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10yo boy not sure what's going on anymore

My son is 10 years old.We have for the last 5 years seen doctors,psychologists,and psychiatrists.I am about at my wits end.I know my son better than anyone being his Mother and know in my heart something isn't right with him.There has been no definite diagnosis,I have heard gifted,ADHD,and borderline bi polar.I don't like the idea of medicating children but did try some for ADHD and encopresis with minimal results not worth continuing.When I talk to these professionals I get sad looks and disbelief.Sometimes I feel to get anyone to listen to me  I would need to videotape my son and his behavior for the next few months to show it to them.So to my point.There is a possibility that there may have been abuse at some point since before his school  years his bio Father and I split custody,and he still sees him over school breaks,there isn't any abuse that I know of for sure though. Our first problems started occurring around the age of 4 with stool withholding,it has been ongoing ever since.In first grade I started getting phone calls home about him having outbursts and crying fits and how he couldn't sit still.Second grade was awful,my husband joined the Navy and couldn't be with us and my son threatened me with violence,we had constant struggles at home and at school over schoolwork,when he would get into trouble he would slide notes to me about how he hated himself and wanted to die.At this point I took him to the first counselor,in coalition with a psychiatrist.I really liked her and felt we made some progress in his anger management,but I decided to move on to someone who had a specialty in encopresis.Third  grade we got into manipulation issues,his teachers generally don't see any outbursts or problems until he gets comfortable.He tries to bargain with the teachers and explain his way out of why he shouldn't have to work like the other children.Halfway  through the year due to my husbands job we moved and at his new school his teacher didn't let him get away with this behavior.We have now moved again and are starting it all over again.After a few months he has started with his outbursts and told his class that he is going to kill himself.That is the 3rd time in his school career that he has done that.He is very full of himself and believes that school or chores of any kind are a disruption to his life and it is ok for the rest of the world to do these things but he should be absolved from them,when I tell him that's not fair his response is "Life isn't fair"Recently I have been trying very hard to work with him on taking responsibility for his mistakes and genuinely being sorry for hurting people,but before he will ever apologize he must attempt to weasel his way out of it and push blame off anywhere but on himself.The only times he shows gratitude or helpfulness is when he has something to gain.He throws tantrums,will kick,punch,throw things,or hide and break or destroy something.He has friends but when they come over I have to force him to let them choose some activities,and sometimes he just goes off alone without them because they  don't want to do things his way.He manipulates his sister behind my back to get his way with the tv or computer.He rarely cries,only gets angry.We have tried groundings,taking toys, revoked privileges,rewards,ignoring behavior,I am against hitting and even tried spanking him once and he laughed in my face,nothing phases him.He is so smart,loves to read,amazing at math,he is bright and energetic,hates to write.He was recently grounded for lying about a school project to me,he also lied to his teacher about me in regards to this project.He pits the teacher and I against eachother by lying to both of us about the other.Off and on for years I have wondered if maybe I am imagining more than there is here,then I also worry that there is more than I can possibly know and it frightens me.My sons bio Father has sociopathic behaviors but was never diagnosed,and I see so much of his Father and his same behaviors in my son.All I want is to be able to help my son but he has a way of pulling a veil over the therapists eyes,they tell me "There's something here but I'm not sure what."His current Dr. tells me I need to actively get him more friends and put him in sports,my problem with that is his tantrums when he doesn't win or doesn't get his way,he is so not a team player and I had to remove him from boyscouts because of it.How many doctors and specialists do I have to go to before someone actually helps him.He tells me his school counselor that he sees on a weekly basis and him don't really even talk anymore they just play a game together.His psychiatrist's office has been supposed to get back to me now for a month about getting him in for an appointment.I feel like he is slipping through the cracks even though I am really trying to get him the help I think he needs.Am I going about this wrong, is there some other avenue I should explore?
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Avatar universal
Thankyou so much for all your help!I am doing doing some reading and research and I will check out the sites and book.
