At a loss

[klmno]

WOW! Who would I discuss this with- a dr or a psychiatrist? Can this come and go? Would depakote have relieved the symptoms for 3 mos before they return?

Antother thought- difficult child told me yesterday and brought up again today that "sometimes he has flashbacks of bad moments in his life and he isn't always sure if they are dreams or really happened". I asked for examples and he said one was how much it bothered him when he was in elementary school and would get blamed and in trouble for something when it wasn't him that did it. Another was the first time I forgot to hug and kiss him good bye when I dropped him off at day care. These don't sound like hallucinations to me, but what questions should I ask to find out if there is anything serious going on with this?

 

[Sara PA]

What is it that the AP is really supposed to be doing for BiPolar (BP) that lithobid and depakote wouldn't or shouldn't be doing?

Risperdal is approved to treat manic episodes of bipolar disorder and as an add-on that makes both lithium and Depakote more effective.

I'm getting that your son was on Prozac for the better part of a year, if not longer. I can tell you that it took my son well over 6 months to start feeling normal after getting off Celexa. There was an almost immediate improvement but he was still cycling 6 weeks after stopping it and he was on 400 mg of Lamictal at the time. I suspect that some of your son's medication was added to treat the bad reaction to Prozac despite him being off it for 6 weeks.

 

[Sara PA]

The akathisia is medication related -- an adverse reaction -- and should be discussed with the psychiatrist.

After my son was off the Celexa for a few months we began to talk about his false memories for the first time. Some were false, some were greatly distorted. He just mentioned the other week again that he doesn't have clear memories of the years before he took the antidepressant but we don't talk about it so much anymore. No point. The damage is done, we have to move forward. But he is now very much aware that he can't trust his memories or perceptions of what happened prior to his stopping the Celexa. He was truly made psychotic by antidepressants.

 

[flutterbee]

I was on risperdal .5mg at night for a short while when I had severe depression. I was told at that dose it helps with irritability and impulse control, which it did.

However, it did make me feel very 'weird' - which is how I would explain it if I were a child. It made me very fuzzy - caused cognitive issues. I would call a friend and tell her that I have to go to the post office, bank and grocery store. Then I would call her when I got back and she would make sure I made it to all those places. Usually I had forgotten at least one. I would forget what I was talking about mid-sentence. Ok. I do that now. But, this was 2002 - years before the health and cognitive issues I have now. This was completely unusual for me. It also caused nightmares that were very vivid. It was bad enough for me that I stopped taking it and only took it PRN when I could feel the extreme irritability coming on.

 

[flutterbee]

Oh, and I also felt very spacey on it. At times it was like I was just an observer - everything would at times seem very surreal. I did dissociate some while I had the depression, but this was a different feeling.

I should also point out that I am very medication sensitive.

 

[klmno]

Ok- I will tread lightly with the therapist issue. I will discuss the akathisia question with psychiatrist- although I will have to wait until the next appointment.


Heather- difficult child is also a little medication-sensitive, as is his grandmother (my mother). What you described as side effects of risperdal- he has exhibited all that since being on mood stabilizers (lithobid and depakote).

I have been debating the need for day treatment- if I can arrange it. What do you ladies think about this under these circumstances? Would I be over-reacting?

 

[Sara PA]

What is it you expect from day treatment? My son was in day treatment after his suicide attempt. The day treatment program was a total farce. The approach was that the kids could control themselves and behave if only they wanted to. My son was still on the antidepressant -- violent and psychotic -- with a doctor (his personal psychiatrist was the same one he had in the hospital and at day treatment) who either didn't know or chose not to believe that my son was clearly having an adverse reaction to the drugs she was prescribing. When he became agitated and hostile, they called me to pick him up and take him home! I asked them why they thought he was there! They knew he was violent towards me but that didn't stop them from demanding I take him home with me when they thought he was going to be violent there. Gee, thanks for all the help. Pretty much, all they did was sit around and talk about feelings. From what my son said (admittedly he wasn't a reliable reporter in those day), the focus was usually on why they couldn't get along with their parents.

But that's what the local program was like. Others' milage may vary.

 

[Sara PA]

Lithium, Depakote and antidepressants as well as antipsychotics can all cause akathisia.

 

[klmno]

Thanks, Sara. Then, what do you recommend?

 

[Sara PA]

Well, that's just our experience. Check out what is available in your neck of the woods. (Or did you mean about medication?)

by the way, what are your son's lithium, Depakote and thyroid levels?

 

[klmno]

All I know is that lithium and depakote checked out in therapeutic range- thyroid cam back normal once and apparently outrageously abnormal once. I gave the results to psychiatrist so I can't recall the exact numbers. difficult child took a blood test on Friday so psychiatrist can make sure that the "mistake" (as psychiatrist calls it) on the thyroid level was the outrageous reading and not the normal one. psychiatrist said the results on those two tests were so different that it would be virtually impossible and that there had to be a lab mistake. I hope he is right- let's just say it wouldn't be the first outrageous, unexpected thing to happen in my family.

 

[Sara PA]

Hypothyroidism can cause depression.

 

[smallworld]

Hi there, sounds as if it's still hopping in your household.

A few thoughts for you:

Sara mentioned akathisia. My son experienced akathisia on Risperdal (0.5 mg BID). Akathisia is internal and external restlessnes akin to agitation. My son acted as if he wanted to jump out of his skin.

When my son first started Seroquel (Risperdal's cousin) while in day treatment last winter, he said he was experiencing depersonalization -- "like watching youself from a foggy third person dream" (from the psychiatrist's hospital notes). This side effect did go away in time. Could this be what your son means when he says he feels weird?

