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emandryu
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02 Jun 2010, 10:46 pm

Sorry to just blurt it out but I've been on so many websites looking for what I can do for my 13 yr old.
He is diagnosed with Aspergers. He is coming off of Abilify and we have not started a new medication although lexapro has been suggested. We had hoped that some biofeedback might help him to get control of the irritability and anxiety he experiences...

My son is very self-analytical and aware. He has a heart of gold and could be upset about pollution or nazis for days... But lately, teenage hormones?? losing the structure of school being out?? he has had more anger. Not just more anger - but more impulsiveness with anger. This kid says "Yes Ma'am" to his teachers and always offers to help when we go somewhere. I have had people come up to me in the local store and say 'You're... ***'s mom, right? What a great kid!" So this is SO not like him.

He threatened his dad with a gun a couple months ago when we first started to take him off the abilify (we are doing that because his cholesterol is dangerously high) (dad is a hunter...that's why we have a gun in the house) Locked and ammo is stored separately. We figured it was just trying to go off that med too fast and let it go because he's usually so responsible and responsive to our getting him to cool off...

But last night he just went off. Punched a hole in the wall and told me he 'needs help' because he was going to get a gun again and wave it around to freak me and my husband out. My husband used to be a corrections officer. I'm not afraid of him being able to subdue our son if needs be. And we've talked about the moral and legal ramifications of his actions, even in words... (terroristic threat - even verbally is a felony) My son is a Reasonable person. But not with this anger. It is SO intense and he feels so impulsive....

I am shy about trying meds because with that impulsiveness - what if he was one of those" May cause suicidal tendencies in teens" ??? Abilify made him feel normal - but is killing him. We are going very very slowly off of this - over 2 months now decreasing the dose with a compound pharmacy... but now that it's so low, it doesn't help at all.

He was really scared that he might not be able to control himself in the 'moment'. Someone please tell me I don't have to lock this child up for a 'might happen'... I want to be a responsible parent. He has two siblings I have to watch out for - and himself...

He has been in counseling for over a year to talk about his feelings. He is undergoing biofeedback which HAS helped the nightmares and some of the anger...but it's like now instead of being irritable all the time, it just stores up and then who knows what will set him off (it was asking him to take the trash out when his legs hurt from working out last night) or how bad it will get if he does get mad.

I'm scared for him because HE is scared for himself... I honestly don't believe he would do anything to his family or himself...but then I've never seen him this out of control before. I'm thinking of taking leave from work...but it's just so out there...it's not predictable or regular....today he was fine like nothing happened. But I don't want to piss him off in the kitchen and have him impulsively stab me either....

Any advice is welcome.



Caitlin
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02 Jun 2010, 10:51 pm

That is a very scary situation for everyone - most of all him I'm sure. I really strongly suggest you contact your family doctor immediately. These strong and volatile emotions and threats should be taken as a sign that your son needs more help than he is getting... possibly urgent help.


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Ferdinand
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02 Jun 2010, 11:01 pm

I get nasty, violent tantrums if I am really mad.

Perhaps he doesn't, like myself, know how to control his anger or express it in a healthy, appropriate way.


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Eldanesh
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02 Jun 2010, 11:34 pm

I've always been a strong advocate that violence is violence. Sure you may want to investigator alternative solutions then standard teenagers but don't let him walk all over you because he "can't help it."

I can understand how he could be violent though. If I got it right, AS short circuits anger straight to physical energy, hence "meltdowns." Seeing as NT guys often have such a phase in their life as well it is safe to say AS struggles would only exaggerate the problems.

I'm no expert on treatments myself, of course. I was diagnosed late and grew up all through high school thinking I was normal, if not eccentric. I still suffered all the same social challenges initially that I keep hearing about from others. I guess the biggest difference for me is I got involved in team sports early and got to show peers that I wasn't lame ALL the time :roll:
I honestly don't know if that was also an emotional venting opportunity (back to the kinesthetic emotion thing) but I do know that relative to others I saw and have heard of, I got through public school relatively unscathed, certainly no meltdowns. I was certianly never popular, and didn't want to be, but I very much enjoyed being afforded a certian amount of respect from my peers, being a member of "the team".

