Guest guest Posted October 27, 2009 Report Share Posted October 27, 2009 My 2 sons started taking Abilify when they had angry outbursts. It completely eliminated them for one son, and greatly decreased them in another. > > > My ds, 13 years, has been having some issues with becoming agressive when > in a panic attack. He has thrown things and threatened to do more. His eyes > become glazed over and he is not himself. He wants me to answer his > questions " just right " or OCD rears its ugly head and he panics that he will > be " unclean. " I have tried not answering, and my husband and I have held him > down a couple of times, while he raged. He eventually calmed, but its not > pretty. When he is calm, he says he doesn't want to be that way and tells me > how OCD wants the questions asked and promises to try harder, but it is > really getting tiring. He had a few of these in the beginning of his OCD, > but they subsided for the past few weeks, and now are excalating again, > though I will say they don't last as long as before. > > He was on Prednisone for 5 days starting 12 days ago to see if he has > PANDAS, during which time he improved so much it was established he does > have PANDAS. Could coming off the Prednisone cause this? He has been on > Luvox for now week 12 with very gradual improvement of the OCD, and he is > trying to challenge it through his exposure and response therapy. He still > gets very anxious though. His therapist, who is very experienced with > children and OCD ERP therapy says he is doing better because his panic > attacks are getting better and he is doing more activities, though it is > still very little, and requring less rituals (true). He says maybe I should > try walking away, but I'm afraid he would trash the house or the car if I > did. His psychiatrist put him on Clonazepam which calms him a little, but he > still had a panic attack while on it today (his second day of taking it). > When I am able to answer his questions " just right " he immediately gets > relieved, though it is increasing how often he has me answer these > questions. I know, I shouldn't be enabling, but my ds was and is pretty bad > off and it's very, very hard. The questions just kind of spiraled out of > control in the last week or so. > > Any thoughts on whether my ds should be on something stronger for his angry > panic attacks? I've literally taken almost everything out of the house that > is breakable except necessary items, but there are still things he could > throw. Or does it take a long time for the Clonazepam to work? His therapist > thinks he needs something stronger. My husband is going to call the > psychiatrist himself tomorrow who is a nice guy, older, though usually open > to ideas. So if anyone has any thoughts, please let me know. I'm getting > exhausted here. > > Anita > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2009 Report Share Posted October 28, 2009 Are they treating the PANDAS at all? I don't know, but it does seem to me that coming off the prednisone could be responsible especially if they are not using antibiotics to treat the PANDAS. My daughter does not have PANDAS, but her OCD does worsen the more we accommodate it. Just a few thoughts, Best wishes, > > Subject: Agressive behavior > To: > Date: Tuesday, October 27, 2009, 9:57 PM > My ds, 13 years, has been having some > issues with becoming agressive when in a panic attack. He > has thrown things and threatened to do more. His eyes become > glazed over and he is not himself. He wants me to answer his > questions " just right " or OCD rears its ugly head and he > panics that he will be " unclean. " I have tried not > answering, and my husband and I have held him down a couple > of times, while he raged. He eventually calmed, but its not > pretty. When he is calm, he says he doesn't want to be that > way and tells me how OCD wants the questions asked and > promises to try harder, but it is really getting tiring. He > had a few of these in the beginning of his OCD, but they > subsided for the past few weeks, and now are excalating > again, though I will say they don't last as long as before. > > He was on Prednisone for 5 days starting 12 days ago to see > if he has PANDAS, during which time he improved so much it > was established he does have PANDAS. Could coming off the > Prednisone cause this? He has been on Luvox for now week 12 > with very gradual improvement of the OCD, and he is trying > to challenge it through his exposure and response therapy. > He still gets very anxious though. His therapist, who is > very experienced with children and OCD ERP therapy says he > is doing better because his panic attacks are getting better > and he is doing more activities, though it is still very > little, and requring less rituals (true). He says maybe I > should try walking away, but I'm afraid he would trash the > house or the car if I did. His psychiatrist put him on > Clonazepam which calms him a little, but he still had a > panic attack while on it today (his second day of taking > it). When I am able to answer his questions " just right " he > immediately gets relieved, though it is increasing how often > he > has me answer these questions. I know, I shouldn't be > enabling, but my ds was and is pretty bad off and it's very, > very hard. The questions just kind of spiraled out of > control in the last week or so. > > Any thoughts on whether my ds should be on something > stronger for his angry panic attacks? I've literally taken > almost everything out of the house that is breakable except > necessary items, but there are still things he could throw. > Or does it take a long time for the Clonazepam to work? His > therapist thinks he needs something stronger. My husband is > going to call the psychiatrist himself tomorrow who is a > nice guy, older, though usually open to ideas. So if anyone > has any thoughts, please let me know. I'm getting exhausted > here. > > Anita > > > > ------------------------------------ > > Our list archives feature may be accessed at: http://health.groups.yahoo.com/group// > by scrolling down to the archives calendar . Our links > may be accessed at http://health.groups.yahoo.com/group//links > . Our files may be accessed at > http://health.groups.yahoo.com/group//files > . > Our list advisors are Gail B. , Ed.D.