Monday is therapy day. Taz goes from play therapy with the psychologist, to OT for an hour, to Speech therapy for 1/2 hour. All in a row. I plan on changing the play therapy to another day after this month but Taz does well having Speech right after OT. Anyway, it's a long afternoon for all of us. And I was probably pushing it when I insisted we stop at the book store on our way home so I could grab a couple books I've really been wanting. I should have known better, especially with Taz being so unstable lately. But I did it anyway.
He did well playing with the train table for about 15 minutes while I grabbed the books I needed. Then we went to the check out and he very suddenly started screaming on the top of his lungs that he was hungry. He already ate all the snacks that I brought and it was almost dinner time so I said (in the most loving way possible) Oh you're hungry? Well we can eat something right when we get home!
But of course, that wasn't good enough. I don't usually mind public outbursts, especially in over-stimulating places like the grocery store and Target. There's always a little tot screaming here or there. But in a book store....well....let's just say he made a big scene. Everyone was watching us as we screamed our way from the children's section in the back of the store to the check-out in the front of the store.
As we waited in line and began to check out he continued screaming, running away and hiding (a new behavior but not going far), then yelling nasty names at Chica and screaming at her to stop watching him. But who could take their eyes off of him at that point? I stayed calm. I mostly either ignored him or made calming statements. Ironically the check-out girl had to call the manager about the pricing on one of my books which dragged the whole thing out longer.
Pretty quickly Taz escalated to trying to scratch Chica, who was just sitting quietly in her stroller. So I very calmly told him I would hold his hand so he wouldn't hurt anyone. He screamed louder but oddly did not try to scratch or hit me. I was almost finished paying when Taz suddenly screamed...
I peeeeeee!!!!!
And sure enough, I looked down, and there was a giant puddle on the floor under him. Now there was already a line formed behind me and there was only one check-out lane open. So everyone behind me had to wait while the worker got a roll of paper towels, and they all watched me clean up the pee puddle as my son screamed on the top of his lungs "I peed!!!" and continued crying and jumping around like a lunatic.
I could just feel the eyes poring into the back of my skull.
But. I did not lose my cool. I did not blush or look around sheepishly or apologize to anyone. Yes, I was embarrassed. Humiliated actually. But what good does it do to show it? It just makes me look like a floundering idiot.
Instead I stayed cool and confident. I was hoping it would make it seem like I meant for that to happen. You know....like when you trip over something but look cool doing it and it seems like you did it on purpose? Same idea.
I don't think it worked.
Anyway, if it was just about the screaming it would be no big deal. But add on top of that the name calling, the aggression, then peeing on the floor, and that puts this epic experience #1 on my list of most embarrassing public meltdowns ever.
Monday, April 12, 2010
Saturday, April 10, 2010
Mania
How do you describe mania exactly? Have you ever tried to explain it to someone who doesn't have a frame of reference? It's incredibly difficult.
For us, it goes way beyond being hyper. Yes, Taz is more hyper than most kids on a daily basis. Yes, he gets wound up easily, he gets rough, and he gets really silly and giddy. When he's like this he can pass for any ADHD child.
But true mania is different.
(Sidenote: In the bipolar world there is mania and there is hypomania. I'm not exactly sure the difference, just that one is more severe than the other. What I'm describing today is a more severe manic episode that Taz experiences every once in a while. There are times where he has the less severe form of mania; i.e. giddiness, racing thoughts, tunnel vision, grandiosity, hypersexuality, etc.)
I finally nailed down how different mania is than hyperactivity while I was talking to my mom about it today. When Taz is hyper I can at least slow him down with the right interventions and get some response from him. There can be an interaction. There is some amount of acknowledgment and reasoning behind his eyes, even if he continues to be impulsive and hyper.
When he's manic, there is nothing. There is no response. There is no reaction or interaction. There is nothing behind his eyes. He has a big eerie grin on his face but no acknowledgment about what he's doing. I could probably tell him, in all seriousness, that I'm going to drive the car into the lake and he would just smile at me. Maybe even laugh.
It's scary. The only word I can think of to describe it is psychotic.
