Continued from Excruciating Ride
I often search Flickr for just the right photo, but I don’t always find what I want. In this case, the picture is worth about a million words.
The roller coaster we’re riding with our son right now isn’t any fun.
As I walked into the hall, my son whipped the pencil away from his chest.
“What are you doing?” Reaching for the pencil, I leaned over to see whether he’d progressed through his school work. I used the pencil to point, summoning as much nonchalance as I could.
“You need to fill in these blanks in pencil, please.” I handed the pencil back, adding, “Pencils are for paper; pencils are not for poking people.”
He nodded and took it.
After he finished his school work, I gave him a journal assignment. He wrote about suicide by a pencil stab.
An hour later, he growled in frustration when I wouldn’t believe an obvious lie. He left the house and headed down the driveway. The timing worked well, because we needed to head to an appointment, so I pretended to think he was going to get in the car.
Unlocking the vehicle, I called, “Hey, thanks for getting out of the house so quickly so we can be on time! Do you want me to meet you at the end of the driveway?”
He froze, then turned slowly and shuffled back to the car, muttering, “wearing the wrong shoes, anyway.”
His sister gave him a sharp look. “Were you trying to run away?”
“Yeah, but I need my other shoes.”
She shook her head. “Running away is stupid. What are you going to eat?”
In a cool, flat tone that gave me chills, he said, “Dead squirrels, probably.”
By late August, I was spending an average of seven hours per day closely monitoring our son. Completing tasks became almost impossible; he didn’t want to move, so he began a sabotage campaign. When we put the house on the market, we asked the kids to try to keep things neat for the showings. He thought buyers would refuse to purchase the house if he worked against us. He trashed his room, wrote on the walls in permanent marker, decimated a large planter…every time he wasn’t by my side, I looked for the next bit of destruction.
He did the opposite of whatever we asked and began doing things he’d never done in the past, like climbing out of his window to leave the house. Hubby and I did our best, but…have you ever tried to keep an 11 year-old in sight at all times? It’s even harder than it sounds.
Cameras and a newly-installed alarm system helped, but we still couldn’t supervise 100% of his day. Showers became especially problematic, because he’s really too old for one of us to stand there. He plugged the drain with toys and toilet paper, defecated in the tub and filled the curtain with water, letting it go when it became too heavy (all over the bathroom floor).
Because he is diagnosed as “on the edge” of the Autism spectrum, the in-home counselor suggested we apply for ABA therapy for help with behavior modification. Good ABA therapists have successfully helped non-verbal, low-functioning children learn to communicate and to perform self-care tasks. If his apparent inability to follow directions stemmed from the autism, the therapists would be able to help. And maybe, once he had a habit of doing the right things, he would feel better about himself.
While I sat outside with the supervisor, outlining the challenges of the last several months, another staff member sat with our son to evaluate him. I explained to the supervisor that he’s great one-on-one with an adult, so I expected the other therapist to find nothing. Sure enough, when she joined us, I saw The Look.
The Look, n., facial expression indicating the parent must be out of her mind, as this child is brimming with intelligence and compliance.
Thankful for backup from the in-home counselor, the supervisor and I explained there is more to this kid than becomes obvious in one meeting. We were approved for services, but staffing shortages meant ABA wouldn’t start for several weeks.
A week later, the threats of suicide came almost daily, sometimes several times a day. His moods swung between anger and depression. I couldn’t leave him alone with his sister for even a minute because he started lashing out at her.
ABA wasn’t going to be enough.
We began looking for residential treatment, this time for a program that lasted more than a few days.
Angela Duckworth, author of Grit, believes we reach “expert” level by practicing our craft for at least 10,000 hours; K. Anders Ericksson specifies those hours are spent in “deliberate practice.”
Therefore, I would like to announce that
I am an expert.
For at least thirty years, I have deliberately practiced…procrastination.
Don’t even have to try anymore; Hubby agrees my practical level of procrastination is unbelievable—even mind blowing.
Blog procrastination happens when I know it’s time to write but I’d rather pretend nothing is happening.
Writing about the last six months is painful, terrifying, discouraging.
I’ve been procrastinating.
As I mentioned earlier, the roller coaster with our girl has morphed into a super-fun ride most days. (And yes, I know that super-fun is technically not a word.)
The roller coaster ride with our boy…not so much.
Right now, his roller coaster is excruciating.
When we began our journey, people supported us in the best ways they knew. However, few had the experience to understand, so we stopped trying to share our angst, because conversations went something like this:
Me: “Our foster son won’t stop screaming. Anything sets him off. He won’t let me touch him until he’s out of his mind—then, still screaming, he clings to me like the earth is falling away and I’m the last thing standing. Sometimes it lasts for hours; I don’t know what to do.”
