Milly Meets Lavender

Recall how I spoke about Milly, my Aspie 10 year-old, and her new fascination with sexuality.  We had The Talk with her, and now she’s bursting with questions about “doing it”.  I thought we were finally past the worst of it.  She stopped asking me if I liked “neck kissing” like the ladies on TV.  She stopped asking my husband and me what we were really doing in our bedroom when our door was locked.  After all, we don’t always lock the door.  Why lock the door only sometimes? Were we having sex?

Aspies are not subtle.  It’s positively grating and unnerving, but, on some level, I thought it might be good for me.  Let’s just get it all out there.  Yes, men have penises.  Women have vaginas.  Men put their penises in women’s vaginas.  They roll around a lot when doing this.

It doesn’t sound the least bit fun when I put it like that, does it? I’m trying to imagine some guy in a bar saying to me, “So, I’d really like to put my penis in your vagina.  Whadya say?” I shudder at the thought.  I think that’s how Milly is imagining it.  She is very literal in her interpretation of events.  Sex must sound positively disgusting to her then.

So, imagine Milly’s confusion and my husband’s amusement when, last night, Milly decides to go digging in his sock drawer for a flashlight.  The sock drawer seems to be a place to hide things for many people.  For years, we have hidden a variety of things under the socks in my husband’s sock drawer because the girls weren’t tall enough to reach it.  Secondly, there has never been a reason for any of the children to go looking in their father’s sock drawer.  They don’t wear men’s socks after all.

Milly is different.  She thinks like her father.  He keeps a flashlight in his sock drawer ergo she will look in his sock drawer for a flashlight.  Would she think to ask out of respect for our privacy? Hell, no.  Her only goal is to find a flashlight.  Did she find what she was looking for? No.  She found something altogether different.

She found Lavender.  My vibrator.

She hoisted the lavender vibe high in the air and declared more than asked, “Wow! What’s THIS?” I wasn’t home.  Thank God.  My husband looked up from his computer, and, apparently, tried to look insouciant.

“It’s nothing.”

“But, what is it?”

“Nothing.  Put it back.”

“What is it?”

“It’s not a flashlight.  Put it back.”

She reluctantly returned Lavender to her resting place and continued searching for a flashlight.

My husband quietly informed me of last night’s events this morning as I drank my morning coffee.  Not only does Milly find everything I try to hide, but she also has the hearing of a dog–“I can hear you, you know,” she shouted from two rooms away.  I asked my husband if Milly figured out what Lavender was for.  He just laughed and shook his head.

I can see it now.  “Does Dad massage you with that purple thing? Why is it shaped like a penis? What do you do with it? Where do you put it? Why do you have one? Does it belong to Dad? Does he use it on his feet? Is that why he has it in his sock drawer? Why is it purple?”  The next time the door is locked: “What’s going on in there? I hear a noise.  Is that purple thing out?”

The sad thing is…this is the most action Lavender has seen in a year.

I gotta get these kids out of the house more.

Schizoaffective Disorder vs. Schizophrenia

I’ve gotten a lot of hits on this blog searching for the difference between schizoaffective disorder and schizophrenia.  It’s an important question for not a few reasons.  It’s an even more important reason if you’re the caregiver.  Grace’s exact diagnosis is schizoaffective disorder-bipolar type.  When she’s stable, that means that the mood component of her diagnosis is relatively under control.  She does, however, hallucinate almost daily, and we do deal with a certain level of paranoia almost every day.  Grace experiences sundowning which means that as the evening comes her symptoms worsen.  Last night, for example, at 6:45 PM, her speech was disorganized; she was fearful to sleep in her room.  She was stumbling around the house and mumbling to herself about something I couldn’t understand.  I saw her swatting at the air.  For Grace, this is actually pretty decent symptom management.  We wouldn’t have any sleepovers when she’s like this, but this is the reality of managing psychosis in a young person who experienced the onset of this disease at 10 years-old.  Overall, I am looking for insight.  Does Grace know that what she sees isn’t real? Yes.  Does Grace know that her fear is a product of her brain misfiring? That’s a bit harder actually.  Lately, she’s been waking up around 4 AM and lying in bed paralyzed with fear until morning.  She’s too terrified to get out of bed and ask for help.  There is a lack of insight into her fear.  We are working on this.

What I’ve described is the “shizo-” part of schizoaffective disorder.  In Grace’s case, however, she truly has almost all the symptoms of schizophrenia including the cognitive symptoms.  The “-affective” part of schizoaffective disorder refers to either mania, depression or a mixed state.  In Grace’s case, she has experienced all three while experiencing psychosis.  I would say that it was frightening, but it was also just plain weird.  She presented as an adult in her bipolar symptomatology with four weeks of severe depression, one transition week characterized by intense migraine-like headaches, and two weeks of mania.  This was a predictable cycle.  Attached to this was psychosis complete with positive, negative, and cognitive symptoms.  During her mixed states, we battled suicidal ideation.

