I have posted before about my almost 14 year old son. This summer he was pretty stable with a schedule of regular sleep, exercise and medication (lamictal and abilify). When school started he began complaining of trouble with his memory and problems focusing. We also noted increased edginess and his grades began to drop. He was started on a low dose of stattera to see if that would help his focusing.
Last week we had a major crash. He became very depressed with no interest in school or sports, began self medicating and became suicidal. We saw tdoc, pdoc, and there was talk of hospitalizing him. My husband and I took turns staying up with him for three days and never let him out of our sight. We immediately stopped the stattera and the pdoc started him on wellbutrin XL. We were scared to start the wellbutrin because he had increased agitaiton and suicidal ideation on prozac two years ago prior to starting the lamictal but we were desperate.
He is doing a little better. Today he was extremely agitated and irritable. Think normal adoescence X's 3. He wanted to go to his game today and played but choose to skip the team dinner after. He did seem a little better after the game and is sleeping now.
I am so torn with starting the AD but we didn't know what else to do and the pdoc really wanted us to try it or hospitalize him. We have already used up all of our MI benefits for the year so we would have to pay out of pocket. I know they would only keep him a few days and we were able to get through the crisis at home.
Once again I am turning to my friends on this board. Any advice or suggestions?
I'm so sorry to hear Drew is having problems again. It is scary how quickly they can turn around, isn't it? I'm not quite clear from your post if you gave him wellbutrin or if it was just prescribed?
What was he self-medicating with? I know he's asleep now, but does he seem less depressed? When do you see the pdoc again?
I can see why you want to keep him out of the hospital if you can. Please let us know how he's doing...and how are YOU doing?
We started the wellbutrin on Thursday. He was less depressed today. Prior to today he was so depressed he was moving slow. Today he was either depressed but not as much, or very irritable. It's hard to describe but he was so irritable he almost didn't make sense. He was better after his game.
He self medicated with pot. This was a big deal. He has been training very hard all summer and had two big games this weekend. There is no way he would have done this if he was feeling better.
I have been a basket case. I really felt like we had made some headway this summer in getting him somewhat stable. I came home and found him trying to get into my husbands locked gun cabinet. I didn't sleep for two nights and really haven't been able to eat. I do think we are over the crisis for now though.
I know that sick feeling you get in the pit of your stomach. There's nothing quite like it. I really feel for you and wish there was more that I could say. I know you've been worried since the beginning of school and your worst fears came true. It is weird that he changed so quickly. There is so much that remains unknown about BP. What did the pdoc think was going on??
I think the pdoc was a little surprised too. He just saw him less than 2 weeks ago. He has been calling every day. I think he wished we had put him in the hospital but I just can't do that unless I have to. He has never officially dxed him with BP. He uses the term severe cycling mood disorder with psychotic features. I think he gave him the wellbutrin because it is faster acting but I'm wondering if he needs another mood stabilizer instead. Oh I hate these meds. Who knows maybe the strattera caused it.
The sick feeling in the pit of your stomach is exactly how I feel.
How is your back? I read that you are planning the surgery for Jan. Did you see the new surgeon at U of W?
I know everyone is different, but the only thing that helped my son really get a handle on things was the combination of 3 mood stabilizers. Two got him to the point where he was about 95% stable, but when he added the 3rd one he felt "normal" -- like he had been pre-BP (if there is such a thing.) Of course he was older, so who knows if something like that would work for Drew.
If your son is anything like mine was, he turned to pot because his world was swinging wildly and he was trying to gain some control over it. My son self-medicated with pot for years before he got a diagnosis and was put first on lithium. That only helped somewhat so he kept smoking. Well, that didn't work out too well...and he eventually realized he had to be clean and sober and be treated through conventional medicine. Although frankly, if it weren't for the fact that he knew he would need a job and might be drug-tested, he might still be smoking. He felt marijuana was more effective than many of the "legal" medications he took, and probably far safer, too. He knew if he took too much lithium it could kill him, but didn't figure that would happen with pot, for example.
It sounds like your pdoc still isn't much of a believer in younger kids developing BP. Poor Drew. He must have been feeling really out of control to start up with the pot again right before the big games. These kids really are so fragile in so many ways.
I hope you can get some sleep. I am going to go try...and will check in with you tomorrow.
