8 year old w bp and add... at wit's end

[sarahfaye304]

Where to begin?? My son is almost 9 years old and was diagnosed wit hbipolr disorder and adhd about 2 years ago. He never had any developmental problems or behavioral issues before kindergarten. His IQ test are exceptionally high and he is extremely articulate and bright. However, he refuses to do any of his work at school and has been suspended at least 5 times this year for disruptive or aggressive behavior. He has been hospitalized twice and sent to an alternative school program to teach him to "behave in appropriate ways at school". He has been on several different medications and currently is on Vyvanse and Depakote ER. His major issues before being hospitalized were hallucinations and suicidal ideation with aggression toward other students at school (he tried to stab 2 kids with scissors and has hit several other kids and the principal). After starting the Depakote and Vyvanse his mood swings seem to be better, but he still refuses to do any work at school and has fits when he loses recess and refuses to cooperate with punishments at home (like writing sentences or doing extra chores) to the point that I am losing my mind. I have tried positive reinforcement (sticker charts, allowance, game time, etc), negative reinforcement (taking toys, games, time out, grounding) as well as spanking and manual labor (he spent an entire weekend raking leaves and scooping dog doo out of the backyard and still went to school Monday and refused to do work). He will start in a behavioral disorder class March 1 and I'm hoping that will help him to do his work but I'm starting to lose hope. Is there anything I haven't tried that I should? Would military school or something like that help him? I feel like I'm constantly on him and it's killing me. I just want to enjoy my little boy and see him succeed.. Can someone please give me some advice on how to motivate this child to do his school work? He's a great kid; he just seems to change when he gets to school and doens't seem to care about the consequences...

[DLA]

Sounds like you've got all your ducks in a row.  It's so great that you have a plan and are following through with it.

Moving to the country sounds great for the both of you.  He can get lots and lots of exercise and you can get some good fresh air.  I live in the country and wouldn't trade it for anything in the world.  Living in an apartment for 1 1/2 years almost made me lose what little is left of my mind.  lol   Maybe when he gets a little better he could have a dog.  A dog that keeps him playing would be great exercise and encouragement for him.  And dogs are the best when you're bipolar.  They seem to sense what kind of mood you're in and act accordingly to it.  My dogs would sit patiently with me and just comfort me in my depressed states and of course, just lived for me to be manic so that they got lots of play time.  It is very very soothing to just sit and pet an animal.  

Tweak the meds, too, of course.  Think you are a wonderful mom.  You are changing so much in your life to try and help your little boy, that makes you a wonderful mom!  I think once you get him out there and he can expend some of the energy you will have an easier time with him.  Also vitamin D comes from the sun and it is VERY important to have sufficient amounts of vitamin D to use the seratonin in the way it is suppose to be used by the body.  

Here is hoping and praying for the best relationship you and your little boy can have and to enjoy being a mom again.  It really is the best when it's good.  My little boy just turned 8 and when things are good there is no comparison to it in the world.

HUGS to you and him.
Dac

[crzychick]

The anger could be coming from the mania tho.  Not everyone has "happy" mania.  It might start that way but it can turn to what is called dysphoric mania which includes agitation, anger,rage, energy, agitation, rapid speech.  So maybe the med tweek plus the exercise will do the trick.  Best Wishes.

[sarahfaye304]

thanks for all the suggestions and empathy... the vyvanse/depakote combo was started about 6 months ago after he had a major breakdown and was hospitalized. before that he was on a regimen of about 6 different antipsychotics and anticonvulsants (he doesn't have seizures but as we all know drugs can be used for many other purposes and mental illness is not an exact science..) he seemed to do well on the current regimen for a while. I agree that it's probably time for a tweak with the depakote.. Currently he is on 500 mgER per day and I think it may be time to go to 750 or something but I don't want to only think about medications. My main focus with medication is to control the hallucinations and major cycling, but I think in the end he will have to eventually learn to deal with at least some anger and learn to control himself as far as resisting the urge to not do his work, etc. Honestly, about the only ADD medication we haven't tried is Strattera and I think if there is another change in the ADD meds we wil be trying that next.  I am going to try the martial arts thing again and we are also moving to the country where he can have lots of room to run and play instead of being cramped in an apartment. Also he will be starting a new school in a BD classroom so hopefully that one-on-one instruction and planning in the classroom will help as well. Fresh start maybe will do him some good..(I hope!) I guess I'm just looking for strategies that other parents have used with success to motivate kid with these issues and discipline techniques that don't involve constant punishment. I'm starting to feel like I can't enjoy being his mom because I'm constantly on his rear to get him to do the right thing....

[debj52]

hi, just reading around the forum on things that i can associate with and this time it is my granddaughter that me and hubby are raising and her little brother to anyway she has bipolar and adhd to and she takes invega 6mg and straterra 60 mg and let me tell you she is doing great...she takes the invega at night and the other in the am......she used to take depakote and she did not do well on it....well i sure hope all goes well with your son and you .....take care .....deb

[crzychick]

Have you had his thyroid checked?  I looked up his meds on drugs.com and The Vyvanse says it can effect it.  Also his Depakote may need a tweek.  The anger issue may just be a break thru of the manic.  Talk with his Pdoc about it.

Quote from  Drugs.com:  "Before using Vyvanse, tell your doctor if you are allergic to any drugs, or if you have - a personal or family history of mental illness, psychotic disorder, bipolar illness, depression, or suicide attempt"   There are other things listed but that one stood out to me.  Perhaps your son is on the wrong combo of meds?

[DLA]

Ah, the perfection thing.  Know it well.  My 8yo is the same way.  Has been for several years now.  I have to be really persistent with him to make him participate in anything, but in the end he really appreciates it.  Normally.

Would always be worth a shot again.  Maybe someone different can reach him.  Martial artist, I mean.

[sarahfaye304]

I actually tried martial arts when he was younger and he would not participate. If he doesn't do something perfectly the first time he gets very angry. I have been considering it again and may try it.

[DLA]

Some of my friends who have children with behavioral health problems have enrolled them in martial arts and explained to the instructors what the problems are and they have had a profound influence on them.  Not only does martial arts teach them discipline, and control it also gives them a safe outlet for the aggression.

Of course, before I did any of this I would talk to his pdoc or counselor about it.  But it really has worked wonders for my friends.