Re: Update on Abby

[Guest guest]

Gwen:

I'm glad that you were able to have Abby admitted. Hopefully they will be able

to get her life back into her own control -- or at least start down that road.

Regarding Wellbutrin: It is an antidepressant, but NOT and SSRI. It works on

norepinephrine rather than on serotonin. My son takes it as an adjunct to his

Celexa to boost the antidepressant effect. I think that Abby and her therapist

are correct in wanting to get the depression under control before working on the

OCD. Kathy H can confirm this. Depression is a life-threatening illness; ocd,

generally speaking, is not, even though it certainly limits our kids' lives in

profound ways.

Sorry to hear about your husband's kidney stone. I worked in the ER for many

years, and the people I saw in the worst pain were suffering from kidney stones.

Worse than labor, that's for sure. Lots of fluids and pain medication until the

stone passes is about all you can do.

Hope you can take care of yourself while Abby is in the hospital.

Jule in Cleveland

[Guest guest]

Gwen -

I hope things are settling down a little for you and Abby. That's great that you found a therapist!

As to the Wellbutrin, it has helped my son a great deal. His big problem was with rages which the psychiatrist thinks are from depression. We recently took him off Wellbutrin to try to address his adhd more. We upped his Prozac and added Adderall. Thursday we saw the psych and are putting him back on it. Ian has been begging to go back to Wellbutrin. He says that nothing has helped him as much. He's only 9 and his depression was never as severe as Abby's but I do think the depression needs to be addressed first. Having suffered from depression myself since I was 19, I know that when it's bad, I can't think or deal with much else. Now, on the other hand, when I tried Wellbutrin for me, I felt like I was losing my mind. I would blow up at the slightest provocation. We have tried many SSRIs for Ian and they always seemed to hype him up too much. Wellbutrin gave him the best self control.

Best of luck, I hope things turn around for Abby soon.

Update on Abby

First of all to Jay, I'm glad to hear you made it through the medical testing. I sincerely hope they can determine what is going on with Leigh.And to Lana, what a relief to have this trama behind you. Sounds like did remarkably well.We made it through Thursday night with Abby at home. I stayed home from work on Friday to be with her. She slept most of the morning (pretty typical when she gets this depressed). Early on Friday afternoon a bed opened up and we were able to have her admitted around 4:00 Friday afternoon. As soon as I told her there was a spot available, she seemed to "lighten" up. I guess it was the relief of knowing she was going to a "safe" place to ride out the current storm.They did all the intake interviews with both of us present. This forced Abby to answer questions in front of me that she normally would prefer to keep private. (Sort of an unplanned exposure. I think it was good.) When I spoke to her later in the evening she sounded quite subdued. I remember from last time that the first 24 hours are pretty tough. Even though she is there by choice, she is once again face to face with how little control she has over herself right now. I'm sure she is very afraid.The psychiatrist at the hospital is suggesting moving Abby off the Paxil and onto Welbutrin. Does anyone on the list have experience with this? They are also going to increase her Zyprexa to 5 mg. For some reason, I'm feeling very uneasy about the Welbutrin. I guess because it is not one of the main drugs they recommend for OCD.When the psychiatrist asked me what my goals were for this hospitalization, I suggested that I would like to see Abby get to the point where she was willing to work directly on the OCD using E & RP therapy. She immediately told the doctor, that she and her therapist have discussed this and agree that they need to get the depression under control before she can begin any form of therapy. By the tone of her voice, I could tell that even discussing the therapy caused a large anxiety spike.On Thursday, I spent the afternoon calling around to find CBT/ERP resources in our area. I found two Anxiety Disorder Clinics that both listed specializations in OCD. One of the doctors called me back. He told me he had just gotten back from a conference on OCD. I asked him whether it was the BTI in San Francisco. And he said, yes. I explained that one of the doctors on our list was there. He said that he was the only non-Kaiser doctor in attendance. I'm very hopeful that when Abby is ready to try ERP we can use this therapist. As I asked him questions, he seemed to be quite informed on the March protocol and was willing to do therapy as often as daily depending on the need and willingness. Just to add a little excitement to my life, my husband came home last night with severe back pains. About 4:00 AM, I finally took him to the Emergency room only to find out that he has a kidney stone. So today, I have been nursing him as well. Hope everyone else is having a great weekend. I'm going to hit the bed early tonight. I need to buid up some energy for when Abby is released.Gwen in OregonYou may subscribe to the OCD-L by emailing listserv@... . In the body of your message write: subscribe OCD-L your name. You may subscribe to the Parents of Adults with OCD List at parentsofadultswithOCD . You may access the files, links, and archives for our list at . Our list advisors are Tamar Chansky, Ph.D., and Aureen Pinto Wagner, Ph.D. Our list moderators are Birkhan, Kathy Hammes, Jule Monnens, Gail Pesses, Kathy , Roman, and Jackie Stout. Subscription issues, problems, or suggestions may be addressed to Louis Harkins, list owner, at harkins@... .

