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How and if to discipline for bad behavior during highs

Discussion in 'Parents of Children with Type 1' started by pabiabi, Mar 10, 2012.

  1. pabiabi

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    A bit of background. My almost 12 year old was dx a year ago this week.

    We were completely blindsided by this as there is no diabetes in our family history. Of course AFTER the diagnosis, many things over the last couple of months began to make more sense.

    One of those things was how her personality had changed. I remember googling "the bipolar child" a few weeks before she was dx.

    My daughter is normally a very affectionate and loving child. My dh and I have often commented how wonderful it is to have such a sweet child when our others outgrew the hugs and "love yous" at a much earlier age- she has remained very affectionate and a people pleaser. SHe never fails to write us sweet notes and tell us how much she loves us.

    However, that all does a complete 180 when she is high (over 250 ish). She becomes completely irrational, will scream at the top of her lungs at her siblings, throws things, slams things- has even laid on the floor kicking and screaming like a 2 year old in a tantrum. It is such a dramatic departure from her "normal" self, that in the past we have done our best to ignore these outbursts and coax her in to testing and correcting.

    But I have started wondering if this is the right thing to do. While I realize that she doesn't have the full capacity to think clearly, going through life with outbursts like this, will in the long run I think, make her life more difficult.

    And coaxing her thru testing and correcting is becoming harder and harder too as it makes her SO mad when I suggest it. (I can relate in the sense that when I am moody and my husband suggests it is PMS- it really makes me mad... especially when I know he is probably right!)

    She was in a middle of one of these episodes this week so I took her computer access away. She began "growling" at me and actually started to hit me. That's when I realized I need some additional parenting skills to work through this.

    Do any of you have a child of about this age (12) who reacts so strongly to highs? How do you deal with it? How do I know how much she is capable of controlling and how much is really beyond her ability?
     
  2. Becky Stevens mom

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    I do know my son doesnt feel very good when his blood sugars are very high. He doesnt behave innappropriately though. And you say this has been going on for awhile now? Could some of it be due to hormones? Does your daughter seem to be angry about having diabetes?

    I remember when Steven was much younger he would have awful tantrums and I would test his blood and it would be on the high side so I assumed that his blood sugar was high and it made him have these temper tantrums. I spoke to the CDE about it and she said that it was possible that the tantrums were causing adrenaline highs. Kind of like, what came first? The high BG or the tantrum. She also told me that if he was having a tantrum that I should discipline him as I would my other son. She said that I could test his blood, treat him if needed then give a time out or the usual punishment for that type of behavior.

    I think all kids need definite boundaries and rules to follow. Of course I dont know your child. You may want to discuss this with the endo and see if there is a social worker at the hospital that you can speak with.
     
  3. Rcj176

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    Hmmm...
    When Elizabeth was younger and during diagnosis time she would walk in a room and all the other kids would "duck" for cover. She was the meanest thing ever. Because of her age it was easier for us to try and redirect her without having to pull out all the discipline with her. She couldn't help it and didn't know how to express herself.
    Now with Emily, she is 12 as well. She was diagnosed 15 months ago approximately and is in the full puberty timeframe. She has outbursts towards others that I have to sit down and have talks with her about...but nothing as physical as you have described with your daughter. I have just been explaining the feelings she has been having. They have been increased with a higher than normal blood sugar and during her monthly visitor or right before. I am just reassuring her of what is going on and hoping that at some point she will realize this and be able to remove herself and go take a hot bath or walk away from a situation before it escalates.
    Is there another adult that can help you diffuse the situations? Or can she be reasoned with enough to help her understand what is going on?
     
  4. Sarah Maddie's Mom

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    I can't say that I've seen anything like this. Grumpy and a bit short tempered when high (very high 300's) and for a prolonged time, but not anything much more than that.

    Are you sure that this tantrum behaviour is always linked to bgs? I'd really want to be sure on that point if I were you. In the meanwhile, I think she's old enough to take her aside, when she's not high, and talk with her about the inappropriate nature of her tantrums and help her come up with other ways to cope with her feelings that come from highs, if that is in fact the root cause.

    It is a difficult and emotional age but still, I think you are right to want to put an end to these outbursts.

    Good luck!
     
  5. MomofSweetOne

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    It sounds to me as if you may be dealing with a systemic candida/fungal overgrowth in her body whose symptoms dramatically increase as high BGs cause the fungus to release more toxins into her body.
     
  6. Lakeman

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    As a parent I think...Could your response to these behaviors be equally appropriate regardless of the reason for the behaviors? If she is acting in ways that need to change what does it matter why the behaviors need to change as long as she can? Would it not be equally appropriate, for example, for you to let her know what her behavior is and that it is not ok as a first step no matter the cause? Uncontrollable behavior of course would not be punished - but we neither know that this is uncontrollable nor is punishment in the lay sense of the word our only option.

    Say what is not appropriate
    State your expectations
    let her know how you will help her to change her behavior
    let your actions be as logically connected to the behavior as possible
    and let it be as without anger as possible

    I think it is often possible to find responses that address both "medical" issues and behavioral issues

    best wishes
     
  7. nanhsot

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    This is a very touchy issue for me, as my son has pretty radical behavior changes when he's high as well.

    For us it is something we've talked out when he is NOT high, so we can come to some understandings of what we expect.

    Basically, we let him know that we know he can't control his anger at those times, but that the way he treats us is NOT acceptable and we won't allow him to treat us that way.

