exceeding my ability to cope - child harming himself - Mothering Forums

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#1 of 18 Old 02-15-2008, 10:03 AM - Thread Starter
 
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I don't know what help anyone can give me here, but I have to say this somewhere or I will fall apart.

My son has been diagnosed with a host of psychiatric type problems in the last year, and recent events have left me stretched so thin I feel like I am reaching the end of my resources.

He was diagnosed with ADHD in 1st grade, OCD and Tourette's in 5th. His mood swings have always concerned me, but they've been explained as part of his other conditions. By the end of 5th grade he's taking Focalin, Lexapro, and Fluphenazine. Mood swings continue to worsen (both anger/sadness and giddiness/euphoria).

He starts scratching his arm in response to anger/depression. We are referred to a therapist who specializes in OCD children. She involves him in stimulus/response therapy. He shares that over the summer he attempted to suffocate himself with a pillow when he became very depressed about having Tourette's, but his mood is determined to be stable now.

He cut himself on the arm with a butcher knife (2 weeks ago Sunday). I was horrified but hid my reaction and calmly talked with him about why he did it. He refused to allow me to bandage it, but we compromised on cleaning/neosporin. The cut was a good two inches in length, not deep enough for stitches, but it will leave a good scar.

Coincidentally, he had a doctor's appt the next day, Monday. She increased his levels of Lexapro and ADHD medication and told us to bring it up with the therapist (duh)!

Tuesday he took the new, increased doses of medication for the 1st time and got in a fight on the way home from school. The other child is a neighborhood bully who has picked on my son (and others) intermittently...I routinely deal with his mother. My DS lost it and attacked him with a ladder that was lying in someone's front yard...I believe he would have seriously harmed him if he could.

He was hysterical after the fight...he called me, and a couple of friends walked him home. I rushed home from work to meet him and found him trying to hang himself.

The therapist doesn't have a system for after-hours response in her office, so I called the pager desk (she's part of Texas Children's Hospital), and the on-call child psychiatrist told me to bring him to a psychiatric hospital for an emergency evaluation. I did and he was admitted for 6 days.

They diagnosed him with Mood Disorder NOS (not otherwise specified) and said that his treatment plan would be for bipolar, although he was too young for an official bipolar diagnosis at this time. Lexapro and Concerta can make a mood disorder worse, I am told, and the increased dosage probably sparked off Tuesday's "depressive episode." His history of mood swings now seems significant.

He comes home from the psych hospital with a raging case of strep throat.

He can't go back to school until I've met with his teachers and counselor, who make me wait until Thursday to see them. They don't really want him back unless he's under the care of a therapist or child psychiatrist.

He needs to see a therapist weekly. His therapist does not see children with mood disorders.

We meet with a new therapist but she refuses to take him into her practice because he may need access to afterhours care and she doesn't have that. She says he needs to be receiving therapy from a child psychiatrist.

His child psychiatrist doesn't offer therapy. I have faxed him a list of child psychiatrists covered by our insurance and he's looking over it for me. This will be yet another new person in my son's life.

The therapist (who met with us but refused to take us into her practice) says that he needs me more than anyone right now. Historically, I have been the only one who can calm him down/talk him through his moods, and she says that right now my time/attention is crucial for him.

The doctor from the psych hospital says he needs to be picked up and dropped off at school, and not ride the bus. His school is open from 8:00 to 4:00. I teach from 8:15 to 4:15, 45 minutes away. His father (we're both divorced/remarried) will pick him up two days a week. My new husband will pick him up two days a week. I will juggle my schedule on the remaining day. My boss is Not Happy. The psychiatrist from the hospital is Not Happy. He says my son needs for ME to pick him up.

My job pays for our house. If I quit/lose it, we would have to sell our house and move into an apartment. We have 3 dogs, one quite large. The big dog is my son's dog. Selling our house and moving into an apartment would mean getting rid of HIS DOG, which would further traumatize him.

I just don't know what to do. I love him so, and I want to give him everything he needs, and I just keep hitting these dead ends, and I don't know what to do anymore.

Holly

So...I'm 43 and pregnant with #3 - how'd that happen?  

