Depression isn't just sadness

For those of you who haven't been following along I was diagnosed with severe Depression, severe Anxiety and Post Traumatic Stress Disorder in late February.

Of those three mental illnesses, the only one I was aware I had was the Depression.

In light of Robin Williams losing his battle with his Depression, A LOT of postings, comments, articles etc have circulated about Depression and some of them not really explaining Depression for what it really is.

It is more than sadness.  AND he lost his battle with his mental illness.  He didn't choose to kill himself anymore than a person chooses to have a heart attack.  Unfortunately treatment wasn't enough and my heart and prayers go to his wife and children.

Depression is like all the colour has been sucked of the world, a weight dropped on you, a voice of self doubt/loathing/all things negative sits in the back of your head making quips about your choices/lack of choices etc. It is all encompassing and it is entirely internal.  Oh yes there are physical manifestations from the Depression, but it starts from within.

I often refer to it as falling down the Well of dark and despair.  The further down you fall the harder it is to see the glimmer of light above -hope.

It is a circle of self defeating behaviour that even when you know what to look for can be hidden quite well.

I can tell you that only those who were given the privilege of reading my LiveJournal knew I suffered from Depression.  To everyone else, I was this up beat, always smiling, always happy person.

It was the face I showed the world despite the fact I was falling apart piece by piece on the inside.

And even those who could read my LiveJournal weren't always privy to the worst posts.  The posts I deleted after writing because I didn't want to worry anyone with how bad I was feeling.
Because I was afraid of losing the thing I hold most dear to me, my son, if anyone read what I wrote and decided I wasn't a fit parent because I was broken.

All of the posts I deleted were dialogues about me working through whether or not I should take my own life.

To the LiveJournal whole of you I said the only reason, and I maintain that still to be true looking back, that I am here today is because of my son.

The only thing I wanted to be in the entire world growing up was a Mom.  So the thought of walking away and him living a life without me was near impossible.
Though in the darkest of moments even that wasn't enough to stave off such thoughts of ending my life.
Not because I wanted to leave him, or any of you, but because it was the only way I could get away from the Darkness and Despair.

I know now that some amount of my issues played a part in the failing of my marriage, it wasn't the only thing, but it did factor in.

This is why I had to move home.  This is why I am in counselling.  This is why I am taking an antidepressant that I laughingly refer to as my "happy pill."

This does not mean my struggle is over.  Even with an antidepressant I struggle some times for a moment, maybe a day to as much as a week. But I am where I can ask for help if I need it and I have a sense of moving up and forward instead of stagnant and downward.

I am still hesitant to jump into the social realm of things.  It is an overwhelming prospect at times.
And I find myself at times holding people at arms length when I don't need to.

It's hard to let people in when you aren't okay and still learning how to be okay.

I don't know if I will ever be totally okay, but I know that I am in a better place then I was even a year ago.

That is good enough for me for the moment.

I have Depression, Anxiety and PTSD so what?

I am so open about it because there should be no shame in having to cope with any of those mental illnesses.
There are valid reasons, situations and circumstances that resulted in me developing Anxiety, Depression and PTSD.

Will I need to be on an antidepressant for the rest of my life?  Maybe, I don't know.

And I am okay with that.

Because the way I was before I found the right medication and amount for me was not the me I wanted to be.  It was a dark, horrible place to be in.

I feel like the me I was before I remembered the stuff from my past.  The me who when working with children had an infinite amount of patience, who wanted to go out and be social, who wanted to get up out of bed. I want to spend time with my child instead of feeling like it was a chore.
And me admitting that while I was at the bottom of the well of depression, anxiety and PTSD that I spending time with my child was a chore doesn't make me a bad parent.  Especially since it was just a chore to get out of bed.  That is what Depression does to you.  It shuts you down and it puts a cloud of dread and darkness over all things good.

I don't feel like I am about to fall to pieces at the smallest thing.  I don't spend endless nights awake worrying about stupid useless things and then beating myself up for worrying about stupid useless things.  I don't rip peoples's heads off and hand them back them for the slightest frustration.  My memory is better AND I sleep well when I do sleep.

