Sunday, July 18, 2010

So This is Therapy?


I met with my son’s therapist this week and after describing the voices he’s been hearing, the invisible man he saw and the quick mood changes, our therapist thought deeply for a moment and said, “There’s nothing more I can say to help”.

Hmmmm... I wondered, can’t you do some more research or something?

Our therapist agreed that what we’re dealing with is pure chemistry. If my son is well, he can do well and if he’s not, he can’t. In other words, when the chemistry is off in my son’s brain, no therapy is going to help. We can’t do any more than what we’ve been taught to do. We just have to wait for the chemicals in his brain to return to normal.

He then went on to say that my son’s case is very unusual, it’s like a “mixed bag of symptoms”. He finds the voices and visual hallucinations almost unheard of in children, then he referred to bipolar kids being less than 1% of the population. So this all seemed to stump him. He said that we have a moving target and he doesn’t want to look ahead into the future and get our hopes up. He just wants to deal with each symptom as they come and try our best to help him get through his childhood the best we can.

From there, he said the only alternative left is more medication, so I was told to speak with our psychiatrist’s nurse (the gal in charge pretty much). When I spoke with her, running through all the symptoms and when they occur, she said that it appears he was having rapid cycling and the voices were a concern. Our option is to increase the Trileptal, but first we were told to monitor these behaviors for a little bit more before we increase the meds. I like this approach, going nice and slow.

As I pushed further for what she thought my son’s symptoms were she said “It sounds like bipolar, but since he’s so young we just never know what will happen in the future.”

I asked her, “So you think it’s possible with all his symptoms that he may still out grow this?”

She said, “Yes... and we don’t want to label him at such a young age since this could be hard on him.”

At that I kinda laughed, “but he already knows something is wrong, we aren’t hiding it from him by not putting a label on it, in fact, he’s already labeled it. He calls it his ‘anger problem’ and said this week that it’s ruining his life”.

Then I asked her “So either my son has bipolar symptoms as a child and will grow up to be bipolar as an adult or he has bipolar symptoms as a child, but his brain will change as he develops and he’ll be free of medication and illness as an adult?”

She said “Yes. That’s pretty much what we’re looking at. So your job is to keep him safe, keep those around him safe and try and help him have the best childhood possible under the circumstances and don’t think about tomorrow, just take one day at a time because today is perfect.”

hmmmm...

ok.

8 comments:

  1. Mama Bear: You need a new psychiatrist and a new therapist asap. And I would never, ever listen to that nurse's advice. Today is not a perfect day for your child. That is completely idiotic. He is suffering. If she was hearing voices and seeing scary shadows would it be a perfect day for her? What kind of advice is that? What if his voices tell him to kill himself? What if they tell him to hurt someone else or commit a crime? He needs an anti-psychotic. He needs some relief. Drive to Stanford and get a real psychiatrist that knows what the hell they are doing and then have that doctor refer you to a therapist (PhD) near you. For your son's sake.

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  2. Your therapist doesn't seem quite up to date with medicine's current views in childhood Bipolar. Rare? Unusual? While there are certainly less Bipolar children than nuerotypical, it's not an obscure phenomenon. Far from it.

    I've had hallucinations since I was in Kindergarten, and they have progressed and stayed with me through the years. Your son is far from being the only one to have to deal with this. Back when they first started to become a problem, nobody wanted to treat it. I just had a vivid imagination, they concluded. It until it was a threat to my safety, and I had to be hospitalized for it, was anything done about it.

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  3. Psychosis is a nightmare all on its own, so different from mood symptoms, and not getting it addressed is just not fair to anybody, especially your son. As I described it [untreated psychosis]:

    "Psychosis really is a different experience. Not that the deep depressions, out-of-control rages and meltdowns, manias, and mixed states aren't terrible in their own right, because they certainly are. They have their own way of skewing your feelings and outlook; but psychosis twists everything about the way I perceive...everything! That man on the park bench is a pedophile/murderer looking to kill me. The elderly lady on the train that smiled is a spy/worker for the spirits, and she's keeping an eye on me, watching everything I do, thinking of better ways to tell the spirits to torture and kill me. Getting to a dead end (river) in the woods, having the wind blow, and then a "shadow" (spirit's pets) is a signal they are going to make something very bad happen to my friend, who is by me, soon. The wind blowing means their presence, especially "her's". Not being able to be left alone, because the spirits rage and I am afraid someone will come hurt me. The air conditioning turning on at Borders Book Store is really the spirits filling poison into the air. Then there are my spirits, and all that come with them. Demanding I hurt, even kill, others, and then sending shadows and demons to hurt me when I refuse, which I can feel. Then screaming and threatening me, while they, the demons, the shadows, are all right near me, to injure myself. Scratch, cut, bite, slam my head against the wall. Jump in front of cars. At its worst, I mumble to myself, push words together to make a new one, speak in erratic sentences, and sometimes rhyme. My overall state is irritable, extremely moody, unpredictable, easily set off, and no impulse control. Banging my had, punching the tables and walls to hurt myself, kicking things as I pass, screaming (a lot) at others and them. Having panic attacks when they're right there, breathing really heavily, crying, rages, lashing out at myself and others. Sometimes, my very expression changes and I get this paranoid, deranged look in my face. I laugh witch-like for no reason. The whole world has become a nightmare to live in, and a lot of it seems to be pulled from the terrors our sleep. To put simply, I get really, really....scared. Mood symptoms alone can't do that, at least not to me. "

    and:

