Sunday, January 22, 2012

Tell Me More!

First, I have to thank all of you who responded to my last post, Have You Been Scared of Your Own Child? I can’t tell you how much you helped me, especially since it was such a vulnerable post, I was nervous about sharing it with you, but I felt so encouraged to see so many of you that could relate.

But now I need your help. Since we’re still in search of a good therapist, I wanted to know if any of you could share how you deal with your child’s threatening behavior. I’m trying some different things out. Such as Meg’s insightful post about asking my son, “What can I do to help?” If you haven’t read it yet, go there and see for yourself, it’s pretty good stuff! I’ve tried this technique twice now, the first time it derailed his anger, allowing me to redirect him, but the next time I think he was already too revved up and wasn’t able to respond.

I’m also trying to keep in mind some advice I got from follower “Betsy”, who shared with me long ago that anger is a secondary emotion and that I should consider what emotion preceded it, then acknowledge it with my son. If you haven’t noticed yet, he seems to be quick with his anger lately, I had another incident tonight. I think we need to go get his blood levels checked. I’m afraid his growing body is affecting things.

In the meantime, please share any techniques that have worked with your child. I would also be interested in hearing about how you discipline them. Not for rages of course, but for regular defiant stuff. How does your child respond? Are you finding success?

Please tell me more!

* * *

Meg’s Post at Raising Bipolar:

By the way, I have 99 followers, who wants to be #100???


  1. Hi Mamabear,

    Meg's post is very helpful and insightful. Sometimes this works with my son as well, but not always. Another thing that helps my son is to try to help him label the preceding emotion. He seems honestly confused by his emotions because he seems to experience all of them, happy or sad, so strongly that he can't identify his feelings. Then we discuss appropriate ways to react to that emotion. It might not always ward off the anger and rage, but it is something that I hope will help him learn to understand his own emotions and learn appropriate reactions to them.

    Another thing that we do that seems to go against wisdom is to joke, laugh, touch, and (sometimes) tickle him. This works in between his rages, if he is generally crabby and can't seem to turn the switch off. Touch is a big thing for my son. He is constantly hugging family, whether it is me, my husband, or grandparents, etc. I've learned that when he wraps up in his blanket and crys that we don't love him, he wants to feel loved, but he needs to feel it through touch--not just hear it. So, I might tickle him a little, but I do this while rubbing his back, legs, feet, head, whatever is flailing at the time. It seems to give him the sensory input he craves, and it calms him down. (When it would seem to do the opposite.) This is the one thing that seems to ward off the depressions we used to see. I guess it distracts him from his bad thoughts enough, he forgets to have them. This developed over time as we learned that he needed to be held when he was upset, but just holding him allowed him to spiral downward because he didn't always get enough sensory input from that touch.

    I am interested to know what others do as well.


    1. I agree with you Michelle, I feel like the more I can get him to connect his actions to his feelings the better I can change his actions. I like how you are able to use touch to help your son calm down!

  2. For the typical defiant stuff we've worked up a family rules and their consequences sheet. We have it posted on the walls so there is no confusion about what is going to happen. There are levels to it, the first level being a gentle reminder that the behavior is one that will start the consequences. The next level is to take five minutes, etc. (Most of my consequences on geared towards a calm down.) We also have a separate consequence for specific behaviors we are working on. In our case it is bad language. Since there is a correlation between watching things with bad language and using it--he loses internet privileges for bad language.

    For the rages I try to keep myself calm, and engage with him as little as possible. I haven't tried the "how can I help?" but I suspect it would only escalate things more in the heat of the moment. I do find that humor sometimes works to derail a fit in its early stages. But once it gets going I just have to ride it out. And dish out the consequences later.

    1. That's a good idea to have the rules written down, this can help with expectations!

    2. Just tonight I thought I might not be the only Mom that goes through this with a son. My son is 13, 5'6 & 220 lbs. He hasn't been diagnosed but I am positive its a Mood Disorder/Depression/Anxiety. I have been raising my 4 children alone now for 7 years this coming November. My oldest 3 are successful, one graduating with three B A's and a Masters, another daughter in college and my other son a USMC. This 13 yr old is bossy, nosey, funny, smart, defiant, loud, cute, strong, athletic, gifted in academics and 100% disrespectful. Consequences don't work. I'm sad, tired, scared and sad, besides being confused and disapointed. He's defiantly letting his grades slip and might have had a concussion, ineligible for football and has had 4 Impact re-tests, with unusual results declaring a possibility of a "faked" concussion. He demands things and guilts me into things. Being consistent and loving, tough and sympathetic does not work for us.

    3. Hi Selene,
      Sorry to hear about your challenges, have you had your son evaluated yet by a psychiatrist? I understand your struggle, it wasn't until we got meds on board that we were finally able to get the therapies to work.

  3. Mama, one thing I though about last night is that you might ask your psychiatrist about removing the Tenex. I know a lot of kids with bp have aggravated mood issues/rage/anger from Tenex and now that you have the Lithium on board it may be time to see if he does better without the Tenex.

    If the meds are wrong or off all of the therapy and talking etc., etc. is going to be futile.

    1. I have heard of that too Meg, but I wasn't sure if that was the case for my son because when he was placed on Tenex he got better, not worse with these symptoms. Is it possible for Tenex to cause problems later down the road?

