I apologize for not getting an update out sooner. The past 30 hours have been frustrating, exhausting, and busy.
Yesterday morning we had to be in Mankato at 6:45 to meet with Dr. Spieker, the psychiatrist. That meant up at 5:30 and out the door by 6:20. Cassie was NOT thrilled with that, to say the least. Unfortunately, having an appointment that early also meant she was very subdued and compliant during the appointment. No typo there, yes I meant unfortunately. Since she was so subdued, I don't feel the psychiatrist got a good "feel" for her personality. Cassie is a very complicated young lady and it's impossible to sum her (or anyone for that matter) up in an hour. I don't feel that Dr. Spieker got a good grasp on the extremities of Cassie's moods, as she doesn't feel that the bipolar diagnosis is correct. She seems to think Cassie may have Conduct Disorder and ADHD instead. ADHD, yes, I can see that. But looking at the list of symptoms of Conduct Disorder, I disagree. Here they are...what do you think?
Aggression to people and animals, including:
* bullies, threatens, or intimidates others
* often initiates physical fights
* has used a weapon that could cause serious physical harm to others (e.g. a bat, brick, broken bottle, knife or gun)
* is physically cruel to people or animals
* steals from a victim while confonting them (e.g. assault)
* forces someone into sexual activity
Destruction of Property, including:
* deliberately engaged in fire setting with the intention to cause damage
* deliberately destroys others property
Deceitfulness, lying or stealing, including:
(now this is where is starts to fit a little better, I think)
* has broken into someone else's building, house, or car
* lies to obtain goods, or favors or to avoid obligations
* steals items without confronting a victim (e.g. shoplifting, but without breaking and entering)
Serious violation of rules, including:
* often stays out at night despite parental objections
* runs away from home
* often truant from school
I don't know, the ADHD fits, a milder case of bipolar seems to fit, and the latter half of the symptoms for Conduct Disorder seem to fit. Like I said, Cassie is a complicated girl with layers of issues and challenges. I'm sure it's not just one thing, making it difficult to diagnose.
Dr. Spieker does see signs of depression, and so has put Cassie on Strattera, a non-addictive anti-depressant. She is staying away from the more addictive ones because of Cassie's experimentation with drugs and alcohol.
Then at 2 we had court. Nothing was really decided there. The judge went through all the charges/petitions and Cassie had to admit or deny them (she admitted them all). He said he's being asked to make a pretty major decision based on very little information, so we have another court date on July 8. In the meantime, we'll be meeting with the probation department and the county more to do some assessments and get them up to date with all of our challenges.
In the midst of all of this yesterday, we had Qwest out to our house to connect our wireless internet. We have disconnected our landline, so don't try that number any more. :-) We were told no one had to be home for the connection, but they were wrong and the tech showed up while Cassie and I were in Mankato. Chris went outside to talk to him and inadvertantly locked himself out of the house. I told the tech over the phone that we were going to disconnect our HickoryTech service after we were up and running with Qwest, so he went ahead and assumed I wanted him to cut the line. I did not, and since Qwest had sent us the wrong modem for our service, we ended up with NO service for most of the afternoon.
Dar was working on getting the new modem set up last night around 6:30, and I was at work. Cassie got mad at us for not letting her stay overnight at a friend's house. This is one of the friends who she sneaks out at night to see. She's 17, has a license and a car, and is pregnant. She is not a person we feel is a good influence on Cassie. She's the one who has taken Cassie to Le Sueur several times when Cassie had run away. Cass flipped out on us, refused to calm down or cooperate, and was in general screaming, yelling, arguing, and was out of control. We thought we were going to have to take her into the ER to get her admitted to the mental health unit for 48 hours. She did finally calm down and ended up in tears. She said she loves us and doesn't know why she gets the way she was, that she doesn't try and doesn't want to, but doesn't know how to control it. After we got her calmed down (it was around 8pm by this time) I ended up going back in to work for a few hours.
What a day, what a night. Glad that's over! We did start her on the anti-depressant last night, so we're praying it's the right dose and that it helps.