Now I periodically suffer the bad night with regards to the stuff that is the root of the PTSD.  With counselling starting, this has been a problem lately, but nothing in comparison to the past.

Yes I have been blogging in some detail about my journey with counselling and the PTSD and it is open to be read by the public, but because the situation doesn't just affect me but others personally on my facebook, google+ etc  I have only posted it to my LiveJournal.  If you wish to read those blogs, let me know and I will redirect you to my LJ.

Of course having said everything above, doesn't mean every day is a wonderful.  Some days are still hard.
They just aren't near as hard as they were before I asked for help.
And asking for help didn't result in the world ending.

And I am not alone.

And so I hope someone out there who is stuck in the Well of Depression that I was will read this and realize they can get help and there is nothing to be ashamed of.

Still Here. Life seems to be Going in the Right Direction

So a year has officially past since I told Andrew I was leaving him.  It will be August 17th before we officially stopped residing in the same house.

I have no regrets, if anything life has reinforced that I am where I am supposed to be now.

I am sad for the loss of the relationship.  Obviously this was not how I would have expected things to end up when I married him 8 years ago.
One thing remains clear we still aren't going in the same direction at all.

William has come to terms with the fact that Andrew and I will not ever get back together.  This does not mean he hasn't stopped feeling sad/frustrated.  He likes that we can get along and we don't fight anymore.
After Andrew attending the All Sections End of Year Scout camp with William and me as a Leader William commented on how that was the best camping trip ever with Mom and Dad because we didn't fight once.


I have started counselling for the issues from my past.  The session itself went well.  I kinda spiraled downward for several days afterward.  Fortunately I went to visit KW and was distracted by gaming, good friends and a birthday party.

I almost feel like me again.  The me I lost a very long time ago.  I am still not feeling as socially inclined as I have been in the past, but slowly that will come too.  I feel at times I still need to hold the world at arms length.

I have my seemingly infinite amount of patience back --which is a good thing since I have taken on the task of home schooling William.

I will be looking for ideas and sites etc in the future for Grade 1 etc.

For the moment I have just been focusing on getting his printing caught up, between Jen (my sister) and I we have found a number of inexpensive work books that William has been THRILLED to get.
He thinks they are the best thing in the world.  And I have let him jump around through the books (especially the ones on spelling).  He has also had to read me a book of his choosing every day to increase his concentration.  We are now getting 3/4 of the way through a book (generally something from the Fly Guy series by Tedd Arnold) before he starts "forgetting" words.  "Forgetting" meaning he will read x number of pages perfectly and then we will hit a point where suddenly he doesn't know a single word --and no it isn't from memorization I have had him start at different points in the books and get the same result.

He is also back to sleeping in his own bed.  I suspect that whatever was causing his stress at school was the culprit because bed time (aside from the "I'm hungry") has been relatively problem free.

William and I are just over half way through me reading him Harry Potter and the Goblet of Fire.
We have now watched the first three movies.  He hated the third movie.  "It had TOO many CHANGES from the book Mommy."  He thought the second movie was okay and he has now watched the first one about 10 times over the past couple of weeks so it is safe to say that is his favourite.

We will be stopping after the Order of the Phoenix.  I am hoping at that point that he will take up an interest in trying to read some of it on his own in a year or two.

I can't wait to hear hit thoughts on The Lord of the Rings versus the movies when he gets older.

Not Life Threatening, just life changing.

Now that I have processed the results of my doctor's appointment last week, I am ready to share.
It has been a bit of a struggle on how to write this, but I am okay with being open about it.  There is no shame in anything that I have.

So last week it was my turn to finally get to meet and discuss me with our new family doctor.

I was fairly confident about this appointment in light of how well he listened to me about my son and got the referral to the Success for School program for William.

We had done the cursory stuff at the general appointment back at the beginning of January.  One of the reasons for my appointment being so late was waiting for the files from my former gynecologist's office to be forwarded to him.  The other because we needed a longer appointment time and I wasn't willing to discuss my issues in front of William.

