What/where now??

Discussion in 'General Parenting' started by Mag, Apr 14, 2007.

  1. Mag

    Mag New Member

    My difficult child is nearly 17 now, has been diagnosed with ADD, Obsessive Compulsive Disorder (OCD), and Pervasive Developmental Disorder (PDD) -- with facets of Asperger's and/or Bipolar....they can't seem to decide on anything specific. We've been dealing with different aspects of all this for years, but the biggest and worst now is the rage that's been escalating over the last year or so. He sees a wonderful psychologist every week who has taught him every coping skill/anger management technique in the book, went through a gamut of medications with his psychiatrist, and just finished 5 weeks in a group therapy course that did absolutely nothing. He finished yesterday, and already he flew into rages because (last night) he couldn't have pizza, and (this morning) couldn't ride his bike until he'd done his chores. He literally has tantrums like a 3 year old....screaming, crying, kicking....but then goes into throwing chairs or whatever else is handy, screaming profanities, lashing out with whatever is around.

    He's recently been switched from Trileptal to Depakote and we're waiting for his bloodwork results to see what his levels are. But we're at a loss otherwise....what do you do for anger management when they WON'T use what they've learned? There's no consequence or reward that makes the slightest difference to him, nothing we can "hold over his head" so to speak to give us any leverage. It doesn't matter to him a bit what he'll gain or lose if he stops at that moment. We've mainly been told to call the police or 262-help, but boy, that's hard to do. We just don't know where to go from here :smirk: Any suggestions? :smirk:
  2. guest3

    guest3 Guest

    maybe if you do call them once that will be enough to help get him in line. My difficult child II has been for an emergency psychiatric evaluation and boy if we bring that up when he's flipping out he registers it and does not want to do it again. I feel for you we will be where you are soon I am sure as my difficult child II is way out of control and Psychiatrist and counselors think he's such a great kid! Which he is, but a big LIABILITY, when he loses it.
  3. ROE

    ROE New Member

    Your difficult child sounds a bit like my difficult child up until about the age of 15(he's 16.5 now). I am no expert on medications but in my opinion I'd be looking at his medication. mix. Maybe his behavior will improveme when the depakote kicks in. When my teenage difficult child was tantruming like a 3 year old, and I know what you mean... I believe there was something chemically going on (my difficult child has no history of sub. abuse) because he was not like that all of the time. in my opinion if the medication. mix is not right the coping skills and consequences are not going to matter, which you have indicated. been there done that too. I also got the same advice about calling the police.

    Sorry I am not more helpful. Good luck.
  4. Mag

    Mag New Member

    I guess I'm afraid of what happens if we DO call the police. I think it WOULD help him....scare him a bit into thinking next time. But I'm not sure just how much calling them sets into motion? Would they definitely take him off to be hospitalized or just talk to him first? I know the second they got here he'd calm down immediately --- he won't rage in front of other people.
  5. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    He may not be NOT using it, but CAN'T use it. Therapy isn't very useful (firsthand experience here) unless you are medically stable. Are you seeing an improvement or is he even worse? I didn't like the affect antidepressants had on my kid. Prozac made her so angry she pulled a knife on herself. If he has possible bipolar, Prozac could be triggering him to be even worse, and I'd say, if medication related, it's not within his control. Depakote takes up to eight weeks to kick in and it has to be at a therapeutic level to help. I'm no doctor and this is just my own observation, but if I had a kid that age with bipolar, I'd prefer LIthium or Lamictal to either Depakote or Trileptal. From what I've seen (admittedly, I haven't seen everyone in the world, but do have bipolar and have been in self-help groups) Lithium and now Lamictal seem to work a lot better. Of course everyone is different, but Lithium has been the Gold Standard for bipolar for years.
  6. ROE

    ROE New Member

    That was always one of my concerns too. In my area, I don't think a call to the police would necessarily result in a trip to the hospital unless he was still out of control when they got there or there was alot of damage done.

    My difficult child was at his raging worst in his younger days (10-11). Although we were encouraged by t.doctor and p.doctor to call the police whenever he lost control. We never did. Maybe we were wrong, but I felt that as long as I was still physically able of containing him when needed I would not call the police. I didn't think it would accomplish anything but put his name into the system at a very young age. As a teenager, his tantrumming was not as prolonged. By the time the police would've responded, it would've been over. Many will disagree with me here, but I don't regret these past decisions. I would call the police in the future if my difficult child ever rages out of control again because I am no longer physically capable of containing him.

    If you think calling the police will help, than try it. You may want to talk to the PD ahead of time, let them know the situation...that your son has a diagnosis etc..This could be helpful if you end up contacting them repeatededly in the future. Your difficult child has an illness, he's not a criminal.

    Good luck.
  7. Mag

    Mag New Member

    I think that's a huge part of it, and that's what the program he just left didn't seem to get.....I don't think he CAN use it unless we find some medications that will help him become more stable. That's why I insisted on their psychiatric re-evaluating his medications, which is where the change to Depakote came in (he's been on 2 weeks today.) He has thyroid and pituitary problems, so I *think* Lithium is something they want to stay away from. I want to work him off the prozac, as well, which is another thing this psychiatric was willing to do, so I'm hoping with these changes, we can get SOME help for him to take the edge off, at least, and give him a chance to get stable.