I am so sorry Drew is having a hard time. I think the beginning of school is stressful for our kids and it sounded like Drew did fine in the beginning, but things were unraveling just a little for him and he reacted.
I'm on my way out, but I'll post more later. The one thing I wanted to tell you is that Zac is on a low dose of Wellbutrin and is tolerating it really well. He had terrible reactions to both Celexa and Zoloft, but Wellbutrin is fine. Hopefully, it will help Drew, too.
I'm thinking about you, Lor, and keeping Drew in my heart.
I am so sorry to hear about Drew's setback. I have a feeling that the Straterra may be the culprit but I guess we really can't be sure of that. And I do certainly understand how you are choosing to keep him at home....our insurance gives us the option of inpatient or outpatient in which the benefits are doubled. So if we have 2 days left in the benefits for inpatient then we can get 4 outpatient days. So if you have something similar and have a day left you could get 2 days as outpatient if your insurance works similarly.
So how is Drew doing today???? I hope that the Wellbutrin is helping somewhat. It sounds like it might be kicking in if he was able to go to his game. And they say that exercise is almost as good as an antidepressant from some of the newest studies. Also, Lor, I have also heard that Wellbutrin has the least likelihood of triggering manias as the other antidepressants.
It's good that the pdoc is checking in with you.
Please know that we are all here for you....picture us keeping watch with you wanting to keep Drew safe until he comes out of this. We are right there with you, Lor, all the way.
I'm back and you and Drew have been on my mind all day. Adolescence is tough all of the way around and I think meds are harder to stabilize because, just as you hit a pattern, their hormones change or triggers happen and BOOM!
I'm glad that Drew is feeling a little better. The Wellbutrin seems to be a good, safe drug and he may need an adjustment to his mood stablizers, too. Have you been able to get any idea at all what caused him to feel so badly?
My husband and I are always worried when we leave Zac in the house alone, no matter how well he's doing, because we never know when the tides may change and what he'll get into. The truth is, guns or not, if they are looking for something to self-destruct, they can probably find it. We haven't made plans for a long time that take us too far from home for too long. It's just the way it is for now.
Has Drew ever had any anti-anxiety meds? Ativan used to work well for Zac, but we stopped it because of his substance abuse background. The clorazapem (sp?) works well, but makes him sleepy. The Seroquel seems to be the best to take the edge off. Just another thing to consider.
How is Drew today, Lor, and how are you? We can all empathize with that feeling you are feeling now because we've been. Post when you can and tell us how everyone is doing.
Lor, has drew ever taken seroquel? i think that is a great drug and i wish my son would take it..because of weight gain, he stopped. i cant blame him,he was packing on lbs like crazy. Maybe that would help him out since it does kinda take the edge off. Wellbutrin is also a good drug, my son was on that a few years ago and loved it.hes had a coupla of seizures after that so now is a big n0-no for him to ever go back on it. but im really thinking of a mood stabilizer for drew...
Things are much better here. Every day is a little better than the one before. Drew went back to school for half a day today. He said it went well and he seemed OK when he got home.
Goody, our benifits for any type of psych is $300 per year with a lifetime max of $3,000. Of course that was exhausted in the first psych eval. We pay for all of Drew's care including his medications out of pocket. We have no coverage for inpatient care. The problem is that we purchase our insurance since my husband is self employed. Our choices were very limited because we have some preexisting conditions in the family. We are looking to make a switch for next year but will need to get his partner and secretary to come in with us so we can purchase as a group. If your purchase as a group they can't deny you because of preexisting conditions.
I don't know if the straterra caused this or not. Drew did well this summer but we really controlled his environment. No stress, plenty of sleep, meds at the same time each day, 2 hours of exercise, plenty of time to relax and a couple hours on the water fishing or wake skating each day. It was almost a full time job for me. Whenever the schedule got a little off we did see problems. I'm just not sure he has ever really been stable. He definately never got to where he was before this whole thing started.
Of course with school starting there was more stress and less sleep. He was having so much trouble focusing and he quit working out or running except for practice or game days. He was getting edgy even before he started the staterra and the real crash came about 10 days into it.
So far he seems to be doing OK on the wellbutrin. We hate the meds and never thought we would medicate one of our kids and now he is on three. I really want to give it time to work before we try anything else.
