Newbie seeking support & counseling Q | ADHD Information

Strattera can cause mood issues at thw wrong dose. Especially if he's underdosed. What does he weigh? My daughter takes Strattera and I've found the even keeled mood the BEST thing about the Strattera! Some docotrs will add a small amount of stimulant to the Strattera, you can keep the dose low that way. Just a thought. All stimulants react differently too, may be worth it to keep trying.

Hi all,

Our 8 1/2 year old son was diagnosed with ADHD one year ago.  He is currently on 40 mg Strattera.  (We tried several Ritalin-type drugs but none worked).  The Strattera is only somewhat effective in helping him control his impulses and stay on task. 

In conjunction with the med, our son sees a psychiatrist, although not always on a weekly basis.  The psychiatrist has been helpful with respect to school issues that arise, but has not been particularly helpful in suggesting ways to deal with the constant angry eruptions that arise at home.  We feel overwhelmed (and depressed) by these eruptions, which have become a daily occurrence. 

Can anyone recommend a counselor in the MD/Washington DC area?  (We are choosing not to medicate for anger at this time).  We need help desperately, to retain our sanity and keep joy in our lives.  I feel very guilty about finding my son to be such a challenge, particularly because he is an only child, but that's the way it is.

Also, how do you keep the joy alive while dealing with your ADHD child? All thoughts are appreciated.

Thanks in advance!

Henny

 

 

I know a great play therapist up here in Baltimore County, but that's probably a bit far for you to travel.  Do highly recommend play therapy, though- it has help my son soooooooo  much, especially with the anger and the constant frustration that was cause the majority of his tantrums. 

I know that strattera, unlike the stimulants, is dosed by weight so you may want to check to be sure he's on the appropriate dosage.  Have you tried Adderall, or any of that type of stim?  Sometimes switching to a different type does the trick.

Play therapy?  That sounds interesting, although my son does that with the psychiatrist.

As for Strattera, yes, he is on the max. dosage for his weight.  We have tried the stimulants, but they made him more aggressive and angry.  As I indicated, we've tried several of the stimulants, to no avail.

One problem we have is that the psychiatrist seems to be more focused on the school issues, and not on the home issues.  I think my husband and I need to find a separate counselor for ourselves.  I thought the psychiatrist could help us, too, especially since he knows our son, but for some reason that's not happening.

Thank you for taking the time to reply!

 

 

 

 

Thank you for your reply.  No, my son isn't underdosed.  He weights about 72 lbs, and the psychiatrist figured that 40 mg was the maximum dosage for his weight. 

I find it interesting that your daughter's mood is even keeled on Stattera.  We did add a small amount of stimulant to the Strattera, and it made my son even more belligerent.  (We were on vacation in Chicago at the time and needless to say it was no vacation).

It's been frustrating that we haven't reached any kind of equilibrium, and it's been 1 year already.  I raise this question with anyone who reads these posts:  have you had a similar experience in that it's taken a year or longer to get your child on an even keel? 

We have begun to question the capabilities of our psychiatrist, though we know we is a Hopkins grad with many years of experience and is well-regarded in our community.

Thanks in advance for any replies.





Hi there have you tried to plan out his day in advance so he knows whats expected of him through the day and with good success will be rewarded? Heres what Im doing and so far it seems to be working, I got a white board and hung it up and starting with the morning routine I write down everything she needs to do (get dressed, brush teeth, eat breakfast, get back pack ready etc) as she does everything I praise her and tell her how great she's doing and remind her of the rewards, then in the afternoon/ evening I write down what needs to be done, everything from snack and homework to shower etc. At the end of the day I sit down with her and ask her how she thinks the day went, because honestly it doesn't always run smoothly, and she'll tell me with help what could have done better etc. She then gets a star, green for a great day, yellow for an okay day, and black for a really bad day. I don't make it easy to get green because I want that to be great behavior with little reminders but not unattainable. Then when she gets 10 green stars she gets to pick a prize from a pretty good prize box ( I've got movies, kites, girl stuff like earrings, etc) I do give rewards for a yellow day which usually is dessert. The goal is to have attainable goals and to be rewarded. So far its been working and she's excited for the prizes and she sees the reward getting closer and it working. Right now I can't give her meds because she had a really bad reaction with Adderall and they have to do more test to see if she can tolerate the meds. She is 7 and believe me we have our days but having a plan each day helps her focus. Good Luck Ashy'smom39500.0008101852

40 would be his lowest dose not his highest, he could go up to 60. My daughter is actually 83 pounds and we've recently gone to 80mg. So even staying within the guidelines your sone at 72 ponds would be 40-60 mg, lots of room to go up. The formula is weight dviide by 2.2 (for weight in kg) then dose 1.2-1.8 times weight in kg, so for him 40-60.

We do not have a lot of anger/aggresssion with my daughter anyway, but she is a 13 year old girl and has ALL kinds of hormone issues going on . Really, this is helping keep her even. I think becasue it's a 24 hour coverage and we split her dose in the morning and after school. She is EXTRMEELY inattentive and it's not really doing it for school, which is why we've recently (like 2 days ago) increased. Stimulants cause her excessive anxiety, tics, real ups and downs so we do not want to use them either.

If you are unhappy with your psychiatrist, I'd find a new one. Unfortunately yes, for kids that have side effects to stimulants it can be quite tricky. The psoter who suggests good routine has a good poijnt. Structure is so hlepful in avoiding some anxiety in these kids.

A thank you to Diane and Ashy's Mom for your thoughtful responses.  We see the psychiatrist tonight, so I will raise the dosage issue with him.

