bipolar child, behaviour escalating

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SarahP
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Date Joined Mar 2005
Total Posts : 1185
   Posted 4/17/2006 12:38 PM (GMT -7)   
I posted here before about my daughter and got some great input, so thought I'd ask for more.
Her therapy center has a two month wait for med eval, and I haven't even gotten a call to set up appt. yet. She is 11, bipolar, ADHD, and ODD and on no medications at all right now. She was marginally manageable up until the last couple weeks, but now it's gotten WAY out of control.
Little things like me attempting to brush/fix her hair (which she refuses to do) turn into total battles.. I mean screaming, becoming verbally abusive,etc..
An example of her behaviour: Saturday night her older sister seriously injured her knee in a softball game, so we made an ER trip. I could not get my daughter to sit in a chair in ER and be quiet. Every two seconds she'd pop up and do SOMEthing to her sister. Annoy her, touch her, make fun of her. And this child was in pain and not needing the extra annoyance.
It's like she's running on speed right now. Doing odd things like pulling up her top and exposing herself to her sister and doing the same thing while sitting out in front yard under sprinkler.
One minute I think I have control of her, and she does an end run around me. I'm spinning in circles with this child, and have no idea what to do. I don't really want her on medication, but right now it's not an option to leave her unmedicated. Something disasterous is going to happen. Her pediatrician refuses to medicate her at all, he said her therapist needs to deal with that. Short of hauling her in the center and making a huge scene, I have no idea how to get this process speeded up.
Any suggestions? Thanks everyone for listening.
Sarah
I'm not procrastinating----I'm still doing yesterday!!!! 
I have no medical training, any medical opinions expressed in my posts are just that....opinions.


Putter
Regular Member


Date Joined May 2005
Total Posts : 204
   Posted 4/17/2006 1:05 PM (GMT -7)   

Sarah, I'm sorry to hear that your family is having such a rough go of it lately. Just wondering if you have considered a second opinion from your family doctor, or asked for another referral. I completely understand where your doctor is coming from in regards to wanting a more experienced opinion prior to writing a prescription, but asking you to wait two months without any help is a little much considering the circumstance. Is there a councillor at the school or school board who could write a referral to ask for more prompt assistance, or maybe another family doctor in the area who has some specialty in the area? From an outsider's perspective, it sounds unusual that there isn't anything the doctor could do for your daughter in the meantime even as an intermediate step. I've been really lucky to have a GP who is relatively accessible who isn't shy to call in help from his specialist friends and ask for advice and help me until I can get a regular appointment with the specialist. He realizes there are limitations, but there are times when it isn't reasonable to just say sit and wait.

I really hope that you'll find some answers for your daughter soon.
Take care,
Putter


putter@healingwell.net


tweety36
New Member


Date Joined Apr 2006
Total Posts : 1
   Posted 4/24/2006 7:46 AM (GMT -7)   
I know how hard it is to try and get help I have a 13 year old and she first tried to kill herself at 8 she has had to many atempts to count now i was told she was bi poler when she was 9 and it has been an up hill battle ever sence.I know when the dr would not give my child med and he wanted her to wait 6 weeks to see the phsy dr i made one of the hardest choice in my life and put her in a hospitial for 2 weeks it turned out to really save her life they got her on the right med and instead of 5 she only has to take 2 it really saved her life i hope you get the help you need i know it really stinks waiting

SarahP
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Date Joined Mar 2005
Total Posts : 1185
   Posted 4/24/2006 8:00 AM (GMT -7)   
Well... so far, he pediatrician won't touch it. He says he is not qualified to manage meds that she would need and he wants it done under physciatric oversee. Which will take at least two months. There are only two therapy centers here that deal with this and one place is horrid... tried that last year and it was (shudder) not a nice place to be. The place she goes to is great with therapy and wonderful staff, but ONE doc there who can script meds and she stays absolutely booked. Her therapist gave me the name of a Wellness Center that she said could possibly help, and I've called several times and no answer, finally get someone and waited on hold for thirty minutes, called right back, no answer.
We do have a mobile crisis thing, and the therapist told me not to hesitate to use it if I feel like she gets out of my control. I guess the next major "brawl" in my house I will have to use it and see what comes out of it. She usually ties up with her sister or brother and when I break it up, she becomes verbally abusive to me or to them. The " I hate you, this family sucks, you suck, you're stupid, I'm stupid, you hate me" variety.
Her sister who is 13 tore up her knee playing softball. While she was on crutches, my bipolar child attempting to kick her leg out from underneath her... she got whacked with a crutch in return. Then came running to me crying about it... she got a little upset when I told her it was a just punishment..lol.
I really subscribe to the policy of natural consequences, but it gets hard with the odd behavior of a bipolar child.
Sarah
I'm not procrastinating----I'm still doing yesterday!!!! 
I have no medical training, any medical opinions expressed in my posts are just that....opinions.