Friends my age: “Yeah, my kid does that, too. I just turn on the TV and he settles down,” or “Put him in his room, tell him he can come out when he’s done, and shut the door.”
Friend my mom’s age: “Tell him if he doesn’t stop crying, you’ll GIVE him something to cry about.”
Friend my grandmother’s age: “He probably has gas. Have you taken him to the doctor?”
Social worker: “If he’s too much for you, we’ll find another placement.”
The above suggestions didn’t help.
But those kinds of conversations prompted me to start this blog, because Hubby and I agreed no one should feel as alone as we did.
Have a troubled kid? You are not alone.
Terrified of the future? Wondering whether your child will have the ability to function in society? “Cautious optimism” is your motto?
You’ve come to the right place.
Everyone’s story line is a little different, but the internal conflict connects across all boundaries: parents want beautiful life to happen for their kids, but we don’t always know how to best assist.
We want them to thrive, be mentally healthy and happy, be successful, have a great future.
Three months ago, the main life plan for our eleven year-old son was
His roller coaster almost went off the tracks in August. The happy boy who lived with us during the summer of 2016 was long gone. He used his intelligence to charm and manipulate adults but could not stand his peers. Aggressive behavior caused his expulsion from two summer camps.
Several life alterations (loss of Hubby’s dad, job changes, selling our home, moving) or hormones may have something to do with the downward spiral that held a tenacious grip on his personality; we don’t really know the cause. Hindsight sometimes holds clues and answers, but in this case, we can’t find any triggers.
I once read that talking about suicide is “just” a cry for attention unless the person has a plan. (We can discuss “just” another time…if a person is reaching out, there’s a reason.)
Our son had a plan.
Several plans, actually.
When he was upset, I often sent him to write in his journal; after he finished, he allowed me to read it and we took time to discuss his thought processes. As he found that I would not give him a consequence for anything he wrote (he tested this with a list of swear words), his writing became darker and included plans to run away or harm himself.
His list of ways to die included throwing himself in front of a vehicle, drowning himself in the pond or stabbing himself in the heart with a pencil.
Because of his extreme behaviors and inability to function appropriately in most settings, he had an in-home counselor ten hours a week. She became an invaluable presence in our family, mostly for me. (I no longer had to wonder whether I might be overreacting.)
We monitored him closely, working with the in-home counselor with the goal of keeping him with us.
We were, in a word, Hypervigilant.
We installed an alarm on the house to alert us if he tried to leave in the middle of the night, and cameras so I could keep an eye on him when I had to be in another room. Most of the time, I slept only when he slept, woke before he did and kept him in my physical sight almost all day. If I needed to use the restroom, I took the monitor, and only took showers when another adult was in the house. Hubby took over when he got home from work so I could get a little rest.
We were exhausted but determined to do everything we could to prevent residential care.
We believed our love could be enough.
Our in-home counselor agreed he needed immediate and urgent help after he acted out a detailed suicide scene in front of a camera in our home. We aren’t sure whether he chose the setting intending a manipulation, since he knew the camera was there. Regardless, the underlying issue remains the same: his thoughts were focused on ending his life.
As I explained that we might need to seek help from a facility outside our home, he shrugged.
“You’ve done all you can. You’ve tried everything else. We might as well try this.”
We checked him into an acute care psychiatric facility that afternoon. We visited every chance possible and each time he fed us lies (people hurting him, taking his shoes, trying to fight him). After a visit on day 5, Hubby and I resigned ourselves to the knowledge he’d be there a while as his mindset was obviously not changing.
Less than 24 hours later, a nurse called and told me they planned discharge that day. I was shocked.
“He told the doctor he’s not thinking about suicide anymore, so he can come home now,” she chirped.
I asked to speak to the managing director, who told me they could only keep the child if the child continued to want to hurt himself or someone else. Since our boy knew the right words, he had to come home.
The next day, as I painted a closet, I glanced at the monitor to see him trying to shove a pencil through his ribs.
Photo by Peter Nijenhuis
**We’re up to $35; see below!
We’ve all seen (and occasionally participated in) a Meet & Greet post. You know, “drop your link in the comments and maybe someone will click.”
Instead of posting a hit-or-miss link, let’s change it up. Your mission, should you choose to accept it:
1. Describe your blog in nine words or less.
2. Paste a link to a post you’re proud of writing. Bonus points for adoption, mental health or parenting themes*, but it can be anything.
