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Old 03-14-2006, 09:31 AM   #1
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goody2shuz HB Usergoody2shuz HB User
Daughter Home A Week ~ Need Help Evaluating Progress

Hi, Everyone Thanks for getting me through Erin's hospitalization....I wouldn't have been able to have done so with all the wonderful support offered here. Thanks You!!!

I am rather concerned and would like some input from you wonderful people. Erin has been on the Abilify 5mg and Celexa 5mg daily for a little over a week now. She started both full doses on 3/6/06. My husband and I, while we do not notice a whole BIG change in Erin, we DO notice that when placed in confrontations she does not get as frustrated or agitated as she use to.....so that IS an improvement. Her mood, though is sullen and sort of mopey. She comes home from school and when asked how her day was she says the same dull "okay". We sit down and have a snack together with barely a word said.....getting any info is like pulling teeth. She quietly leaves the counter and goes up to her room which is spent on the phone with friends or listening to music. Any effort on my part to get her out to do something such as a puzzle or to go out to the store is refused.

The first few days she neglected to do everything on her agreement in terms of chores....I mentioned when I first saw this happening that she had a few days grace period being that she had some readjustments to make but after the weekend the contract would be in full effect. I must say that for the most part she is sticking to it.

The only time she initiates conversation is in terms of our rethinking the part on her contract regarding her BF. Seems that her BF "is not allowed" to come to our house to see her (which was agreed upon by all parties including her BF and his mom prior to her discharge). He is not calling her when he says he will and I see Erin's dispappointment in that....she seems desperate to have him in her life to the point of making all the phone calls.....only to see her further disappointed when they are not returned. I gently reflect back how that must make her feel and also point out that if a boy really likes you he would go out of his way to make you feel extra special. She takes the disappointment out on us. She wants to be able to see him in town with other friends around....at first I was against this but I am thinking about reconsidering this since she has one day after school to go to a friend's house or grab a bite to eat with friends as well as weekend nights so long as we know who she is with, where they are and there is parental supervision.

We see a different psychiatrist tomorrow.....my question is how much of an effect are we suppose to see with the meds???? And have we given it enough time or do we need more?? I attribute my daughters "down" state to what's happening between her & her boyfriend. When I asked her how SHE feels the meds are doing she tells me that they really have no effect on her other than making her tired to the point of falling asleep in school. I seem to see less tiredness so I don't think that is completely true. When we point out how well things seem to be going between us, particularly to when she doesn't get her way and the contract, she says that's because she spends most of her time in her room.

Okay.....so I need some help to feel confident that the meds are doing their thing and that she is on the right ones OR even needs them. Being that things are much more peaceful at home I can see somewhat of a positive effect. Also I KNOW that we need to have her on meds to keep her safe in terms of hurting herself. BUT....are they at the point of seeing their overall effect?? What bothers me the most is that I do not see my daughter smiling or happy, although, when on the phone I do hear some laughter with friends. My older daughter questioned me several times why Erin sounds so tired and down on the phone.....so her family is somewhat concerned.

So....what are your thoughts on this??? Is it too soon to see any more of an effect??? And how much of this is NORMAL teenage behavior??? I did speak to my best friend about this and she says her teenage son IS much to himself but does converse in a happier manner although not all the time. With Erin there seems to be no happy convos.....everything seems so blah.

I can't help but worry about the Celexa.....it is a SSRI and I have a feeling if I discuss what I have here with the doctor tomorrow he will only up it. Do we wait it out to see if there is more improvement in terms of her mood??? I mean....we have heard laughter with her friends so I am leaning more towards waiting it out. One thing I am glad of is that the appointment we have with the psychiatrist tomorrow is with one in the same group as the psychiatrist who saw Erin while hospitalized (who has no room in her practice to followup with Erin). AND this appointment was made as a new patient even BEFORE she was hospitalized....so I am almost thinking that in a way it will be a second opinion for us. Of course they will know Erin was hospitalized but I would like to ask the doctor to reevaluate Erin because of my concerns...what do you think about that???

I still am somewhat uneasy about the unclear diagnosis....although from reading the posts on here I would rather them lack a diagnosis than misdiagnose Erin. I know that time is going to tell most of all what is going on. And that what we want most of all is Erin to feel safe with herself but I cannot shake the sadness.....I know if the BF weren't an issue we might see the true effects of the meds.....so m gut says to give it a litttle more time before making any changes. Anyone else agree with that???

The thing is, if Erin is not on the right meds....how will I know??? I know it is only a week but I like to always be one step ahead as you can see . Each night I go to sleep I am dreaming the same thoughts of whether we are doing the right thing for Erin. I feel so unsettled and just wish that I KNEW what was the right thing to do for her. this is one time in my life that I feeel this way and I am having the most difficult time with this as a mom.

Knowing that she sees the doctor tomorrow and the psychiatric social worker on Thursday makes me feel somewhat better. But when will this feeling of uncertainty go away???? As a mom I always thought I knew what was best for my child but this is just one of those times that I just don't know.

Thanks for listening ~ Goody

Last edited by goody2shuz; 03-14-2006 at 09:42 AM.