 

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#2 of 18 Old 02-15-2008, 11:03 AM
 
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I just want you to know someone is listening. I have nothing to offer you but encouragement. You sound like you're trying to do everything you possibly can for your child. Obviously it won't help the current year, but could you look for a closer teaching job? Keep plugging along. I hope you find some support through the healthcare system soon.
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#3 of 18 Old 02-15-2008, 11:17 AM
 
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Oh Holly . I don't have a lot of time right now but I just wanted you to know that I too am listening and thinking about your situation. It is so hard to see your child suffer and try to help. It is obvious from your post that your love for your son is tremendous and it is breaking your heart to not be able to help him. You're doing all the "right" things and it still doesn't seem to be what he needs.

Please don't beat yourself up, you are obviously doing everything that you can to ensure your son's health. It is simply not possible for you to do everything, all the time - as you pointed out - being there every day after school would have serious negative ramifications in other areas of your son's life.

You are in a very difficult place, but I can see you are doing everything that you know to do to help your ds.
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#4 of 18 Old 02-15-2008, 03:31 PM
 
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I just wanted to say that I used to do the things your son is doing now and I commend you for taking the time to listen and be there for him. Although, I do not have tourette's but the OCD and and mood disorder fits.

Lexapro and zoloft made me even worse, it was not a good time in my life. For the first time in a long a time I feel very good. I changed my diet, no gluten first and then no dairy. What a difference it has made.

So it may be something to look into to change his diet.

Hang in there, hopefully you will soon find a therapist/psychologist that is a good fit, and keep doind what your doing

wife to DH 2/03, mama to DS 3/03 & DD 1/09
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#5 of 18 Old 02-15-2008, 07:46 PM
 
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I wish I had more practical advice to give you, but maybe your son's therapist or the hospital staff might be able to help you find more resources or support. s mama

Jen, journalist, policy wonk, and formerly a proud single mama to my sweet little man Cyrus, born at home Dec. 2007 . Now married to my Incredibly Nice Guy and new mama to baby Arthur.
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#6 of 18 Old 02-15-2008, 10:29 PM
 
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Yikes! As soon as I saw Focalin and Lexapro, along with mood swings, I was like uh oh. (I work in adult psych but know how stimulants and SRIs can agitate persons with bipolar disorder). I haven't been in Houston for awhile so I'm not up on the current providers.

I think at this point I might get a little nasty with the insurance company and "let" them help figure something out. Of course, they're not going to want to pay for another inpatient hospitalization, so they may be more amenable to helping you find a child/adol psychiatrist and therapist, who preferably practice in the same setting and specialize in mood disorders. And there is something like this in the area, I'm sure of it. If TCH is not

The poor little dude needs a stable combination of providers that know what they're doing and can create a plan of care that will get him feeling better. I'm so sorry you guys have had to go through this.
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#7 of 18 Old 02-15-2008, 11:04 PM - Thread Starter
 
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Thanks for the hugs and kind words. I was really needing them...I've been feeling very isolated throughout this experience. I appreciate it more than I can say.

Still no luck with a therapist. I was rejected yet again by a guy our child psychiatrist referred us to. Over the phone, having never met my child or seen his records, he told me to readmit him to the hospital because he needs inpatient care, which is a totally ridiculous suggestion. Like I could take him back to the hospital and say, "I know you discharged him, and he hasn't had any incidents or episodes, but I want you to readmit him anyway, based on the opinion of a guy I talked with on the phone."

I am going to try for more referrals on Monday.

I am tired in my bones.

So...I'm 43 and pregnant with #3 - how'd that happen?  

 

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#8 of 18 Old 02-15-2008, 11:07 PM - Thread Starter
 
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Quote:
Originally Posted by perl View Post
Yikes! As soon as I saw Focalin and Lexapro, along with mood swings, I was like uh oh. (I work in adult psych but know how stimulants and SRIs can agitate persons with bipolar disorder). I haven't been in Houston for awhile so I'm not up on the current providers.