But it's hard for other people to believe without seeing it. They try to explain it away. He's manipulating you. He's looking for attention. He's trying to make you mad. He's trying to be funny.
No. He's not "trying" to do anything. There is no thought behind it. There's nothing.
I guess you just have to see it to believe it.
(Sidenote: Taz was like this before medication but it had mainly stopped since starting medication. It does not appear to be caused by the medication he is on, although you never know. He did have a severe episode yesterday and today and the psychiatrist is aware of what is going on and ordering blood tests to check med levels next week.)
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In other news. I think we may be getting intensive in-home services sometime in the next couple months. We've tried this before through our local social services office (a foster/adoption response team is a free service for licensed families) but it didn't turn out well. The worker was undereducated and inexperienced in regards to serious mental illness. She looked at us blankly and said I don't know what to do at week 5. She was lost after her "Happiest Toddler on the Block" technique didn't work. Seriously. That's what she came armed with. We were supposed to grunt in caveman toddler language what we thought he wanted and he was supposed to calm down once he realized we understood his needs. I think I laughed out loud when she explained it.
Anyway, I'm hoping for a better experience (but I won't hold my breath). This is a program derived from the Yale Child Study Center specifically for families living with severe psychological problems, who've tried other resources, and who are at-risk for hospitalization. While I'm not planning to bring Taz to a hospital anytime soon, I have to admit that if he was much bigger and this violent, I would have no choice.
So...how do you describe mania? How do your kids display it?
For us, it goes way beyond being hyper. Yes, Taz is more hyper than most kids on a daily basis. Yes, he gets wound up easily, he gets rough, and he gets really silly and giddy. When he's like this he can pass for any ADHD child.
But true mania is different.
(Sidenote: In the bipolar world there is mania and there is hypomania. I'm not exactly sure the difference, just that one is more severe than the other. What I'm describing today is a more severe manic episode that Taz experiences every once in a while. There are times where he has the less severe form of mania; i.e. giddiness, racing thoughts, tunnel vision, grandiosity, hypersexuality, etc.)
I finally nailed down how different mania is than hyperactivity while I was talking to my mom about it today. When Taz is hyper I can at least slow him down with the right interventions and get some response from him. There can be an interaction. There is some amount of acknowledgment and reasoning behind his eyes, even if he continues to be impulsive and hyper.
When he's manic, there is nothing. There is no response. There is no reaction or interaction. There is nothing behind his eyes. He has a big eerie grin on his face but no acknowledgment about what he's doing. I could probably tell him, in all seriousness, that I'm going to drive the car into the lake and he would just smile at me. Maybe even laugh.
It's scary. The only word I can think of to describe it is psychotic.
But it's hard for other people to believe without seeing it. They try to explain it away. He's manipulating you. He's looking for attention. He's trying to make you mad. He's trying to be funny.
No. He's not "trying" to do anything. There is no thought behind it. There's nothing.
I guess you just have to see it to believe it.
(Sidenote: Taz was like this before medication but it had mainly stopped since starting medication. It does not appear to be caused by the medication he is on, although you never know. He did have a severe episode yesterday and today and the psychiatrist is aware of what is going on and ordering blood tests to check med levels next week.)
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In other news. I think we may be getting intensive in-home services sometime in the next couple months. We've tried this before through our local social services office (a foster/adoption response team is a free service for licensed families) but it didn't turn out well. The worker was undereducated and inexperienced in regards to serious mental illness. She looked at us blankly and said I don't know what to do at week 5. She was lost after her "Happiest Toddler on the Block" technique didn't work. Seriously. That's what she came armed with. We were supposed to grunt in caveman toddler language what we thought he wanted and he was supposed to calm down once he realized we understood his needs. I think I laughed out loud when she explained it.
Anyway, I'm hoping for a better experience (but I won't hold my breath). This is a program derived from the Yale Child Study Center specifically for families living with severe psychological problems, who've tried other resources, and who are at-risk for hospitalization. While I'm not planning to bring Taz to a hospital anytime soon, I have to admit that if he was much bigger and this violent, I would have no choice.
So...how do you describe mania? How do your kids display it?
Friday, April 9, 2010
Out for Blood
Taz has been relatively stable on his current med combo. Then the past couple days something inside him flipped.