 
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Old 03-14-2006, 11:52 AM   #2
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crisma HB User
Re: Daughter Home A Week ~ Need Help Evaluating Progress

Hi Goody! I don't know much about bi-polar, but I do know that I went through a real bad time a few years ago with depression and anxiety and it took a while to get me where I needed to be with the meds. Everything I have read about says it takes about 2 weeks to get the meds in your system. I don't know about the bi-polar meds though. But the depression meds I was on made me feel so drained for the first few weeks.I know you are worried about the diagnosis and the meds, but you are on the right road! I am sure trying to diagnosis a teenager is a difficult thing, because there are so many highs and lows with them that are totally normal. I am starting to see that in my oldest son, who will be 13 in a few weeks.

I am sure this is hard on you because you are not able to "fix" Erin. As moms we are supposed to be able to make everything better(or at least we think it should be that way !). I hope the doctor that you are takin Erin to tomorrow can help give you a clearer picture and make you feel more at ease with all that is going on with her. I myself would not be comfortable with a not so clear diagnosis! But these mental health problems never seem to be easily diagnosed. Keep your head up and stay strong. I know this cannot be an easy time for you and your family!

Sending lots of prayers your way!
Cristie

 
Old 03-14-2006, 01:45 PM   #3
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Ruth6:11 HB UserRuth6:11 HB User
Re: Daughter Home A Week ~ Need Help Evaluating Progress

Hi Goody
From the depths of my extensive parental experience , here are some groups of "Typical Adolescent Behavior"
* Neglect of Chores - avoiding family duties such as caring for pets, helping with meals or doing the dishes, shoveling snow, taking out the garbage.
* Interpersonal Relations - not getting along with others, including fighting with siblings or friends, hitting, arguing, and teasing
* Personal and Interpersonal Activities - watching too much TV, talking too long on the phone, staying too long after school for sports or clubs, frequenting the shopping malls, decisions when to see friends, bad choice of friends
* Personal Appearance - dressing inappropriately, hair styles, makeup
* Homework / Academic Achievement - neglecting homework, obtaining poor grades
* Cleaning the Bedroom - neglecting to make up the bed, leaving clothes on chairs or on the floor, not cleaning or dusting
* Bedtime and Curfew - not getting home when expected from outings, or staying up too late
* Health and Hygiene - poor diet, bad personal hygiene, or substance abuse
* Spending Money -- poor spending habits, not earning money, poor budgeting

And from observing 5 teens in my family and 12 teens in Mr. Ruth's grow up, here are some other observations.
1) Purple hair, mohawks, black eyeliner all around, mutiple piercings are all normal.
A % will get a tattoo as soon as they are legally able to at age 18.
2) Most teens start speaking to their parents in monosyllables until they are out of high school. "Nothing" and "fine" are normal.
3) Most teens WILL try drinking, smoking & sex. It doesn't matter what you taught them - the Peer Group generally rules. A smart girl will get the Pill on her own, one not so smart or one determined to get pregnant will get pregnant.
4) There are things going on in your teens life that you won't hear about until they are in their 30's - if then. In fact, according to my mom you NEVER want to hear about them!
5) Hormones, hormones, hormones. Behavior isn't always because they are awful, or nuts. Hormones hit your brain like any other chemical and can cause major problems with behavior and mood.
6) Communication is great. But don't count on it over the teenage years! Teens are needing to become independent - not having to tell their parents everything. My sister used sit, sullen, over dinner.... eat, then get up and leave the table without saying a word! The magic is that everything you taught them during the first 14 years is still there when they are mid-twenties!

Whew! I know there's more - and I sense that you (just like I would!) want to be an involved, aware, concerned, sharing kind of parent.
The thing is, teens are designed to start moving AWAY from parents.
And there it is, how do you keep them safe while they are gaining their separate selves?

Also, some meds can take 10 days to two weeks to settle in and get to the proper strength in the blood stream. Most have a half-life.

You may get some conflicting advice on this, but Erin needs to have separate time with a counselor from you two. And there also needs to be built in family sessions.
She needs to talk to her counselor separate from you with the knowledge that EVERYthing she says is NOT going to be repeated to you.
Legally each state is different on what information is allowed to be shared when the patient is a minor. And certainly some things a counselor should let you in on. But she won't open up if she thinks everything is being repeated to you no matter how close your relationship has been to this point!

Want to hear something about me that not many people know? In my family I have 4 nieces & 1 nephew. As each reached the age of going to parties I would pull them aside, give them a little card with some free long distance minutes on it and my phone number on it, and I would tell them,

"This is a card for you. If you are ever at a party or a place that you shouldnt be, and you're afraid to call home, and there are things going on there and YOU DON'T WANT TO BE THERE - tell your "friends" that you feel sick, call me and I will come and get you NO QUESTIONS ASKED. I will take you home, or to my apartment (I was still single of course!) and that will be that.

The thing is, NOT ONE of them ever needed the card. I was never sure what that meant exactly, but either they wanted to be there and face the consequences or they behaved admirably!

Ok, that's it for now before I get up another head of steam here!
I would honestly say that once the system starts you can be an observer on the mental health angle - and the hard part is treating her like a budding adult rather than the child you have always known.
I was so sick there really wasn't a question of growing up the same as everyone else.
(Not real sure about your question on my self-esteem? Kind of asking about the stigma of having a mental illness as a teen and it's effect on me?)
Ok, there I go again!
I knew I should have sat down with a bigger pot of coffee!!!
A Big Hug,
Ruth

 
Old 03-14-2006, 08:06 PM   #4
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Re: Daughter Home A Week ~ Need Help Evaluating Progress

Hahahahahahaha....oh Ruth I really needed this post!! Okay, so you didn't want to directly answer my questions but in your own special way I guess you did.

