Coping (or not) with Oppositional Defiance Disorder in my Child
Life in our house has never been boring. I'll give my kids that.
But somedays, boring would be heaven. You see, I'm the mom of two girls. One 9 and one 14 and step-mom to another 9-year old girl, 2 days younger than my youngest. That alone would make most moms scream on a daily basis. One in high school with puberty, hormones, a boyfriend (But shhhh! I didn't tell you that!) and the dreaded grades. My younger daughter is smack in the middle of elementary school, in third grade. She is a conflicted child, always needing attention, but craving independence. Acting out, but not wanting the attention for it. Wanting help, but getting mad when you do try to help her. She has never been good at expressing her feelings. Throw some mental health disorders in the chaos that is girls at home, and we're in for a helluva roller coaster ride.
My oldest daughter was diagnosed with Aspergers Sydrome 3 years ago, and is doing pretty well. She's extremely high functioning, but socially awkward and tends to obsess over the same movie for a week, repeats things in threes (Sheldon anyone?) and never makes eye contact. We have the typical everyday arguments about putting away laundry, turning off lights, and not taking a 20 minute shower.
My younger daughter was diagnosed with ODD at age 6. She was the youngest patient her psychiatrist had been treating at the time and was even hesitant to treat her because of her age. When I explained that I was at the end of my rope, out of options and the therapy was just not working, she allowed me to schedule an appointment.
Since the age of three, my younger daughter, Beth* had tantrums. Not just screaming and crying, but throwing things, punching, trying to throw herself off the bed, and sometimes passing out from screaming. These tantrums would last between 30 and 45 minutes. I had to sit in her room with her to make sure she didn't hurt herself. It was scary and at three, I didn't want her on medications. She wasn't old enough for a therapist since she couldn't talk about why she was angry. So I just dealt with it. At that time, I was a single mom and felt terribly for my older daughter, who would witness the tantrums, scared for me and for her sister.
According to Wikipedia:
Oppositional defiant disorder (ODD)
...is defined by the DSM-5 as "a pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least six months as evidenced by at least four symptoms from any of the [defined] categories and exhibited during interaction with at least one individual who is not a sibling". Unlike children with conduct disorder (CD), children with oppositional defiant disorder are not aggressive towards people or animals, do not destroy proper
I asked myself all of the questions
Why is she doing this? What triggered this one? What am I doing wrong? Why doesn't she do this anywhere else but at home? At the time, there were no answers to my questions. Not until we started talking with her psychiatrist and therapist. She suggested a positive behavior program in town called TIES. It reinforces the good behavior by praising the kids who are following directions, but ignoring when kids don't follow directions.
We tried the TIES program and made it through the whole thing, even the time when I was required to work as a teacher as a payback for the class. It went well. Katy did well in the class and I thought we were making progress. But as soon as the class was finished and I tried to implement the principles at home, she reverted back to the tantrums and refusals.
When you have a child with ODD in the middle of an episode, nothing makes them happy. Not because they aren't satisfied, but it's not in them to accept what is in front of them. Praise doesn't work. That leads to unwanted attention, which pushes them further into oppositional mindsets. On the flip side of that, consequences don't matter, either. They just don't care. I could empty her bedroom of all the toys, furniture and decoration and make her sit in an empty room, staring at a wall and she just wouldn't care. This makes it difficult to find what makes an impact on them. Not until the episodes pass do things start to make an impact. Rather than make apologies, she acts out her remorse. It's pictures with "I'm sorry Mommy" scrolled on them. It's cleaning her room and making me a snack as an apology. It's asking if she can do my nails. It's a vicious circle that seems to be never-ending.
- TIES | St. Luke's | UnityPoint Health - Cedar Rapids
Teaching Interventions to Empower and Strengthen Families (TIES) is a free program offered by UnityPoint Health - Cedar Rapids for children six and younger.
The next few years were difficult for us
We went through therapists, books, even a medication trial to control her "eruption point". But when an oppositional child refuses medication, it's pretty much impossible for it to happen.
When Beth started school, I started to get worried about what would happen. I wanted to head it off at the pass, but wasn't sure what to expect. What came about was shocking. At school, we had no issues. Zero. Ziltch. She followed directions, offered to help her teacher, was eager to please and soon became one of the best students in her class.
With this new development, and her new-found love of school, life got better. She was still seeing the psychiatrist, but less often. I decided to give it a rest for a bit and see if the routine of school was what made the difference in her. This was a good option, if only for a while. But then, the inevitable tide turned.
A Teeny-Tiny Tangent:
When Beth started kindergarten, our school district (a dozen years earlier, and I'm not entirely sure why) had set up "Early Childhood Centers" for Preschool and Kindergartners only. I never understood why the district thought it was a good idea to keep those kids separated from role-model older students they could learn to be like. But that's beside the point.
So, when she started Kindergarten, it was good. But with transition to first grade, there was a change to another school (another thing I don't think our illustrious school board had thought of, but that's another issue for another article) and another group of (older) kids. Still, school was good.
Over the course of the school year, we met with counselors, psychiatrists, her pediatrician and I read all I could about the subject, wanting to know what to expect during puberty (which was a coin flip, not knowing if it would be better or worse)
Her psychiatrist and counselor suggested that her defiance is rooted in her anxiety of wanting things they way she expects them. So we tried a small amount of Sertraline to see how it would affect her. The doctor suggested that relieving her anxiety would relieve her defiance. HOWEVER, here's where the catch 22 comes in. Any guesses on how you get an oppositional kid to do something (take medicine) that she doesn't want to do? Bribery. Plain and simple.
Well, we thought that was working. BUT...when cleaning her room one afternoon, I found a little stash of blue Sertraline pills in her bedroom. From that point on, she had to stand in front of me and take them, then I check her mouth. I felt like a prison guard or psych ward nurse watching over a prisoner or patient. It sucked. But I got her to take it. And for the rest of the time, it was smooth sailing. One. One fight done. I felt like I could do this, I felt like I could tackle this beast and win. Or at the very least, teach Beth how to fight and win.
Activities She Enjoyed Helped with Anxiety
Fighters Don't Win Every Round
As with any mental illness, there are bad days. Along the way she has had hiccups, as most kids do, but nothing more than a little tantrum here and there. Don't get me wrong, life is not sunshine and daisies. It's an ongoing struggle to keep her medication going at her dad's when she's there, and teaching her to pick her battles, take a step back and allow her to just be herself when there are no expectations (weekend nights, snow days, pool time, etc).
She has discovered that working with her hands, whether crafting, planting flowers, playing with play-doh, or even helping her dad fix cars is a great way for her to get her mind off things that are bothering her. She has her own room with the things she loves; her Kindle, crafts galore, her bug bin for watching what she collected that day, and a view to the backyard that makes me jealous. She has her loft bed to escape the bad days, and a radio with headphones to be even more alone when she needs it.
Beth will be going into 4th grade later this month, and I think we have come a long way from the little girl in her room, throwing things and flailing. She is a delight to everyone on her good days, but even on her bad days, I wouldn't trade those freckles and blue eyes for anything else in this world.
So whether you're trying to grasp for solutions for that little one who is still flailing, or sending your well-armed college graduate out into the world, hang on tight, and never, ever let go. They will always need you to fight some battles with them, no matter how small.
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The latest Tweets from Jared Padalecki (@jarpad). http://t.co/yG3JbF8hBX. facebook.com/JaredPadalecki
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Jared is an actor on the CW's television show, Supernatural. He has created a nonprofit organization to bring attention and put a face on the battle against depression