Help! Severe Aggressive/Defiant Behavior! - Page 3

[Oh the Irony]

I've dealt with aggression and I'm a single mom. I'm also self-employed with two small business and I know of the overwhelm and guilt which you speak of. I feel for you, I really do. My son would go off for 30-60 minutes but not hours. That was hard enough.

My then 4 year old (now 5) would hit me, pull my hair, bite me, kick, scratch, throw things while I was driving etc. He is also in play therapy with someone who does EMDR. I also had to physically restrain him while he raged. I've felt anger and a desire to physically hurt him that I didn't know I had in me--my older son was and is so easy to deal with.

I was really, really concerned about kindy. About if he would make it and what the hell I would do if he didn't. (He talks ALL day long and as an introvert trying to work from home with inadequate childcare it was overwhelming me) And yeah, worse for me than for my parents who babysit.

My last ditch effort three weeks before school started:

1) Got him on the Feingold diet. www.feingold.com Aggression is one of the listed symptoms--take the little quiz for him. It takes some work to get set up, but is good after that.

2) Started using the Nurtured Heart approach from the book Transforming the Difficult Child by Howard Glasser.
One of the big things for me in the book was about how our reactions energize the negative behaviors. They like the reactions. My son can totally push my buttons and I was giving him a "Show" for it. Toning down my reactions, setting clear expectations for behaviors, etc really helped.
He does suggest a point system but I find it quite different from some other systems. My son responded really well to it. You would need the book. This also takes some planning and effort.

It has been so worth it. The last time he hit me was BEFORE we started these. He can still be intense, but it is oh so much less. If he starts getting kind of wonky--I do look at myself immediately. Normally I'm stressed about something.

If he gets impatient, I may see how I've been impatient with him. And if I respond to him with impatience it all escalates QUICK. If I'm calm then he can get out of it.

My older son had panic attacks and anxiety/depression last year. I did everything I could think of: acupuncture, herbs, fish oil, counseling, therapeutic listening, OT for sensory issues, etc. I spent thousands of dollars that I really didn't have to spend. He still was having problems. Put him on meds and it was a HUGE shift. So not what I wanted but it has been a wonderful thing for him. I know that I tried my very best and so did he...

So yeah, make another big push just so you know you've done what you can do. Do what you can--emotionally and financially. And then do a trial of the meds to see what happens if you need to. It doesn't have to be forever. And certainly look into options.

eta: crossposted with zinemama. I agree that you don't need to do a last ditch effort but if it will give you some peace then go ahead...
I've also been wanting to check this out: www.beyondconsequences.com I haven't read the books so excuse me if they are yucky.

Great big hugs for you. It is really, really challenging.

eta: I hesitated to post this as my issues weren't on the level you describe but it seemed like you really wanted any ideas you could get.

[Satori]

You son hasn't been dx'd as mentally ill/bipolar yet because of his age. The behaviors you are describing however are textbook for a bipolar child and many of the mama's on this thread who have mentioned BP do so because we have BP kids and know the hell your going though. Get the book I recommended and read it. Believe me, I understand how hard it is to accept a mental health dx, I waited 5 months before I could even admit it to my parents and it was dd herself who told my mother that she was bipolar not understanding the stigma attached to such a dx. I was scared to death to even try meds but it got to the point I had to remove dd from the home because she became so violent and there was serious fear of CPS stepping in a removing my younger dd to protect her and the only way to prevent it was to remove older dd for 3 months while we started meds. The difference is night and day and I regret not starting meds years ago because of the amount of damage done to the mother/child bond because of the BP symptoms.

I had a really hard time deciding to try meds, we had a behaviorist by the time dd was 2 due to the severity of her temper tantrums and it only for worse from there. I started a thread back when TSHTF earlier this year and I finally made the decision to medicate. I think it might help you to read it and our experience in trying Risperdal. I have posted all though the thread and I strongly encourage you to read the whole thing http://www.mothering.com/discussions....php?t=1045812

Originally Posted by Bisou

Just to be clear, my son has NOT been diagnosed as bipolar or with any mental illness of any kind. They have only described him as having "emotional disregulation." I've asked about Oppositional Defiant Disorder (ODD) because a therapist friend of mine said that's what it sounds like, and reading the description, that sounds like a pretty good description of his behavior.

Some of the people who read my description of my son's behavior have kids who are bipolar or know about bipolar disorder and thought it sounded like a possible diagnosis, but nothing has been diagnosed yet.

I guess if somone said, "Your son has X, and this is the recommended medication," maybe I would feel more convinced, just like the people who are mentioning diabetes and saying I'd give my son insulin if he had diabetes, right? Of course. To continue the analogy, this is like saying, "Something is wrong with your son, and we're not sure what it is, but we'd like to give him insulin and see if he feels better. If the insulin makes him sick, we can always stop it and try something else, like maybe medication to reduce his blood pressure." That's how it feels to me! It seems sort of like throwing darts while blindfolded and hoping to hit the right thing.

[zipworth]

Hugs to you Bisou, you are a wonderful mother and are clearly doing the best you can.

[stik]

I apologize if I'm repeating things other posters have said - I haven't read the whole thread yet, just your post.

