[PinkandBlue]

Hi, I'm new here and so glad to find you all. I'm single mom to 14 y/o girl adopted three years ago. She began stealing from me and at school and raging when I gave her consequences at home for unacceptable behavior, right after the adoption court date. She has had many psych hospitilizations over the past year, and 4 in the last two months. She has been on a downward spiral, especially for the last 2 years. She has been expelled from school for theft and taken to jail earlier this year. She also began cutting in November, and threatens to kill herself (had one attempt at age 8 during a rage) to counselors, school administrator, in group, and to me. She provokes physical fights with me now, hitting and throwing things at me. I've had to physically tackle her before to keep her from destroying in the house/hurting me or her.
I have called 911 and have police reports for the rages when she becomes dangerous to herself/me. I do not feel that either one of us are safe alone in my house now, until she gets help. The one-week hospitilzations are not effective, besides the fact that she charms everyone there and lies about me (she doesn't love me, she's just like my biol mom, she hits me) OK, I slapped her twice which I am not proud of.
I am planning and have taken steps to have her committed to the state hospital lbecause it is a longer stay and they may be able to do her some good. From there, it will be the Waco facility for RTC. I cannot deal with her anymore. I am convinced that nobody else could, either. I do not have any hope for her future.
She has been diagnosed bipolar and has borderline traits, is diagnosed conduct disorder and mood disorder. She is on concerta, zoloft, ambilify.
Is there any hope for her? Any advice?
Thanks,
Meg

[sundara]

I do not feel that either one of us are safe alone in my house now, until she gets help.

The above being the case, no, you are not overreacting by calling 911 and/or hospitalizing her.

She provokes physical fights with me now, hitting and throwing things at me. I've had to physically tackle her...

You MUST avoid doing this at all costs. If she is breaking things, get out of the house & call 911, as she is not exhibiting safe behavior, and trying to stop her places you both in danger and puts you at risk of being jailed for assault as well. Remember, the house has things in it, which are much less valuable than people (even though it is hard to stand by when this is going on).

I've had 3 kids/6 hospitalizations, and I am surprised that there have been so many for her in such a short time yet the hospital is not recognizing that there is an issue? This seems a bit strange. Is there another facility she can go to? Does she have a therapist outside the hospital? Does the hospital have a day-program?

I definitely would not allow myself to be alone with her for any length of time until this resolves to a much better situation.

For my son, we had to put him in a facility run by shelter, inc (kind of a half-way house) after the hospital. He was begging to come home pretty quickly, as the hospital stay was for a month (with much less reason for him to be there than what you are going through!) and then he was in the shelter facility for another 4 weeks.

One thing you have not mentioned is if you know the cause of her rages, and whether or not you have told her that you will always be there for her, but that this is about her behavior. (Maybe she perceives the hospitalizations as you trying to abandon her. Do they have visiting hours? have you been able to separate her behavior from her value as a person?)

One of the things that therapy should be addressing with here is to talk about the size of the problem vs the size of the reaction, talking about manipulation and emotional blackmail, etc. Are they doing any of this?

For my kids, the "main" wards at the psych unit were less effective at this - their goal was to calm them down and then ship them out (since insurance no longer pays once they promise not to hurt themselves). The ward my daughter was just in was for SI (self injury) and ED (eating disorders) and this unit was much better at identifying these types of behaviors & working with her 24/7 to recognize these distortions.

BTW, yes, there is hope and there probably is someone who can help her. But, you need a break & you need to find them (one of them is you, what I am hearing is that you are exhausted. We all hit that point, but that is why this forum is here). Keep working to find the right dr for her (therapist, psychiatrist, etc). Is her team hearing you? Do you feel that they are truly figuring out her issues? do they believe you? do they have you participate at some level in her therapy (so that she can no longer triangulate)? These are all important goals to work towards.

I would recommend reading some of the Attachment Disorders area of special needs forums here, as many of those discussions revolve around these same types of behavioral issues.

[PabloandCarlosMama]

I empathize with you and your situation. I'm a single mother to two boys (one of whom is in a long term, out of home placement), and understand how hard it is. I so often ask the same question. Somehow, it must be a mother's job to have hope.

You are exactly right in trying to get her into a long term treatment facility. With all of her hospitalizations, there should be a good case for her to go into residential treatment as well. She is not able to be safe in your home, and she won't be able to heal until she can be contained in a structured, 24-7 staffing situation. There is hope for her if you can find the right team--therapist, psychiatrist, mental health case worker (does your county provide this?). You also need a support team for yourself. These boards, particularly the special needs board, are good places to start. You may also see if there are adoption support groups or NAMI (National Alliance for the Mentally Ill) family support groups for those dealing with a loved one who has mental and emotional problems. Often, there are many adoptive parents in these groups as well.