Every case is different, though.



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03 Jun 2010, 12:10 am

That is an emergency. Talk with his doctor about hospitalization. If they decide hospitalization is warranted, then pick the hospital carefully.


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03 Jun 2010, 3:30 am

I am afraid I can't offer you advice that would fit into the space of a forum post. But I can offer you a book that might help explain some of the problems you are having. It is still a work in progress at this point, but it has been getting good reviews. I am not sure, but it may help you out.

Anyways, if your interested, just let me know and I will email it to you. So either post your email in the reply, or send it to me in a private message.



Kiley
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03 Jun 2010, 10:08 am

I think you should get immediate care from a qualified Psychiatrist and consider inpatient care. When safety is involved it's important.



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04 Jun 2010, 1:03 am

I was homicidal as a kid but it was because no one would take me seriously about the bullying. Medication only made things worse.


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emandryu
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04 Jun 2010, 8:13 am

Thank you all for your replies - he started weight training and I told him we'd also ride bikes when I get home from work for one-on-one time. I never thought of the anger-energy concept - but I know he was much calmer when we had time together riding bikes last year...

I'd love any book ideas - I am still learning about how he thinks/processes things differently.

I have one pysch dr - but it seemed he never cared about the whole picture - like behavior modification, exercise, counseling...only "what are your symptoms...here's the latest drug" In fact, when they said Pfzier was getting fined for bribing doctors I was sure he was on the take. It's hard to find people here (rural midwest) BUT I did talk to the biofeedback professional as she works a lot with ODD and ADHD and AS...she suggested risperdal (spelling?) as one that seems to have worked with other patients with few or no side effects. She said she hates abilify and thinks that his coming off of that is what triggered such a high response....

Anyone hear of risperdal?

I didn't hospitalize him because everything is 'normal' now.... I did talk to my boss a little about taking family medical leave off if needed, but it seems like this isn't some temporary thing. The problem is needing to give him ways to defuse himself in case he feels that intense again. These two incidents were literally months apart. I can't hospitalize him right now...probably should have when it happened... But I guess I want to find out how to prevent it from being that intense in the future. Anger is ok...but that kind - uh-uh. So either medication or technique... I'm still up for more suggestions on those two items. Thank you so much for taking time to read and respond.



gramirez
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04 Jun 2010, 8:34 am

Abilify is a very new med which seems to make autistics crazy (aggressive). Risperdal is usually the med of choice for these kinds of instances and is very effective. I've been on it myself. I'm really surprised that your sons doctor didn't try Risperdal first (they almost always do), but that's probably pressure from drug companies...


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04 Jun 2010, 8:42 am

Hello again.

To answer your question about risperidal, I can give you a copy of what is in the book:

There has been an increasing trend to prescribe the drug Risperidone (Risperdal) to children who shouldn’t be on the drug. Risperidone is an antipsychotic which effectively works like a depressant (opposite of a stimulant). It slows down the mind and mellows the person out. It also can negatively affect the person’s ability to think normally. Those who take the drug say that it induces a ‘brain fog’ effect. In very high doses, this drug can effectively make people so zoned out that they act like mindless zombies. That’s why they have received the knick name ‘chemical strait jackets’. There are also many serious side effects that come with this drug such as uncontrollable muscle spasms which can persist long after the medication has stopped.

The drug has been approved to help reduce violent aggression and extreme irritability in autistic people. Some autistic people who take the drugs say that it helps them to stay calm and it reduces their anxiety related problems. These people they feel as though the ‘brain fog’ effect is worth the peace provided. After all, it is better to be in a fog and not understand everything that’s going on around you than to violently lash out at everybody and wind up institutionalized. However, this drug is often being prescribed for much more than just extreme irritability. Since it is the only drug approved for something related to autism it is often the first drug that a psychiatrist will prescribe to an autistic patient, regardless of what the problem is. Children have been prescribed risperidone for things such as not making eye contact, or having delayed speech, or stumbling through their words. If you take your child to a psychiatrist and explain that he has autism then you will likely walk out of there with a prescription of risperidone no matter what he struggles with.