I have dealt with children whose behaviors were as severe as your son's. I am not a doctor and I cannot diagnose, and my experience was not recent. However, your son's behavior reminds me of the psychotic children I used to work with. It's very typical for children to direct their aggression at trusted caregivers. It's also common for mentally ill children to be abused by caregivers - this can be both a cause and an effect of their condition.

I know that psychotropic medication for children is frightening. Very few medications have been studied for safety in children, and they all have side effects. However, there are cases when the child's symptoms are more dangerous than the side effects of the medication. The behaviors you have described are more dangerous for your son and others around him than the side effects of Risperdal.

Risperdal has been used in children for at least the past 15 years. It is a very serious medication. Responsible doctors prescribe it only to children whose symptoms are extreme.

I can understand why you are uncomfortable with the idea of giving your son Risperdal. I can also understand why his doctors want to prescribe it for him. The behaviors you have described are symptoms of serious mental illness.

You can't cure mental illness with behavioral intervention, because the child's internal stimuli overwhelm and block out the external stimuli you are trying to provide to modify the child's behavior.

It is clear from your post that your son needs medical treatment for his mental illness. This should include therapy. Honestly, when a child's behavior is this extreme, treatment typically needs to include medication.

[Maiasaura]

Originally Posted by Bisou

My parents have made it very clear that if we try medication and anything goes wrong, they are going to hold me responsible.

Well...your parents aren't raising your son, you are. They had their chance to raise kids when they had you, and now it's your turn. What you do with your son is your business. I don't mean to come off harsh here, but my mom gets in my stuff about how my son is raised, too, and I hear so much of parent/MIL/FIL meddling from other people too, that it's just one of my hot spots You don't even have to let them know if he gets diagnosed with anything, or if you try him on meds-- it truly is none of their business. Nor anyone else's but YOURS Egads, made it clear? They are going to hold you responsible?? For what? Sorry, just going off on a rant, here...

Originally Posted by Bisou

It takes a lot of energy to engage with him and direct him positively without doing too much of "No, don't do that. Stop that! Put that down!" and just picking on every little thing he is doing instead of using a more positive approach.

Sigh....oh, yes, how I know. Maybe it might help you, if not him, to tell him what he can do. Even if you are telling him the exact same thing, at least it's phrased in the positive. That helps me a lot-- I don't know whether it helps my son, honestly but it makes ME feel not so negative.
The other thing I do is-- I've adopted something from my son's first and second grade classrooms. They have something they call "compliments". There's a jar full of marbles, or those flat fake jewely things that are sort of like colored rocks, in the classroom. Whenever an adult gives the kids (or one kid) a <verbal> compliment, a "compliment" (marble) goes into the jar. If it's an adult that's not related to the school, such as a parent volunteer, they get two "compliments" for one compliment. To clarify, the marbles are actually called "compliments".
I now have a compliment jar at home. My son has it in his room. I have my own jar of marbles and I give him compliments all the time-- for doing things that I want him to do, but I didn't have to ask, for good behavior, for helping without complaint, for doing extra chores, you name it. It's good for both of us-- he earns a special treat of his choosing when the jar's full, and I am training myself to notice the good in him, not just the bad. AND he is motivated to behave better. Yes, it's reward-based, but the reward is so long in coming that it's more about behavior than reward (there's a quart mason jar to fill, after all).

Originally Posted by Bisou

For the people who mentioned bi-polar disorder or have bi-polar kids, were your kids having problems in all situations (home, school, etc)? I know you're not medical experts, but what do you make of him being able to control his behavior at preschool and (to a certain extent) with his grandparents but not so much with me?

Mostly. But not always. He had some pretty bad behavior all the way around, and I've had daycares and schools call me pretty consistently.
I think, about the selective behavior with your ds, that he probably knows the boundaries of whoever is caring for him, as in, what they will put up with. Maybe. I'm no expert.
Like I said, too, I'm not positive my kid is bipolar, yet, but it runs in his family, so wouldn't be surprised.
Frankly, if he is, I'm glad it's a possibility we caught it early. I would way rather he be on meds now, than self-medicate later, 'cause both sides of his family are rife with addiction. Including me and his father.

Originally Posted by Bisou

For those of you with bipolar kids, what were they like as babies? Did you find them to be difficult babies as well?

Exceedingly. He was so hyper in utero that I remember saying to the tech who did our ultrasound-- I'd gone in just the once, to see if my baby would tell me his sex-- that "if he's that hyper IN, I can not imagine what he'll be like OUT". I wanted him (oh, naive mom, me) tested for ADHD at nine months old. He had severe, severe colic for three months-- 3 hours of unconsolable screaming and crying, every day, at random times, from 2 weeks old till about 3-1/2 months old. He was violentish and hyper as a toddler. We couldn't go to any playgrounds that weren't fenced in, because he'd run away-- INTO the street. On purpose. At age 3, when I could finally leave him for a half hour in the mornings in front of a video to get some extra sleep, one day I woke up to find him in his little baby rocking chair, with my two biggest butcher knives in each hand, and a sh*t-eating grin on his face.
At 5, he beat up his best friend at said friend's birthday party-- attacked him from the back.
It's been a long haul, yep. We've come such a long way since then!

Originally Posted by Enudely

My friend has a kid with pretty bad ADHD and she gets really annoyed when someone suggests that the illness can be cured by eliminating sugar from his diet or taking him out into the woods a lot.