    Personally, I now remove myself from the situation. He KNOWS he is high, he now recognizes it, and pointing it out only exacerbates his anger. It's hard but my current method is to disengage, ignore, walk away, not engage the fight. Treating our property with disrespect (computer, etc) is not tolerated so if something needs to be taken away it is, but really only for the duration of the outburst, not in a punishing way. So if she's throwing things, remove all throwables and walk away from her, leave her alone so that she has nothing to focus her anger on. (my son doesn't physically lash out though, so I don't have a lot of experience there, he lashes out emotionally).

    I'm not really articulating well, but basically my current way of dealing is to just leave him alone. He is in charge of his own diabetes for the most part so I am confident he will test/correct and he generally does, what I have changed about my own reaction is to just leave him be, don't feed the outburst and don't acknowledge the reason. When he's that angry he sort of wants to engage/fight/anger others for some reason, so that's where I focus my reaction and don't engage. He's gone so far as to tell me what's wrong with my marriage, and my parenting, etc, so it's like he TRIES to tick me off (he's admitted this). It's so out of character, he's a very calm, logical, reasonable, sweet guy normally. He's opinionated and outspoken, but never mean. Except when high.

    We did take him to a counselor for a while, to address this specific issue. The counselor is also Type 1 and recommended by our endo team. He gave him specific things to work on at these times (after the rages he realizes and was wanting to change). I have not asked him for specifics as it is his private session, so I really can't tell you what he's changing but things are better. You might see if a few anger management type sessions with a counselor (preferably one who deals with D) might be helpful.

    For our family we also deal with it head on in that when he's calm we tell him that managing his diabetes MUST be a priority, that his behavior is such that being high is a big problem and he can't ignore his numbers and staying in good range must be respected. Basically he knows that of course for his health staying in range is needed, but also that staying in range is important for our family's mental health. And he does understand this and works to get there. So I guess I'd also focus on what is making her high and prioritize avoiding the highs. More easily said than done, and diabetes happens, so know I understand that! But if the highs are frequent that's a problem I'd address more aggressively, to avoid the behavior. At 12 a girl is going through lots of physical changes, so you might be needing a lot of tweaking at certain times of the month for example. So while addressing the behavior is of course important but I didn't want to ignore the obvious in that her diabetes management may need an overhaul during puberty.

    For my son he strongly dislikes his own behavior, acknowledges how awful it is, which helps. I know he doesn't choose to be that way and he dislikes it within himself even as it happens. That does give me empathy. But being empathetic doesn't mean I will tolerate being treated that way. So now I remove myself, don't engage, walk away.

    I've shared with him that I am scared for his own marriage, that he needs to figure this out NOW because a wife may not understand and continue to love like I do. A mom can't divorce you....you can't undo a biological relationship after all! Not so true of a wife. Same with work situations, etc. That seemed to make a pretty big impact on him, realizing that his whole future could be impacted by his behavior. (though I will say he never does this to friends, really only to me and somewhat to his dad/sister)

    Good luck, happy to talk this out anytime if you like.
     
  8. hawkeyegirl

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    You know, Emma (a young adult T1 who posts here) had a really insightful post on this a little while back. I hope she chimes in here. Essentially she said (and I hope I'm getting this right) that for her, bad highs are similar to bad PMS. It's definitely a biological reason for her to feel bad and cranky, but she's not without ability to realize the reason she feels that way and mostly able to avoid taking it out on others. I think it's a learned skill to get to that point, and it's something you can help your child work on.
     
  9. emm142

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    Hello ;). Yep, I don't claim to speak for anyone other than myself, but for me highs are definitely comparable to bad PMS. They make me feel crap and they do make me more likely to get annoyed with people, but I do still have the capacity to restrain myself from being mean. If your daughter is anything like me, I think it would be far from beneficial to teach her that she has no control over herself when her BG is high. After all, if you teach her that she can't control her outbursts then she will think that she can't control them and she is less likely to bother trying to. On the other hand, if there are consequences for her actions whilst high then she is likely to try and control them. I'm not advocating anything radical, but personally (if she is like me) then something like a computer ban or whatever seems fair enough.

    It SUCKS that we have D and it really sucks that sometimes it affects us emotionally. I hate the times that I'm stuck in the 300s and I'm angry at the world and I don't even like my best friends. On the other hand, I have been taught self-restraint so that I am able to act normal despite feeling like crap, and I am very glad that I have. If I wasn't able to control my behaviour whilst high, I don't think that I would have any people left to be friends with when my BG is in range. ;)

    In short, I think that consequences are generally a good idea for bad behaviour during high BG, and I'm glad that I had them.
     
  10. pabiabi

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    Thank you all for your insightful responses. I read them all and took them to heart.

    I am 100% convinced that Riley is affected by high BG. They make her irritable, mean, irrational and somewhat combative. I believe that the possibility exists that her 12 year old hormones could be playing in to this, but it's such a stark contrast from when her numbers are good, that it's impossible to ignore.

    Yesterday, while she had 4 hours of good numbers we had a little chat. I referenced the other day when I took her computer away. I asked her about growling at me. She was clearly embarrassed. I asked about hitting me and she says she doesn't remember that. I think she does, I think she is embarrassed about that too- as she should be.

    So- here is what we came up with. I'll have to let you know later this week if it actually works. I told her that when I witness this kind of behavior again I am going to give her a hand signal (she hates being told to test). When she gets that hand signal, she needs to grab her kit, go immediately to her room I to be alone, test and correct. It was agreeable to her at the time. But I am not confident it will work when we are up against the "beast".

    Again- thanks everyone.
     

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