      I will definitely be looking into that with the doctor, his impulses were up today, things are definitely off right now.

      Either way, we were hoping to stop the Tenex, but when Thanksgiving break hit, he became less stable and we had the same thing through Christmas break so we've been leery about changing the meds. But I imagine it won't be long before we remove Tenex altogether.

  4. I like the idea of the posted consequences sheet. I would like to see what you have Meg. Consequences are what we struggle with. I keep asking, but has anyone heard of Tantrum Disregulation Disorder? It mimics bp and autism symptoms. It is new and my Pd did not know anything about it. She was going to look into it. She knew some changes were taking place and she was not up to date totally on the changes as of yet.

    As far as controlling our son: We ask our son if he wants attention. Usually yes and we then snuggle and talk. Not always that easy. Another thing we do is ask him to tell us the first thing that pops into his mind of what is going on. That has taken practice on his part but is some what successful. I will ask him the question of what pops into his head and before I finish the sentenc I snap my finger. I sometimes have to repeat the question but some of the answers are very simple.

    1. Yes, I have heard of the Temper Disregulation Disorder, also called severe mood disregulation disorder. It will be used in a lot of kids that have bipolar-like symptoms, but lack the mania required for the diagnosis of bipolar. I know our old HMO will use this label on all kids instead of "bipolar" to avoid controversy according to our second psychiatrist. This new label may bring about new research which may have new medication or treatment options. When I was at Stanford, a researcher told me that she believes this will just cause more confusion, just another label without the research to back it up. Only time will tell, but I won't be surprised if a lot of our kids get diagnosed with this label once it becomes official in 2013. I was told that a lot of these kids, once adults will have something other than bipolar disorder, most likely depression or anxiety or both.

  5. i would say its the meds,probably one of the meds is making him to rage ,talk to the docs. see if he can do well only on lithiun and melatonine ,maybe stopping the other meds,will make him more stable.

    1. I agree, I’m looking into that. I was also looking into his Lithium, we changed the pill from 2-150 mg to 1-300 mg per a dose. Basically switching out 2 small pills for 1 larger pill. The dose is the same amount of Lithium. When this change was made, the drug was created by a different manufacturer. I am looking into it to see if it was possible that when we switched manufactures, we changed how the Lithium was absorbed by the body (maybe different fillers?) I know it is a long shot, but the timing of the pill change matches the increase in mood issues.

  6. An idea which worthes what it worthes.

    But even if your son is 10 yo, I think that to label his emotions, go one step behind.
    Instead of getting him words to tell, and complicated stuff, go simpler. The simpler, the better.
    The most important is that he can use it when he is feeling on the nutshell.

    You can try smileys, for example. As they are simple, they are better usable. Your son may cope better with smileys in the meltdowns than he can with words. So one step behind cannot harm. And the most important is not what will your neighbors say.
    Choose smileys with him, and the simplest smileys will be the most usable. For example, if a set of smileys is beautiful but too complicated, it will be useless.
    If he likes the yellow PHPBB smileys, be it :D

    Also, you can also give him simplified mood charts, that he can use with smileys.
    A table with an entry for "Brain", "Body".

    If your child is not a drawer in his mind, you can prepare a sheet of paper with this table, the you plastify it. You put in the boxes some scratch or Velcro.
    Then, you print some sets of smileys to let your son choose. Again, the simpler, the better.
    After your son chose the set of smileys he likes most, talk with him about which emotions he feels most. It will help to narrow the choices to 4 or 5 key smileys.
    You make a sheet of paper with these smileys, like pictograms for PECS, you print, plastify and add Velcro which he can scratch on the board paper.
    Put everything in a box that you label with his name : it's his box, to express himself during a meltdown (it can be also a notebook....).
    you can also make it portable for outside.
    Let him choose if he prefers a notebook, a box etc etc... Let him decorate the way he wants.
    The more you involve him, the more you empower him, the better.

    Practice this strategy with your son when he is himself : he can't learn this strategy when he is in a middle of a meltdown.
    Still when he is in his former self, you can agree to a key sentence when you notice he has an imminent meltdown, like : "Ok, I see it's time for a break. Let take the emotion box so we can sort it".
    Practice when he is himself.

    When he has a meltdown, don't change the key sentence, it will only confuse him. Use always the same key sentence when you notice an imminent meltdown, first and foremost.
    If you change the key sentence, he may not remember what he learnt when there will be a meltdown. So it will only fuel this meltdown you want to desperately avoid.

    Another trick which can help is redirecting his wish to hurt in a different way : he can hurt without hurt.
    Like a pillow to crutch.
    If he yells, you can agree a place he can go to yell, like the garden. Same strategy to practice : only when in his former self, not during a meltdown ; same key sentence each time you notice an imminent meltdown.

    With these strategies, with the time, he will understand that he can ask you to go to his emotion box, in the garden to scream, to crutch the pillow....

    But to express his emotion when unwell, the simpler, the better.
    I won't emphasize enough about it, but it's very easy to forget it.

    I know it doesn't substitute a therapist. But there are available tools. And who knows, the new therapist may learn something new when you'll tell him about all this :D

    Hope it helps.