*With your link, please note the post theme, e.g., “Adoption,” “Mental Health,” “Parenting,” “My Happy Place,” “Honey Badgers are Misunderstood,” etc.
3. Reblog this to increase the number of participants. For every comment below, I’ll donate a dollar* to Compassion International, a fabulous organization committed to child development and rescuing kids from poverty.
*If the comment number rises beyond my ability to personally donate, I commit to raising the money.
4. Click at least two links and read the posts.
Have fun! And ignore the lemur. Feel free to hug.
At some point, we’ve all searched for parenting or adoption or mental health resources.
I’m compiling a list…please forward me links, book titles, etc.
If everyone sends 2, we’ll have
over 1000 resources
on our list!
(I’m assuming there will be some overlap.)
People need help. Let’s be the community where they find hope, healing and health.
Add info in the comments or email me: Casey@hypervigilant.org
*Commentary on the resource is helpful but not required (e.g., “great guide to first-year parenting,” or, “this agency provides post-adoption support in Cambridge, UK”).
He is eight years old. Skinny and awkward and adorable. We sit at the kitchen table, coloring.
His dad is one of my favorite college professors, fascinating and intelligent. His mom is the woman everyone in the girls’ dorm wants to be when we grow up: wise, soft-spoken, graceful.
Sometimes I babysit. Today, I dropped by to see his mother and play with my little buddy.
“Draw Toby again,” he pleads.
Toby, the multicolored, furry creature I created just for him. Toby is talented, musical, always smiling. Also, he has a chronic habit of leaving his high-top sneakers untied.
I pick up a marker and begin to draw.
He is nine years old. We sprawl on the floor, watching monochromatic terror and insanity crescendo on the screen. The original Frankenstein. I listen for his little sister, napping in the next room.
I am a little shocked that this movie, his favorite, will not give him nightmares. Pretty sure I’ll have one.
I glance at him as the monster comes to life.
His smile is wider than the sun and twice as bright.
He is ten.
I sit in the Florida autumn sun, absorbed in test preparation. I ignore the tiny berries sailing by my head.
Sauntering past my chair, he tosses my notebook into the bushes and takes off running.
He’s fast, but I’m still faster.
I catch up and toss him over my shoulder.
I carry him toward the pond, fabled to be frequented by a large alligator. He screams with laughter, pleading for his life. I agree to give him one more chance.
He is eleven.
He rides a large pony. I walk with him, showing him how to keep heels down, how to communicate gently through the reins.
I grin at his parents, thrilled with his quick success.
I snap a picture of his adorable little sister sitting on a Shetland.
The family moves out West. I leave Florida. My life moves on, as does theirs. Other than intermittent communication, we lose touch.
The picture of his sister remains on my dresser through grad school and three moves. I love those two kids with all my heart. The distance devastates me.
He is twenty-something. He writes a beautiful letter, thanking me for the time I spent with him during his childhood. He writes about Toby. I had forgotten.
We lose touch again, until he mails a picture. He’s married a beautiful girl.
I am happy, so happy for my boy.
He is thirty.
I read his sister’s message, stunned.
None of us knew how deeply he was hurting.
We are so thankful that he trusted in Jesus to give him eternal life, and now he isn’t hurting anymore.
We never saw this coming. I’m heartbroken.
I imagine his parents’ devastation. His family’s deep loss. They were close. Having practically lived with them for several years, I can vouch his parents were some of the best in the business. Not perfect, of course, but amazing. And still, this unexpected tragedy.
Once, I heard a slogan, something along the lines of “Suicide is Not the Solution!” Unfortunately, for many teens and young adults seems to be a solution. And in some cases, the solution.
They think it’s the final solution to a life too overwhelming to comprehend, too hopeless to navigate.
Over 800,000 people die due to suicide every year and there are many more who attempt suicide. Hence, many millions of people are affected or experience suicide bereavement every year. Suicide occurs throughout the lifespan and was the second leading cause of death among 15-29 year olds globally in 2012.
-World Health Organization (bold mine)
And I think of our two children, with their insane start to life. The neglect, abuse and resulting depression they’ve both experienced. Hubby and I were naive and fully untrained when they arrived. We made tons of mistakes. We still do. Although we do our best to learn and grow, both of us are far from perfect.
Children who’ve survived the foster care system are at even higher risk for suicide.
• Adolescents who had been in foster care were nearly two and a half times more likely to seriously consider suicide than other youth (Pilowsky & Wu, 2006).
• Adolescents who had been in foster care were nearly four times more likely to have attempted suicide than other youth (Pilowsky & Wu, 2006).
• Experiencing childhood abuse or trauma increased the risk of attempted suicide 2- to 5-fold (Dube et al., 2001).