OH yeah. I can so totally relate.

Originally Posted by Kismet_fw

I have a nephew who was diagnosed as ADHD very young, with bouts of very odd, sometimes aggressive behavior, and meds did help him. But my sister in law also found out that limiting foods with certain dyes and other chemicals helped reduce the amount of triggered events he was having.

It made a difference for us, when DS was little. Not so much now.

Originally Posted by Kismet_fw

This is SO much for you to handle with him, but by eliminating one thing at a time for a month or so to see if there is a difference, you might be able to identify something. At this point, anything that will help reduce the load on your shoulders is good.

That's pretty good advice all the way 'round, for everybody, I think-- simplify, simplify, simplify. I wonder now that I've ever needed dryer sheets! Somehow I just don't get static anymore. And I haven't used one in years.

Originally Posted by Oubliette8

just because your son responds in a certain way t one of these drugs does not mean he has a condition- psychiatric conditions are diagnosed by behaviors, not by response to medications, because we simply don't understand the causality yet.

Oh, mama, don't get me wrong--I wasn't suggesting a diagnosis. It's just one of those many, many AA sayings. I was just saying, it's a possibility that if something works, well...it works. And if it's an off-label use, and it works for what they say it works for-- well, the OPs son has something, cause most kids don't act like that, so if some med can help them for awhile...well, I no longer see that as a bad thing. Their lives are pretty well disrupted right now. One of my DS's meds is a blood pressure med, I think. I'm dubious, too, but they help him, and considering what it was like before, well, I'm willing to have him stay on them for awhile.

Originally Posted by EdnaMarie

I have a cousin who had a seizure on medication for bi-polar. It was horrible. But she needs the medication to function and be a mom to her son. She just needed something different. There are lots of medications for different disorders that can be tried. It sounds like you're a really attentive mom, so he will have you to pay attention to him to see what's going on there.

That's one of those decisions where you have to decide if the cure is worse or is the disease worse. Those are tough decisions, sometimes.

[VisionaryMom]

My son is much the same as yours. He also is 4 and has been this way since birth as well. His behavior seems to escalate regardless of what we do. We also have been told that attachment parenting is bad for him and that we've allowed his behavior because we're not tough/don't make him afraid of us.

I don't have advice because we're at the same place. DH lost it last night and went off about how angry and hurt he is (to me, not DS). I am the "landing spot" for DS's anger, which is frustrating because I am his biggest advocate.

As for the Risperdal, we don't medicate. I myself have taken Risperdal, and it's not a safe drug in many cases. It's not something I would give DS unless I absolutely had no choice (and we may get there). I have a real problem with psych drugs for a developing brain, so I do understand your concerns there. I know that some mamas here have Clonidine prescriptions for their LOs with aggression so that they can give it to control the outbursts, etc, but not necessarily medicate constantly.

[Bisou]

Hi mama:

I really appreciate your post! If I am reading it correctly, it sounds like you put your older child on medication (after trying all other options) but not your younger child?

I have been giving it my ALL the past few days, trying to really engage with my son, be upbeat, patient, creative in trying to ward off outbursts (yet without just caving into him and letting him run me like a little dictator, as he sometimes tries to do), and things are going better. Sometimes it does seem like my efforts make a difference, but it takes GREAT effort on my part, and other times it doesn't seem to help at all.

I am not quite ready to try medication yet. Not yet. But I am certainly weighing all options, and it's good to hear about other people's experiences with both medication and non-medication options.

The trauma of the break in, resulting in our move and losing all of our neighborhood friends, and then the force-feeding situation at his daycare resulting in a move to a new daycare, is only a few months old (it happened in May and June). Actually, he was doing MUCH better before all this terrible crap happened, as was I.

I totally see what other posters are saying that I shouldn't blame his behavior entirely on my moods and frustration, and I know that's not the full picture. He has always been a "challenging" child, and it seems like his behavior really ramps up when things are stressful in our lives and calms down when they are not so chaotic.

I do have to say that his aggression is less frequent than it was before we started play therapy, but it's still not entirely gone. He is also reckless and rough, at times, and I almost wonder if he is doing it on purpose, or is it really an accident? Only a few days ago I was following him out of the bedroom and he slammed the bedroom door into my face (it's a very heavy, solid door). It was like someone hit me with a baseball bat; it dropped me to the ground, screaming and crying in pain. It seemed like possibly an accident, like he didn't know I was right behind him, but even when he's being "good" he always seems to be hurting me. When we are playing, he will do things like throw his head back and smash it into my face, and I can't tell what his intentions are in doing that. Sometimes it seems like he gets so wild he just isn't thinking. He is a very active child (and I make sure he gets LOTS of exercise, as much as 1-3 hours of very active outside time daily), but they've never suggested ADD/ADHD.

They've never given a diagnosis of any kind, so far, even when I've asked.

Anyway, again, thanks to all of you who are posting. I find it extremely helpful to hear all these different perspectives, and it's also nice to know that I am not the only mom dealing with this sort of thing.

THANK YOU!

Originally Posted by Oh the Irony

I've dealt with aggression and I'm a single mom. I'm also self-employed with two small business and I know of the overwhelm and guilt which you speak of. I feel for you, I really do. My son would go off for 30-60 minutes but not hours. That was hard enough.