I have been spending the evening helping him with his homework. He wants to catch up but he is just so spacey right now. I helped him do a research project last night and when he tried to turn it in the teacher told him he had already turned it in early last week. The worse thing was he forgot to do the assignment which was due today so he got a 0 on that and it was much easier than the research project he did twice.
Algebra is impossible for him right now. This is the same kid who was doing long division problems in kindergarten. We are just taking it one day at a time and hoping that it gets better.
Well I don't want to sound too negative. Other than the school work he is doing much better. He is joking around with us and I even heard him singing before he went to bed tonight. We are trying to keep things quiet and get back into a routine.
Thank you again for all your advice and support. I'm not sure anyone who hasn't gone through this with one of their kids can really understand what it is like. I hope everyone is doing well and look forward to your updates. It gives me hope to hear how well some of the kids are doing.
Glad to hear Drew is a little better today. It is tough and you're right about others not understanding unless they have a child who's been there. We're like a secret society in some ways!!
As I've mentioned before, our son wasn't diagnosed when he was in high school and we didn't realize he was even having problems...but he played sports, but didn't have them during the summer, or at least not as much and we could always tell. There was a big difference in his level of irritability and grouchiness. But he was able to handle school well. He never took the amount of meds he takes now while in school. It will be interesting to see if he can handle grad school. Of course the field he has chosen is almost entirely mathematical, so it will be a big challenge. I don't think he could do it without taking Provigil. It just took him so much longer to do any calculations and he tells us his abilities are less than before he began taking meds.
I know how you feel about your son being on such strong medications. When the pdoc started combining meds, I really freaked out. But I don't know what the alternative is. If he'd just stayed on the lithium by itself, I believe he'd be dead by now (because it wasn't controlling his symtoms enough).
Well, just take it one day at a time...as I always used to say to Goody: baby steps...baby steps.
Lor, it really is baby steps ..and sometimes 2 steps forward and 1 step backwards. these kids do not deal well with change, like going back to school after 2 months of being home is huge for him. Give him some time and im sure you will see improvement every day..
I know he's very private, but would he be willing to have you talk to the school just to say he's going through a rough time (no real description) and could he get a few accomodations until he's feeling better? Just the example you gave of him doing the research project twice and then getting a "0" on homework should be enough without going into details.
Drew reminds me alot of Zac in so many ways. Although their passions are different - Drew's is sports and Zac's is music - they both grew up confident in their intellectual prowess. Zac also had a hard time with Algebra and I also couldn't believe it. Like Drew doing long division problems in kindergarten, Zac was adding multiple triple digit numbers in his head in second grade. His third grade teacher thought we should put him in a private math enrichment class because she thought he was so gifted mathematically. By the time he got to Algebra, he seemed to almost have forgotten basic multiplication!!! (ok - that's an exaggeration, but he really struggled and made ALOT of careless mistakes and Geometry was a complete and total nightmare!)
The point is I think that challenges in academics is something new to them and another thing to make them lose their footing. Something which once came easily and for which they got a lot of recognition is no longer a safe haven. Add to that the meds when they are not working or ceasing to work, and you have a perfect storm. Last year, the introduction of Zoloft caused a huge setback for Zac, but we didn't realize it until his science teacher was able to pinpoint the exact date when she saw him starting to drift.
Most schools do not understand kids like ours. Even if they are compassionate, they often assess the child based on their behaviors. I remember very clearly the Child Study Team, early on, focusing on Zac's substance abuse history. I told them that I understood why they were concerned about that, but why were they not equally concerned about his self-injury issues, which started in Middle School, where the Middle School knew about it and could not give us one recommendation of where to turn for help, and was long before the substance abuse? It's easier for them to focus on where the child is either acting out or failing than it is to be proactive about how to help these bright, but troubled, children.
I know I'm always on this soapbox and I apologize for always bringing it up. But hindsight is 20/20 and if there is anything I can do to help either Drew or you experience less pain, I will.
The best news is that Drew is starting to feel better. I just saw an article by the National Institute of Mental Health that said they believe youth suicide is up because fewer are on anti-depressants so, hopefully, the Wellbutrin will help him get through this rough spot and he'll be on his way!
Drew continues to improve. He was actually able to do half of his algebra homework without my help last night. I'm not sure if it's right but at least it is done. It does seem to take him longer to do everything right now but even that is getting a little better.
