14 year old boy, anger

[brink]

Hi Everyone. It's been a couple of years since I've been on here as we had our son's Tourette's and behavior fairly under control. Well, needless to say, he's hit puberty and at 14 years old, he's taller and stronger than us. He's so very full of anger and swears at us (not allowed, and not a tic). He was also diagnosed with Aspergers, but it seems to be on the brink of it, rather than full fledged. We are at a loss as he is starting to have his rages again and we cannot physically control this, without both of us holding him down.

 

Is there anything any of you can recommend to us to get through this difficult time? I know many of you can relate, and many of you now have older TS, Asp kids.

 

Thank you in advance.

[MomWithOCDSon]

Hi --

 

My DS, now almost 16, went through a tough time at around 13-14, also. At 12-13, he received an Asperger's dx from two docs, but they have since opined that he no longer fits the criteria and have removed that dx. Still, he's always been a little "quirky" . . . marches to the beat of his own drummer, if you will.

 

His comorbidity in the past, however, has been Asperger-ish combined with OCD, rather than TS. I do think puberty and the need to start to feel independent and in control contributes to the behaviors and the conflicts, especially with parents. Ultimately, though, we found out that our DS was also impacted by an auto-immune response to strep (almost an allergy, if you will) that contributed to an explosion of these behaviors at the age of 12 (PANDAs); once we got that under control, the behavior started to settle down and return to where he was before -- still a little quirky and faced with some OCD behaviors, but fully functional, happy and reasonably compliant. I'm just wondering if you've investigated the possible role of infection and/or auto-immune response in your comorbid child, since it sometimes gets misdiagnosed or goes undiagnosed altogether?

 

Anyway, assuming that you've ruled out any other possible health impacts on your DS's behavior, I might suggest one or two things: 1) Ross Greene's book "The Explosive Child" has some great tools and techniques for conflict resolution that work even with older kids. Basically gets everyone -- parents and kid -- to "buy in" to the process and come to concensus, lessening the need for rebellion and improving communication. It worked great for us in those bumpy 13-14 years. 2) I don't know if Lamictal is ever recommended for kids with TS, but being prescribed this medication began a true turning point in our DS. It is an anti-seizure medication that is also supposed to be a glutamate modulator, and it almost immediately helped our DS to view issues from a less emotionally-charged place . . . to step aside and evaluate a situation and himself without holding on so tightly to that outsized sense of "what's fair" that he had a tendency toward and that underlaid so many of his arguments with DH and me.

 

A few thoughts. Hope things improve for you soon!

[dcmom]

Hi Brink- I totally feel for you. I am not in your position (2 younger dd's with pandas/ocd)- however I have envisioned myself there many, many times. During my younger daughters worst episode (she was age 7- and tiny for her age), we also had to hold her down to keep her from hitting and/ or running away. Not memories I like to think about- but it has always made me wonder what happens if this goes on when she is full sized?

 

I will second what mom said above- have you looked at pandas/ pans or an autoimmune connection? Especially if you have seen or are seeing a big change that doesn't seem right. We are also able to "treat" our kids medically, and see them live pretty normally. A few weeks of steroids over a years time. Anger is a HUGE pandas red flag in our house. Mostly, my girls are happy, respectful, cooperative kids- but, when we start seeing temper tantrums or rude/nasty behavior- we know something is up.

 

Whether or not that pans out for you, I would also suggest some intensive therapy. At 14 (and full size), my worry would start to be time. You want time to help him get this under control prior to adulthood (legal adulthood) and even a driver's license. I highly recommend the program at the Rothman center at University of South Florida. Now, they focus on ocd, and know a lot about pandas, but I do think TS is also a specialty, and I know they do wonders for behavioral issues. It is a three week, one hour per day, outpatient, therapy program. It is one of, if not the, best things we have ever done for our kids (and we have done a lot). Dr Eric Storch is in charge, and you could contact him and discuss your son. He will be very up front as to whether their program is a fit, and if it is not, may be able to make some suggestions. He is a wonderful person and doctor.

 

Good luck!

