13 yo son with diagnosed anxiety

[kree819]

My 13 yr old son has always been "off". Very intelligent, walked,talked,read early, but has always had very bad temper tantrums,is easily frustrated, becomes almost psychotic when angry/upset/anxious, and will self harm, i.e. bang head on wall,floor,etc and or destroy property, swear, and give suicidal ideation at these times.  Afterwards,( could be 10 min, could be 2 hrs) he feels very remorseful, quite hopeless, low self esteem-"i"m terrible, everybody hates me, everybody wishes I were dead," etc.  Then, he goes on about his business(playing online with friends,talking on the phone) and could be fine for the rest of the day, or the rest of the week....and me and the rest of the family are left to pick up the pieces everytime...But as soon as something doesn't go his way or according to his plan, he blows up into these rage attacks, He NEVER learns from "last time".  He seems so very insensitive to anyone else's needs at all....He blows up about food issues- very picky- a lot.  2 yrs ago, he refused to go to school, became suicidal, depressed, anxious and this is when he was dianosed with "school phobia"
"social anxiety" and depression. On top of these crazy mood swings, he is anxious as well- dosen't really go anywhere but maybe video store to buy something he wants, and refuses to take the bus to school, I drive him 25 min each way which is a huge problem for me, he refuses to bend...and when I say refuse I mean temper tantrum in a grown boy...screaming swearing breaking things, banging head on car window when I'm driving,he threatens to jump out, etc.  
He does have some anxiety, but can anxiety cause all this explosiveness & mood swings?  I belive he may be bipolar or BPD or ODD as well, but his therapist is stuck on the anxiety- I think its changed alot and that was the main issue 2 yrs ago, but what's going on now....he's not really much better after an initial improvement when he was first put on zoloft...then serroquel was added at night, and now they want to add abilify in the am as well...your opinion please?

[Kevin Kennedy, Ph.D.]

It sounds like the providers agree that your son displays Bipolar Disorder (even with his anxiety). His pharmacological treatment would be appropriate in light of such a diagnosis. The medication suggestion is sensible and he might achieve much more self control than he is displaying at the current time. It is not unusual for a person to display both a Mood Disorder (such as Depression or Bipolar Disorder) and an Anxiety Disorder (such as Social Phobia or Generalized Anxiety Disorder)

[jdtm]

but can anxiety cause all this explosiveness & mood swings?


I belong to a support group for parents and teachers of children suffering from anxiety.  The answer to your question from what I have observed first-hand and learned from the members in our group is "yes".  One child from our group was expelled from school and sent to a "special" school for delinquent children for one year.  He was 7 years old at the time and diagnosed with ODD.  Two years later, he was diagnosed with social phobia (which I believe was the correct diagnosis).  Of course, anxiety may not be the only issue in your son's case.

I can't comment on the medications used except that no one in our group uses the meds you have listed.  Although zoloft is one of the SSRI group, it may not be the best medication for your son.  Our own child tried three different meds for social anxiety before finding one that worked well.  Have you tried Cognitive Behavioural Therapy?  This therapy can work wonders for an anxiety-ridden person if he/she is ready to face one's fears.

As for the "refusals", "tantrums", "food issues", frustrations, etc., I know of these only too well.  We see these behaviours very often from children in our group and often indicate anxiety.  Of course, I know that these behaviours are also symptoms of other disorders; however, everything in your posting I have seen/heard from our anxiety-ridden children.  I wish you the best -

jdtm

[kree819]

thank you for your opinion, we've been having such a hard time getting help....
On monday after discussing how he exploded, banged his head against the wall, very hard, btw, and then kicked a hole in the wall all because he was upset beacuse we "had no food" which translates into plenty of food, just not exactly what HE wants, and wanted to go to Dunkin Donuts to buy a bagel, (even though we had bagels),and I reminded him that he wanted to save his money for a game, he became out of control...and we can "see" just by looking at him what kind of mood he's in, and I knew before it happened that something was going to happen, his therapist said "you need to figure out a way to calm down/do something else instead of kicking holes in walls....."
REALLY?  Isn't that her job? If he could do that, or if I could teach him that we probably wouldn't need a therapist?  This is after 2 years of seeing her.

Neither her nor the prescribing nurse have given us any helpful techniqes or ideas
and our whole family is now so out of control, I don't have much faith in what they say his issues are...He has 2 younger sisters, 10 and 4 who have been hearing him threaten suicide, and rage for over 2 years, not to mention the previous 10 years, he's always been "spirited"...now my 10 year old is refusing to take the bus to school and starting to "rebel" at all the energy her brother takes from us.And we don't even know how to discipline him...Most times I dread interacting with him...finding out what his "demands" anre that day...

The thing is, on the flip side, he is the nicest boy in the world....he is very kind,sensitive, intelligent, gentle,loves animals, not a bully or a fighter at all, was a toddler who could share toys easily and can/does get along with everyone...People constantly tell me "what a nice boy he is, great kid, etc...)
Its like Dr Jeckle and Mr Hyde..and I want OFF this ride!  

[RockRose]

Kree - I'm kind of stumped.  

I read both your posts,  word for word,  and had a specific child in mind that I know who is just like your son.

