We had a rough beginning to the month of January. Acadia was having a hard time adjusting to being home and there was a lot of anxiety about schoolwork, nighttime, and transitions. On the 7th, we took her to see Dr. D who prescribed citalopram (Celexa) for the anxiety, as Dr. T from NIH had recommended. She started taking it on the 10th. We started to see some improvement about a week later, although I'm not sure whether it was due to the med change or just settling in to the structure at home. Acadia had about a week and a half when things were finally going smoothly for her. We were able to do schoolwork and daily routines, and we were working hard on the anxiety and seeing cooperation on her part.
Monday Cadi had an appt with Dr. L. We went in with a good report, things had been going well for a couple of weeks. We agreed to wait on changing anything and see if things would continue as they had been. Of course they didn't. The tide came rushing in. Monday afternoon she started to get irritated and frustrated. Tuesday we had a difficult morning trying to do our routines and go to the library for school. We were only there about 30 min when Cadi got really frustrated and started hitting her head and biting her knees. We came straight home and she was hitting and kicking in the car. When we got home she tried to throw her backpack in the snow and when I took it from her she punched me in the arm. We went inside and she started crying and hitting her head again. She was saying how much she hated herself and how she could never make herself behave. She had a strong urge to bite something. I wrapped her in a quilt and she let me hold her. I asked her if she wanted to apologize for hitting me and she did. I forgave her and explained that she needed to forgive herself too. She was biting her hand so I got her a carrot and she ate that and calmed down. She even finished some schoolwork and seemed okay until later in the afternoon. I gave her 5mg of Adderall at about 2pm. This is her normal dose but lately I had been forgetting to give it to her in the afternoon. She had a rough afternoon and evening, but I don't remember any specifics.
Wednesday morning we tried to do schoolwork and get ready to go to the therapist. She was frustrated, crying, angry, depressed, and trying to express her feelings to me. I decided to just read out loud to the kids for school. We managed to get to the therapist, where she drew a sad and frightening picture of herself and a tornado that was sucking her up. She stopped using words and communicated with the therapist only by using props and acting out her feelings and drawing scary pictures. At one point she ran out the door and down the hall. The therapist asked her if she felt like hurting herself, and she nodded. She asked if she felt hurting me and she nodded harder. When asked how much she pointed to the opposite ends of the room. When we left she started communicating with words again to me. We called Dr. D and got some Ativan to calm her down. We went home, watched a movie and ate supper. She seemed okay during this, and even laughed during the movie. I had bought her a teething toy which she was using constantly to bite on really hard. As soon as the movie was over, the anxiety rose up again. She was crying and panicked. She refused to be alone. I tried to tuck in her bed and she wouldn't stop crying and trying to explain the feeling she had. She seemed driven to have to get me to understand it. She asked me what she could do with all the problems she was worrying about. I suggested we pray and she could start by asking God to help her with the things she was worrying about. She started praying by thanking God for everything she could think of...but then she couldn't stop. I could tell she was getting tired of listing everything of so rapidly and I told her that was enough, but she said if she didn't thank God for everything it would disappear. I suggested she use the word "everything". She wouldn't, but eventually she switched to crying out to God....."Why won't you help me....you're the only one who is big enough to handle my problems but you won't help me. Why can't I see you, why can't i know that you're real? you have to help me i need you!" etc. She finally stopped praying.
I asked Dan to take a turn with her. She kept on talking and crying with him. He finally left her and said she could come down if she needed anything so of course she immediately came down. she started checking the livingroom and listening to the floor. she said she was checking for bombs. she said a homing missile was hidden in the cupboard. We couldn't tell if she believed they were really there or if she was worried that they might be. She drew a robot on her knee and called it "squarebot" she said he was her only friend. I took her up to bed with me and Dan slept on the couch. I read Winnie The Pooh out loud until we were both falling asleep. At one point she asked me "What is the point of living? No, mom, really, I need to know". She also said she would kill herself if she could but she didn't know how. I had given her another Ativan at 8pm. At about 11 I couldn't stay awake anymore so I shut the light off and gave her a back rub. She said it was the best feeling in the world, but then she kept getting freaked out that it wasn't my hand. Finally we both fell asleep and slept all night. I got up at 7:30 and she slept until 9am.
Thursday was a repeat of Wed. Super anxious and depressed. Wanted to run, so I took her outside and she ran in the snow. I had to stay with her constantly, she just kept going from one thing to the next trying to either express her feelings to me or try to get away from them somehow. Mom came over and took care of Lily and the house, so I could watch Cadi. When Dan came home i had to take a nap. She would get distracted by computer or movies for a while and then it would just hit her again and she would start freaking out. She hasn't really been aggressive since Tuesday, although she has talked about wanting to be. She still bites her knees and blankets. She made a huge barricade of stuff and said that she was blocking her feelings. I had to stop her after a while because she couldn't make it big enough to satisfy herself. Last night went about the same except I got her to watch a DVD in bed for awhile by herself. I still had to come in and sleep with her. She said she really wanted to kill herself but she wasn't brave enough. When she went to sleep she woke up a few times and said she'd had a nightmare and asked where she was.
This morning she is still the same. We are watching her closely to see if she is safe, and so far she is, but she is so tortured. She is in a lot of mental pain, and I wonder how long it's right to keep her at home, as much as I don't want to admit her. I am going to call Dr. T today and also see what Dr. D thinks we should do now. It has been more than 3 days now. We have taken her off the citalopram only since Thursday am. So if that's what's causing this it may still take longer for it to get out of her system.