Addictive personality kids?

[Mukmuk]

nm

 

 

[Plink]

I woke up thinking about your situation.  It took me a while to process my thoughts, and I think it is because the word "addictive" threw me for a loop.  A word that you may want to google is hyper-focus.  It is often used to describe the actions of children with ADD or Autism, but don't worry about the diagnosis, just check out the descriptions.  

 

Children on the Autism Spectrum (who also tend to deal with sensory issues) are often described as "getting stuck." Similar to OCD, these kids feel true anxiety when asked to deviate from the plan that is already in their mind, whether or not the plan is a good idea.  Treating the anxiety results in greater flexibility in their behavior.

 

The other common cause of hyper-focus is ADD.   Everyone understands the inattention part of this diagnosis, but those of us with close experience know that the opposite side of the coin, the hyper-focusing, can be just as disruptive.  This attention to only one topic can be so strong that they are entirely oblivious to the world around them.  You could stand in front of them and yell fire, but it will still take 30 seconds for them to break away from their thought process and react.  It is not a lack of desire to switch topics, but a neurological issue.  Treating the ADD results in more flexibility.

 

So, all that to say, I would talk with the professionals who did his original testing and see if they can refer you to someone who works well with children who have multiple issues like your son.  They will be able to help you work out the true root of  his problems, and by treating that root cause (which may or may not include medication) you can help him to become more flexible.  

 

One more thing - If they do recommend medication, please encourage your DH to allow your son to try it.  Your concerns about addictions are well founded for untreated disorders.  It is well documented that people will try to fix their internal unbalance, and will often self-medicate with drugs or alcohol, if they aren't given the option to treat their disorder properly.  Those with proper treatment, however, are less likely to turn to destructive addictions.  

[Tiramisu]

I'm really wondering if this is OCD. OCD is not uncommon with smart kids with quirks. It would explain the picking and the games addiction very well. My understanding is that it is something that very often needs to be addressed through medication, a specific type of antidepressant, I think. sbgrace once linked a study in a thread she started about a natural supplement (amino acid?) that was shown to be very effective for OCD, perhaps as effective as medication. The study was done at Yale. You may want to send a pm to sbgrace about this. She's very knowledgeable. 

 

I wish you the best in addressing this. It's very hard to deal with but there are options for treatment. Maybe with more information you dh will be agreeable to trying something.

[wapiti]

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[wapiti]

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[Tiramisu]

Also, FWIW, Mukmuk, this is not very different from one of my ds11s, one that has had his share of issues.  I'm (very slowly!) forming a big picture of this situation, with way too many unknowns.  Another poster (kbutton?) has commented that sensory stuff and anxiety are two sides of the same coin and I'm beginning to see that.  It's as though the actual, physical nervous system (sensory stuff) has a huge impact on the mental reaction (? see, vocab area of my brain not working. need more coffee).

 

eta, we also do magnesium citrate - I have renewed commitment to it since it magically fixes ds's bedwetting and constipation and the ped is ok with it (well, I think she thinks it's such a small dose that it's unlikely to hurt, but I swore up and down that he does not wet the bed when he takes it, but does if we miss it) - and I am amping up the probiotics.  I have not found a nutritional silver bullet yet.  I don't think he has attention issues but sometimes it "looks" like it, but most adhd meds would be contraindicated by his heart condition anyway.

 

Tiramisu, just to report in, I had an interesting conversation with the ped the other day about the constipation, that the cause might simply be a slow motor thing (nervous system), which is not at all surprising when I consider the big picture.  (Apparently she has a child like that and some sort of family history of constipation.)  As an aside, we did go ahead with a bunch of testing, including celiac (she said my yeast theory is kooky, but celiac is mainstream).  No results yet.  He was complaining that his heart hurt so we had to go for an EKG, which fortunately is the same (abnormal) as it's been.  She suggested the possibility that the excessive thirst could possibly be psychological - great.  He indeed is over-sensitive but I do believe he is actually thirsty - the sensitivity makes it hard to feel sure.

