Hi, I was wondering if anyone here is familiar with what a mood disorder might look like in a young child? My DS is already diagnosed with ADHD, TS, and ASD, as well as being gifted (I guess hg would be the right label... hard to be sure these days?)
Ever since DS was young he was variable in his behavior. I used to say I thought he had cyclic adhd or asd, because sometimes he would seem to come out of it and be totally normal. Now that he is older and medicated for adhd, it's more the opposite. He generally seems pretty normal, but will slowly fall into about 2 week long episodes of miserable behavior that are only partially controlled by adhd meds. Before he gets his meds in the am and after they wear off in the pm he is unbearable during these episodes.
This time he started getting more negative and irritable about 3 weeks ago or so, but was still functioning generally OK. More yelling and oppositional behavior, but I thought maybe we were going to avoid the full descent. Then last week it started. After great reports from school for over 2 months I started getting phone calls. I had to pick him up early one day. Another day he hit a little girl in the face for cutting in line.
At home he has been a terror. He screams and cries about everything, throws tantrums/items when upset, hits, flips out if he loses a game, etc. The only time he seems happy is when he is annoying us mercilessly while giggling like a maniac. When given a consequence he goes into full blown crazy tantrum mode, throwing anything he can get his hands on, often at us.
This is not normal for my DS. He is generally a loving child who is eager to help out his mommy and who loves to do nice things for me/surprise me with little gifts. He's usually happy and has a great sense of humor, he loves to make up jokes and share them with us. He does have his issues normally, especially when not medicated, but he would never harm me when he's not in one of these moods. He is usually a bit of a sore loser, but he's likely to just say (in an upset voice), "OK, you win, I'm never playing this game again," and maybe have a little cry. When reminded that his behavior doesn't meet expectations he will put on a little smile and say good game sweetly and help me clean up. So, it's like the same strong emotions are always there, he still has tantrums and cries about things that other kids take in stride, but this full blown crazy irritable behavior, aggression, and just plain meanness that crops up randomly and lasts about 2 weeks each time is very concerning.
I know it seems like I should be asking a professional, but believe me I have. They either say it's part of asd, blame me, or try to convince me to put him on an antipsychotic. No one is willing to discuss a mood disorder in an 8 year old with a diagnosis of ASD. I also have been trying to get him into CBT for years, but every provider says he is too young to benefit. They will not make exceptions due to his high intelligence and overall great insight (when he stops to reflect, not in the moment!)
Even the school is amazed at how great he is doing at processing after the fact and the insightful things he says. They introduced "criss crossing" to him recently, which is an empathy/walk in the other person's shoes sort of idea and he has latched onto it, constantly telling me when he's doing it, when I'm doing it, and when he thinks someone should be doing it. He started crying the other day randomly and I asked him what was wrong and he said he accidentally criss crossed into his 1 on 1 he has at school when he said something mean to her earlier that day and he was crying because he was feeling how she must have felt. Then he ran upstairs to get materials to write her an apology letter. I'm pretty sure he could benefit just fine from CBT.
DS also seems to have some phobias. He is afraid of the dark to an usual degree and it terrified of bugs to the point where I can no longer get him to go outside much at all. If he sees a bug he runs right back in. He does not appear to have a lot of anxiety otherwise. He doesn't like to be alone at all, which I guess could be anxiety. He also is hesitant to try new things, but usually likes them when he does. He often says to me that he is worried about trying something, but that there's a good chance he will like it because I usually pick good things for him and he trusts me. But he still seems nervous and negative about the new thing until we get started. And then after he tells me how silly he is for doing it again, thinking he won't like something just because it's new and ending up loving it. He also does not cope well with stress at all. He is not generally a worrier, or if he is, he doesn't express feeling worried.
So, if anyone has any experience with mood disorders, does this sound like one? I know depression can look very different in young children and that irritability is a big thing to look out for, but it's also a symptom of just about everything for kids his age! The docs put him on prozac when he was 4 to treat suspected anxiety, but after a few months it made him totally crazy and manic and I took him off of it. It always seemed to me that all of his mood symptoms got much worse after the prozac, so I feel guilty about giving it to him, like I ruined his emotional brain somehow... but maybe he would have had that crazy episode even without it? He never even got up to the therapeutic dose because I saw enough improvement where we were at to want to stop there. He had been kicked out of 2 schools that year and we were looking at number 3, which is the only reason I relented and tried the medication for my little 4 year old. It's so hard to know what to do when your kid is failing at life and all the pressure is on you as the parent to do something about it
A year later at 5 we tried tenex to help with the adhd and tics, but it had the opposite effect, it made him so unhappy and miserable and not himself that we had to take him off of it. It also affected his ability to think. He could no longer do complex calculations in his head and seemed to lose interest in the more cerebral activities that he had up until that point really enjoyed. When I brought up the obvious brain fog to the docs they said it was great, he was more like a normal kid!
Up until this past week DS has been doing great. He just had a birthday and really enjoyed his party. His school is doing a wonderful job with him. They use the 1 on 1 to give him his differentiated curriculum as well as to be there in case he needs behavioral help. He is actually learning there and filling in some gaps in math. He loves school! They have him doing fifth grade reading and math, but he's still in class with 2nd graders. He even gets gifted pull out, which doesn't normally start until 3rd grade. I didn't even have to ask for any of this! He's even doing all of his own writing now. Turns out having someone scribe for him helped him gain confidence to take over and do it for himself. His teacher says he is now the top writer in the class and does amazing work for a 2nd grader. This is great because writing had been such an area of concern for so long! He doesn't have any friends at school, but he has good friends outside of school. Some friends are from his old gifted school and some are the kids of my friends, all are above average intelligence to highly gifted and I think that helps DS to get along with them. He often tell me that he knows that the kids at public school don't have any interest in playing the way he plays, but that it's OK because he would rather play his games by himself than play games he doesn't like with the other kids. His bestie loves the game they play, which is just an ongoing imaginary story in some crazy made up science based fantasy land. DS also loves to play board games and card games, but usually he plays with adults as he likes games designed for older players that have rules too complex to learn in one kid sized gaming session. He plays different things with different friends, so he doesn't just play the same thing all the time. He tends to do best with 1 or 2 kids at a time and really enjoys his time with his friends!
He was doing so great! But this thing, whatever it is, is still with us and causing serious problems at school right now. Any ideas/insight would be greatly appreciated!