He is WAY manic. But the main problem is how violent he's suddenly become.
Okay, he's always been aggressive. But normally (at least since starting meds) it has been half-hearted; meaning not much force beyond his swats and pushes. But yesterday...man! He was going for blood!
He was full force attacking Chica and me. It felt terrible for Chica. Every time he went near her she flinched. And when he hurt her she looked at me like why can't you stop him?
I tried. I tried and tried. But with two mobile children and one small house there is only so much one person can do. Aside from tethering one of them to me all day there are going to be opportunities for Taz to go after Chica. Pretty much every time he walked by her, any time she made a noise or even looked at him, he wanted to hurt her.
I think people don't really understand how hard it is to keep two kids apart. Especially when one of those kids (being a 1 yr old) doesn't understand to stay away from Taz. And Taz, who has bipolar, and doesn't want to stay away from Chica.
I tried using consequences to deter the behavior but when a bipolar child is unstable consequences don't do squat. I'm sure you know what I mean. Half of me feels sympathy for him because he probably feels really bad inside. And part of me is really angry at him for attempting to hurt a vulnerable innocent baby. I mean, that's my child he keeps attacking!
So. I'm not sure what to do as of now. I called pdoc and left a message. I emailed our psychologist to see if she had any ideas. I've heard that a lot of bipolar kids have seasonal effects, including becoming more manic in the spring. Maybe that's it?
Either way, I'm happy to have a break tomorrow. I'm working most of the day (I do per diem work some evenings and weekends) and Dh will be left to deal with it. Good luck honey!
He is WAY manic. But the main problem is how violent he's suddenly become.
Okay, he's always been aggressive. But normally (at least since starting meds) it has been half-hearted; meaning not much force beyond his swats and pushes. But yesterday...man! He was going for blood!
He was full force attacking Chica and me. It felt terrible for Chica. Every time he went near her she flinched. And when he hurt her she looked at me like why can't you stop him?
I tried. I tried and tried. But with two mobile children and one small house there is only so much one person can do. Aside from tethering one of them to me all day there are going to be opportunities for Taz to go after Chica. Pretty much every time he walked by her, any time she made a noise or even looked at him, he wanted to hurt her.
I think people don't really understand how hard it is to keep two kids apart. Especially when one of those kids (being a 1 yr old) doesn't understand to stay away from Taz. And Taz, who has bipolar, and doesn't want to stay away from Chica.
I tried using consequences to deter the behavior but when a bipolar child is unstable consequences don't do squat. I'm sure you know what I mean. Half of me feels sympathy for him because he probably feels really bad inside. And part of me is really angry at him for attempting to hurt a vulnerable innocent baby. I mean, that's my child he keeps attacking!
So. I'm not sure what to do as of now. I called pdoc and left a message. I emailed our psychologist to see if she had any ideas. I've heard that a lot of bipolar kids have seasonal effects, including becoming more manic in the spring. Maybe that's it?
Either way, I'm happy to have a break tomorrow. I'm working most of the day (I do per diem work some evenings and weekends) and Dh will be left to deal with it. Good luck honey!
Thursday, April 8, 2010
Normalcy!
I live on the East Coast and Hallelujah it's 85 degrees here!
A big part of keeping me sane, and keeping my family healthy, is playing outside. This past week or so we've been outside in the sunshine for hours upon hours. I love it. More importantly, my kids need it.
We live 1/2 mile from a lake and although I prefer the real beach (coastal people know what I mean), we spend a lot of time here too. Today was our first trip of the season.
In my last post I talked about normalcy and how I'd like to have just a few hours of it once in a while. Well, God must have been paying attention because today, I did!
There were several of Taz's friends there from preschool. They played in the water (which was freezing cold although they didn't seem to care), they chased each other, they splashed and laughed. It was so....well....normal. And Taz fit right in. He even chased the girls around with seaweed on a stick!
I didn't have to watch him like a hawk like I usually do. I could chat with the other moms and spend time with Chica (who, it turns out, does not like sand). It was wonderful.
We did have to leave a little early because I could sense a meltdown coming over a sand shovel. But that could be normal for any over-tired four year old.
