What do I do?

[Alisonlg]

Ok...so, things were going rather well with M, as you all know, with the exception of the increasing irritability and building bottled anger, which we addressed with the psychiatrist and he advised us to increase the Tenex and said that we should see an immediate improvement.

Fast forward to today, approx. 2 1/2 weeks after increasing the Tenex, and we've had 2 full blown violent rages and several other episodes/meltdowns of pure frustration, etc. Basically, we haven't seen the "immediate improvement" we were promised...if anything, it's worse.

Anyway...my question is two-fold.

1) While there can be several triggers for his irritiablity, frustration, and inability to cope, the triggers for his violent rages have been about him not getting what he wants. Example...one was on vacation...his grandmother had bought him several Lego sets to keep him busy during the week and she had given him one of them that morning. After he completed it, he wanted another one of them. It was the expressed intention that he get ONE at at time/a day so that they would last throughout the week, as she had only bought a few sets. So, I stood the position that he had already gotten his one set for the day and offered him other alternatives to keep busy, and he immediately went into a violent rage, punching, kicking, pushing his head into me, etc.

Today, he is not yet violent, but he has been crying, whining on the couch for almost an hour, and is on the verge of getting violent because he has already used up his daily allotment of video game time and he wants more time to be able to play with his friend when his friend comes over later. He knows how much time he gets each day and he chose to use it.

So, my question is...am I wrong? Should I be rolling over and letting him have whatever he wants to avoid these rages without limits (the limits are set...I mean, it wouldn't be like a Basket C situation where I just didn't bring it up...these are set rules already and he's throwing a fit to get around them...and if I try to basket B it...well, we've never had luck with Basket B...he never upholds his end of the deal, if you Know what I mean?.). I just don't know how to handle this. I feel so tired and burnt out at this point. I feel like everything I have read and done has just gone to mush and I'm incapable of knowing what the correct thing to do is anymore, because nothing seems to work anymore.

2) Would you call the psychiatrist? should I consider 2 violent rages (he knows about the 1st one) and several episodes reason to call or just par for the course? M has an appointment on the 22nd (in 2 weeks). I don't feel like we're in "crisis" and I feel like we could survive the next 2 weeks, but I'm not sure if I should call since we didn't see this wonderful improvement he thought we'd see.

Heck, maybe it's all my fault...I'm causing the rages/episodes by the way I'm handling it. :frown: Any advice you can offer would be appreciated.

 

[Sunlight]

you cannot let his rages and tantrums make him think that will earn his rewards. call the psychiatrist and report in on the medication not helping.

 

[busywend]

I have to say that once I let up on the rules, my household was less of a battleground. It was getting to the point where we were both becoming unhealthy with the way our house was being run.
Now, that does not mean she got free reign. But, expecting him to be able to stop a video game, using up a specified amount of time - my difficult child would have never been able to do that. She would have melted down everyday as soon as the time was up. It did not matter if I stuck to the consequence, dealt with the raging, ignored it, whatever - she never learned. Never figured out how to do something like this.

That is the underlying problem that I have faced. Getting difficult child to learn. I know she does not learn from punishments. Do I do it - yes. But, not nearly as much as I used to as it was pointless. I just had to let go of trying to teach at this time due to the battle that would ensue.

I have recently (difficult child is 16 now) started to implement some rules and consequences - 'do to get' type things. It is still a fragile ground we walk. But, she seems to get it a bit better. Have not had her just do something without being reminded - but it is better than it was at 12 and for sure better than it was at 8.

It was not how I wanted to parent. But, it worked better than my traditional parenting techniques.

 

[smallworld]

Alison, the psychiatrist said you should see an immediate improvement. You haven't. I'd call the psychiatrist and report what you're observing. I would not wait until the appointment to get a read on what's going on.

Summer is a hard time for difficult children because there's a lot of unstructured time. While I would absolutely not give in on limits already set -- but that doesn't mean you couldn't change some limits for the future -- I would try to avoid getting into these situations by keeping M busy. Not sure what he likes to do, but right now my girls are baking cookies and having a blast.

I feel for you. This is not an easy situaiton.

