Thursday, September 9, 2010


I need help.  Lots of it.  I'm in the midst of a crisis with M2.  Not that this is anything new, of course, but here I am again.  The great Circle of Crises.  Pass the Mike's and the chocolate - time to dig back into the trenches.

My baby is growing up, which does contribute somewhat to the mental mess that I am this week.  She came home from school yesterday toting this:

I discovered this was loose about a week and a half ago.  I thought it had a month to go before it came out.  With M1, it would have taken that long because he wouldn't dare touch a loose tooth.  Even the dentist, last time we were in, commented on how loose his tooth was and proclaimed that he'd never seen a tooth that loose that didn't fall out on contact with any solid substance.  M2, on the other hand, is a different species.  I knew this, but I still couldn't have predicted the enthusiasm with which she attacked that tooth.  Within a week, I had narrowed it down to "it'll be out in a week or two," and by Tuesday afternoon, I told her violin teacher, "It'll be out by the end of the week."  So I wasn't entirely surprised when she came home Wednesday afternoon and told me she'd been bored during naptime and yanked the tooth and it bled a LOT and she got to go see Miss Gayla to get her necklace.

I suspect this boredom during naptime may be related to the purported vomit session during naptime today.  Nobody saw it, nobody smelled it, and she's as healthy as a horse, but she got out of naptime and got to go to the office again and people made a fuss over her.

I may be the only one who suspects this particular scheme, and I may be way out in left field with it, but she's not above it.

Which brings me to the real, honest-to-jeepers reason I need help.

We went and visited her psychiatrist last week.  After the whole rigamarole with The Scheduling Queen, I don't think they dared to move me again.  So we got in and the doctor gave us several options ranging from doing nothing to doping her up with lithium.  Since the doctor was still fairly well convinced it was anxiety, I decided to give that diagnosis a fair shot and try an SSRI.  I mean, honestly, if the diagnosis really WAS anxiety, that'd be lovely!  Much better than bipolar.  Easier to manage.  Something I have experience with and can work with.

He prescribed her 5 mg of Lexapro to be started last Saturday.  The main side effect we had to worry about was mania because in many children and adults with bipolar, SSRIs can actually cause manic episodes.  We headed out of town on Saturday with the girl trying out the new medication.  I don't know about Oz, but I was holding my breath and hoping against hope that she'd be a new child and settle.  She was overly excited on Saturday at the Science Museum and pool, but it was the first day on the med and she had been manic all week, so this wasn't anything out of the ordinary.  She wasn't bad on Sunday - a little silly, but nothing horrid.  My grandmother thought she was normal.  (Yet another reason I like that woman.)  Monday was a day off, and we did yard work.  Then she dismantled her room and bounced and bounced and bounced.  Tuesday she went back to school, had a violin lesson where she did tolerably well, came home and bounced and bounced and bounced.  But no tantrums.  I thought I was raising Tigger!  Yesterday, she thought about having a tantrum, but it didn't happen.  Still bouncy.

Today... *sigh* and we're back to square one.  Still bouncy, but throw sassy and kicky and shrieky and tantrum-y back into the mix. 

Now, I know the meds - IF they are going to work - wouldn't have had time to really kick in yet.  If there is an anxiety component to all of this - and I won't deny that there is probably some separation anxiety in there somewhere - the Lexapro won't really kick in for at least another week or two.  We do go back on the 22nd, assuming The Scheduling Queen doesn't get a bee in her bonnet again like I strongly suspect she might.

However, the doctor had said the side effects were likely to show up way before the effects of the medications.

The question now is, do I e-mail the doctor and tell him that the manic episodes are worsening?  Do I wait it out another week and see if it gets better?  Do I dare mention the new symptoms that are arising with this new week?  Do I dare continue trying to implement any sort of therapy?

Right now I'm trying to implement a feelings chart where she circles the faces of all the feelings she has to see how *she* interprets her feelings on a daily basis.  I've also got a sheet with a stoplight on it that would be a forerunner to therapy (stop, think about it, talk about it, calm down, then act).  But she used them for all of 45 minutes today.  She circled three different feelings in that time frame, used the stoplight as a manipulating tool to talk about random stuff (disjointed thought processes may be part of her mania), and then completely refused to use them as soon as she was truly good and mad.  I'm going to try to keep at those, I think, but I'm still not sure what else to do.

Any thoughts?

Cute as a button, especially with the gap in her teeth, but yeesh.  I'd love some advice on this one!


Mom on the Verge said...

If you can stand it, I'd stay with the Lexapro for the full two weeks. She may be a little wild, but as my sister says, "Worse things have happened." You won't know if the Lexapro works until you try it for two weeks.

When I'm doubled over with doubt, I try to ask myself, "Has this EVER happened before?" Aaaand the answer is usually "yes".

We tried The Boy on one of the ADD meds, and his hissy fits turned into uncontrollable rages. For THAT, I stopped meds.

You know best. Also, you probably need to go out for a beer with buddies. Unlike me, I'm sure you have some!! ;)

Sarah said...

Thanks... I don't know that I need to get out, but I do need to remind myself that at least her tantrums aren't getting worse. Deep breaths!