Help! Severe Aggressive/Defiant Behavior! - Page 22

[Anastasiya]

Originally Posted by Bisou 

I have had ONE doctor (not more than one) suggest Risperdal, and this woman was a complete jerk.  Right in front of my son, she said he was an awful kid, that he was "cute now, but he won't be cute much longer," that he had no friends (which was true because we had just moved and he had changed preschools, but mean to say the way she did), and actually yelled at him in her office because she expected him, at 3 1/2, to sit there for an hour with nothing to do while she talked to me, and then he climbed on my back and shoulders.  After the session, he said, "She was so mean!" then cried for an hour. 

I am sorry, but I have no respect for this person or her opinion, and I am not about to take the advice of someone who obviously knows nothing about what is appropriate for a child to hear about himself.  This is the only person who suggested Risperdal for my son.
 

Your OP says two people suggested it.

I too have been following this thread for a long time, and I am concerned that in your worry to not possibly damage his brain with medication, it is certainly being damaged anyway by these violent rages. Like you said in your OP, you don't want his brain to be trained to respond this way to things, and he IS getting older and more dangerous. It doesn't matter how often the rages come, but the fact that they do occur and cause great damage and he loses all control of himself.

He needs to be trained to react differently. You can't do a restrain hold on a ten year old.

Furthermore, you yourself had medical issues with your own rages and depression and suicidal thoughts, and his father reacts in violence and rage, so perhaps this truly is something genetic and cannot be fixed with diet?

If I were you, I would at least give the meds a try....that's it....just a TRY, and go from there.

[Bisou]

Just to clarify, the rages I had were caused by medication. 

Originally Posted by Anastasiya 





Your OP says two people suggested it.I too have been following this thread for a long time, and I am concerned that in your worry to not possibly damage his brain with medication, it is certainly being damaged anyway by these violent rages. Like you said in your OP, you don't want his brain to be trained to respond this way to things, and he IS getting older and more dangerous. It doesn't matter how often the rages come, but the fact that they do occur and cause great damage and he loses all control of himself. He needs to be trained to react differently. You can't do a restrain hold on a ten year old.Furthermore, you yourself had medical issues with your own rages and depression and suicidal thoughts, and his father reacts in violence and rage, so perhaps this truly is something genetic and cannot be fixed with diet? If I were you, I would at least give the meds a try....that's it....just a TRY, and go from there.

[Bisou]

I should clarify that my son's therapist is no longer suggesting medication.

[GoBecGo]

Tell him if he's feeling uncomfortable about the exploration/play he should just say "i think i'd rather play *insert favourite sport*" and leave.  Tell him he doesn't have to join in.  It sounds like he's got a difficult task in making/keeping friends if he's feeling anxious but not empowered to simply not be involved.  In addition it is more likely that he will react inappropriately to such games and get into trouble over it (i say that as a survivor of sexual abuse, i'm not accusing him of anything, i just mean his whole context for that sort of thing is not and cannot be innocent any more, so ideally you want him to discuss concerns with you and minimise his interaction on that level with other kids - for my abuser, my brother, the fact that he'd been abused meant his innocent exploration quickly turned into abusive behaviour which i suffered for 7 years).

How much progress do you think the professionals have made in diagnosis/treatment?  I would imagine PTSD would be looked for initially, right?  I mean your son suffered at least one horrific sexual assault resulting in a severe injury, so surely they are aware that he will very likely have ongoing issues from that?  Does he know about these things happening?  Does he have a conscious memory of the attacks?  Has he been able to talk about it?  Perhaps it would help him to know WHY he flies into these rages?

I do hear that you felt the behaviour was violent from before he was assaulted the first time, but my DD did very similar things (and bloodied my nose on several occasions) at 18 months and we now look back and know it was a phase.  Is it possible that the phase of acting that way (which i can't think of how to describe, but for us it was like she would be upset over something or want something and she would escalate it without limit, up to and including headbutting people's faces) arrested when he was assaulted and so he has never been able to "move through" it?

