When I arrived at the emergency room, Rob was being tested for drugs (negative). He was calmer, but still angry. The intake person at the mental hospital had already come over to check him out. She had me answer a questionnaire about Rob's symptoms/personality and a little light bulb turned on in my head. Answering "yes, yes, yes, yes, yes...." to the questions posed shocked me into realizing there was more going on with Rob than just his ADHD. But the more immediate problem was that this nurse thought Rob would be ok to come home. That same night. A few hours after he held the knife to his throat. Turns out Rob had only told her about threatening to kill himself... he didn't mention that he had also threatened to kill someone else. I told her I did NOT want Rob to come home until he was thoroughly checked out and I was sure he would not be a danger to himself or someone else. So they admitted him. He was not at all happy about that. His biggest concern seemed to be the fact that he could not smoke a cigarette. He's been smoking for a couple of years now, as a way to calm himself down. Thinking he could not smoke was really upsetting him and he would not stop bitching at me about it. He finally fell asleep and I didn't wake him up until the nurse from the mental hospital came back, hours later, to admit him. Again I answered questions on the admittance forms that raised more red flags for me, and I realized that Rob had been showing classic symptoms of bipolar disorder for a long time.
When I finally got home, I did some research on the internet. The first thing that jumped out at me was the fact that medications for ADHD will often cause a very bad reaction in a person with bipolar disorder, and it clicked with me that the Focalin Rob had been taking had made his moods much worse... in fact I think it really threw him into a full blown manic episode which then, together with the highly stressful events of the past couple of weeks, led to a major crash into depression. That night's episode seemed to me to be truly psychotic.
Rob continued to be highly argumentative with me while he was at the hospital, but when visiting hours were over he was very quiet. I would say "sullen". The therapist was saying "compliant". When Rob talked to the therapist he indicated that his problem was due to his girlfriend. His therapist agreed with Rob that this suicidal episode was his overly dramatic response to a fight with his girlfriend. I asked the therapist, "did you read my responses to the questions on the intake forms"? Well, she looked them over again while I was sitting there. I told her that Rob is highly intelligent and is a master of manipulation. He had no problem convincing her that he was fine now. He would break it off with the girlfriend, and all would be well. Meanwhile, before the therapist came into the room to talk to us, he was writing a note to his girlfriend and begging me to drive it over to her house. I told the therapist that she needed to get together with the psychiatrist and review what I was telling her. Rob has been displaying most, if not all, of the symptoms of bipolar disorder.
After further review, the psychiatrist diagnosed "mood disorder (NOS)". Not otherwise specified. This is a typical initial diagnosis for bipolar disorder. Rob was released from the hospital after 4 days, with the specification that he attend IOP (intensive outpatient program). IOP was from 8 to 5 daily. He was prescribed Neurontin (anti-seizure, mood stabilizer) and Seroquel (anti-psychotic, mood stabilizer). He learned some coping skills at IOP, and was also prescribed Clonidine. This medication is usually used as a blood thinner, but the psychiatrist indicated that it was helpful with ADHD, but he also said that once Rob was stabilized he may need to add an ADHD stimulant again.
If I had started this blog when these events happened back in November, I would have had an outlet for the rage and frustration that I felt daily. My notes would have been about Rob's daily moods, my daily moods - the nightmare of the whole thing. But I was in shock, I was numb... I still don't know how I feel about this diagnosis. I cried for days, couldn't close my eyes without reliving the horror of Rob with that knife... When Rob came home I was terrified. He was openly hostile. He could not talk to me without getting angry. He would follow me around the house, calling me names, swearing at me, hitting things... I actually locked my bedroom door at night. Never before had I ever thought he would hurt me. Now, I really wasn't sure.
I tried to keep him in the house, close to me, so I could keep an eye on him. Rob has never been able to stay in the house. He has been going, going, going since he was old enough to leave the house alone. Rob would wake up and the leave the house within 1/2 hour... every day. He would be gone as long as possible. He needed to move, move, move - he needed to find his friends, hang out, move on to the next friend... I could not keep him home. We agreed that he could leave the house for periods of time, for "missions". He would tell me what mission he needed to accomplish, "pickup his friend Mike", "go to the drugstore", "apply for a job at this certain store", and he would be allowed to accomplish one mission at a time, with a pitstop at home in between. I have no freakin' idea what this was supposed to accomplish. I just felt I needed to manage his day to help him stay in control. This lasted for about two days, then he stopped coming home between missions. He stopped calling me from his cell and giving me his whereabouts. He would answer his phone if I called him, though... so life went on. I was still scared and shaky, but I was also relieved when he wasn't home. I could breathe a little without him hounding me. But I was also worrying constantly about what he was doing, who he was with, is he getting angry, is he out of control right now and I don't know it????