 

I agree with kbutton about the sensory and the anxiety. How can you not feel anxious when your perception of the world is disordered? It's not fun, but as he gets older I think it will be a relief, to some degree, to know there's a benign reason he feels that way. I think it helps us to roll with things a little bit more than we might otherwise. Self-talk: "Nothing is really wrong. It's just my SPD acting up. Might be a good time to hide under the covers in a dark quiet room for twenty minutes."

 

The motor thing also makes complete sense to me. It would fit our situation, too. To tie this in with the sensory, I had a friend who was seeing a gi specialist at a major children's hospital who said lots of kids with motility issues have SPD.

 

I think I will coin a new name for all of this. PWW. Pervasive Wonky Wiring. (Not to make light of the issues that you and the OP are going through, because I have my own very similar things to deal with and feel it, too. But, really, wouldn't be nice to have a name that explains the whole picture?!!)

[Tiramisu]

inositol (B8)?

 

Accurate diagnosis is so important as anxiety meds and adhd meds are often contrary to each other (sorry, my vocabulary fails me this morning)

 

Very true about the meds.

 

The study I was thinking of used something different, NAC. I want to spell it but I'll get it wrong. N-acetylcysteine?

 

http://forums.welltrainedmind.com/topic/444394-effective-natural-treatment-for-ocd-perhaps-other-conditions/

[sbgrace]

oops. Edited and copied below.

 

 

[wapiti]

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[Tiramisu]

 

 not quoting but replying.

 

We had a similar situation when one dd and I have watched simulations of autism. She is actually very social, so she'd never get an ASD label but her processing is similar. Interestingly, other dd's have watched them and couldn't relate and they have similar processing.

[Mukmuk]

Tks for the information, Plink, Tiramisu and Wapiti

 

When it was 1st suggested to me that ds has anxiety, I had brushed it away. After all, we homeschooled subjects that he liked to the risk of being so lop-sided (I was hoping to balance things gradually especially in the last 2 years, but the time was never right to add subjects, or if we did, few subjects really gained traction). But I'm not so sure now. I see a reaction, a flare of anger as a coping mechanism, when asked to do something new. The lengths he goes to to avoid anything new is remarkable. An increase in flexibility sounds like a dream!

 

Plink, I read up on hyper focus. Bingo. He says he just can't stop thinking and visualising and just loves to be in the same groove over and over again. Orienteering him to a subject in a conversation takes time, although it can be done. I have heard his friends call him obsessive, because he couldn't talk about anything else other than his pet subject at the time.

 

His OT thinks that the two sides of his brain is not connected strongly. Well, he is ambidextrous. I'm taking extra care that he writes with his left hand steadying the paper. This seems to be helping with the pinching and the focus somewhat.

 

Is there a definitive test that reveals dopamine levels? ADHD/OCD tests are, if I'm not mistaken, highly subjective. Could a nutritionist help instead? Goodness knows, we've been through this route too, but maybe there's something our previous nutritionist missed.

[sbgrace]

My son is very much like that. Someone mentioned hyperfocus, and I do think it's the word you're looking for. My son has an autism spectrum diagnosis. He likely would qualify for ADHD too, but the two can be hard to tease apart. Either could result in hyperfocus, as could OCD mentioned above.

 

My son does have OCD. For him NAC has been a fantastic treatment. I don't have information that it has helped anyone else. The study I saw was phase 2 pediatric, and there had been a previous study. There are also positive published studies with its use in other disorders that over-lap with OCD. So there is reason to think it would help more than just my son, but I've no proof of that! Our good results are anecdotal in other words.

 

My son still hyperfocuses like you describe. He just doesn't do it with the anxiety producing OCD stuff. He loves thinking, and talking, about his favorite topics. In school subjects, he's often with me but not really with me. He's there and pretending to be doing whatever, but his mind is on his favorite topic.