I am not sure what to say about the medication.  I have known people with diagnoses of various illnesses/disorders who could not live without their medication.  People with bipolar who will be suicidal and attempting suicide within a few weeks of going off meds, schizophrenics who have NO periods of wellness when off medication.  For those people the comparison with insulin really is a valid one.  But i totally get why for you, with no clear dx, and no clear path through, you are hesitant.  I think i'd be looking for another evaluation, with a child psychiatrist, and a review with his psychologist/OT/other treatment practitioners to try to get a clearer picture of where everyone is.  I too would hesitate to follow the advice of the dr you describe with the medication - over in birth forum lots of people are told to run away from Ob's who are horrible/have ridiculous ideas and expectations, i agree with you, if that dr really thinks a 3yo should sit not moving for an hour with nothing to do she really isn't the dr i would want assessing something as big as need for medication for my child.  I'm sorry Choli but "the doctor has no clue about what is age-appropriate" isn't the same as "the dr was mean".  

OP -Perhaps you would be more open to medication IF you had a clearer diagnosis and a "path" of treatment through this?  If you want to try diet modification before you try medication then by all means do so, but perhaps a multiple pronged attack would be most appropriate?  Find a dr you ARE comfortable with, who you CAN trust.  Find therapists who DO recognise the trauma your son has suffered and DO have a plan on how to help him come to deal with them.  Ultimately your son might benefit enormously from medication, so maybe it's time to try to find a way to figure out if it's appropriate.  I agree that medicating without faith in the prescribing dr or the treatment process isn't a good idea.  But clearly, as you say yourself, he still needs help.  Hang in there.

[zinemama]

Can't get the quote thing to work, but OP you stated:

Last night he told me that there has been some sexual exploration going on at school, including large groups of children (7-9 kids), both boys and girls, unsupervised in the bathroom.  There have been multiple incidents, and I think he's had a lot of anxiety about this.  I asked him if he was worried about this, and he said yes.  When I asked him on Saturday, once he finally calmed down a bit, what was bothering him, he said there was something going on at school, but he didn't want to talk about it.  I know that this kind of thing is normal for kids at his age, but I think given the sexual/physical abuse he's had, it may be traumatic to him.  In the least, it was something he was really worried about.

I'm a former teacher. Large groups of elementary age boys and girls in the bathroom unsupervised is NOT normal under any circumstances. I would be very hesitant to believe this and in any case, I would be talking to the teacher ASAP if my child came home with a story like that. Have you contacted the school yet?

[JessicaS]

Hello!

There have been several responses removed from this thread.

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[wilddreamergrl]

I just saw that you had replied to my posting, apparently before they removed it. I think it would be possible to use some of the principles of the GAPS diet as a vegetarian, although certainly implementing all of it would be hard. But starting with gluten free/casein free might be a good start...a lot of families have benefitted from that basic change. Honestly, there are some GAPS families that were previous ethical vegetarians that made the change because it was the only thing that would help their kids, but that is a very personal thing. There are also discussions on the GAPS yahoo list about how to do it while remaining vegetarian, so you might check that out. The basic premise - increase good gut flora through probiotic supplementation and probiotic foods, and remove as many of the foods that feed bad gut flora as possible - would still help, I think.

I disagree with the PP's who say that diet cannot heal mental illness. I have seen too much. One of the moderators of the GAPS yahoo list was schizophrenic. The whole nine. On meds, homeless, everything. She is completely recovered and lives a normal, med-free now.  There are autistic kids who have recovered on GAPS, bipolar, OCD, pretty much every mental illness you can name. Diet is powerful, more than we realize.

Thinking of you and your son and hoping for the best!

[fuzzylogic]

Please remember that explosions of rage, screaming, anger---are cathartic and in such, self-rewarding and self-perpetuating.  A trial of something to decrease this may well reset the trigger so meds can then be stopped.