• Among 8-year-olds who were maltreated or at risk for maltreatment, nearly 10% reported wanting to kill themselves (Thompson, 2005).
• Adverse childhood experiences play a major role in suicide attempts. One study found that approximately two thirds of suicide attempts may be attributable to abusive or traumatic childhood experiences (Dube et al., 2001).
-Helen Ramaglia, Suicide and the Foster Child
If this tragedy can happen in my friends’ family, it can happen to anyone. There’s no way to guarantee our world’s children will discount this solution, be willing to consider other avenues, when it seems so easy to simply fall asleep. Forever.
I’ve experienced depression. Desperation. Futility. Bleak future. No chance things will improve. No way out.
One way out, it seems.
There is no single cause to suicide. It most often occurs when stressors exceed current coping abilities of someone suffering from a mental health condition.
– American Foundation for Suicide Prevention
And just as someone who is depressed may believe the untruth that suicide is the only door to relief, we have some myths of our own.
The following are common misconceptions about suicide:
“People who talk about suicide won’t really do it.”
Not True. Almost everyone who commits or attempts suicide has given some clue or warning. Do not ignore suicide threats. Statements like “you’ll be sorry when I’m dead,” “I can’t see any way out,” — no matter how casually or jokingly said, may indicate serious suicidal feelings.
“Anyone who tries to kill him/herself must be crazy.”
Not True. Most suicidal people are not psychotic or insane. They may be upset, grief-stricken,depressed or despairing. Extreme distress and emotional pain are always signs of mental illness but are not signs of psychosis.
“If a person is determined to kill him/herself, nothing is going to stop him/her.”
Not True. Even the most severely depressed person has mixed feelings about death, and most waiver until the very last moment between wanting to live and wanting to end their pain. Most suicidal people do not want to die; they want the pain to stop. The impulse to end it all, however overpowering, does not last forever.
“People who commit suicide are people who were unwilling to seek help.”
Not True. Studies of adult suicide victims have shown that more then half had sought medical help within six month before their deaths and a majority had seen a medical professional within 1 month of their death.
“Talking about suicide may give someone the idea.”
Not True. You don’t give a suicidal person ideas by talking about suicide. The opposite is true — bringing up the subject of suicide and discussing it openly is one of the most helpful things you can do.
-Suicide Awareness Voices of Education (SAVE)
That last point is important. Ignoring the problem or the symptoms will not “make it go away.” We have to talk about it. We must. Below are suggestions for beginning the conversation.
Ways to start a conversation about suicide:
- I have been feeling concerned about you lately.
- Recently, I have noticed some differences in you and wondered how you are doing.
- I wanted to check in with you because you haven’t seemed yourself lately.
Questions you can ask:
- When did you begin feeling like this?
- Did something happen that made you start feeling this way?
- How can I best support you right now?
- Have you thought about getting help?
What you can say that helps:
- You are not alone in this. I’m here for you.
- You may not believe it now, but the way you’re feeling will change.
- I may not be able to understand exactly how you feel, but I care about you and want to help.
- When you want to give up, tell yourself you will hold off for just one more day, hour, minute—whatever you can manage.
Preventing Suicide, Helpguide
In my deepest depression as a teen, suicide crossed my mind. It never became an option because I had too many nosy adults in my life. And that was a great thing.
In the minds of the hopeless, suicide seems to be a solution. We need to help them see that although suicide may appear to end the problem, it doesn’t solve anything.
Be the nosy adult,
especially if you’re in the life of a child who has been in the foster system or experienced some kind of abuse.
Kids are dying for someone to care. Literally.
If you or someone you know is considering suicide, call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) or visit their website: National Suicide Prevention Lifeline.
Continued from Part 1
I’m not 100% comfortable with medication as a solution for attention problems.
I can’t deny the efficacy of certain prescriptions—last week, our son had his FIRST PERFECT WEEK at school.
Granted, we only had two days in class due to snow but this is still a first. Two days, back-to-back, with only green marks (given for helping, staying on task, getting behavioral compliments from teachers in supplementary classes, etc.)? Never happened before.
The potential for success is incredible.
Possibility of side effects, now or in the future, concerns me.
I can say, in good conscience, that we tried EVERYthing before turning to medication. Still, nagging guilt plagues me, an oppressive feeling we “gave in” to the road more traveled.
Some of my friends say things like
Drug companies are the devil
Pharmaceutical conglomerates care about making money, not about making kids healthy
and although I’m not sure they’re correct on the first count, I acquiesce on the second. Companies are formed and sustained for one purpose: to make money for someone.
