All Things Hold Together

So, we met with the Nurse Practitioner at the pediatric psychiatry department for our follow-up visit about The D, last week. I haven’t written about it yet because it is just a lot to deal with. There is such a stigma surrounding mental illness and it really took me some time to accept it.

To some extent, I already knew. A while back, Bob started using the term “special needs child” to describe what I was dealing with, on those days when I was feeling like a failure for not getting enough done.

We already began the process of accepting that we could never expect “normal.”

Anyway, the diagnosis is Severe Mood Dysregulation, with ADHD and ODD (oppositional defiant disorder).

SMD is very new. It does not even have diagnostic criteria in the DSM IV (which is the book that psychiatrists use to diagnose mental disorders). It is an area that is being researched right now, so she was able to get us in with a really good doctor, who is going to help us with a behavior plan. He has a lot of experience working with families of children with ODD to develop strategies for managing behavior.

The ODD was absolutely no surprise. I have known that he met all the criteria for years. Honestly, I thought it was a made up disorder to describe children who lack structure. Well, I was wrong. We do not lack structure. And I have two other children who do not act this way. The D really has problems that require a different approach.

ODD is treated with behavioral therapy, but he also has ADHD. I, along with the teachers he had in public school, thought that he did not have ADHD because he can and does focus on school work.

As it turns out, some ADHD children can become hyper-focused on things that interest them - like video games, etc. The D just happens to be interested in reading and school work.

She prescribed a stimulant for the ADHD. It is supposed to calm his mind down enough so he can process things. The D often wants to do the right thing, but he says that he can’t help it. He is excited to take the meds, hoping that he will be able to control himself better. That is good, but also sad. I can’t imagine how that feels for him!

He starts tomorrow. We wanted to start on a weekend, in case he has a bad reaction. I want Bob home and a car here. (I don’t have a car when Bob is at work.)

Last weekend, we went away, so we couldn’t start it.

The medication was the hardest part for me to accept. I became a mom around the time that it came out the kids were being over-prescribed Ritalin. You know, adults just couldn’t handle rambunctious boys, so they gave them medication.

Well, I was always anti-medication. I want to let my boys be wild. I homeschool for Pete’s sake! They do not need to sit still all day. Or at all, really.

But that is not what this is. This is a boy who has no ability to calm himself - even when he wants to. He has over-the-top reactions to every mood - happy, sad, angry, you name it. He wants to control himself, but lacks the biological means to calm himself down.

I don’t know what the medication will do, but I am hopeful. I know that there is a lot of work to be done, but this could help calm things down enough to get that work done.

So, that’s what is going on with The D. I will update you about how things go. I also want to share how this has helped my husband and me to lean more on God. But that is another post altogether.