[earthmama369]

[QUOTE]It's just so hard because he does so much better, but then he's so much worse.  Some people have mentioned Bipolar PD, but I don't see him having depressive states, though the "My mom hates me" stuff is definitely on the depressed side.  He's never really shown a depressed side before.  It was always either fine or out of control anger.[/QUOTE]

This stood out to me. Depression is kind of a misnomer, in that you think "sad." Many, many people with depression manifest it as anger, or at least partially so. So outbursts of rage could absolutely be a sign of depression.

[Bisou]

Hi Zinemama:

I didn't mean that it was normal to have all those kids in the bathroom, but that sexual curiosity and exploration is normal at this age.  (Not that I want him doing that!)

It was happening on recess when they have only 2-3 adults and 75 kids on the playground.  The kids were going into a small building near the playground where there are large bathrooms with many stalls.  Only 1-2 kids were supposed to go at a time, but there were 5-7 kids from at least 2 different classes.  Basically, the recess monitors weren't keeping track of who was in the bathroom.  This didn't happen in the classroom or under supervision of the teacher.

I have already talked to the principal about this. 
 

Originally Posted by zinemama 

Can't get the quote thing to work, but OP you stated:

Last night he told me that there has been some sexual exploration going on at school, including large groups of children (7-9 kids), both boys and girls, unsupervised in the bathroom.  There have been multiple incidents, and I think he's had a lot of anxiety about this.  I asked him if he was worried about this, and he said yes.  When I asked him on Saturday, once he finally calmed down a bit, what was bothering him, he said there was something going on at school, but he didn't want to talk about it.  I know that this kind of thing is normal for kids at his age, but I think given the sexual/physical abuse he's had, it may be traumatic to him.  In the least, it was something he was really worried about.

I'm a former teacher. Large groups of elementary age boys and girls in the bathroom unsupervised is NOT normal under any circumstances. I would be very hesitant to believe this and in any case, I would be talking to the teacher ASAP if my child came home with a story like that. Have you contacted the school yet?

[Bisou]

Wilddreamer:

I had a friend who was schizophrenic (I say "was" because she later committed suicide), and in trying to research things with her mom to help her, we came across strong evidence that schizophrenia was tied to wheat sensitivities.  They even did a study where they removed wheat from the diets of schizophrenics in an institution and a good number of them completely recovered!

My friend had celiac sprue, which is a severe gluten allergy, yet she continued to eat these foods occasionally even though they made her sick.  From what I understand, with this disease the intestines can actually die, or parts of them die, that prevents you from absorbing the correct nutrients for mental health.  A LOT of our mental health has to do with our intestines, so I think that makes sense. 

Anyway, I am still figuring out what I am going to do to help my son.  I think I may request some blood work from his doctor as a starting point.
 

Originally Posted by wilddreamergrl 

I just saw that you had replied to my posting, apparently before they removed it. I think it would be possible to use some of the principles of the GAPS diet as a vegetarian, although certainly implementing all of it would be hard. But starting with gluten free/casein free might be a good start...a lot of families have benefitted from that basic change. Honestly, there are some GAPS families that were previous ethical vegetarians that made the change because it was the only thing that would help their kids, but that is a very personal thing. There are also discussions on the GAPS yahoo list about how to do it while remaining vegetarian, so you might check that out. The basic premise - increase good gut flora through probiotic supplementation and probiotic foods, and remove as many of the foods that feed bad gut flora as possible - would still help, I think.

I disagree with the PP's who say that diet cannot heal mental illness. I have seen too much. One of the moderators of the GAPS yahoo list was schizophrenic. The whole nine. On meds, homeless, everything. She is completely recovered and lives a normal, med-free now.  There are autistic kids who have recovered on GAPS, bipolar, OCD, pretty much every mental illness you can name. Diet is powerful, more than we realize.

Thinking of you and your son and hoping for the best!

