any mental health people familiar with ODD?

[April]

I'm not asking for mental health advice necessarily, but since my health insurance doesn't cover mental health, if anyone has a kid with ODD, maybe you can give me some information.

I have a difficult child. She has been difficult since she was 3, but with puberty, it has become hell on earth to live in my home. it's hard to make anyone understand exactly HOW difficult, because most attribute it to her being a teenager, but it's much, much more than that.

So I went online and started researching bi-polar and ODD symptoms. she fits 14 out of 15 symptoms or signs of ODD, and a decent amount for bi-polar, except for one huge thing.

She ONLY behaves this way at home. I get compliments from her teachers on how well behaved she is in school. She is an angel with my mother. Her friends parents have complimented me on her manners and behaviors.]

But seriously, one time, after we left my mom's house, she was in holy terror mode before we even made it to the end of the block. It is so bad in my house and has lasted for so many years, that while I love her dearly, I dread going home after work because I will have to deal with her. I'm considering moving her to my mother's for a few months, just to get a break.

We did family therapy, but the therapist didn't (or couldn't) seem interested in doing a diagnosis, and gave us various tools. However, my husbands employer would only pay for so many sessions, and things don't seem to be getting better.

I am about 95% positive it's ODD, except for the fact that she behaves everywhere else. Could she literally just be that awful for us with no mental health reason? or could it still be bi-polar or ODD and she just controls it for other's?

I'm looking into an actual psychiatrist, but I need to find out who I can afford or if DH's work with cover some sessions with a psychiatrist. But then again, even if we found one, and she was diagnosed, she refuses to take any sort of medication, including Tylenol. So what good would it do?

I guess I'm halfway ranting, halfway asking for advise. I'm just lost right now, wanting to cry. It's hard to love your kid, but want to actively avoid them as well,.

[Sapphire Silk]

I'm skeptical that it's ODD if the behaviors only happen at home. However, she really needs to see a therapist skilled in working with kids, and needs to be evaluated over a period of time before any diagnosis can be made.

Family therapy may also be indicated if the problem is more at home than anywhere else.

If you live in the United States, your health insurance is supposed to cover mental health. That's actually separate from Obamacare itself.

[MoonCat]

Well, here's my question: Does your mom put up with "holy terror" behavior? Do her teachers? If the answer is no, then I think her behavior is well within her control. She chooses to behave differently at home and feels she has a right to. Please DON'T take this as criticism of your parenting skills. I truly don't mean it that way. But kids know what they can get away with at home, and mother/daughter relationships can be fraught with intense emotional issues. I really think family counseling is a great idea. I only wish I'd done it years ago with my own mom, it would have helped us understand each other better.

[Seshat]

Another possibility is 'willpower exhaustion'.

If she does have something, and has learned (or developed) techniques for handling it, then it's quite possible that she uses those techniques when she's not at home, but it's an effort.

Then when she gets home, off come school shoes, school uniform, lets her hair down, slumps into a comfortable chair -- and her mind is tired as well, so off comes the 'outside manners'.

Try having a listen with her in which you introduce the concept of willpower exhaustion. Then a few days later, tell her that if she is exhausted when she gets home, she's welcome to go spend some time in her room (or maybe at an art table, doing some gardening, at a piano) to rest and recover some willpower.
Then when she's ready to act like a civilised person again, she can come back and interact with the family.

But you (and other adults in the family) won't tolerate her being rude.

DO make allowance while you're giving this a try. For the first month or two - longer if it seems to be working, but needs your support - when she starts misbehaving in this way, ask her if her mind is tired and she needs to give it a rest.
Even if she says no, suggest that she go give it one. If she still refuses, send her to her room. (Forcibly give her a mental rest.)

Night before last, Bast suggested I take a rest or have a Valium, and I practically screamed at her for daring to suggest such a thing - even though we both knew it was exactly what I needed. Being fully adult, and experienced in handling myself, five minutes later I did just those things and apologised.
Your daughter is neither mentally fully mature, nor as experienced as I am. She can't be; not if she's still a teen. Hasn't been alive long enough.


If this is working, or even vaguely seems to maybe be working, allow her to be the one to suggest mental rest: even if it's in the form of her snarling 'I'm going to my room!'
Don't let the snarling be the default behaviour, of course. After a week of snarling, ask her if she can try to withdraw a little bit sooner, while she's still capable of making it a polite announcement.
Then sooner, and sooner, until gradually she becomes capable of 'I'm feeling worn out, may I go to my room?'
(The answer to that, btw, should be 'yes' unless there's DAMN good reason otherwise.)


