Disturbing newish behaviour - not sure what to do (long)

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I've noticed a couple of phases where puberty seems to hit the boys, and one is really early, in the 10 -12 age range, sometimes before any other signs, and one seems to be later in high school (haven't hit that one yet with my son, so I have less of a feel for it; that mention is strictly from prior reading on this board). That initial onslaught, in 10-12 age range, does affect AS kids emotionally, and often very strongly. It is quite common for new behaviors to emerge in this age range. Some of the triggers may be hormones, some may be middle school, and some may be the combination, but we seem to see it a lot.

My 16 year old had a tough time between 10-12 with regard to emotions, that was our hardest bit of puberty. He's NT but I would imagine it would be tougher on our aspires.

PersonalEnigma -- do you think cognitive behavior therapy on top of Prozac may help the symptoms of anxiety? I think your son is old enough to gain some benefit from CBT -- and CBT combined with a medication as a treatment plan may help your son both with the immediate symptoms of anxiety as well as form some strategies to manage the way he thinks about things that are very frightening to him.

Agreed re: risks of SSRI-class drugs (prozac, paxil, zoloft, celexa) for young children and teens -- this is a 'class' effect meaning drugs within the same class can be "activating" even for adults.

However the original poster said she believes prozac is indeed helping her son's anxiety in visible ways, thus I thought the next steps are to optimize dosing and combination, or to look at alternative combinations including non-medical combos (like CBT.)

Prozac is actually one of the few tested safe for kids under 12. However, with the wrong dosage it can be bad. I know when he first started on it we raised the dosage once and it was too high. Can't remember the exact issues, but it was clearly off, and I dropped it back again. He has gained weight since we last did the dosage though, so he might need more for his weight.

CBT might be an idea. Will have to look into it again. I've not looked in a while.

So far Logan had a few bad anger episodes these last couple weeks, but has made use of the punching bag we got him for Christmas as a potential stress reliever. He seems to go "red" when using it, but comes in less angry (though very very tired). He had one episode a couple days ago where he though he "heard the voice of God". It didn't say anything bad, but still it's the first time he's commented on that kind of voice...

I will be contacting the doctor's office later today - hopefully I can get through.

I think one of three things might be happening.

1. He gets so upset and worked up that he is no longer paying attention to what he is doing.
2. He is using the "What happened?" card as a defensive mechanism.
3. He is having seizures brought on by the stress of the situation that cause temporary amnesia. Note that in the context which you described, the seizures would not be the rages themselves, only a by product of them.

And yes, SSRI's can cause rages in children and teens.

Here are my thoughts that may or may not help you...

Prozac can cause violent outbursts in children and adults just as you described with your son. It is well documented and I have seen it myself. The combination of an anti-depressant such as Prozac and an antipsychotic can cause lethal behaviors in many people. The combination must be managed very very carefully. Although to be fair, these meds do work great for many people.

Please keep in mind that every medication works different for every person. These are not working for your son. If you make a med change, imo, insist that you make one change at a time. Don't change the dose of one and take him off the other at the same time, etc...

We were extremely lucky that the first medication we tried did work for us. My son's violent behavior (6 hour full-blow ragest several times a week) stopped immediately after starting Abilify. He has been on 2.5 - 5 mg for a few years now. I played around with the dose until we found the right one which was 2.5 mg in the AM for him. Abilify is also an antipsychotic.

I believe that your son sometimes can't remember what happened until later. I don't think he's faking this. As far as the voices, they can be caused by either of the medications he is on. You might want to get on some blogs and look up what real people are writing about side effects of these medications. The actual side effects that real people are experiencing may not be on the label.

You might want to have your son checked for hypoglycemia (low blood sugar) or diabetes since these types of meds can often affect sugar and insulin metabolism. If he does have either high or low blood sugar, it could cause violent behavior and black outs as you describe.

I also agree with another poster that these rage episodes could be seizure-related.

Please make sure you do your own research on medications before you start your son on them. The docs can only tell you what the label says.

Well.... You guys are probably going to have a good laugh at this, but... Logan came clean.

He was terribly upset last night when I was tucking him in. It turns out that he was faking it all along. All three big symptoms. The red rages, the blank-outs, the paralyzing anxiety attacks, and the "other" voice. He was feeling horribly guilty about it all.

It started with him wanting to get out of trouble. He kicked and hit another kid and realized that he'd be in a lot of trouble, and thought that if he claimed to not know what happened he'd be safe. The idea came from a video game he liked to play. The game's main character has an alter-ego that takes over in fighting situations. The character isn't aware of the alter, who is very different. Of course it's a spirit-type ego that takes over and is a part of the whole game story. I had talked to him about it not being a real thing, and thought he was ok with it. I guess he was really, he just thought it was a useful tool to use to avoid trouble. Ironically we dealt with the issues the same as we would have if he had been "aware" of what he did. I held him responsible either way.

It increased as an attention seeker. Any attention is good attention... His sister (who was 3 when this came up) is very demanding of my attention and jealous of Logan. I work very hard to try to keep things as even as possible, but it doesn't always happen that way. By arguing with himself I would have to take time to try to help him. By being distressed I'd sit and talk with him alone. He could have just asked of course, but that's too simple I always listen to him when he wants to talk. Crisis or no.

As things continued they started to get out of control. He faked not being aware when hurting his sister, partially because he couldn't cope with the fact that I'd be REALLY angry at him. I really didn't believe he'd blanked out there, but how can I argue it either? After the event he was so uncomfortable about the subject - no wonder, he was hiding the guilt of having done that and having known what he was doing, plus lying about it all. He really believed that if he came clean I'd punish him more (which is definitely not the case - the situation was dealt with and is finished from my point of view).

The incidents at school were partially stress related, but mostly avoidance and attention-seeking. He didn't want to get into trouble for behaving badly, and recognized that his behaviours weren't ok. So he acted out.

Before he confessed to me Logan gave me a big story about having a talk with his alter and coming to an agreement. The was he was talking worried me a lot as he made it sound more like a split than a "voice". I was going to come on here with my new concerns. He realized that he had only made it worse. The little lie kept growing with a life of its own.

Honestly, I am thrilled with the result. I can handle a kid who loses his temper and has not learned good self-control. I can deal with a kid who is seeking attention and worries enough to pull stunts to get attention. It is FAR better than looking at a possible Personality Disorder in addition to everything else.

So, I will still be talking to Logan's doctor, and he will be admitting the truth to her. His meds still need looking at, but honestly until these incidences he's been doing well on this and has failed on SEVERAL others :/ I hate guineapigging him.

Thanks for all the suggestions and support. I can't be happier that this is all stuff that can be managed. I'm not pleased that he lied to me, that he faked all this, or that he pulled the idea from a video game, but it's something I can deal with.

I hope you are taking this opportunity to discuss tangled webs and the mess one gets in when they attempt to deceive. Play it right, and he will never lie again. He needs to integrate every last piece of tangle this lie cost him and everyone around him.