5 y old daughter is a mess - on meds! | ADHD Information

My son is autistic with a LOT of ADHD tendencies. I've
noticed that with HIM, when his mood is truly stabilized,
that any symptoms of ADHD are gone. He's been on
Risperdal for 3years now and is still on a relatively
small dosage considering his age (10yrs) and size (97lbs,
nearly 5'). I've noticed the excitability/irritability
has increased over the past week or so, but I'm HOPING
it's just end of school year stuff. I'm giving it another
week and if we're still having issues, back to our
specialist we go. He's been relatively calm today (first
day in a week!) so maybe that's a good sign.

HTHHi Audry,
I just turned 41 myself.  :)
It sounds like you have a lot of experience with this stuff.  Thanks for letting me know what works for your kid.
We are still waiting for the other shoe to drop with the adhd med.  So far, no mania but I am watching for it.
She seems less moody now but i guess it has only been 10 days.
I have asked for abilify many times but the doc says it might make her extra hyper.
I have several books on bipolar children and adhd....for a while i thought she has both but now i am not + on the bipolar.  My bro has severe ADHD, my husband has add, annd others in my family have it as well and I have severe anxiety so i have wondered if she has adhd and anxiety.  of course, she could have her own mix of things.  i asked my doc if i could be bipolar and she said no, same with dh.
HOw can I tell if she is bipolar?

Her moods are very much affected by sensory stuff. 

Today she only yelled at me once or twice and never hit me...actually no hits for a while now.  She even went on stqage at school and sang three songs for her pre-k graduation tonight.

She still throws tantrums over things I cannot fix --- sometimes just once a day, other days 8x a day!!!

any idea on how to tell if it is biploar or adhd/anxiety?

Thanks,
Angi


Thanks!  I hated my name as a child, but love it now (at the ripe old age of 41, ha).

Anyway, an FYI, Risperdal is not a mood stabilizer.  It's an atypical antipsychotic that is sometimes used as a stabilizer, but it's in the same family as Zyprexa, Abilify, Seroquel, etc. 

Most bipolar children need a combination of a mood stabilizer (depakote, lithium, trileptal, tegretol, etc) and an antipsychotic to get the best benefit.... my daughter was on Trileptal and Abilify for a few years, now Lithium and Abilify for a few more years, and is doing wonderfully.... I know another child on Risperdal and Trileptal who is also doing well.... you kind of have to experiment a bit.

and of course hopefully I'm way wrong and your daughter will be just fine.... but I felt like passing on the info just in case.....

Audrey
Wondering if you tried any other mood stabilizers besides the Depakote (like Lithium Tegretol, Trileptal).... cuz she sounds almost just like my bipolar daughter to me. 

Her positive reaction to Risperdal is another clue that bipolar might be a possibility.

If she is bipolar, the ADHD meds will do her more harm than good, even if she has ADHD as well.... the stims can work for a while, then cause mania....

Just a thought,
Audrey
Hi Audrey,
I love your name!
Thanks for writing.  No, we have not tried other mood stabilizers besides risperdal and depakote.  We do know that the risperdal helps the sensory issues for her.  Nothing else has helped calm her in that way. 
The adhd meds are still working pretty good.  She still throws fits and whines but it is nothing, nothing, nothing like it was.  But, now i am wondering if mania is around the corner.  omg.  i sure hope NOT!


