Re: Raging

[Guest guest]

my daughter does too. severe.

In a message dated 2/26/2010 10:02:02 P.M. Eastern Standard Time,

tom-pauline@... writes:

I'm new to the group. Have a 16 year old son. He has had raging for

years, often when he doesn't get his way. We had thought and been told

that those were manic episodes. However, we started seeing a new

psychologist who believes it is related to OCD and is questioning the

Bipolar diagnosis. Any thoughts on raging and OCD? Is that common? How

do we differentiate between mania and OCD rage? We've had damage to

walls, carpets, bed linen, tennis racquet, guitar, etc. Pretty severe

and aggressive behaviors...and

Thanks for any advice.

ine

Houston, TX

__________________________________________________________

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[Guest guest]

Welcome to the group, ine.

Not all with OCD will have rages, but many do. At 16, you've got to wonder how

much the teenage hormones might also play a part in it too. Teens with OCD can

be a challenge. I know that our very compliant son became much mouthier, moody,

and defiant when he hit the teenage years. Although you do say that he's been

raging for years have you notice it worsening since he hit his teens?

Does he rage when " he " doesn't get his way, or when " OCD " doesn't get it's way?

I mean, is it because OCD has him in it's grip at that moment and he NEEDS to

finish the ritual to get his temporary relief before it starts cycling again?

Does he have other symptoms of bipolar disorder, or is it just the raging? If

not, I would question that diagnosis too. I don't know a lot about bipolar

disorder, but others in here do, so hopefully will respond too. I do recall

reading about it at one point, being concerned for our own son because he became

a bit hyper when he first started taking meds (which can be a common side

effect).

Here is some information that might help you figure it out. . .

**********************************

Symptoms of Bipolar Disorder

The primary symptoms of bipolar disorder are dramatic and unpredictable mood

swings.

Mania Symptoms~

Mania symptoms may include excessive happiness, excitement, irritability,

restlessness, increased energy, less need for sleep, racing thoughts, high sex

drive, and a tendency to make grand and unattainable plans.

Depression Symptoms~

Depression symptoms may include sadness, anxiety, irritability, loss of energy,

uncontrollable crying, change in appetite causing weight loss or gain, increased

need for sleep, difficulty making decisions, and thoughts of death or suicide.

Bipolar Types~

There are several types of bipolar disorder; all involve episodes of depression

and mania to a degree. They include bipolar I, bipolar II, cyclothymic disorder,

mixed bipolar, and rapid-cycling bipolar disorder.

Bipolar I~

A person affected by bipolar I disorder has had at least one manic episode in

his or her life. A manic episode is a period of abnormally elevated mood,

accompanied by abnormal behavior that disrupts life.

Bipolar II~

Bipolar II is similar to bipolar I disorder, with moods cycling between high and

low over time. However, in bipolar II disorder, the " up " moods never reach

full-on mania.

Rapid Cycling~

In rapid cycling, a person with bipolar disorder experiences four or more

episodes of mania or depression in one year. About 10% to 20% of people with

bipolar disorder have rapid cycling.

Mixed Bipolar~

In most forms of bipolar disorder, moods alternate between elevated and

depressed over time. But with mixed bipolar disorder, a person experiences both

mania and depression simultaneously or in rapid sequence.

Cyclothymia~

Cyclothymia (cyclothymic disorder) is a relatively mild mood disorder. People

with cyclothymic disorder have milder symptoms than in full-blown bipolar

disorder.

Does any of this sound like it fits?

**********************************

On the OCD side of it, here is a quote from Aureen Wagner's book about OCD and

rage. . .

