ADHD? ODD? Please help, I'm beside myself over this.

[DoomaYula]

When one of my now-7yo twins was 4yo, he was suspended from preschool for having a meltdown and throwing a chair at a teacher and at other students. At the time, I took him to a play therapist and his behavior seemed to improve. He saw her weekly for several months, and slowly saw her less and less frequently. He saw her for about a year total.

In the last six months his meltdowns have returned. As he is now larger, he is inflicting more and more damage and I'm getting worried about his level of violence. When he gets angry -- and I never have any clue what is going to set him off, or why -- he starts screaming and either kicking, hitting, or throwing things. Usually "things," like whatever is nearby, but I'm worried that as he gets older it will turn to people. I have nightmares about him growing larger than me.

I took him to the ped after the woman who babysits (about once per week) said she could not have him at her house anymore due to his damaging her fridge, stove, etc. The ped sent us to a pediatric psychiatrist who dx him with ADHD and ODD. He did it based on observations, talking with me, and having my son and me both fill out questionnaires.

He put him on Intuniv for ADHD, and suggested another therapist, who my son has been seeing for about six weeks now. At first the Intuniv put him to sleep about 8h after he took it, but now his body seems used to it, and he is getting increasingly more erratic and violent. I have absolutely no idea what will set him off. I have no idea how to help. Tonight he was sent home from a youth group for having a meltdown and throwing chairs at the other children.

We eat clean, very little processed food, almost 100% organic. Raw milk, grass fed, range, local. I mostly unschool, and the kids get about 1-2h of screen time per day. (A lot of meltdowns when it's over.)

I called his therapist, and he is seeing the psychiatrist again on Friday, but I'm just at my wit's end. I'm sad, I'm scared, I'm feeling overwhelmed. I'm 36w pregnant.

[vocalise]

I didn't want to read and not respond. Hugs, mama.

My reading is that it *might* be ODD, but what other problem behaviors does he display? Does he openly defy you and others, or is it really just unpredictable/violent tantrums?

When I was little, I had awful tantrums, and in retrospect, I think they were the early manifestation of my bipolar II disorder.

You're doing all the right things, from the sounds of it. Get him help. Love him to pieces. And maybe do some research on techniques you might be able to try to help him manage his behavior. I know there's a system developed specifically for working with kids with ODD, but I can't remember what it's called right now.

[Emmeline II]

I think there is something going on besides ADHD. I would ask for an evaluation for bipolar disorder.

[DoomaYula]

Thank you. I'm really trying hard to love him tremendously. I always tell him that I love him, but I don't like XYZ behavior. I just started re-reading How To Talk for the fourth or fifth time, for a refresher.

I started thinking maybe bipolar today? I don't know. He is not particularly defiant, it's just that something sets him off and I never have any idea who/what/when it will happen.

The therapist has seem him in post-meltdown mode once -- prior to that, I swear he must have thought I was making it up! -- and he (therapist) said that ds showed some REALLY extreme black/white thinking. Like, "I do everything in the house while my siblings don't do anything; everyone hates me; etc." The therapist noted that he seems to blame everyone else for everything.

It's just starting to really affect all of our lives -- I worry about taking him places, I worry about leaving him with a sitter. I was getting iron infusions last month 3x/week and I actually had to take him with me to the chemo center once because the sitter wouldn't watch him.

[SilverLace]

What you are describing sounds more like Asperger's than ADHD. My ss has both... but his AS is much more the issue.

The black and white thinking, the trouble with school, the unpredictable meltdowns/outbursts are in many people's stories of AS. And the people thinking we are making up how hard/bad it is.

I've said it before- I think the best evaluations come from neuro psychologists. Good luck.

[2xy]

DS1 was only violent towards me and his dad. He never had any problems at school or daycare, but had horrible meltdowns and outbursts at home and sometimes with us in public places or at the homes of friends.

He had an ADHD/ODD diagnosis before he even started Kindergarten. In 2nd grade, he had a full, two-day workup at a well-known children's hospital. He was evaluated by a team of specialists and also was given an IQ test.

We tried different parenting techniques, family therapy, individual therapy, the Feingold diet, and eventually medication. Nothing ever really helped him. His behavior was less extreme, but was still prone to fits of rage, depressed mood, poor attention span, and hyperfocus. At age 11 they labeled him as possibly bi-polar. He was on mood stabilizers at that point.

When his dad and I separated, he freaked out and ended up in a children's psychiatric hospital for a week.

Long story short, he had sleep apnea. Chronic sleep deprivation can cause all sorts of mood problems, as any new mother will attest to. It also contributes to poor attention span. He did not fit the stereotypical image of a person with apnea...he is thin, doesn't snore, and didn't have big tonsils. I began suspecting sleep issues about three years before he got a formal diagnosis, as they run in the family. Nobody would listen to me. They kept telling me that people with ADHD have sleep problems. I kept saying that people who have sleep problems look like they have ADHD. Someone finally referred him for a sleep study, he had throat surgery to remove extra tissue, and he has been like a new person since he was 13yo.

Whenever the subject of ADHD and such arises, I tell my story. It's not that I think all troubled children have sleep disorders, but if I can save even one from years and years of painful living, it will be worth rambling about. I deeply regret that the first dozen years of my son's life were full of chaos, turmoil, and drugs. I also regret not being able to give my younger child as much attention as he deserved because of spending so much time dealing with his big brother.

[joensally]

Hugs to you. This sounds terribly hard.

The challenge with ADHD and ODD diagnoses is that they're subjective and based on inventories of observed behaviours. Defiance tends to be a hallmark of ODD.

I'd look at ASD, bipolar or sleep apnea. Have you ruled out allergies?

[Emmeline II]

What you are describing sounds more like Asperger's than ADHD. My ss has both... but his AS is much more the issue.

The black and white thinking, the trouble with school, the unpredictable meltdowns/outbursts are in many people's stories of AS. And the people thinking we are making up how hard/bad it is.

It can be both, as with my ds, who exhibited the behaviors the OP described but improved a lot on an ADHD medication and CBT. But the increasing erratic and violent behavior and mood swings seems like the descriptions of bipolar in children that have been described here.

Edited by Emmeline II - 11/10/10 at 7:40am

[Kreeblim]

Edited by Kreeblim - 11/21/10 at 1:39pm