 

I had used pycnogenol with him at pretty high doses. I dosed at levels used for pediatric asthma in studies; lower dose was used for pediatric ADHD in studies I saw. We saw results in the hyperfocus with this. When I accidentally double dosed him, it was night and day improvement. He seemed normal. The results on our typical dose were less dramatic, but there is improvement. We stopped because he was going into surgery and it can be a blood thinner. I had hoped maybe we could do without. I'm one who thinks anything you use, including natural, needs to be used with caution. If it's effective, it has the potential for side effects too. You're changing things internally. But, clearly, I need to pick it back up. My son is a mess without.

 

Both the NAC and pycnogenol increase gluthione in the body. So this appears to be key with my son, but is also key with others (adult and pediatric studies) with ADHD symptoms. I can link some studies if you'd like. The NAC also helps with glutamate processing, and both of these areas are probably part of my son's issues.

 

edited to add: Here is a published pediatric ADHD pycnogenol study (1 mg per kg per day) http://www.ncbi.nlm.nih.gov/pubmed/16699814 I want to say the pediatric asthma study was 1 mg per pound. That's the dose I used. But I can't find the dosing in that study when I just googled. So I'm not at all sure where I got that number!

 

 

[Mukmuk]

Sbgrace, that is amazing information. Thank you for giving me hope!

 

Our previous nutritionist had recommended CoQ10 and axtaxanthin. Could the effects be similar to pycnogenol? The dosage is very low though. I forget how much, but it was a pill every other day. Do you have articles on NAC with dosage indications? I plan to bring it to the nutritionist to inquire.

 

Tiramisu, PWW made me smile. Oh how I need some light heartedness at this moment!

[sbgrace]

This is a pediatric OCD study with NAC. http://clinicaltrials.gov/show/nct01172275 The dose in this study is: 1 900mg tablet once a day for 1 week, then 1 900mg tablet twice a day for 1 week and then 1 900mg tablet three times a day for the remaining 10 weeks of the trial. Studies I saw stated that results are seen "beginning around week 9" or maybe it was week 6 at full dose. It takes a while. I have a friend trying this dose with her son with OCD. She hasn't yet see results with him. They are several, maybe 4, weeks in. Our dose was based on the previous OCD study and is 1200 mg twice a day. As I mentioned, this hasn't solved our hyperfocus issue here. I guess perhaps he would be worse without, but he's severe now!

 

My son takes coq10 for a metabolic issue affecting mitochondrial function. We only use the type sold by epic4health. Our geneticist told me other forms are likely a waste. I don't know if that is true, but the Tischon sold by epic4health is the kind used in studies. Now that I think of it, we have been very spotty on coq10 use lately too. It's a very potent antioxidant, but I've never heard of it for ADHD or similar issues.  I haven't heard of axtaxanthin.

 

 

 

 

[sbgrace]

I just thought of something. We have started using c8 sciences brain training program. It's to work on ADHD. But they make their tasks intentionally boring. The idea is that the child needs to learn to continue to focus on an uninteresting task...sustained attention and vigilence sort of. I hope this will help my son. It has research support.

 

The real issue is that he needs to be able to keep his focus on non-preferred things long enough to succeed in life.

 

But, even if this is successful, I want to help him not obsess so much on his favorite things. Because this is a social impediment too.

 

I feel discouraged sometimes honestly. It's been a hard couple of weeks here. This is an interesting, and somewhat positive, take on hyperfocus. http://voices.yahoo.com/hyperfocus-adhd-misunderstood-symptom-11595822.html it is so my son.

[Mukmuk]

Thanks for the info, sbgrace. I'll find out more about pycnogenol.

 

Feeling the pain :(.

 

I'm doing Brainology with ds to educate him on taking active control of his situation. He does seem to be responding with less zoning and more willingness to try new things. Not helping with anxiety however.