" Rage often accompanies OCD, even though temper outbursts and aggression are not

part of the diagnosis of OCD. Many children with OCD do not have episodes of

rage. Rage can be the result of being frustrated or thwarted in completing

rituals. Children often become exhausted by the unrelenting demands of OCD, and

may therefore be on a hair-trigger. They have little patience left to give to

routine matters. Children with OCD could also be prone to being oppositional,

defiant or non-compliant apart from OCD. "

Is your son doing any CBT/ERP (cognitive behavioral therapy / exposure and

response prevention) therapy for his OCD? Or is he on any medications? The

therapy can raise their frustration levels as they confront the OCD. And

medication can have different affects on different people, so can also

contribute.

It can be hard to sort out what is causing the meltdowns, but I sure wouldn't

rule out OCD and being part of the problem. I'm glad you have a psychologist

helping you.

One of our moderators, (Barb) had similar issues with her teenage son. I'm

hoping she sees your post and can share her experience.

Glad you found us.

BJ

>

> I'm new to the group. Have a 16 year old son. He has had raging for

> years, often when he doesn't get his way. We had thought and been told

> that those were manic episodes. However, we started seeing a new

> psychologist who believes it is related to OCD and is questioning the

> Bipolar diagnosis. Any thoughts on raging and OCD? Is that common? How

> do we differentiate between mania and OCD rage? We've had damage to

> walls, carpets, bed linen, tennis racquet, guitar, etc. Pretty severe

> and aggressive behaviors......

>

> Thanks for any advice.

>

> ine

> Houston, TX

> ____________________________________________________________

> Nutrition

> Improve your career health. Click now to study nutrition!

>

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>

[Guest guest]

Bipolar disorder and OCD can be co-morbid conditions. yes, kids with OCD rage

when they are faced with their fears, but raging when not getting his way may be

more a mood disorder.

Bonnie

>

> I'm new to the group. Have a 16 year old son. He has had raging for

> years, often when he doesn't get his way. We had thought and been told

> that those were manic episodes. However, we started seeing a new

> psychologist who believes it is related to OCD and is questioning the

> Bipolar diagnosis. Any thoughts on raging and OCD? Is that common? How

> do we differentiate between mania and OCD rage? We've had damage to

> walls, carpets, bed linen, tennis racquet, guitar, etc. Pretty severe

> and aggressive behaviors......

>

> Thanks for any advice.

>

> ine

> Houston, TX

> ____________________________________________________________

> Nutrition

> Improve your career health. Click now to study nutrition!

>

http://thirdpartyoffers.juno.com/TGL2141/c?cp=DZbLFlARoFvDZ1GWlLAthAAAJ1BbA4AYJ8\

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>

[Guest guest]

Our 9 yo daughter w/OCD has had rages for years. Her therapist said that

OCD-inspired rages typically did not last more than 30-45 minutes while manic

episodes can go on much longer. Every child is different, but this is a general

guideline. We have had kicking, screaming, sitting down and refusing to move in

public places, property damage, throwing things, running away, and one memorable

episode outside the therapist's office in a public hallway where she lay on the

floor kicking and carrying on for about 30 minutes in full view of passersby.

She did finally calm down, and then wanted to know why we couldn't go out to

lunch after therapy! We have also learned to tell her that although the rage is

not " her fault " , she is responsible for making reparations for damage. When she

broke the window in her room, she had to pay to have it fixed. If she breaks a

toy or book of hers, we will not replace it. She is doing much better on Zoloft;

the rages

are less intense and much less frequent. I have also learned to read her body

language and tone of voice to tell when I need to back off as a meltdown is just

around the corner.

Good luck with your son,

(mom w/OCD, 9 yo dd w/OCD)

>

> Subject: Raging

> To:

> Date: Friday, February 26, 2010, 9:59 PM

> I'm new to the group.  Have a 16

> year old son.  He has had raging for

> years, often when he doesn't get his way.  We had

> thought and been told

> that those were manic episodes.  However, we started

> seeing a new

> psychologist who believes it is related to OCD and is

> questioning the

> Bipolar diagnosis.  Any thoughts on raging and

> OCD?  Is that common?  How

> do we differentiate between mania and OCD rage?  We've

> had damage to

> walls, carpets, bed linen, tennis racquet, guitar,

> etc.  Pretty severe

> and aggressive behaviors......