But then your last paragraph totally threw me.  With all this extreme behavior,  your son is kind,  gentle,  loves animals,  everyone loves him,  thinks he's a great child,  etc.

I really can't even begin to get a feel for what you're saying.  

Are you really searching your heart and being completely honest about how others perceive your son,  and how he is at home?  

Frankly,  it's unbelievable.

[LindaLD]

I can relate to all you said...my brother who is now 52 yrs old, was/is exactly the way you describe.  When he is what I call "normal" he is the most caring, loving person you would want to meet, loves his two dogs (all animals) as though they are people and all people love him....but the rages....our family still lives in this nightmare and have since he was in his teens.  Currently, he is under medication and in a mental facility (tried suicide 2 times I know of).  We still haven't figured him out, and because of his age now and the hurt and pain it has caused our family, we have had to let the State take it over.  So sorry, but get him some counseling or something, I don't know what to tell you, but the meds did him no good because that didn't address the emotional problems he seems to harbor.  You have all my best wishes and the hope for the future...my motto has always been...hope for the best, prepare for the worse.

[kree819]

hmmmmmmm...........what don't you get? Have you ever heard of Dr Jekyl and Mr Hyde?  "nice" one minute "nasty" the next, then back to "nice".....Why is that unbeliveable?  Thant's why I am searching for a proper diagnosis.....and these MOOD SWINGS are what makes me think he is bipolar.....but the Drs he see call it anxiety.....what I'm asking for is if these behaviors are consistant with anxiety, or someting else, or if anyone else has had this experience..and from the other responses, some have...sorry it's so "strange" to you....

[laurellie]

My brother who is 43 shows many of the same signs and symptoms as your son.  He is loving and caring but then at times he can be just awful.  He has gone to the point of dis-owing my sister and I because he states that we are talking behind his back about him to our parents.  About 10 yrs ago he tried to commit suicide and was diagnosed with bi-polar disorder.  He has been off his meds for about 7 yrs now and his mood swings have been more drastic.  I feel what you are going through and know that the behavior is very hard to deal with.  My brother lives at home with my parents and at times his disease has made it impossible to visit or talk to my parents because of his illness.  Like any other illness it needs to be treated and hopefully you will find someone that will listen and help.  Take care.

[laurellie]

I wanted to say that with a long history of family psych issues I have learned that the depression, mood swings, anxiety and many other individual characteristics all play a role in how a person relates to situations.  Just remember that not only your son needs help but also yourself and the other family members (other children) need to seek counseling for your son's behavior.  Take it from someone who lived @40 yrs without knowing of the psychological problems of both her mother, father and brother.  As an adult with 2 young children you start to question yourself and wonder about your own thinking.  It is so important to other family members to get help when they need it rather than to be @40 yrs old and getting help for things that happened when you were a child. I believe that when one family member has psych issues the whole family needs therapy to deal with it.

[kree819]

Thank you so much.....yes my family is being torn apart by these issues.....my father was a "yeller" ( this is part of the illness...whatever it may be...I have these tendancies myself)and to this day I get a knot in my gut when anyone raises their voice or begins to get angry/upset, so at times I find myself feeling "afraid" of my own CHILD!!! How rediculous....yet no one( the "professionals") can seem to offer me any help.....If anyone can recommend a great Dr for us in the MA or NH area....I'm all ears.

[Pearl99]

My friend has a boy about the same age who started around 10-11 to show similar symptoms. It went beyond ODD/anxiety and she only came to be able to deal with it after several years in therapy herself.  She was angry at him, enraged really, that he had become so unmanageable and had thrown their family for a loop, including imminent divorce etc.  (Yes she still loved him but the rage was pretty big).  They eventually got a mental health counsellor provided by the state to actually live in their home for a while to study him and really come to see how he was acting. By that point he had been kicked out of school pretty much for violent behaviors, drawing weapons, truancy etc so they spent lots of time together. In any case he ended up on heavy antipsychotic meds but then became much better. The behavioral therapy they ended up getting was for the WHOLE family and the couple even avoided divorce.  He is seriously mentally ill and won't be able to live w/o meds (I'm sorry I can't remember the exact diagnosis but it wasn't bipolar).

The turning point was the homestay counsellor and involving the whole family. It's not just the boy who had a problem; the whole family had become really involved and depressed, unable to function.

[ginga18]

MY 10 YR OLD SOUNDS THE SAME ALTHOUGH NOT AS BAD,(YET). HE HAS VERBAL AND RAGEFULL TANTRUMS YELLING AND TRYING TO CONTROLL THE HOUSE , HE BECOMES ENRAGED WHEN THINGS DO NOT GO THE WAY HE WANTS. HE FIGHTS WITH HIS 9 YR OLD SISTER ALL DAY KICKING HER,THROWING SHOES, TELLING ME I HATE HIM . THE NEGHIBORS SEE THE ANGER AND ARE CONCERNED WITH HIM PLAYING WITH OTHER KIDS , IS IT TIME FOR MEDICAL INTERVENTION???IF I GROUND HIM HE STATES HE WILL ONLY STAY HOME AND MAKE ME MISERABLE.