[TOaksMom]

Hi Brink,

 

Last month, my 15 DD and 18 DS were recently diagnosed with Lyme and co-infections. Like yours, a year ago my son was diagnosed with slight Aspergers too. My daughter has the tics, OCD, and rages. The doctor thinks that their Lyme is congenital and I have tested positive. Bartonella is the co-infection that causes the most psych symptoms and includes the rages. After two weeks on bactrim and azithromycin that was started at the beginning of December, my daughter's rages which were so bad that the neighbors called the police because she was screaming so loud and for so long and we wanted to commit her to a psych hospital, stopped and haven’t returned. I put her on that combo in desperation before the Lyme tests came back and it was what I had available in the medicine cabinet. Our Dr. later told me that bactrim targets bartonella. She is now on rifampin which is better for bart.

 

So I thought I'd share my experience with you. I know what it is like to not know what is wrong and every doctor you see sends you to the psychiatrist for psych meds which don't work. I have found that this article does a good job at explaining Lyme and the symptoms. The funny thing about bartonella is that fleas, sand flies, and mosquitoes also carry it as well as ticks and there are 8 species known to infect humans. The tests available are expensive and aren't that accurate so it is helpful to find an LLMD who can make a clinical diagnosis.

 

Here is the link to the full article: http://naturalnutmeg.com/?p=1677

 

Here is a part of the article that discusses the symptoms in children. Note the sentence where it says that they may be misdiagnosed with autism.

 

Are the symptoms of Lyme disease in children the same as they are in adults?

 

No. Most frequently the symptoms of Lyme disease in children look quite a bit different than in adults. Children under the age of 15 account for 25% of reported cases of Lyme disease. While some children present with the more common features of Lyme disease in adults many of them present in ways that are much different than adults. Many children develop sleep problems, including nightmares. New onset bedwetting may also develop. Daytime urinary frequency is often seen. Some children present with odd skin sensations, others with discomfort when being touched. They often complain of headaches that can range from mild to debilitating. Commonly, children present with isolated neuropsychiatric and gastrointestinal changes. This makes the diagnosis of Lyme disease in children more challenging as well as more crucial.

 

Neuropsychiatric changes can range from mild to downright scary to parents and teachers. Children may experience acute changes in personality, abrupt behavioral changes, uncharacteristic outbursts, and trouble tolerating their normal environment. Some children have outbursts of rage; this is often directed at one family member or schoolmate. Children may also have problems with speech and motor skills leading to rapidly declining grades.

 

Difficulty in processing auditory input or changes in the ability to focus with the eyes often appears as a lack of focus leading a child to be misdiagnosed with attention deficit hyperactivity disorder (ADHD). Some children with Lyme disease develop problems with sensory integration and have a difficult time focusing when they are exposed to multiple stimuli at once. This leads to confusion and, in turn, poor behavior.

 

Happy children may become irritable and sad. Children may have an abrupt change in their mood to the point they are depressed, anxious, psychotic, and even suicidal. If this is the case, it is important to consider Lyme disease as well as co-infection with Bartonella henselae. Some previously outgoing and gregarious children become withdrawn or reluctant to play. Children may develop odd, repetitive behaviors and/or tics. When several of these symptoms are seen in the same child, they may be misdiagnosed with autism.

 

Children and adolescents often exhibit Lyme disease symptoms in the GI tract. These include abdominal pain, heartburn, nausea, vomiting, diarrhea and blood in the stool. Gastrointestinal Lyme disease may mimic colitis or Crohn’s disease. Small intestinal bacteria overgrowth may be present. H. pylori are frequently resistant to treatment if Lyme disease is also present in the GI tract.

 

Good Luck!

[tpotter]

I would check for 3 things:

 

1) Mycoplasma Pneumonia

2) Bartonella

3) Babesia

 

 

 

MycoP is walking pneumonia, and Bartonella and Babesia are tick-borne diseases (sometimes called co-infections of lyme), and some people are beginning to believe that mycoP may also be tick-borne.

 

All 3 can be responsible for causing rages. Both my children have all 3 along with other issues. BTW, my older son is also dx with Asperger's, but I believe that it was probably PANS all along. Definitely got worse in mid-teens. Tx for all 3 above helped tremendously.

[nicklemama]

I somehow missed this posting. I agree with all the above. DS age 9 has raging. He's been diagnosed with PANS, ehrlichia, anaplasma and babesia. He had mycoplasma pneumonia in Nov and that set things off again. Treatment has helped him tremendously. When all this started at 5.5 yrs of age, we were told he had aspergers. He no longer has those symptoms since we started treating his infections.