Oppositional Defiance Disorder

by outnfree 7 Replies latest watchtower medical

• 

  outnfree

  I have always felt that my goal as a parent should be to raise healthy (where it is up to me), happy, well-adjusted children who will be a credit to society. For the most part, I think I'm succeeding. Despite AND because of my past involvement with Jehovah's Witnesses. Morals have been clearly driven home, yet, my children had only a moderately restrictive JW upbringing because of living in a divided household.

  My 12 year old son has been diagnosed with Oppositional Defiance Disorder which scared the bejeezus out of me!

  My husband has the attitude that our highly intelligent son's difficult attitude is come by honestly -- apparently my husband sees himself in our son. And that may be more true than my husband realizes. For, since this diagnosis came to light, I have learned that both my mother and my aunt have been on Paxil and Zoloft for anxiety type disorders and that the generation of second cousins on this same side of my family has a large percentage of children with anxiety/ODD disorders. (My one cousin and I feel that some of the first cousins should/would've been medicated while we were growing up had it not been taboo to admit to these sorts of problems in our family.)

  My son's defiance is not openly manifested when my husband is around (which is partly why my husband is taking a rather ostrich's-head-in-the-sand attitude). Nor is he a discipline problem at school. He reserves his defiant behavior mostly for me and his siblings.

  He is on medication -- Paxil and, of late, Tileptral to help him sleep -- but his social skills are still atrocious. He cannot seem to empathize. I keep trying to point out the ways in which he is hurtful to others, but he insists he was "joking" or that his remarks are "funny" -- which they are not. Yet, he has a very "thin skin" if the joke is ever on him. He is loud, too, but doesn't notice it.

  He is clinically depressed. He has no real friends. Since about mid-way through 4th grade. (He is almost through with 7th.) There are a few neighborhood kids who suffer his presence because he is gifted athletically. Same goes for soccer(football). His teammates like him well enough in small doses, and respect his ability, but he has formed no personal friendships from his participation in the sport.

  I guess what scares me most is that ODD can develop into real sociopathy.

  Anybody have any ideas for the types of therapy that might be most useful. Anyone have tips for the rest of the household as regards coping skills? It has been said that a household is only as happy as its least happy member, and when my son is being difficult, we are all quite miserable. The older children are avoiding bringing friends home now that one can drive, because they don't want to be embarrassed if their brother behaves badly. Family outings have been marred or cancelled penalizing all for one's bad behavior. What to do? What to do?

  Thanks.
  outnfree
• 

  pamkw

  Hi outnfree,

  I understand just what you are saying. It sounds like you live at my house. Blake also has a warped
  sense of humor, and doesn't know what is truly funny and what is being mean. He is very defient at
  school, doesn't want to do his work, etc. And at home, he is a big NAG, beg, beg, want, want. He is the
  most demanding person I know. He is now on depakote, and adderal, since he is adhd also, and he takes
  trazdone at night to help him sleep.

  I have know for over a year about the adhd, but I knew there was something more. He was also so
  angry,and could rage for hours at a time. I had him put in the hospital in March. That is when they
  started the depakote. This does seem to help his rages.

  But I know how you feel, I do not take him to stores, or any place if I think he will not be able to keep
  it together. He also has behavior counseling a couple times a month, and this summer, I am putting him
  into a group a couple days a week, just for kids with emotional disorders.

  I read a bunch of stuff on the web about ODD, and it makes me soo sad. I was telling my sister,
  Oh my God, my kid might end up in jail.

  I don't always cope very well, and I am glad now that I am divorced, my ex husband would not be able
  to handle the way Blake has become.

  I really don't know what to say, we just get by some days.

  You are not alone,
  Pam
• 

  outnfree

  Pam,

  Thank you SO much for answering.

  I would like to know more about Blake's hospitalization. Matthew has at times acted so badly and been so out of control/angry that even HE wishes he could be made "all better" and has actually requested going to the hospital.

  I have not allowed this. Because of the stigma, I must admit, and also because I think my husband would freak out. But I'm wondering if it would be beneficial.

  I KNOW I have to start individual therapy. I, too, was thinking that group therapy this summer would be a good idea. He desperately needs better social skills! I'm thinking that if he acts up horribly this summer at any time, I'll get him admitted to the local kid's home.

