Adding an Additional ADHD Med to Intuniv

We decided that Mae needed something in addition to the Intuniv to help her focus in school and at home. The Intuniv makes her calmer, but is not as effective at keeping her focused, so we are adding Vyvanse to the mix starting today. The psych doc said that he has posted a lot of Intuniv info on his blog, including the need to add another ADHD med to it in many cases. You will find his blog on the right of this page under Great Resources, Dr. Charles Parker, Core-Psych Blog.

It has been raining and raining and I think it is affecting my moods and energy levels. All I want to do is sleep! My kids are always crankier when the sun doesn't shine.

More on Handling the Difficult Child

One of my blogger friends Mary the Mom came up with a wonderful set of guidelines for disciplining the difficult child without spanking, which, many of you know, often exacerbates the problems with explosive, bipolar, or severely ADHD children. You can find a link to her site on the right of my blog, towards the bottom. Her blog is Muddling Through Mayhem. Check it out!

Possible New Good Friend

One of the new young ladies at Caroline's private school happens to live a minute from our house, plays lacrosse, and comes from a very nice family. She is also diabetic (type 1) so that makes this friendship even better, because, as I have said many times, managing bipolar disorder is a lot like managing diabetes, with the constant medication adjustments depending on their blood levels, etc. Monitoring their meds becomes a full time job in itself. I don't want Caroline to share that she is bipolar too quickly. She did that before a few years ago with another new friend and it really backfired with the mom obviously discouraging their friendship. I just want this young lady to know Caroline for Caroline, not the girl with the mental illness. If this girl decides not to come back to Caroline's school (she can't stand the disruptive troublemakers either) then I will be very bummed. But at least she plays lacrosse, lives very close by, and I can tell her mom is someone I could trust to be a good rule-enforcer.

Lacrosse tryouts happen this week for summer games. I hope that Caroline will make the select team and be able to play and make up for the lost spring season. We shall see!

Stressed today: prom is tonight for my oldest, and besides all the preparation (hair, brow wax, makeup, is the camera ready, pick up flowers, go to picture session, etc), we had two soccer games, ballet rehearsal, a sleepover last night, the Greek Fest which my kids won't miss, and I am now totally wiped out. But my husband and I are going on a date, so I hope I perk up. I just want to sit, not drive, just sit.

Problems with Drug Manufacturer of Lamictal ODT

Unfortunately, we may have to switch Caroline back to the regular generic Lamictal instead of the extended release because GlaxoSmithKline is having a problem with manufacturing, exactly what I don't know. This is disappointing because we did notice an increase in effectiveness with the name brand and not the generic. Our insurance wouldn't pay for the name brand Lamictal, which is why we requested the Orally Disintegrating Tablets, which only comes in the name brand.

Bad Day

Oh, I wish the end of school were here. Caroline is having a very difficult time staying at school. She says she can't deal with the behavior of the boys there anymore. She only has twelve more days of school, including six days of final exams. I had a conference with the assistant principal today about strategies to help her get through the final push. I really felt like pulling my hair out from the stress of dealing with Caroline's attitude of "I quit!" My husband is out of town so I am playing single mom and having to be four different places at the same time (all I do is drive it seems.) Caroline had her last meeting with the counselor she has had since last May, and now we will have to adjust to someone who is new. Oh boy. I am just really tired tonight. Tired of homework, and kids who don't want to do homework, the end of year projects (four in two weeks) the AP exams, the SAT, etc. I am looking forward to summer in a big way.

Handling the Rages

One of the worst parts of dealing with a bipolar child is handling the many rages. These are not your typical temper tantrums. One of my children can still throw a major tantrum, but nothing like what we have seen in the past with Caroline. When she was very young, three or four, I was so bewildered and defeated by her rages that I would frequently call my husband at work and beg him to come home to help with her. He was able to do that then (only in big emergencies now) which was a lifesaver. Bipolar rages are more akin to seizures than to fits of anger. They are triggered by seemingly nothing, and the power behind them makes little ones look like the Incredible Hulk. I can still see her face distorted, red, eyes in this weird glaze, screaming, clawing, kicking, biting, physically trying to hurt me or one of her sisters. Awful. Really awful.

I have been asked how you handle these incidents. Honestly, we tried so many things. We tried spanking her, which no matter how "correctly" we did it, produced only greater anger. (she thought we were inviting battle.) We tried time-outs, loss of privileges, holding her, yelling at her (never works), throwing her in the car and driving around (actually the best calming tool) and in the worst of scenarios we took her to the hospital. If she was a danger to her sisters, we took her to the hospital. If she became a danger to herself, we took her to the hospital. If she was raging but it didn't become dangerous, we would let her rage in her room. Nothing strikes at your heart more than when you have an angry, out of control child who is scaring her siblings and you, and you feel helpless to solve the problem.

She has outgrown most of this, we think, or the meds she was put on at Meridell have solved this problem. She hasn't raged like that in a very long time. We are very thankful for the passing of this mixed-state behavior.

How to Know When You Need to Find a New Psychiatrist

On the CABF online support group for parents of bp teens, a woman asked what we thought about her psychiatrist suggesting that her son, age 16, who was finally doing well on his present med mix, could go off of his meds because he had probably "outgrown" the "bad behaviors" he had first exhibited nine years earlier when he was first diagnosed. What?!?! We were all appalled. Obviously this doctor is unaware that bipolar disorder is not a conglomeration of "bad behaviors" that kids can grow out of eventually. Don't we wish! Rather bipolar disorder, like Aspergers or schizophrenia is an organic, genetically influenced, biological, and chemical disorder! We emphatically suggested that she find a new psychiatrist fast. To experiment with "what happens if we just stop all of the meds" when her child is finally functional is downright cruel. Tapering one med at a time I can see. But to stop cold-turkey to see if he miraculously improves doesn't make any sense at all. Some doctors just don't get it. We have been firm with our doc, as much as we believe that he is brilliant and on the cutting edge of psychiatry, that we are unwilling to change Caroline's present med mix prescribed while at Meridell except to try tapering later because she too is the most stable she has ever been. Don't fix what isn't broken, right?