I know Erin is becoming her own independent being and for the most part I am 100% behind that!! Funny how today when she got home and I asked how her day was she said "good" and I told her that I thought there was a way we could make it even be better!! I sat down & told her that not being able to see your boyfriend, no matter how your parents felt about him, must suck and so we were going to figure out together a way for them to see one another that was acceptable to all parties. We talked about compromise and came about an acceptable middle ground....I was not going to compromise on her seeing him at his house but she could get together with him at other people's houses and at the movies, local restaurants and places so long as they were in a group. She was okay with this.

The IM that we found with the sexually explicit talk was with her BF and went on to the two of them discussing becoming intimate (I had not read on to this part since it was 20 pages but did when she was in the hospital) I took the opportunity to discuss that further with her....the BF in the IM indicated that he had sex 3 times, twice with the same girl and once with another. He indicated that he wasn't going to rush Erin and would be very gentle with her. With this knowledge I indicated my concern and asked her that when & if she were thinking about becoming sexually active that she should feel free to come to me and we would get birth control. She indicated that perhaps we should do so now. Okay....I must admit my heartbeat went crazy and I almost lost it but I counted to 20 just like my cybertwin would. I sat down calmly and told her that I still thought that she was not emotionally ready for sex, that for girls it was a big part of themselves and to please listen to what I had to say ....that we would definitely go to the gyn but we were going to list the pros and cons to the pill and becoming sexually active. Of course the pros were to prevent pregnancy, improve acne, & decrease bleeding and of course to have sex with less worry. The cons we came up with were STD's, emotional investment to another who could walk away, the pill's side effects such as increased stroke, heart attack, infertility, ovarian/uterine cancer and weight gain amongst the few (of course my knowledge came in handy here). And I told her that the pill was not 100% effective and there was still a chance of pregnancy. She commented on the .1% and I told her that that went up and if you did not use it right, and if you were using other meds such as antibiotics that the effect of the pill could be significantly decreased.

I went on to tell her that my greatest concern was that it was obvious that her BF was with 2 girls and they were now history and that she could easliy become #3 and that he could walk away and she would be left feeling as if she had lost so much more than just a BF. She got a little argumentative saying that her BF said he would be with her forever and he was not like that etc......need I say more??? I told her that all guys say that to get some and will say just about anything to get some....that sex was on their minds 24/7 (this elicited a smile from her) while for us girls it was something that sealed the relationship as something special and often involved our entire heart & soul. I asked her how she would feel if she gave a part of herself that she held as something very special and the guy just walked away on to the next girl??? She got quiet and said that it would really hurt her.

We talked a little more and then I teased her when she told me that her BF would be there forever and I said "get him to marry you and then we will get her the birth control". Can you believe Erin picks up the phone and calls the BF and asks him to marry her???? Of course he said NO (which says alot about the guy!!) and I made a point of laughing while she was on the phone with him shouting how no 15 year old guy is ready to get married nor is any 14 year old girl!!!

Tom arrives on the scene just in time and he took Erin out for a bike ride and upon return we all sat down and talked. Imagine how my heart melted when my dear wonderful husband goes on to tell our daughter how guys want sex and how he did at her BF's age.....that he didn't have sex until he was much older (in his twenties) and that he knew 2 things for sure.....that a guy will say just about anything to get sex AND when it comes down to settling down he looks for a woman who is special and sees sex as a very special thing and not something to do with just any guy. He told Erin that he hoped that she would wait until she found that very special guy who she knew loved and respected her and that sex and making love was something that bonded two people in such a special way and that it should be with somebody that you see "forever" with. That's when my heart melted and all the love I feel for my hubby overflowed.

Erin actually smiled alot during our convo...there were moments when we said some rather funny things and as parents answered some of her questions like if we still did it!! I looked at her and said " We'll we're not dead yet, are we???" She kind of did her "ewwwww" thing like most of us did when we thought about our parents doing it The highlight of the convo was when we asked Erin if she understood and she said that she did and instead of running up to her room she hung out with us for quite a while afterwards randomly asking questions.

Okay.....so how did we do??? And no....I am not cancelling that appointment to the gyn!!! I discussed with Erin how part of her problem was being impulsive and that I was not going to allow her impulsivity to affect her entire life....that we would see the doctor and get the script and that she would have it available for when she would ever need it but that I was hoping, really hoping , that she would not see it as a means of doing something with little thought. And that she should realize how special she was and how much we knew that she was capable of making the best choices in her life and be smart about it. I shared with her how sometimes children did things out of rebellion towards their parents and that we hoped that she would never do so because the one who usually ended up the most hurt would be her. I shared with her how my best friend had married a man that her parents didn't care for because he didn't have a job and looked as if he would never provide for her. Erin knows of my best friend and her situation and financial struggles and has often cried with me when seeing me feeling my best friend's pain. I told her that for almost her entire marriage, my best friend has been so unhappy and that I am sure that part of the reason she married the man was because of her parents dislike of him. Erin has been aware of this and hopefully will apply that to her future choices as well.

