My 10 Yr Old Niece Had A Phychotic Breakdown Last Night- I Am So Sad

Specialties Psychiatric

Published

Hi,

I am writing this here to use as a sounding board. I know you will understand. I am still completely in a state of shock & heartache.

My niece (Becky) is a very bright, sensitive, loving, & sweet girl. However, she has been diagnosed with severe ADHD since she was three years old.

She has been on all types of medications (sorry I can't recall the the names of all of the medications she has been on). I do know that she does take Klonepon (sp?). The problem is that the medications have caused her all sorts of problems such as severe ticks, or loss of memory, lack of sleep etc. She started a brand new medication last week called Steraterra (50mg).

Last night all hell broke loose! I received a frantic call from my sister (her mother) who said to come over to their house ASAP. (she is going through a divorce & couldn't locate the father at that time). I could hear Becky SCREAMING in the background "help me help me help me" "I am going crazy, I can't walk, I can't see" and hysterically crying. I told my sister to call her phychiatrist immediately and let her know what was happening and what she needed to do.

I arrived 40 minutes later (that's the distance we have from one another). At that time, her father had been located and she was curled up in her father's arms. However, she was still hysterically crying, grimacing, & curling her toes. She indeed could NOT walk & was having a hard time swallowing. She was also hallucinating (kept thinking people were staring at her, thought I was a child, saw spots on my sister's face & was very dizzy). Her phychiatrist called back & said this was a bad reaction to Steraterra & called in an order of haldol.

Now what really broke my heart was Becky's insessant crys of anguish. She has many personal issues that she is overwhelmed with.

She is blaming herself for her parent's impending divorce (classic). She is convinced that her father is going to forget about her & her brother. She is also distraught over the recent passing of her beloved grandmother (my mom). She gets picked on at school ( I hate those bullys!) because she wears glasses and can't concentrate. She thinks she is ugly (and she honestly is a VERY pretty little girl). In addition, she said she feels like she is a slimy alien.

We kept hugging her, kissing her, holding her, letting her know that she will be alright, soothing her etc etc. When I left about 2 hours later, she was still crying, but the haldol seemed to be starting to work.

When I called my sister this morning, she sounded like crap! She doesn't know what to do. She was calling back the phychiatrist for further instructions. I told her Becky definetly needs either family & or individual counseling, plus a GOOD antidepressant. My sister wants to take her off all adhd medications. However, when I spoke to Becky she said she felt much much better, but still dizzy.

Anyway thanks for reading this. If you have any advise, please let me know so I can pass this onto my sister.

Thanks

Jules :kiss

Dear Jules,

I know exactly what you are going through right now...my case is somewhat similar. I had four miscarriages in my forties and have no living children of my own. I do have an eight year old stepson who I believe has bipolar disorder. My husband and his mother were only together for eight months, but she has made all of our lives a living hell. I have been married to my husband for four years.

My stepson was losing five pounds of weight between two week visits, claimed there was no food in the kitchen and that he was not allowed to go into the kitchen, he claimed that he had to wipe his feet off before going to bed due to all the filth there, he is not allowed to have children over to visit nor is he allowed to go to other children's home to visit...his mother has not worked his entire life and has another child by a previous husband. How she lives on our child support only and sends two children to private school, I will never understand.

I have reported the mother to the principal of two different schools, reported her to a psychiatrist who suggested that I contact a psychiatric hospital in the area and did so, I have gone to court and witnessed the judge telling the mother that she had to move back to the town where she was living and allow my husband and I to monitor her more closely-and if she did not, then she would lose custody.

This past weekend, my stepson did not arrive for visitation...and nearly every visitation, there is some attempt by his mother to sabotage those visits. When I spoke with my stepson on the last visit regarding his feelings about me and his father, he broke out in such anger at my husband for not liking his mother and the fact that he could not even stand next to her much less talk to her. I was aware at his anger toward me, but not toward my husband...and I informed him that even if I died today, his daddy would not be with his mother again and he would have to accept that too. He began to spill his guts with his face showing all kinds of expression, he yelled, he trembled, he cried, and he got into a fetal position...honestly, he looked very much like an inpatient psychiatric child. My heart was broken for him and I informed him that I appreciated him having the courage to share his feelings with us...which made him pleased too.

The thing that I will never understand is that his mother cannot even meet basic care needs for this child, but he adores her...not having children of my own, I can only speculate that this is a strong bond between a mother and son. Regardless of the fact that he knows we take much better care of him, he wants to live with her...and quite honestly, I want him there too, but I do want him cared for...it is a very sad situation indeed and we have sought psychiatric care for him which his mother will not follow up on...she won't even treat him for allergies that we had diagnosed and bought the medicine for him.

So, this is what I have come to believe about the State of Indiana...it is difficult to find anyone who cares about the vulnerable elderly and children of their state. I have only lived here for four years and if I could leave in ten minutes, I would...but, my husband wants a relationship with his son so for now, we will remain here. In the meantime, I will continue my fight for the vulnerable elderly and my stepson....nothing more that I can do at this point....

I realize I have no answers for you, but I do empathize with you and May God bless and comfort your niece and family.

Barbarb

Specializes in Critical Care.

Jules

I am so sorry for your niece. It sounds like she has a long road ahead of her. Any chance of switching schools? Is she too young for contacts? I know that sounds trivial, but if it might improve her self worth it's worth a try.