My then 4 year old (now 5) would hit me, pull my hair, bite me, kick, scratch, throw things while I was driving etc. He is also in play therapy with someone who does EMDR. I also had to physically restrain him while he raged. I've felt anger and a desire to physically hurt him that I didn't know I had in me--my older son was and is so easy to deal with.

I was really, really concerned about kindy. About if he would make it and what the hell I would do if he didn't. (He talks ALL day long and as an introvert trying to work from home with inadequate childcare it was overwhelming me) And yeah, worse for me than for my parents who babysit.

My last ditch effort three weeks before school started:

1) Got him on the Feingold diet. www.feingold.com Aggression is one of the listed symptoms--take the little quiz for him. It takes some work to get set up, but is good after that.

2) Started using the Nurtured Heart approach from the book Transforming the Difficult Child by Howard Glasser.
One of the big things for me in the book was about how our reactions energize the negative behaviors. They like the reactions. My son can totally push my buttons and I was giving him a "Show" for it. Toning down my reactions, setting clear expectations for behaviors, etc really helped.
He does suggest a point system but I find it quite different from some other systems. My son responded really well to it. You would need the book. This also takes some planning and effort.

It has been so worth it. The last time he hit me was BEFORE we started these. He can still be intense, but it is oh so much less. If he starts getting kind of wonky--I do look at myself immediately. Normally I'm stressed about something.

If he gets impatient, I may see how I've been impatient with him. And if I respond to him with impatience it all escalates QUICK. If I'm calm then he can get out of it.

My older son had panic attacks and anxiety/depression last year. I did everything I could think of: acupuncture, herbs, fish oil, counseling, therapeutic listening, OT for sensory issues, etc. I spent thousands of dollars that I really didn't have to spend. He still was having problems. Put him on meds and it was a HUGE shift. So not what I wanted but it has been a wonderful thing for him. I know that I tried my very best and so did he...

So yeah, make another big push just so you know you've done what you can do. Do what you can--emotionally and financially. And then do a trial of the meds to see what happens if you need to. It doesn't have to be forever. And certainly look into options.

eta: crossposted with zinemama. I agree that you don't need to do a last ditch effort but if it will give you some peace then go ahead...
I've also been wanting to check this out: www.beyondconsequences.com I haven't read the books so excuse me if they are yucky.

Great big hugs for you. It is really, really challenging.

eta: I hesitated to post this as my issues weren't on the level you describe but it seemed like you really wanted any ideas you could get.

[Bisou]

That is interesting what you said about your son being hyper in utero, because my son was EXACTLY the same way! He kicked and squirmed and pushed constantly. It was just crazy. I used to tell people it was like having a wild horse trying to kick down a stall in there.

I am also with you on parents/grandparents butting in. I know that my grandparents (mom's parents) NEVER did that with us when we were kids. They just held their tongues. I think because my parents are helping me financially (paying for my son's childcare) and with babysitting, they feel like I am a dependent too, and they treat me like a child, which pisses me off to no end!!!! I am 35, have a Masters degree, teach college, and have many other accomplishments under my belt. It's not like I am a loser, but my parents have sort of always treated me that way. Even when I was in high school and an A student, debate team captain, star of most of the musicals, choir president, and working a part-time job (from the age of 14), they still thought I was a drug addict (not even close!) and irresponsible. Man, they should've traded me for one of my classmates to have a clear picture of just how good they had it!!!!

I am going off on a rant, but obviously my relationship with my parents is a hot topic for me, and since having my son, it's gone completely into the toilet. It's just NOT good at all.

Anyway, again, thanks for the wonderful insight. Every time I come to MDC for support, I am never disappointed!

Originally Posted by Maiasaura

Exceedingly. He was so hyper in utero that I remember saying to the tech who did our ultrasound-- I'd gone in just the once, to see if my baby would tell me his sex-- that "if he's that hyper IN, I can not imagine what he'll be like OUT". I wanted him (oh, naive mom, me) tested for ADHD at nine months old. He had severe, severe colic for three months-- 3 hours of unconsolable screaming and crying, every day, at random times, from 2 weeks old till about 3-1/2 months old. He was violentish and hyper as a toddler. We couldn't go to any playgrounds that weren't fenced in, because he'd run away-- INTO the street. On purpose. At age 3, when I could finally leave him for a half hour in the mornings in front of a video to get some extra sleep, one day I woke up to find him in his little baby rocking chair, with my two biggest butcher knives in each hand, and a sh*t-eating grin on his face.
At 5, he beat up his best friend at said friend's birthday party-- attacked him from the back.
It's been a long haul, yep. We've come such a long way since then!

[Bisou]

I would agree with you to a certain extent, except that he has not been diagnosed with a mental illness at this point. They haven't even suggested it or said, "Well, he's too young to be diagnosed at this point, but he probably has X." They just say he has "emotional disregulation." I guess if they were completely convinced that he had a mental illness, I might be more inclined to go in this direction.

My son has just been through SO much, and I think, honestly, he is angry and scared and is acting out because of that. Both his dad (who is not in the picture at all) and I have very strong personalities, and my son is very strong willed and also extremely bright.

