Mixed Bag - Frightening Episode
Sunny did very well in school on Monday. Then Dad came home, and everything was great. However, we had a very disturbing episode at dinner.
While Guy unpacked, I took him to his tutor, who lives in Nana's neighborhood, and then we went over to Nana's house to have dinner.
At the end of dinner, Sunny pushed away his plate, said, "I'm outta here!" and got up. He wandered off about ten feet and then circled around.
That's totally unacceptable to do at the dinner table, and he knows that. He came back and sat down for a bit, but it was like something flipped in his mind. He became oppositional and verbally threatening. "I'm never coming to Nana's house again!" "I'm never talking to Mom again!" He started talking to himself, and when we asked him any questions, he told us to be quiet because he was busy talking to himself!
I didn't want to to cause another full-on meltdown right there, so we didn't do a time out. I just told him that because of his bad behavior at the table he lost the privilege of blowing out the candles after dinner, then we left.
In the car, he kept on backtalking. So I told him, "You really need to be honest about what you say. You can't just say angry words you don't mean. If you really want me not to to talk to you, I'll do that. We'll try it for this car ride back. I won't talk to you at all until we get back home."
He told me he didn't mean it. Then he called me a meanie, and said he wasn't ever going to talk to me again. He cried and was very upset for most of the ride back. He patted me on the shoulder a few times, and I patted him back and squeezed his hand, but I didn't say anything. He kept up a constant dialog with himself. At one point he sobbed, "I don't know why I'm doing this, I'm getting myself in trouble." Then he went back into "Mom is a meanie" mode for a few minutes.
When we got back home, I gave him a hug. He also got a hug from dad and a long talk about what just happened. He apologized.
Sunny said he missed his foster mom. Guy and I talked later, and I don't think that's what's behind all this. Sunny misses his foster mom a lot, and that's only natural. He's very expressive about that, he doesn't hide it in any way, and when he brings it up, we talk about it and offer to call her on the phone.
I tend to take Sunny at his word when he says "I don't know why I'm doing this."
My mother said she was very shocked at his behavior and had not seen anything like it before, especially the way he was talking to himself. It's almost as if there were two Sunnies. For example, at some points he was saying things like "leave me alone" or "don't talk to me" but he would move closer as he said "leave me alone", and he obviously wanted me to talk to him and got very upset when I didn't.
I think I handled it well in that I kept it from escalating. He got through the worst of it in the backseat of the car. I'm not sure if not talking to him was a good idea. But then again, if I had talked to him, it would probably have upset him just as much.
Afterwards, and then again in the morning, Sunny was his normal self again.
Maybe moving his medication half-dose to the morning helps him in school but hurts him at home.
We'll talk about this with the therapist. I'm up in the air as to how much of it is specifically adoption-related. He could be thinking that bad behavior might get him back to his foster family. But he seems pretty secure in his place in the family... and I tell him all the time that I love him no matter what his behavior. I know that "I'm going to push you away first because I'm scared you'll push me away" is a common theme but that just doesn't seem like it explains the episode, especially the strange dialog he was having. I do know that he was profoundly anxious, torn and confused during the episode.
Given what I know of Sunny's personality -- how expressive and articulate he is, how much he loves finding reasons for things -- it doesn't makes sense. Maybe this is something that no one has any control over, except on the chemical level.
I'm going back to reading about childhood bipolar. I said I was 99% sure he didn't have that, but now I feel more like 50/50. Maybe his medication was at the right dose, and now that it's at half strength, he's starting to have hypomanic episodes. If that's the case, he needs to go back on it, and soon. I want to talk to the therapist, and wait just a bit longer to see what develops.
We're also going to try putting him to bed at 8pm instead of 8:30, in case he needs more sleep.
ETA: I talked to our therapist. She told me it was probably a good idea not to talk to him in the car. Her take is that the episode was caused by too many emotions (from his complicated past) cycling back and forth. Sunny is good at expressing and naming his emotions, but if they come too fast, he loses that ability. She thinks the medication helps him handle those emotions, and supports putting him back on a full dose if necessary, until he grows up a little bit and gets more of an emotion vocabulary.
She also gave me a great specific recommendation: that we get a CD player for his room. He can choose which discs to play when he goes to bed and put them in himself. This will give him more control over his environment and help him practice how to calm himself down. I'm going to try that starting today.
We'll check in with her when we see her next weekend.

Foster Care System Perspectives

3 comments:
This all reminds me so much of when Slugger's doctor and I tried reducing and then eliminating his anger management medication. I really didn't think he needed it and he did great for a while on reduced dosage. But, in the long run, he proved that he did need it. I hate having Slugger on that med -- but if he needs it, he needs it.
By the way, when Slugger gets very emotional and upset he often says he misses his foster family, his brother, and/or his biological mom. I know he misses all of those people and we talk about them frequently. However, when he's upset, it's usually not about missing them. I think it's just a familiar, known issue that he can pin his emotions on at times when he doesn't know what else to say.
I think there may also be a possibility that that strange behavior was caused by the "comedown" from the meds (and with a full dose there was not a comedown because the dose lasted all the way until the next dose). So, on coming down from the meds he may actually get worse than his "natural" level would be.
My other sister has a stepson who comes for short visits of up to a week. This stepson was put on meds (by his own mom) on the grounds that he had trouble doing his homework (although his mom used to only make him do his homework as a punishment for something). My sister does not give him meds when he is with her, and she said he is always difficult for the first 1/2 day or day or so.
1/2 meds may be a difficult, kind of "in between" amount. The only way you may be really able to tell if he needs the meds may be to take him off them completely (little by little if appropriate) and then wait for a few weeks and see if he adjusts to an acceptable equilibrium (not perfect, but workable). Just before Christmas or summer vacation might be a good time to enter the "non-medicated" phase... but I wonder if it is a good idea to do this when you are still in that probationary period?
I should make it clear that I am not a fan of meds except for serious problems which cannot be solved in another way. So many children who are in sub-optimal circumstances get put on meds for other reasons. I don't think you can know whether he really needs them or not without taking him off completely and then waiting a few weeks for him to adjust physically and psychologically, and then judging whether his normal behavior is something that can be put up with and worked with. Now might not be the right time, but I think you should definitely try this at some point. Perhaps it might be better when he is a bit older and can express himself better, and he can better understand issues to do with meds and how he might feel when coming off them, and has attached himself more firmly to his new family?
We've decided to put him back on the full dose. Then we'll revisit in the summer, and see if we can make another attempt to get him off at that point. He should be more settled then, and we won't have to worry as much about school behavior.
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