ODD?

[StrugglingAgain]

Oh PLEASE tell me again that ODD could subside some after age 8. My son is 8 1/2 and has been nasty to me, hit me, defied me, and on and on and on, since his birth. I can't even help him with his homework because he's so ugly to me. DH feels compelled to help him after his hard day at the office and of course, that makes me feel guilty. My son takes out the bulk of the ODD on me and it wears me down, I tell ya. He just flat out tells me "NO!", whenever it's something that doesn't suit him. Do ANY of you remember telling your parents that? HA>>>>I'd not be here to tell you about it!

[LitlBaa]

This is something I've been wondering about Katie. She's always been argumentative and will skip dinner even if she's starving because she didn't get her little way over something. The day hasn't successfully started for her unless she's picked a fight with either me or Hubby, and it can't possibly be bedtime unless someone in the house is upset about something.

If we ask her to empty the dishwasher, she stacks the newspapers. If we ask her to take out the trash, she only takes half. If we ask her to hang up her bath towel, she puts it back on the shelf. I'd put in a smiley screaming with frustration, but I don't think we have one!

Everything's a fight, everything's a battle, there's no reward great enough and no punishment great enough. I really feel sorry for her, she makes her life so much harder than it needs to be.

[mctavish23]

Hi Struggling,

What I am talking about is data on kids where ODD was the one and only problem(no comorbidity). I also dont know the sample size used in the study, however, that wouldnt be too hard to find.

The main thing I wanted to point out to you is that all acting out isnt ODD. In fact, physical aggression and destruction of property are NOT included in the symptoms used to diagnose ODD. Those behaviors are more serious and would then come under one of two other diagnoses used for strictly behavior problems: Disruptive Behavior Disorder NOS ( Not Otherwise Specified) and 2) Conduct Disorder. Both of those involve more serious acting out than ODD, which then eliminates the idea that symptoms would basically disappear by ages 7-8.

I hope that makes sense, as Im not trying to discourage you or upset you. Either way, the ticket is behavior modification in terms of how to deal with it.The best behavior mod book I know is ..The Parents Guide to Attention Deficit Disorder....by McCarney & Bauer (Hawthrone Press). It doesnt matter if child has ADHD or not, because it covers all areas of acting out . There's no theory either; just practical things you can do today/right now at home.

I hope things get better for you and your family.Take care.

mctavish23(Robert)

[StrugglingAgain]

:-/On top of all this talk of ODD...I had the rug jerked out from under me today. We had a visit with the child psychologist and I told him I was NOT going to Dr. Weasel anymore (psychologist)......that man and I just do NOT get along where my son is concerned. Anyway, the child psychiatrist said he thinks we may very well be looking at a diagnosis of Bipolar when my son (now age 8) is twelve or thirteen. He said it's very hard to diagnose at this age. AAAAAAAHHHHHHH!!!! OMG, if we have "Bipolar" along with "ODD", I think I'll just jump off the next cliff. This is SO unfair to my little boy and I just want to cry for him. We adopted him at birth, but we know the biological father very well. HE is in and out of prison, can't hold a job, has one short relationship after another, is an alcoholic, a drug-user, an abuser, and the list goes on. Isn't it a shame that all this may have been genetically dumped on one little boy. I hope we can prevent all those things from happening with him! Maybe the diagnosis of ADHD/ODD is the least of my worries!

[AnneM]

{{{{Struggling Again}}}} ... I am sorry that you are going through so much confusion right now ... My adopted cousin has bipolar which was only recently diagnosed (at age 22) ... If only it had been spotted and diagnosed sooner... !

What I am saying though is that 'forewarned is forearmed' ... and if your little guy has (or will have)bipolar you are (by getting it spotted so young and being "ahead of the game") in a ver, very good position to REALLY help him ...

[Dad2Brooke]

StrugglingAgain, I agree with AnneM, forewarned is forearmed. By knowing now you can do something about it.

Not to upset anyone, but to state the obvious, his biological dad probably never got diagnosed and helped.

It is a shame that our kids have to struggle through such seemingly insurmountable burdens. But they are not alone, they have their parents to love, care, nuture, advocate and help them through it.

Your doing the right thing for your child. Getting th help he needs at an early age. Things will work out OK, you'll see!

[mctavish23]

Hi
I also agree that forewarned is forearmed.This gives you the time to learn as much as you can before puberty hits.I may have said this before but up to 97% of bipolar kids have ADHD but it isnt the other way around.

