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I am ready to quit....


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I can't do this anymore. I am so frustrated more than not. I have a 9 year old that we pulled from PS last year. This is our first year hs'ing and I know there are supposed to be growing pains but this is beyond. There are days she refuses to do work. She will just dawdle and play. We have been at it all day and she has done nothing. I feel I have tried everything. We have a separate room for her, I have lowered my expectations for work, We take frquent breaks, we have tried not taking break, incentives. Nothing is working. And lest you think it is just me, this is the problem the PS was having with her. My frustration with the PS is that they were OK with it and she was falling farther and farther behind. I don't know why I thought I could do a better job. She is my niece she has lived with us for 5 years and has been recently diagnosed bi-polar. She also has ADHD and a whole other bunch of labels. I know I can get more out of her some days than school can in a whole week but the stress of it all. It runs our life. What do you do when you have a kid like this? I feel like it is more than I can handle. I feel like it is a waste of my time and effort.

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First of all, what meds, if any is she on? Meds can cause a lot of side effects or they can really help improve the situation.

 

Do you feel she really is bipolar? If so, is she in counseling? Getting proper meds? How about the ADD? Has she been tested for learning disabilities, etc. that can go along with this?

 

My 12dd has bipolar and ADD along with a long host of other special needs. 11dd has a mood disorder and ADHD, again with a long list of other special needs. Finding the right meds made about 80% or more of the difference here. It is really amazing the difference the meds made.

 

It was some trial and error to find the right meds. We are also still adjusting doses as they grow, mature, metabolism changes, etc.

 

I would also look at her learning style. How does she learn best? Would she do better with a unit study type program? How about a more self taught program? traditional textbooks? For us, we tried Sonlight but it wasn't a good fit for the girls. Now we are using ACE paces and it is SO much better, esp. for 11dd. She likes that she knows EXACTLY what to do each day, can do much of it on her own, etc. That along with her meds has made school almost easy most days.

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She has been seeing a therapist and a psychiatrist. Right now she is on concerta and strattera. We haven't been treating the bi-polar. We tried a few meds but it was scary. I can see the bi-polar I guess. She is moody and goes from one extreme to another. It is hard to keep up. She has had a battery of tests so we know she doesn't have a specific learning disability but she is behind in some things. She also tested well with her IQ so we know she isn't "a dim bulb". That is where my frustation comes in. I know she is capable but I have to micro manage her. She has to ask questions about everything. It is exhausting. I have had maybe 3 days where she is able to complete her work quickly in under 1 1/2 hours. Other days it will take her all day off and on. I was planning on doing unit studies next year but honestly I don't know if I can do it. I feel like my other kids suffer for her problems. I can't be there for them like I want to because of her needs. It is draining.

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Adopting (or parenting) a child with special needs is TOUGH.

 

Do you think that the Strattera has helped her at all or has it made things worse? Strattera is an SNRI which is related to the SSRI anti-depressants. It can be very risky to use in children with bipolar. It can trigger mood swings, aggression, suicidal/homicidal behavior, etc.

 

Did she have the symptoms of bipolar before starting Strattera?

 

What meds did you try for the bipolar? What was her reaction? Does the psychiatrist have LOTS of experience treating children with bipolar?

 

This is a personal soapbox of mine. As the parent of one with bipolar, another with a mood disorder, and foster parent to many more, I have learned a great deal about this area.

 

http://www.bpkids.org and http://www.bipolarchild.com are great resources.

 

Can you get any respite for her? That is a HUGE help here. I have a friend that takes my girls every Wednesday afternoon for about 3-4 hours. It is so nice to just do what I want, if I want, and nothing if I don't want.

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I have heard that ADHD meds can be really bad for children who are bi-polar. From your description, it really sounds as if illness possibly combined with medications are causing the problems. That is where I would focus my energies. Once that is taken care of and stabilized, academics should become much easier.

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We have tried two bi-polar medications. risperdal and something I can't remember the name. She became very agitated after a few days on both. We have also tried coming off her meds and then going back on one at a time. Strattera seems to help her moods as far as not melting down and crying about EVERYTHING. Concerta seems to help her focus somewhat. She is not moving as much. Our dr. left and we have just started with a new one. I saw him last week and then we are seeing him tomorrow AM. He specializes in pediatric.

 

I will ask him more about the combination. I didn't want to medicate for the bi-polar but I can't do any more. I am crying,,,she is crying,,, it's a mess.

 

As for respite. My friends don't really understand. They are busy with young kids of their own. My MIL hated the idea of us taking her anyway. They don't see behind her tantrums and lack of social skills. My mom is the only one who really can help. She takes her sometimes. I tend to just switch off with my husband if I need time away. Things will be humming along nicely for a few days and them WHAM!! the **** hits and I feel like I am failing my family. I brought this mess into the home.