Today so far she seems to be calmer, more compliant and respectful. We've been to the dentist and Wal-Mart and home again this morning. Now she's upstairs sleeping...again. I got the mail this morning and the assessment from Dr Serdy was in it. That's depressing in and of itself.
The summary part of the 5 page assessment: [anything in these brackets is something I've inserted]
Her clinical scale profile suggests severe adjustment problems including impulse control, concurrent with anger, moodiness, authority conflict, school maladjustment, and family difficulties. Her low frustration tolerance and the need for constant stimulation cause her to behave recklessly or irresponsibly. She is a risk-taker who probably abuses alcohol or other drugs and may tend toward exhibitionism.
She is self-indulgent, hedonistic [definition: devoted to pleaseure], immature, and defiant if her desires are frustrated, she appears to have an exaggerated sense of self-importance and may have rather grandiose plans. She charms and persuades others easily, but she may actually feel quite insecure and inadequate. She excessively denies problems or tends to blame others for them. She may be overactive, agitated, irritable, and moody. She is prone to angry outbursts when she becomes frustrated.
Her content scales indicated assaultive or aggressive acting-out behavior due to her report of considerable problems controlling her anger. She may appear overly interested in violence and aggression. [I don't see the violent/aggressive part at all] She may be sexually promiscuous, flirtatious, and provocative.
School is a problem area with her disliking all aspect of school except for being with her friends. Truancy or suspensions are likely. She reports not liking to read or study. She has difficulty starting projects, tends to give up easily, and allows others to take charge.
She is frankly exploitive in relationships, using her charm and powers of persuasion to con others. She avoids deep emotional attachments. She has numerous misanthropic [definition: believing the worst of human nature and motives; having a sneering disbelief in the selflessness of others] attitudes. She sees the world as a very hostile place and she believes that others are out to get her. She looks for hidden motives whenever someone does anything nice for her. She believes that it is safer to trust no one because people make friends in order to use them. Because she believes that people inwardly dislike helping each other, she reports being on guard when people seem friendlier than she expects. She feels misunderstood by others and thinks they are very jealous of her. Other validated interpersonal problems include her family as being a significant problem and describes her family in terms of discord, jealousy, fault-finding, anger, serious disagreements, lack of love and understanding, and very limited communication. She looks forward to the day when she can leave home for good, and she does not feel that she can count on her family in times of trouble. Her parents and she often disagree about her friends. She indicates that her parents treat her like a child and frequently punish her without cause. Her family problems probably have a negative effect on her behavior in school. Anger control problems are significant and she reports considerable irritability, annoyance, and impatience with others. Temper tantrums and aggressive behavior may characterize her interactions. She is associating with others who use drugs and alcohol, confirms increasing involvement with alcohol or other drugs, and acknowledges that her use is problematic. She may feel that alcohol or other drugs facilitates social interactions and may therefore also be a coping strategy.
Treatment Plan Recommendations:
Psychiatric evaluation is needed to address - pharmocological treatment. Behavioral therapy, cognitive behavior therapy including self-control skills, mood regulation skills, anger management, addressing her sexual promiscuity is needed. Family therapy with conflict resolution skills and drug and/or alcohol intervention are likely needed. With these treatment options it may be helpful to test her again when she appears more stable to determine if she does have some underlying cognitive deficits.
So, that's that. Hard for a mom to read. I've always had this dream of having such a great family. We try so hard to play together, do fun things together, always telling the kids we love them, hugging them, encouraging them to try new things and do their best. We love Jesus and try so hard to set a godly example for our kids. We've tried to instill godly values in our kids. To love God and follow Jesus, to have solid relationships, to model a strong marriage, to love family and be there for each other no matter what, I want nothing more than to be a great mom whose kids know she loves them and they can count on her love and support no matter where their life takes them. Apparantly I've failed in everything I've tried to do with my family. Oh, my goodness, does that hurt. Like a knife stabbing into my heart. This road is so NOT where I wanted my family to go. And looking forward, the road ahead looks so long, and twisted, and steep, and dangerous, and painful, and hopeless. Apparantly God is teaching us to rely on Him, and I am, and He better not leave us, because I can't do this otherwise.
Please, please, please, keep us in your prayers.