I am not saying he doesn't have a mental illness, but one has not been diagnosed or even suggested yet, and I have to wonder if he is just acting out in extreme rage because of the horrors that he's faced as a young child that he has no way of controlling.

Maybe I am just making excuses for him, but it seems to make sense to me. . . . . .

Thanks for hanging in there with me, everyone, while I work this out. I do appreciate it!

Originally Posted by stik

I apologize if I'm repeating things other posters have said - I haven't read the whole thread yet, just your post.

I have dealt with children whose behaviors were as severe as your son's. I am not a doctor and I cannot diagnose, and my experience was not recent. However, your son's behavior reminds me of the psychotic children I used to work with. It's very typical for children to direct their aggression at trusted caregivers. It's also common for mentally ill children to be abused by caregivers - this can be both a cause and an effect of their condition.

I know that psychotropic medication for children is frightening. Very few medications have been studied for safety in children, and they all have side effects. However, there are cases when the child's symptoms are more dangerous than the side effects of the medication. The behaviors you have described are more dangerous for your son and others around him than the side effects of Risperdal.

Risperdal has been used in children for at least the past 15 years. It is a very serious medication. Responsible doctors prescribe it only to children whose symptoms are extreme.

I can understand why you are uncomfortable with the idea of giving your son Risperdal. I can also understand why his doctors want to prescribe it for him. The behaviors you have described are symptoms of serious mental illness.

You can't cure mental illness with behavioral intervention, because the child's internal stimuli overwhelm and block out the external stimuli you are trying to provide to modify the child's behavior.

It is clear from your post that your son needs medical treatment for his mental illness. This should include therapy. Honestly, when a child's behavior is this extreme, treatment typically needs to include medication.

[Bisou]

Thanks for sharing your experiences. I will definitely check out the book you recommended along with all the other books people have recommended.

I am so glad that medication worked for your daughter and family, and it sounds like you went through the same gut-wrenching decision making process that I am going through.

It definitely has damaged the bond between my son and I, and my feelings are worse some times than they are others. This past week he had one day of tantrums for about six hours. While he wasn't being extremely violent, he was screaming, thrashing around on the floor, and completely out of control emotionally for hours. I was just trying to get him dressed to go do something fun! It was my day off and I had planned to take him to the zoo, or the park, and lunch---things he normally loves to do. It makes no sense. He should be thrilled to get dressed and go, but he wasn't. He also wasn't thrilled to stay home and relax. It was a no-win situation.

When I was finally able to get him dressed and out of the house, I had completely shut down. I wouldn't even talk to him or look at him anymore. He was saying, "I love you mommy. You love me, right?" but I wouldn't answer him. In my mind, I was thinking, "What the hell is wrong with you? (You being ME, not my son.) Are you a f*king heartless monster or what? He's only four! He's a baby! Tell him you love him you awful bitch!" but I just couldn't even bring myself to engage with him. His six hours of tantrums finally ended with me sobbing and lying on my bed and just completely broken. From there I totally shut down.

I definitely don't want to be that kind of mom. I don't want to be emotionally unavailable. I don't want to be cruel. If we have too many more days like that, medication will have to be an option.

Yuck. Yuck. Yuck.

I wish they could do some sort of blood test or brain scan to know what's REALLY going on with a child. If there could be a certain diagnosis, like "Yes, we have positive confirmation that your child does have X," like they can with diabetes or high blood pressure, it would make this a whole lot easier.

Originally Posted by Satori

You son hasn't been dx'd as mentally ill/bipolar yet because of his age. The behaviors you are describing however are textbook for a bipolar child and many of the mama's on this thread who have mentioned BP do so because we have BP kids and know the hell your going though. Get the book I recommended and read it. Believe me, I understand how hard it is to accept a mental health dx, I waited 5 months before I could even admit it to my parents and it was dd herself who told my mother that she was bipolar not understanding the stigma attached to such a dx. I was scared to death to even try meds but it got to the point I had to remove dd from the home because she became so violent and there was serious fear of CPS stepping in a removing my younger dd to protect her and the only way to prevent it was to remove older dd for 3 months while we started meds. The difference is night and day and I regret not starting meds years ago because of the amount of damage done to the mother/child bond because of the BP symptoms.

I had a really hard time deciding to try meds, we had a behaviorist by the time dd was 2 due to the severity of her temper tantrums and it only for worse from there. I started a thread back when TSHTF earlier this year and I finally made the decision to medicate. I think it might help you to read it and our experience in trying Risperdal. I have posted all though the thread and I strongly encourage you to read the whole thing http://www.mothering.com/discussions....php?t=1045812

[Bisou]

This is good information. Thanks for sharing it.

I know several posters on here have had children with similar problems and had great results with medication, even the one I've been offered for my son, but it's hard not to be scared. Even my son's therapist seemed a little surprised, even shocked, that this was the first medication they wanted to try. She said, "Was that the ONLY option you were offered?"

The other options the therapist recommended were getting a second opinion from a child psychiatrist, getting involved with some sort of intervention program through the school district, or (an idea she didn't like) calling DHS, the department of human services, which is like CPS. This was suggested by the behavioral pediatrician, but the therapist didn't think this was a good option.