Oh, by the way, the photo above...is not anything like what our beach looks like. It's more like the beach I picture in my dreams.
Wednesday, April 7, 2010
Tough Decisions I Shouldn't Have to Make
On a weekly basis my thoughts fluctuate between having hope for Taz's future and feeling the opposite, hopeless. Well, today I'm feeling utterly hopeless.
Taz has been on risperdal (3x day), seroquel (12mg at night for sleep, the only thing that keeps the night terrors away), and depakote (2x day). For those who don't know, risperdal and seroquel are anti-psychotics and depakote is a mood stabilizer. It's pretty typical that someone with bipolar is on anywhere between 2-5 different types of medication, usually a combination of mood stabilizers, anti-psychotics. BUT, every medication works differently for every person. Which is what makes medicating children VERY tricky. Like I've said before, it's a guessing game.
For us, the difficulty is exacerbated by Taz's age. Our pdoc (or psychiatrist) is very experienced in working with young children and strikes a good balance between being aggressive to treat the illness but conservative in dealing with medication and Taz's age.
We had an appointment on Monday morning to check in about the med combo he's on now.
Since Taz has started the depakote, more than a month ago, he has been eating NON-STOP. And I don't mean snacking here and there on high carb foods. I mean shoving food into his mouth like he's been starved his whole life, then asking for more before he's done chewing. He's been eating two, sometimes even three, of each meal. So, 3 breakfasts, 3 lunches, and 3 dinners. Plus snacks in between. And the problem is getting progressively worse.
Even though Taz is very active and skinny, and as of right now he's not gaining tons of weight, I'm still concerned about this side effect.
Pdoc didn't think it was any big deal unless he is gaining huge amounts of weight. But why would I want to wait that long? Maybe it's just not a big deal in the grand scheme of things? Maybe he's seen worse side-effects and I'm just being a wuss? I don't know. I'm new at this.
Anyway, I've been depressed, discouraged, and feeling hopeless all day because we are down to three options and one very big realization.
The options:
1) Keep everything the same and deal with the eating problem in other ways
2) Taper down the risperdal to see if it helps
3) Take him off the depakote and don't replace it
And the big realization is...(dum dum dum)....this is as good as it's gonna get, at least for a couple years (when he's old enough to try another mood stabilizer).
Yikes.
I think I'm still naive about all of this. I mean, I've never raised a mentally ill child before. How am I supposed to know what to expect? I put all my hope in that medication would make him "normal". Now don't give me any BS about there being no such thing as normal. You know what I mean!
Even when Taz is stable, or having a good day, there is still "stuff" there. Anxiety, fear, short attention span, social delays, the list goes on. I would love, not for my sake but for his, if we could get just a few hours a day of normalcy.
So I put all my hope in medication. And it's working, to the minimal effect. But when we are late with the risperdal, Taz falls apart. If we skip a depakote dose, Taz falls apart. So, what choice do we have? We have to keep him on all three. It's what's holding him together (although he's still very fragile) enough to get through the day.
I guess I can figure the medication is the glue that's holding all the bipolar pieces of him together. He still might wobble here and there. He's fragile enough that even a little bit of shaking will knock him over. But when the ground is secure, it's the glue that helps him stand strong.
And I think it sucks that we have to choose between side effects of the drugs and side effects of not being drugged. That's the tough decision no one should have to make.
So we chose side effects of drugs. We made a small basket of low calorie snacks (rice cakes, raisins, etc) that Taz can have access to anytime. But those are the only things he's allowed to eat between meals. I'm hoping it's worth it.
What did you choose for your kids?
Taz has been on risperdal (3x day), seroquel (12mg at night for sleep, the only thing that keeps the night terrors away), and depakote (2x day). For those who don't know, risperdal and seroquel are anti-psychotics and depakote is a mood stabilizer. It's pretty typical that someone with bipolar is on anywhere between 2-5 different types of medication, usually a combination of mood stabilizers, anti-psychotics. BUT, every medication works differently for every person. Which is what makes medicating children VERY tricky. Like I've said before, it's a guessing game.