[Guest guest]

:

FWIW -- my son was on 60 of Prozac and Adderall for ADHD. The Adderall turned

out to really exacerbate his OCD/anxiety. We took him off of it and added a

small dose of Risperdal. he took a small dose of Ritalin just in the morning to

help him concentrate at school. Now at 12 he doesn't take a stimulant at all.

He is fidgety, but he seems to be able to concentrate ok.

Jule

[Guest guest]

Hi Gwen,

I apologize for not responding earlier. I wanted to ask you about the

interview with Abby. Did they also interview you and Abby apart? To conduct

a thorough investigation, this would be a huge benefit.

>When the psychiatrist asked me what my goals were for this

>hospitalization, I suggested that I would like to see Abby

get to the point where she was willing to work directly on

the OCD using E & RP therapy. <

Tom has been hospitalized a couple of times. Each time has been ocd related,

but the local childrens hospital refused to treat it with ERP (I have this

in writing). They will happily prescribe the medications, and even provide a

level of talk therapy or form of cognitive behavioural therapy - but not

ERP! Each time his depression was improved, and they would lable him with

conduct disorder. As a social worker, trained in the ERP part of hte therapy

- this is very frustrating to me!

I do agree that the depression needs to be lifted in order that Abby can

begin to comprehend what you are asking her to do with ERP.

I see in another post that you are trying to take care of yourself between

trips to the hospitalS! GOOD FOR YOU! I do hope that your husband is up and

about soooner rather than later. Lets hope that Abby will have somewhat of

a recovery before returning home.

Keep you your dedicated work - and do try to get some ME time!!

wendy in canada

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[Guest guest]

,

Thanks for your response. Those were good questions. Here are the

answers:

> I apologize for not responding earlier. I wanted to ask you

> about the interview with Abby. Did they also interview you and Abby

> apart? To conduct a thorough investigation, this would be a huge

> benefit.

Yes. The Social Worker has spent much time with Abby and also

conducted an extensive background interview with me. This also

happened during her previous hospitalization. Each time, the Social

Workers and Psychiatrist have indicated that our accounts seem very

consistent and that I seem to have a good understanding of Abby's

issues.

The problem is that Abby does not want to talk about these issues.

She holds onto past hurts. But so far the OCD keeps her from being

able to share these hurts with the people involved and move forward

in these relationships. Discussion of emotional issues is very high

on Abby's list of anxiety-producing situations.

> Tom has been hospitalized a couple of times. Each time has been ocd

> related, but the local childrens hospital refused to treat it with

> ERP (I have this in writing). They will happily prescribe the

> medications, and even provide a level of talk therapy or form of

> cognitive behavioural therapy - but not ERP! Each time his

> depression was improved, and they would label him with conduct

> disorder. As a social worker, trained in the ERP part of the

> therapy - this is very frustrating to me!

>

> I do agree that the depression needs to be lifted in order that

> Abby can begin to comprehend what you are asking her to do with ERP.

Our experience with the hospital has been similar. While I have not

requested the ERP, their program involves working to adjust

medications and doing general group and individual therapy to help

the patient through denial to understanding of what their issues are.

Their main focus is to help establish a treatment plan prior to

discharge that will keep the forward momentum moving after they leave

the hospital. In my meeting with the Social Worker, I explained

Abby's refusal to have her father and I involved in any therapy

related to her OCD and her reluctance to try E & RP. I had already

found two Anxiety Disorder Clinics with therapists trained in CBT and

E & RP, along with a Support Group for Teens with OCD.

In our meeting with Abby, the Social Worker presented this as her

recommendation. She explained that Abby needed a new therapist

specializing in OCD and that this would involve both individual and

joint parental sessions WITH THE SAME THERAPIST! Abby immediately

expressed her opposition to this idea. The Social Worker calmly

said, " I know you don't like this idea, but this is what has to

happen. "

In each hospitalization, our biggest benefit has been that Abby will

accept (though she doesn't like it) the recommendations of

professionals. She also is able to be angry at them without having

to take it out on her father and I. In her heart, she want help and

she wants us to be involved. But OCD fights hard to defeat this.

Gwen

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