chrismom2152
New Member


Date Joined Apr 2006
Total Posts : 2
   Posted 4/25/2006 10:13 PM (GMT -7)   
Sarah
I know exactlly what you are seeing and how you are feeling. The only difference is that your daughter is 11 and mine is only 3 and she is bp, adhd, odd and we are looking at an anxiety disorder. I got to where i was scared for her. Im not sure where you live but this is what i did...oh yeah i fully understand about the pediatrician not wanting to do the meds. Mine is the same way in fact it has gotten to where now when ever i call all her nurse tells me is to call either my insurrance company or her terpist. Now Kamryn has a pcyhitrist and a psychologist. it took us from nov. 2005 to March 2006 to get her in. we just started her on respidrel and I dont know if it is even working. But I know what you are feeling I do. Back in Nov. I called her pediatrician when this all started and she told me to ask myself "Are you able to keep her safe or is it possible they could hurt someone else?" I learned that when she was at school i couldnt keep her safe so the last straw was when she tore apart the class room and they had to remove the other kids. I called the hotline for the childrens hospital out here in fort worth and they told me to bring her in tobe evaluated. She ended up staying for 7 days. The one thing that worried me is what are they gonna medicate her with and they reasured me that by law they can not give them anything with out your concent. The only thing they can give her is benydrel if she is not alergic. then they will contact you. I now feel  alot easier about admitting her if i have to now that i know the program. And only use a childrens hospital if you can. But the only thing you can do is love them and just hang in there. If you are going to do meds the hospital can get them going faster. I know it is frustrating and you just want to give up cause get that way almost everyday. between doctors and the battle with the school with this i just want to give up sometimes. so hang in there and do what you have to do with her just remember that you are the mother and sometimes you have to do what ever it takes to get your baby the help she needs. Sarah I am always here if you need anything.
kamryns mommie-sending hugs! Cause they help!!!!
sharalynn, and the kyds


tra
Regular Member


Date Joined Mar 2006
Total Posts : 100
   Posted 4/26/2006 8:18 PM (GMT -7)   
I know just what you are going through. I have a son who is almost 11 and is ADHD, Bipolar and ODD. He is on medication though. We still got through a lot of what you are describing every day. I would not hesitate to use that crisis center if it is going to get your daughter going on some meds. It is going to be a process of trying different meds to see what is going to work so I don't see why the pediatrician can't at least get her started. That is what mine did for my 8 year old who is ADHD, ODD, Depression and Anxiety disorder. The medication did not work, but at least we tried sooner rather than later. Good luck I hope it all works out for her...and you
Tra
 
mom to >
Kimberlyn-ACC, Seizure disorder and Brachial Plexus
Dylan-Bipolar, ADHD and ODD
Raeanne-ADHD and Anxiety disorder
Madalyn-our new addition