Some clinicians believe that schizoaffective disorder is really just a form of schizophrenia.  Some don’t know what to make of it.  Some clinicians believe it to be on the bipolar spectrum.  Here’s what I know from the literature.  If a person had psychotic symptoms prior to the emergence of affective symptoms, then you are most likely looking at a schizophreniform diagnosis.  Grace has hallucinated for most of her life.  The affective symptoms didn’t show up until she was ten years-old.  This places her on the schizophrenia spectrum rather than the bipolar spectrum.  What does it matter since she would be clinically treated the same? It matters because schizophreniform diseases tend to progress, and a child must be cared for very specifically if they fall on the schizophrenia spectrum.  Bipolar disorder tends not to progress.  In schizophrenia, the brain atrophies.  The brain, on average, loses 5% of its mass, and there is an aggressive form of schizophrenia wherein patients can lose up to 20%.  Most people will lose that 5% in the first five years after the prodromal phase of the disease.  The interesting part of dealing with something like schizoaffective disorder in children is that there is no way of knowing which way a child will go until they reach about 18.

Grace is being closely watched for the development of pure schizophrenia as well as for how her current symptoms progress.  There are a few things that often determine prognosis.  If you have a family history of schizophrenia (Grace’s great-grandfather), maternal prenatal complications (check), and an early age of onset, then oftentimes the prognostication isn’t promising.  So far, Grace is doing as well as I could ever imagine in terms of her own personal level of hope for her future, but her brain is being ravaged.  She is not the same girl she was three years ago.  Not by a long shot.  Her biggest accomplishment this month is that she learned to unload the dishwasher.  This might sound odd that a 13 year-old girl just learned to do this task, but Grace’s executive function skills are so impaired now that unloading the dishwasher was, for her, like reaching the top of Mt. Everest.  She was very proud.

For one of the best discussions on the differences between schizoaffective disorder and schizophrenia, please read the following article complete with slide deck.  You’ll see just how nuanced the issue really is and what a pain in the ass these nuances are for the cream of the crop in the mental health field.

Resources:

Understanding the Diagnostic Challenges of Schizophrenia Versus Schizoaffective Disorder (Slides With Transcript)

FragEEElay

The holidays are seductive in their nostalgia.  As soon as the cooler weather arrives (or perhaps the warmer weather in the Southern hemisphere?), I begin to think about what’s on the way.  I used to think of the forthcoming onslaught.  The frenzied shopping, the familial demands, and that Xanax prescription hidden in the back of my closet, tucked away for just the right moment.  No more.

I cleaned things up around here.  No more mean relatives for Thanksgiving or Christmas.  No more obligatory holiday parties with family members we haven’t seen in five years “just because” it’s what we’re supposed to do.  I know too many people who hate the holidays because of the stress, and I didn’t want to be one of those people anymore.  I thought I had done a pretty good job of a seeking out and eradicating the holiday awfulness until…

The girls had an extended Thanksgiving Holiday break.  This translated into three days home during the week and the following weekend.  Five days.  Doireann is almost 17 now.  She sort of skipped being a typical teenaged girl and went straight to 65 year-old curmudgeon.  She’s the embodiment of Crankshaft from the comic strip.

crankshaft_081219

Eadaoin, on the other hand, is the embodiment of a 15 year-old girl but amplified 100 times due to her mood and anxiety disorders.  On one day, she might be relatively stable.  The next day she’s crying and moody.  The day after, she might be awake at 3 AM eating marshmallows in the living room while watching cartoons.  She is prone to panic attacks and crying in public at the drop of a hat.  Due to her mood lability, she can be quite rude and self-centered.

Grace is herself.  She tries to do well every day.  Currently, she tries to deal with Eadaoin who is wrapped up in her own world much like Grace was a year ago.

And then there is Milly, the 10 year-old Aspie who just wishes her sisters would get their shit together.  Typically, Aspies are about two years behind developmentally so Milly is about 8 years-old emotionally.  She is beginning to play with toys and games appropriate for a girl who is in the second grade.  She is also trying out new behaviors that I’d really like her to forsake, but all children do this.  They watch other children essentially act like assholes, and then they come home and give it a whirl.  “Hey, I just saw a kid throw a granola bar at his mom’s face.  I wonder what would happen if I did that? Hmmm…that kid is throwing himself to the ground and yelling at his mom.  What would happen if I did that? That kid just flipped his mom off with his attitude.  I wonder what would happen if I did that?”  Some kids do it only once and get a clue.  Some kids are tenacious and must experiment many times before they form a proper hypothesis, gather enough evidence, and come to a conclusion.  Milly seems to be the latter.

So, what do you get when you put all four of these children together for five days during two major holidays–Thanksgiving and Hanukkah? Mayhem.  You get mayhem.  The first night of Hanukkah was peaceful, but there was an argument about lighting the candle.  Grace was fearful about a fire starting, and Doireann had to say something snarky.  Enter the Powder Keg.  I had to stay up late to finish all the pie baking for Thanksgiving so I woke up on Thanksgiving Day with a migraine.  No matter.  Drugs and coffee took care of that.  The Powder Keg sat in the room with everyone waiting to be lit.  The bickering began.  Like hens clucking and pecking, the girls were at each other all day long.  We made it through the Thanksgiving Feast for which I was grateful.  The next day it was tense.  More fighting.  More problem solving.  Eadaoin was instigating.  Milly was antagonizing.  Grace was pacing.  Doireann was avoiding.  My husband was reacting. I was protecting the Powder Keg.  Saturday arrived.  The day we buy the Christmas Tree.  Yes, yes, we celebrate Hanukkah and Christmas.  We’re one of those families.  Tensions were running high.  Everyone demanded that the tree meet certain specifications.

