Saturday, May 28, 2011

The ADD meltdown...

I had cause to relive Erik's meltdowns in the past week or so, and it wasn't pleasant.

Image from
Between the age of 15 months and 7 years of age (maybe later, I try not to think about it often), Erik had literally thousands of meltdowns. They weren't tantrums, he wasn't ever prone to temper tantrums - none of my children were until I had Ari (now I know what people mean when they speak of the two year old tantrum). Erik's meltdowns were never like tantrums. For one thing, they always started out off a clear blue sky. At first we had no idea what they were, one minute he'd be laughing, then his bottom lip would start quivering and the crying would begin. We'd try to hug him and ask him what was the matter. He'd pull away from us as if we were hurting him. Then the screaming would start and his eyes would become wild and frantic. The more we tried to comfort him, the more and louder he would scream and his arms would flail and he'd seem horrified as if we were attacking him.

Around the age of 18 months, he had a night terror, and after that we would refer to his meltdowns as day terrors because they resembled the two night terrors he had in total to some degree. The only difference was the night terrors were quite a bit shorter and sitting in front of a tv with the sound turned down seemed to bring him out of them in about 20-30 minutes. When we tried this with the day terrors it didn't work. They usually lasted 45 minutes to an hour.

During his day terrors, Erik couldn't see or hear us. He went into a zone, and it was a frightening place for him. He would only surface from the zone once his body was worn out, and then he'd sob himself to sleep and sleep for up to three hours.

By backtracking, we found his most common trigger was over-stimulation. Unfortunately, it didn't take much to overstimulate Erik. When he was little, something as small as a new person entering the room would set him off - not screaming right away, though. Usually, his symptoms started with him getting excited, then excitement would turn to hyperactivity. He couldn't come down from his high and he'd overdose on adrenalin and then the crying would begin. Any more than three quiet people in one room was always risky! Outside was better, outside usually calmed Erik.

I found this out when he was four months old and had a daytime crying jag. I couldn't settle him with feeding or rocking (he was overstimulated, but I didn't realise this), and then I started to worry what the neighbours might think I was doing to him so I took him out into our front yard, and immediately he started to calm down. It was like magic.

So, his day terrors usually started with giggling, and because of this, I often received funny looks and comments of "He's just happy" when we were out in public and Erik was giggling and I was telling him to calm down, to breathe, to look at me. People probably thought I was overly controlling, but they couldn't see the day terror barreling down on us tornado-style.

I was talking to mum about this today, and she told me I used to do the same thing as a child - and even as an adult. I can't remember doing this, but as zoning out is a symptom, I guess that isn't really very surprising.

As I've mentioned before, I have Attention Deficit Disorder. I have always suspected Erik also has ADD. I did try for a diagnosis some years ago, but as soon as I mentioned I had ADD, the doctor seemed to decide Erik didn't have ADD. Apparently because Erik was advanced in his drawing (drawing 3D objects at age eight - usually something eleven year olds do), his frontal lobe was developed too much for him to be a candidate for ADD. I suspect the doctor thought I was seeking to medicate Erik (I don't take medications myself, I certainly wouldn't medicate my child). Considering that my own brain structure suggests I shouldn't be able to walk or talk, I doubt an ability to draw in 3D automatically precludes the diagnosis of ADD.

My mum also checks of most of the boxes for ADD, but has not had any sort of diagnosis. Today she told me two anecdotes of her own meltdowns that she is able to recall. The first was from when she was nine and her mother had to go to the theatre one night and mum didn't want her to go. She remembers hanging onto her mother's ankle and screaming, but moreso the feeling of not being able to stop screaming. She also remembers a year when she received 16 Christmas presents (which was uncommon for Icelandic children at the time) and when she had finished unwrapping them all she wanted more and basically lost the plot when none materialised.

To both of us, these stories reflect two things ADD sufferers experience. Hyper-focusing, the inability to let go of a concept or repetitive thought, even if you really, really want to because you are aware that it isn't serving you; such as wanting her mum to stay home, but just not being about to let go of this thought even though she was aware that her mum was getting very angry about having a nine year hanging onto her ankle.

The other thing it reflects is Over-stimulation. Too much adrenalin in the system from being excited and not being able to "come down" from the rush without crashing into the zone of screaming.

From the outside though, these events are often viewed as the person being "spoilt". In fact, not so long ago, mum was reminded of the second anecdote when listening to Icelandic radio and hearing a family member recalling the "Horribly spoilt eleven year old who threw a tantrum because there were no more presents to open after she'd already open sixteen!"

I was watching Parenthood the other night. One of the characters on the show is a boy with Asperger's (a mild form of Autism). In one scene of the show, the boy had been taken out of his daily routine and promised as many rides as he could handle on a roller-coaster at a theme park. The child had to wait in a long queue to get on the ride and was obviously very excited about finally being allowed to ride this particular roller-coaster. Then as he and his father were finally seated in the roller-coaster there is an announcement over the loud speaker than the ride is broken and will not be operating for the rest of the day. The child is devastated and is shown having a meltdown while screaming "You PROMISED I could ride it as often as I wanted to!" which from the outside would look like a massive tantrum from a spoilt child.

These days meltdowns, particularly in older children, are commonly linked with autism and Asperger's, but many symptoms of autism, Asperger's and Attention Deficit Disorder, overlap, such as over-stimulation and hyper-focusing. Unlike autism and Asperger's, Attention Deficit Disorder is often still put down to parenting skills, or lack thereof. Ir is still not uncommon to hear, "He just needs some boundaries", or "I wouldn't let my child get away with that kind of behaviour".

These days, Erik doesn't have meltdown or day terrors. From the age of about six, they declined in frequency from 4 or more a day, to one or two a week, and then one day Dave and I realised Erik hadn't had one in more than three weeks. Partly this was because we'd expended a lot of energy shielding him from over-stimulation, and partly because he had learned to recognise his own triggers. He still only has two dominant modes; very sedate (often hyperfocused on television or an activity) or hyped up. We still have to separate him from other people when the giggles set in (because they often lead to reckless behaviour like running through the house at speed - think small house, lots of bodies including a toddler who can't dodge oncoming traffic easily), but more and more, he is learning to regulate himself.

Sometimes he withdraws when he's not coping and then I find him in his room and there will be terror in his eyes like before, but now he screams on the inside. He never wants to talk about it, but I persist in teasing it out with careful questions. Sometimes - often - he'll cry when he finally releases whatever is winding him up, but afterwards he is always a bit more relaxed.

As for me. One of my meltdowns led to seizures (I only learned today that the seizures had been preceded by a meltdown - I must have zoned out) when I was 31, so I guess they do still happen. I certainly know I have a lot of trouble sleeping because of over-stimulation of adrenalin (the flight or fight response - I'm a fighter). As we get older we learn to recognise and mediate our physical reactions, and to try and be aware of hyper-focusing as well (with mixed results). It's a journey, and sometimes, if we're lucky (like today when I talked to mum) we'll see a helpful road sign that makes the way ahead a little clearer to see.


Mrs Cheets said...

I recognise Boyd in a lot of what you say abour Erik, I have been trying to work out how to help Boyd get through his 'episodes' and a big one always happens at a transition time, or a change in routine. ADD has crossed my mine, I may look into it further.
Thanks for sharing,

Sif Dal said...

Michelle, I'm amazed you got through all of that - it's a bit of a ramble! My heart goes out to you with Boyd, I hope you find some answers. xx

Good Job!