Mental Health

I don’t usually post about Andrew in particular, though I read a lot of blogs where moms with difficult kids post often about the challenges they face. But today I’m making an exception.

Almost a year ago Andrew had such an escalation of out of control behaviors that we (as his parents) were driven to put him back in therapy, and then to have him evaluated by a psychologist. Though we had been warned at the onset that Andrew’s bioparents had mental health issues (specifically bipolar disorder) and that it could be inheritable, we had spent the intervening years trying to make his life consistent and supportive with the hope that eventually the trauma of his early years would have less impact on his behavior. Last May we finally realized that, for Andrew, his mental health issues weren’t going to be fixed by our parenting.

With diagnoses of Mood Disorder-NOS and ODD, we began the trial-and-error process of finding medications that might stabilize his moods. There’s nothing worse, for a parent, than the second-guessing that comes with this kind of treatment. All along I’ve wondered, “is he really that bad? am I exaggerating his behaviors? am I just not adapting my own personality and style to his particular needs? am I medicating him unnecessarily?” Even though the doctor was very clear about the reasons for Andrew’s diagnoses, and even though I’ve had lots of outside input on the techniques we’ve used with Andrew, and I know INTELLECTUALLY that all my worries are mostly just made up – still EMOTIONALLY it has been very hard, and I have worried about this decision on and off for the last nine months. Thankfully, I have relied on Tom, who has a very pragmatic take on the whole “medicate-don’t medicate” issue – “if it helps, great! if it doesn’t, we’re no worse off than we were”. It’s good to be reminded that the world doesn’t hang in the balance of our decision!

Anyhow, we finally arrived at a mixture of medications that seemed to be doing the trick – but again, I’m wondering “does he really need ALL these medications? could he do as well with one less”? His doctor wondered the same thing, so we began the process of taking him off one. Oh my head (as one of my favorite bloggers says)!!!! What were we thinking???? Here we are, starting another nine weeks of school and Andrew is coming apart at the seams. He can’t focus, he can’t do his school work, he’s started being aggressive with other kids again, he’s melting down at the slightest provocation (he holler-cried for 20 minutes because I told him one of his math answers was wrong). The doctor has restarted him on the missing medication, but it will take a week before Andrew is back up to the same dose he was at before. Here’s hoping that it will be effective again…

On the upside, it has been good for me to actually SEE that there is a real and quantifiable positive effect on Andrew’s moods (and therefore behavior) when he is properly medicated. That’s not to say that Andrew medicated is a completely different kid. Because he is NOT. But when he is feeling good he is able to control his impulses. He is able to redirect his frustration or boredom to a more socially acceptable activity (ie – he chooses NOT to hit the person he’s mad at or poke the nearest person because he is bored). He doesn’t demand a near constant river of attention (it’s more like a trickling stream!) and can tolerate other people talking without interrupting or trying to redirect all attention to him. Most importantly, he is receptive to learning new ways to do things – to handle being angry or frustrated, to be calm with himself and not need constant outside attention and input.

Another thing I’m realizing is that helping Andrew feel better and learn more acceptable behaviors is really important for HIM. My feelings about and toward him took a serious nose-dive this past month. Yesterday I couldn’t even stand the sound of his voice – it just brought back all those years of struggling with him, and reminded me how much this month has been a repeat of those seemingly endless years. If Andrew is going to have positive relationships (and that is the essence of a happy life) he is going to need help. If we don’t make sure he gets the right kind of help, he’ll struggle with making and keeping positive relationships in his life.

One of the things I keep coming back to as I try to make sense of my journey as a parent is how differently it has turned out from what I imagined. Somehow I thought I’d be the parent of a good sized family and things would run a lot like they ran when I was a kid in my parents’ home. I never imagined we’d raise an only child for ten years. I never imagined that we would add to our family through adoption. I never imagined that we would deal with such issues as birthparents, trauma, abandonment, attachment, mental illness. I think Tom and I were pretty good parents to Spencer our first ten years of parenthood. We were on the same page about things like discipline and consequences and what we thought was most important for him to learn. And maybe that is partly why we’ve ended up building our family the way we have. If we had had more children the way we planned, maybe we wouldn’t have been all that challenged personally. We had good examples of parenting in our lives and we had pretty good parenting skills.

But the parenting we have done with Andrew (and to some extent with Haley) has been a whole different ball-game. And speaking for myself, it has been so DIFFICULT for me. Andrew has pushed ALL my buttons. Because of his early experiences and his mental health issues, he doesn’t respond to traditional parenting. Andrew doesn’t learn from consequences – he will do the same thing over and over and be surprised the 1000th time that the same consequence has arrived. Andrew needs very FIRM boundaries (there can’t be any 2nd chances and the adult needs to step in quickly when Andrew is misbehaving. He will only escalate until someone steps in). He also needs boundaries that are appropriate for a child quite a bit younger than he is currently (he was still cutting hair and clothing and draperies with scissors last year – hence the need for scissors to be kept out of reach).

This is all SO counter-intuitive for me. I’m all about teaching kids and then letting them make choices and live with the outcomes. I’m all about giving kids more responsibility and freedom as they get older. I’ve so enjoyed watching Spencer learn and grow and become responsible. Spencer had free access to markers and scissors and glue at a pretty young age – having to clean up after himself a couple of times was all it took before he learned that the joy of using these tools was worth following the rules. Part of me has really resented the fact that I’ve had to become this hard, unyielding parent for Andrew. Even though he is happier when I’m keeping him closely in check, I feel so angry that I’m having to be responsible for all his behaviors and having to be so vigilant. But it has also taught me, in a very concrete way, that loving someone is about what THEY need, not what I think I want to give.

There are so many things that I wish I had done differently with Andrew, and that I still struggle with now. But I’m also grateful for the things he has taught me about love and sacrifice and revelation and mercy. And I’m grateful that God thought I could be more than I thought I could be.