I guess I am also concerned with getting him involved in a program through the schools because I hate to have him labeled as a problematic kid before he even has problems at school. He has not had ANY behavioral problems at his past two daycares, and I've asked every single teacher: "Is he cooperative? Does he listen? Does he get along well with the other kids?
and I've only heard YES, YES, YES. The worst he has done is not wanting to share a ball and throwing it over the fence so no one could have it (as in "If I have to share it, then no one can have it!"). This isn't good, but it doesn't seem like totally awful behavior. This definitely makes the whole thing much more confusing for me. If he had a mental illness, wouldn't he be having some noticeable problems at preschool? He's been in childcare for two years and has never had any behavioral problems except for right after the abuse that happened at his first daycare.

Originally Posted by Oubliette8

You asked if just trying the drug can be dangerous, and I'd have to say it can be. You never know how many doses it will take before tardive dyskinesia sets in, although the risk increases the longer it is taken. As an adult, when I developed extrapyramidal symptoms (uncontrollable muscle movements in my face and neck) I could not describe what was going on. I had no idea it was my medication. I would have continued taking it thinking I was otherwise ill, or that they were odd symptoms of my PTSD before I attributed it to the drugs. Thankfully my therapist took one look at me and told me to call my doctor ASAP. They weren't minor signs either- I had to bite my lip to keep it from curling up, and my neck was so sore that I could not hold my head up for more than a few minutes. Other, generally reversible symptoms can include increased agitation, and a sort of fogging of the your thinking. I often felt that I could not think, and attributed it to my mental health DX instead of the drugs at the time. I'm unsure that a 4 year old would be able to identify these issues, or say that they come from the medication. I'm not trying to scare you, merely trying to answer your question based on my experience. There are, of course, people who take these drugs with NO side effects and for whom they are beneficial.

I'm wondering, and I should say I'm not a doctor, if they would consider trying an anti-anxiety medication first? Risperidal is largely unstudied in young children, so I'm unsure if they would be any more inappropriate than that. it would still be off label usage. My thought being, if its a manifestation of Post traumatic stress, the acting out may be your sons way of dealing with his fears and anxiety that he cannot otherwise express. And anti-anxiety drugs generally have a calming effect. The upside is, they tend to have fewer, and less serious side effects than antipsychotics or antidepressants. It might be something to think about.

I do want to say that I've never been in your situation and have no idea what I would do if I was. I don't think there is any one right answer. Its great to see you are looking at all options, I'm sure whatever decision you make will be well supported.

[Satori]

Originally Posted by Bisou

When I was finally able to get him dressed and out of the house, I had completely shut down. I wouldn't even talk to him or look at him anymore. He was saying, "I love you mommy. You love me, right?" but I wouldn't answer him. In my mind, I was thinking, "What the hell is wrong with you? (You being ME, not my son.) Are you a f*king heartless monster or what? He's only four! He's a baby! Tell him you love him you awful bitch!" but I just couldn't even bring myself to engage with him. His six hours of tantrums finally ended with me sobbing and lying on my bed and just completely broken. From there I totally shut down.

BTDT many many times but I was thinking "WTF is wrong with you!?" for both of us. I did become emotionally unavailable after years of constantly being beaten down by her. I was near suicidal because I just couldn't take it anymore from her and it felt like that was my only option and I was seriously considering giving her up for adoption as well hoping to find a family that could better meet her needs because I obviously wasn't but what I didn't understand was my dd was/is mentally ill and I wasn't treating that illness. The Dr's KNEW back when she was only 5 she had a mood disorder and labeled her as severely disabled but I didn't know it until recently when I got copies of her records to apply for SSI. They knew she was bipolar but becasue of her age they couldn't dx it nor did they ever mention it to me. I only found out about the dx on total accident when the Dr put the ICD9 code on her lab work order and I googled it and it came back as BP1 and I called and asked about it and he called me back and explained it and strongly encouraged me to read about it online and recently published books on childhood BP and so I did and it was like "OMG!!!! Someone wrote books about my dd!" I mean just page after page after page it was literally like someone personally knew my dd and wrote a book about her and it just explained so much about her and gave me answers to the "WTF is wrong with you!?" question that was always in the back of my mind with her.

You mention any stress makes things worse for your son, thats very very common with mental illness and while you can do everything possible to make things stress free his mind is still a mess and he needs help clearing it. My dd spent 3 months living with my parents while we got things under control but when she came home there was more stress all around and we needed to add a mood stabilizer and opted for Lamictal and between the Risperdal and Lamictal we've got a really good combo and she's a totally different child, one I never dreamed I could have. She still drives me crazy a lot but she no longer pushes me to the edge and adoption is totally off the table. She still acts out on occasion but NOTHING like before, before I was terrified to turn my back on her for fear she'd hit me in the head with something heavy (she would throw what ever was closest to her at me when in her fits and it didn't matter what it was and it didn't matter if I was holding the baby). Now I don't worry so much since the demon seems to have left and sorry but for a long time she did act like she was possessed and just so full of anger, hatred and violence. With meds thats no longer the case. Well most days

[Satori]

Originally Posted by Bisou

If he had a mental illness, wouldn't he be having some noticeable problems at preschool? He's been in childcare for two years and has never had any behavioral problems except for right after the abuse that happened at his first daycare.