What I wanted to discuss was my on going battle with Depression.  Anyone who is privy to my live journal would know that this isn't a great surprise and has been on going for years.
That I had tried to do something about it a couple of years ago, but was fluffed off by that doctor as just needing to "exercise more, lose weight and get more sleep."
So I continued to hold all the pieces of me together and threw myself into my work and other things in my life to try and keep the darkness at bay.
I succeeded in making others believe I was okay despite falling apart on the inside.

Anyhow I knew things had been getting progressively worse and the break up didn't help much either.

I hadn't realized just how bad things were, and as the Doctor pointed out, how well I was managing despite it all.  It was also recognized that I was right that I did need to get help or things would eventually get the kind of worse that I have been worrying about.

After a lengthily 45 minute (my appointment was supposed to be 30 minutes) interview and 3 surveys later I was diagnosed with severe Depression, severe Anxiety and Post Traumatic Stress Disorder.

All I am willing to say about the Post Traumatic Stress Disorder is that it is from being sexually abused when I was 9 years old by someone who was a friend of the family at that time. That is all I am really willing to say on this subject at this time.

The Depression and the Anxiety are linked to the PTSD and have had other life factors build on top of them.

I am on a medication to treat the 3 disorders -Cipralex.  I have been referred to the counselling program through my Doctor with the Couchiching Health Centre.

Tuesday was a hard day because not only did I find out just how bad things had gotten I had to find the courage to talk to someone I had only met 2 times prior to the appointment about a sensitive time from my past.  I didn't cry my way through it, but spent the entire time on the verge of crying which is just as draining.

No I haven't noticed anything yet with regards to the medication, too soon to tell ask me in another 5-7 weeks.

So far I am only suffering from benign side effects like dry mouth, lack of appetite and being really tired by about 10pm.  The only reason I am currently up is I am on fever watch with William.

However just the relief of finally having my issues recognized and something done about them has been tremendously huge burden lifted off me.

So not life threatening, but certainly not what I was expecting with regards to the out come of my doctor's appointment to be when I went into it last Tuesday.

The important thing is that I am going to be okay.

Book Review of Mindy Klasky's Girl's Guide to Witchcraft as posted on Goodreads

Recently I won an ebook version of Single Witch's Survival Guide by the lovely Mindy Klasky during an online contest.

I decided it would be best if I reread the original Jane Madison series given how long it had been since I first read them.
If you are looking for a dose of romance and a dollop of fantasy mixed with some witchcraft and a hint of humor this is a good place to start.

I have opted to not go into great detail about the plot because I don't want to spoil anything for new readers.

Girl's Guide to Witchcraft is a nice mix of fantasy and romance.  I like romance and have found good romance to come by.
I am not one for gratuitous sex scenes and having my heroine be rescued by the main male character.  So finding a romance set in a modern day setting coupled with fantasy with no bodice ripping male lead and helpless heroine was a big win in my opinion.  Despite some of the issues Jane face (I don't want to give any spoilers)I found her relationships believable.  Though the second time through I was very much aware of the impending "issues" and I wanted to smack Jane and tell her she could do better!

I find it interesting that because my perspective on life has changed since I first read Girl's Guide to Witchcraft that I relate and view Jane differently.  Jane has trust issues from a previous relationship and I can relate to her apprehension about starting new relationships.  I am also very aware of the growth that occurs to Jane over the course of the book, not just with regards to the romance, but on a personal level too.  Between discovering she has magical powers and her grandmother springing a pretty epic surprise on her she is forced to redefine herself and figure out who she is.


I thoroughly enjoyed reading the book the second (I think it may actually be third) time through.
I fell in love with Neko and his antics all over again.  I find myself always hungry especially after a scene between Jane and her best friend Melissa (who owns a bakery).  Mindy has a way of describing food that make me hungry. I am still in total awe when it comes to Melissa's philosophy on dating.

I look forward to rereading the second book in the series.

Consistency is Key

I think I have been saying Consistency is Key since college.  I don't recall which professor said it in my first year, but it has stuck with me ever since.

A conversation over some of the issues that are arising out of my son's class sparked this train of thought.

See we don't see even a third of the negative behaviour that is occurring at school with my son at home.

Even at Beavers he has pushed the limits, but only twice has he even come close to doing anything resembling what is happening at school.  His Dad complains a bit more about negative behaviour, but that I think is mainly because he hasn't seen his Dad in two weeks etc.  There are other factors causing the behaviour.