>

> Thanks for any advice.

>

> ine

> Houston, TX

> ____________________________________________________________

> Nutrition

> Improve your career health. Click now to study nutrition!

>

http://thirdpartyoffers.juno.com/TGL2141/c?cp=DZbLFlARoFvDZ1GWlLAthAAAJ1BbA4AYJ8\

z0qI3qJ4l-x8EJAAYAAAAAAAAAAAAAAAAAAADNAAAAAAAAAAAAAAAAAAASQwAAAAA=

>

>

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[Guest guest]

Hi ine and welcome.

I just read BJ's post and she has outlined well some of the possibilities around

the raging and OCD. We went through some very great difficulties with this, to

the point that our son could not live with us for a period of time.

In our case we found the medication played a very big part in it, but was not

the only part. The severity/intensity of the OCD was also a leading factor, as

is the teen component.

Medication(ssri's) - Amped up reactivity and impulsiveness, and is well known to

increase anger and agression in some (we learned after the fact). The gasoline

added to the " fire " of OCD. Without it our son could not function and the

severity of the anxiety was crushing and ERP could not even be considered, so it

was needed, but there was a trade off.

Bipolar symptoms were triggered at higher doses with ours, but he is not

bipolar, so even if you see mania/hypomania it's possible it's medication

related.

OCD - Probably the leader of the show, in the sense that it propels them to do

what they need to in order to get relief from the anxiety created by the

obsessions. Our previously reasonably well behaved kid truly became a nightmare

to deal with. There is a certain charge to the anger/rage when it is OCD based,

and you can usually track the root cause of it.

Teen - As BJ already said, the hormones and basic instability of this age that

can be internal and external. As well, they are on their way to adulthood and

want to be self determining, which can create conflict in parent interactions,

never mind with OCD along for the ride.

The enmeshment that can happen with parent and child with OCD can create huge

power struggles and the OCD must always win. It can be an impossible situation

to manage with a teen who also needs to have the power/control and is being

controlled by the OCD, and then a parent is trying to " control " the

" child " (their perception)

For us it was a combo of all three for sure, but the medication was what put it

all over the top. You don't mention what medications your son is on, so I'm not

sure the possibilities here. We did need to add a mood stabilizer for a period

of time, even when the ssri dose was lowered substantially, and we had the

question of bipolar for a while too. In the end our son did best on a low dose

of ssri solo (20mg celexa vs 60-80mg more typical dose needed).

We are in the process of tapering medication, as our son is doing well, for a

year and a half. We are down to 5mg now. Our son reports feeling more himself,

and this is what we see as well. There is a softness there now that was not

there with the celexa, even on the lower dose.

Our son often said he felt nothing, and could not feel empathy, it was

concerning, but now we can clearly see it was because of the medication. So

medication really can affect how they feel and respond. Also, the OCD would

make him obsess over the fact that he felt nothing and why this was, and on and

on, so it can be very difficult to try and uncover what is truly going on

through any conversation with them (that's if/when they'll talk!)

Ok, this is getting really long.... I will close by saying I would look at the

medications for one. Since you have a psychologist on board now, hopefully the

focus can turn to ERP, as this truly is the ticket out - our son will tell you

so! When he started to learn how to manage the OCD, or more specifically when

he was ready, willing and able, and decided to take it on, there were still

outbursts over OCD things, but much less so, and not it the extreme as when

medications were a factor.

I hope this helps some. Please feel free to contact me offline to talk about

any of this. I know how bad this can get, and how powerless you can feel to

deal with it.

Warmly,

Barb

Son 18, doing well now.