For us, the difficulty is exacerbated by Taz's age. Our pdoc (or psychiatrist) is very experienced in working with young children and strikes a good balance between being aggressive to treat the illness but conservative in dealing with medication and Taz's age.
We had an appointment on Monday morning to check in about the med combo he's on now.
Since Taz has started the depakote, more than a month ago, he has been eating NON-STOP. And I don't mean snacking here and there on high carb foods. I mean shoving food into his mouth like he's been starved his whole life, then asking for more before he's done chewing. He's been eating two, sometimes even three, of each meal. So, 3 breakfasts, 3 lunches, and 3 dinners. Plus snacks in between. And the problem is getting progressively worse.
Even though Taz is very active and skinny, and as of right now he's not gaining tons of weight, I'm still concerned about this side effect.
Pdoc didn't think it was any big deal unless he is gaining huge amounts of weight. But why would I want to wait that long? Maybe it's just not a big deal in the grand scheme of things? Maybe he's seen worse side-effects and I'm just being a wuss? I don't know. I'm new at this.
Anyway, I've been depressed, discouraged, and feeling hopeless all day because we are down to three options and one very big realization.
The options:
1) Keep everything the same and deal with the eating problem in other ways
2) Taper down the risperdal to see if it helps
3) Take him off the depakote and don't replace it
And the big realization is...(dum dum dum)....this is as good as it's gonna get, at least for a couple years (when he's old enough to try another mood stabilizer).
Yikes.
I think I'm still naive about all of this. I mean, I've never raised a mentally ill child before. How am I supposed to know what to expect? I put all my hope in that medication would make him "normal". Now don't give me any BS about there being no such thing as normal. You know what I mean!
Even when Taz is stable, or having a good day, there is still "stuff" there. Anxiety, fear, short attention span, social delays, the list goes on. I would love, not for my sake but for his, if we could get just a few hours a day of normalcy.
So I put all my hope in medication. And it's working, to the minimal effect. But when we are late with the risperdal, Taz falls apart. If we skip a depakote dose, Taz falls apart. So, what choice do we have? We have to keep him on all three. It's what's holding him together (although he's still very fragile) enough to get through the day.
I guess I can figure the medication is the glue that's holding all the bipolar pieces of him together. He still might wobble here and there. He's fragile enough that even a little bit of shaking will knock him over. But when the ground is secure, it's the glue that helps him stand strong.
And I think it sucks that we have to choose between side effects of the drugs and side effects of not being drugged. That's the tough decision no one should have to make.
So we chose side effects of drugs. We made a small basket of low calorie snacks (rice cakes, raisins, etc) that Taz can have access to anytime. But those are the only things he's allowed to eat between meals. I'm hoping it's worth it.
What did you choose for your kids?
Friday, April 2, 2010
Crap! I Must Have Jinxed It
Yeah...so you know when I was talking yesterday about how we've been doing good....yeah, about that....
It seems as if I jinxed it. I hate when that happens!
Today (and it's only 10:15am mind you) has been a complete disaster. Everything should be good. Taz slept fine, ate enough, lots of exercise. I even tried to make a semi-structured schedule for him. Albeit very lame with my own pencil drawings of activities. I plan on printing nicer pictures this weekend to use as a schedule. Especially since I'm homeschooling after this month (more on that later).
But, none of that made any difference. Taz was manic at first. I thought that would stop once he had his morning medicine. It did stop, but turned into extreme irritability. I don't know which I prefer. Both are really annoying to deal with.
So, this could mean it's a bad day, all day. Or he could perk up after his afternoon risperdal. It could go either way.
It's nice out so I planned lots of outdoor activities, plus some down time. With most bipolar kids it helps to keep busy. He whined all morning to color easter eggs. So we did. Then he whined all during easter eggs to have a snack. I told him after we finished he could eat an egg. Then we went outside, where we usually have a great time.
Well, his powerwheels wouldn't work the way he wanted. Meltdown. We wanted to go on a wagon ride with Chica so we started to, but every time she moved from her seat, he would hit her. So I took him out. Meltdown. We came inside for a snack (yes, another. His depakote makes him eat like crazy). Taz had a meltdown over where to eat his cracker. Ridiculous!