This is a common misconception, there able to hold it together for short periods of time but after a while they just sort of explode and thats usually when mom the safety net shows up. One of the reasons I pulled my dd from school was while she as a perfect angel at school she became a demon by the time we got home just 5 minutes later because she couldn't keep up the behavior and all the pent us frustrations of the day came pouring out. They know its not socially acceptable to act that way and it still boggles my mind that they can keep it together then lose it when mom shows up. I just keep thinking why can't they continue to keep it together? But the truth is they just can't, its to taxing on them. Its explained in detail in that book I suggested.

I need to get ready for school but I'm sure other mama's can answer questions as well.

[Bisou]

I hate to admit thinking about adoption at times too, only for brief moments. But my thought process would go like this, "I can't handle this! I'm going to have to give him up! I can't be his mom anymore! I can't!!!! But I couldn't live with that decision! I'd have to kill myself!" Not fun.

My parents have offered to take him, but having him raised by my parents is NOT an option. They are not emotionally healthy people at all. They were completely emotionally unavailable to me when I was growing up (as well as now) and both emotionally and physically abusive. (They have never showed this behavior with my son, except for one time when my dad gave my son one swat on his behind. I was FURIOUS and told them that if he was ever spanked again they'd never see him again, even if that made my life completely miserable!)

I was single when I found out I was pregnant. I had been broken up for about 2 1/2-3 months from his dad because I had FINALLY extricated myself from the really crappy relationship that it was (after 2 1/2 years of dating), and then I found out I was just about three months pregnant! Since I have polycystic ovarian syndrome and was told I couldn't have kids, and was already 30 and had never been pregnant, while I briefly considered terminating the pregnancy, that really wasn't a question. Adoption was just way too painful to even think about. I felt like I had been handed a wonderful, miraculous gift, and while I knew single parenthood would be extremely hard, I didn't think it would be THIS hard! Not even close. I expected maybe 80-90% joy and 10-20% hardship. Instead most of the times it seems like I got the reverse: 80-90% hardship and 10-20% joy.

I have been single now for five years (from the pregnancy until now), and it's been so hard. I haven't even tried to date. I have no social life. I have no time to exercise because I have way too much work to do. I have lost pretty much all of my friends because I just don't have time to do anything with my work and parenting responsibilities. It's just grueling. I keep thinking that something has to change, but there's just not much wiggle room with anything. If I want to add something to my life (like yoga before bed), the only way to accomplish that is by cutting out more sleep. I am sure I am not the only single mom in this situation, but adding my son's behavior to this makes the strain of single parenthood nearly impossible.

It's shocking that the doctors/therapists put that diagnosis down but didn't tell you about it. I am surprised that they wouldn't have said something like "Well, we can't give her an official diagnosis at this age, but we think she is bipolar. We won't be able to diagnose this for sure until she is older.

The medical profession can be so frustrating at times!!!

It's also interesting about what you said about your daughter being able to hold it together at school and not with you. Sometimes when I pick my son up at preschool, I can't even get him in the car because he throws a big screaming fit, and it's so embarrassing! I always thought maybe it was the stress of missing me all day, or sometimes he would feel like other kids hurt his feelings, or if the teacher told him not to do something, even very gently, he'd be all devastated about it and be very upset. He has such a hard time, but I do find that if I sit with him or hold him and try to talk to him and listen to his concerns and upset, sometimes that helps. When it's nice, we always also go to a nice park in the hills and I let him play for two hours or more! He never seems to get tired though. I have taken him hiking straight up a hill for an hour (and he was only 3 at the time!) and he was completely fine! Not tired in the least!

I know what you mean about the "demon" part though. I said in another post that sometimes I think that's the only explanation.

Thinking on the genetic side, I don't know that his dad was bipolar, but he was certainly irrational. We would be all cuddled on the couch, watching a movie, having a great time, then this change would come over his face and he'd say something totally out of the blue like, "Don't even try to lie to me! I know what you've been doing, you bitch!" I'd be saying, "WHAT? What are you talking about?" He was always accusing me of cheating, which I never did. I never even flirted or talked to another guy. I am not that kind of person. He was so irrational though and would fly into rages. In my opinion, he almost seemed like he had multiple personality disorder. His behavior never seemed to fit the descriptions I've read of BPD in adults, though I've never known anyone with BPD. He never hit me but he did push and do other rough/dangerous behavior, like driving 90 miles an hour in a 45 mph zone to terrorize me. He was the WORST person I could've gotten pregnant from---of course! Seems to be my luck.

Anyway, sort of rambling again. All this brings up a lot of different thoughts for me.

Originally Posted by Satori

BTDT many many times but I was thinking "WTF is wrong with you!?" for both of us. I did become emotionally unavailable after years of constantly being beaten down by her. I was near suicidal because I just couldn't take it anymore from her and it felt like that was my only option and I was seriously considering giving her up for adoption as well hoping to find a family that could better meet her needs because I obviously wasn't but what I didn't understand was my dd was/is mentally ill and I wasn't treating that illness. The Dr's KNEW back when she was only 5 she had a mood disorder and labeled her as severely disabled but I didn't know it until recently when I got copies of her records to apply for SSI. They knew she was bipolar but becasue of her age they couldn't dx it nor did they ever mention it to me. I only found out about the dx on total accident when the Dr put the ICD9 code on her lab work order and I googled it and it came back as BP1 and I called and asked about it and he called me back and explained it and strongly encouraged me to read about it online and recently published books on childhood BP and so I did and it was like "OMG!!!! Someone wrote books about my dd!" I mean just page after page after page it was literally like someone personally knew my dd and wrote a book about her and it just explained so much about her and gave me answers to the "WTF is wrong with you!?" question that was always in the back of my mind with her.