In terms of depression, my understanding is that Seroquel is better at treating depression than Risperdal. Perhaps the switch from Seroquel to Risperdal has caused your difficult child to feel more depressed?

 

[Allan-Matlem]

Hi,
It is great that you have a relationship with your child , so that he can confide in you , trust you to help him. In order to help our kids we need to access them , their feelings and expereinces. Although medications are important and can be critical in stabilizing a child , when we focus only on medications , we are giving a message - that the solution to our problems are drugs , everything is brain chemistry , just don't self medicate with drink or drugs. Why is he talking or feeling this way , what is bothering him , how is his competence/self esteem/self respect , does he feel that he is successful , does he have close relationships , peers, young adults as cheerleaders , what about a buddy-tutor, mentors , is he lacking skills to help him navigate the world etc . I am sure most parents don't want medications to be the long term solution. Ross Greene has written on this subject , I will share on another thread.
Sending you prayers and positive thoughts in your direction
Allan

 

[Marguerite]

I'm glad Janet raised the possibility that difficult child may have got the therapist wrong. That's not necessarily saying that difficult child lied, but he could have simply heard what he wanted to hear. on the other hand, from what you say this therapist does sound a bit of a worry and difficult child may not have been so far off the mark.

On your other thread I was urging you to be firm and take back control. However, a couple of things here -
First, it is really good that he is talking to you as frankly as he seems to be here, about how the medications make him feel as well as about his emotions. That is very important, given your concerns that the medications may not be right for him in a number of possible ways.
Second, although I did say on the other thread that you need to be in control, it IS okay to tell him you don't have all the answers. But it is still good he talked to you about it because together you can work at finding the answers.

Round about this age, kids begin to work out how fallible adults really are. He's already caught you and therapist in a conflict of information (as far as he interprets it). Maybe at this point you need to find independent information that you can point to, to explain just where you get your opinions on drinking and drug-taking interacting with his condition or his medications. Find a reference online maybe. Or perhaps challenge the therapist to come up with some reference to justify HIS position. Then pass this on to difficult child - he needs to be kept in the loop regarding his own condition and its management. If that means admitting to him that there are still question marks - so be it. You think he hasn't already worked out for himself that things are a bit confused right now? Having him on board as an active team member in his own health management could be a way to get his cooperation.

I really hope you can find a path out of this maze, it must be so confusing for you right now.

Marg

 

[klmno]

Thank you, Marg! The approach you described is what I am working on- I am trying to deal with things along those lines, but I obviously haven't mastered it yet. It does help me to stay focused on it when someone here reminds me of it.

I like your idea of finding "data" somewhere to show him about the dangers with drugs and so forth. Maybe I can get him to look at some stuff with me today.

I'll respond a little more on the other thread.

 

[susiestar]

I am quite alarmed at what your difficult child says the therapist said. I would want to discuss this iwth the therapist and your son at the same time, NOT the therapist alone. You probably have a pretty good gauge of when difficult child is lying, and problem do NOT have this gauge of when/if therapist is lying.

We have had tdocs refuse to discuss things with us (parents) after asking them to clarify what they told our difficult child regarding medications and sub abuse. It has been in the part of the session where teh therapist and Wizard speak with-o husband or I that difficult child is then told NOT to tell us things. IF you have any idea this may happen, wait until you get things arranged with the courts to change tdocs IF you feel it is needed.

I am always wary of ANY professional who tells my child not to tell things to me or to his father.

It sounds like your difficult child is asking for help. I would at least look into a day treatment program if one is available, simply because it may help to have some supervision during the summer. Around age 13 is when kids start experimenting with drugs/alcohol and the danger times are right after school before parents get home, or in the summer if left alone while parents work. And of course no teen wants to go to "daycamp".

I do know of tdocs who have admitted to telling tweens and teens that a "little" sub abuse is not a problem. in my opinion it is totally unethical, and probably illegal.

I would very very carefully sound out the therapist, and if I needed to discuss it with therapist, would be sure difficult child was with me - because I have usually had some idea of when difficult child was lying. And then could tell by how difficult child reacted if the therapist was misunderstood, or was in CYA mode.

It is really good that difficult child opens up to you on this. I would make a call to the psychiatrist if akathisia is suspected. Also would call after about 2 weeks to get results of thyroid tests.

Hugs,

 

[klmno]

I am always wary of ANY professional who tells my child not to tell things to me or to his father.

Me, too- even if it is teachers, or family, or anyone telling difficult child not to tell me something.

I would very very carefully sound out the therapist, and if I needed to discuss it with therapist, would be sure difficult child was with me - because I have usually had some idea of when difficult child was lying. And then could tell by how difficult child reacted if the therapist was misunderstood, or was in CYA mode.

Very good idea! Strange thing is- therapist told us he didn't have any opngs. for the next few weeks so he put difficult child on the waiting list and told me he would write a letter for me to take to court and that he would call me next week (which means this week).

 

[susiestar]

I find the wait/no openings to be very very odd. Most counsellors that are reputable only take clients when they know they have regular openings for the client. Maybe it is different because it is court ordered, but it sounds very very fishy to me. The tdocs behavior, I mean. What is the court letter to say, that he was too busy to see/treat your child? I do know that sometimes they have conferences, vacations, etc.. (cause like parents, they are people too!) but usually they would have someone to cover their patients. Not be in the office but have no openings for several weeks.

Hugs,