Monday, July 26, 2010

ADHD with a Little PTSD and GAD on the Side

I need to change the name of my blog from "Battling Bipolar" to "Battling Acronym Disorders".

I was pissed today. Really pissed.

I had a phone conversation with Taz's psychiatrist at the hospital, who is also the director of the hospital program. Just like I said in my last post, I told him that I could get any doctor to prescribe ADHD meds, no one is disputing he has that, but what we came for was a mood stabilizer or some other medication used to treat bipolar. And that I wasn't happy with the Intuniv results, Taz has still been aggressive and irritable at our visits.

And then it all came to a head. Dr. F started going on and on about Taz not having bipolar and that he was getting older and learning how to push buttons and test limits. Again, I did not put my child in a psychiatric hospital because of ADHD and button pushing!

I said that if the hospital is supposed to be teaching me behavior management they are doing a pretty crappy job because so far, no one does a damn thing when Taz attacks me during visits. He said they were still observing the "interactions he has with his mom and dad" and the behavioral stuff will start soon.

I said, what? Time-out? Do you think we haven't thought of that in the last two years!? I'm not an idiot! (I probably shouldn't have said that part, I'm sure it didn't help my case for not being a crazy parent)

Then Dr. F proceeded to tell me that he asked Taz why he hits us and Taz said because we're dumb. Then Dr. F asked me where he would get that language from?

Umm....let's see. Daycare, his older cousin, TV, friends in the neighborhood, everywhere! We certainly don't talk that way so it's not from us. I'm still not quite sure where he was going with that.

I reiterated again that Taz doesn't have a behavior problem (are you getting tired of hearing this yet?), that he has a disorder that's symptoms are behaviors. We have done everything imaginable to change Taz's behavior... and it just doesn't work.

Taz is not able to connect an action to a consequence.

We've had this reiterated by professionals over and over. Then Dr. F asked me what usually happens when he gets aggressive and out of control.

This is what I explained. When Taz gets aggressive it's hardly ever just a smack here or there. It's usually a meltdown that includes destruction, aggression, and complete loss of control. It becomes all about calming him down. We can't use logic or reason because he's not "there" enough to process that. The only thing that works to calm him down is to remove him from people and things that he can destroy.

I described how in our old house we cleared out a room for him where he could sit on a bean bag chair and calm down but couldn't hurt people or break things. And it worked. He would calm down then we could process through what happened.

Now. Here's the catch.

We could put him in that room 20 times in one day and process through the event 20 times. But the next day, the next week, the next month, the next year, he will make those same 20 mistakes over again.

He doesn't change. He is not learning.

That's when the conversation changed. He agreed, over the phone still, to start Invega (a new form of Risperdal that is extended release). He started it today.

So...about an hour later I had an appointment at the hospital where the therapist was going to facilitate an interaction between Chica and Taz. Taz was sleeping, which apparently is happening a lot during the day because of the meds, but should wear off after a while, so the therapist listened to my concerns then brought in Dr. F.

Now. Here's the weird part. For some reason, Dr. F did a complete 180.

Is it because of something I said? Is it because I so eloquently stated my case which was so intelligently thought-out? Let's just go with yes.

Dr. F said that Taz may have bipolar and is likely to end up with some mood disorder but he can't diagnose that now at his age. He does not believe Taz's behaviors are planned or controlled and they are not a result of anything we are or are not doing. Thank you!

So. Bottom line from Dr. F: Taz has ADHD. He has developmental delays. And the rest of the issues we're seeing are due to early childhood trauma and anxiety.

Dr. F explained that the first 12 months of life are imperative for emotional development. If Taz endured an enormous amount of stress as an infant/toddler, which he did, the cortisol (stress hormone) levels in his body were probably elevated enough to cause damage to the brain. It causes people to get stuck in a hyper-vigilant state where they are constantly on guard for danger.

Basically, when Taz is frustrated, feeling challenged or threatened, he immediately loses higher brain functioning (logic and reason) and only uses his lower brain (fight or flight). Which is why sometimes it seems as if Taz is literally fighting for his life.

Dr. F felt like the on/off switch Taz has for meltdowns is more consistent of a child coming from a traumatic background than a child with Bipolar. What we see as depression he thinks is really anxiety. The violent thoughts and ideas he also says is common for people with PTSD.

This is something I can buy into. At least for now. Do I think Taz has some mood issue that will come to a head at some point in his life? Absolutely. Do I think he has bipolar now? Yes, I still do. But since we can't seem to get a mood stabilizer going to find out, I'm willing to try the Invega and Intuniv instead.

Now for the big news!

Taz is coming home tomorrow!!!

I told them I was taking him home. The psychiatrist would have liked to keep him one or two more days but agreed to let him get his vitals checked outpatient so he could come home. I feel like we're at the limit for keeping our attachment secure. He needs to come home now. He's asking more consistently about going home and tonight he asked me to stay overnight with him. He's increasingly more anxious when I visit. And he says he doesn't like the hospital. He's definitely ready.

And of course, so am I.

I think I have a greater appreciation for what Taz brings to my life. Even when it's hectic and crazy and aggravating.... I still need him. I need to be able to hug him before bed and know that I'll see him first thing in the morning.

I just love him so much.

So what should I rename my blog? Raising Complicated Kids is already taken. I'm kind of mad she thought of it before me :)


  1. Blog name - I like "Battling Acronym Disorders" or even "Battling Childhood Acronym Disorders"

    I am glad that your conversation changed Dr. F's view point. I do agree with what was shared regarding the first year of life. Your description of Taz is so dead on for my Miss M, who is now 7. They can lable her whatever they need to but just keep me supplied in Abilify and Risperdal or Miss can't keep her mood from being all over the place.

    You are doing an awesome job!!!

  2. Wow. I don't know what to say about Dr. F., except that it sounds like he has some mood issues of his own. What you are describing about not processing that connection can be aspie or bp, but factor in the rages, and I vote for bp. The infant trauma thing I can buy, but what would be the harm in just trying him on a mood stabilizer and antipsychotic to ***see*** if that mix works. Ugh. We had a frustrating hospital experience with my daughter's first hospitallization...It was tough. The 2nd hospital was awesome. Thanks to them, she's doing awesome. Glad you are bringing him home!

  3. You do realized that the acronym of 'battling acronym disorder' is BAD, right!

    and have I sent you to this blog? I've been recommending it to everyone recently . . .