Hi,
I will try to keep our story short.  This is my first posting here, and I am SO thankful to have found others who understand.  Our only child, who is 5.75 yrs old was dx with ASD when she was 2.  SHe never really fit that label though and the several doctors we have been to changed it to "mood disorder" and "anxiety disorder" and Severe "sensory processing disorder."  She is on Risperidone 1.5 mg daily.  It is the only thing that has ever allowed us to have a somewhat normal life.  HOwever, it is not working anymore.  It does still help with the sensory issues, but her mood swings were off the charts...so the doc gave her Depakote...a few months later she was depressed from the depakote.  ?  Just not herself and seemed sad and quiet SO UNLIKE her.  So we took her off of it.    So, she has always seemed very ADHD so we agreed with the doc that she should try adhd meds.  So, this past week we have tried her on dexadrine.  At first we thought it was helping....calmer, nicer, less angry, could actually sit down for a minute or two.....we started her on 2.5 mg.  We finally had hope for a few days.  Today we finally gave her the full sprinkle pill of 5 mg and she cried throwing fits for 6 hours straight.  OMG.  She has been a mess all day.  It is way worse than without the med.  So, here is our problem....is her anxiety kicking into full gear from the dexadrine....or is she bipolar or something instead of adhd, or does the dexadrine just not agree with her.  Crying all day for toys she wants, or when we say no, or when there is something she wants to do .....It does not help that she refuses to eat and that causes some of the fits I am sure. 
So, what am I asking....I do not even kknow.
EVERY single doc, therapist, etc has been at a loss to figure out what is going on with this poor kid.  She now see's a therapist and a child psychiatrist, along with developmental peds, natural psychiatrist, etc etc.  NONE can figure her out!  What kind of doctor can figure out what kind of meds this kid needs.
Yes, she does have an IEP and although she is TAG (talented and gifted- really smart) she has to go to the special ed classroom because of her impulsivity and scratching of other kids because she is pretending to be a dog.  
She is exhausting to everyone around her.  She is demanding, bossy, and oppositional and at the same time, brilliant, sweet, sometimes thoughtful, and caring.  Each day is different and we never know what to expect.  We even had her allergy tested to see if there was anything there.
I think it is ADHD plus anxiety OCD type stuff going on.  However, the doc put her on celexa and she got more and more out of it and became very agressive.  We took her off of it.  PLEASE HELP US.  WE ARE RUNNING OUT OF HOPE.  WE ARE IN OREGON.  IF YOU KNOW OF ANY DOCTOR WHO SPECIALIZES IN MEDS FOR KIDS WHO KNOWS WHAT THEY ARE DOING...WE WILL DRIVE FAR.  THANK YOU FOR READING IF YOU MADE IT THIS FAR!!  :-) 
Hi! Think you've found the place you need to be! :-)

Just my initial thoughts - 2 is really young for an ADHD diagnosis.
Sensory processing disorders are hard core. If that's what she's got, poor
kid!

If it was me, I would send her to a neuropsychologist to be retested. It's
expensive if your insurance doesn't cover it, but it's so worth it. It sounds
like people are guessing about what's going on with her. It does sound
like ADHD, and kids can have processing disorders plus ADHD, but lots of
other things might be causing the behaviors, and I would get the whole
battery of test done now that she can communicate so you can figure out
what's going on.

Let me tell you about my son - when he was in the 1st grade I thought he
was going to be expelled for lashing out at his students. I had no clue
what was going on - until I had my first parent/teacher conference. First
of all, the teachers discipline of choice was to keep a kid in at recess with
their heads down on the table. My kid was a ball of energy, so chose to
keep him from burning it off. Really smart. Then, when she sorted kids
by their reading ability she cut corners and had them "read" The Cat In
The Hat to her. My kid heard that so many times he could repeat it
perfectly in his sleep! But she decided he was a top reader, and
immediately gave him top level books. She never taught him how to read
and expected him to do it!

I seriously believe that my son's acting out was a direct result of his
frustration, which was exacerbated by the really bad choices of his
teacher. I think that applies to all kids with ADHD - get rid of the
frustration and you will stop the negative behaviors.

My son went to a neuropsych and we got an 8 page report of changes we
could do for him. He'd had tests to discover that he has both hyperactive
and inattentive type ADHD, he has poor executive skills, which are the
ability to understand, remember, and follow rules in a nutshell, and he is
off the charts in matrix reasoning, which is the ability to figure things out
without instructions. Just knowing those things made so many of his
behaviors understandable! So the suggestions were simple - give him
checklists, give him transition heads ups, keep him on a schedule, and
the one that made the biggest impact (read the marble post for info),
stop punishing him, but instead involve him in behavior goal setting. He
won't remember the rules, but if he has a goal and can reach a reward he
will. And the rewards he wanted were things like being driven to school
(10 mins) vs going on the bus (45 mins min). Very doable.

The suggestions were so tailored to him that when we did them it was
like he was on medication when he wasn't. The school tried to do them
with other kids, and they weren't so successful, because they weren't
tailored to their issues.

Knowing exactly what sets off your daughter and exactly what will help
her achieve will make all the difference. Because I bet she's frustrated
seeing other kids having easier times than her - my son was, and told me
about very clearly and precisely - and that frustration is leading to more
negative behaviors and more self-doubt and frustration. It's a vicious
circle.

