Normal sibling rivalry vs. scary violence

amother

Natural

Mon, Jul 22 2019, 7:07 pm

Please, please explore medical reasons (as well as trauma) before settling for a psychiatric diagnosis. I have experience with this and have seen children exactly the way you describe (with rages, aggression, hate towards their mother and siblings, disregard or lack of understanding for external consequences, irrational thinking) recover with medical interventions. Just be informed, a psychiatrist has to find something wrong with your child based on the DSM alone. He/she does not have a full medical lens when looking at your child. The question is not really whether your child is presenting with mental illness like symptoms but more is about what is going on in his brain that is inducing them. The medical piece can not be disregarded given the pain you are all in and your parental role. I have seen MANY children with DSM diagnoses of autism, tourettes, ADHD, ODD, Intermittent Explosive Disorder, DMDD, bipolar, even LD, etc who then went on to have a medical explanation and have gotten better with antibiotics and other medical treatments. That's not to say that psychiatric meds may not be useful simultaneously to bring some relief while recovery is happening. This may all sound crazy but I have seen crazy things. If you think about it, it all does make sense from a neurological perspective. After all the brain is the part of the body that controls emotions and behaviors. Tumors, Alzheimer's, TBI are all perfect examples of this. Again, you can only find if you look. Best of luck. Please know this was written with genuine care for all of you. You sound like truly a wonderful parent; please don't blame yourself for something that is like internally induced.

amother

Forestgreen

Mon, Jul 22 2019, 7:19 pm

Good for you Op
you are being a good mother and advocate for your son and whole family
my heart goes out to you
(people who say more consistent punishment etc, while well intentioned, really does not speak to your kind of situation and the type of discipline and help a child like you are describing needs)
also I am sure you are davening -- I have seen what seems like similar children and situations turn around for the good IY"H this will be for you and your son and family.
it is so difficult when you are in it -- so hard to know whats going on how best to contain it how best to address it...may you be benched that this next step proves to be a huge one in the right direction. Every step even those we feel are missteps are one step closer.
All you, and all of us parents, can do is do our best (above and beyond) and continue at the same time to strengthen in bitachon and emunah. Sometimes the "toughest" or challenging kids turn out to be the best very special adults. I have seen this. Its a tough road though.
And it is a very good thing and encouraging sign that he can behave and does so at school. Gives the proper therapies more to work with - gives sign of his strengths and can help guide professionally targeted interventions effectively. something obviously is going on with him, it does not mean he has some super serious diagnosis though obviously the behavior is not tolerable or acceptable and is a sign something needs to be addressed seriously.
May we hear good news soon!
hugs and hatzlocha

nanny24/7

Mon, Jul 22 2019, 9:43 pm

OP my DS had Pandas. He was an antibiotics for a long time and we took his tonsils out because of the Pandas. We did find both treatments to help however when we tried weaning off the antibiotics there was a setback and I am pretty sure Dr. Schulman would have recommended the Cunningham Panel (a $900 lab tests than many insurances don't cover) to see if he is a good candidate for IVIG. However we decided instead to stop the antibiotics anyway, and then start him on regular Psychiatric meds instead. IVIG does have risks and we didn't feel those risks would be worth it in our case. We also didn't want to keep him long term on antibiotics indefinitely when there didn't seem to be a permanent cure from the antibiotics.
Feel free to PM me.
My point is it's not necessarily either or. You can explore PANDAS if you want to but you can see a psychiatrist for regular meds also weather before or after or at the same time. (It may just be tricky to start both EXACTLY the same time as then it will be hard to determine which treatment is helping him or not)
Hatzlacha and Hugs!!

amother

Cerulean

Mon, Jul 22 2019, 10:17 pm

nanny24/7 wrote:

I am not for or against IVIG or psych meds. I just want to point out that there are risks with IVIG and there are equal risks of psych meds on a still growing and developing brain. It's picking from 2 not great choices.

bigsis144

Tue, Jul 23 2019, 9:50 pm

My two boys were very riled up before bed (though at least they were working together against bedtime, and not at each other’s throats), and DH and I were trying to physically keep them from jumping down the stairs, etc.

