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Teen's Morphing Flares?


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Hi Everyone,

 

Have been gone from this forum because we had been doing quite well. Well, we are back. Long story short. History of PANS since age 7. Treated with antibiotics and did well.

 

Seventh grade was rough right around puberty. Started flares every month with sinus infections. We discovered he had elevated tissue transglutaminase and thus we eliminated gluten and dairy with great success! Eighth grade was okay with only about 3 more milder flares.

 

This summer and again with the start of high school (a whole new germ pool), we've noticed a change in the "flare," however. It used to be classic abrupt, increased urination, dramatic OCD, terrible brain fog,...the usual.

 

But now, the last two flares (including this one which is severe) is more bipolar in presentation because the last two have been preceded by a few days of higher energy, ADHD type days prior to the dramatic flare. He had a cold last week and now another one this week. The current flare is food refusal, off the chart anxiety, OCD (checking homework over and over and over again), trouble sleeping and worrying about trouble sleeping. His face changes. He has trouble putting sentences and thoughts together. His ability to process information is slowed to a snails pace. What would normally take 5 minutes is taking an hour. It's extremely scary as you all know. My child completely changes.

 

My impression is that most mood disorders are probably autoimmune and inflammatory in nature and so I'm not too concerned with what to call "this."

 

But I was wondering if any of you with older kids saw a change in the patterns, with or without a degree of "hypomania" (higher ADHD type energy) prior to a big time flare?

 

(am quite sure with the start of high school his diet lapsed and the exposure to new viruses are responsible for this bad flare that we are in.)

 

 

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Yes, we definitely saw that with our DS in high school, as well. I tend to think it's partially developmental and partially because, as our psych explained it, the "dissonance" between "normal, acceptable behavior" and these flare behaviors tends to grow as a child gets older because of societal and peer pressures. What might've been more easily excused or accepted in terms of flare behaviors in a 10-year-old is less acceptable in a 15-year old, so it looks "more odd" coming from someone at that age.

 

We found some additional help during these flares from three supports: 1) taurine supplements; 2) zinc; and 3) lamictal (or lamigotrine). The taurine helped his executive functioning so that he could focus on a series of tasks and not lose his place as he moved through, say, taking a shower or getting dressed. The zinc we've continued because it has some anti-ADD/ADHD properties and he's somewhat zinc-deficient to begin with.

 

The lamictal was a different animal and tougher decision since it is a prescription med, but our psych felt strongly that it would help him, so we decided to try it; it did, indeed, help tremendously. Its an anti-seizure med that has glutamate-modulating properties, and his behaviors certainly suggested some excess brain glutamate mucking up his processing abilities. It didn't eradicate the OCD or anxiety, but what it did do was make it possible for him to get less worked-up about it and "spin out." Instead, it gave him the ability to be a little more objective about some of his obsessions and/or compulsions and to be less volatile when he was coached to "move on" or refocus.

 

You've been on this road for a while, so I know you'll get through this. Hang in there!

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