So Ruth.....another pot of coffee for us....I know that you are feeling much the same way as me in regard to Erin....does she have Bipolar or is she a typifal teen with the hormones raging a little more than most??? Who knows....but one thing I do know for sure is even if she does have Bipolar there is nothing wrong with her and it doesn't make her any different in my eyes because I happen to know one beautiful, smart, caring, confident person who IS Bipolar who I happen to love very much!!! Knowing YOU alleviates most of my fears because I know that Erin IS special and will always be that way whether she is Bipolar or not.

And BTW....my question regarding self esteem did not come referring to once you had the knowledge of being Bipolar or even knowing something was wrong....NO, I wanted to know how your self esteem was before you were even diagnosed!! I sure hope that I didn't offend you in anyway, my dearest friend.

((((HUGS)))) for putting up with me and my long posts!! I must say that your last post must be a record in length!! We may need lots more coffee if we keep up at this pace.

On a serious note, Ruth I cannot even begin to tell you how much your friendship means to me!! Thanks for all the time and love you put into showing me you are there and that I am never alone even during those tough moments in my life. You ARE truly one of His angels to me.

Love ~ Goody

 
Old 03-14-2006, 09:32 PM   #5
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goody2shuz HB Usergoody2shuz HB User
Re: Daughter Home A Week ~ Need Help Evaluating Progress

Cristie ~ A BIG thanks to you for your continued support as well. I figured as you pointed out that the meds are going to take some time to adjust to.....Erin's main complaint is the tiredness and I told her that we will definitely talk to the doctor about this tomorrow (Oooops...today ). We may bring up changing the time she takes them from evening to morning....that way she will be most tired when going to sleep each night.

Thanks again for your continued prayers and support...it really means alot and I consider you to be among the fleet of angels carrying me along these tough times. Thanks for being there for me!!!


(((HUGS))) ~ Goody

 
Old 03-15-2006, 01:48 PM   #6
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Re: Daughter Home A Week ~ Need Help Evaluating Progress

Okay, Ruth I need you and hope that your metaphysical antennae are up in the full range to hear me.

I met with the new psychiatrist that will be following Erin. He intitially met with Erin and then called me in. He asked from my perspective of what brought us to ask for help for Erin. We spoke for a while and then he told me that he felt that Erin is in a more sluggish/tired/ depressed state than he would like to see her in. That he wasn't leaning towards Bipolar even after reading the other psychiatrists notes but more of a depression (based upon his evaluation of Erin and her state that was before him....which was sleepy and somewhat stupperish/sluggish). He went on to tell me that as the other psychiatrist explained.....it is difficult to clearly diagnose adolescents and that he wanted to increase the Celexa to address the sluggishness and depressed state that seems to be apparent to him.

I expressed my concerns regarding a SSRI and he explained to me how all meds had their safety measures and that we would increase it slowly from 5mg and eventually get her up to 20mg which should enable us to get her off the Abilify altogether if it shows that Erin is leaning more towards depression. He said that this was the only way to differentiate what is going on with Erin.....that either the Celexa will show that it is enough to take care of her depression and IF by chance he were inaccurate and she was leaning towards a Bipolar we would definitely see by Erin's reaction to the med if that were so by increased activeness (manic symptoms) with the buffer or safety net of the Abilify already in place. I was extremely nervous with all of this and asked if he knew of a safer antidepressant to work with. He told me that the Celexa was by far the safest with kids despite it being a SSRI and that even getting up to 20mg was still on the lower end of the dosage for Erin and that he was not concerned about any effects. Of course he said there were some risks involved but that with any antidepressant we would have that. He saw more risks in not treating her depressed state and having her on two meds when all she might need is one. He said that if anywhere along the way we saw any indicatons of hyperactivity/mania we could always take it a step back.

So the plan is as follows:

Abilify 5mg at bedtime
Celexa 10mg for 4 days with breakfast
then 15mg for 4 days with breakfast
and 20mg with breakfast after that

Okay.....fire away with your opinions, my dear friend!! I need you big time!! What makes me a little bit nervous is that the doctor is going to be away for 2 weeks but he said that there would be a covereing physician and two extremely qualified NP's to assist me with any problems or concerns I may have along the way.

I do understand that increasing the Celexa with the Abilify is giving us a cushion....being that I have never seen a manic episode what would I be looking at as my first red flag to back off on the Celexa??? I couldn't think of a better person to ask than YOU!!

(((HUGS))) for being my cybertwin who stands with me through it all ~ Goody

Last edited by goody2shuz; 03-15-2006 at 01:55 PM.

