Please somebody direct me to some help

[Sara PA]

My experience in calling 911 for a raging teenage boy is that you only make the situation worse and you prolong the raging. Actually, I never did it but I could see what happened when my son even thought I was reaching for the phone and what happened when others (once it was my son himself) called 911.

If he isn't to that point yet, he will will shortly be big enough that ambulance personnel won't touch him. Police will be called. Considering his legal problems already, that might not be in his best interest. Nor is it likely to get him to calm down; police presence and his fear of what they could and might do are more likely to lead to escalation of the raging. And, at some point you have to worry about how police will respond. Police respond to physical violence with force. They carry guns and they do shoot raging, mental ill people -- particular males.

There is a big difference between how emergency personnel respond to prepubescent children and almost full grown boys.

 

[Sara PA]

Something you said just rang bells in my head...

Think back -- is the raging less or more than before he started the lithium? After my son went off all but the Lamictal, we thought there was some mania (most because he wanted to stay up all night playing video games). So we tried some Lithobid. I have to admit that he did seem calmer but after a few weeks we began to see a restart of the regular violent rages. When the dose went up to 600 mg, we saw daily raging......those 45 minute long rages I have seen since he was two and which I identified back then as seizure activity. The Lithobid lowered his seizure threshold and allowed for an increase in seizure activity which, for my son, often manifests in emotional seizures. We stopped the Lithobid, the daily raging stopped.

Did your son ever have any neurological testing done?

 

[klmno]

He had a "regular" EEG in 2006- prior to starting any medications. The a sleep-deprived EEG last fall, while on mood stabilizers. Both came back normal. He was examined by a neurologist briefly. He has had neuropsychological testing done, as well.

You are correct re. calling police- I would only do that if danger (life or death) was truly immenent- then I would shoot for calling an ambulance. My son is on probation- calling police steers more attention to punishments through detention and less attention toward mental health treatment.

He raged before taking lithium and lithium basicly stopped it. It would come back if we tried to titrate down on lithium to switch it out and then the raging came back a couple of months ago anyway. Now that you mention it, raging while on lithium has been much worse- more destructive, impulsive, and leading toward violence at times. I can't be sure if this is a natural progression though, or related to the lithium.

 

[smallworld]

The sleep-deprived EEG while on mood stabilizers (specifically anticonvulsants) might not have yielded an acccurate result because the anticonvulsants treat seizures. We had to bring my daughter's Depakote dose down to do a sleep-deprived EEG.

 

[DammitJanet]

Just for what its worth...Lithium caused me to flip out.

 

[klmno]

I can't remember if depakote had been started just before or just after the eeg- I need to check my records.

Now that you bring up neurology- difficult child told psychiatrist a couple of months ago that he felt like he was have short seizures because he was having quick involuntary movements of arms or legs periodically. Lithobid had just been increased due to raging coming back. psychiatrist took difficult child's report to mean a reaction to that dose of lithobid, not seizure activity. This is why the lithobid was lowered back and an AP added. Whe the first AP wasn't working so well, the lithobid went back up and the AP switched.

since he has bee monkeying around with the lithobid, will the thyroid test results be accurate?

 

[Sara PA]

Once again, keep in mind that EEGs rule in seizure disorders, they don't rule them out. The temporal lobe, the part of the brain that is responsible for many aspects of emotions, is deep in the brain and notoriously difficult to read with the technology we have. It is estimated that about 50% of TLE is detected with EEGs.

The raging should be less with the lithium if the raging is caused by bipolar disorder.

More flashbacks from The Bad Years -- that belief that things would be worse without the medication, that the "natural progression" would be far, far worse without the medications. Eventually, I began to ask myself if he was better or worse on the medications. The answer was worse. That's when I went looking for help and found that the medications were likely making things worse. Shortly after that most of the medications went.

 

[klmno]

Flip out in what way? Mania? Did it happen right away or after taking it for some time?

 

[klmno]

I've had those thoughts myself, Sara. Unfortunately, as long as the courts are involved and he has a CHINS (for services) and psychiatrist recommends medications, I have no choice.

One thing I will say, if he is going to come off lithium, he needs to be locked up until his body adjusts. I will not live with him alone through this- unless psychiatrist finds some other medication to compensate for it, and we already tried trileptal.

I will say- I never saw anything close to rapid cycling until he was put on mood stabilizers.

 

[Sara PA]

Yeah, I meant to mention that part about being involved in the criminal justice system. been there done that.