[Plink]

I think I will coin a new name for all of this. PWW. Pervasive Wonky Wiring. (Not to make light of the issues that you and the OP are going through, because I have my own very similar things to deal with and feel it, too. But, really, wouldn't be nice to have a name that explains the whole picture?!!)

PWW!  Love it!

[Paige]

Look up maladaptive daydreaming. It's related to OCD.

[Arcadia]

For example, he recently picked up chess. I found an electronic version with bells and whistles, and there he is again! When I switched him to a vanilla version of the game, his enthusiasm waned noticeably.

 

This sounds like sensory seeking too that your child loves the electronic version more.

My sensory adverse kid is lots calmer when he plays a fun electronic game with sound mute. When sound is on, he gets agitated and it is harder for him to stop playing.

[geodob]

It should be noted, that their are 2 sub-types of PWW.

While their is Pervasive Wonky Wiring.

Their is also Pervasive Wiggly Wiring.  

[Tiramisu]

It should be noted, that their are 2 sub-types of PWW.

While their is Pervasive Wonky Wiring.

Their is also Pervasive Wiggly Wiring.  

 

geodob, Thank you for for this helpful information.  :D

 

Could you please explain the differences between these sub-types? 

[dsmith]

I don't have much to add at the moment. I would like to read the replies more in depth later when I have more time, as I see a lot of info that may be relevant to ds.

 

Mukmuk - I'm curious about the pinching and scratching you mention. Could this be OCD related rather than sensory related? Ds has similar issues, but they are anxiety/OCD related. He was also sensory seeking when younger and before meds, but that came out in much different ways, like spinning, jumping, crashing into things, etc. he was also very sensory defensive, which led to a lot of anxiety issues.

[Mukmuk]

Dsmith, ds wasn't particularly wiggly when young. He had no problems sitting in his seat at school as much as the next kid. But he loves to pinch at things, say, a scab, or a piece of skin. He loves to get his hands all wrinkly in a shower (he spent a lot of time in the shower till I put a stop to it recently) and then proceed to peel. Any loose skin, even on me or dh is fascinating to him, and he can't help staring at it. What is particularly destructive is that he loves to peel the corners of his mouth, and several times, he's worked them into huge sores. On a regular basis, he likes to stretch his mouth in an exaggerated yawn for that tearing sensation. I tell him to be self aware when he does it, but he's just not.

 

Scratching is a new problem. When asked to do exercises at the OT, he'll descend into a fit of scratching to delay performing the exercises.

 

At its worst when he was younger, ds has sat through days of being barely functioning at the work table as he pinched away. Lately, all this worsened again (although he's never been completely free of this). I'm wondering if it's because I've become slack in giving him his vast array of supplements. What seems to be helping is if he keeps his hands (palm side) in contact with something all the time, to give him constant sensory information rather than a complete deprivation (he doesn't like to touch anything), and then have an onslaught of information via pinching. I've also become more consistent with his supplements.

[Plink]

Oh, that really does sound more like OCD than sensory issues. I'd talk with his doctors asap.

[Mukmuk]

Thanks for that, Plink. At least there's a name or something to work off!

 

As I'm googling, can you tell me what OCD means? Other than the acronym implies, what are the issues? Is it very serious? Sorry I have no idea at all :(.

[Mukmuk]

I just googled and frankly, the description doesn't fit ds at all. He has no compulsions to wash his hands etc. He's been worried before about the state of the world and how he can help it, but that seems to have passed. He's usually a very cheerful and optimistic kid, just not a very functioning one when he gets into these episodes.

[Jennifer-72]

OCD is far greater then a compulsion to wash hands. That is just a common one people associate with the condition. The way you describe his pinching and picking at his skin is very in keeping with OCD.

 

You say he had had some episodes of scratching at the OT. Had she not suggested anything or expressed concern that this maybe something other then sensory? I would find it very puzzling and somewhat concerning if she hasn't. Does she have SIPT training? What you are describing really does appear to go beyond sensory issues and requires some further assessments.

