Has anyone solved the escalating meltdown problem (teen AudHD)? Need hope/advice.
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Anonymous
https://pmc.ncbi.nlm.nih.gov/articles/PMC11001629/ https://sachscenter.com/autism-vs-borderline-personality-disorder-bpd-in-women/ |
Anonymous
Oh that’s helpful. Thanks. Also, “17 years of escalating behavior on meds” is completely inaccurate. If you read through the posts. But yes, the fact that this has been happening with varying frequency over the years and is still happening at 17 means we need to look at how we’ve been reinforcing this behavior, consider meds again, and consider whether this may be something beyond the typical disregulation of ADHD and Autism. One of the most confusing thing about this is that there are long periods of time where this doesn’t happen at all and I think it’s over for good. It was definitely not as extreme on meds, but the other side effects were as troubling. And it’s been a year since she’s been off the meds. Until about 2 weeks ago, she had done this once or twice since then. |
Anonymous
Another one: https://www.liebertpub.com/doi/10.1089/aut.2023.0031 |
Anonymous
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OP I think this comes from built up shame of diagnosis and realizing they aren’t “normal” and maybe going off meds helped normalize her because yes, med roulette makes them feel like experiments. And I bet a lot has to do with how you parent her to reduce these episodes. I know it does for us and when I try to be hard nose (it’s the real world, I’m exhausted of coddling etc…) and episode can occur.
Also, for my DD she tries so hard to fit in - instead of working on how best she can work a situation that is healthiest for her. And she has triggers that she will avoid and suppress until it gets to a breakdown level where she has no control. And there is a lot of trauma in the shame and wanting to fit in and then blurting out something you shouldn’t. And replaying it in your head and hating yourself for it. I think your best bet are teen group therapies and maybe some EMDR therapy to reduce trauma. I also think a camp before she goes off into the real world. |
Anonymous
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OP, I have an 18 boy with anxiety, OCD, and ADD inattentive. He’s on medication and is doing pretty well taking Luvox (anxiety/OCD) and Focalin (ADD).
Over the years, he’s struggled with terrible outbursts. We call them meltdowns now - he’ll have some kind of trigger that gets him in an anxiety or shame spiral and he’ll cry, scream, bang his head, pull his hair, etc. All his harmful behavior is self-directed but it’s very upsetting for me to witness. When he was younger it felt impossible to deal with - nothing I said seemed to calm him down and trying to restrain him from self harm only made him more upset. It would take him getting physically exhausted to begin to calm down and I’d spend a while cuddling him and reassuring him. What helped him most was his friendship and relationship with another ND kid - she is his safe person and vice versa. They help each other through challenging times but every now and then something can happen when he can’t reach her to talk things through. So when he does have a meltdown now, I’m able to remind him of all the people who love him including her. He can usually cry it out for a few minutes and talk to me. It’s a huge shift from before and he’s learned how to cope by talking things over with her or other trusted friends. I’m an option further down the list but he knows I’m always available. During her good days, I would encourage you to discuss coping strategies with her to come up with some ideas to trial. If she feels like she needs a physical outlet, could she hit a punching bag or pillows? Exercise like running or boxing could also be a way for her to release those feelings. If she feels like she needs someone to listen, are there options through your insurance or health providers where she can reach someone on call or a helpline? The excessive texting seems like she was looking for an off-ramp and just kept spiraling when she couldn’t connect with you. I’m sure you’ve heard all these suggestions before but just wanted to share what’s worked for us and that things can get better as they get older and learn more. Wishing you all the best! |
Anonymous
You mentioned the details of her recent outburst and I wanted to also share how I deal with it for my boy. Anxiety and OCD can make him take things from 0-60 in seconds if I can’t help him regulate. —— It started with her asking me over text while I was at a meeting to take her to the doctor because she thinks her vocal chords are strained (as background, her vocal chords are strained from her last meltdown a week ago and she's a singer so she is very anxious about it). I replied that if her voice isn't better in two weeks (and gave a date) I would take her, but that I think she just needs to rest it a while. —— For the scenario above, I would recommend trying to accommodate her request with a built in off ramp. “Yes, we can schedule an appointment when I get home. In the meantime let’s try rest and some tea. If you start to feel better we can always cancel the appointment. Does that sound like a good plan?” She needs to feel like her concern is acknowledged, respected and addressed appropriately. And you’ve offered a cancel option so once she’s past the crisis moment you can touch base and agree to keep the appointment or cancel. I’m not trying to sound like my family has it all figured out - we still have our moments too! But I do think involving my son in the planning for addressing a problem has been a huge help in avoiding spirals. |
Anonymous
| I really think you need to consider meds again before she turns 18. How has her psychiatrist not considered a mood stabilizer? |
Anonymous
Mood stabilizers are very serious drugs with serious side effects. They’re not for a kid who is able to control this behavior in public settings, has 6-8 month reprieves, and is sensitive to side effects of medication. |
Anonymous
We tried Abilify a couple of years ago when this was happening more frequently, and she woke up at 2am every single night unable to fall back asleep. We considered Lamictal but the potential fatal rash was something I’m not willing to risk — she isn’t all that body aware so I was afraid we’d miss it. Other mood stabilizers have not been considered because this behavior comes and goes and seems to be a more learned/reinforced behavior that one attributable to a mood disorder. |
Anonymous
Sure. but the level of violence OP is describing is not sustainable. If it ramps up she may have to kick her out of the house or call the police. So at a certain point, you try the meds. |
Anonymous
Lamictal and/or Latuda are actual great options for teens like this. |
Anonymous
Abilify is the worst one to start These are not learned/reinforced. She has a lot of sensory/mind stimulation she can't control. Sounds like a ton of anxiety mixed with ADHD and not have the coping mechanisms to work thru it. Just letting it go without trying a calming medication is kinda crazy. Her mind is probably spinning all the time and trying to control the outbursts more as she gets older but it's debilitating. She needs help |
Anonymous
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Hi OP, lots of good advice here (and some not so helpful).
We did DBT and it was helpful in so many ways. Her finding her strategies and the dialectical thinking “I can both need to go to Dr and Mom can’t do it right now” she develops will help. It does take time. Other than that, Ross Greene and the Plan B method are excellent. It gives them a sense of control while working in the confines of what works you. And other than that, I’d focus on connection as much as possible. It’s hard at this age, but it’s important that she feels deeply loved by you despite the behaviors. I personally think the reason these things go in waves (at least for our son) is that something started for whatever reason, but often tied to other stressful events in his life, and his own shame and disconnection from us puts him in a vulnerable state. So “fill the bucket” as much as possible I’m sure it’s exhausting. Hang in there |
Anonymous
And the right med can give her the 1/2 second she needs to not act on the impulse and even recognize the rage in her to do something about it |
Anonymous
You need to give back your degree if you determined this without testing or treating her. You’re making huge assumptions and it’s unethical for a professional, which I doubt you are. |