Any experience with threatening child? | ADHD Information

I would take the kill talk more seriously than your pediatricain has. Do you have any recourse to get help sooner?

We went through this prior to diagnosis. Our then 9 year old daughter was having rages (slamming doors, throwing things, hitting) and talking of dying (us and/or her). Us yelling just escallated her rage. Most fights were about homework and we were taking away everything as punishment for the behavior, to the point that she did not care. She would refuse to go to school and ran away a couple of times. She started seeing a psychologist for evaluation and play therapy.

To handle this, I explained to her (during a calm time) that people get mad and she would have to learn to express her anger in more appropriate ways; and that I would ask her to go to her room to calm down when she was angry (this is not a place for punishment, but a haven). When she was calm we would talk about how to solve the problem. So when ever she got mad, I would calmly tell her to go to her room to calm down. When she calmed down, I would then praise her for getting a handle on the anger. We put ogram's marble system (top thread of this forum) in place to reinforce the positive behaviors we wanted to see. We got her appropriate accomodations at school and we got the diagnosis of ADHD. It turned out that she was so frustrated with school failure and the stress of not fitting in, she developed anxiety, depression and defiance.

I would also look at a med adjustment. The dose may not be the right one, he may be having rebound (when it is wearing off) or the med is not working because of potential stress (brain and meds do not work as well at these times). Also adding guanfacine (Tenex) to augment the Adderall (if the Adderall seems to be working for school) may be discussed with the doctor. It works on some ADHD symptoms (hyperactivity, defiance, impulsivity, is calming, helps with weight and sleep issues but not attention).

It is tough to watch you kids struggle, I really feel for you with what you are going through.

Hi All!

I need some help and advice please. I have a 9yo son with ADHD. Currently he's on Adderall XR 30mg. For the last 3 months, we've been experiencing some major behavioral issues with him especially when we want him to do his homework or even just brushing his teeth.  We will repeat ourselves over and over. Finally, after we've exhausted ourselves, and we try to reprimand him or take away his privileges, he goes "ballistic" on us. He says that he wants us to kick him out of the house, he wants to kill himself or he wants me to die. He's actually picked up a knife and threatened to use it on himself.  He says that we love his sister (4yo) and that we hate him and that he would be better off dead. Honestly, I'm at my wit's end.....I don't know what to do anymore......I've called our Ped. but he thinks it's all theatrics. I've tried to find a child psychiatrist but I'm not having much luck for his age group. Has anyone had this type of experience b4? How did you handle it?  Thx!

 

The school saw what was going on that I saw at home so they made him go to a school before he was put on meds which he's on Metadate in the morning and ritilan in the afternoon when he goes ballistic he needs time to calm himself down when my son does that I tell him to go to his room until he can talk to me with out yelling and then some he still does all those things but not to the extreme of what he did.....Pookie - This same behavior happened to my son when we increased meds.  Its one of the reasons I stopped them.  My son was also physically aggressive with his peers.  When i stopped the stims this behavior went away.  I really think you need to look at this as a possible side effect of the higher dose of meds.Adderall is widely known for rebound, and that may be what you are seeing. I would call the ped. and make an appointment with a Child Psych ASAP. pediatricians are just not knowledgeable enough about these meds to diagnose or prescribe them.

Maybe check out "Child struggling with weight" thread. I personally feel comfortable with Clonidine and its use - Vickie seems very familiar with different meds, so I'd consider the guanfacine with its comparison to Clonidine. Seems logical if it can help with weight and some ADHD symptoms.

You definitely need a pediatrician you can feel comfortable with and that takes all your concerns seriously. Fortunately, I really trust ours and at this time, have not sought a psychiatrist - not many available around here.

I hope you find the help you want for your son.

Pookie - How long has your son been on the same med? My son was on Concerta 36mg for over 2 years. He was also originally diagnosed ODD (oppositional defiant disorder) Within the past 6 months or better, his behavior had escalated to everything your experiencing. We had/have him in behavioral counseling which helps some, but finally we switched his medication to Daytrana (patch) 20mg. It doesn't seem to give him the rebound in the evenings and tapers off slower. Most days are better (2 days last week I thought aliens invaded the boys body because he was an angel - even nice and POLITE to his 3 year old brother ).

We also give him Clonidine in the evening to help him sleep. Our mornings were a living hell, but now that he's sleeping better, we don't have as many problems. I doubt he'll ever be a "morning person" (I'm not  ), but it's bearable. Does your son having sleeping issues? If so, I'd recommend checking into help with sleep. Kids get crabby just like us when we don't get enough sleep and it can affect the whole day.

