Interrrrresting psychiatrist appointment today

[TerryJ2]

You can all say "I told you so," now.
After giving the psychiatrist an update, he was speechless. He agreed that difficult child sounded depressed and on the spectrum, but added that he felt he was in the middle of a soap opera. He said difficult child's behavior was more like a 15-yr-old than an 18-yr-old, and that he was shooting himself in the foot. He added, "And Mom, I'd try to stop putting everything onto a diagnosis like bipolar and start talking about irresponsibility and just plain being a teenager."
difficult child, for the first and only time, did not text during the session. Because he has a borrowed phone that only works on WiFi. He had to listen to the entire thing. I used to get on his case about texting during mtngs, but the psychiatrist let it slide. Ticked me off royally. Not today.

So, today, difficult child took the bus to school, showed up for first period, and was called to the office for ISS. He had skipped out on too many classes and they had his number. Or so they thought. He left class, and kept on walking, all the way home!
He woke me up around 9 and told me he'd overslept, and could I take him to school? Sure. And could he have a Starbucks? Sure, I'm in the mood, too. Sounds good.
I got an angry ans machine msg from the school attendance office a few hrs later. Arrrrrggh!

psychiatrist also said that if he ever talked to his mom the way difficult child talks to me, he'd--hhmm, can't remember, but something like he'd have been kicked to Mars. "But you have different parents."

He also said that what I was seeing was not so much ADHD/impulsivity, as it was flat-out defiance. I agree.

difficult child is being upped to 300 mg lithium 2x a day, continuing to titrate with Strattera, and if things only improve slightly, psychiatrist will introduce an atypical antidepressant. But he wants to make sure difficult child is at a higher dose of lithium before that.

He said in the meantime, no more skipping ISS to pay for ... skipping. (He slapped his forehead at the irony. I have to say, that today is the first time in maybe forever that the psychiatrist "got it." Did he hear all of you talking???)

Even after all this, difficult child had the gall to ask me to pick him up a steak for dinner at the grocery store! I'm speechless.

No, I made chicken and rice and edamame and difficult child didn't want it, so he opened a can of soup.
(Guess what kind of soup? Chicken and rice!) Fine. husband, difficult child and I sat at the table together and ate, and went over difficult child's history homework. It was almost normal. Scary normal.

 

[BusynMember]

Heh, Terry.

I still t hink psychiatrist soft-peddled it. I think it's beyond what he said. We had the same problem with the psychologist we took Princess to see. Most therapists tend to be way too soft on the kids, adults or not, in my opinion. The one Princess saw told her to tell me that I need to trust her more.

Now I didn't go into the sessions, even though she was a minor. She wouldn't talk at all if I was there,. But she would talk a little if I wasn't. God knows if any of that was true...she was taking drugs at the time. When she said that to me, she was very smug.

I didn't even know how to respond. She was on parole for drugs and we had just learned she was climbing out her window every night to run the streets and she never told us the truth about anything and his advice was that we should trust her more? I told her I didn't agree and that she'd have to earn our trust (when I could gather my wits to answer). She didn't want to go back and we didn't make her go back.

The fact is, your son is g oing to be a father and he doesn't care. He is using drugs and the psychiatrist isn't addressing it. Instead he is trying to fix it with psychiatric drugs which Son will mix with recreational drugs and which are not working. He's been taking them for years. He is doing what he does out of defiance, not due to any disorder. So was my daughter. However, she did get a whopping bipolar diagnosis while she was using drugs. The bipolar seems to have disappeared since she quit.

At your son's age, in my opinion, not only should you not sit with him in a psychiatrist's office, but he needs to be pushed to grow up and be responsible, even if he is now functioning as a fifteen year old. They grow up FAST when we stop making excuses for them and doing stuff for them, paying for them and stop TREATING them as if they are young teenagers. They have no choice but to grow up if we stop treating them like they are younger than they are.

At any rate, I wish you lots of luck, hope the medications help and hope this kid grows up so that he can be a father. I have a very low expectation that D. is going to actually give her child up for adoption. Most girls these days just will not do it and renege even if a family is already picked out. If she does not put the baby up for adoption, she can finger him as the father and go to court for child support and get it. Hopefully she will do right by the child, but it is extremely rare that it happens these days. A friend of ours (a couple) had three birthmothers pick them out for their babies and all three backed out so they went the foster care to adopt route.