Knowing this, why do we—as a nation—fall in line for the daily dose?
The unfortunate truth is this: other alternatives require more time and sometimes bring less direct results. In the world of mental health—mental health of children, in particular—we search for expedient outcomes. Medication is fast, and in some cases, immediate.
Research for alternatives led me to an option so easy it’s laughable. MOVEMENT. Activity requiring physical effort, carried out especially to sustain or improve health and fitness. In other words, exercise.
One of the article links cracked me up: “exercise-seems-to-be-beneficial-to-children.” No. Really?
According to several studies (see the links throughout this post), exercise can be just as beneficial as medication. Some claim prescriptions may be eliminated by implementing a consistent workout routine.
Why don’t we hear more about exercise as an alternative to drugs?
To be fair, our doctor did recommend exercise—not to replace, but to supplement the medication. After I explained our involvement in Karate twice a week, Scouts, family chores (yes, cleaning up counts as exercise) and treks through the woods, she agreed that no one could call our family sedentary.
CalorieLab even has a cool page for learning how many calories you burned vacuuming or doing other chores, if you’re interested.
She also recommended limiting screen time. Our kids watch about four hours of TV. Not per day. PER WEEK. Much lower than the national average, according to an American Academy of Pediatrics article. Where these kids find time to spend 7 hours a day (A DAY!?) entertained by screens is beyond me.
I have to agree with Yasmin; money seems the root of the problem; drug companies court pediatricians and other doctors constantly. I saw three reps during our 30-minute stay in the waiting area.
If you don’t know the answer to this question after years of watching Richard Simmons Sweat to the Oldies, I can’t offer you help. I mean, really.
Stop pretending you’re not overcome by memories. You know you loved it.
Okay, let’s get serious. Shake off your nostalgia.
This article in The Atlantic shows pictures of brain function with and without exercise. Due to the wording, I can’t determine whether the pictures are a representation of the study or genuine, actual slides. Either way, the visual difference is staggering. The article references children sitting in class with “blue heads” for nine months. Lost learning potential could be significant. An excerpt:
John Ratey, an associate professor of psychiatry at Harvard, suggests that people think of exercise as medication for ADHD. Even very light physical activity improves mood and cognitive performance by triggering the brain to release dopamine and serotonin, similar to the way that stimulant medications like Adderall do.
Exercise makes you feel good.
No small accomplishment for a child who tends toward a negative self-image. Many kids with ADHD feel “less.” Less able to do the work, less likely to succeed, less likable (due to their sporadic behavior) than their more focused classmates. Exercise can improve self-image in many ways—not just physical.
Exercise reduces “learned helplessness.”
ADHD kids are likely to quit before they start because they feel they won’t succeed regardless of what they do. ADDitude mag editors also quote John Ratey as a resident expert, but are more conservative. This article describes exercise as a supplement rather than replacement for medication.
I see “learned helplessness” in our children, both of whom struggle with attention (although our guy has a much more difficult time). Our daughter, in particular, would rather not try if she sees potential for failure.
Simple math problems take FOR-EVVVV-ERRRR because, instead of relying on her bank of memorized facts, she counts on her fingers before answering. This backfires, as she is often distracted while counting and ends up with an incorrect answer. This reinforces her idea that she won’t get it right. We’ve worked very hard with her, encouraging her to use the first answer that “pops into” her mind.
Exercise jump-starts your brain
Exercise turns on the attention system, the so-called executive functions — sequencing, working memory, prioritizing, inhibiting, and sustaining attention.
-John Ratey, M.D.
Working memory is the key for many ADHD individuals. Our son scored very high on psych evaluations in almost every area except this. Without working memory, we can’t perform two tasks at once—at least, not easily.
How much, how often?
- WebMD suggests 150 minutes of exercise per week in an article about adult ADHD
- According to an article in Inverse, some schools have implemented three 20-minute exercise sessions or use “time-in” instead of time-out: if a child acts out, he or she spends the “time-in” on an exercise/ machine
Exercises to try
- Push-ups, squats
- Sports/Martial Arts
Not all exercise must be physical, although aerobic exercise is an excellent strategy to focus that brain. You can also try the following:
- Try focus exercises geared toward ADHD.
- Train your Brain. The jury is still out regarding brain-training games, but it seems logical. If your brain is a muscle, and you engage in consistent brain workout, I conclude that it will be stronger and better. NeuroRacer sounds pretty cool, although they now focus on aging adults. I contacted the company to ask if the game is available to the general public.