Consistency.

It is key.

I can't stress that enough.  If you go back and look at my blog on tantrums, I feel like I say it at least 10 times.

Doesn't matter what aspect of parenting, teaching, home day care, preschool etc etc etc you are involved in being consistent is important.  It doesn't matter the philosophy either.

Children need to know what is expected of them and what is going to happen when certain things occur.

If there is no consistency then they will use that to their advantage be it positively or negatively.

My son has now "tried" 5 different reward based systems at school.  I say "tried" because with the exception of the sticker chart none of these have been tried past the 2-3 week mark because they weren't working.  
I am using a modified of the second version to decent success.  He has criteria that gets him a reward if he follows through.  There are 3 goals set out each day.  One goal is always achievable, not ridiculously easy, but one I know he can meet with ease (getting dressed/washroom routine at meal times or setting the table/clearing the table etc).  He needs to feel successful for this to work.  The second goal will be something he can do, but struggles with from time to time (ie getting dressed/undressed for outside/school).  The third goal will be something he is working toward but doesn't do consistently at all (cleaning up properly, homework (reading etc), Listening and participating at Beavers (this has been down graded to a goal 2 now).
He always gets the goal 1 achievement.  The rewards on goal one range from little bugs and such from the dollar store (sold in packs of 8, he gets 1 per successful day), goal 2 can be things like educational iPad time (means he has to play his games not mine) or snack treat he doesn't get often etc, goal 3 are things like iPad time where he can play any game he wants (aka Angry Birds, Cut the Rope etc), tv time, going to a movie etc.
Each morning we review what the goals are for that day and we go from there.  He is allowed reminders as long as he doesn't throw a temper tantrum (rare at home) or start screaming at me (was becoming an issue since mid January).  Either of the two behaviours I just mentioned occur and he loses the reward.  Though the screaming gets one prompt of "You need to Stop, Breathe and Think through what your choices are.  You keep screaming we are done."
After the second week there has been a significant decrease in the screaming and currently all I need to do is the cue of Stop Breathe and Think and he comes around within 30 seconds.

They are still struggling to get consistent success at school.  In part because I don't think they are consistently implementing anything they have tried with him.
And neither have the expectations been explained clearly to my son.

He can't tell me why he is getting a star.  He just knows if he gets 5 of them he gets to do something he wants for 10 minutes.  Generally that something he has picked out at the beginning of the day.

So what are they reinforcing?  Because I don't know.

On the days that the extreme negative behaviour has occurred I will also be told leading up to that point he had met his goal of 5 stars (or whatever it was at the time).

So clearly something isn't working if he is succeeding at getting his stars but he is still reacting extreme emotion wise.

Perhaps because nothing is truly being reinforced?  Or consistently implemented to truly reinforce something?

Being told "you need to do good things" to a child is pretty vague.

What are "good things?"

What do "good things" look like?

Last year I loved the program his kindergarten class ran.
It worked strongly on teaching children to look at each other and recognize what the other was feeling.

There was a very clear, concise short list of classroom rules that went something like the following:
1. Keep your hands/body to yourself unless helping a friend
2. Listen to each other
3. Talk to each other and if that doesn't work ask a teacher to help out
4. Share and take turns with toys
5. If you made the mess you help clean it up
6. If you can't say something nice, don't say anything at all --specifically no name calling
7. Make the Right choices.  Life is about choices.  You always have a choice in every situation.
If you make a mistake, it's okay, learn from it, fix it or deal with the consequence, move on.
8. (was added mid year) Tattling means trying to get someone in trouble on purpose, telling means there is a problem that someone isn't listening or being safe.

And they were reiterated, they were talked about and reinforced daily.  William could sum this up to me with no problem by the beginning of the New Year.  They also had a program going where every day a child was Captain Medium.  Captain Medium got to be the line leader for the day, take the attendance to the office and that sort of thing.  He/she was also responsible for helping her/his peers remember the rules or appropriate behaviour for the classroom.  To be medium was to keep calm, not too silly, not too loud and be a good friend by listening, helping and communicating (talking) with each other.