 
Old 03-15-2006, 07:42 PM   #7
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Re: Daughter Home A Week ~ Need Help Evaluating Progress

Goody - I received your post. I want to begin by saying I'm so sorry for what you are going through and I know how you feel. Sort of anxious, helpless, and at the mercy of the doctors and the medicine to help bring your daughter back to who you know she really is. It will happen. I think you said she was on the meds for one week. From my experience, one week is not long enough to see a real improvement. Six weeks would be ideal to start seeing your daughter again. You will see improvement before then, but to see her smile and laugh again may take longer. So, was she diagnosed with bipolar in the hospital? What symptoms did she have for them to suspect bipolar? You said you have not seen any manic symptoms with her; I'm wondering why they would diagnose her with that then. Manic symptoms can vary in degree. Some people with bipolar can be hypomanic, which would be bipolar II. Hypomania can manifest as anger, hostility, irritability, poor judgment. For instance, my daughter's first symptoms of hypomania were when she was taking Zoloft alone before her bipolar diagnosis. She was put on Zoloft for much of the same reason your daughter was put on an antidepressant. She was down and seemed depressed; seldom smiled and laughed and had little energy. Her pediatrician put her on Zoloft and took her thyroid levels. Three days later he called with the results, which showed a severe hypothyroid condition. We believed this is what was causing her depression so he kept her on the thyroid meds and the Zoloft. Within two weeks she became a different child. She was skipping school, running away from home, being argumentative, crying a lot and throwing fits, and making other poor judgments like drinking a fifth of Jim Beam at her friends house the day she ran away and skipped school. She was 13 years old. These type of symptoms might be something you would look for in mania/hypomania. Maybe not these exact things, but just things that will stun you that your daughter is doing. Things that you know are not her. One thing I learned was to pick and choose my fights with her. At this delicate time with her mood, getting her to trust me in this state of mind was not easy. Teens already think their parents are too controlling. Throw bipolar in the mix and all the sudden you are downright THE ENEMY. I am fortunate that I am able to distinguish the difference between a child with a mood disorder and a normal teen. My middle child, who is 17 is a normal teen without any mood disorder. Sure he gets in trouble at times and makes a few bad choices now and then, but all in all, he's no trouble at all. Nothing close to what I've seen with her and their little brother.

Let me know if your daughter seems to be improving with the increase in Celexa or not. I'm curious to know. Hang in there and be strong. That's all we can do. Good luck!

 
Old 03-15-2006, 07:54 PM   #8
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Re: Daughter Home A Week ~ Need Help Evaluating Progress

Goody - I just read your other post talking about your daughter's history of anger and agitation, etc. This is probably the hypomania that convinced the hospital that she had bipolar. I think it is very risky for your new doctor to have her on such a small dose of the Abilify (is this a mood stabilizer?; I've not heard of it before). It really sounds like she has the symptoms of bipolar. The right combination of meds can help her become just a normal as you remember her to be. I never wanted my kids on meds either, but when I saw what they were fighting, it broke my heart that they had to struggle that way. We literally saved my daughter's life by putting her on the Trileptal. She also needed Seroquel for a short period of time as this help relieve the mania more quickly.

I really hope you are doing okay. I know too well how you feel. One day you will look back and wonder how you ever got through it...

 
Old 03-15-2006, 08:17 PM   #9
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Ruth6:11 HB UserRuth6:11 HB User
Re: Daughter Home A Week ~ Need Help Evaluating Progress

Goody! Pull that tanker of coffee in and we'll put a dent in it before we're through!
I can't argue with most of what they're saying - Bipolar is VERY hard to diagnose in the teen years. And yes, an SSRI is safer if the person is on a mood stabilizer. (But hasn't she only been on it a couple weeks?) And maybe I'm extra cautious, but couldn't they even start her at 2.5 mg? We're not talking an adult here - And why ISN'T there an anti-depressant without bold warning re: teen and suicide risks?

My self-esteem was actually fine except during "bouts". I was a shy child, and always knew that I was "different" than most kids, but not necessarily in a bad way. I was very creative, enjoyed being with adults, read everything I could get my hands on and excelled in school.
If I wasn't sick I was in school and doing great like any other kid. I had boyfriends in high school, was in a school group or two, went to proms.
It's just that when I got sick it was for long periods of time. And there was no middle ground it seems.
My manias didn't really show up until later, and didn't get obvious until my late 20's.
Keep in mind that I moved away from home at 19 and managed to support myself until I landed in the hospital.
So, my "symptoms" at Erin's age were basically - being housebound. I had a tutor come to the house my freshman year for a couple classes. But there was no way I was functioning like any normal teen.
It's just that everyone is different. I wish they hadn't medicated me so soon. Unfortunately I was also VERY subject to any side effects a med might have - which made matters worse of course as far as a correct diagnosis.

This 2nd doctor's method is an ok one - and we CERtainly don't want to take any risks with Erin's health by NOT treating the depression.
If we didn't have the history of cutting and suicidal thoughts I'd be much more cautious about meds at this point.

I can only imagine the look on your face during your little "talk". (By the way, she is aware that there will be a pelvic exam before the prescription for the pill is dispensed?)
All a joyful part of being a woman and doing grown-up woman things, huh?
Deep down I find it very sad that our girls are having sex so early nowadays.
As you know, there are so many threads from young women here at HB who don't understand that emotions don't always go hand in hand with sex for men like they do for us.

And BIG applause for Erin, I probably would have run for the hills if I had to talk in detail about sex with my parents! I only hope that 1/10th of the words will kind of linger overhead in times to come... this boyfriend/girlfriend things becomes a teen's entire world. Their self-esteem is all wrapped up in someone else, I just never seemed to get into trouble with that.

And Goody I ALWAYS mean to answer your questions! Ask them again if I've sloughed over them, ok?

One other comment, I always thought that if there was a "first sign of mania", there wasn't going to be much chance of just backing of the meds and having everything die down. Usually (at least in adults) once it is triggered it is set in motion until it's done.