- Learn something new. Khan Academy offers free classes; the site is amazing. Learning a new skill stretches your brain. Remember when you learned to read? C-A-T. Struggling to decode words. Look at ya now—reading is as easy as breathing. Always wanted to learn Chinese? Greek? Spanish? Learn to play an instrument, to cook authentic Italian food, to swim. Now you have a reason.
- Do math. I’ve seen exponential (see what I did there?) improvement in the kids’ focus as we’ve dedicated time to learning long division and double-digit multiplication.
- Write. (YAY!) The creative process, research, putting words to a page whether written or typed, editing—all of these contribute to better focus. I’ve never been diagnosed ADHD (except by all my best friends and Hubby), but I do have my suspicions. When I practice faithful writing, everyone can tell.
Our new routine started today. 30 minutes of sustained activity each day—that’s the goal. Hubby and I don’t often sit (we like to DIY, and we’ve been remodeling the kitchen for several weeks). The kids, however, would prefer to meld with the carpet, or couch, or whatever.
As I mentioned above, we all take responsibility for chores at home. Daily chores take a legitimate 15 minutes (for the 9 year old) and 25 minutes (for the 11 year old).
I’ve stopped counting their chores toward daily fitness because she, in particular, moves at a very slow pace. She’s admitted a hope that we will give up if she takes forever. So far, no dice. Sorry, honey.
During research for this post, I realized that our kids don’t participate in sustained physical activity every day. So, today, I instituted the first daily “30 Get Up and Move Minutes” session. 30GUMM for short, because I’m a nerd. If the weather is nice, out they go. If I look out a window,they should be walking, running, playing with the dogs, swinging, etc.
Our first day of bad weather, I plan to break out the Wii. Yes, it’s screen time, but at least they’ll be moving, so I think it counts. Sort of like tricking them into exercise. Bwah ha ha ha.
Do I have to forgo meds?
This post (including Part 1) is not intended to denounce medication as originating in brimstone.
Although I don’t like the thought of possible side effects, school and self-image are my main concerns for the moment. As long as the side effects remain only on the pharmacy document regarding “all the horrible things that will probably happen because now you are looking for signs of them,” they’ll keep popping pills. Responsibly and at the lowest possible dose. If side effects occur, we’ll re-think the plan.
And for the moment, we’ve had no issues.
On the other hand, I plan be more intentional about integrating physical and brain exercise. Getting them in shape, body and mind, can only benefit. If we’re able to phase out the medication, that will be a lovely added bonus. I’ll let you know how it goes.
How about you?
Are you a medical teetotaler or pill pusher? Is BigPharm the evil villain, or do you think alternative medicine is for hippies? Have you found ways to focus? What’s your strategy?
Of course, if you think freebasing Vicodin is a panacea, I recommend keeping that to yourself…
We’re all interested in what you have to say. Share below!
To medicate or not…that is the question.
Hamlet’s angst is nothing compared with the stress parents face in the decision of whether to alleviate ADHD symptoms with medication.
Everyone has an opinion to voice, including 95-year-young great-aunt Judith.
In myyyyy day, we just sent the kids outside to run around until they fell over. Worked like a charm.
Right. That’s helpful. The kid is in school all day, expected to be motionless and butt-in-seat for almost seven hours. A colossal task for a child whose small body vibrates with energy. There’s little time built into the school schedule for “running around.”
I agree that the issue of exercise must be addressed (another post) but changes in a public school drag out as only bureaucracy can.
While school officials and teachers are not allowed to recommend medication, parents of kids who fall under the “ADHD” banner can read between the wide-rule notebook paper lines.
We have tried all the strategies available to us but she’s still having significant trouble keeping up with the class. Have you talked with your pediatrician about sleep, diet changes…other…possible solutions?
And then there are the
meddlesome individuals concerned friends with opinions.
Have you read about the side effects? My friend’s brother’s girlfriend has a facial tic and hallucinates. She was on that Concertadderalin drug for fifteen years. I bet that caused it.
What is a parent to do?
When the kids first came to live with us, our girl was the picture of perfection in public. This byproduct of Reactive Attachment Disorder was a boon, because…the same could not be said for our little guy.
At age five, he unleashed mayhem and havoc with a talent Spiderman’s supervillain Electro would envy. Especially at school.
Electro, as photographed by Compulsive Collector
Finding the social worker to be less than helpful, I appealed to a local government agency and procured a behavioral mentor. Three quit, without ceremony, in quick succession.
The last one, a no-nonsense black Mary Poppins, worked magic. As they say in the South, she yanked a knot in his tail. While she was present, he managed to keep his behavior to a notch below “expel that kid.”
The bus ride home…that was a different story. I found myself in the principal’s office, “volunteering” to drive the kids to and from school (because bus behavior was a notch above “expel that kid”). The chaos on the bus was just too stimulating for his hyper little brain.