    Thanks so much for your input!
  8. Mag

    Mag New Member

    It's not easy to call the police on your own child....even when things are really bad. At the same time I don't want it to become an idle threat. But with today being so horrible, I ended up putting him in the car an hour or so ago and going down to the PD. I felt like he needed to know we meant business and that we were running out of options as far as handling him went...that we weren't going to accept having things thrown at us and being hit and kicked and punched. The officer we met with was very nice. He gave him some straight talk about what would happen if they had to come out to the house, about being taken either to a hospital or to Juvenile Detention (and how since difficult child is only about 4'10" and 95 lbs at 17 years old) he'd be the bottom of the ladder as far as 'rank' goes. He didn't try to scare him, especially, but he did try to give him a honest picture that it wouldn't be a piece of cake.

    So while I don't think this is going to drastically change him, I hope it will at least curb him a bit for now....and I feel I've broken the ice if we really NEED to call them.
  9. Marguerite

    Marguerite Active Member

    Mag, you said, "what do you do for anger management when they WON'T use what they've learned?"

    You also noted MWM's advice on that - I'm with her. She & I each have at least one child with Pervasive Developmental Disorder (PDD), we have had a lot of practice and maybe made mistakes along the way as well as had some successes.

    The tantrums like a three-year-old - you are very observant. because that is exactly like what they are. he simply hasn't got the social skills to throw a tantrum like anyone much older.

    I've often described difficult child 3 to other kids, as being like a genius five-year-old. Instead of then expecting him to respond socially as an equal, they then have a better understanding if his behaviour is then not what they expect. If another kid doesn't understand (and if we don't understand, how can another kid?) then they will be afraid, and fear in a kid often leads to aggression and rejection. Once they have a more sympathetic understanding, they tend to be more protective and less judgmental. This then has a positive feedback response in that difficult child 3's behaviours improve as his anxiety level eases.

    With your son, you have typical teen hormones aggravating the problems. Boys that age are going to be more aggressive and even more impulsive (if that's possible). This makes it even harder.

    But by this age, they know what is right and what is wrong. The trouble is, they can't use that information when they are upset. Even as they lash out, they know it's the wrong thing to do, but they can't help themselves. You can practice and program them all you want, but if you can't program them WHEN THEY ARE ANGRY, it all goes out the window.

    However - when I joined this site, I was recommended to read "The Explosive Child" by Ross Greene. It took me some time to get my hands on a copy, but I still absorbed some useful info about it from this site which I began to use. But once I got the book from the library and began to read it, we saw BIG improvement, just form me subconsciously changing my attitude and methods of handling our son. Then I had to explain it all to husband, so he could get on board too.

    You might find it hard to believe, but there ARE some advantages to having a teen with Pervasive Developmental Disorder (PDD). They are loyal, once they give their loyalty. They are terrible at telling a convincing lie. They tend to be law-abiding, having an almost encyclopedic knowledge of what is right and what is not. Implementing this - it's another matter, when they are upset, but when they have control they are good. (I'm not talking about obeying parents, when they're given a task to do - that's another matter, and there is a good reason for this as well as a way around THAT problem).
    They are less likely to get up to mischief sexually, or with illicit drugs. They are far less likely to get involved in gangs, unless they're the innocent dupes being used.
    They're also generally very, very intelligent. They generally have a very keen sense of justice and fair play.

    I'm not saying it doesn't happen, but the odds are far less. And all these things can be used. It often means you need to change your way of parenting - some things aren't needed, other things you may have discarded, still ARE needed.

    The first, most important thing - try and get inside his head, try and see through his mind what is making him tick. And keep hold of this thought - inside, he's a good kid trying to do the right thing, but in despair at ever being able to get it right. No kid chooses to be bad. Aspie kids especially, want to blend in, or at least to have the skill to blend in when they feel they need to. But he's likely to be very frustrated with himself at his failure to "be good" and also with the world for keeping on changing the rules, when he's trying to understand them. His self-esteem is likely to be rock-bottom and serious depression is common. He needs to know you love him unconditionally - not easy when he seems so difficult.

    Sensory integration problems can make it harder for them to hold it together, and more likely for them to explode. Communication problems, such as misunderstandings, also add to frustration. Punishing these should perhaps be a low priority for a while. A rage out of frustration - it's often quicker to help him hose down the frustration, rather than punish for bad language in the heat of the moment.

