Thursday, August 9, 2012

Some good news

Evil Extremo has been defeated! It's only been a few days, but I think it's safe to say that, for now, Perrin has decided to honor his commitment to transform the villain to the superhero. We have had a few hiccups where Extremo has emerged during times of extreme frustration, but those times have decreased more and more with each passing day. Yesterday, he reared his ugly head during tutoring for just a few minutes, and he immediately apologized and renewed his promise to work harder at being good. There was another moment when Perrin started to scrunch his face up in villain mode, and then excused himself to his room for five minutes to rage it out. He emerged fully refreshed and cheerful. I feel that Extremo has been Perrin's way of compartmentalizing his anger and keeping it contained within this character, so I don't yet want to discourage him from expressing those negative emotions in a way that he can deal with. It's a hard line to straddle - we want him to be able to work out his anger and frustration in appropriate ways while not feeling that he has to isolate himself to do so, but for now, I think it's best to contain it until he can express that without exploding or becoming physically aggressive.
He is also no longer retreating as far into the fantasy world as he had been. I'm seeing more and more moments of clarity where he can stay engaged in conversation or appropriate play with friends, resulting in some very successful playdates. The mania is subsiding, and he's able to quiet his mind and body long enough to be truly present in life.
I'm optimistic that this is the beginning of a good period for him. We have had great success with the medication that he's been on for the last 2 years, and I know that someday we'll no longer be able to use it, but I'm hopeful that with the addition of the trileptal, we will see longer periods of stability. But, honestly, for now, I'm just gonna live in this moment and cherish the calm for as long as it lasts.

Thursday, August 2, 2012


I haven't posted in awhile, because not much has changed. Perrin's mania lasted for over a month, with our days spent trying to keep him calm and safe. His neuropsychiatrist prescribed trileptal, which is used for bipolar disorder and tics, and he started taking it this week. He also increased his risperidone dosage, so hopefully things will calm down soon. The last couple of weeks have been challenging in dealing with rapid cycling with some severe mood swings. Perrin will be ridiculously happy one second, and then in the depths of despair the next, crying that we all hate him and that we shouldn't love him. His anxiety in social situations has increased substantially, and the mania only added to this. During one playdate, he just walked in a circle around the room singing, and when I tried to talk to him, he just kept saying, "Mom, I can't stop moving." He literally could not stop. He was frantic. I do think that his mania is coming down, which is why we're seeing more mood swings and anxiety. I'm hopeful that the new medication combo will help him become a little more stable. It would really be nice to have a coherent conversation with him again.

Our most concerning issue right now is with Perrin's alter ego, Extremo. Last year, Perrin developed an obsession with superheroes. Then he started creating superheroes and supervillains of his own, giving them unique powers and personalities. We were fascinated and applauded his creativity.  At first, it was just this funny little character that Perrin would pretend to be, and we would all battle it out in a very nonviolent, fun way. But as the mania increased this last month, Extremo emerged more frequently, and now Extremo is Perrin's primary persona. Very rarely do we see Perrin anymore. He introduces himself to people as Extremo. He growls, puts on this scary face, and becomes a villain. Ask him a question, and he responds as Extremo, going off on a long monologue about defeating "those pesky superheroes." I'm going to be brutally honest here. Extremo is a bit of an asshole. I do no like Extremo. He's rude, beligerent, defiant, and mean. Extremo laughs maniacally when told to do something. He does not care if he has hurt you. He doesn't care that he scares other children to the point where they don't want to play with him. If Extremo is satisfied, then Perrin shows himself and is a sweet, fun-loving child. Often it's like watching a person emerge from a split personality, and Perrin will apologize for Extremo's behavior and seem genuinely remorseful.  He's quite happy as Extremo, threatening to destroy the world and at times, even threatening to destroy me if I don't turn to the dark side. You see, he has turned me into Anti-Girl, and I am a superhero that must be destroyed.
Both Perrin's neuropsychiatrist and psychologist are as concerned about this as we are. At times I'm not even sure how tight Perrin's grasp on reality is, and there are days when he's so retreated into this fantasy world that it's almost impossible to talk to him about anything.
Bear in mind, we don't just allow Perrin to act like this without consequences. He has lost many a privilege due to his behavior when he's Extremo. He simply doesn't care about them. Do you think a true evil villain cares if he doesn't get to go to Chipotle or can't watch TV? Nope. He'll just spend that extra time plotting his next move to destroy the planet. He serves up his revenge quite cold.
The psychologist and I had a long talk today during his session, and we agree that it's time for Extremo to go. We're now in the process of trying to turn Extremo into a superhero before banishing him altogether. Perrin has agreed that if Extremo feels the need to do evil things, he will go to his room to do them and emerge as a hero. What upsets me the most about all of this is that Perrin has told us many times that he just doesn't like being Perrin, and no matter how much love and praise he gets, he still feels that he's not deserving of any of it. I do get it. I truly do. Super villains aren't insecure or sensitive. They just do whatever they want and to hell with everyone else. They don't have tics and have a hard time reading. But they're also lonely and reviled, and I can't allow Perrin to retreat so far into this that he can't come back out. I do not want to stomp out his creativity and his amazing imagination, but I also have to raise a child who can function in society at some point. Too bad we can't exist in the Marvel Universe.