  We have a house in Florida, but I'm afraid to go there on vacation with him without my husband being present. He doesn't listen, so last year, he flew down with his older sister, while the eldest and I drove the van down. I was sure I couldn't cope with any outrageous behavior on the trip which was sure to be long and tedious.
  This year, I was hoping to send him to soccer camp, just to have a break at one point during summer vacation, but he's decided he doesn't want to go. (Maybe he knows on some level that he's bound to get in trouble/be unable to manage himself -- we call them meltdowns, as in nuclear! -- and it would be a bust all around.)

  Demanding? Oh, yes! And thanks to his years of JW indoctrination he always expects my Yes to be Yes and my No to be No and is SO black & white despite unforeseen changes in circumstances that it drives ME mad!!!

  Phew! Just being able to say some of these things out loud is a relief.

  I, too, worry that my son could end up in jail. I already have a nephew who's in and out of there, and I wonder if he wouldn't be classified ODD if he were growing up now.

  Have you read "The Explosive Child" by Ross W. Greene? Good insight.

  My son's dose of Paxil was recently increased from 20 mg to 25 with the Trileptal added to help him sleep, but I think it's been causing him to be more angry and disruptive. The problem with some of the other drugs is that blood monitoring is necessary and he's deathly afraid of needles.

  I'm also wondering -- is there just the Hyperactivity Disorder part of ADHD (as there is just the Attention Deficit minus the Hyperactivity)? Because, while Matt can focus for extended periods of time on anything he's interested in, he also has this annoying habit of not being able to keep still or silent when not engrossed.
  He makes repetitive noises with anything he can get his hands on.
  Do you know off-hand? Otherwise, I'll have to do research.

  Well, I suppose that's enough venting for one day. I am just SO glad to know you're out there.

  Thanks for sharing.
  outnfree
• 

  Mommie Dark

  First: who is making the diagnoses on these kids? It's vitally important to get an accurate diagnosis after appropriate test batteries have been done. A pediatrician or GP is NOT qualified to make these dx...it takes a complete neurological and psychiatric evaluation to rule out other causes of the behaviors. A reputable neurologist will usually have a counselor for referrals, one who is trained in dealing with ADD, ADHD, and ODD. Don't settle for less. Your kid's future could be at stake.

  Several other emotional/psychological problems share symptoms with ADHD and its neurological siblings. It's vital to let the right professionals make the diagnosis, and to use the services of the right counselors to help you make the lifestyle/parenting modifications that will work for your kid. Otherwise you could be wasting your time, money,and energy on the wrong interventions and treatments.

  I don't understand why doctors are giving these kids Paxil and tranquilizers. These are not the first-line drugs for treating these disorders. Don't just accept scripts without asking lots of questions, like"why THIS drug? What do you expect this drug to do?"

  It's also vitally important that you NOT get lost in dealing with your child's problems. You may find you need to grieve and mourn for your hopes for a 'normal' life for your challenged child. You also need to balance that child's needs against those of your other kids.

  There is no shame in hospitalizing an out-of-control child if you can't cope any other way, especially when the ODD results in violent behavior. So long as the experience includes more than restraint and drugging, it could be helpful.

  I heartily suggest FAMILY therapy, not just individual therapy. It can help you all learn coping skills, and it involves the whole family in the process of making a life around the child's disability (and it is a disability.) The other kids may feel helpless or overwhelmed, and family therapy will give them a voice and an outlet for their frustration. It can also help you to find a reasonable perspective when you feel like all you can see is your kid's problems.

  It's a painful fact that a huge percentage of ADHD and ODD kids never learn successful life management skills. It's not anyone's fault, so don't waste your precious time assigning blame anywhere. It's just one of those hard facts we parents of brain-damaged kids have to accept. (accepting that these neurological glitches are brain damage is hard for some of us, and it's pc to use pretty euphemisms, but facts is facts, and dressing 'em up in pretty packages won't change 'em.)

  As for the ADD/ADHD/H thing, be aware that any ADHD kid can concentrate for a long time on something he finds interesting (like video games). It doesn't mean they are faking when their attention sputters and fades at difficult or boring tasks. Also hyperactivity and poor attention span can result from many other sources than the brain dysfunction that characterizes genuine ADHD. Again, proper testing is necessary. When in doubt, get a second opinion. Even doctors can be misinformed about these disorders.