    Giving him time to absorb an instruction, or to adapt to a required change in activity (I bet he plays computer games, and gets really aggro when interrupted?) can make a big difference.
    Example - difficult child 3 is playing a car chase computer game. I call and tell him his dinner is ready. he either ignores or says, "In a minute!" He might even answer rudely, and scream at me to go away and stop bothering him. While this is unacceptable, it is natural. I don't immediately punish because there's no point - pushing the point is only going to cause a meltdown and I STILL won't get what I want - compliance.
    So I get a brightly-coloured Post-it note, write on it "Dinner is served - 7.15 pm" (or whatever time it is that I have called). I ask him how long he will be, before he finishes the run or he gets to a save or pause point. If he gives me a time more than ten minutes away, I ask him to pause it before then. But I write down the time we agree on, under the first time. I stick the Post-It note where he can't miss it (say, the corner of the screen, but where it isn't obscuring his game) Then I walk away and set the oven timer.
    When the timer goes off, I remind him again, "Dinner's ready!" and I add, "you said you would have stopped by this time, you agreed."
    If he replies with, "I don't remember you telling me!" (and of course, he may not - these kids may reply with all the right noises, but totally blank out what you said) than I point to the note, and he can't deny it.

    The first few times can be hard, but you HAVE to keep calm and not punish. Just point out that YOU are talking politely, and you are trying to do the parent thing by feeding him (or reminding him to have his bath, or whatever it is).
    And the best thing - the penalty for non-compliance is a cold dinner, eaten alone. Natural consequences. No punishment enforced by a vengeful parent (which is often how they perceive punishment - definitely non-productive and not healthy).

    A lot of the raging in Pervasive Developmental Disorder (PDD) comes from fear, frustration or anxiety. Punishing someone for an adrenalin reaction doesn't work - it's like punishing someone for being afraid of spiders. It's only going to make them MORE afraid of spiders.

    Anyway, I've only touched the tip of the iceberg. Don't try to do too much at once, only deal with one tiny part of the problem. Consider him as a really untidy room which would benefit from being scraped out and dumped in a skip for total disposal and replacement - only somewhere in there is a precious, priceless, fragile object. So you clean the room slowly - no hurry, no timetable, only time and meticulous patience is needed - and slowly, slowly, remove and tidy, square inch by square inch. Keeping calm always and treating him with the respect you want him to treat you - if possible - helps. It all may seem like you're giving way and spoiling him, but it actually works a different way.

    Read the book. Or read the thread on Early Childhood, which discusses the book. It will explain it better than I can.

    by the way, I just heard easy child 2/difficult child 2 tell difficult child 3 to get off the computer game, it's 10 minutes since she warned him that it was time to stop gaming and begin his evening routine. He immediately turned it off with good grace and has got on with his tasks. Unheard of, even six months ago!

  10. Big Bad Kitty

    Big Bad Kitty lolcat

    WOW, Marg. What a wealth of information.

    Mag, my prayers are with you. I hope something that someone said helped you. It sure opened my eyes.
  11. KateM

    KateM Member

    Hi, Mag. Your difficult child is very similiar to mine. He was on Depakote for several years and it was the best medication for him! It really helped with controlling irritability and lability. Unfortunately, he had to go off it because it raised his bld ammonia level.

    We have tried several other medications, but none have been as effective as Depakote. You are correct about the thyroid problem and avoiding Lithium.

    Marg has given you great advice while you arewaiting for the Depakote to "kick in". It will take 8 weeks. Good luck to you!
  12. TerryJ2

    TerryJ2 Well-Known Member

    GREAT post, Marguerite!
    I love the Post-It note idea and the conversation, "I don't remember you telling me that!" LOL! So typical.
  13. TerryJ2

    TerryJ2 Well-Known Member

    He sees a wonderful psychologist every week who has taught him every coping skill/anger management technique in the book
    Mag, that reminded me, the other day, difficult child was trying to get me to go outside to play baseball with-him. I was sitting at the computer here and he came in 3X to remind me. Finally he put his hand on his hip and said, "TRANSITION TIME!" just like the psychiatric recommended. Too funny! Sometimes these things come back to haunt us.

    Good luck, Mag. You seem to be doing all the right things. Good luck with-the medications, too, especially weaning him off of them. Sometimes the combos aren't good, and with-the hormones, will change the results over time.
    Interesting about difficult child being short and bottom of the rank... during our tour, Ron told difficult child the same thing.
  14. Marguerite

    Marguerite Active Member

    A funny thing happened yesterday, when difficult child 3 went to play at his (autistic) friend's house. Friend's mother said over the phone, "Friend wants difficult child 3 to play chess with him."
    I told difficult child 3, who said, "Does Friend want to play chess, or is it his mother saying he does?"
    This was very perceptive for difficult child 3, and I later shared it with Friend's mother, who chuckled. She told me of a recent incident, she had been trying to get Friend to do something he didn't want to do (it might have been playing chess, or going to the beach). Apparently difficult child 3 had said, in patient, quiet tones, "If Friend doesn't want to do it right now, it's HIS choice, you shouldn't force him."
    It is exactly what I've been repeatedly telling difficult child 3 when he's nagging brother or sister to do something for him, when they really don't have to. One of those situations where you hear your own voice coming back at you, only in this case it was from another household, and he's told a parent!

    Basically, since I've begun modelling patience and consideration for difficult child 3, he's begun to take this on as his own behaviour pattern. Which is a darn good thing - people are less likely to want to kick his head in, and this is Survival 101 for him!

    Now if I can only stop him from teaching adults how to parent...