 

[Steely]

Ditto what busywend said........exactly, word for word, is what has wound up happening in our house....and may possibly need to happen in yours. All I knew is that I could not take the rages anymore, and I had to modify and modify until I was able to breathe. Now that he is 16 it is easier, but he is still wobbly between stability and not - so I tread lightly - while slowly increasing the expectations.

Definitely call psychiatrist - call him continously and have him tweak the medications until M feels better - that is what he is there for. Sometime I call the psychiatrist once a week when we are going through a medication change. And she will not change his medications if she is going out of town, so that she can always be in touch. You need that type of relationship with your psychiatrist - but sometimes you have to force it.

 

[BusynMember]

A few questions:
1/Did he do this before the Celexa?

2/I think you have to decide if you want to stop the rages or enforce discipline. If it were me, until he was more stable, I'd let some things go, but it's really up to your priorities.

Is he up for a re-evaluation? Doesn't seem like he has a firm diagnosis...
Call psychiatrist. My old psychiatrist felt Tenex was ineffective, but that was his opinion.

 

[Alisonlg]

Thanks for your thoughts and advice, ladies.

I called the psychiatrist, as you suggested, and the receptionist said it sounds like we should bring him in tomorrow, so we have an appointment for tomorrow. I'm not convinced the Tenex is doing anything positive...I'm really not sure why he's really on it at all, really. The psychiatric hospital psychiatrist put him on it to "keep him from boiling over" during his rages because he noted that while he was raging, it looked like his blood pressure was rising and he just seemed ready to blow...at least that's what he told me. Last I heard he either had a diagnosis of ADHD or a rule out of ADHD, so that may be the true reason they put him on it since we were unsuccessful with the Aderall and the Straterra...who the heck knows.

To answer your questions, MWM...

1) Did he RAGE before the Celexa? Is that your question? Yes...daily...for hours....sometimes up to 6 hours...we'd have to restrain him...it was awful. This was pre-medication and during our earliest of medication trials. It actually wasn't until the Celexa that the raging stopped. The re-emergence of the raging is recent...anger, irritability, and frustration has been slowly building over the past month+.

2) I see what you're saying. I don't want to see him rage and I don't want to have this "explosiveness" in my house. In fact, in the Parent Report and Assessement I wrote for him, in the last paragraph I wrote, "If we could remove the word 'explosive' from our vocabulary, this would be an ideal picture." LOL I just wish I had a proactive way to avoid this without outright giving him the impression that his rage "won" the battle, so to speak, Know what I mean?? I think I *may* have thought of a way, at least with the video game time...I might work, and it might not. I hope it doesn't backfire.

Re-evaluation! I almost have to laugh...an evaluation is something we've been pushing for, fighting for, you name it for so long. Ever since the begining of the year I've been trying to get him in somewhere, but couldn't...and then started his psychiatric hospital revolving door of admits...with no real diagnosis's given after all of that. Now, his psychiatrist just treats him. But, he starts seeing a therapist in a couple of weeks and I *believe* they have a neuropsychologist on staff, so this might be the start of something beautiful.

 

[totoro]

I am glad you called! And they are getting him in tommorrow. At least it will make you feel a bit better about the medications.

I feel for you about not getting a diagnosis. I just can't understand why some of our kids can get a diagnosis and some can't. I know it is complicated etc.
You just wish someone would spend time with them and actually see them, see the symptoms, everything.

For us the Mood Disorder/BiPolar (BP), Anxiety and Sensory Integration Disorder (SID) have been pretty consistant diagnosis's but in between that we have been told K was Pervasive Developmental Disorder (PDD)-not otherwise specified, Not Pervasive Developmental Disorder (PDD)-not otherwise specified, ADHD, Not ADHD, ODD, Not ODD, Yes ADHD...
It makes you want to scream. You want to not care about the "label" but it kind of makes a difference for parts of the treatment, especially medications. And unfortunately school.

Well I hope he mellows out and you get some answers! HUGS

 

[AtThe Brink]

Alison, how did the doctor appointment go? I was thinking about your post today. Sometimes I need a little time before I post my thoughts. So this is what I think. I think that there are just SOME things that aren't worth the meltdowns, such as the situation on vacation. But when it comes to something like him wanting to ride his bike in the street, etc. then THAT is something to battle about because it affects his safety. Know what I mean?? I hope they can help you and M get M's rages under control or at the very least manageable. HUGS!