As far as therapist's go, it's all about rapport. It is tough sometimes to find someone who clicks with both you and the child, so I hope you find someone you can feel comfortable with.That way the therapist is better able to communicate and vice versa.

Once again, I wish you and son much luck.Take care.

mctavish23(Robert)

[Amsmom]

Oh dear Struggling,
I absolutely understand what you are going through. My ds8 was dx bipolar last year. It was not a surprise to me, as I recognized all the symptoms. It is not an easy ride, but please know that there is help. I am lucky that we have an excellent child psychiatrist. I know Dr Weasel,the psychologist, is a jerk, but is the psychiatrist better? I don't remember whether your son is on medication. My ds is on Depakote, Risperdal and Wellbutrin. Unfortunately with bipolar, there frequently needs to be a combination of meds to stabilize mood and this combination truly is effective for my ds. My ds also seems to have inherited this illness from his "father". I call him the donor as he doesn't even call or visit my ds. The donor is a substance abuser (alcohol and drugs) and spouse abuser. He abused me when I was pregnant with ds and abuses his current wife. Yes, it is horribly sad that these innocent little boys could have inherited this illness from these men. The donor is not formally dx and doesn't take meds, but I know he is bipolar. I agree with the "forewarned is forearmed" thought. If this does turn out to be the dx, you can gather information and learn how to cope and help your ds. I recommend The Bipolar Child by Demitri and Janice Papolous ( sp?). Struggling, I recommend strongly that you go to therapy to be able to vent all that you go through with your ds. I don't know how I would survive without my therapist. My ds also used to be very aggressive with me. I can tell you that Risperdal and behavior therapy have ended the physical aggression. There is hope, my dear StrugglingAgain. Please let us know how you are.

[StrugglingAgain]

Amsmom, my son is on Ritalin LA, Focalin, Risperdal and Clonidine. The aggression is a little better than it was a year or so ago. The child psychiatrist wants very little to do with the day to day stuff of what we go through, he just wants to be the one to prescribe and monitor drugs. He wants the Dr. Weasel to handle the behavior modifications, etc. We've been to three therapists (in three states) to learn behavior modifications and Dr. Weasel has no more to offer than what we already know. IF my child blossoms into Bipolar in a few years, it's my understanding that all the drugs of choice will change. Maybe that's what's wrong in the first place...maybe he isn't ADHD/ODD alone, but in addition to Bipolar. MAN, this is a confusing disorder. Personally I've HAD it with therapists counseling ME, it gets me nowhere! If I wasn't so tough I'd run away from home and never come back...but, my little boy needs ME!!! So here I stay...do or die! He's worth every second of it, though, and I SO glad to have him.

[Amsmom]

Hi there,
My son is unable to take stims. Ritalin and other stims made his symptoms worse.

I wasn't suggesting that a therapsit counsel you, I was suggesting a therapist you can go to to pour your heart out in an unconditional atmosphere. I dont want anyone to counsel me either! I go to my therapist and rant and rave about how tired and stressed I am and I feel better.

Your ds is lucky to have you, you are a wonderful mom!!

[AnneM]

I have also often heard/read that the stims can make bipolar worse ... so i would definitely lean towards questioning the Ritalin with your doctor ... (or rather your NEW doctor as it definitely doesn't sound like you are getting where you want to be with your present one!!) ....

I so much agree with your comment that IF bipolar shows itself later the meds will be changed ... but IF they think bipolar is going to show itself then the meds should be altered accordingly NOW !! ...

I agree with you that none of us want to be "counselled" but I also agree with Amsmom that someone you can literally "pour your heart out to" can be worth a lot ...

GOOD LUCK!!

[Honeysmom]

I am getting into the discussion a little late here, but I have a few points I want to make.

Honey was dx'd with ODD the first time when he turned 4. He has been offically dx'd 4 times since.

ODD is more than destructive behavior. It is lying, melting down (where the destruction usually comes in) and more like a loss of cohearence in the face of change.

Oppositional Defiance Disorder is a bad name for this affliction. It gives the impression that it is intentional. It is not. It is a loss of control and cohearence in the face of change. Sometimes Honey will lost it and not even know why. Sometimes he will lost it when going with the flow would be to his benefit and he knows it.

To add to the misery he is feeling, he is severly speech delayed, so imagine getting as angry as you can and not having any control over that anger, then take a piece of tape and put it over your mouth. How are you going to react? Probably with violence. What else do you have?