My mother had baby in another room.
DH had DS6 at the top of the stairs.
I was with DS9 at the bottom of the stairs.

DS9 was extremely disregulated, hyperventilating after running around for the past 30 minutes. He had tried to yank the baby out of my mother’s arms, had leaped onto my back from half a flight of stairs up... we were both sitting on the floor and I touched his arms to ground him and spoke soft and firm - “DS9, it feels like you’re out of control right now. What can we do to help you use your ‘adult brain’? Did Mrs. A [his therapist] have any suggestions?”

DS looked at me with an odd expression, and said, “Ema, can I do something mean?”

I didn’t know what to say to that, I didn’t know what he wanted to do. Maybe he wanted permission to vent his angry feelings and say something disrespectful?

I guess my moment of thoughtful hesitation was all it took for him to decide what he was going to do, and I was halfway through “what do-“ when he slapped my face.

I was so shocked I wasn’t even angry, I was just broken.

“What? You hit me?”

(More soon)

Stars

Tue, Jul 23 2019, 10:05 pm

bigsis144 wrote:

I'm crying.

(You write that well)

amother

Gray

Tue, Jul 23 2019, 10:45 pm

I know a child who threatened a sibling with a knife. He was explosive, defiant, no self regulation...
His therapist reported him to acs, and he was admitted to the emergency psyche ward. He wasn’t allowed to be released until they were able to regulate him. In the hospital he was evaluated (adhd, slow development...) and a treatment plan was made. He was medicated. Once he was able to self regulate and understand the severity of his actions, he able to go home. It took 2 weeks but he was released as a different child. He did have some flare ups but never as intense.

The parents were horrified he was admitted, but looking back now that is what finally brought about a change in the boys behavior. They know it was the right thing to do. Today he is married with children kah.

bigsis144

Tue, Jul 23 2019, 11:08 pm

amother [ Tangerine ] wrote:

Op, how long has he been this way? Or, how long has he been challenging in a unique way?

He is my oldest, so I have no frame of reference to compare, but he has been a brilliant, stubborn child for as long as I can remember.

He has always bucked authority (though BH he has generally been able to keep it together at school and stay out of trouble).

Sibling rivalry since his brother was big enough to get in his way, manifesting as physical violence and name calling...

But it has gotten significantly worse in the past 2 years (since we moved to Maryland), and has been kicked into overdrive in the past few months (since the baby was born).

I’m glad I wrote things down, because it can all blend together into a haze...

Last edited by bigsis144 on Tue, Jul 23 2019, 11:09 pm; edited 1 time in total

motheringmother

Tue, Jul 23 2019, 11:08 pm

BigSis, sending you all the hugs in the world! My 13 year old ds has shown similar behavior patterns and it is so scary, makes me feel so helpless. There is tons of amazing advice and support here, as well as really heartening success stories. I'm sending you tons of chizuk!

Crowdsourcing on this thread with all you wise women: Ds13 is similar to the ds described here, but with less cruelty and overt violence, but still very explosive and uncontrollable when angry. Very hard to control -- doesn't take direction and doesn't really listen to anybody. Someone on the thread mentioned a therapeutic boarding school, and I am desperate for more info on whether anybody has ever done that and how it's worked.

Happy to follow posts or pm if with personal experiences.

bigsis144

Tue, Jul 23 2019, 11:38 pm

(Part 2)

DS9’s eyes got wide too, and then he looked away from me.

I couldn’t settle my thoughts on anything to SAY to him, so I just got off the floor and walked away. DS9 called after me, “right I’m a bad boy?”

I went upstairs and quietly told DH what had happened. If DS9 had been thrashing and accidentally hit me - been there, done that. He’d never done something like this - it was obviously impulsive, yet I’d clearly seen the thought cross his mind before he made a really really bad decision.

DH didn’t say much, he just said it was not okay for DS9 to hit me, and then asked me to do bedtime with DS6, which I did.