[dsmith]

OCD comes out in different ways in different people. Ds has Aspergers and a tic disorder along with OCD tendencies. In times of stress he picks his scalp or twirls his hair. He also licks his lips a lot, to the point where the skin will crack and bleed. He doesn't wash his hands constantly or anything like that. At night he has compulsive negative thoughts which come and go. None of these behaviors interfere with his day to day functioning, but his tics do if they are very severe.

[Mukmuk]

I see what you're saying, Jennifer and dsmith. No one has ever mentioned OCD. His OT in particular, "hates to label", which doesn't help much at all. This really is an eye opener. He recently expressed dismay at himself for repeatedly ordering the same dish from a particular restaurant that we frequent, even though he doesn't particularly like it. He couldn't understand why.

 

Are the remedies to this primarily medication? Can CBT help?

[Lecka]

What is the OTs response when he scratches in order to delay doing an exercise?

 

If it was my son, it would be escape behavior.  Though my son has a lot of escape behavior, lol.

 

If you ever see FBA standing for functional behavior analysis, it can describe some behaviors (not all, but when it is helpful I think it is very helpful).  

 

So if he is exhibiting an escape behavior, does the OT have an idea of why?  Is the exercise very hard for him?  Is he anxious about doing it properly?  Is he not sufficiently motivated?  Etc etc etc there are many reasons it could be.  And whatever root cause it may be -- needs to be figured out.

 

B/c -- for my son at least, the rule of escape behavior, is that it begets itself.  If he finds it "works" for him in one situation, he will try to use it more in other situations.  He just does (this could also be just him).  

 

However locally I have found that some OTs do not have any way to handle my son's behavior.  Some just do not know how to handle it.  

 

Then some do.  

 

Of course any one can have a bad session and sometimes bad sessions are on the way to things improving (like in Good Will Hunting when Will sits in Robin Williams office for a full hour without talking).  But Robin Williams has A PLAN, you know?  And Will is used to his tactics *succeeding* when he has displayed them in the past, so he has continued to use them.  

 

I think though, it is helpful just to possibly identify some behaviors as escape, but you don't have to treat them that way.  Traditionally you don't let kids out of things when they display an escape behavior (and that is what we do with my son in many cases).  However ----- I have heard that this is not a good thing to do for anxiety, that kids really need to work with a CBT therapist, and do cognitive-behavioral therapy.  I have heard good things about it with anxiety.  

 

But whatever information you find -- probably you need to share with the OT or look for an OT who is familiar with whatever you end up needing.  

 

B/c OTs are not magical for behavioral things, and sometimes there are behavioral things as well as sensory things.  Maybe things start as sensory, but if they develop into behavior, then it is there.  The same as if you walk on your foot wrong, you will end up with your whole leg having problems, and it won't all be fixed by fixing your foot.  I don't think that is bad at all ----- it is just my point, that the OT may be good but also not have all the tools or information he/she needs, right now.  

 

(Here also, an OT who "hates to label" also probably hates a "behavioral approach."  For your son -- I doubt a behavioral approach would be good, but CBT really might be.  But some people who hate "behavioral" also throw out the B in CBT.  That is great when it is not needed, but I would say "how is that working for you?" when they happen to have a child and they can't get the child to do things and the child has a bad time, but that child does well with a behavioral approach.  That is the case with my son.  CBT is not appropriate for him quite yet b/c his language skills are delayed, but I have heard very good things.)  

 

(Unfortunately some kids do not do well with a behavioral approach -- but it seems like kids do and some don't.  The parents I know who have had trouble with this same SLP/OT office have turned out to have their kids do well with behavioral.  BUT there are also many satisfied parents there, and parents who have had the opposite experience, and had the good experience with the SLP/OT office.  I don't know how to know without trying it out, though.)

[Snow]

You might find this site helpful:

http://www.trich.org/about/skin-picking.html

 

It's sometimes categorized as just OCD but it's really a subset along with hair pulling.