 

[TerryJ2]

"I have a very low expectation that D. is going to actually give her child up for adoption."
I agree.

 

[TerryJ2]

Yes, the psychiatrist did address the pot use. He said he'd love to put difficult child back on Concerta, because it seemed to work better than the Strattera, but he needs difficult child to comply/cooperate and he couldn't be sure of that. He again mentioned behaving more like a 15-yr-old. So that's another reason he wants to work with increasing the lithium dose while we make sure that difficult child isn't using.

A psychiatrist or therapist has a tightrope walk when it comes to defiant patients. They have to have the person's trust and respect, so that the person will confide in them, but they have to be strong, in a clear but not rude way when it comes to reality. This psychiatrist also mentioned that difficult child needs to be "reality based." That's the same term that our therapist used.
We're supposed to keep difficult child grounded in reality. He is somewhere else in his head sometimes. He just shuts down. He used to do that when he was little, way before pot. He'd sit on the floor, turn his back to me, and look away from me, just like the dogs did if I were disciplining him. It was funny and scary at the same time.

Did your daughter do things like that?

Also, he used to bang his head against the crib until it bruised. When my easy child did that, the pediatrician said, "When it hurts, she'll stop." I used that same advice with-difficult child but to my horror, he didn't stop.

 

[BusynMember]

Well, Princess was not a problem at all until s he was using drugs. But my Autism Spectrum Disorders (ASD) son Sonic banged his head, had tantrums and shut down. I'm not sure exactly why, but he got better and better and became a really nice young man with no mental illnesses or behavioral issues. Everyone loves him. All Autism Spectrum Disorders (ASD) kids sometimes think a lot and aren't paying attention to the moment. I don't think that's odd for your son nor that you actually need to ground him in reality. He isn't half as affected as my son, who really does not like to do the things most twenty-one year olds do. I really do think defiance is your son's biggest issue and I don't believe changing medication one way or another will make much difference. Although he does have autistic traits, I don't see him as being clearly bipolar and wonder how they came up with that. Defiance and anger is different from bipolar disorder.Of course, I hope I'm wrong and the medications help his behavior, but while they can affect mood (for the better or worse), they can't make us behave differently than we want to. I know from taking psychiatric medications. They don't change you. If you get the right mix (and that can take years) it can change your level of happiness and THAT helps.

When my daughter (back to her) used drugs she was totally in lying mode, did more than we thought she did (drug-wise), got out of trouble a lot due to being a cute little Asian girl who looked so innocent, did not do well with psychiatrists and therapists (she was in the hospital once) and once she quit, she became a normal young women. Using drugs stunts your emotional growth so she really grew up fast after quitting. Made a huge difference.

I think a lot of our kids, especially when they are not being with honest with us, are also not being honest with their mental health professionals. I mean, your son maybe tells the truth to them. I don't know for sure. It's just the way I think because if they tell us stories, why would they tell a doctor, who has some power over them, the truth and get themselves into trouble?

I am appalled that this psychiatrist allowed your son to text in his office during a session. It never occurred to me that anyone would try to do that while seeing a shrink...lol. If I saw that, I would have grabbed the phone. That's like wasting your money....

Sigh...well, I wish you luck. It can be quite a trip for us as parents. Time is your friend.

 

[in a daze]

My kid was diagnosed with bipolar 2 at at age 25 because of irritability and that no anti depressants seemed to work. The real cause of many of his symptoms was drugs and alcohol. When he was hospitalized for the fourth time 2 years ago that psychiatrist orders a neuropsychological exam and guess what....no bipolar disorder, but major depression, anxiety, and personality disorder.

Just something for you to think about. He may very well be bipolar for all I know, but it seems that bipolar disorder has become the diagnosis d u jour just as A D H D was a few years ago.