msauro
New Member


Date Joined May 2006
Total Posts : 2
   Posted 5/15/2006 8:36 AM (GMT -7)   
Hi,
I just found this web-site and I can honestly say, I am glad I did.  I don't feel so alone, I just feel bad that we are all in the same situation with our children.  I have 2 children, 12 year old girl and 9 year old boy, both of them fight like cats and dogs.  My daughter is mild MR and has social issues and a language disorder, she is around a 4th grade level.
My son is the opposite, smart as a whip, too smart.  He mimicks every behavior he sees, especially from her.  When he was 5 the school  thought he was ADHD, I thougth he was spoiled because he is cute and was always getting his way.  Everyone outside of the family continued to spoil him, give him everything, always telling him he is cute.  By the time he was in 1st grade, it was a nightmare, I was in school all the time, he was running out of class, verbally abusive, physically abusive etc. all because he was bored and he didn't like it when he was told he couldn't do what he wanted.  I had a therapist go into the classroom and observe him, she said it was the wrong class for him and the teacher, she just did not have the patience, and he figured out how to get out of the classroom by misbehaving, the pricipal refused to move him to another class.  2nd grade was a little bit better, I did try him on different meds for ADHD, he just got worse, it didn't surprise me because I didn't think it was ADHD.  I tried Strattera which seemed to help a little but the side affect for him was mood swings (outbursts of anger/frustration).  They said his mood/frustration was bad so I stopped the Strattera.  Part of this mood thing though was that the teacher kept making promises to him that she never followed through with, so she just kept feeding into his attitude and his behavior.  He is now in 3rd grade, the school has agreed that they can not handle him any longer because he is out of control (no kidding I said) I had been telling them that for years, is now in a 45 day program and they say he can not go back into public school because of his needs.  He has also been seeing a councelor once a week.  He is now on Strattera again, moods/frustation started again which actually have always been there except now he gets over things quicker.  At times he can be out of control, physically, verbally abusive, distructive and loves making up stories (he is trying to get me all to himself and telling stories about my husband and daughter) etc.  There has not been any clear diagnosis, some say ADHD, others say Anxiety with a little ODD.  The pychiastrist now wants to try him on Abilify.  I am not crazy about meds, however, I want him to be safe, I also want the family to be safe from him too.  He is only 60lbs and about 4ft tall, I don't want to start pumping him up with all of these drugs and have him get more messed up.  I am going out of my mind with his behaviors when he doesn't get what he wants, he just gets so mean and usually throws things (his gameboy or something).  Does anyone know anything more about Abilify or even if it will help him out with the frustrations/moods that he exhibits when is told NO?  I just don't know what to do any more with him, he is a charmer, cute and knows how to play people.  It is really scarey because at 9 years old he shouldn't be so good at getting what he wants from people, but he knows how to do it.  I know I am rambling on, but any help or advice anyone has would be helpful.  Thanks

Ellie 1
Veteran Member


Date Joined Apr 2005
Total Posts : 1291
   Posted 5/15/2006 3:40 PM (GMT -7)   
Hi Msauro,
Welcome to healingwell. I don't have any experience with a bipolar child but I was on Abilify myself. I did very well on it for the first couple of months. I just happen to be ultra sensitive to meds and became hypomanic with alot of anxiety once I had a therapeudic level in my system. This is NOT the average reaction. I have heard many, many, good things about this med. I don't know about it's use with children though.
Good luck to you
Take Care
Ellie
Good judgement comes from experience and alot of that comes from bad judgement.
 
Unknown
 
 

msauro
New Member


Date Joined May 2006
Total Posts : 2
   Posted 5/16/2006 6:31 AM (GMT -7)   
Thanks, I am hoping that the Abilify will work I am concerned about it causing more anxiety for him and him not eating.

Grams4
Regular Member


Date Joined May 2006
Total Posts : 29
   Posted 5/18/2006 8:26 PM (GMT -7)   
Hi msauro - I came to this site from the breast cancer forum.  Reading your posting about your son was just like reliving my life over for the past 6-years. My grandson (who lives with me and my husband) was having rages, psychotic episodes, getting removed from school, threatening to kill people, threatening to kill himself, throwing things when told "no", etc. at age 7-8 years. He was diagnosed as ADHD, then ODD, and most recently as bipolar disorder with psychotic features. He has had several different medications in the past years. Two-years-ago they added Abilify to his regimen. It was like a Godsend. He is so much better now. He is stabilized and has started being interested in a few things in life now. He sees a therapist every 2-weeks and the child psychiatrist every 2-months. He goes to group therapy through the school year. He is currently 14-years-old. He is also on Trileptal, Cogentin, and a little bit of Celexa for constant depression. We have to be careful with the Celexa though, as it can make bipolar disorder worse.

Good luck to you and your family. I hope something in my post can help you.


Dx: August 2004; bilateral mastectomies September
Diverticulosis, GERD, depression
 
Life is lived in the present.  Yesterday is gone.  Tomorrow is yet to be.  Today is the miracle.
 