  I heartily recommend parents join an advocacy/support group. You can find wonderful resources for parents online. My contact info is probably too old to be useful; my kids have been out of school for years. (and yes, they still at 23&24 are unable to hold a job and stay out of trouble; with the best goodwill in the world they continue to screw up their chances and get into scrapes. If you take it personally, it will kill you. You have to learn to keep them and their probs in some perspective. Don't forget to take care of YOU too.)

  I wish you the best in dealing with your children. Let me know if I can help you find resources. YOU ARE NOT ALONE!
• 

  pamkw

  Hi Mommie Dark,

  My son was diagnosed by a psychiatrist, at the local mental health center, I was sent there last year
  by my GP for testing for adhd. This last spring I sent Blake to a pediatric psycology ward for a week to
  be observed. That is where they decided he was also ODD. Now with meds, he acts like a typical
  little boy. As onery as ever, but not so moody, and does not have these horriable rages. Now when
  he starts to rage, he is able to get himself under control with a little help from whoever is
  taking care of him, me or the school.

  I fought the doctors and the teachers for years before I put him on meds last year. I did everything else
  I could think of first. But now I know that he could not survive without medicine. We do have to
  take blood tests every so often to check the drug levels, but that is a small thing compared to how
  much better his life is all around.

  Thanks for the good post.
  Pam
• 

  pamkw

  I forgot to add this part to my last post. We have a whole truck load of therapist to help us here in S
  Salina. Blake has a case manager, I have a therapist, and a wraparound manager, and Blake has his
  own theapist, and we are going to start family counseling also, to help Brandon.

  the wraparound manager is someone who once a month brings together all the people that work with
  Blake, me, therapist, teachers, relatives, coaches, whoever, and we compare notes on how best to help
  Blake. We only stress positive things, it is not a place to say bad things about him.

  This makes for losts of appointments, and more stress for me, but I am giving it a try to see if it will
  help. I have met alot of other parents on email lists for kids with adhd and other emotional problems.
  I recently got off the lists because it made me so depressed, to see what I may have to deal with.
  But now that I know Blake is also odd, I may have to get back on them.

  All we can do is get by and do our best.
  Pam
• 

  outnfree

  Thank you, Mommie Dark (and Pam)!

  A little history may be in order here. My son threatened his older sister at knife point one day about 2 years ago after school while I was on my way home from work. He was SO out of control it was frightening. He had had another episode a few weeks before, and the GP had suggested I take him to the hospital to the outpatient psych team there. I had no idea when I went to the hospital that they would make me go to emergency first to overrule any physical causes for his outrageous behavior (Including drug abuse). This freaked him out even more because he is afraid of needles and they wanted blood.
  So it was NOT a happy situation. The PERC counsellor then interviewed us and recommended he be admitted to a local lock-up facility. I agreed, but when I got there it was a holiday weekend and two rational and one irrational things made me change my mind. Firstly, there was no actual psychiatrist on the premises at the time of admittance to make an evaluation and to whom I could speak and if I signed my son in he'd be there for a minimum of 48 hours and longer if the staff felt it necessary. Secondly, even though my son had agreed that he needed help, nobody would let us go behind the locked doors to see where he would be staying, what the facility was like, etc. And thirdly, I didn't want to leave my 10 year old baby, who by now was fearful because of the lack of forthrightness, somewhere on Friday night where I wouldn't be able to see him until Sunday PM and then only for 1/2 hour. The regular staff was on holiday and he'd be in until Tuesday at least. There would be no plan, no program, etc.
  Plus that "stigma" which I know in my mind I shouldn't feel, but having felt shame for my mother's and sister's nervous breakdowns when I was younger, I was not wanting more of that awful feeling myself. (Selfish, I know.)

  Matt calmed down, finished the school year, and I brought him to a psychiatrist. It's true he didn't do much in the way of any evaluations, but he did interview me & my husband, as well as Matt, and since some of what I described as his "symptoms" -- sometimes he DID experience panic attacks, I'm sure of it -- and my family's history, Paxil was prescribed.

  Matt did/does much better on the Paxil. If he misses a dose it is immediately apparent by the change in mood by all of us (except, perhaps his Dad).

