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Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7662
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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My son goes from ok to frustrated to the point of emotional

Customer Question

My son goes from ok to frustrated to the point of emotional outburst instantly. He has depression also, is Bupropion appropriate for him...it ameliorates the symptoms but doesn't eradicate them.
Submitted: 1 year ago.
Category: Mental Health
Expert:  Elliott, LPCC, NCC replied 1 year ago.

Elliott, LPCC, NCC :

Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Elliott, LPCC, NCC :

Dear friend,

Elliott, LPCC, NCC :

I believe that I can help you.

Elliott, LPCC, NCC :

First of all, the possible "T" drugs are:

Elliott, LPCC, NCC :

Thorazine - an older antipsychotic, today rarely used because of the high occurrence of serious side effects

Topamax - a mood stabilizer, also used for migraine headaches

Trazodone - atypical antidepressant, most typically used now as a sleep aid

Trileptal - a mood stabilizer used to treat bipolar disorder

Customer:

topomax was the one

Customer:

he also suffers from migraines unless he smokes pot

Elliott, LPCC, NCC :

I would like to know what sets your son off.

Elliott, LPCC, NCC :

Are his outburst very angry?

Customer:

he is angry but he doesn't exactly lash out...he just moves very fast like he is barely in control...he has opened a cupboard door into my head without noticing he even did it...also in moving past me has knocked me aside without noticing

Customer:

he is set off by my asking him to do something

Elliott, LPCC, NCC :

Does he ever hurt or mutilate himself (cutting or even eating disorders)?

Customer:

he says ok before i finish asking the question, then if what i was asking isn't what he assumed I have been accused of changing what I was going to ask so he'd be wrong

Customer:

no cutting

Customer:

he can't quit eating

Customer:

is very overweight

Elliott, LPCC, NCC :

Does he have fast streaming thoughts? Rapid speech at times?

Customer:

not really

Customer:

he had a learning disorder as a child but it was never identified

Elliott, LPCC, NCC :

Does he fear or react to abandonment or rejection?

Customer:

he was considered disabled

Elliott, LPCC, NCC :

With no label?

Customer:

his father shunned him from age 13 to 26, he has not gotten over that

Elliott, LPCC, NCC :

or diagnosis?

Customer:

no label

Customer:

or diagnosis that I was ever told

Elliott, LPCC, NCC :

Does he make eye contact with others very readily?

Customer:

yes, but he may not maintain it

Elliott, LPCC, NCC :

Does he engage in repetitive motions?

Customer:

no

Elliott, LPCC, NCC :

Can he stay on task?

Customer:

no

Customer:

he's forgetful of everything

Elliott, LPCC, NCC :

Is he able to work or drive?

Customer:

yes

Elliott, LPCC, NCC :

Does he work and if so what does he do?

Customer:

but I avoid riding with him because if he gets frustrated ... driving isn't his first concern

Customer:

he is a cafeteria worker

Elliott, LPCC, NCC :

Does he have friends?

Customer:

yes

Elliott, LPCC, NCC :

And enjoys a social life with them?

Customer:

if he talks about his work situation and the way he is treated he tears up

Customer:

he socializes with his friends

Elliott, LPCC, NCC :

He is bullied at work?

Customer:

he may not be bullied as much as discredited and considered dumb, he won't shave, have his hair cut or be clean so he looks like a street person

Customer:

considered dumb is the part that seems to make him tear up

Customer:

he isn't dumb

Elliott, LPCC, NCC :

But disorganized and scattered?

Customer:

very

Elliott, LPCC, NCC :

Does he sometimes appear driven or on the go?

Customer:

no

Customer:

he overcomes by inertia

Elliott, LPCC, NCC :

Does he have trouble keeping still? Does he fidget?

Customer:

and if I try to talk with him about his situation ... which now is that if he doesn't take his pills he needs to find another place to live...he doesn't respond he just looks at me until I'm finished talking

Customer:

he fidgets, but not as much as when he was younger

Elliott, LPCC, NCC :

Did some of these symptoms begin before age 7?

Customer:

yes

Customer:

his head is large for his body

Elliott, LPCC, NCC :

How is his relationship with his father now?

Elliott, LPCC, NCC :

And what did the neurologist say about that?

Customer:

until his father apologizes and acknowledges that he did Logan wrong there will be no real relationship

Customer:

he said it was part of a genetic thing...no diagnosis that i was told there either, everyone acts like it's a major secret

Elliott, LPCC, NCC :

So he feels abandoned by his father and abandonment or rejection may set him off? He is also rejected by fellow workers.

Customer:

the psycologist that talked wth me about Logan said that his large head and his freckles had something in common and then said genetic

Customer:

but that was about it

Customer:

yes

Customer:

he does feel abandoned

Customer:

which is one reason I have a hard time trying to tell him he needs to leave (for my safety) and find a place on his own if he doesn't take his pills

Customer:

his work number on his phone is programmed under "hell"...but he resists trying for another job

Elliott, LPCC, NCC :

What do you mean your safety?

Customer:

when he is frustrated he moves exceedingly fast...he snatches a cabinet door open not seeing me in the way and I get hit in the head...he doesn't even notice

Customer:

he knocks me aside to get past me and doesn't even notice

Customer:

if he is in the kitchen cooking and has a knife, i won't go in the kitchen

Customer:

he is very impulsive when frustrated

Customer:

and I can't always tell what will frustrate him

Elliott, LPCC, NCC :

Did the neurologist use the term hydrocephalus?