The above was applied consistently, expectations were clear.  The consequences were clear (time away if they were really upset, sitting down away from the group if hands on was involved, giving back the toy if they took it away, talking it out with the teacher's help if necessary when disagreements occurred).  The fact is by the end of the year most of the class could articulate clearly when they were upset with each other and resolve it on their own most of the time.

And now all my son can tell me is that they have to do "good things."  And tattling is a daily occurrence.  My son tells me there is a child in his class who tells the teachers that he hit him even when he wasn't anywhere near the kid and the teachers's believe the kid who is lying.  He also tells me the same kid does this with almost all the other boys in the class.

I have asked several times in person, and in writing what the classroom expectations/rules are that they children are being told regularly so that I can help reinforce them by reviewing them at home.

I am still waiting for an answer.  The Principal couldn't tell me anything useful either despite claiming "the teachers in his room are doing some good programming to help him cope."
She was a bit taken aback when I said it would probably be more successful if they stopped changing what they were doing every couple of weeks.

Really Universe can you give us a break?

So I am officially an Instructor for Orillia First Aid and Safety Training.  (YAY!)

I was supposed to teach my first large class over the weekend.  Instead I spent Saturday morning in the ER.
Why?
Because the Universe decided that I needed a curve ball thrown at me.  Walking down the snow covered back porch stairs I slipped half way up and landed smack down on my tail bone and slide to the bottom.
I was holding the railing.  I figure it is the only reason I ended up bruised not broken.

So what is the difference between healing a badly bruised to the bone tail bone versus a broken one?
I get to heal 4 weeks sooner than a broken tail bone.  Otherwise the healing process (ice, taking it easy, cushions for sitting etc) is exactly the same.

This meant I wasn't able to help teach the week day Standard First Aid Course this week.  Mainly because I couldn't get William back and forth to school and because this week I really needed to just take it easy.  I have full confidence in my ability to teach the next weekend course and the re-certification classes next week.  Tomorrow I will teach the Safe @Home Alone class in the evening.  Fortunately we do the CPR and First aid at the end of that class.

And while I heal I get the joy of being super paranoid about whether I caused the pilonidal cyst to reoccur.
Because I was told by the nurses, the surgeon and the people on the forums of those suffering pilonidal cysts that a direct blow to the area during the first 2 years post surgery can trigger a recurrence.

So far I have been told by a trusted source who humored me and looked to make sure there was no tell tale redness and swelling of an abscess setting in that I have a rainbow bruising of deep purple, red, blue and green across my nether regions and swelling that would accompany such bruising, but no redness or heat around the surgery scarred area.

Which is a relief, but doesn't make me any less paranoid.

My son is having a massive worry fit because he thinks I actually have a cyst again.  Took me a bit to get through to him that I fell down.  Though I was honest in telling him I could no longer guarantee the cyst wouldn't return.  This led to tears and worrying about not being able to go swimming and such this summer.
He was reassured that if the cyst were to return I wouldn't be having surgery in the summer again, ever.

Beavers is going to be interesting as we have both a Tobogganing night and a Skating night scheduled for the next two meetings.  I have already told our group that I will be standing at the bottom of the toboggan hill cheering them on this week.
Ice skating is in two weeks, we shall see how I am feeling.  Thank goodness the roller skating night is in April.

Conveniently the cushions etc they recommend you use to sit on for bruised/broken tail bone are the exact same cushions one uses when dealing with a pilonidal cyst.

But Universe, I don't need this crap!  I need to work!  I also need to be able to get the stuff that needs doing with regards to my son's situation and his school.

Tomorrow I get to wait for phone calls to be returned otherwise I will be leaving messages again and I will keep this up until I get a response.

I cannot --I refuse to believe, that my son is solely responsible for what is happening in his classroom right now. I seriously think his teachers have written him off as a problem kid and now it is boiling down to a battle of wills and control between them and him.  And that unconsciously or consciously they are setting him up to react the way he does.

How is it he never had these issues last year, at home in a home day care setting (including coping with a very aggressive 12 year old autistic boy who functioned at a 4 year old level socially) or during 2 years of preschool?
You'd think during all of that we would have seen extreme aggressive behaviour.  Heck he wasn't even displaying this behaviour when he started at this school.  It started somewhere around mid November and has just continued to escalate from there.