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Here is a website with info about bipolar in children. I'm surprised risperdal was tried first, since it is an anti-psychotic and what you are describing sounds more like a mood disorder. IMO, you *really* need a professional whose specialty is bipolar in children. You can waste a lot of time with doctors who don't quite know what they are doing. The website I linked has a link to specialists so you can find out who is in your area.

 

Really, everything you describe makes it sound as if this girl is not on the right medications for her illness.

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I would focus on treating the bipolar FIRST. Once you get that under control you can work on the ADD stuff, academics, etc. The difference with the proper medication is amazing.

 

My 12dd is on Tegretol, Lamictal, and Risperdal and then a tiny dose of Dexedrine (started only after she was stable on meds for the bipolar). 11dd is on Lamictal, Risperdal and Dexedrine as well.

 

Are either of the birth parents bipolar? Are they on meds? If so, and they are working for them? Meds tend to work for others in the same family. So if one family member is doing well on Lithium, then it make sense to try it for another family member.

 

I don't have a link right now, but try googling, "pediatric bipolar treatment guidelines" to see if you can come up with them. They explain the meds, their uses, combinations of meds, what order to try them, ect.

 

Can you call the adoption agency (if you have one) or local community mental health to see if she qualifies for respite services? That is who pays ours. It is a huge blessing as I have 3 kids with lots of special needs.

 

Basic mood stabilizers are lithium, Lamictal, Tegretol, and Depakote. Lithium and Lamictal are often used together. Anti-psychotics are also often used with a mood stabilizer. These include Risperdal, Zyprexa, Geodon, Abilify, Seroquel, etc. Many kids with bipolar need 1-2 mood stabilizers along with an AP.

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In some areas, there are agencies that will provide respite care; some will come to your home. The Association for Retarded Citizens (ARC) is one. I know that your dd isn't retarded, but they sometimes help with other issues as well. They would be a good place to start to see if there is respite available in your community. Another place would be a public mental health center (they often coordinate the services.)

 

1. Put on your own oxygen mask first. That's what stewardesses tell you on planes. If you are not functioning, you can no longer help your kids. It sounds like you really need to do whatever you need to do to get replenished yourself.

2. I agree with the others. I would look for someone with lots of experience with kids who are bipolar. Sometimes children have both disorders; sometimes one is mistaken for the other. The meds are tricky if there is a dual diagnosis and you want someone with experience. Just ask the doctor: how many bipolar kids have you treated under the age of 12?

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Depacote was the other drug. I am getting the impression from this new doctor that maybe he wasn't making decisions that made sense. I know they have to be careful with what they say about each other but he also did leave the practice. He was highly recommended. I will look at the list and check if the new dostor is on it.

 

I guess I just need to really get on this. I am afraid to medicate too highly but if I am feeling this way about her than I need more help.

My sister is her mother and she has been in and out of prison for 4 years. She was never really diagnosed with anything but shen has a very hard time functioning. A lot of drug use and dealing. We know there is something going on with her just not anything she is willing to be diagnosed for.

 

I'll let you know if anything comes of tomorrow's meeting. I have never really let loose about this before. Thank you for listening.

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http://www.bpkids.org/site/DocServer/treatment_guidelines.pdf Here is a link to some treatment guidelines. I don't know if they mention Lamictal much as it is a very new medication for use in bipolar---not a new med, but newly used for bipolar kids. Print this out, highlight what stands out to you, ask the doctor questions, etc.

 

As to Risperdal and Depakote not working well for her, I would let the doctor know her response to them but also try to find out what dose she was started on. It could be that the dose was too high or too low for her age/size, etc.

 

Risperdal and Depakote actually are good meds for kids with bipolar. They don't work for all kids, but they are reasonable choices. You do need blood work though with Depakote---did they have you do that? many of these meds are dosed by blood levels which means that you have to do a blood test first thing in the morning, before giving the morning dose and 12 hours after the night dose. It is a pain but very important to make sure they are on the right amount of medication.

 

Kids can metabolize the meds differently. Target dose of Lamictal for kids my dds' ages and size is about 150-175mg/day. Well, 11dd is on 87.5mg/day and 12dd is on 625mg/day. VASTLY different doses for full bio sisters that are only about 1 inch and 3 pounds difference in size. With out the blood tests 11dd would be toxic on 150mg of Lamictal while it would be doing almost nothing for 12dd.

 

I know time is short, but if you can, try to write out a time line for the new doctor of what meds you tried, what doses, what other meds she was taking when they were started, how long you tried them, etc.

 

This med thing can be a real pain to figure out as there is no one formula for all kids. You need a doctor that will work closely with you---likely visits every 1-2 weeks at first, then monthly.

 

Hang in there though, it can get better. My 12dd who was extremely difficult when she was younger is doing very well now.

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