>

> I'm new to the group. Have a 16 year old son. He has had raging for

> years, often when he doesn't get his way. We had thought and been told

> that those were manic episodes. However, we started seeing a new

> psychologist who believes it is related to OCD and is questioning the

> Bipolar diagnosis. Any thoughts on raging and OCD? Is that common? How

> do we differentiate between mania and OCD rage? We've had damage to

> walls, carpets, bed linen, tennis racquet, guitar, etc. Pretty severe

> and aggressive behaviors......

>

> Thanks for any advice.

>

> ine

> Houston, TX

> ____________________________________________________________

> Nutrition

> Improve your career health. Click now to study nutrition!

>

http://thirdpartyoffers.juno.com/TGL2141/c?cp=DZbLFlARoFvDZ1GWlLAthAAAJ1BbA4AYJ8\

z0qI3qJ4l-x8EJAAYAAAAAAAAAAAAAAAAAAADNAAAAAAAAAAAAAAAAAAASQwAAAAA=

>

[Guest guest]

I have a nineteen year old daughter who has OCD. She also has narcolepsy and at

a visit with a new nurse practitioner at the narcolepsy doctor's office, we were

told she probably had Biopar Disorder as well. I really did not see this but

the nurse pract. was pretty sure of herself. She had asked Hannah a lot of

questions about sexual thoughts and things like that. Now, part of Hannah's OCD

has to do with excessive sexual thoughts and preoccupation so the doctor was

going from there and getting the diagnosis of Bipolar. The thing is, Hannah's

tantrums and sexual thoughts are directly related to her OCD and she does not

show classic signs of Bipolar Disorder for her age--like sexual promiscuity. At

the time the nurse pract. spoke to Hannah, Hannah was having a lot of OCD

thoughts that the woman mistook for Bipolar. The woman questioned the

qualifications of the doctor we have seen for years and suggested we have a

complete work up done on Hannah and begin treatment for Bipolar. I immediately

spoke to our doctor and she pointed out that not only does Hannah not show the

sexual behavior that is common in people with Bipolar, she also does not exhibit

classic manic and depressive states. She rattled off several other reasons it

is not Bipolar for Hannah. Within two weeks, Hannah's moods were better and her

sexual thoughts had settled down. This was over a year ago. I now refuse to

see the nurse pract. when we go for narcolepsy check ups because I think she is

not familiar enough with OCD to talk to Hannah about it. It always comes up at

these check ups because of Hannah's medication. They always want to question

whether or not she needs everything she is taking for it. I have had to work

really hard to be firm on letting them know that they get to treat the

narcolepsy and not the OCD. It's tiring but has to be done. Not knowing your

son, I don't know but I think it is possible for OCD to look like Bipolar

without being Bipolar. I hope this helps. Kelley in NV

Raging

I'm new to the group. Have a 16 year old son. He has had raging for

years, often when he doesn't get his way. We had thought and been told

that those were manic episodes. However, we started seeing a new

psychologist who believes it is related to OCD and is questioning the

Bipolar diagnosis. Any thoughts on raging and OCD? Is that common? How

do we differentiate between mania and OCD rage? We've had damage to

walls, carpets, bed linen, tennis racquet, guitar, etc. Pretty severe

and aggressive behaviors......

Thanks for any advice.

ine

Houston, TX

__________________________________________________________

Nutrition

Improve your career health. Click now to study nutrition!

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[Guest guest]

Thanks to everyone who responded to my question! Your answers have been

very helpful. I have lots more questions for the psychologist that we

see on Monday again.

Have a great weekend everyone!

ine

____________________________________________________________

Nutrition

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[Guest guest]

I'm glad the group was helpful, ine. Please update us on how it goes

Monday. Hoping you get the answers you need.

BJ

>

> Thanks to everyone who responded to my question! Your answers have been

> very helpful. I have lots more questions for the psychologist that we

> see on Monday again.

>

> Have a great weekend everyone!

>

> ine

> ____________________________________________________________

> Nutrition

> Improve your career health. Click now to study nutrition!

>

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>