The challenge may not be easy, but it is possible.


SMSIRL
Veteran Member


Date Joined Aug 2005
Total Posts : 1061
   Posted 5/30/2006 10:28 PM (GMT -7)   
msauro - you are right when you say "Part of this mood thing though was that the teacher kept making promises to him that she never followed through with". I've seen all these behaviours dealt with by proper therapy, but the biggest enemy is inconsitancy. It is important to choose your battles. It is also important not to forget to reward good behaviour or simply show affection. It is so easy to do when a child's bad behaviour over such a long period exhausts one. Life turns into a long set of battles where there is no energy left to be friends. However, if the affection isn't shown or praise not given then attention will be sought using any means possible. Children would rather have you angry at them than not pay them attention as they see it. If rules etc are incosistant then children will not learn, because they know there is at least some context in which they can use their current behaviour to advantage. It is only when there is never advantage to a behaviour and that there are alternatives that bad behaviours fall out of the repetoire. This brings another issue to mind, namely it is important for parents and any other care givers to be on the same page. If they are not it is a great predictor of problems. So, positions need to be worked through in advance by all involved. Choosing your battles is very important for the same reason. You must win if the child is to learn. You cannot, purely from an energy point of view if nothing else, win thousands of battles. So, if you try you will fail and the child will retain the negative behaviours. Furthermore, if everything with a child is a battle with a parent this leaves no space for positive experiences. This can lead to depression and low self-esteem. In those that are inclined towards "endogenous mood disorders" issues like this can help initiated the process.

With no particular reference to the individual cases above, any issues within the family need also be addressed because they frequently are sensed by children with issues and that has an impact on them for which they have poor capacity to address. So, periods of difficulty for parents such as bereavement are frequently triggers for periods of bad behaviour. I have seen much footage of work carried out by The Tavistock Centre on children with such behaviours. Interestingly resolving the problem in a number of case was centred around dealing with unresolved grief in parents. Once resolved the childrens' behaviour improved. The issue here was that grief had made one or both parents emotionally less available as the child saw it, and most of the interactions with the child focused on practical needs and controlling their behaviour. The child then used bad behaviour to regain what it percieved as lost affection. The parents then responded to the childs behaviour thus rewarding it with attention. The child then learnt to use these behaviours as ways to achieve its ends. This is why the problem seems to get worse when there are chrisis such as sickness in siblings etc. The child senses the parent being preoccupied as a loss of affection. So, they go into their repetoire of bad behaviours. In 2 of the cases in the Tavistock material no treatment was given to the child at all, as once the grief was dealt with the parents became available at times other than when behaviours were bad. Obviously, with behaviours that have been longer standing more work would be necessary with the child. These observation are as true for other people in the childs life not just the parents. Hence, the need for consistancy.
 
As an aside on consitancy between parents, it is often the case that the correct consistant position is somwhere between the two. As both parents usually try to counter what the see as excess of the other. So, the parent who sets limits often needs to do more of the affection showing and reducing the number of issues for which they correct the child, while the other parent needs to uphold new agreed set limits and correct the child.

Whatever, the chemical nature of the moods, behaviours can always be helped by using such techniques as are mentioned above. Some mood issues add complexity such as a feeling of being remote often interpreted as a loss of affection or being judged negatively and can be delusional. However, the response of seeking attention through acting out is not different in most case [very rearely they are directed acts]. Furthermore, remaining in the same relations to the child during these periods can improve the outcome. Be affectionate, and show interest, and don't equate the behaviour with the entirity of the child's personality. Recall with him//her warm memories of shared joy and pride in the chilld from their past and how they still are your loved child. This dosn't preclude limits but choose the battles carefully. The majority of the interactions with the child should be positive from their point of view. The limits set can then be seen as reasonalble and are circumscribed. Hence the child knows it is the behviours that are being sanctioned not them [if they feel the later the behaviours will be hightened]. Futhermore, this positive element emphasises that they can get the attention without causing grief.

After many years dealing with acting out behaviours, I can assure you that if you persist that things can and will get better. Just don't try make it all rigth at once, but make the important things right first. Finally also remember to look after your own health needs as you need all the energy you have.

Post Edited (SMSIRL) : 5/30/2006 11:37:14 PM (GMT-6)

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