I don't know... it just seems like there's something else going on prior to this that led to the cutting. "everybody does it" just doesn't ring true to me... Do you know of anything that might have led up to the self-injury? I keep going back to that, and maybe it's a symptom rather than a coping mechanism?

And lastly (for now!), didn't her mood kind of slow down a bit because of the Abilify?
Why not taper down on the Abilify before adding an SSRI to "up" the mood from the stabilizer?
It is MUCH easier being the kid than the adult in situations like this. I knew there was something wrong, but I didn't agonize about it like my parents did!

Oh, and - the male ice dancer is pretty much out there doing a solo forgetting he even has a female ice dancer in the same rink...
<heavy sigh>
Ruth

Last edited by Ruth6:11; 03-15-2006 at 08:21 PM.

 
Old 03-15-2006, 08:55 PM   #10
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Re: Daughter Home A Week ~ Need Help Evaluating Progress

Okay everybody it's time to celebrate!! My best friend & I prayed today over the phone....Ruth this is my metaphysical friend who knows just when I need her the most sorta like you . When I shared my concerns about Erin and the boyfriend she immediately lifted her up in prayer and had me in tears. We went to the doctor and I was feeling so overwhlemd by it all (as described above).....I just knew that the boyfriend was just too much stress for Erin at this time. To add sex into the equation was going to break my little girl when she was emotionally a mess. Red flags were flying all over the place in terms of this BF. My best friend & I were bound to pray him out of her life!! Her life depended on it!!!

Well Erin was late getting into bed and when I yelled out a reminder she asked for a special extension because she had just broken up with her boyfriend!! Tom & I asked "WHAT"?? at the same time!!! We asked her to come down and tell us what happened. Apparently she was called a "prude" and told him that she was sick of his pressuring her and treating her so poorly. We told her she didn't deserve to be called such a thing and that respecting yourself enough to hold onto your values and morals was so important and that a boyfriend worth keeping would treat you the same way with respect and knowing how special you are. Tom & I asked what "prude" meant in today's language and she said somebody who won't do sexual things. We continued to tell her that there was nothing wrong with having beliefs and values and to be strong enough to hold onto them and how proud of her we were that she was able to do so.

On our way to the doctor today I played a favorite CD of Linda Ronstadt....I shared with Erin how it was my "breakup CD" to make me feel good after breaking up with a guy when I was younger. There was a song "YOU"RE NO GOOD" that the two of us belted out!! After hugging Erin I went out to my car and presented her with the CD telling her it was time to hand it down since my breaking up days were over and she smiled and ran up to her room and blasted it. A little while later I went up to check on her....she was half asleep and as I snuggled with her I told her that I was there for her if she felt bad. She told me that she actually felt good because she had found her self esteem and used it knowing that she had to break up with her BF!!

So my friend.....do you believe in miracles???

Get that coffee because we have lots to cover!! ~ Goody

 
Old 03-15-2006, 10:37 PM   #11
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Re: Daughter Home A Week ~ Need Help Evaluating Progress

Donte ~ thanks for checking in with me, I am going to need all the help I can get around here!!

As far as any diagnosis...we do not have one!! During the hospital stay the first psychiatrist wanted to start her on just the Celexa seeming to see more of a depression going on. She was only there for a day and I voiced my need to have her evaluated more before placing her on ANY med. I also voiced my concerns about placing her on an antidepressant without evaluating her thouroughly for Bipolar since I had read about the dangers of the Celexa triggering a manic episode in a bipolar patient. The doctor agreed to evaluate her some more. the next day she agreed that she saw evidence of my daughter skipping down the halls and acting giddy with the other patients. She wanted to start her on the Abilify stating that it would act as a mood stabilizer as well as an antimanic and decrease her suicidal/self injury as well as her overall frustration/agitation. She started her on 2.5mg and increased it to 5mg on March 3rd. She added 5mg of Celexa on March 5th stating that she was treating the symptoms and observable traits and felt that in order for us to understand it better Erin had something like a mild Bipolar I without that diagnosis and that the meds would balance out some of the moods she was experiencing with the hormonal surge placed upon her at this time and that many teens were being treated this way to assist them through a short period of time in which they would eventually be weaned off the meds over a period of 6-8 months.

Erin has been on the meds for 10 days and has been quite tired on them. We have seen improvement in terms of her general attitude and behavior.....she is less agitated but seems somewhat sedated and down.

When we saw the doctor today he told me that the sedated effect was from the Abilify and that we needed to increase the Celexa to overcome that and also in his opinion he would have started Erin on the Celexa feeling that she is in more of a depression than anything demonstrating Bipolar and that would be his goal.....to treat her for depression and get her off the Abilify altogether. Since he agreed that in kids it is difficult to clearly diagnose he thought keeping Erin on the Abilify would serve a a safety net while increasing the Celexa. If she were Bipolar or possessing true manic traits, we would see this by increasing the Celexa and see obvious manic traits appearing but if she were depressed we would see less tiredness and a return to normal balanced behavior. Once on the Celexa and doing well he would like to ideally get her off the Abilify and have her only on the one med.

The end result would be through working with the meds differentiating whether Erin is suffering from depression alone or an affective/mood disorder. He said that this would be tweeking us towards finding a true diagnosis eventually.

Okay Ruth now for your concerns......

