My son is so sweet. I know this. I will never believe otherwise. There is not a malicious bone in his body. He has such a gentle, sensitive heart. He would never intentionally hurt anyone.
But I fear.
Kbug will be 13 this month. He is one inch taller than me and 145 pounds of pure strength. The hormonal changes seem to be making him very irritated, agitated, and angry. When he gets frustrated or wants to get out of an activity — which is most of the time lately — he’ll cry, he’ll stomp, he’ll kick the wall. He grits his teeth and tenses his body, he slaps his hands on his hips, and he seeks pressure on his forehead or right above his upper lip — he might grab someone’s hand and try to bring it to his forehead or lip for pressure (having some claim he was trying to bite them), or press his own forehead on your shoulder or elbow. He cries. His volume increases, crying and yelling various sounds and slapping the table so hard it shakes. Yesterday, he attacked the therapist repeatedly by grabbing, tackling, throwing around his arms and legs, and when I tried to help, he blindly attacked me too. I felt his strength in this almost fugue state he was in and it was scary. He head-butted me; I know it was for pressure and not to hurt me but it still hurt. I have a very minor black eye. He was oblivious.
My son has always had episodes of mania where he’s extremely giggly and non-compliant. He wants to engage others in this extreme silliness, and will grab and fall on people. He will start hopping on one foot in a circle and fall, crashing into nearby things on purpose. He can start chirping and laughing very loudly. This usually happens in Target at the farthest point in the store from the front doors. (Target, by the way, is my son’s worst behavior store. He’s much better at Wal-Mart.) Now, these manic episodes can turn into the angry episodes very quickly so they are basically the same behavior.
We took Kbug put-put golfing last weekend. He didn’t like the instruction his dad gave him; he just wanted to kind of push the ball to the hole and had to be prompted for even that level of engagement. We played five holes with Kbug crying loudly, and then I watched as my mainly non-verbal son angrily struck the golf club repeatedly against the ground. He didn’t want to play and we were making him play and he was mad. And he was telling us that in his way. And he was completely innocent and had absolutely no idea he had a weapon in his hands.
So I fear.
Kbug has never demonstrated empathy. I have cried in front of him and he has never shown the slightest concern. His own reaction to pain is inconsistent and sometimes inappropriate, like laughing when he stubs a toe, and his reaction to others’ distress is excitement which comes off as enjoyment (he really is sweet, I swear!). His understanding of pain is a complete mystery to me. His understanding of danger, to himself or others because of his actions, is unknown to me. I have no idea if he understands his actions enough to have any remorse.
Working on behavioral ways to alleviate and deal with his frustration, anxiety, and anger is a specific goal on his IEP and his ISP, as well as a family goal. I called the behavior therapist last night and she is coming up with strategies right now. His mania was really bad when he was 11 and we put him on Abilify (only 5 mg) for a little over a year and he gained 50 pounds and became pre-diabetic so we switched to 40 mg Geodon for 4 months. I saw signs of tardive dyskinesia (I did! I don’t really care if he wasn’t on it long enough to develop it or not, Mr. Psychiatrist) so we took him off that and I will not put him back on any anti-psychotic medications even if they help a little. I don’t want to put him on anything again, Depakote and Lithium are the only options left that I know of and either of those are going to be an absolute last resort. We are only a few weeks away from the communication device with all the professional support and hopefully we can help my son find his voice and some peace with that.
My son deserves the world to see his sweet nature. Because it is there, even if right now it is very hard to see. He would never intentionally hurt anyone.
But it still might happen.
I fear.
Kbug's Teen Years 
My son is on Risperidone 1ml morning & 1ml evening and it does help keep him calm but not entirely. At 18, he still does have screaming fits and stomping his feet. What the medication seems to have done is help when he becomes aggravated or aggressive. I know how helpless you feel at times, but all we can really do is talk too one another & try too comfort each other. Take care of yourself.
Thank you Barbara! Both the Abilify and Geodon helped but not also not completely. I’m not ruling out meds, just if we have to try them again we’ll go with a different class. You take care too 🙂