(http://www.ocdawareness.com ), Tamar Chansky, Ph.D.( http://www.worrywisekids.org ), and Dan Geller, M.D. > (http://www2.massgeneral.org/pediatricpsych/staff/geller.html > ). You may ask a question of any of these mental health > professionals by inserting the words " Ask Dr.(insert name) " > in the subject line of a post to the list. Our list > moderators are Castle, Judy Chabot, BJ Closner, and > Barb Nesrallah. Subscription issues or > suggestions may be addressed to Louis Harkins, list > administrator, at louisharkins@... > . Our group and related groups are listed > at http://health.groups.yahoo.com/group/ocdsupportgroups/links > . OCF treatment providers list may be viewed at http://www.ocfoundation.info/treatment-providers-list.php > . > NLM-NIH Drug Information Portal may be viewed at > http://druginfo.nlm.nih.gov/drugportal/drugportal.jsp?APPLICATION_NAME=drugporta\ l > . OCF recommended reading list may be viewed at http://www.ocfoundation.org/ocd-oc-spectrum-disorders-book-list.html > . > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2009 Report Share Posted October 28, 2009 Hi Anita - I am so sorry. If you had a great response on 5 days of Prednisone, this adds greatly to the clinical picture, showing PANDAS. Generally, while the OCD does flood back after the 5 days, it does not cause withdrawal for a short time on steriods. You are just seeing the return of the disease now that it is not being treated. 5 days is just diagnostic. Who prescribed this? Did they have a plan for what to do if this diagnosic was positive? Generally the next step is anti-biotics. Do you need a referal to a PANDAS doctor? There are very few nationwide, but I'd be happy to provide. They also do consults back to your local doctor. Is your ERP therapist helping you with a strategy for how to slowly withhold reassurance? It does just keep multiplying, so finding a strategy here is very important. I know how hard this is at first - it is heartbreaking when you know it is " problem solved " if you answer. But it is not really - the child will just increase the asking & thus increase their pain. It's a slow process to reverse but very very very worth the effort. in NC > > My ds, 13 years, has been having some issues with becoming agressive when in a panic attack. He has thrown things and threatened to do more. His eyes become glazed over and he is not himself. He wants me to answer his questions " just right " or OCD rears its ugly head and he panics that he will be " unclean. " I have tried not answering, and my husband and I have held him down a couple of times, while he raged. He eventually calmed, but its not pretty. When he is calm, he says he doesn't want to be that way and tells me how OCD wants the questions asked and promises to try harder, but it is really getting tiring. He had a few of these in the beginning of his OCD, but they subsided for the past few weeks, and now are excalating again, though I will say they don't last as long as before. > > He was on Prednisone for 5 days starting 12 days ago to see if he has PANDAS, during which time he improved so much it was established he does have PANDAS. Could coming off the Prednisone cause this? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2009 Report Share Posted October 28, 2009 Thanks, . We are trying a reward system for asking the question just once. So far today he has gotten down to 2 a couple of times, but then has suddenly gone to 15 or 20. I try to really praise him when he gets to the 2 level and he really, really responds to the praise. Poor kid. He gets a big reward if he can go a week with one question. His therapist just says to walk away at times, but I'm scared too when alone because I can't handle him physcially. My husband I did it twice and it was hard. Actually the second time he didn't struggle as hard and he told me it helped him to get out his anger when held (not a positive solution though, I know). His therapist says he will help him with more relaxation techniques, but he is slow learner in this ballpark. I do have a local pediatrician working with Dr. K. in Chicago for the Prednisone boost and willing to help more if he can. He was hard to find and I feel fortunate to have found him, thanks to some help I got from some group members. Dr. K. recommends the IVIG therapy I guess since he thinks he's had PANDAS at least since age 9 when he was diagnosed by a neurologist with Tourettes. When I see him, I'll ask more specifically about starting the antibiotic too. I am hoping the IVIG therapy helps him, but trying not to set my hopes to high due to no guraantees. > > > > My ds, 13 years, has been having some issues with becoming agressive when in a panic attack. He has thrown things and threatened to do more. His eyes become glazed over and he is not himself. He wants me to answer his questions " just right " or OCD rears