Anger issues and Medication

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My son is 9, diagnosed with PDD-NOS. He has some pretty bad anger issues, though not sure if it's related. Anyway...he has been getting really bad lately, punching teenagers and the like. It's been hard, and he's had these issues for years and I have worked with several people doing everything I can to try to help him. It has been suggested by his psychologist to medicate him. He feels that his mind moves so fast, that when he gets mad (he can go from being fine to an uncontrolable rage before you can even process what's happening) he isn't able to think about his reaction before doing it, he's all impulse and by the time you get to him it's too late and then he feels bad, like a failure. His doctor feels that he is in danger and there are significant safety issues, as well as it is keeping him from having any kind of relationships (he took on 6 teenagers at the pool, and punched one with no fear at all, he freaked out the kid he was playing with and sticking up for, and the kid wouldn't play with him anymore. This is just one example)

I am at a loss as to how to help him, I've tried everything but my son says he can't control it. I totally believe him because he feels really bad afterward. For example, the 13 year old girl he punched in the face he feels bad for. She was mean, and in my opinion she kind of had it coming, and despite his feeling that she deserved it he feels bad for her and guilty for doing it. He doesn't care that I was dissapointed and afraid that he could have been jumped, he feels bad for her and he's really sorry.

I am not really a fan of medication, particularly this young, and up to this point I have tried everything I can think of to help him and he's not getting better, he's getting worse. He's not using what I know he knows, he's tired of the coaching because he knows how to behave, he says...he insists...he can't control himself, and has said this for several years (he calls it bad germs that take over his mind and body).

I know medication can be life changing, and his psychologist feels that it will help him greatly, and it may be what he needs in order to use the tools that have been given him and respond to the CBT he is going through, and I really LOVE this doctor, but I also know that it can be a roller coaster nightmare as well. His doctor says it doesn't mean forever, but it will help, and he feels that his condition is severe and he knows that medication, for me, is a last resort.

I'm scared to death to start down this road and I'm freaking out. Is there anything that you would recommend, have experience with, or anything that you would greatly steer me away from? or anything to make sure I ask at my first appointment? I want to go in educated about meds (this is new for me) and I would like to tap into your experience, particularly if you, or someone you know started young. I think my son's age is freaking me out the most. He's so young and I don't want to mess with is brain, but I want to help him and I'm so conflicted.

Thanks everyone!

Hi I'm not an expert on medicating kids at an early age, but I can share my own experience. I started taking meds at the age of 6 for epilepsy and continued for 6 years. The meds controlled my seizures and I took them without a problem because I would rather not have the seizures.

While anger issues are not seizures, it sounds like you've tried everyting possible to help without medicating him. Overmedicating children is not a good thing, but sometimes a little medication is necessary, like with my seizures, and very helpful. Your son says that he can't control himself; he may have this intense fight or flight instinct that he can't turn off. A little medication may help turn off or dampen this instinct and allow him to relax and stop lashing out . This may help him be able use what he learns in the CBT lessons better.

Note, you should definitely continue with the therapy even with medication.

He's been taught the rules on how to behave, but doesn't know what it actually feels like to calm down and think through a confrontation in a non-physical way.

I am definately continuing therapy. The medication is supposed to do exactly what you said, to help him slow his brain down enough to use the tools he has been given, and respond to the therapy. I have stopped social skill therapy because I feel it's counterproductive. Reminding him of what he can't control is just making him feel bad because he knows what to do and wants to do it and he can't.

Is it really that unusal for a 9 year old to lash out at somebody that was more than likely being a bully?

I think everybody has their breaking points and if this person kept pushing and pushing your son over the edge, it was always only going to be a matter of time.

Obviously violence isn't the answer, however, its not uncommon for anybody (Aspergers or not) to react in this way.

This is all the time. The teenager thing freaked me out because they were so big and there were so many and he was so unafraid, and since it's been getting worse and the kids are getting bigger I'm afraid he will get hurt, or hurt someone else.

He has a short fuse and is very rigid. He also is a negative thinker and tends to take things personally. You leave him to his own wits for 15 minutes in an unstructured activity with any number of kids, 1 or 6, just playing, you can guarantee someone will make him angry and there will be a conflict. The extreme anger doesn't happen regularly, you never see it coming, but afterward you can see why it happened, if that makes sense. Winning and losing is always an issue, and I try as much as possible to keep him out of anything competitive, even though he can take something non competative and turn it into a competition, but as he gets older that's what kids do, they play games. He has done really well at baseball, but that's different, he has a specific job at a specific place and it works for him. Nobody is taking a ball away from you like basketball. He wants to play basketball, but as soon as someone takes the ball or he feels they wronged him in some way, out come the gloves. He wants friends so bad, and he loves to play games, he can't handle it.

I'm curious as to what kind of medication they are talking about.

My husband was a fighter aspie. He fought the entire time he hit puberty until he reached about 22 years old. At that point, people became just an annoyance he ignored. I really want to help because he sounds a lot like my husband, but I don't know exactly how he stopped it and I asked him and he just said the people around him changed. I think what helped him was he found his concentration. the thing that interested him enough to focus all his attention on.

I'm not sure what kind of medication yet, which is part of the reason that I created this post. I haven't wanted to go here so I haven't spent a lot of time researching this. I was referred to another doctor for that, and I have my appointment on the 25th. His therapist says he needs something to slow his mind down, that it goes from zero to 60 in a second, and he becomes all impulse, and by the time he gets to the point that he can think he screwed up. He needs something that will help him to be able to slow himself down enough to have a chance to overcome the impulse and use the strategies he has been taught. I don't know what kind of medicine does that. We are also trying to work with him to see more positives, rather than always focusing (and blowing out of proportion) the negatives in everything, which hopefully will keep the anger from manifesting itself in the first place.

I would think tenex might be a good option. It has very little adverse side effects.