His behavior was not unlike a puppy with separation anxiety (freaking out, destruction, snapping and biting). And like said pup, once he could see us, he calmed.
By the end of Kindergarten, we thought we’d turned a corner. Maybe the pup was maturing. The behavioral aide told us she didn’t feel he needed her any longer.
What we didn’t realize at the time: he transferred his need for a parental figure temporarily to her during school hours. His ability to self-manage appeared to grow, but in reality, he simply allowed himself to relax when she was present.
Because he seemed to have made such progress, the agency deemed a behavioral aide unnecessary for first grade. Then he escaped school. And then the Assistant Principal tackled him to prevent a second escape. The behavioral aide was reinstated, but Mary Poppins was no longer available.
By this time, we had him in occupational therapy, were using ABA techniques at home and had an in-home counselor visiting several times a week in addition to the”office” counselor. I averaged three hours of sleep, because he woke up between 3 and 4 each morning, screaming. (The girl didn’t fall asleep until after midnight most of the time.) We tried natural remedies like melatonin and installed blackout curtains. I read every book and article available. Tried every behavioral modification. Rewards. Negative consequences. Bribes. Nothing worked.
While cycling through a parade of aides, I began discussing medication with his counselor, who referred me to a psychiatrist. Because the children were still in legal custody of social services, I had to fight with the Bat from Hell to get approval to try meds. Her level of hostile resistance reminded me yet again that she must have spent almost no time learning about these children. Even the school was (unofficially) on my side by this time.
We received grudging approval for a low dose of Concerta. His improvement was almost immediate but the effect was brief; the pill was too small to last through the day. Applying for permission to increase the dose margin, I could almost hear the social worker’s clogs dragging. She ignored most of my requests, but by the middle of second semester, we’d tweaked the prescription to a still low but more effective level.
In late Spring, for reasons unknown, he relapsed into mania. Glue poured over his desk. Crayons broken and thrown. Another child’s head slammed into the wall. Attempts to escape. The social worker suggested an increase in meds; we agreed while graciously gritting our teeth in a slightly we-told-you-so manner.
The higher medicine adjustment allowed him to stay in school, but he stopped eating and began a yawning tic. Dark circles appeared under his eyes. He looked like a patient of chronic illness. The school year ended and I worked with the doctor to remove medication for the summer. The side effects concerned us more than his erratic behavior.
At this point, we discussed home schooling. After that first touch-me-not year, he has always been most settled at my side. I understood the commitment, having home-schooled ten of my own school years. If we homeschooled, he’d have one-on-one attention and infinitely fewer distractions.
Hubby and the counselors and doctors all agreed—against me. He needed the social interaction; many of his issues began (and sometimes still stem) from his inability to handle interaction with others. Keeping him in constant contact with others is key.
When the school year started again, his psychiatrist suggested guanfacine. As I understand it, the drug was initially meant for blood pressure. Soldiers in a military hospital took it for heart health, but their PTSD symptoms were suddenly ameliorated. ADHD and PTSD can be related (and our son does, in fact, have a PTSD diagnosis). We’ve experienced a shift from insanity to relative composure, with no side effects.
The medication also helps him stay asleep. Lack of sleep exacerbates ADHD symptoms (in EVERYONE, right?) so the sleep aid is very beneficial.
For a short time she also prescribed Strattera, but I saw no improvement and didn’t like the possible side effects, so we discontinued the prescription.
Now in fourth grade, he communicates frustration brought on by his impulsivity.
I want to be good. But I do the wrong thing! It’s like I just can’t help it!
The psychiatrist asked our guy if he’d like some help being focused. With a pleading look on his face, he nodded. She described a dose of Vyvanse, so low that our pharmacist had to order it. He’s taken it for two days. Because it wears off throughout the day, I see very little change by the time he’s home. However, his teacher is enthusiastic in her praise for his new attitude. (She’s worked incredibly hard with us to help him self-regulate; we text throughout the day. I am so thankful for her.)
I tell you our story, not to support medication, but to give you my perspective. I am overjoyed that we may have found his perfect match. I am thrilled to see him so happy; it’s evident in both what he says and how he carries himself (he has had two days with no “bad marks” since starting the med, and he’s proud of himself).
I am weighed down by unbelievable, maybe-irrational, massive amounts of guilt for “giving in” and medicating. I am terrified that long term side effects, yet unknown, may plague him in his teen or adult years. I pray the list of already recognized side effects will not visit him. I feel like a failure. Maybe if I’d changed our diet, gotten up an hour early to take him for a run each morning, found an alternative, we could skip the meds altogether.