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189897 tn?1441126518
COMMUNITY LEADER
    I almost don't know where to start.  All of the things you have said would lead me to believe he is a child with high intelligence with ADHD who has also had problems due to the constant movement (new schools, dad gone, etc.).  Oh, I would also guess that his sister is younger and much easier to deal with.  That also does wonders to a kids mental state.
   Oh wait, he was diagnosed with ADHD.  At about 8 or so, you tried stimulant meds.  This kind of medication makes a normal person hyper.  The effect on your child was to make him "sluggish" -very important side effect - then he got used to it?  The teachers saw the effect, but you didn't at home (well the meds do wear off, thats why you take it every day).  A good doc. should have explained to you thats pretty normal.  It takes time and experimentation to find the right med for the child, as all kids are different.  The point being, that besides his symptoms - which are very typical- his reaction to the meds almost guarantee the ADHD diagnosis.  
    What I don't understand is how you got abandoned by your doctors.  Maybe it was because of the family movements. And of course, it all was complicated by your husband going on tour while he was still quite young.  I tend to think that the competence of your doctors may have had something to do with it.  
    The point is that the the way you work with an ADHD child is different than with a kid without ADHD.  Those tried and true methods that you were brought up with - don't work.
    Oh, before I forget,  I seen seen other posts from parents about their child having either Enuresis or Encopresis problems.  In the,  "The ADD/ ADHD Answer book," by Susan Ashley (p.72), she says that anxiety, changes in family, and emotional trauma are commonly seen in children with secondary enuresis and encopresis.  Kids with ADHD have a much higher percent of problems.  Part of that in my own opinion is that they just ignore the signs until its too late, due to their constantly changing focus.  I will also add that a young, male, elementary school child will typically avoid  the bathroom.  If the teacher won't let them go out during class time, problems happen.  Makes me wonder where the problem was happening.  But several factors come into play.  What bothers me is the doctors just saying its a psychological and sent you on your way without any suggestions on who to see next.  Ya, its psychological, thats very important to know, but no other help ideas?
     I guess what I have been trying to say is that your child really, really seems to have ADHD.   Yet, his actions continually surprise you and leave you unsure as what to do.  This makes me feel that you really don't understand ADHD, what it does to a kid, how the child with it reacts, and how to deal with it.  If you had been seeing the same pediatric psychiatrist the whole time they (I hope) would have laid all of this for you.  I can't do that in a single post.  It would take a book or more.
   The book I recommend the most on the ADHD site is,  "The ADD/ ADHD Answer book," by Susan Ashley.   I super highly recommend that you get it immediately and start reading.  It will literally cover most of the things that you need to know.
    I am embarrassed by the actions of your school.  The only thing that I can think of is that since he is new to the school he got lost in the shuffle.  But, to be seeing a private therapist is pretty cool.  However, that doesn't normally happen!  So they obviously think there is a problem.  Why they haven't figured it out yet is beyond me.  The problem is that the school year is almost over.  Hopefully (I guess) you will be back at the same school next year.  You need to make an appointment and talk to the principal and make sure that he gets a teacher that knows how to work with kids with ADHD.  Next, (and the book I recommended tells how to do this), you need to put in writing to the principal before the end of the school year for a special education evaluation (p.82).  This will lead to either an IEP for him or a 504. With this, his new teacher will have more information on how to work with him and he will be protected from things like suspensions.   Of course, this also can be done at the start of the school year, but it wouldn't hurt to get the ball rolling now.
    Ok, for you.  I do understand what is going on with you at home.  I have seen 4 years of similar posts.  Frankly, its hell for both you and him.  It would be easier if you had been in the same place with dad at home the whole time.  Think it would have reduced the anxiety.  But it is what it is.  
    The book I recommended will give you lots of things that you can do at home to make life easier for both of you.  The section alone on homework is well work the 10 or so bucks on Amazon to order the book.  I also think that you really, really need more information on ADHD.  The book is great.  Some other web sites you might want to check out are:
     http://www.consumerreports.org/health/conditions-and-treatments/adhd/symptoms-of-concern/adhd-symptoms.htm
      http://www.healing-arts.org/children/ADHD/
  