Then I spoke to DH again, and he said DS9 seemed to be feeling down and guilty, and asked him what he’d thought would happen after slapping me. DS9 said he thought I’d hit him back.
DH told DS9 he would be punished - no videos for the rest of the week. DS9 protested the punishment mightily and asked that I come in. I went into DS9’s room and he blurted out “sorry”, then looked back down at the book he’d been reading.

I sat next to him and softly said “you hit your mother. That is not okay. I think you know that.” He said sorry again and gave me a hug - he felt so vulnerable and sincere for once.

I hugged him back gently until he let go. He looked back at his book. I said, “when you get out of control, you do bad things, but you are NOT a bad boy. What can I do to help you do the right thing, even when you’re frustrated?”

And he said, “you could just give me what I want.”

Maybe I should have kept the conversation going but my brain was still foggy. I gave him a kiss, said, “You know I can’t do that. I love you forever and ever, no matter what.” and left the room.

That was the best I could do for now. Gotta give myself credit for not hitting him back. I’m sure better reactions are possible, but I did the best I could.
Making more calls in the morning.
Gotta get some sleep.

Last edited by bigsis144 on Tue, Jul 23 2019, 11:44 pm; edited 2 times in total

simba

Tue, Jul 23 2019, 11:45 pm

bigsis144 wrote:

You did amazing. And you have me in tears.
Wishing you tons of luck!

nanny24/7

Wed, Jul 24 2019, 1:12 am

amother [ Natural ] wrote:

I'm not familiar with the risks of IVIg beyond perhaps a headache directly following the infusion. Do you mind sharing what they are? We agreed with our drs prescription of IVIg as we were told that it can cure and is a time limited treatment.

Well I know of 2 children who had an anaphylactic allergic reaction to it which is actually not uncommon but all nurses or hospitals administering IVIG should have the necessary antidotes prepared on hand to respond to any such symptoms so there are still very high chances of survival since presumably a reaction would be treated immediately. It is still incredibly scary though for that to happen and there are no guarantees. This is even worse when the insurance doesn't pay for the IVIG to be done in the hospital but rather only at home. (Dr. Schulman refused to do it in her office, perhaps due to liability issues). When I was considering IVIG I was inquiring from Hatzolah if I can hire a paramedic from them to stay with us the whole time so he can rush us to the hospital if need be without waiting to call for help. This may not have been really necessary since Hatzolah comes quick anyway but I have been in plenty of emergencies before and frantically panicking and calling Hatzolah and running to open the door for them etc... is no fun. I was still scared of that though since there is a lot of family history for us with life threatening allergies.
Also, according to Dr Schulman my son would have to stay home for 2 weeks since IVIG resets the immune system which actually makes the immune system very weak right afterwards and it can be dangerous to get sick immediately after treatment just like anyone else who is immunocompromised. Additionally, there are very real psychological risks as well, as many kids get much worse before they get better which can be part of the healing process but again no guarantees as to how that plays out and what safety concerns come up for the child and others around him/her. This Dr Schulman told me as well. I don't know if she tells everyone this. She felt she had to really warn me perhaps because my son was a very complex case.
As a matter of fact one of the kids I know that had a severe allergic reaction had the IVIG done at the doctor's office which is really not much safer than doing it at home since there is only so long the injection/ IV they have on hand lasts and the child must be rushed to the hospital in any case for more treatment.
Also, let's not down play the trauma and hassle doing the actual treatment is for a fragile and volatile child. Being stuck to IV 4 hours. Being home for 2 weeks. I don't know. I wish I can say I am confident my DS could have handled that calmly and smoothly without regressing. I am not that optimistic.
It's true that psyche meds have risks too.
But at least they are more studied and we know clearly what the risks are. I am not mocking IVIG or any research that has been done and perhaps the research will catch up soon so we have more info on who can most benefit from it with the least amount of risk.
Also giving antibiotics long term hasn't been studied as much as I would have liked it to be.
So that's my opinion as a mother. But everyone is entitled to theirs and to do what works best for them.