But at the end of the day, it’s about my boy. And at the moment, he’s moved from feeling that he’s the “bad” kid in class to knowing that he CAN succeed. He has a taste of what it is to enjoy school. To ignore the barbed words from his arch-nemesis. To refrain from throwing the lunchtime green bean back at its sender. To have control. To focus.
He no longer drags himself to the pickup line, weighed by the knowledge that we need to have yet another discussion about his behavior. He actually trotted to meet me today, a grin on his face.
I got EIGHT green marks today. Eight. And no red ones. Pretty great, huh?
Pretty great, indeed.
I’ve written an adoptive version of the alphabet song. Sing with me, now: O-C-D-P-T-S-D, A-D-D-M-R-ADHD. F A S, R A D, got a new I E P, now it’s time for therapy, next time won’t you come with me?
Our kids came with baggage, and each tote is packed with letters.
Our son has such severe ADHD that initially, several different therapists thought he was on the Autism spectrum, on the Asperger’s end. His PTSD caused night terrors, inability to sleep and unwillingness to leave me. His main concern: that Hubby and I, like all other adults who previously claimed to love him, would disappear.
Our girl also has PTSD and ADHD. Her hallmark, though, is RAD, or Reactive Attachment Disorder. RAD can occur when a child is denied early bonding experience with a caregiver. Children with RAD often fail to thrive, aim direct defiance at main caregivers, are awkward in social interaction and form very quick and superficial attachments to peripheral caregivers (teachers, Sunday School teachers, counselors). They may also act inappropriately close with acquaintances and strangers. The benefit to this disorder: she will never, ever, ever EVER be anything but an angel in public. Her number one goal, with almost pathological precision, is to be seen as “sweet.” I know this because she told me. The drawback: she has a love-hate relationship with anyone called “Mama.”
RAD has colored our relationship from the very beginning. She called Hubby “Daddy” almost immediately, but made a point of not calling me anything at all. Once, I reprimanded her and she said nastily, “You’re not my real mom.” I was actually prepared for that one, so while the disrespect was unattractive, the actual statement wasn’t a big deal. I wanted to say, “Wow, that’s the best you can come up with? Every adopted kid says that. Come on, I know you can find a more creative insult!” But, since she was seven at the time, snarky comments just weren’t appropriate. Lately, she’s been very obviously doing the exact opposite of everything I say. In general, if Hubby, her teacher, her coach, her therapist, or even a total stranger gives her a directive, she obeys with little push-back. If I, on the other hand, ask her to do something, she uses one of the following tactics:
1. Ignores me completely.
2. Does the polar opposite.
3. Completes the task as slowly as humanly possible.
She watches to see if I’ve noticed, which our in-home counselor pointed out. “She (does whatever it is) and then looks at you from the corner of her eye to gauge your reaction.” Since she mentioned this, it’s become something of a game. I pretend not to notice, because any attention to the bad behavior makes it exponentially worse, but I’m actually watching her watch me. The “game” makes things a little more bearable…she thinks she’s sly, and it’s actually pretty funny sometimes. It’s also a little heartbreaking.
Parenting a RAD child is exhausting. Talking with Hubby this evening, I noted that her mama-targeted disobedience is getting really, really annoying, but assured him that I’m not taking it personally. His response: “If you’re annoyed, you’re taking it personally.” As usual, he sees and understands. I should just be honest. Sometimes, I just want her to give me a break.
Earlier today, I picked up Thriving Family, a free magazine sent by Focus on the Family. The words, “Why Don’t You Love Me Back? Understanding why some adopted kids reject Mom…” leaped out at me. The article, by Paula Freeman, notes that what I’m feeling isn’t uncommon among adoptive mothers. In an effort to avoid more hurt, adopted children who have experienced a rift or loss of their birth mother may reject anyone in the Mama role. “The thought of losing another mother is simply too much to bear. Thus Mom becomes the target of her child’s rejection because she is the greatest emotional threat.”
Maybe it’s time for a mental shift. This kid isn’t going out of her way to make my life miserable; she’s keeping me at a distance (likely subconsciously) to guard her heart from being broken again. I need to find ways to connect with her (she’s girly, so…painting nails, window shopping, making crafts) and reinforce that THIS Mama isn’t going anywhere. Where she is, mentally and psychologically, happened over the course of seven years. Expecting her to be “fixed” in a few short months is ridiculous bordering on insanity. It’s going to take a lot of time, and about six tons of patience.
And eventually, hopefully, our girl will no longer be defined by RAD. Unless, of course, it’s the 1980’s definition.