[Oubliette8]

Hi Bisou,
I was thinking about this thread today, and I think a really positive sign is that he is improving quite a lot with what you are already doing. So he's not perfect, but it takes time to heal and learn new skills. Once every few weeks/a month is MUCH better than every day. That's a huge improvement! So you had a set back, that's not a big deal so long as he keeps moving forward overall, and (as my therapist would say) probably to be expected. Its also, of course, normal to be discouraged by set backs. Sure, maybe he'll grow into a very large uncontrollable child, but if he continues improving at this rate, he might also be recovered by the time he gets that big. I'd cross that bridge when you get to it. I'd also really suggest reading the Whitaker book before medicating. It talks a lot about the idea of brain chemical imbalances etc, in addition to specific info about subscribing psych meds to kids.

Also, I agree with what others have said about him being sensitive to your moods. I'm similar myself, I often pick up on people's moods when others don't. And sometimes I misinterpret it, so I wouldn't be surprised if it happens with a young child as well sometimes. For instance, if someone is stressed out, I'll feel it, and maybe think they are angry with me, and become frustrated when I try very hard to be pleasant and they still seem off. (all unconsciously of course). When in reality, maybe they are stressed because of something completely not related to me and whilst I feel they are reacting to me, they don't even realize they're presenting as stressed. If that makes any sense. I can see how, if it happened to a 4 year old, it might lead to a meltdown and confusion.

Hang in there, I hope things start looking up. I'll be thinking of you guys.

[Bisou]

Hi Oubilette:

Thanks for the encouragement.  :o)

Maybe you already mentioned the Whitaker book, or maybe someone else did, but I missed it.  What's the title?

[Bisou]

Are you talking about Anatomy of an Epidemic?  I just Googled "Whitaker medication children" and I think this is what you might be referring to.  Am I right?

[Bisou]

What about studies like this?

Two-year prospective follow-up of children with a prepubertal and early adolescent bipolar disorder phenotype. American Journal of Psychiatry 159 (2002):927-33.

 

Lithium, antidepressants and mood stabilizers all failed to help bipolar youth fare better at the end of two years. Juvenile bipolar patients treated with an antipsychotic medication, which is a standard treatment, “were significantly less likely to recover than those who did not receive a neuroleptic.”

 

If you look at Whitaker's site (Anatomy of an Epidemic) he as a lot of research that shows that psychiatric drugs don't help many people and also can cause irreversible harm and brain damage. 

 

I know there are people on here who feel their children have been really helped with medication, and I don't want to discount that at all, but I just have such GREAT fear of medicating my child when I see article after article saying this sort of thing.

 

Also check out what the book reviews for Whitaker's book (on Amazon, for example) say about all of this.  This is what gives me GREAT pause in considering this for my child.  Whitaker claims that some of these medications even cause brain damage and says that they do not help with any "imbalance in brain chemistry" -- that that is a myth.

 

What do I do with that information?  This is what makes me scared to even try medication.

[fuzzylogic]

Ok, reading that study hypothesizes that maternal warmth and an intact family are the only predictors of recovery.  ANY other intervention:  therapy, meds of any kind, did not predict recovery.  I have two main issues with this study:  one, it dates to 2001 and involves a relatively small sample size.  two, the title of the site under which it is published and the singling out of meds by this site as ineffective, when in truth all interventions were found ineffective, is highly indicative of someone with an ax to grind.

Is it possible that meds were tried only for the more affected of the kids?  Yup.  Is it possible that the more interventions applied, were in general applied because the kids were sicker to start with.....probably.  It would be possible, for example, to state that a hospitalized patient receiving 3 or more IV meds was less likely to recover than one only receiving a single med......well, why?

You don't use 'em unless you need them, and the first one didn't work.

[Oubliette8]

Originally Posted by Bisou 

Are you talking about Anatomy of an Epidemic?  I just Googled "Whitaker medication children" and I think this is what you might be referring to.  Am I right?