Also, some parents give their child a fast acting stimulant in the afternoon to taper off the rebound. My doctor never discussed "rebound" and I'm not sure she "believes" in it, but when I described what his behavior was, she suggested the Daytrana and said she's had a lot of positive comments from kids/parents.

IMO I would definitely change the dose, try the afternoon booster or change meds completely.

Thx everyone.

zjmom....we upped his meds in June 2006 because they weren't as effective. Adderall seems to be the best for Dylan. He doesn't have sleep issues. However he's soooo thin. I've been trying to find a psychiatrist for him but haven't found anyone yet... his Ped isn't taking this seriously.

One of the reasons my daughter was put on guanfacine (Tenex) was that she was losing weight on the concerta and the doctor could not raise the concerta to a more effective dose. The guanfacine helps with weight issues as well as having effect for some ADHD symptoms. It is similar to the clonidine zjmom uses. I hope you get into a psychiatrist soon, so you can get your son more help. It is hard with an unresponsive pediatrician.just a thought, could it be early onset bipolar?  Sounds a lot like my son.  Maybe worth ruling out anyway

I have a question...

If one tells a pediatrician or counselor about your child talking about killing himself, don't they have to report this to social services? I would rather be able to talk with someone who can help and deal with the situation versus being in the system. I think it's great if you can actually have one of these doctors such as Gutsy who would help without other involvement knowing you are trying to get your child help. I believe my son's ped. would be like that, but I'm not sure.

Don't know if I'm getting my point or concerns across how I want it, but I was scared to inform anyone my son was threatening himself because he'd already acted aggressively towards his brother once and immediately social services was called and a boys home was being brought up left and right from the counselor.

I agree that the meds can be making him worse.  We tried Concerta and Strattera for my son the aggression and irritablilty got so bad that I had to take him off.  My son may not even be ADHD, possibly what he has just is mimicking it.  With that said, my question is how was your son diagnosed?  Through the pediatrician by observations and descriptions or has he been through clinical tests?

I am in strong agreement with everyone else that you need to go to another professional than just the ped.

Good luck. 

Pookie- Do you have a local children's hosptial or mental health facility?  I fyou call and tell them your son is in crisis they should be able to help set you up with a psychiatrist quickly- most psychs will squeeze you in in times of crisis, even if they end up having to refer you to someone else for ongoing treatment.  Another alternative is to see a psychologist or other type of therapist until you can get in the psychiatrist- they might be able to help you find ways to cope with the behavior, even if they can't do anything about the meds.

zjmom- they will not call social services if the child is only threatening himself.  They are more concerned with other people being in danger.  Any counselor who is reporting a suicidal/ self harming child to social services is an idiot- who would that help?  If anything the counselor should be refering the child to someone who can help them.

Pookie - My DS was diagnosed at 7 with ADHD and ODD at age 9.  We tried a few of the stimulate meds but he does not tolerate them well.  He was an emotional mess, anger (slamming the bedroom door 30 or more times in a row - hitting - throwing things) as well as the "I wish I was dead" "I might as well kill myself" etc.  Very heart wrenching to here my 9y old want to kill himself.  The beds were the key - he take 4 different meds now and none are stimulants.  Perhaps you need a med adjustment?

Does your pediatrician prescribe the meds or do you have a psychiatrist?  Regardless I would look at changing the pediatrician.  I would not tolarate a Dr telling me not to be concerned about a 9y old thinking about death.  But I would definitely look into have a psychiatrist to prescribe the meds if possible.  I know that is not always easy.  Good luck, breathe deeply and do not let him see how frustrated I know you must get at times.

The ped sounds irresponsible.  I called mine with the same problem when my son (then seven) started talking about killing himself.  He gave me clear and good advice (to consult with the school counselor, which I did, and which TOUCH WOOD has helped) and if it didn't work to come back to him.  He's lucky to have a mom like you who takes him seriously when the ped is making light of it.

Does his school have a counselor or somebody like that who can help?

I think I'd urge my ped to listen to me a little better. Or switch peds. I find it
unacceptable that the pediatrician is writing something this serious off as
theatrics. How very unprofessional of him.

Do you or your DH work at a place that has an EAP (Employee Assistance
Program)...they will often do the inital psych visit and then refer the patient
on to the appopriate professional.

If not, perhaps the next thing to do is call the insurance company (are you in
the US?) or a physcian referral line or similar.My son on Adderall and after a while his aggression got really bad. His dr and his psycologist told me Adderall will make them aggressive. He is now on focalin and we're trying to find the right dosage. I suggest you talk to your dr about changing his medication before things get worse.