Noney

Specializes in Critical Care.

Barbara

This isn't intended to be a flame. I sense some hostility on your part towards your stepson. It's as if you are just doing your duty. Perhaps he senses this also. Believe me (I'm speaking from experience) a child knows if a stepparent resents him. Perhaps you don't, if so I apolagize in advance.

Regardless of the fact that he knows we take much better care of him, he wants to live with her...and quite honestly, I want him there too, but I do want him cared for...

I have only lived here for four years and if I could leave in ten minutes, I would...but, my husband wants a relationship with his son so for now,

Noney

Jules,

I don't know if it is possible in your niece's area but an inpatient admit to a pediatric psych unit to get her off of all of her meds and re-stabilized might be a good idea.

I'll be thinking about you (& your niece)

-nancy

Jules,

I empathize for you, your sister adn your neice.

I agree with Nanacy, an in-patient stay for stabilization of medications seems to be warrranted. I work inpatient child/adolescent psych, and we see these types of cases on a regular basis. Probably only needs a few days to become stabilized.

Barb - I think you undersestimate the citizens of the state of Indiana (my home state, by the way). Have you reported your concerns to child protective services? Funding is down in all states, and if you think the child is being neglected, make the call - after all, you are a mandatory reporter (not tended to inflame)

chris

Chris,

I have reported the child abuse, yes...I am a mandatory reporter, but even if I wasn't, I would have taken action. I also reported another nurse with four children for abuse-this was after three years of attempting to help her and her children...she was committed for five days to a psych hospital after she had voluntarily checked in, but she still has her children. So, obviously my experiences in Indiana have not been good ones in regard to children and I won't even go into what I have seen with the elderly...other than to provide ONE example...I reported elder abuse in Nov 1999 as a DON and that investigation just got settled.

I am not clear as to what part of Indiana you have lived in and perhaps there are other states that have many of the same concerns, but these experiences and the manner in which they have been dealt with are new to me. Trust me, I am not angry by your reply, but I do see major differences in various parts of the Midwest. Btw, I am actively attempting to involve politicians to affect changes in health care here and perhaps you have some suggestions.

Noney,

I respect your opinion and observation...after four miscarriages, the culmination of those losses and seeing that women like my stepson's mother can have children, I was very hostile...but, I chose to seek help for those feelings and I am very glad that I did too. I knew that I resented her and not my stepson but I wanted to ensure that I was not transferring those feelings to him. Also, a stepmother knows if she is resented as well...ty for your response.

Jules,

After rereading my post and others, I realize that I should not have posted my personal situation. I guess I needed someone to listen to my pain as well and I apologize for taking away from your niece's experience. I do hope all has worked out for her by now.

Good luck,

Barbara

Specializes in Hemodialysis, Home Health.

Oh my. How terribly traumatic. I'm left without words. Only deep feelings of empathy and a desire to reach out my arms to wherever all of you are and embrace each one of you in a long, warm, heartfelt, and reassuring hug. :o

I agree that your niece could probably benefit from an inpatient admission to get stabilized and get her meds adjusted. I would suspect that if she's been diagnosed as severely ADHD she might actually have bipolar disorder, and would be cautious about using an antidepressant without a mood stabilizer first. She also needs to be monitored carefully for EPS symptoms today. We generally don't use Haldol on children and when we've gotten adolescent admits from the ER who've been given Haldol, almost every one of them has wound up with EPS.

Barb, your statement about the woman who you reported disturbed me. You said she had a 5-day voluntary psych admission "but she still has her children." You're seeming to imply that because she has a mental disorder she shouldn't be allowed custody of her children. I'm sure there's more to it than that and am not asking you to justify your statement, but it did sound like you were saying she shouldn't have her children if she's been admitted to a psych unit.

As for your stepson, yes, children do love their parents regardless of neglect and abuse. At eight, he probably doesn't think that his mother's treatment of him is unusual. Why don't you start your own thread and tell us about your stepson and why you think he might have bipolar disorder (Sounds like his mother might have a DSM diagnosis for sure)?

luci

Jumping in late...

If it hasn't already been done... I would definately consider an impatient admission for med management.

I don't beleive d/c of all ADHD meds is a good idea. Not for severe ADHD. I would want to R/O some other things, though.

She is very young, and needs to get a good understanding of what is going on in her life. She also needs to be able to do this, without medications altering her thinking to such abnormal levels.

In the end, best wishes to your niece. She has a long road ahead of her. Hopefully with good support, she will see the love that seperated parenting can bring.

David Adams, ARNP

-ACNP, FNP

I work on an inpatient adolescent psychiatric unit. We are the state hospital for children ages 7-17. The average stay for kids in our program is 4-6 months after they have exhausted community resources. The idea here is to keep the child in the community and to try everything possible before placement. Typical community resources would include outpatient therapy, intensive on-site (in your home or at your child's school) therapy, case management, and medication management. Normally a child has a history of crisis stabilization unit admissions before they qualify for admission (in addition to the outpatient services mentioned above). These children are generally a danger to themselves or others and cannot be maintained in the communtiy.

Without a doubt the family would benefit from family therapy and your sister would benefit from her own therapist. I would also suggest a support group for your sister as well. I hope this information helps. Good luck.

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