My son was arrested for something stupid that happened after he was jumped in school. The kid who jumped him got detention, my son accidently hit a teacher and he was charged with felony assault. That coincided with our getting a copy of my son's phos discharge statement*, our learning about the psychiatric side effects of the drugs he was taking and our decision to fire the psychiatrist responsible for it all. (Ah, those were exciting times.) If I could have, we would have just taken him home and taken him off all the medications. But there was the court demanding that he plead guilty to something -- anything -- so that the court could keep an eye on him and make sure he "got the help he needed". I threw my $500/mo doctor and therapist bills at them and the two inch file of medical records and demanded to know what additional help they thought they could provide and, oh yeah, were they going to pay for it? We went to trial and the public defender got the charges dropped. We dismissed the therapist until my son was more stable. We found a new doctor who stood by supportively while my son discontinued all but the Lamictal and, eventually, after trying some other mood stabilizer add-ons, the Lamictal. That was the doctor we had when it became obvious the lithium was allowing seizure activity to occur. We never did get a new therapist. By the time my son would have benefitted from a good one, if we could find one, he was unable to trust medical personnel. He wouldn't even go to the ER when he had a gash in his head and a concussion.

Boy, I'm having a lot of memories stirred up.

*That discharge statement was so full of factual inaccuracies and so biased against me that my son refused to see the doctor again.

 

[DammitJanet]

K...I lost insurance for reasons too lengthy to go into right now but because of that I was forced into the public income based mental health system. Their psychiatrist's have their own rigid ideas of how to treat bipolar and werent at all interested in listening to me when I told them what I had been on for YEARS successfully. By the time I actually got into them I had run out of my own medications so I had to cold turkey all these psychiatric medications and try it "their way." I did but I was kicking and screaming the whole time. I refused depakote completely because of two reasons...the weight gain plus it caused a life threatening wbc problem for Cory. I took lithium for about 3 weeks and was a basket case the entire time. I actually expected it to work somewhat because Cory took it fairly successfully. At that point I got nasty and told them that I would either be put on what "I" knew worked or I would be put on nothing. I got their attention.

Lithium made me irritable, angry and it gave me non-stop eating.

 

[klmno]

Thanks, Janet, Sara, and all! I have spent the day doing domestic chores, talking with difficult child, and researching some of these links that you kind ladies have provided. I feel a little more hopeful now (I hope it isn't too idealistic). Anyway, the therapist that we see tomorrow had mentioned a couple of options before. I want to discuss them more in length tomorrow- one being day treatment.

Then, I will write a heart-felt letter to gal and judge. It might not do any good, but I at least want them to know that as long as they are involved, I can't really do any more without signing over custody or them taking custody. I could do more if they were not involved- this was proven when I had difficult child at the er several weeks ago and it was at the place where he could have gone straight into their day treatment from inpatient after a few days- IF he hadn't had outstanding charges. Hopefully, they will consider that although things aren't "cured", he has made a drastic improvement in functioning at school and in the community and I do think they realize that I am not a mother who lets her kid just do whatever he wants, but he does need more than this. Hopefully, the judge will see that I shouldn't lose custody in order to provide it- especially if they see that I could provide it if they weren't involved. Of course, I still need to keep in mind that they became involved because of difficult child's illegal actions, not theirs.

I would like to add- people with BiPolar (BP) and other mental health issues, particularly that effect behavior, are to be admired, in my humble opinion. My son (and apparently most others) not only has to deal with what is going on with him, but then there seems to be so much more BS added to it that he has to bite his tongue about and tolerate and deal with from people who think they just have all the answers when they really have no clue. These people are mixed in everywhere, it seems.

 

[Shari]

Holy cow, what a weekend you've had. Yikes.

I think your plan of attack is right on. If your judge has any human component left to him/her, surely he/she will at least consider what you are saying.

Good luck.

 

[amazeofgrace]

gosh, call 911, and then go pack a bag for yourself, since you'll more then likely be waiting somewhere for a really long time. Your tooth brush, your medications, good book, blanket/pillow, deoderant, make sure you're dressed comfortably, cell phone recharger. Also some water bottles and snacks, maybe a deck of cards and difficult child's paperwork and contact names.

Praying all is ok

 

[Marguerite]

KLMNO - way up higher, I don't know how many posts ago, you said, 'These "episodes" happen quite often on Sundays. I have no idea why.'

Have you kept a diary of events? If so, go back and check if this is really the case. Also look to see when other similar episodes have happened, if any happened on another day. See if there is a pattern.

I'm a bit naive on this score, Sara might be able to help - does diet link in at all? For example I remember hearing of a boy who always got a migraine on Monday morning before school and doctors for a long time put the problem down to school avoidance and anxiety - it turned out that the family treat was to go out to the local Chinese restaurant on Sunday nights for dinner, and the kid was actually reacting to MSG.

Maybe there is something that happens on Saturday - taking his medications later in the day perhaps, or more successful in skipping his medications - that means Sunday is the day for problems to manifest.

This could be useful information.

Marg