 

[TerryJ2]

Somewhereoutthere, I am so happy that your autistic spectrum son is doing so well. Bravo. One thing I have tried to do over the yrs is to take my son out in public, to events, and to put him on teams. He had a few panic attacks during baseball opening season and went home, but the games themselves were fine. Wish he were on a team now.
Transitioning has always been a serious issue for my son. Once a routine is established, he will resist change with all his might. Through huge effort, he has improved greatly, and to further my point, I know a woman in a nearby city whose son is Aspie and she quit taking him outside. It was just too much work to deal with-the meltdowns. I guess he'll never have a job or live on his own. She is doing him no favors.

In regard to your daughter, from your description, it does sound like her personality did a 180.

I can't see that so much with my son. I can definitely tell when he's coming down from a high, because his irritability is off the charts. But he has similar, if milder issues, after a steady diet of milk, cheese, wheat and fat, such as pizza and fast food. And red dye. This has been the case since childhood. It's a poison to his system, just like drugs. He refuses to see it. WE can. Red ears, bloodshot eyes, tantrums, diarrhea, etc. You can't tell me he was doing drugs when he was 4.

by the way, I've been on this board since he was little, so you can go back and read the notes where I started to work with doctors and dxes.
If my son were like your son, when he's off drugs, it would be a wonderful world! But he has been unusual and different ever since I held him in my arms when he was 2 days old. His defiance started when he was about 1. I'm not aiming for perfect. Just accountability and honesty.

In regard to defiance, follow-through and consistency on our parts, as parents, is really important, and we have not always been good at that. husband is hardly home, and I tend to forget things, especially when I'm stressed.

Inadaze, lithium doesn't work for autism. And difficult child has been much better on lithium. MUCH better. That's one giveaway. Plus, genetics is a huge factor, and I've met both birthparents and both sets of grandparents. Long story, but he's got a mixture of both, I am convinced. Also, the bmom and her mother are both extremely defiant. As women, they are considered "bossy." They argue with you no matter what you say. Is the sky blue? Nope. Green.

His biodad, who I think is on the bipolar spectrum, did pot for yrs. Took him till he was about 30 to straighten out. difficult child does not know that. (I kept in touch with-the gmom for a while.)

 

[TerryJ2]

inadaze, the psychiatrist also said that bipolar has been over diagnosed. He said that it's a catch-all for anyone on the mood spectrum. He thinks difficult child is more dysthymic or something else I can't recall. Either way, lithium is our stabilizer.
He also said that bipolar people tend not to be 50.50 with-moods, they're more like 80 % depressed, 20 % manic or hypomanic.

He said he sees hypomania in difficult child, not flat-out mania. I totally agree with that.
He spent nearly an hr with us yesterday!!!

 

[BusynMember]

Terry, oh, I remember your son. My Autism Spectrum Disorders (ASD) son was VERY difficult when he was very young, but for some reason his behavior changed when he got older. He is definitely different from most twenty-one year olds and much emotionally younger. He is also obsessive. I also took him out, put him on teams, etc. They are just different types of people...it happens!

I do think heredity is huge with all people. I have no knowledge of Sonic's birthmother other than she used drugs and did not leave with hiim from the hospital. Underneath th e addiction, I suspect a beautiful person who was desperately poor and sick. I don't even know if the birthfather she named is really his birthfather as there is speculation she had a lively career to get drugs, but I know she grew up in almost the poorest section of Chicago, bare of jobs, cleanliness and hope.

Your knowing Difficult Child's birthparents are really helpful to you and can help t he psychiatrist too. If he does better on Lithlium thatn I would guess he does have bipolar because it is for that and no other psychiatric disorder.

I hope your journey gets easier and ends soon. Enough is enough, right?

 

[Tanya M]

Hi Terry,
Just reading along. Don't have much to offer but wanted to let you know I'm sending you positive energy and a hug.

 

[pasajes4]

My son's therapist advised me to look at his behaviors independent of any diagnosis' he had been given. The question then became: 1. Does he know it is wrong and choose to do it anyway. 2. What was the purpose of the behavior? 3. Did he have the tools to make a different choice? 4. Were the consequences appropriate, timely, and effective? We worked on this for years. Did it help? He knew when he got locked up he was solely responsible for the mess he made.