[Mukmuk]

Ds has been to *so many* therapists and psychs. None of them has ever picked it up. But when I run through the number of times I've said he's got rigid thinking, it all adds up. Ds did a test at his previous nutritionist which revealed low serotonin and dopamine levels. I had gotten tired of all the dosing (and the $$$ we had to spend), and since things had started to look fine, I had taken my foot off the pedal late last year. She's our first stop this week.

 

His OT is a patient man. He coaxes ds and they generally work well together. I thought I was starting to see a reduction in his avoidance behaviour.

[Tiramisu]

I'd talk to a doctor and try to find a psychiatrist and pediatric therapist who specifically works with OCD, because they have seen many different manifestations to help you decide if it's indeed OCD and get the right therapy. If it is, it's important to remember there's a biochemical cause, meaning the right therapy can really help a lot but it often comes down to medication (or supplements) if it's to the degree that it's interfering with everyday functioning. Sorry to be repetitive. I've known people with the hair and skin picking who function normally, but I also knew someone with a serious case who pulled out all eyelashes, eyebrows, and much of her head hair. With skin, I know people who have very scarred fingers. It couldn't hurt to try to find the right specialists to help you figure it out. You may not need them but you might feel better to have those contacts established.

[Lecka]

If what his OT is doing is working, then it is working!  I don't think there has to be one certain approach, just -- that there is something.  I think rapport is so important, too.  It may not *look* like the OT is *doing* anything, but if he is getting him to work on things he avoids, or he is circling back to meet the same goal in a different way, then I do think that is good.

 

Honestly I think there are just some less-qualified people in our town.  Specifically, telling me my son spent an entire 45 minutes asking for me, and not doing anything.  And seeming like -- no clue what to do about it.  Like -- she was getting paid whether he did anything or not.  

 

Just a dud for him.  Other people in the waiting room were having better experiences, so at least I think she was good with other kids.  

[sbgrace]

That skin picking sounds like an off shoot of Trichotillomania. There is an informative website that goes over treatment options. http://www.trich.org/treatment/options.html They've had successful treatment in adults with the NAC (after 9 weeks of use). But I don't think the pediatric studies were as encouraging. NAC is cheap and safe, though. I'd be tempted to try it.

 

Cognitive Behavioral Therapy, if you found someone experienced in Trichotillomania or at least OCD, would be helpful. The website I linked has a database to get names of treatment providers in your area. If there is no one, the OCD Foundation online has a database for OCD specialized therapists. That would be the next best option. You don't want just any therapist, or even just any CBT therapist. These anxiety disorders have very specific and different treatments compared to other conditions. You need someone who is trained and experienced in these specific areas. That therapist may be able to help with the other issues too, as it's all a "sticky mind" at some level.

 

 

 

 

[Geo]

What another poster referred to as hyper-focus is actually perseveration. Perseveration appears similar to OCD, but as you have seen, when the interest stops delivering the stimulation, they drop it quickly. Dr. Bryan Rourke has a video where he discusses this. I will try to find it and post it here.

[Mukmuk]

Thanks so much, Arcadia, Geodob,Tiramisu, Lecka, Sbgrace, and all others who have helped. I found a therapist who purports to deal with OCD, but she seems to be more focused on adults. I'll be asking his Ped and doing lots of calling.

 

Right now, I have a lot of contradictory feelings - relief to know something can be done to help, guilt that I've been so impatient with him, and fear of the unknown.

[Geo]

What another poster referred to as hyper-focus is actually perseveration. Perseveration appears similar to OCD, but as you have seen, when the interest stops delivering the stimulation, they drop it quickly. Dr. Bryan Rourke has a video where he discusses this. I will try to find it and post it here.

 

ETA: Well, I butchered that name. It's Dr. Russell Barkley (I used to know that)...here's the video:

http://m.youtube.com/watch?v=Yfkg0VWx3rM