Until you do get her out of your home, call the police every time she tries to physically harm you. Keep a journal of her activities and your responses so that you can protect yourself from false allegations.

You sound like you've been fighting a big war, and there is help out there, but it takes a lot of work to get it all in place. I'm sending you my best thoughts and prayers.

[PinkandBlue]

Thank you so much for the hope message. I know that those of us who adopt live in a different world than others, and although I know what is a normal teenager since I've taught JH-HS for 18 yrs, when it is your own life you sort of lose perspective of what is safe/not safe, etc. because your everyday life is so different. I've never been afraid of anything, anyway unless it has 8 legs ) I think that I have accepted so much of what happens with my daughter as normal & routine for a kid with her background, where now I am beginning to realize that things are getting unmanageable for me.

She was taken into police custody/admitted to the same crisis hospital tonight again. After restraining her, I have a very sore arm and wrecked shoulder, hair missing, and only one hole in the wall this time. I just got home from the hospital at 10 p.m. and am looking forward to a good day at work tomorrow. My classroom is my grounding and sanity this Spring. I will have her transferred to the better hospital ASAP. We have dc'd the Zoloft because it dawned on me last wknd that when she started taking it is when she became suicidal, began seriously cutting, and raging a lot. That was in December. She is on her 5th hospitilization since then. I love this child and hate the disruption in our lives that this is causing. She is very lost. I suppose that I hate the thought of sending her to RTC because she may see it as sending her away. And yet, (don't tell anyone I said this!) I am personally at breaking point. Mental illness is a new territory for me. Thanks for the reference to NAMI. I will definitely find them.
I'm new at posting here, and apologize if the whole thread is included in my reply.

[PinkandBlue]

Sundara, thanks for your reply. I've been busy keeping things afloat and figuring out how to post here without including the whole thread...
Part of the treatment issue with my daughter is that when I adopted her she was healthy so I kept her basic medicaid insurance. Now that she has issues I have found out that I cannot upgrade her medicaid so we are stuck with no intensive OP or RTC available other than commitment to the state hospital in Wichita Falls, which is no better than what I have been doing here with the psych crisis treatment hospitilizations.
Good news... I have an open enrollment period with my employer for the next month during which time I can add her to my insurance, which will open up new options for treatment. How timely, thank God. Will be effective in September.
I love this child and as traumatic as things have been, our relationship has deepened. She has ruined almost every venue and relationship in her life since I've adopted her. I am her lifeline and she is beginning to know that. Yes, she does know that I am on her side, as she told me tonight, during another hospital admission. She knows and states that she is "crazy", out of control, and needs help. She knows that I hate hospitalizing her but that she is not safe at home when she cuts her arm up (it's really bad) and throws things at me. The police called the medical team to my house tonight because of her cuts.

All the questions you bring up... thanks for keeping me grounded. I have covered all those bases. Again, my issue is her insurance coverage and what exactly to do with a raging, destructive and abusive 14 year old who is unsafe with herself when the only option is to hospitalize her at the local psych crisis hospital who will release her in ~10 days to be admitted again in approxi ately 14 days. There are better options in September when new insurance kicks in.

Thanks for your input... this is a huge learning curve for me, mental illness is new territory.
And, by the way, I love this child.

[NoelleSin]

Pink and blue: Of course you love her if you didn't you wouldn't be asking the questions for guidance into this entirely new and bizarre world of MI. NAMI is a great resource for families dealing with mental illness, I am in NJ and we have a county chapter in almost every county they hold monthly meetings and family eduation courses.
The hospital is holding her for the minimum stay because she has a place to return to, this is one of the hardest things for a parent to say to a hospital that they refuse to take their child home with them post discharge and request more appropriate placement. If you can from the initial family meeting with this hospitalisation put in the request to explore therapeutic placement post discharge, even a youth shelter with perhaps transitional living arrangements available to residents. A dx of bi-polar disorder does not have to be life altering for your daughter, healthy limit setting and positive reinforcement of appropriate behaviors works wonders. I noted your medication concern also a significant side effect of Abilify is hyperactivity known on the street as AbiliFLY... I would encourage you to do significant research into the medications being prescribed to her as many are not therapeutically approved for use in children and the effects on the growing brain remain unknown due to off label use of psychiatric medications. I would try even following up with your guidance office at school to request info for placement post discharge and then for continued therapeutic interventions, (or does your employer offer EAP services perhaps they could link her to treatment) drop in centers for her to go to, an after school program that can be set up through school or even through the hospital as part of the discharge plan have her intaked prior to discharge, meaning have the hospital make the referral and schedule the intake prior to discharge if that type of program is available in your area. Good luck, I will keep both of you in my prayers and where there is life there is always hope.