ODD is not a hopeless dx. It is hard as hell to deal with and it turns your life and every idea you ever had about raising kids upside down. No's and timeouts do not work. Behavior charts are out the window. I tried 1-2-3 Magic and it did nothing for us with Honey, but our DD it works wonders for (no ADHD or ODD).

ODD is a lot of work and let me tell ya, we have just started our way up the mountain to finding ways to effective help Honey.

The actual criteria for ODD is:

A pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, during which four, or more, of the following are present:

1. often looses temper
2. often arges with adults
3. often actively defies or refuses to comply with adults' requests or rules
4. often delibertly annoyes other people
5. often blames others for his/her mistakes and misbehaviors
6. is touchy or esilsy annoyed by others
7. is often angry or resentful
8. is often spiteful or vindictive

We have had all of these, except #8, constantly since Honey was able to express them.

To give you an idea of how this is for us, we consistantly spend upwards of 2 hours per day enduring tantrums. If we are lucky we can ingore it, if we are not we deal with it. It is obvious that we need more help and guidance and we are working on it.

I guess this got sort of long, but the main point I wanted to make was that ODD is not hopeless, it is more of a mood disorder, it is not intentional on the part of the child, and if not handled properly is setting a kid up for a life where he/she does not know how to handle anger and frusteration, usually leading to legal (jail) problems and what is charecterised as CD (conduct disorder). It also takes a big toll on kids and parents confidence and self-esteem. I do not know any kid who would want to be this way. Most of them have no idea how to change it.

Thanks for listening to my rant. A dx of ODD should not be taken lightly, but you can work with it.

Becky

[lisle]

Just a thought:
Current thinking from the Harvard U. group is that ODD is early onset bipolar. It shouldn't be treated with stims or AD's as they will escalate the onset of mania and cycling and each time there is depressive symptoms the bp gets worse (there are brain studies of this that show reduced brain volume). Talk to the dr. about this as he may think that bp is diagnosed later, an older theory.
lisle

[StrugglingAgain]

This is EXACTLY what my son's child psychiatrist told us at our last appointment a week ago. He said for NOW we treat the ADHD/ODD with stimulants as they are helping, BUT he thinks the large mgs. that my son must take because of his metabolism may be an indication of Bipolar, just not being able to diagnose it at this young age (8). It scared me to death! He said that often he finds that the patients where the only thing that works is high doses of stims is just treating the symptoms until they broaden into Bipolar symptoms and then must be changed completely.

[ohmama]

Struggling,
It sounds like your doctor is saying you should give stims till it turns into bipolar at a latter date when the child is older? Then treat the bipolar? I must not be understanding that correctly? To give stims when there is suspicion of bipolar is not what I am familiar with. As some of the other posters have brought out, bipolar or the possiblility of bipolar not yet manifested, should not be treated with stims as this only makes it worse. If there is bipolar and ADHD present the bipolar should be treated first according to what I've experienced with our doctors recommendations.

I say this because from the testing along with the SPECT brain scans taken of my son, the doctor was able to determine there was the start of bipolar disorder that needed to be brought under control or we could expect full blown bipolar right around the corner. The idea was to bring it under control not to aggravate the condition to bring it out and make it worse.

The dx in addition to adhd, mood disorder, anxiety disorder, and temporal lobe dysfunction called for the temporal lobes to be stabilized (certainly not with stims) first before the adhd could be addressed. This is done with a mood stablilzer/anticonvulsant to calm focal areas of increased activity, enhance mood stability, calm irritability, and stabilize temporal lobe function.

To start with a stim as in a one size fits all adhd treatment can be disastrous for this type of disorder (if bipolar is there). From the sound of your boys symptoms there is more than just adhd going on?

Bringing the temporal lobes under control is what we are doing with the first step. Next comes a stimulating antidepressant to enhance prefrontal cortex function and calm limbic hyperactivity. Finally there would be a psychostimulant to enhance prefrontal cortex activity and prevent prefrontal cortex shutdown with concentration. This type of med is used to treat primary adhd as well as to improve add-like problems that persist after a primary mood or anxiety disorder has been treated. It would only be considered if there remain significant attentional difficulties and/or hyperactivity after improvements in the mood and behavioral problems occur with the prior two meds.

I would question the use of a stim and do further investigation of bipolar or temporal lobe disorder. Have you considered getting the SPECT imaging done? This can show you inside the brain when it is working. Takes the guess work away and gives you a better dx.