  Of course, he needed counseling, too. I felt he needed a man, because he's outnumbered here 3-1 sibling-wise, and Dad was NOT reinforcing his need for help. Reluctantly cooperating, that's all.
  So I got a referral and this guy DID do a battery of psychological tests and questionnaires for us and his teacher. But, as you know, finding the right therapist can be tricky and while I was happy with him (he agreed to read "The Explosive Child" and wound up buying his own copy), Matt didn't care for him too much. And the guy himself never told me that the diagnosis was ODD. I had to ask Matt's psychiatrist what the psychologist had reported, exactly. THAT's when he, who previously thought anxiety disorder/depression told me that he diagnosis was Oppositional Defiance Disorder.

  As I said, Matt didn't like the psychologist, and frankly, I was still in denial myself. I admire Pam for her courage in facing facts immediately and going to work to get her son help. I think I've been sending mixed signals. Perhaps, like my husband, I just don't want it to be true. But I know it is. And I know Matt needs help. As do the girls.

  I took him to another psychologist and he really, REALLY did not want to go to therapy. I got him into the car, but when we got there, he refused to get out and come inside. Finally, I left him in the car and said I was keeping the appt. even if he wasn't. He made his way inside sometime after I was filling out paperwork. Of course, he had left the car door open and was amazed when I said I didn't care, I wasn't going back out to close it and that he would now accompany me.
  He did. We liked this guy better. This center where he works is affiliated with a hospital and there is group counseling available as well. I'm signing off here in a few minutes and calling to set up our next appt. (We see the psychiatrist again this PM.)

  NO neurological tests have been done, however. But I am on the phone right now with my neurosurgeon seeking a recommendation! (You've both got me moving and thinking, thank you very much!)

  MommieD -- do you know what the first line drugs are for treating these disorders? My cousin's ODD daughter -- who is in kid jail (not County Juvenile detention but state kid jail) -- is taking Tegretol with amazing results thus far. (Oh, I know the woes of kids messing up over and over again. My single-parent sister sent my out-of-control-nephew to a group home because she couldn't control him. After she died, I was left to deal with the young adult model, as I was trustee of a five-year trust, and it was just awful. No conscience and everything is everybody else's fault! So far, I'm not there. But Matt got into fisticuffs with not one, but TWO teammates on Tuesday, so that's scary.)

  I absolutely HATE what Matt's disability has done to the family dynamics. I am often depressed about that myself. I always wanted to be the cool mom whose house the teens felt good about congregating at, and now my 17 year old doesn't want to bring her boyfriend here because her brother's a "psycho"! We tried family counseling for about a month or so, and I was the only one who thought it valuable.
  But if I nag enough, I suppose everyone would return.

  Thanks for the insight on ADHD, too. Because that seems to me a real possibility the more I observe my son.

  Yes, I may need all the things Pam has -- a therapist for Matt, a therapist for ME, a family therapist, and group peer counseling for Matt.

  How wonderful you both were to take the time to post such long and well thought out replies!

  I'm sure I've been rambling, but I haven't even time to edit. Kids will be home soon, and I've got that psychiatrist appt. after school.

  I feel like I've been given a pep talk (AND a gentle prod)!

  Thanks again.
  outnfree
• 

  pamkw

  Hi again,

  It was one to the hardest things I ever did sending Blake to the hospital. It was 3 hours away from me in
  Kansas City, Ks. And I left him there for a week. I hated it, they only had vistiation in the evening
  and I only go visit one time. But I knew if someone else could see how he was, that maybe
  we could get him some help.

  I held off a long time not wanting to see Blake's problems. When they said he was adhd, I was so
  sad. But this year when they told me he was odd, I was relieved, I knew there was more wrong
  than just adhd. From email lists I have been on with other partents of adhd children, alot of these
  disorders run together, it is called comorbidty (I probably have the spelling wrong). I guess
  I am saying that it is not uncommon to have more than one problem.

  The increased meds seemed to work well this week. Blake went a whole week with no office
  refferals. That is a miracle in itself.

  I guess you just have to do what you can to help you kids. And you have to ignore how you might
  feel about it. But there are times I really feel like I must have done something to cause all this,
  then I think, get real, stuff happens.

  Though somedays I wish for kids that just were not so hard to deal with.

  Talk later,
  Pam