[PabloandCarlosMama]

It's so good that you are coming back to the board for support. We're here for you, and you have a lot going on in your life right now. It's ok to admit that you can't manage your daughter's illness. I found that when I got to the place of acknowledging that I couldn't handle things alone, that's when life with a sick child became more hopeful and easier to deal with. You don't have to do this alone. I'm glad you'll have her on your insurance, because hopefully that will enable you to get access to a therapist who specializes in attachment and trauma issues. Once you hook up with other parents in your community, you will also get networked into other resources that will help you cope.

Before I advocated for my son to go to residential treatment, I feared that he would could get worse because I was letting him down by having him leave our home. One of my friends helped put it in perspective by saying that placing him in treatment and getting him the care he needed was ultimately the "best gift I could give him." This has been true, but it's very counter-intuitive and most people don't understand.

I wanted to add my agreement with the other poster who is encouraging you to ask about alternative placements for your daughter after this current hospitalization. Both of your lives are at stake, and it's not safe for either one of you having her come home yet again with no plan. Another alternative might be to see whether there is a facility--maybe the state hospital where they could a 30 to 45 day evaluation of your daughter to determine proper diagnoses and medications for her.

Hang in there, and keep coming back. "Where there's life, there's hope" is a great mantra during hard times.

[sadoyle1216]

Is she linked up with MHMR? With her diagnoses and severity of problems, I would think that she would be eligible for services there. I know that they don't offer a whole lot for adult services, but the child/adolescent units generally have a wider range of available services, much of which Medicaid should pay for.
Also, has anyone thought about putting her on a mood stabilizer like lithium or depakote? In my professional experience (I've worked in adult mental health for about 10 years), Abilify is good with controlling mania, but may not be as effective in stablizing mood swings. Just a thought.

[PinkandBlue]

I've been talking to MHMR for a couple of months now, and with her discharge two days ago I was given a number for someone to set up a plan for her. This is a new contact. I have exhausted all resources for getting her committed to the state hospital. I will tell this MHMR committee that I am unable to parent her. She plays the good girl and gets discharged and then immediately begins stealing and destroying at home again, every time. I give up. It isn't worth my time, money, emotional and physical health to do this alone anymore. I can physically restrain her now, but she will soon be too big for me to do so. I will hopefully make contact with the MHMR committee person tomorrow. I am also going to talk to my adoption attorney about release of custody. Has anyone been through this before?

[M.I.Ur.Birthsister]

I don't have any personal experience to offer here. But I do have a close friend who is bipolar, suffered SI, and suidal as a preteen and teenager. She also had periodic rage issues, which she took out on her younger brother. But she was the sweetest girl, really. It was like she just was not in control of her feelings and mood. The bipolar diagnosis came really late, and medications tried were sometimes helpful sometimes not...and there is no actual cure. But she's in her twenties now, and fairly stable. She's a great person...sensitive to others, trustworthy, and trying to be productive despite her severely disabling mood phases (which seem always to derail her classes and other efforts to live a normal life). The older the gets, the more wise she is in her disease, and the more capable she becomes in coping/wrestling with it. I know her mom went through an emotional rollercoaster during the early years, in and out of hospitalizations, struggling with insurance and public service limitations, etc. It's worth it. She's worth it, and so it your daughter.

A short idea about the rage...have you tried sitting down while she is NOT raging, like during a good period, and agreeing on an action plan for you both to take during the rage? For example, while she's in a good, cooperative mood, take her out for ice-cream or whatever bonding activity she likes, and agree that the next time she rages, you will both take a walk in opposite directions from the house for ten minutes and come back, meet in front of the house, and do it again and again until she feels calm enough to go back into the house together (wear watches). Agreeing beforehand helps curb impulses later on.

Have you read "Parenting Your Complex Child" by Peggy Lou Morgan? It has some nice, practical advice and is written by a mother of an adopted, autistic, bipolar son (adopted at age 15 months with dx of downs syndrome, age 23 years at time she wrote the book). It's really good.