    "If it's psychosis, it's just a much different world. To be quite honest, I'm not even sure I can describe it. I'm certainly not happy, energetic, or getting some sort of thrill. If anything, the world is now this scary, nightmarish forest that I have no idea how to naviagte. Reality just grows furthur away, and my own little Hell goes. I'm disoriented and detached, at most. The mumbling, combing of words, nonsense sentences, and new words just all seem to come with that. It doesn't feel great; but it just seems to be normal and make sense. The hallunations and delusions just take over, and my parents, friends, and doctors seem to be in another universe, unable to reach me. There are times 'they' feel more real than what is actually real. Of course, when I read my psychotic writing, it chills me. That is NOT me, and that does NOT sound like me. Most of it doesn't even make sense, and some of it is just plain delusional, using terms and beliefs that have to do with the (rather evil) spirits that dominate my psychotic life. The writing is barely connected to reality, and the confusing words and sentenced are just as disconnected. Truly, psychosis is the scariest place to be."

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  4. I don't want to frighten you, and there is no guarantee that your son's symptoms will progress further; but I don't want to see your son go through all of that. To be honest, I hate giving advice; but the only way these "therapies" work, either that be medication or psychotherapy, is that everyone is on the same page, and both you and your son are listened to. I have been through multiple therapists and psychiatrists, and the process of finding the right one is long, frustrating and painful; but it's worth it. At the moment, my psychiatrist also administers psychotherapy, and I love him. There is complete trust; he knows what he is talking about; and engages me in treatment options. If I feel a medication is on too high or low of a dose, he listens. You need to find that doctor and therapist for your son. When you find the right one, you'll know.


    As for telling your son a diagnosis, this is my response (that was written in response to a father that posted on 'Meet Erika':

    "When I was younger, trying to survive the daily mess in my head, I was told so many things. At school, I was lazy, a brat, spoiled, a sore loser. The teachers and faculty had no idea about mental illness; they just saw everything as behavioral. I got in trouble a lot, and was embarrassed and ashamed. So many kids thought of me as a freak because of my extremely high anxiety, hour(s) long meltdowns, sadness turned into uncontrollable energy - all of that. Then teachers were yelling at me and saying I was lazy in front of other kids. My self-esteem just went low. When you add in all the behaviors - the rages, anger, lashing out - and all the trouble I got into, I thought I was a bad kid. That I would be better off dead or gone, because I couldn't seem to stop and everyone told me I could. I once planned to runaway; but went back on it last minute.

    Bipolar was not my first diagnosis. Anxiety disorders, ADHD, unipolar depression, and others. To be quite honest, being given the diagnosis was like a directions guide, explaining everything about my life thus far. While I did have issues feeling that I sick or different, the relief was great. Somebody was telling me I wasn't bad; it wasn't my fault. I still had self-esteem issues for when I hurt someone or worried them; but it wasn't so bad anymore. I really wasn't just spoiled/bratty/sore loser!"

    Hope your son is doing OK toady.

    With Love,
    Erika

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  5. I agree with Meg, that your son is not getting the treatment he deserves from his psychiatrist or his therapist. He should not have to suffer one day if there is medicine that can help him. While a label is not all that important at this point in his life, allieviation of his symptoms is paramount. He deserves to work with mental health providers who are familiar with children with similar symptoms, which there are plenty.

    If he is viewed as unusal by his service providers, than they are not the right match for him.

    Good luck and hang in there.

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  6. that therapist doesn't sound very well-read. he's either not reading the right stuff or not reading at all. recent data shows 1 in 10 children has a mental illness. my son is 4 and his meds aren't working but we still go to therapy every week and there are still things she can do with him. your son needs therapy to help him deal with the voices and the feelings of anger. to teach him how to cope as he gets older. to explain what's going on in his head so he doesn't feel so alone. everyone knows therapy doesn't cure bipolar. but there are many ways it can help. and the whole label thing is just a crock to me. yes we don't want a child to think of himself as only "being bipolar". but that bipolar is part of him just like having a good sense of humor, or being a people person, or liking music is. when you give it a name it helps you understand it. and understanding ones disorder is essential when he gets older an becomes an adult. to be successful he needs to know when he needs a med change or when he needs help. that's the only way people with bipolar can be functioning adults. i would change therapists as quick as possible.

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  7. I agree with all of the above. Find someone who is willing to help you or help you find someone who can. In other words if they feel they can't help at least they can help you find someone who will or at least try. We have had the same thing-trying to find someone who will listen and help. It has been a long struggle and very frustrating-it sounds like that is the case with most complicated cases which I guess is somewhat comforting. I thought it was just Arizona. Hang in there and don't give up! Thinking of you.

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  8. I'm not a fan of your therapist. People don't out grow bipolar. I think you need to begin searching for a new PDoc. Possibly one who specializes in children. I did answer your questions to this on tomorrows post on Ask a Bipolar It kinda digs deeper on how I feel about "Labels".

    Sorry things are so confusing. Keep searching for answers, things will get better soon :)

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