Rob continued to rant and rage at me every time we were together, and he would call me while I was working to argue with me too. One night after being particularly horrid with me and his friends, I caught him in the basement with a telephone cord wrapped around his neck. By the time I found him he was purple, but he was still concious. I got him to go to bed and gave him a double dose of the Seroquel.
I was still reading everything I could get my hands on about bipolar kids, and I was surprised to learn that several other disorders are co-occurring with bipolar disorder. OCD (obsessive compulsive), ODD (oppositional defiant), BPD (borderline personality), Tourette's Syndrome, Asperger's Syndrome, with a staggering percentage of ADHD thrown in. According to what I read, Rob has many symptoms of the OCD and ODD, along with the ADHD we've known about since he was young. A few symptoms of the Tourette's as well.
Rob has had three sessions with his therapist so far. I've sat in with all of them. The first two sessions Rob was actively participating, the last session he was withdrawn and would only contribute a "yes" or "no". He has not had his first session with the psychiatrist yet, that's scheduled for January 15th. On January 8th I will meet with the psychiatrist alone. Rob has not been able to sit at his computer, not at all, since coming home from the hospital and he's considered absent with a medical excuse.
Rob has appeared more stable to me for the past two weeks, and has stopped arguing and bitching at me constantly. He's still very argumentative about everything, but he is not as confrontational as he had been. His sleeping habits still suck. He is up till 2 or 3 in the a.m., but sleeps in till 1 or 2 in the afternoon. He can't fall asleep without the Seroquel, but holds off on taking it as long as he can. He has been compliant with taking his meds, but he will forget to take them if I don't remind him every day.
He was doing pretty well, until Saturday.
When I arrived at the emergency room, Rob was being tested for drugs (negative). He was calmer, but still angry. The intake person at the mental hospital had already come over to check him out. She had me answer a questionnaire about Rob's symptoms/personality and a little light bulb turned on in my head. Answering "yes, yes, yes, yes, yes...." to the questions posed shocked me into realizing there was more going on with Rob than just his ADHD. But the more immediate problem was that this nurse thought Rob would be ok to come home. That same night. A few hours after he held the knife to his throat. Turns out Rob had only told her about threatening to kill himself... he didn't mention that he had also threatened to kill someone else. I told her I did NOT want Rob to come home until he was thoroughly checked out and I was sure he would not be a danger to himself or someone else. So they admitted him. He was not at all happy about that. His biggest concern seemed to be the fact that he could not smoke a cigarette. He's been smoking for a couple of years now, as a way to calm himself down. Thinking he could not smoke was really upsetting him and he would not stop bitching at me about it. He finally fell asleep and I didn't wake him up until the nurse from the mental hospital came back, hours later, to admit him. Again I answered questions on the admittance forms that raised more red flags for me, and I realized that Rob had been showing classic symptoms of bipolar disorder for a long time.
When I finally got home, I did some research on the internet. The first thing that jumped out at me was the fact that medications for ADHD will often cause a very bad reaction in a person with bipolar disorder, and it clicked with me that the Focalin Rob had been taking had made his moods much worse... in fact I think it really threw him into a full blown manic episode which then, together with the highly stressful events of the past couple of weeks, led to a major crash into depression. That night's episode seemed to me to be truly psychotic.
Rob continued to be highly argumentative with me while he was at the hospital, but when visiting hours were over he was very quiet. I would say "sullen". The therapist was saying "compliant". When Rob talked to the therapist he indicated that his problem was due to his girlfriend. His therapist agreed with Rob that this suicidal episode was his overly dramatic response to a fight with his girlfriend. I asked the therapist, "did you read my responses to the questions on the intake forms"? Well, she looked them over again while I was sitting there. I told her that Rob is highly intelligent and is a master of manipulation. He had no problem convincing her that he was fine now. He would break it off with the girlfriend, and all would be well. Meanwhile, before the therapist came into the room to talk to us, he was writing a note to his girlfriend and begging me to drive it over to her house. I told the therapist that she needed to get together with the psychiatrist and review what I was telling her. Rob has been displaying most, if not all, of the symptoms of bipolar disorder.