I think at this point I might get a little nasty with the insurance company and "let" them help figure something out. Of course, they're not going to want to pay for another inpatient hospitalization, so they may be more amenable to helping you find a child/adol psychiatrist and therapist, who preferably practice in the same setting and specialize in mood disorders. And there is something like this in the area, I'm sure of it. If TCH is not

The poor little dude needs a stable combination of providers that know what they're doing and can create a plan of care that will get him feeling better. I'm so sorry you guys have had to go through this.

Thanks for the tip. This is a good idea...I should call Blue Cross and pester them! Unfortunately it's now a weekend, and no one is available anywhere. We have wasted the whole week on people who won't see us! I am adding insurance to my list of people to pester first thing Monday morning, though.

Thanks!

So...I'm 43 and pregnant with #3 - how'd that happen?  

 

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#9 of 18 Old 02-15-2008, 11:39 PM
 
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Oops - my phone rang while I was responding and it looks like a thought about TCH trailed off... I think I was trying to remember if UT and Baylor have child programs - I know that UT has child/adol fellows but I'm not sure about Menninger.

The BC/BS people might be around still - they like to deny claims after hours, too! Seriously, though, I remember calling insurance companies at all hours of the day and night, so there's a chance they'll be around this weekend. Good luck and don't give up until they give you an option that will work. Keep us posted!
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#10 of 18 Old 02-15-2008, 11:43 PM - Thread Starter
 
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I was finally reduced to Googling "child psychiatrists houston texas" and got a bunch of results that way. I left messages at Baylor, UT, Memorial Psychiatry Assocs, and some place called "The Mood Disorder Center," which seems promising. Hopefully someone will call me back on Monday.

Off to pester Blue Cross!

So...I'm 43 and pregnant with #3 - how'd that happen?  

 

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#11 of 18 Old 02-15-2008, 11:59 PM
 
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Have you tried DePelchin? I taught a child who was sent there for awhile and apparently it really helped him turn a corner.



good luck!

-Angela
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#12 of 18 Old 02-16-2008, 12:09 AM
 
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Must be regional, but I diagnose pediatric bipolar disorder all the time--usually 5 is the youngest.... And the ocd-anxiety-depression-internal itchiness, psychosis, you name it, can be set off by stimulants given to a kid who is misdiagnosed ADHD.
Pick up The Bipolar Child and see if anything rings true there. You're the expert on your kid--and psychiatry (medication management) in children is a very experimental field.
And who knows, there could be a combination of diagnoses, but the treatment regimen you mention does not sound like one for pediatric bipolar disorder. And remember--pediatric bipolar disorder looks NOTHING like adults... there's no cycling or anything--just a big mess of symptoms that can happen all in the same day, hour, minute.
You could also call the local community mental health agency. While these types usually cater to Medicaid clients (but typically also take insurance) the professionals there have typically seen some tough cases and may be more creative at times than the private practitioners....
Just another note---searching for another child psychiatrist will get you meds but usually nothing more...It sounds as if a shift in that direction is good anyway, but a good therapist can be LPC, LCSW, Psychologist, and an array of other licenses and fields. You might find a good therapist who works in conjunction with a kiddieshrink, and that's the best idea--
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#13 of 18 Old 02-16-2008, 12:27 AM
 
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I'm so very sorry for what you're going thru.

Has ds expressed what makes him sad/angry? Gosh, if only we could get inside their minds.

Is he still on/reducing the meds?

Keep us posted and know you're not alone
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#14 of 18 Old 02-16-2008, 03:15 AM
 
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Holly. How hard.

There are moms with kids (and some themselves) with bipolar on the special needs board. Poor kiddo. Poor mommy.

Rachelle, mommy to 8 year old boys! 

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#15 of 18 Old 02-16-2008, 03:25 AM
 
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Wow! Sorry to hear about all this. Hope you don't mind if I pray for you and your son. Sounds like you need some good things to happen.

If you end up needing to homeschool, I'd be glad to help you find resources that would make it easy on you. (I mention this b/c you said the school wasn't wanting to take him back and he really need you right now, not to tell you what you need to do.) I wish there was more I could do.