As such, many parents will give the drug to their child and hope for the best, just because the doctor recommended it. In reality the only thing they are doing is reducing the child’s ability to think clearly and thus making it difficult for them to grow and learn anything. So, if your child has severe irritability, is acting violently aggressive, and all other attempts to help the situation have failed, then I could see this drug as being your best option. But it certainly should not be your first option. Changing the environment, helping the child handle his stress, and other less dangerous drugs like SSRIs should all be tried first before you give antipsychotics to your child.

There is quite a bit more which goes along with that, but I dont want to post the entire book in this forum.

As for the book I recommended, I should have been more clear. It is something that I am writing myself. It is supposed to be a first read when the parent is new to autism, and is looking for answers to the most common questions. It doesn't go terribly in depth about any one thing, but it may help you to understand the basics. That being said, the book only exists on my laptop. So, if you want a copy you can just PM me your email and I will send it to you. If you want I can just post it on a file sharing service instead, but it isn't entirely finished and I would like to avoid doing that if possible.



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06 Jun 2010, 11:31 am

Hello Emandryu, I do hope you read this

I appreciate the nice personal message you sent me, but since I have responded back, and you haven't opened the message yet, I am going to assume that you don't know how to open your inbox. If you want to do so then look on the top right of your screen (below the advertisement, in the black horizontal bar). You will see where it says 1 new message. Click that link and then read the reply.



Vivienne
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07 Jun 2010, 10:56 pm

Regarding your original post:
Mothers have instinct, yours is telling you that your son needs more help than he is getting. LISTEN to it. His actions may not be in his control, and he is crying out for help, so help him.

I am not convinced this "lull" means all the anger has magically gone away. I am very worried that it is merely building up. I am worried about his ability to maintain this 'normal' appearance.

Drugs that change brain chemistry and functioning are powerful, powerful things. Doctors do not give nearly a strong enough warning about what can happen under the influence of drugs designed to change the way a person thinks and behaves. I cannot stress this enough. I have been on many doctor prescribed drugs. And I have done things under the influence of these drugs that I would never never do now.

IF he has another fearful episode. Take him to the emergency room and have him admitted and evaluated. He has asked you for help, don't leave him to fight whatever is going on inside, alone. Get him the help. This is why he tells his mother and not some peer at school. He is trusting you. Don't let him down.

I know this sounds.. horrible and harsh. But you used the word "homicidal" and "son". Think about that. Part of you knows you're in over your head.

I've been in many a scary situation with my own mental health. And I've learned that the safe play, is always the best play.

Risperdal is an anti-psychotic drug.
I was put on it ten years ago but never told that it was an anti-psychotic. I was never told that I was psychotic. I have not been on it for over nine years. It is a temporary drug.


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11 Jun 2010, 10:29 pm

I would like to say....

As a child, I was the farthest thing from violent or confrontational.

The ONLY time I ever really lost it and threatened anyone physically was when I was about 9, and my parents had put me on some type of SSRI....I don't remember which one, but that was the one and only time I ever flew into a rage. They stopped giving me the medication thereafter and I have have not felt that angry since. I honestly believe it was from the medication and it scares me to think that there are pills out there like that that they give to children and teenagers that disrupt their mental processes and causes them to act in ways they never would normally act and possibly do things they never would have otherwise done.

I'm not against medication when needed. It can be quite helpful to some, but it should not be used purely to treat "difficultness". That which the medication is used to treat should be clearly defined and the medication should have a good track record at treating it.

For example:

Attention problems -> Ritalin or Aderol
Bi-Polar Disorder -> Lithium
Tourette Syndrome tics -> Clonodine
OCD -> Prozac

Are all fine.

But

Ritalin and/or Prozac and/or Lithium and/or Clonodine -> "Difficult child" is not fine.

Be conservative in how you medicate, what you medicate with, and what you medicate for.



blondenurse
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13 Jun 2010, 6:28 pm

My heart goes out to you. Your situation is absolutely heart-wrenching. Being a mother who has had to make exceedingly difficult decisions in the best interest of both my son and the rest of the family, I'd say the last sentence of your post says it all. I'd consider this a psychiatric emergency, regardless whether things are temporarily quiescent or not.

Best wishes to you. I know it's not easy, by far.