I know I have to do something about school. Last year his guidance couselor kept an eye on him and spoke to his teachers when needed. This year that is not an option. Our tdoc is very familiar with Drew's school. He is out of district there. The school has a reputation for sending kids back to their districted school if they become a discipline problem. Apparently that is how they handle problems like Drew's also. Drew really wants to stay where he is for now. He has been there since 4th grade and when things are going well, he enjoys the academic challenge of his current program.
I am considering two options. The first is to speak to the school nurse. I know her son had a problem with depression so hopefully she will understand and may have some suggestions for me. I have never told the school about Drew's medications and they probably need to be aware of it just in case he has a problem at school.
The second oprtion is to email his teachers individually. I could start with the science teacher. He has missed an average of two of her classes per week due to appointments or not feeling well so she is probably beginning to wonder what is up. I think he would agree to whatever I suggest right now. He is pretty subdued.
Any input?
Yesterday was my Dad's birthday. We went to the cemetary and out to dinner. I sent Drew to practice with his Dad. I just don't think he can handle any stress right now and we are trying to keep him on a schedule.
I have been extemely busy lately between Drew's issues, the new baby, my Mom and helping my sister who is having some problems with her MS right now. Oh and I started back to work for the school year. I am feeling a little overwhelmed, but at least this week is a better week than last week. Baby steps.
Thanks for all your support and advice. I hope everyone is doing well and enjoying the fall weather.
I am not the right person to respond, having not had to go through this at the high school level and I know Goody and Hope will respond, but if I were you I would let the teachers know, and the school nurse, too. Chances are, once one knows the others will find out anyway. This way you can put it in your own terms. Schools always want to know if a kid is on any medication, so I would think the nurse could be helpful. And I bet the teachers are wondering what's going on with Drew. They can check school records to see that he hasn't been a trouble maker in the past, that he is intelligent, etc. and they are probably mystified as to why he's behaving this way now. I imagine they will be relieved to know the reasons for his issues.
Think about how you want to present it and word it so you get them on your side rather than feeling like you are making excuses.
Glad to hear Drew is doing better. He'll eventually figure out a way to get his work done -- it may just take longer. My son took a couple graduate level mathematical statistics classes this past year. He ended up getting the second highest A in the class, but he commented many times how much longer it took to do homework than when he was in high school or even college. It is a sad fact that the drugs to have an effect on the brain. But then, marijuana does as much harm if not more.
Just a quick question. How much wellbutrin does Zac take? I know you mentioned it was a small dose. Drew is on 150mg wellbutrin XL. I am just concerned becasue of his reaction to the prozac. He is only on 200mg of lamictal. Hopefully that is enough to keep him stable with the wellbutrin. At one point they were considering increasing the lamictal but didn't because of the focusing and memory problems. I hate these meds.
First of all, I agree with Tsohl. I would tell the school nurse and I would reach out to the teachers so they understand what is going on with Drew (again, you can determine how you want to present it and the level of information), but that he is not simply being a rebellious teenager who no longer cares about school. I would also talk to your sister about the 504 plan. 504s do not require classification and schools are more willing to give them becasue there is no financial obligation. If the teachers are willing to work with you, you won't need one, but if you get someone who simply wants Drew to "follow the rules", you might want to implement one. A 504 gives him accomodations when he's not himself, like more time on tests and extended deadlines if he needs them and I believe it is covered under the IDEA act which gives children with disabilities (and our kids are considered to have a disability) a fair approach to education. If you go online, you can find more information and determine IF and when you might need it.
In terms of meds - Zac is on 300 mg. of Lamictal (taken 150 mg. in the AM and 150 mg. in the PM, which worked much better than even the 200 mg. in the AM), 81 mg. of Concerta in the AM, 75 mg. of Wellbutrin in the AM and 50 mg or more of Seroquel at night. As it turns out the Abilify was not a good med for him, although he was taking more than Drew is and the Seroquel is better. He still has issues focusing but he has always had issues focusing and he does feel better when he takes the Concerta. He said he felt overmedicated when he was on the Abilify and it was one of the reasons why he wanted to do a med wash, but he is feeling better on this regimen.
I hate to jinx anything, but it has been a solid month of having Zac back. He is in good humor, is managing the stress well for the most part, and is much more interactive with us than he has been in years. I just pray it stays, but I am thankful for this month, especially after the nightmare of the end of summer.
Keep asking questions, Lor, and congratulations on helping Drew to recenter himself. He is lucky to have you and your husband.