And now that I've gotten off that bandwagon I'd say that she's
having a bad reaction to the meds. And it could be because she doesn't
have ADHD at all - non-ADHD kids on ADHD meds are a mess.

I would say that as crazy as this is making you I think you're doing
exactly what you need to - you're trying everything and not giving up.
That says a lot about your character and parenting. Remember that when
it gets tough. :-)

Sorry that I don't have any specific advice. I'd go the testing route to
really figure out what's going on with her so you can find the right path
for her.

Keep talking - we're great to vent to when everything really gets to you,
and hopefully you'll be able to learn new things from someone (obviously
not me!). Hi Corrina,
Thanks so much for your response.

It sounds like you have been a great advocate for your son.  It is so nice to hear about success stories like yours.  Thank you.

We are lucky in that our daughter goes to a school where the director understands sn because her kids are both sn.  And, the early intervention folks have been great and our girl (and 2 others) share a special aid in the mornings at school.  We have done a lot of behavioral stuff and tried many different things.

The problem is that we cannot find the trigger for our girl.  We all agree that nothing environmentally has changed from day to day yet one day is decent, the next day is a nightmare, and after that is a good day. 

We have looked at childhood bipolar but it does not totally fit either.

The reason she was dx Autism spectrum at age 2 was that she had severe sensory issues and was afraid of kids due to sensory issues.  She has always been advanced intellectually but the social stuff has always been behind.

If it was just hyperactivity it would not be that big of a deal.  But her inconsistant and hard to predict aggression along with her refusal to follow any rules or do anything asked of her. I have had a black eye from her before.  We have been woke up about half of the days by her attacking us screaming for us to get up hitting and jumping on us mad about something.   She has ALWAYS been very oppositional.  When she was younger we would ask her to do the opposite of what we wanted all of the time and laugh as she would do the opposite, what we wanted.  Well, she caught on to us.

It is kind of ironic, as my dh and i are pretty mellow people.  We never spanked or hit her of course, yet she is a hitter and a scratcher.   We have been asked repeatedly by doctors if she has had any trauma in her life because of the way she acts.  Geeeesh.  She has probably had one of the best childhoods, we have tried to lavish her with love and positive attention.  She is an only child and we waited a long time for her. 

Thank you for suggesting a neuropsychologist.  We have been asking everyone what kind of doc to get her to and the only suggestions are child psych which she actually has TWO child psychiatrists.  They have tried to help, but they just don't know.

I wonder how to even find a neuropsychologist?  I will google it.

Thanks soooo much!!
Angi G.
Hi,
I just left a message on a neuropsychologist's voice mail.  Not sure if they treat kids yet.  But, in my search I found this..... only 120 miles from us!  I also left them a message that we want to have  our daughter seen.  This seems like they might be able to help. 

Complex Neuropsychiatry Consultation Clinic Doernbecher Children's Hospital -

I am wondering what the difference between a neuropsychiatrist and a neuropsychologist is?


Check with her pediatrician - you might get a recommendation of
someone closer.

A neuropsychiatrist works with brain diseases and a neuropsychologist
works with brain conditions. Subtle differences. ADHD is not a disease.
Plus they have different approaches to how they come up with a
diagnosis. Neuropsychologists, I think, have more useful tests to help
crack kids with ADHD.

When I got my son's report, I didn't believe it was going to work. There
were so many simple suggestions - talk about positives rather than
negatives always - how could that work? But they did. Put them all
together, and they worked. There is no way I would have been able to
figure it out with out an objective third party to point out all things that
were going on and how to change them subtly to correct for behavior. It
didn't happen overnight - but within a week everyone noticed the
changes in my son.

Maybe she needs a more consistent schedule. It could be as simple as
she's more or less rested, or she's a little bit hungry and can't recognize
or articulate it. It could be such an easy fix.

Good luck talking with the doctor - hopefully you'll get your answers
soon!Hi,
today we did a half dose of dexadrine (2.5 mg) and only crying and emotional stuff for the first hour....after that we had a calm kid that went to the grocery store and stood in a long long line for 20 minutes which would be OUT of the question any other time.  She asked for candy, I said "No, put it back please" and she did.  That has NEVER happened...and i did not even get yelled at or hit! 
She did get a nice toy though.  :)