[M.I.Ur.Birthsister]

Also you should read "Fatal Flaws" by Stuart Yudofsky (a psychiatrist). Full title: "Fatal Flaws: Navigating Relationships with People with Disorders of Personality and Character". I recommend Chapters 1-3 and 10 (on borderline personality disorder). Although your daughter sounds like she has a combative personality disorder, confrontational and so forth. But like, if you relinquish custody, where will she go? Who will love and care for her? You took responsability for her, and I think that every mother sometimes says, "Omg, can I really handle this? Maybe I'm not competent enough to raise this child?" but then, we find a way or educate ourselves because we Have To. Transformation is possible...and teen years are rough for all of us, let alone those with painful attachment and possible trauma issues plus chemical imbalances in the brain producing uncontrollable moods. Put yourself in her place.

Well...this must be incredibly difficult for you. But I think she needs you. And for SURE she needs a very GOOD therapist, one who can help her resolve whatever emotional problems she is having and a psychiatrist who can recognize underlying physiological problems and prescribe the proper meds.

Good luck to you and your daughter. I'm sure everyone here is rooting for you as a parent and for her improvement.

[aMarylandfamily]

We have been in your shoes at one point and totally understand ... Have you filed a CINS Petition in the Juvenile Courts - I know you mentioned her being arrested but the CINS is separate and can activate many programs for you as well as protect you from being accused of abuse, neglect or abandonment. If not - do so immediately!

If she is definitely bi-polar the zoloft would activate the manic and violent nature and while that may have escalated things recently, she is still a danger to herself and others and that needs to be addressed - if she hurts herself you will be charged with neglect. If she gets hurt during restraining, you will be charged with abuse and you must protect yourself. You can remain a part of her life even if she does not return home to live - the step down programs from RTC allow that and at 14 by the time someone makes progress she should be ready to enter an independent living environment which may be her (and your) answer ... and you will always love and care ... I'm surprised your school did not file a CINS from their end - once you get the right connection you will find getting her help won't be easy but tolerable and always know - even when it hurts - that without you she might never have gotten this help.

You should cross post on the Special Needs Adoption Forum - many posters there have had RTC placements (and/or out of home placements) and share your heartache and yet can provide guidance, information, support but more importantly caring and understanding that the normal folks around you can't.

Take care

[PinkandBlue]

Thank you for the book referrals and your encouragement. Yes, my daughter really is the sweetest girl most of the time. For the past 6 months, though, she has had so much to deal with that I see that she is totally lost. My biggest fear is a suicide/homicide in my home, her developing a drug/alcohol addiction, or totally giving up. Meanwhile, she is supervised as much as possible by myself or others.
We do have a good relationship, and always have. She is attached to me, it is not a RAD issue. We have a plan for rages, and yet it doesn't happen when she doesn't follow through on her part. Lately, I will leave the house in my car when she doesn't follow through. I come back 15-20 minutes later and she has settled down. The last two episodes at home here I would call defiant temper tantrums rather than rages, as she knew exactly what she was doing and didn't seem out of control, only destructive (throwing furniture, kicking walls, throwing objects) and physically abusive to me. I end up physically restraining her and letting her scream it out until she breaks down, which can take 10-20 minutes. Probably control issues, I would guess, since the trigger is always when I give her consequences for misbehavior, typically at school, but lately also at home.
Miraculously enough, just yesterday, I spoke with a contact given to me upon her latest hosp discharge on Tuesday. There are what are called CRCG committees here in north Texas that will access agencies to work very closely with a family in crisis. There is inhome counseling, etc. with the goal of keeping the child in the home. They mostly work with children such as my daughter. I don't know why nobody ever told me about CRCG before now, but I am only grateful that they have come into the picture. I have new hope now, just when I was ready to throw in the towel because I felt that I couldn't do anymore for her.
Every day is a new day in our house. We may go to sleep angry and bewildered, but the morning always begins with our normal routine, and me telling her that I love her as I awake her with a kiss on the cheek.
In addition to bipolar issues, she also has conduct disorder and borderline traits, which is more disconcerting to me and others.
She is compassionate, artistic, fun, and funny. She wants to be a nurses aide, preschool teacher, or masseuse when she grows up. She has a lot to offer. It is so awfully scary to see her threatening her opportunities at the age of 14. I don't know if she will ever get over her theft issues, one of her OCD behaviors. You are right, she is very worth every effort, but my current dilemma is if my home is the right place for her to get what she needs. It sounds as if the CRCG committe will be just what we need for her. I will let you know what happens!

[PinkandBlue]

Thanks for the tip about the CINS petition... I will call our adoption attorney about that on Monday. I have been very open to hospital personnel, her outside therapist, and anyone else I talk to about how I have to fight to restrain her, and haven't had any raised eyebrows. I am the one who gets injured in the process, not her! I am very concerned about legal issues since I work in education and don't want to lose my career due to false allegations. She only tried that once, and it didn't work.