It's just one of those days where nothing goes right for him. It's sad, really.
But I'm hoping he feels better this afternoon.
Like I said. We go day by day.
Anyway....if I don't post tomorrow. Happy Easter everyone!
It seems as if I jinxed it. I hate when that happens!
Today (and it's only 10:15am mind you) has been a complete disaster. Everything should be good. Taz slept fine, ate enough, lots of exercise. I even tried to make a semi-structured schedule for him. Albeit very lame with my own pencil drawings of activities. I plan on printing nicer pictures this weekend to use as a schedule. Especially since I'm homeschooling after this month (more on that later).
But, none of that made any difference. Taz was manic at first. I thought that would stop once he had his morning medicine. It did stop, but turned into extreme irritability. I don't know which I prefer. Both are really annoying to deal with.
So, this could mean it's a bad day, all day. Or he could perk up after his afternoon risperdal. It could go either way.
It's nice out so I planned lots of outdoor activities, plus some down time. With most bipolar kids it helps to keep busy. He whined all morning to color easter eggs. So we did. Then he whined all during easter eggs to have a snack. I told him after we finished he could eat an egg. Then we went outside, where we usually have a great time.
Well, his powerwheels wouldn't work the way he wanted. Meltdown. We wanted to go on a wagon ride with Chica so we started to, but every time she moved from her seat, he would hit her. So I took him out. Meltdown. We came inside for a snack (yes, another. His depakote makes him eat like crazy). Taz had a meltdown over where to eat his cracker. Ridiculous!
It's just one of those days where nothing goes right for him. It's sad, really.
But I'm hoping he feels better this afternoon.
Like I said. We go day by day.
Anyway....if I don't post tomorrow. Happy Easter everyone!
Thursday, April 1, 2010
A Good Day
I've got lots more background stories and bipolar information to put out there, but today I wanted to talk a little about how we're doing now. Because it's pretty good news.
Taz is doing well, at this moment. As in today. Well, sometimes we go day by day here. Actually, he was doing good for the last couple weeks, then this weekend fell apart. I was worried his med doses weren't high enough. Or suddenly stopped working (because that happens a lot).
But then he had a good week. And an especially good day.
I can tell when he's stable because he's much more directable. He apologizes if he hurts someone, does something wrong, or gets too rough. He is able to handle a consequence without raging or laughing, one of the two reactions that mean he's unstable.
He's even more verbal when he's stable.
I'm also playing around with a schedule that works for him. Taz has sensory needs as well. So I'm trying to juggle giving him what he needs, parenting Chica (who is a whole different kid), and taking care of myself. I haven't quite figured out how to balance it yet.
But today we did good. It helps that the weather is better. Spending a long time outside is good for everyone.
I think the lack of structure on the weekends is really screwing us up. I don't really think of Taz as a super structured kid, but maybe we need just a little more.
There's always something to work on. Always something to improve.
So we keep trudging along, trying to find our way to balance and harmony. I have high hopes for the spring and summer. I hope I'm not disappointed.
Taz is doing well, at this moment. As in today. Well, sometimes we go day by day here. Actually, he was doing good for the last couple weeks, then this weekend fell apart. I was worried his med doses weren't high enough. Or suddenly stopped working (because that happens a lot).
But then he had a good week. And an especially good day.
I can tell when he's stable because he's much more directable. He apologizes if he hurts someone, does something wrong, or gets too rough. He is able to handle a consequence without raging or laughing, one of the two reactions that mean he's unstable.
He's even more verbal when he's stable.
I'm also playing around with a schedule that works for him. Taz has sensory needs as well. So I'm trying to juggle giving him what he needs, parenting Chica (who is a whole different kid), and taking care of myself. I haven't quite figured out how to balance it yet.
But today we did good. It helps that the weather is better. Spending a long time outside is good for everyone.
I think the lack of structure on the weekends is really screwing us up. I don't really think of Taz as a super structured kid, but maybe we need just a little more.
There's always something to work on. Always something to improve.
So we keep trudging along, trying to find our way to balance and harmony. I have high hopes for the spring and summer. I hope I'm not disappointed.
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