If this isn't working, then it's potentially not mental exhaustion. But if it is mental exhaustion, or willpower exhaustion, then this should make a world of difference to your home life - and your daughter's future ability to cope with the world.
Also, if it works, then your next attempt at diagnosis should include explaining that you're using this as a coping technique; and how and why you think it's working.

[April]

Let's see if I can answer all the stuff without quoting the hell out of everything. When I called to see if my insurance would cover mental health, I was told that they only cover it if there is a diagnosis. So "Family therapy" would not be covered, but if someone with "bi polar" was attending "bi polar therapy" that would be covered. It's sort of a moot point because I have a $4000 yearly deductible.

MoonCat, I take no offense, because I would be thinking the same thing. My mom is probably scarier to her than I am, but a huge portion of that is they live with me. I don't think my mom has actually punished either of the kids, ever, beyond telling them to "knock it off". School, too, I've seen teachers she has had that scare ME, but also I've seen teachers who were push overs. I have watched teachers argue back and forth with a child for 20 minutes, while this kid was throwing things and screaming. And in the end, the kid got punished by having to change his green card to yellow (Traffic light-green=good, yellow=some issues, red=pretty bad) We're strict, but I like to think we are not over strict. She is usually really well behaved in public.

it's almost like she can't stop what she is doing, when we are at home. if that makes sense

Seshat-That sounds amazing. and possibly very fitting, because I've noticed that if we do "big fun" like an amusement park or something, later when we get home, she completely falls apart into 2 year old like tantrums. we've had her do "time out" like exercises, where when she feels herself getting upset, she takes a break, but it didn't do a lot. I'm going to try to explain it to her in willpower exhaustion though, it has less of a negative connotation to it, which means she might be willing to give it a try

[Waggy6]

I'm taking note of this thread, not because I have any advice, but because my wife and daughter are going through something similar. Having ADD i recognize the symptoms in my daughter, but besides for the occasional talks to others during class notation on grade cards she is otherwise well behaved for her teachers. Like some others have said its like she forgets alls the rules as soon as she gets home, yet there are consequences for bad behavior, which just turns into an argument about how we aren't fair...

[Raveni]

I have two sons that are on the autism spectrum and have been diagnosed with ODD. It is actually harder when they are younger because they are much less communicative.

From their perspective, they simply believe that unreasonable demands are being placed on them at home or other places that have any discipline.

Getting an actual diagnosis will open up a lot of doors that you never knew were there. For example, my school district actually has special pre-pre-Kindergarten classes that helped a lot with getting them used to structure and not hurting other people.

[Seshat]

If she can do things she finds both fun and relaxing when she's recovering willpower, it'll reduce the risk that it's going to seem like a punishment.

[Gravekeeper]

It doesn't sound like ODD if its only happening at home?

But you do need a psych evaluation with a psychiatrist. Therapists aren't of much help here. You need a diagnosis before considering therapy otherwise you're operating in the dark. Plus knowing exactly what it is will give you clear information on what can be done.

You'd be surprised how much anxiety can be lifted by just knowing what the problem is.

[Seshat]

In cases of willpower exhaustion or mental exhaustion, then I believe it is unfair and/or unreasonable to expect self-discipline, exertion of will, or thought, from the patient.

However, recovery is as simple as mental rest. Not 'doing nothing' - that can add to the stress - but doing something that the patient in question finds restful.


I'm not trying to tell anyone how to parent! I'm not there, I have no way of knowing what's happening, and I'm not any sort of doctor or specialist. I don't even think there's a formal diagnosis of 'willpower exhaustion' available: it's just something my family has observed, and thus anecdotal.

So please, DO understand that this is anecdotal, and offered only in the spirit of 'this might help'.



With an old enough child, try what I suggested to April in my post upthread.

With a younger child, just look for signs that the kid is beyond their ability to cope with their own emotions. Or approaching that point.

As a child approaches the edge of their ability to cope, encourage quiet activities that they can do solo. Maybe solo but supervised, maybe entirely solo: you know your kids.

Activities which include an option of pseudoviolence can be helpful - by which I mean stuff like punching and kneading clay or playdough (or bread dough, for that matter).
Yanking weeds out of a garden is also pseudoviolence, good for getting anger and other related emotions out of the system; though whether it is relaxing will depend on whether the child perceives gardening as 'work' or 'fun'.

I enjoy painting the mood out, or doing logic puzzles, but sometimes I'll beat up pillows or our punching bag. I also play endless computer games and do cross stitch.