thought of him as a good engineer) - he also held better conversations with adults, he comes up with amazing ideas and totally does not think like a typical kid his age. He didn't line up toys or objects, but he was more interested in playing with other stuff than with toys. He is very smart. His Special Education teacher just mentioned Aspergers when we met. She said she could see a little of that in him. I mentioned it to the psychiatrist and I think he will look more into that possibility. The psychiatrist says he appears to be socially anxious in that he sits on the edge of the chair/couch when he talks with him and he does not answer opened ended questions like 'tell me about your day'. He also said depression in kids can present as irritability and/or aggression.

 

[HaoZi]

Sounds like mine. After bad experiences with two medications she went to hospital, was diagnosis'd with bi-polar and Asperger's (in addition to ADHD and ODD), got a medication wash and was placed on Zyprexa instead. She is improving every day and have not had a major blow-up since two days before she came home from hospital. She still despises no, but not as adamantly, and I've gotten better at re-directing her, too.

 

[Wiped Out]

You have gotten good advice-just wanted to send some gentle hugs your way.