After further review, the psychiatrist diagnosed "mood disorder (NOS)". Not otherwise specified. This is a typical initial diagnosis for bipolar disorder. Rob was released from the hospital after 4 days, with the specification that he attend IOP (intensive outpatient program). IOP was from 8 to 5 daily. He was prescribed Neurontin (anti-seizure, mood stabilizer) and Seroquel (anti-psychotic, mood stabilizer). He learned some coping skills at IOP, and was also prescribed Clonidine. This medication is usually used as a blood thinner, but the psychiatrist indicated that it was helpful with ADHD, but he also said that once Rob was stabilized he may need to add an ADHD stimulant again.
If I had started this blog when these events happened back in November, I would have had an outlet for the rage and frustration that I felt daily. My notes would have been about Rob's daily moods, my daily moods - the nightmare of the whole thing. But I was in shock, I was numb... I still don't know how I feel about this diagnosis. I cried for days, couldn't close my eyes without reliving the horror of Rob with that knife... When Rob came home I was terrified. He was openly hostile. He could not talk to me without getting angry. He would follow me around the house, calling me names, swearing at me, hitting things... I actually locked my bedroom door at night. Never before had I ever thought he would hurt me. Now, I really wasn't sure.
I tried to keep him in the house, close to me, so I could keep an eye on him. Rob has never been able to stay in the house. He has been going, going, going since he was old enough to leave the house alone. Rob would wake up and the leave the house within 1/2 hour... every day. He would be gone as long as possible. He needed to move, move, move - he needed to find his friends, hang out, move on to the next friend... I could not keep him home. We agreed that he could leave the house for periods of time, for "missions". He would tell me what mission he needed to accomplish, "pickup his friend Mike", "go to the drugstore", "apply for a job at this certain store", and he would be allowed to accomplish one mission at a time, with a pitstop at home in between. I have no freakin' idea what this was supposed to accomplish. I just felt I needed to manage his day to help him stay in control. This lasted for about two days, then he stopped coming home between missions. He stopped calling me from his cell and giving me his whereabouts. He would answer his phone if I called him, though... so life went on. I was still scared and shaky, but I was also relieved when he wasn't home. I could breathe a little without him hounding me. But I was also worrying constantly about what he was doing, who he was with, is he getting angry, is he out of control right now and I don't know it????
Rob continued to rant and rage at me every time we were together, and he would call me while I was working to argue with me too. One night after being particularly horrid with me and his friends, I caught him in the basement with a telephone cord wrapped around his neck. By the time I found him he was purple, but he was still concious. I got him to go to bed and gave him a double dose of the Seroquel.
I was still reading everything I could get my hands on about bipolar kids, and I was surprised to learn that several other disorders are co-occurring with bipolar disorder. OCD (obsessive compulsive), ODD (oppositional defiant), BPD (borderline personality), Tourette's Syndrome, Asperger's Syndrome, with a staggering percentage of ADHD thrown in. According to what I read, Rob has many symptoms of the OCD and ODD, along with the ADHD we've known about since he was young. A few symptoms of the Tourette's as well.
Rob has had three sessions with his therapist so far. I've sat in with all of them. The first two sessions Rob was actively participating, the last session he was withdrawn and would only contribute a "yes" or "no". He has not had his first session with the psychiatrist yet, that's scheduled for January 15th. On January 8th I will meet with the psychiatrist alone. Rob has not been able to sit at his computer, not at all, since coming home from the hospital and he's considered absent with a medical excuse.
Rob has appeared more stable to me for the past two weeks, and has stopped arguing and bitching at me constantly. He's still very argumentative about everything, but he is not as confrontational as he had been. His sleeping habits still suck. He is up till 2 or 3 in the a.m., but sleeps in till 1 or 2 in the afternoon. He can't fall asleep without the Seroquel, but holds off on taking it as long as he can. He has been compliant with taking his meds, but he will forget to take them if I don't remind him every day.
He was doing pretty well, until Saturday.