Ask a Psychiatrist and Get Answers to Mental Health Questions ASAP
Hi [USERNAME]: My name isXXXXX and I am willing to work with you to help identify some solutions you may want to consider to resolve your issue
HiCustomer It appears you are off line now. When you get back on line, and wish me to assist, please let me know. If I am not on line, I shall get back to you. In the mean time, please respond to the following for me: Did the your daughter have a normal pregnancy and delivery with this child? Has the child been placed on any Psychotropics? Is so what, dosage, and for how long? When did this behavior first occur. Has it increased in severity over time? Where is the child's father (is your daughter divorced, separated,)? Does the child have any brothers and/or sisters?
I am back now; had to go to the school because he was not cooperating with the teacher and acting very "cocky". The pregnancy was fairly normal, delivery was long and dilation regressed rather than progressed, almost necessitating a C-section (same thing happened with her first baby). His head was (and is) abnormally large for the size of his body (e.g. at 6 months, his weight was in the 25th percentile, his length in the 10th percentile, and his head circumference in the 75th percentile. He is built just like his father. He has one older half-brother. The parents have been divorced for about 4 years and the child's father moved to Arizona after the split, where his only contact, aside from the occasional phone call or email, was through sending packages of toys. A couple of years ago when he lost that job, he moved back to Canada but chose to move to Victoria to be closer to his parents, rather than to Edmonton to be closer to the child/ren. He has seen them only once since and that was when we took them there for vacation and literally delivered them to him for a day. Since then, he initially phoned weekly and continued to send packages, emailed and texted. However, he has not been in touch for over a month (probably for two months now), did not phone the older boy for his birthday in April, and appears to have stopped all contact. The child feels "abandoned" by his father. The behavior problems started a little over a year ago and I think I already mentioned in the "What have you tried so far" section about his hospitalization and Rolandic epilepsy. He was also diagnosed as suffering from high anxiety. He is on an anti-anxiety drug (dosage just doubled) and an anti-seizure med., but I will have to get back to you with the names and dosages. The behavior issues have certainly increased, especially over the past several weeks when his father has neglected to call him. His older brother just turned 18 and loves his little brother very much. We, the maternal grandparents, are also close by and help out when we can. We have reassured him that we will all always love him, even if we don't like the way he is behaving. We have explained consequences and asked him to think things through and deep breathe before he takes his frustrations and anger out on other people and things. He promises to stop, apologizes, then in a few days starts up again. My daughter (his mother) is very upset because she smacked him last night when he wrecked his bedroom and she has never struck her kids before. I fear she is at the end of her rope and increasingly frustrated over trying to find help for him. I hope this information is enough for now and I will try to get back to you with the names of his meds and the dosages.
PS: My daughter has the number for Children's Mental Health Services in Edmonton but lacks faith that they will tell her anything other than what she has already heard - you have to go through the process (although they did that last year). She also is too busy at work to call so has to hope to catch them after work. Today, his teaching assistant told me that for another child that was having problems, the parents called the police and they were able to bypass "the system" and get him immediate help, but my daughter feels that is a bit drastic.
I will need to discuss these questions with my daughter before I can give you complete information. I know that he was examined last year by a neurologist, and that is when the Rolandic epilepsy was discovered. He also was assessed by a psychologist or psychiatrist before admission to a Children's Psychiatric Unit, where he was seen regularly by a psychiatrist. Otherwise, I will have to get back to you.
I should have noted also that his mother remarried in September last year and in the last day or two he has mentioned issues with his new step-father, although according to the family, he is exaggerating and outright lying in some cases. He has been lying quite frequently lately.
Sorry, I had an appointment this morning and have another at 2:30 (MDT) this afternoon, so will be on and offline as well. I am here now for approx. an hour.
I just sent a more detailed response but it does not appear on this string. Did you receive a response from me in the last 5-10 minutes?
Darn! Bear with me as I try to remember (I'm old!).
Meds: Quetiapine 50 mg (just increased from 25 mg), Lamotrigine 25 mg, both @ hs.
He received comprehensive neurological and physical examinations while in hospital last year. He was in a Children's Psychiatric Unit and under the care of a psychiatrist for that 3 week period. He had a repeat EEG a couple of months ago. However, my daughter just found out, when she called the hospital unit seeking help, that he was also diagnosed with ODD (oppositional defiance disorder), although she was not informed of that at the time.
She reached Children's Mental Health Services and an appointment has been scheduled, but not until June 13. She is also planning to get a math tutor for him, as that is the subject he seems to be struggling with at school and one of the things that "sets him off".
I was wrong about when his father moved away - it was January 2008, so 5 years ago, not 4.
On the maternal side, there are no genetic mental illnesses such as schizophrenia or bipolar disorder, although there is some history of chronic depression. We know no details on the paternal side, although the child's father, in my opinion, is a pathological liar. However, I am not a psychologist or psychiatrist and naturally, have no idea if that sort of thing is genetic or learned behavior. The child has certainly been lying a lot lately.
Sorry, that is all I can recall at the moment. If I have missed an important question, please advise and I will get back to you ASAP. I should be available all evening.
Thank you. Most of those measures have been undertaken already, as in taking away TV, computer games, etc. and explaining consequences. Setting a schedule and adhering to it may help and I will certainly pass that on. The atypical seizure reactions - daytime vs. nocturnal, hallucinations - were the reasons the hospital staff wanted to have him back after summer break for further assessment and treatment. Thanks again.