Quote:
Originally Posted by Ruth
And maybe I'm extra cautious, but couldn't they even start her at 2.5 mg? We're not talking an adult here - And why ISN'T there an anti-depressant without bold warning re: teen and suicide risks?
While I share your same concerns the way it was explained to me is that the info with the bold warnings comes from general practitioners perscribing antidepressants with little knowledge of how they work. Psychiatrists know how to better titrate the doses....from what the psychiatrist told me Erin will still be on a very low dose of the Celexa when at the 20mg and will be progressed slowly in order to gauge her tolerance of the med. The warnings are for higher doses and after long periods of time being on them. According to this new psychiatrist he seems to think Erin will be on meds for a year before being weaned off of them. Erin is already on 5mg of the Celexa and in a sedated state. The doctor today is convinced that it is due to the Abilify and feels the Celexa is at a dose that is way to low to be effective especially with the Abilify to counter it's effects.

Quote:
Originally Posted by Ruth
This 2nd doctor's method is an ok one - and we CERtainly don't want to take any risks with Erin's health by NOT treating the depression.
If we didn't have the history of cutting and suicidal thoughts I'd be much more cautious about meds at this point.
I couldn't agree more. I think that over all everyone's concern is keeping Erin safe. My best friend who so happens to be a nurse commented with the following....

"I COMPLETELY AGREE WITH WHAT THIS NEW DR SAID. I THINK HIS PLAN IS VERY WISE SINCE IT WILL HELP DIFFERENTIATE WHAT REALLY IS THE TRUE DIAGNOSIS!! I am so impressed that he was able to contradict his colleague!! A LOT of Dr's will NOT do that, especially if they are in the same practice. You would not want someone that is afraid to disagree with their peer and since this is hard to diagnose, I think his plan is a GOOD ONE!!! We will pray for the Lord to show you and the DR. what exactly is the right thing to do to make Erin better!!"

Quote:
Originally Posted by Ruth
One other comment, I always thought that if there was a "first sign of mania", there wasn't going to be much chance of just backing of the meds and having everything die down. Usually (at least in adults) once it is triggered it is set in motion until it's done.
This is what scares me most.....being that Erin is in school most of the day I do not know what to do. How will I keep her safe and once it has run it's course will Erin be okay???? This is my greatest concern although on Celexa it says..."There is a slight chance that Celexa will trigger a manic episode. Use Celexa with caution if you suffer from manic-depression (bipolar disorder)."

Quote:
Originally Posted by Ruth
I don't know... it just seems like there's something else going on prior to this that led to the cutting. "everybody does it" just doesn't ring true to me... Do you know of anything that might have led up to the self-injury? I keep going back to that, and maybe it's a symptom rather than a coping mechanism?
Ruth, like you I have run through things over & over in my mind to figure out what went on to cause Erin to first cut. Looking back around 4 months beforehand, Erin had a real difficult time with the loss of two relatives, her Nana (great grandmother) and great Uncle both within a week of one another. Nana was 99 and expected to die and Uncle George was totally unexpected. She was close to both. She took the deaths hard and there were times months afterwards, that I got a call from the school guidance counselor telling me that Erin had been in to visit her again crying about Nana or Uncle George. A week before she first cut, she had to go in for a endoscopy in which an IV had to be started and she received twilight sedation. And the cutting took place while I was away to be with my dad when he had open heart surgery. When we saw a therapist, at the time she seemed to think that the endoscopy perhaps triggered the cutting where she felt in control of the pain that was inflicted on her body whereas when having the IV started she had no control. It could have also been her inability to deal with another possible loss of her grandfather.....those are my guesses. When filling out the paperwork for the history and it asked if there were any events that were painful in childhood when I brought up the deaths Erin was not too concerned about them as being something that triggered any painful memories.

Quote:
Originally Posted by Ruth
And lastly (for now!), didn't her mood kind of slow down a bit because of the Abilify?
Why not taper down on the Abilify before adding an SSRI to "up" the mood from the stabilizer?
It is MUCH easier being the kid than the adult in situations like this. I knew there was something wrong, but I didn't agonize about it like my parents did!
Somehow the doctor sees the Abilify as being our cushion of insurance until we get to the dose of Celexa that he hopes to get Erin regulated to. And yes....we all agree that the Abilify is the culprit in terms of sedating Erin. However, until he rules out the Bipolar totally I don't think he is comfortable taking her off or decreasing the Abilify until we are sure that it is no longer needed.

And on a final note, my dear friend.....okay so the male skater is off doing his own thing out on the ice....you keep up with that conditioning and exercises on the ice needed to strengthen your overall effect...it's just a matter of time before he finishes up his routine and glides on back to you lifting you up high into the air to take your breathe away all the while as you smile to the audience thinking that it was all worth it to have that moment where you are held in the air by the one whose strength and gentle hands you depend upon to get you there. Do not give up hope my friend....a skater always returns to his partner....it may seem as if he is out doing his own thing but it all comes together to astound the audience!!! The judges are waiting and before you know it the scores will be in and you will wearing the Gold and a brilliant smile to go with it!!

(((HUGS))) and a fresh pot off Java ~ Goody

 
Old 03-16-2006, 01:21 PM   #12
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Ruth6:11 HB UserRuth6:11 HB User
Re: Daughter Home A Week ~ Need Help Evaluating Progress

Hi Goody, I hijacked a thread yesterday about the ice dancing situation -
[url]http://www.healthboards.com/boards/showthread.php?p=2249230#post2249230[/url]
but only if you have a chance.