Also, have you thought about trying to talk to an osteopathic doctor? I'm have health problems (Lyme disease and Chronic Fatigue) that cause all kinds of weird symptoms, including emotional. And I'm pretty sure my dd's ADD and auditory processing issues were caused by milk allergies. Not on the same scale is what your struggling with, but you never know if there might be something that could help. Sometimes the natural approach can pinpoint problems the MD's don't see after they put the label on. Probably not the first thing you should do, but after you get the other stuff worked out, you might try to find someone who could at least check if there is anything that could help.

Don't give up. Your his mom and you love him. Just hang on.

Traditional foods eating, homeschooling mom of 2 girls--Miraculously freed of Lyme disease last fall!
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#16 of 18 Old 02-18-2008, 07:42 PM
 
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Thinking of you. Hope everything's going okay.
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#17 of 18 Old 02-19-2008, 09:34 AM - Thread Starter
 
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Things are starting to turn around. I want to address some of the specific advice I received:

everyone: the hugs and support meant a lot! I was feeling very alone, and I really needed encouragement. Thanks! You never really understand the power of a little "huggy" icon until you need one quite badly.

JoJo: the dietary causes idea is a good one, and I would like to explore that further. Unfortunately, he goes to his dad's house one night a week and every other weekend, and I don't think I could get him on board at this time. Maybe eventually, though. I am keeping that in mind. I am afraid that, as you suggested, some of his meds are making him feel worse, and I will be bringing that up with the doctor.

perl, lanamommy, alegna: I called everyone you suggested and more. I finally got some help and some names, called those names, and now we have an appointment Wednesday with a child psychiatrist who teaches at Baylor Med Center. His wife is a child psychologist and they practice together, and they'll both be working with my son. Yay!

LymeadeLady: About the homeschooling. If it gets that bad, I'm willing to do it, and take all the help you and anyone else could give me and more. I really like your blog, btw.

Vito'smommy: he finally talked about it with me a little bit on Thursday. He said, "You know I did that thing (meaning attempting to hang himself) because I hated myself." I told him I knew, and asked him why he hated himself. He said it was because he'd lost the fight with D, he would never win a fight with D, and he was a "shame to his family."

That was enlightening, and I know he got that attitude from his dad. Not that his dad has said that, but he's said enough to indicate that if DS won a fight with a bully, he'd be proud and pleased and wouldn't punish him. Of course, DS then inferred that the reverse would also be true...that if he lost, his dad would be ashamed.

I told him standing up to a bully showed courage, and that I was proud of him for being brave, and that confrontations weren't about who won or lost but about showing that you were willing to stand up for yourself, which is always worthy of respect. (It's not exactly the stance I wanted to take on fighting, but I felt like, given what he already believed, it was the safest thing to say.) He seemed comforted by it. We'll work on that issue some more with the doctor, I'm sure.

I will post again once we've seen the doctor. Thanks for all your help!

On a side note:

DS came home from the hospital with strep throat and now he's having an allergic reaction to the antibiotic! He's covered in itchy pink spots. I had to go pick him up at school and take him back to the pediatrician. Argghh!

So...I'm 43 and pregnant with #3 - how'd that happen?  

 

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#18 of 18 Old 02-19-2008, 02:34 PM
 
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Things are starting to turn around. I want to address some of the specific advice I received:
JoJo: the dietary causes idea is a good one, and I would like to explore that further. Unfortunately, he goes to his dad's house one night a week and every other weekend, and I don't think I could get him on board at this time. Maybe eventually, though. I am keeping that in mind.

perl, lanamommy, alegna: I called everyone you suggested and more. I finally got some help and some names, called those names, and now we have an appointment Wednesday with a child psychiatrist who teaches at Baylor Med Center. His wife is a child psychologist and they practice together, and they'll both be working with my son. Yay!

LymeadeLady: I really like your blog, btw.
You might want to see if you can get specific allergy/intolerances tested if you think food is an issue. Since my younger dd literally has an "allergy" to sugar, the grandparents and nursery workers have taken it quite seriously. If a doctor says it, it carries more weight.

I'm so glad you found some doctors. Hope your appointments go well.

About my blog, THANKS! I need the encouragement too! (I don't have energy to get out much, so blogging's my thing.)

Thanks for keeping us up to date.

Traditional foods eating, homeschooling mom of 2 girls--Miraculously freed of Lyme disease last fall!
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