You mention any stress makes things worse for your son, thats very very common with mental illness and while you can do everything possible to make things stress free his mind is still a mess and he needs help clearing it. My dd spent 3 months living with my parents while we got things under control but when she came home there was more stress all around and we needed to add a mood stabilizer and opted for Lamictal and between the Risperdal and Lamictal we've got a really good combo and she's a totally different child, one I never dreamed I could have. She still drives me crazy a lot but she no longer pushes me to the edge and adoption is totally off the table. She still acts out on occasion but NOTHING like before, before I was terrified to turn my back on her for fear she'd hit me in the head with something heavy (she would throw what ever was closest to her at me when in her fits and it didn't matter what it was and it didn't matter if I was holding the baby). Now I don't worry so much since the demon seems to have left and sorry but for a long time she did act like she was possessed and just so full of anger, hatred and violence. With meds thats no longer the case. Well most days

[zinemama]

Originally Posted by Bisou

I am not saying he doesn't have a mental illness, but one has not been diagnosed or even suggested yet, and I have to wonder if he is just acting out in extreme rage because of the horrors that he's faced as a young child that he has no way of controlling.

Maybe I am just making excuses for him, but it seems to make sense to me. . . . . .

To be honest - and I really and truly don't mean this unkindly - it sounds to me as if you are making excuses for him, that you are resisting seeking medical help for him because of his past.

Yes, it may be that he is partially acting out from what's happened in the past. But you have also said that he has been violent from the very beginning. Does he have a mental illness? Who knows. Does it really matter? The important thing is that you do something about it soon, for his sake as much as for yours.

Take your son to a child psychiatrist. (I guess I was under the impression that you had already done this.) That seems like an excellent suggestion from your therapist.

[Bisou]

To clarify, I have taken my son to a therapist (child psychologist) for almost two years, and we have also seen his pediatrician, and most recently, a developmental/behavioral pediatrician who deals with this sort of thing. She was recommended as the first step in dealing with my son's problems. The developmental/behavioral pediatrician was the one who prescribed Risperdal, but I was not happy with the way she handled our appointment at all, which made me even less inclined to take her recommendation.

My son's pediatrician, whom I love, said giving my son Risperdal would be a "sledgehammer approach" to dealing with his behavior, and recommended that I get a second opinion, which is what I plan to do. All of this has happened in the last few weeks, so it's all very new.

Originally Posted by zinemama

To be honest - and I really and truly don't mean this unkindly - it sounds to me as if you are making excuses for him, that you are resisting seeking medical help for him because of his past.

Yes, it may be that he is partially acting out from what's happened in the past. But you have also said that he has been violent from the very beginning. Does he have a mental illness? Who knows. Does it really matter? The important thing is that you do something about it soon, for his sake as much as for yours.

Take your son to a child psychiatrist. (I guess I was under the impression that you had already done this.) That seems like an excellent suggestion from your therapist.

[thebee321]

I saw an interesting show Wednesday night on ABC, Primetime I think it was called. It was about parenting the defiant child.

Link here:
http://abcnews.go.com/Primetime/pare...ory?id=8549642

I thought a lot of it made good sense. It also addressed trying to break the cycle of abuse for parents who grew up in abusive homes.

Maybe it won't be helpful, I don't know, I just thought of it when I read your post.

[Bisou]

Hey, thanks for the suggestion thebee. You never know what will be helpful and what won't, so I will definitely check it out! Thanks! In my opinion, the more suggestions the better.

[stik]

Originally Posted by Bisou

I would agree with you to a certain extent, except that he has not been diagnosed with a mental illness at this point. They haven't even suggested it or said, "Well, he's too young to be diagnosed at this point, but he probably has X." They just say he has "emotional disregulation." I guess if they were completely convinced that he had a mental illness, I might be more inclined to go in this direction.

My son has just been through SO much, and I think, honestly, he is angry and scared and is acting out because of that. Both his dad (who is not in the picture at all) and I have very strong personalities, and my son is very strong willed and also extremely bright.

I am not saying he doesn't have a mental illness, but one has not been diagnosed or even suggested yet, and I have to wonder if he is just acting out in extreme rage because of the horrors that he's faced as a young child that he has no way of controlling.

Bisou, generally, I think that when hcps recommend psychotropic medication for a child, they are suggesting a diagnosis of mental illness. But if you're not certain, you should ask them directly if they think your son is showing signs of mental illness or not.

Your ds may be acting out in extreme rage because of the trauma he has been through. That doesn't mean he's not struggling and wouldn't benefit from medication. Your son may not be able to benefit from therapy until the neuro-chemical roots of his problems are addressed.

If Risperdal is really frightening to you, please bring that up with your son's doctors. There may be other options that would work for your son.

I wish you and your ds all the best, mama.

[stik]

sorry - double post.