Yes thats the one. His other book "Mad in America" is a good read too, but not as relevant to your current situation. Whitaker himself says he's not anti-meds, but he wants the public to know what they're taking. The evidence for brain chemical imbalances as a cause of mental illness is weak, and the evidence that meds fix these imbalances is even weaker. You can use drugs for behavior control, but there are also significant drawbacks, so its important to be informed.

I'm sorry if I scared you, I certainly didn't mean to do that, I just thought you were looking for a bit more information. As for what to do with the info, you can obviously choose not medicate at all, or you can read up on long term and side effects, as well as what various drugs do and use that to help develop an approach to medication that attempts to minimize harm- for instance, knowing that some drugs can cause agitated behavior or hallucinations would enable you to ask for withdrawal from that drug if they occur, rather than having him labeled with something more severe and the side effects labeled as new symptoms, and placed on a second drug in addition to the first to control the new "symptoms" . Or knowing that some drugs show effectiveness for a certain time frame but then effectiveness drops and side effects rise might allow you to decide to use them sparingly for acute outbursts over a short period of time rather than as a maintenance dose long term. After 7 years of medication myself, I've chosen not to medicate any longer, but I can certainly see how you could use the information to make an informed choice to medicate as well, if thats what you choose to do.

[Bisou]

Hi everyone:

Have had a really awful two weeks or so.  My son has definitely gone downhill, and I am not sure what's wrong. 

I am devastated about this and scared out of my mind, but I am thinking about trying medication for him.  I have read so many articles that say that medication can actually create worse problems than the child had before (for example, induce mania in a child that never had mania before) or cause permanent, irreversible side effects in some cases.  Obviously he's having problems, but no one knows what is wrong with him.  It's so terrifying to me to give him a medication that might make things worse or might damage his brain.  I have known at least 5-6 close friends or relatives who have been on medication for mental health issues, and I have NEVER known a single person who felt they were effective.  I know that's a relatively small number of people, but it just scares me to death.  Whenever I think about doing this to my son, I can't stop crying.  I feel like I have failed him.  I have been too impatient.  I haven't been able to protect him or provide him a safe, loving environment.  I have yelled too much. 

I am so scared that there is something seriously wrong with him, and that he will have a horrible life, that he will never be better, never be able to be happy or have successful relationships.

And, as usual, I am having arguments with my parents and they are blaming everything on me.  So helpful.  My mom always tells me to "try something different" to get him out of his aggressive/rage-filled moods, and believe me, I try everything.  Then last night he was at their house and punched her in the face, and she is mad at me.  I wasn't even there.  Yet she thinks that when he does these things to me I am just not trying hard enough.

So sorry, I am in a terribly dark mood.  Everything seems really hopeless right now. 

I just don't understand how suddenly there are so many kids that have these sorts of problems and need to be on medication.  How can this be?  I don't remember kids being like this when I was growing up.  We didn't know any kids that had these sorts of problems, and we knew a lot of people.  I just feel lost and confused about the whole thing.

The research I've been reading says there is no such thing as "adjusting one's brain chemistry" with medication, and that these medications can cause brain damage in some cases, permanently altering the brain.  This is just so scary to me.  Yes, his behavior is scary too.  I feel trapped between two really awful choices. 

I have been so impatient with him the last week or two, so frustrated with his behavior.  I feel like I have caused this to escalate, but then I can't even tell which is the chicken or the egg: did his behavior cause my frustration and impatience or vice versa? 

Is it because it's all dark and gloomy here, the sun going down now at 4:30?

Is it because it's been cold and rainy and he hasn't gotten enough exercise (and he needs TONS)?

Is something happening at school that's upsetting him?

Is someone hurting him? (This has always been the case when his behavior escalated in the past.)

Is it because something is wrong with his brain?

Is there something medically wrong?

I did ask his doctor to do blood work to test for lead poisoning (which someone suggested).  She is also going to check for celiac disease and a couple other things.  I want to make sure that we at least rule out any medical issues.  I wish it were only that simple.