its ugly head and he panics that he will be " unclean. " I have tried not answering, and my husband and I have held him down a couple of times, while he raged. He eventually calmed, but its not pretty. When he is calm, he says he doesn't want to be that way and tells me how OCD wants the questions asked and promises to try harder, but it is really getting tiring. He had a few of these in the beginning of his OCD, but they subsided for the past few weeks, and now are excalating again, though I will say they don't last as long as before. > > > > He was on Prednisone for 5 days starting 12 days ago to see if he has PANDAS, during which time he improved so much it was established he does have PANDAS. Could coming off the Prednisone cause this? > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2009 Report Share Posted October 28, 2009 So I am NOT a therapist, but maybe talk to yours about this: We could not take big steps - we had to take baby steps all the time. We found it took some time to get down to a low level and we really rewarded consistency (and isn't it great how proud they are of this success!) - so if he is at 20 times, then try to keep it to 18. But agree that you will not answer after 18. Let him have the anxiety if you can - it will make the next time easier and easier. If he tolerates the anxiety at 18 for a day or two, then have him set a new realistic goal. Going down to 2, but then having bursts - for us, that was much harder, than take 2-3 weeks to ratchet it down altogether. We also did note cards that we would ask her to read with the answer (after asking 1x, we'd answer, write it on note card & give to her). Everytime after that, she would have to read it to me, then I would respond. Then after 15, she could read the card if she wished. This helped to break up the ritual of asking. There are a bunch of other ways to delay or break it up that are not as much about relaxation, but about brain tools. I'd recommend " What to do when Your Brain Gets Stuck " - it's a workbook for kids, and VERY helpful. It's written for a slightly younger kid, but I had another teen read this recently and still really like it. I find that young kids and young teens need slightly different tools & approaches than older teens and adults. I understand that reseach shows that " fast and extreme exposure " works better and faster than " baby steps " . But I think kids need to slowly build confidence & learn to trust the tools, or they will quit. They understand less conceptually, and more more likely to trust experience rather that philosophy. So our therapist subscribes to a " baby step " program for kids, and we found it to be very helpful. You'll have to judge based on how he responds over the next few days & what level of understanding & committment you think he has. Meg talks like a little mini therapist right now (she is 8) - last night she woke up at 2 am with some worries. I sat with her for a sec, and she told me " mom, let's not worry about the future. Let's just work on right now " . Funny kid! She was back to sleep very quickly. We did not find " holding " Meg to be effective. Even at 45 pounds, she is very strong when panicked. We just worked really hard on acceptable panic behaviors, especially when not panicked. We did scheduled practice of relax techniques every few hours, every day. This only lasted for about 2 weeks, and then she could help herself with coaching. After about a week of practicing deep breathing (through stomach, not chest) she was able to dial down the panic. I would say a calm repetitive thing, such as " you are panicking, you have felt this before & you will be fine. Take a breath to raise your stomach. You will be fine soon(repeat) " . We also practiced what else we could do when panicking, such as hitting the bed, versus throwing things. But if the urge to throw is strong, then try to redirect. Get him something heavy but not damaging & set up a throwing area. Maybe he can throw into a sofa, or at specific wall. Just keep handing him the beanbags, or whatever is approved to throw. You can also build something where he throws and then you remind to breathe. Wierdly, our daughter learned that she felt a lot better if she stood on her head . So after she started to calm, I would remind her and I think it was the concentration required but maybe also the blood flow to the brain. Glad you found Dr. K - and that you are also working on ERP at the same time! in NC. > > > > > > My ds, 13 years, has been having some issues with becoming agressive when in a panic attack. He has thrown things and threatened to do more. His eyes become glazed over and he is not himself. He wants me to answer his questions " just right " or OCD rears its ugly head and he panics that he will be " unclean. " I have tried not answering, and my husband and I have held him down a couple of times, while he raged. He eventually calmed, but its not pretty. When he is calm, he says he doesn't want to be that way and tells me how OCD wants the questions asked and promises to try harder, but it is really getting tiring. He had a few of these in the beginning of his OCD, but they subsided for the past few weeks, and now are excalating again, though I will say they don't last as long as before. > > > > > > He was on Prednisone for 5 days starting 12 days ago to see if he has PANDAS, during which time he improved so much it was established he does have PANDAS. Could coming off the Prednisone cause this? > > > Quote Link to comment Share on other sites More sharing options...
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