“It must be fluffy like a wedding dress!”

“It should be tall!”

“It should be majestic.”

“Come on, you guys, it needs to fit into the living room!”

Then Eadaoin got lost in the nursery, and everyone panicked.  I sent my husband to find her.  He found her by the koi…of course.  Decorating the tree was like herding feral cats.  It wasn’t fun at all.  It was an exercise in torture.  By the time I got into bed an argument broke out between Eadaoin and Grace.  How could they still have energy to argue at midnight? Why are they still awake? Why do I have children? Will the Powder Keg explode?

Sunday arrived, and I was dragging.  My husband was hiding in the bedroom, and the children were looking sheepish.  I wanted to run away to the art museum alone which was my plan.  I had mediated numerous arguments, dealt with one too many bad attitudes, and not enjoyed the holiday break at all.  I just wanted some peace and beauty, but I had to wear the chauffeur hat and take Eadaoin to a tea party.  My husband and I decided to use our time last night to visit the museum and grab a bite to eat.  Finally, a moment of peace.  No children fighting.  No bipolar moodiness.  No schizophrenic sadness or lability.  No autistic rigidity.  Just the two of us.  A little holiday festivity and no children to spoil it (I do love them, you know).

When we arrived at our domicile, we were smacked in the face with an atmosphere of both contrition and defiance.  Doireann had cleaned the kitchen and was folding laundry.  I have never seen her fold anyone’s laundry but her own.  She had a repentant look upon her face.  She shrugged and said, “Yeah, we’ve been jerks all weekend.  I figured I could do something to help out around here.”  Words failed me which Milly was more than happy to make up for with her larger than life attitude.  “I want a tent in my room! But someone won’t buy me a tent so I made a fort in the living room! And, no, I don’t want to clean it up now because I’m playing with it.” I had just about had enough of her over-the-top attitude, and I could hear my husband draw in a deep breath; I figured he was ready to take her out as well.  Bill Cosby once said,  “You know, I brought you in this world, and I can take you out. And it don’t make no difference to me, I’ll make another one look just like you.”  I thought of him last night as Milly squared her shoulders and stood her ground, protecting her fort.  I searched myself for self-control.  I really just wanted to cry.  That Powder Keg just might go off, and it might go off inside me! I was spending all this money on Christmas gifts…why? I faced off with my daughter and said, “Your fort has twenty minutes to live.  Enjoy it.  Then, it will be put away.  You will then get ready for bed.  That’s the deal.  And, you will also think very hard about your tone of voice and attitude.  Understand?”  She gave me a defiant look.

I proceeded to the dining room wherein I unpacked one final ornament.  The “funny” ornament.  Every tree needs one.  Ours isn’t unusual.  It just makes me laugh.

leg-lamp-ornament

It’s a major award!

Yes, it is the infamous major award “leg lamp” from the American Christmas film “A Christmas Story”.  If you haven’t seen the film, this very tacky and gauche lamp was won by Ralphie’s father.  It arrived one night during a cold December, and Ralphie’s father adored it.  He displayed it in the front window of their home, and Ralphie’s mother loathed it.

Electric sex gleaming in the window indeed!

Just like Ralphie’s father, I was going to hang the Leg Lamp ornament on our tree; it was my final act of attempting to celebrate the holiday–my children’s bad behavior be damned!  Milly insisted with a mix of childishness and defiance, however, that she hang the Leg Lamp ornament on the tree.  I acquiesced.  Life has a way of imitating art sometimes, and  just a few seconds later I heard the sound of glass shattering.

Like Ralphie’s father, I ran into the living room and looked at my daughter.  “What happened?”  Her bottom lip was quivering.  Tears were streaming down her face.  “I didn’t mean to break it! I’m sorry, Mama!” The Leg Lamp ornament was broken.  The girls had gathered.  My husband just stood there.  “Well, isn’t that just typical,” he said.  Grace pointed out,”Well, that’s sort of funny that the Leg Lamp ornament broke.  It’s just like the movie.”  In the moment, I didn’t think it was funny at all.  I had reached the end of myself.  I saw the irony.  I could say nothing.  Actually, I could say a lot of things which is why I chose to make myself go to my room.  I just turned around and exited the scene.  I could hear Milly wailing.  I let my husband handle it.  I sat in my room and cried for about five minutes.  Then, I came out.  I hung up the broken Leg Lamp ornament.  It’s a testament to our Thanksgiving holiday.  We made it through five days of being together and survived.

The Leg Lamp didn’t.  It’s a good thing humans aren’t fragEEElay like Leg Lamps.