I wish there was a blood test or brain scan that could be done for mental illness so I could just KNOW that there is something definitely wrong.  I am so scared to give him medications when we don't even know what's wrong with him.  What if we create a problem that he wouldn't have had otherwise?  What if he's just super sensitive and angry that he's been abused and scared, that he doesn't have a dad, that he doesn't get to spend as much time with me as he wants?

I wish I had a supportive partner (or even supportive family) helping me work through this and make these decisions.  Having the weight of this decision on my shoulders alone is unbearable.  I am so afraid I will make the wrong choice for my son, and if something bad happens to him because of this, I will just hate myself.  

I am just completely and absolutely crushed by what is happening to my son. 

I always wanted a child and was told I couldn't have kids, so getting pregnant unexpectedly was scary, but an amazing miracle.  I had no idea that things could turn out this way.  I always believed if I did everything right, my son would turn out to be loving, smart, and wonderful.  I ate all the right things during my pregnancy, I exercised, I breast-fed for two years plus, I was gentle with him, I spent tons of time with him, keeping him home with me until he was two.  I tried SO hard and I just can't believe he is the way he is.  I feel so responsible.  I wish I could know beyond a shadow of a doubt that there is nothing I can personally do for him and that medication is the ONLY option, but I don't know that.  I don't know anything.  Except that I am devastated for him, and for me, and I am scared out of my mind.

[Surfacing]

Originally Posted by Bisou 
I had no idea that things could turn out this way.  I always believed if I did everything right, my son would turn out to be loving, smart, and wonderful.  I ate all the right things during my pregnancy, I exercised, I breast-fed for two years plus, I was gentle with him, I spent tons of time with him, keeping him home with me until he was two.  I tried SO hard and I just can't believe he is the way he is.  I feel so responsible.  I wish I could know beyond a shadow of a doubt that there is nothing I can personally do for him and that medication is the ONLY option, but I don't know that.  I don't know anything.  Except that I am devastated for him, and for me, and I am scared out of my mind.

Bisou, you are such a resilient, hard working mother. There are things that are within your control, and things out of your control - we try our best with our children and do the best we can. You certainly have tried your best. I hope for some peace for you two soon.

[LynnS6]

:hug

Have you tried posting over in the Special Needs board? There are a number of parents there with kids on medication, and they might be able to give you a more balanced view. 

And a question: If your son had epilepsy or diabetes, would you be so reluctant to medicate? I would quit reading "Dr. Google". Medication can help and it can hurt, but I know of very few documented cases where the hurt was permanent and irreversible. Everyone has a horror story that they'd love to attribute to medication. There is also risk to not doing medication. He's not learning the skills he needs and he's not feeling good about himself. How long into his teenage years before he starts to self medicate with street drugs?

A quick story that I've told several times. Friends of mine have a child with severe ADHD (the kind that the stimulants make worse, not better). They initially declared 'no drugs' and did everything in their power to work with him on his behavior -- therapy, occupational therapy, diet changes, an aide in school to help, pulling him out of school to homeschool. His behavior got worse. He was in rages daily; multiple times a day sometimes. In desperation, they tried Risperdal (an "atypical antipsychotic" if I remember correctly). They really didn't want to do it, but they were at the end of their rope and they were worried about the self image that he was creating for himself (some of his talk about himself was quite worrisome). Risperdal made a difference. As my friend described "it gave him 2 seconds to think before he blew up". With Risperdal, he had time to learn to implement the skills that they'd been working so hard on. Without it, he was not in a place to do learning. He was on Risperdal for 18 months or so. During that time, he learned a lot of skills in self-control. 5 years later, he's still got ADHD, he's still homeschooled, he's still a bit quirky. But he's a delightful young man who's succeeding socially, academically and in many other ways. Risperdal gave him the chance to learn skills that he needed. Once he learned those skills, he didn't need meds. For other disorders, you do need more continuous meds.

You need to find a professional you trust and work with them. (FWIW, my friends also tried anti-depressants with their son and went off them after 2 weeks because they were making him much worse.)