If
you wish to return to the 'Ask Dr. Dunc.' mainpage, please click
here
If
you wish to visit the 'Ask Dr. Dunc.' question archives, please
click here
Question
96: My son was diagnosed with full blown TS and symptoms
of ADHD and OCD when he was 6 yrs old (now 7). He also experiences
bouts of rage and when he is emotionally "hurt" he will
verbalize the desire to do violent things. I don't really believe
he would ever do what he comes up with but...he is currently on Luvox
and with the more recent light shed on the possible conection with
odd behaviors and SSRI's I'm seriously reconsidering giving him the
med. His rages have greatly decreased since his diagnosis but I think
that has more to do with our acceptance of him and his natural developement
than any med (in the last 11 months he has been on Clonidine, Respiradol,
Serequel (2 wks), and now Luvox (in that order). We fired the first
psychiatrist we were with as we by this point had more knowledge of
TS than he did and now find ourselves on at least 3 different waiting
list to get our son some help. In the mean time I can no longer tell
if the medication he is on is doing anything or if it simply the wax
and wanning of the disorder and seriously the more I read about the
medications he is/has been on the more confused and frightened I get.
The next suggested med (via the pediatrition) is concerta in combination
with luvox. But not one physician has ever talked to my son about
what he feels/experiences so how do they know what is the disorder
and what is his lack of understanding and frustration with the disorder?
Please send me some feedback on the direction I should take now...I
feel like I'm drowning in confusion. Meds or no meds? that is the
question. Sincerely, D.R.
Good morning D.R.:
While I cannot counsel you on the medication question, or comment on
your son without even ever meeting him (it would be both presumptuous
and very unethical of me), I CAN say, in general, that your thought
about lack of understanding the disorder is a valid one and can certainly
can lead to frustrations as you mention -- to predict something or control
it with any strategies you need to first know the 'face of your enemy'.
If the physicians are unable to perform this function (i.e. a thorough
demystification), I think that additional resources are a wise move
-- I have many listed under the Resources
section of my website. Whether they be videos
for him to watch, books to read/have read to
him, going to a Psychologist, or going to a presentation
(many children come to mine, for example), any or all of these routes
will be helpful. These decisions can be made independently of the decision
to medicate or not -- some find that learning about the problem is sufficient
to find detours around it, some do medications in concert with this
education, others go the route of meds alone.
While of course he does have differences due to his conditions, much
about rage can be explained as a 'natural reaction to abnormal circumstances'
-- in other words, given the extreme and unique and misunderstood pressures
he is under and the circumstances he faces on a never-ending basis,
it is not surprising that he reacts as he does. Anyone would. It's simply
a matter of understanding this, and understanding the more non-intuitive
aspects of living in these disorders. In fact I have a presentation
on this very topic: "Living IN Disorder", because that empathy
is vital to not simply dismissing these kids with diagnoses assuming
volitional misbehaviour such as Oppositional Defiant Disorder and Conduct
Disorder.
Thank you for your question D.R., and I hope that this helps!