And what is being reported to me by the VP and by my son doesn't make sense to me as a person who has a background in working with children.

If it is known that a child struggles at a specific time in the routine ie clean up time and they are struggling over trying to save something they built out of a blocks etc and another child destroying it on purpose causing the other child to react emotionally and after the third time violently that wouldn't you then intercede or make sure a staff member was there to oversee that things don't get out of hand?  To encourage the one trying to save the creation to take it apart himself or just taking the creation and setting it aside till later and then taking it apart and replacing it in the bucket?
Why force my son to repeat this scenario to the detriment of himself and now classmates and teachers over half a dozen times???
Why would you force a child to sit away from his peers on a chair during circle time because he focuses better, but when he refuses because he wants to be with his peers force the issue including him vocalizing how upset he is and how unfair he views it to the point he kicks the chair into the lunch tables (was reported to me as throwing, he maintains he kicked two chairs  away from the group and threw nothing)?  Why wouldn't you as one of three members of the staff in the room let the child sit with his peers with the stipulation that if he started to be silly or lose focus that he'd have to come to the chair?
Number one tenant to working with any group of children or parenting for that matter: Choose your battles wisely.
This was not a battle that needed to be forced yet apparently this plays out pretty much every afternoon and now it has escalated to the point where my son is reacting overly emotionally to what he preceives to be unfair treatment.
Not only that he can't tell me what the classroom expectations are for his classroom.  Last year he could name me off the whole list -Be a good friend.  Being a good friend means sharing, listening to each other, respecting each other's space, helping someone when they need help, comforting someone if they look sad or hurt.  Hands were for helping, playing, writing, drawing and kept to themselves.  Mistakes were okay, but in the future you had to work toward the right choice and the right choice directly tied into the expectations I just listed above.
Right now when asked about what is expected of him in his current class, all he can tell me is "to do good things."  And he can't even give me a real list of what "good things" looks like other then keep your hands to yourself and no hurting each other.
Heck the kid is on his 4th version of a reward system and he can't even tell me what he is getting the bloody stars for.
It's important for the average kid to have clear expectations.
It's even more important, imperative really, for a child with ADHD to have clear and concise expectations.
Otherwise they can't remember them to begin with.  And what are we reinforcing if he doesn't have a clue why he is getting the reward??

And so I sit waiting to hear back from the intake nurse for the School Success Program, the School Board and the Principal to my son's school.

But I suspect that I will be following through with what I wanted to do back before the winter break is going to be come a reality.  Either he will be transferring to the other school or he won't be going to school at all.

I feel like I am running in circles.

I have toyed with whether to post this or not.   I have decided in light of yesterday's Bell Let's Talk day that despite the fact ADHD -Attention Deficit Hyperactivity Disorder is neurobilogical disorder (http://www.caddac.ca/cms/page.php?67), it still carries it own amount of mental challenges in the form of depression, anxiety etc.


Because of my son's father being diagnosed with ADHD 9 years ago it did not shock me when I was reading copious books on adult ADHD that when they described what children with ADHD presented like my son met every single marker.

I have part of a psych degree, couldn't get a high enough mark in the stats class to continue through.  During that time I did two papers that focused on ADHD, one of them specifically on medication and ADHD.
I have my Early childhood Education diploma and have spent most of my 12 years working with children with special needs (autism and adhd) in both a centre setting and a home day care setting.

It was clear to me that my son has ADHD.  Unfortunately we only recently were able to acquire a Family doctor (in most of Canada there is a doctor shortage).
The doctor however is hesitant to make the diagnosis firm despite agreeing that he meets every criteria for ADHD as indicated on a SNAP questionnaire answered by both the teachers in his classroom and by his father and myself.  As well as a full detailed explanation of my son's experiences from preschool, swimming lessons, what I saw in the home day care setting, day camp and what occurred last year in junior kindergarten.

And the doctor is hesitating to formalize the diagnosis because my son is also displaying signs of anxiety.