      Finally, you really need to find a pediatric psychiatrist that will spend time with you and explain what is going on.  Look for someone who specializes in ADHD.  Its funny, but most parents want the psyc to work with the kid, but its the parent that will achieve the most working with the child.  A good psyc will give you the tools to do that.  And, its possible that you may want to try medications again.  If so, don't expect am immediate miracle.  It really does take trial and error.  Work with the psyc on this.  If the meds work - they are only a  part of the answer.
     And I do need to add that your child is obviously very smart.  It leads to his frustrations and his actions and complicates things because he is trying to manipulate the world around him to protect him.  The more you can understand where he is coming from, the more you will be able to help him.  But that intelligence will work both for and against you and him.  I think the good news is that in many ways you have weathered the worst years.  He is now almost to an age where he will have more control.  But what he is controlling, and how he is controlling will be the challenge.  
      If you have any questions or really anything specific that is driving you nuts and need a quick answer - please post.  It probably wouldn't hurt for you to cruise through the ADHD site and look at people with similar problems.  I think I've got more then a 1500 posts there, so something should ring bells.  Best wishes!
      
    
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Avatar universal
Thanks for the link.Yeah I have been reading into a lot of different things and he seems like he could be all over the place.So many disorders have a lot of the same symptoms.
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Avatar universal
Yes he is in a San Diego school.
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189897 tn?1441126518
COMMUNITY LEADER
   Opps, just saw your hometown as San Diego - so he is at one of the schools down there?
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189897 tn?1441126518
COMMUNITY LEADER
   Just a quick question as I've got to run to a meeting.  You said, "we go to a military community school."  Are you in the States?
   A lot of his behavior including the bowel problems are pretty typical ADHD.  It will take a long post to cover those with ideas of things to do.  Will try and get back to you tonight.
   Thanks for answering the questions, it was helpful.
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13167 tn?1327194124
JD mentioned narcissistic personality disorder - it sounds like he's kind of brushed with that,  to me.  

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001930/
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Avatar universal
I believe it was about 1 1/2 years ago when he was on the last medication for ADHD which was concerta,also guanfacine to calm him down.Previous to that I think he was on vyvanse.For the encopresis they had him on miralax and enulose.Initially for the first few days of medication he would be almost sluggish and not like himself,then after that he would pretty much be back to normal.His teachers said they saw results but at home during schoolwork or any other activities I wasn't seeing a difference.The first psychiatrist who did an evaluation also wanted to put him on anti depressants which I disagreed to.As for the encopresis once we finally after many years saw a GI Dr.after about 8 months of treatments they finally listened to me that he wasn't the typical diagnosis or the disorder,meaning his stools were soft so it was mainly withholding not any form of constipation,they then told us it was psychological and sent us on our way.

He is in 4th grade.He tests pretty well but his regular grades don't always show that.Most of his report cards show that he meets expectations,a few above expectations.So far with the math he doesn't have much problem,I rarely have to help him with it.He does not have an IEP.I think since we go to a military community school they have more programs available,his counselor actually isn't a school counselor she is a private therapist but travels to the school to see certain students.

In the beginning of the year his teacher got a taste of what was going on and sent him repeatedly to the office and they wanted a team meeting.Then they decided to switch his teacher and she didn't think the meeting was necessary.I pushed for it since there was such an issue over his outburst and telling the class he was going to kill himself,but I was told unless the teacher recommends it we can't do it.Just in the past few weeks has his new teacher started having problems,we are supposed to be having constant correspondence  but she doesn't hold up her end.And to me I honestly don't think they are strict enough with him,he has an issue turning in his work,sometimes I find 10 pages of homework completed but not turned in and she thinks this isn't a problem,if he doesn't turn work in the newest punishment is they don't get to use their netbooks in the morning,he couldn't care less.
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189897 tn?1441126518
COMMUNITY LEADER
   Wow, just from the length of your post, I can see how much you care and how involved you are!  I post normally on the ADHD forum (you can check out my posts there) and have a few suggestions, but need a bit more info.  You said, "I don't like the idea of medicating children but did try some for ADHD and encopresis with minimal results not worth continuing."  How old was he when you tried the meds, what was the med, and what happened?
    He should be in about 4th grade now.  How is he doing grade wise?  Particularly, how has he been doing in math the last two months?  I pick that time because thats when new material, especially fractions are introduced.
     Finally, I happen to know California special ed pretty well.  (I'm in San Pedro) You say he sees his school counselor weekly.  That is impressive as our elementary schools don't have any school counselors.  But, to do so, he must have gained their attention. Does he have an IEP or a 504?  What does his school think is going on?  Hope these aren't too many questions for you!
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Avatar universal
Thankyou jdtm I will look into BPD.
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Avatar universal
My sons bio Father has sociopathic behaviors  --  your words


I  am wondering if your son has a personality disorder - whether anitsocial or borderline or narcissistic or whatever ...  If so, medical personnel will not diagnose this disorder until adulthood (some rare exceptions) due to the personality not being "formed" until adulthood.  In the case of borderline personality disorder, often a child will be diagnosed with ADHD or ODD or bipolar or anxiety or OCD or depression (and often a combination of these) before adulthood.  You mentioned "borderline bipolar" - did the psychologist mean your son might be bipolar or was the intent that your son could be suffering from either borderline personality disorder or bipolar disorder.

One place where you might find some help might be "bpdfamily.com" - message forum - Supporting a Son or Daughter Suffering from BPD.  I'm not saying that your son suffers from this personality disorder; however, the treatment of bad behaviours is discussed often on this board and someone might be able to help you.  Even if you do not have (or ever will have) a correct diagnosis, you still must react appropriately and discipline the negative behaviours of your son.  From what you have written, it appears he has no "empathy" - one of the hallmarks of personality disorders.  But, today there is a lot of research and hopefully, one day, some answers.  I wish you the best ...
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