Customer:

no

Customer:

I thought it, but it didn't come up

Customer:

no one called his disorder anything really

Customer:

school said learning disorder but not add or adhd was mentioned

Elliott, LPCC, NCC :

He seems to have the symptoms of Adult Attention Deficit Hyperactivity Disorder (ADHD which used to be called ADD).

Customer:

his primary phys gave him Bupropion for it...it helps a bit

Customer:

If there was anything better I'd be willing to help pay for it

Elliott, LPCC, NCC :

Here are the "official symptoms" and you can see for yourself (from diagnostic manual DSM-IV)

Elliott, LPCC, NCC :

 


ADHD


The Diagnostic criteria for Attention-Deficit/Hyperactivity Disorder from DSM-IV are:



Criteria A - either (1) or (2):



(1) six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with the child's developmental level:




  1. often fails to give close attention to details or makes careless mistakes in


    1. school

    2. work

    3. other activities.


  2. often has difficulty sustaining attention in tasks or play activities.

  3. often does not seem to listen when spoken to directly.

  4. often does not follow through on instructions and fails to


    1. finish schoolwork

    2. chores

    3. duties in the workplace (not due to oppositional behavior)

    4. failure to understand instructions


  5. often has difficulty organizing tasks and activities

  6. often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)

  7. often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)

  8. is often easily distracted by extraneous stimuli

  9. is often forgetful in daily activities



(2) six (or more) of the following symptoms of hyperactivity/impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with the child's developmental level:



Hyperactivity



  1. often fidgets with hands or feet or squirms in seat

  2. often leaves seat in classroom or in other situations in which remaining seated is expected

  3. often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings or restlessness).

  4. often has difficulty playing or engaging in leisure activities quietly

  5. is often "on the go" or often acts as if "driven by a motor."

  6. often talks excessively

  7. Impulsivity


    1. often blurts out answers before questions have been completed

    2. often has difficulty awaiting turn

    3. often interrupts or intrudes on others (e.g., butts into conversations or games).



Criterion B: Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years.



Criterion C: Some impairment from the symptoms is present in at least two or more settings (e.g., at school [or work] and at home).



Criterion D: There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.



Criterion E: The symptoms do not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and are not better accounted for by another mental disorder (e.g., Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).



The diagnosis is coded as:


314.01 ( Attention-Deficit/Hyperactivity Disorder, Combined Type) if both Criteria A1 and A2 are met for the past 6 months



314.00 (Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type): if Criterion A1 is met but not Criterion A2 is not met for during the past 6 months



314.01 ( Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type): if Criterion A2 is met but not Criterion A1 is not met for during the past 6 months


 

Customer:

yes to some but not all

Elliott, LPCC, NCC :

His anger issues may also have to do with abandonment by his father and bullying by others. This causes traumatic stress.

Elliott, LPCC, NCC :

You don't need all.

Customer:

his phys seemed to think that further tests would be needed to verify adhd which my son thinks he has...perceptive I guess

Elliott, LPCC, NCC :

He would most likely benefit from ADHD medication and I urge you to bring him to a psychologist or psychiatrist who deals with ADHD.

Customer:

and Logan thought the doctor assumed he wanted heavy duty drugs

Elliott, LPCC, NCC :

He has so many characteristics.

Customer:

what are your credentials if you don't mind...I don't recognize lpcc and ncc

Elliott, LPCC, NCC :

The drug for ADHD is amphetamine but that is the drug of choice for even little kids. It calms them, paradoxically.

Elliott, LPCC, NCC :

LPCC is licensed professional clinical counselor; NCC is national certified counselor and CCMHC is certified clinical mental health counselor (trained in diagnosis).

Customer:

it doesn't list your ccmhc with your name

Elliott, LPCC, NCC :

Too many letters.

Customer:

lol

Customer:

I appreciate your time and help with this issue

Elliott, LPCC, NCC :

I am just about certain that Logan has ADHD, and he might have issues with Borderline Personality Disorder as well.

Customer:

I will take your advice and encourage Logan to see a psycologist

Elliott, LPCC, NCC :

Which is treatable not by medication but by Dialectical Behavior Therapy.

Customer:

I have experienced bpd in a spouse...not logan's father...Logan is nothing like that.

Elliott, LPCC, NCC :

I shall keep him in my prayers (along with all of your family) .

Customer:

Logan doesn't rage

Customer:

I appreciate that Elliott, I will also pray for you that you will be able to continue your good work.

Elliott, LPCC, NCC :

He has elements of overeating, abandonment, some anger.

Customer:

yes

Elliott, LPCC, NCC :

Thank you so much and give Logan kudos for self-diagnosing. He IS smart.

Customer:

people sell him short

Customer:

I will do. Thank you so much for your help wth this matter. It means a lot.

Elliott, LPCC, NCC :

Thank you for your kind words, and please tell him for me that I know that he is smart and has been pushed around too much. He will start to get better. Encourage him all that you can.

Customer:

thank you

Customer:

have a really good rest of the day

Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7662
Experience: 35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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