Now from my understanding a portion of that anxiety is directly linked to the ADHD and how they internalize things especially if all it feels like they are doing is getting in trouble at school. Which currently from what I am told every day I pick up, a daily occurrence.

He didn't start displaying the symptoms of anxiety till this summer.  Which as I keep reiterating to the teachers and the newly acquired family doctor is in direct correlation to my son's father and I separating.  That the anxiety is likely augmented by the coping with the huge changes that occurred including my son and I moving in with my parents and him having to change schools because we now lived in a different city.
That being said he has always been a worrier.

The wait list for a pediatrician is stupidly long in my area (in Northern Ontario, Canada) --could be 2 years at best for this reasons I have requested how long we would have to wait if we were willing to say go to Sick Kids in Toronto.  We were referred into a School Success Program that when we finally get registered will give us access to a developmental pediatrician how ever no one can tell me how long the wait list will be other then definitely by September of this coming year.  That doesn't help the right now.

I don't know how to help my son cope with his anxiety.
The doctor was less than helpful because all he told me were things I was already doing -clear expectations, breaking things down into manageable chunks, frequent reminders, set routine, lots of physical activity --made more challenging this past week with the incredibly frigid temperatures and the massive amount of snow that fell.

My son out of the blue asked for a picture schedule as he doesn't read well enough to easily glance at a written schedule to help him remember what he needs to be doing.
I was impressed.  Reinforced that I have taught him to recognize things that work for him.  We did have visual reminders of things when I was doing home day care because I looked after several different children with autism as he was growing up.

He manages fairly well for someone with ADHD in an one on one or small group (less then 6 children) situations that are well structured.  This is likely due to the fact the for the first 4.5 years of his 5 years of life I worked from home doing home day care.  I was able to recognize his symptoms and start teaching him strategies in which to cope with.  Unfortunately they don't appear to be translating well into a kindergarten class size of 28.

At this point the only reason they haven't suspended my son for his behaviour in the classroom is because I have been so on top of communicating and taking seriously my son's behaviour.  What concerns me is that he was in a junior kindergarten class last year and though there were definite issues with impulsiveness and attending to task, and touching other kids (not hitting -playing with their hair -especially the girl who had these tight ringlet curls that he claimed looked exactly like springs, general invading of personal space in closeness however there was no violence with regards to hitting/kicking/pinching teachers and some minor typical school yard infractions and scuffles between four and five year olds with turn taking etc.  In the entire year I received 3 phone calls all over his refusal to move onto the next task and standing defiantly crying and refusing to do anything anyone asked of him except to stand and cry and occasionally yell"No!" or "I don't want to!"

This year he has been sent to the office at least a dozen times for having a full out melt down, numerous infractions of hitting, pushing and kicking other children and starting just before the Christmas break he has now hit or pinched one of the staff in his classroom on 6 different occasion.  Every single time over another child destroying the creation he has made out of some sort of blocks and he was trying to save at clean up time.  Now one would think that the teachers would smarten up and catch on that they need to go to my son ahead of the formal clean up phase and have him dismantle his own creation, but no the continue to repeat this cycle DAILY and at least once a week he completely falls apart and throws the toys at the other child and now lash out at the teacher.
The have started a marble economy strategy with my son in that he completes a task or expectation that he struggles with and he receives a marble that he places in his bank.  He reaches 5 and he immediately gets to cash in for 10 minutes of doing an activity of his choosing (lego, computer time, art etc).  The idea is in a couple of weeks time they will up it to 10 marbles.
I think it's a great system except I don't have a lot of faith in the teachers actually being consistent in following through so I see it doomed to fail.
This will be the 3 or 4th thing we have tried since October and the rest all started off strong but by the 2nd or 3rd week he can't even meet the goal once and ultimately I suspect lack of consistency on their part because everything they have implemented we have carried on at home and have met with fairly moderate success.  Some days were complete write offs, but overall I'd say successful.

So here I sit at a loss of what I can do to help my son.
And wondering if I just need to transfer him out of that school because perhaps the classroom's physical size as well as the number of students may be apart of the problem.
I'd like to think the teachers are actually supporting him and doing what they are saying they are doing, but I am beginning to think they talk a good talk, but don't walk the talk.