A couple months ago, we tried the idea of a virtual bank to reward my son for good behavior.  (Giving him an allowance didn't work because he'd play with, lose, and/or give away the money.)  For some reason, the virtual bank was hard to keep up, and the reward system fell apart.  Perhaps we will revisit the matter and try again.  A problem we often encounter with behavior modification-type systems is that when we tell our son that he won't get a reward if he misbehaves, he says that he doesn't care, and frankly, I don't think he cares, which is problematic.

Also, about structure, our son's school week is highly structured in that he has before-school care, after-school care, and then sports practices four out of five weekday nights.  Is that what you mean?  We forego structure on the weekend, mostly because my husband and I work full-time and like to relax, but perhaps that should change.

Another question:  do people find it hard to go away on vacation with their ADHD child due to angry meltdowns, etc.?

Thanks in advance for your feedback. 

reward systems work best when there is MORE reward than consequence. So start slow, pick a few behaviors and make sure at least one he can master easily. Read ograms marble system and use a variation of that. the concept would well with your virtual bank idea I think. He must be able to earn easily at first for it to be worth it TO HIM.

I found with my kids try to keep vacations structured also to some extent. Try to let them know ahead what will happen. Plan out your day (somewhat). The fewer surprises the better. These kids will try to think out their plan ahead in their own head, then if something doesnt go the way they thought it was going to, they lose it.....frustration and anxiety. The more they can know about ahead, the less this will happen. Even if your day is to sit around your cottage until lunch, tell him that. Then we'll go to the beach after lunch and we'll decide what to do for our evening.....etc., etc....I've also found that lowering my expectaion shleps. Dont' expect them to go to Disneyworld and run around and do this and this and this and this and all thats ensory overload, and then be happy and calm to boot! We went to Disneyworld this year. We never spent more than a few hours at the parks and many hours at the pool. We didnt see everything, but we had a great trip. I chose not to push them too hard.

Thank you Diane.  I read ograms marble system and it sounded interesting.  I will print that out.

We went to Disneyworld this Xmas, but it wasn't a great trip.  I don't think we tried to do too much, but our son is quick to flare up over small things and has a hard time getting beyond his anger, no matter how hard we try.

Our son is an only child, which may make it harder in some respects because he expects us to be playmates too.  (Which, by the way, is way too exhausting for us!)

Henny ,

I don't know if this will help , but I used to live in Fairfax Co. and they have a Fairfax County Office for Children that has alot of resources to help kids. I worked there in the 90's for the corporate childcare resource system. Good luck.

Ps. I knew a Henny in college in southwest virginia

hi

my son was also diagnosed just last year and he also is 8. he is not on any meds.

i think  you need to connect with him on his level. give him alot of play time, make him see that you have time for and you want to play with him. we have our son involved in a lot of sports all of which he wants to play. but it turns out to be a big family occasion and we all go to watch him play. so he knows then that we want to be involved and it helps us all connect with him.

having a child with adhd, dosent mean all dome and clume. endless supply of different medication, psychiastrist etc.

hes your son enjoy his youth.

we try look past the adhd, yet we deal with it everyday, school work is a nitemare but i helphim with that everyday

take care

em

ireland

Do you think the current meds are "helping" him? I just wonder if you need to reevaluate him for maybe something in addition with ADHD or instead of. I wonder if bipolar is involved.

You mention how other stimulants didn't work, made him mad. That is exactly what happens with someone with Bipolar and it is not being treated. Adhd meds make bipolar worse. I am just wondering.

There are so many med choices out there that your son shouldn't be suffereing like this once the correct diagnosis is in place and then the right med and dosage are found. We finally leveled off after about 6 months with working the meds and dosages. It was worth it.

Hi Henny - I admit I was wondering along Bethann's line, too - maybe
ADHD isn't the story - or isn't the whole story here. Somewhere here
someone posted a great (and surprisingly long) list of ADHD mimickers -
everything from blood sugar metabolism issues to other dxes. Surely
those things wouldn't respond properly to ADHD meds - maybe there
needs to be a second opinion here, even if you like your psychiatrist?

Also seconding (or thirding or fourthing) the structure vs stimulation
thoughts. Structured activities aren't the same thing as structure in the
home. I find my kid can only "keep it together" as her counselor puts it -
for discrete chunks of the day - it takes a LOT of effort for her to do
things that come more easily for other kids. Think about your work day -
if you get a lot of demands piling up very quickly that you have to
prioritize, it's very stressful. that kind of stress is how a kid with ADHD
faces each and every day. They have higher levels of stress chemicals in
their urine, they have more adrenaline in their bloodstream all day long.
It's exhausting to imagine.

So... in that context, you can see how school or other activities add to the
mix - they involve a lot of demands, social, intellectual, physical - and
the kid has to process each request rapidly (or look like a slacker or get
in trouble). Even sports or music are going to be a place where they have
to perform under stress.

Whereas a structured home or vacation environment is going to be
calming and soothing - no yelling, no fights, nothing unexpected (as
much as you can control all of us). The kid knows what to expect, when
to expect it - maybe the routine on weekends IS more relaxed - that's
great - but it's still a routine, "we get up, read the paper/books/watch
cartoons, then we have lunch, then we have a playdate for 2 hours, then
we do the grocery shopping, then we're home for dinner and a family
game or walk the dog or whatever" it's mellow, it's predictable, it's
orderly.

Believe me - this was VERY hard to adapt to for me, I realized that I often
rush and stress my dd, I tended to allow sudden changes and
spontaneous plans. So much got better when I stopped and reconfigured
our whole way of approaching life.

Sorry that was so long! I wish you well!