I'm glad that your spirits are a little higher!
It's so hard for moms like you and like mine to not dwell on their children!!! I know it's perfectly normal, but to be honest, other than just being there, there wasn't a THING my mom could have said or done that would have changed the outcome of my disorder. She wasn't working at the time and in many ways that was good for ME when I was incapable of attending school, but it was also hard for her because she had so much more time to think and worry about me.

Sorry to keep this so short - there's a storm heading in and whenever the barometric pressure drops I get a sick headache... I could've had a career in the weather forecasting industry!

Last edited by Ruth6:11; 03-16-2006 at 01:23 PM.

 
Old 03-18-2006, 12:15 PM   #13
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Re: Daughter Home A Week ~ Need Help Evaluating Progress

Okay, my friend I have tossed you life ring and hope that it keeps you afloat for a while....you are going to be just fine. I know the Ice Capades and Olympics have come to an end for the season so hang up the skates and let's work on bringing in the Springtime weather....even you threw out a sign here that the barometric pressure has an ill effect on you....well if I am right the barometric pressure has had it's effect at the Mr. & Mrs. Ruth Manor as well!! The good news is that you have more control on that as you may think!!! Not as difficult as changing Mother Nature when we can change the weather patterns of ourselves so much easier. So hold onto that life ring I tossed you and let me lead you into shore and once on dry land you will be fully equipped to take over!!

Now onto bigger & better things....I am hoping the people on this wonderful board can help me with what has transpired in regard to Erin.

Yesterday was her first increased dose of Celexa. We went from 5mg to 10mg which she took with breakfast at 6:45pm. Aound noon she called from school saying that she was extremely dizzy & spacy. I spoke to the nurse explaining how we are increasing the Celexa and told her that perhaps we could offer her water and some crackers and see if we could get her back to class. I also took the opportunity that over the next few weeks we sould slow be increasing the Celexa and the two biggest concerns would be increased thoughts of hurting herself and a triggered manic episode....that although the doctor said these would be unlikely I still wanted Erin observed in school for them. We have her best friend lined up to observe for signs of mania and who will get her to the nurse if need be.

Yesterday I received a call from my brother who has my oldest daughter residing with him hoping to get into a college in his state. Seems that she was arrested, charged and fingerprinted for underaged drinking and suspended from school and up for expulsion for drinking on school premises and failing a breathilizer test. She is suspended for 10 days and will have an expulsion hearing right after that to determine whether or not she can graduate high school there. This comes after almost facing being expelled less than a month ago. We decided to fly Kait home and have her evaluated as well. It just seems that her actions and behavior are so overwhelmingly self destructive and after going through the entire process with Erin it only makes sense to have Kait evaluated as well.

I pick Erin up at school and she says that her thoughts of hurting herself are increasing and tells me that she has cut herself again since coming home from the hospital. This occurred the day before she broke up with her boyfriend when they had been fighting (3 days ago) I called the psychiatrists office and the Nurse Practitioner talks to Erin and feels that she is okay and agreed to tell me if she wanted to harm herself. She tells me that it is not the Celexa but to keep her on the 10mg throughout the week rather than increasing it on Tuesday as previously planned and to call if there are any other problems. I shared with her my concerns about Kait (who we have an appointment for in June with the pyschiatrist) and the nurse advises me to bring her to the ER to see if they will direct her into an inpatient/outpatient program and if not she will make herself available to her on Monday to evaluate her sooner.

The ER's social worker meets with Kait and us and determines that the state's guidelines to inpatient admission is a threat to herself or others and although she cannot give Kait a bed, that if it were solely up to her she would admit her because the way she sees it Kait is her own worst enemy and doing everything and anything to sabatage anything good happening in her life and in a destructive capacity. She tells us that the outpatient program is full with a waiting list and advises Kait to get herself into heavy therapy to help her redirect her life before she finds herself really hurt and/or cannot fix it!!

I don't know how I am still standing.....somehow I still seem to have the strength but it sure isn't easy. I must say that as difficult as it is, it IS nice having my girls under one roof again....and I know that being together right now may be the best medicine needed. Kait did take a moment once home and told me how great it felt to be home again under the circumstances. I know that this doesn't fix the problem.....the thing is whther at home or away the problem seems to be following her. I am hoping and praying that she is beginning to realize it.

Funny thing is when I read some of the posts here regarding bipolar she had me read the again and admitted that it seemed as if she had alot of the same symptoms. I am hoping that when we meet with the Nurse Practioner on Monday we will have a better idea of what is going on.

Thanks for listening again....my intentions this week are to get us all back n our feet. Kait knows that this time at home will be spent on working on what we need to do to get her life back on track and not to see friends. We will discuss what she really needs but we have made one thing clear.....we are not going to fix her mistakes...we will get her into counselling to help figure out why she does such things but it will be up to her to decide which course to take into her future. We already told her that she is not a racehorse worth betting on and that until we see a winner and her wanting to win the race of life all bets are off as far as financially subsidizing college costs etc. Funny how the social worker agreed and brought this all up herself.

I hope that we are doing the right thing....in this role of parenting it isn't always as clear as you would like it to be. I am hoping that some of you here will share your thoughts on this.

Thanks ~ Goody

 
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