Enough...Not sure I can do this anymore | ADHD Information

Hang in there,  it does get better.   My youngest daughter had very violent explosive outbursts.  People outside our home would have been shocked by the things she did.  It too was at the end of my rope.  In 3rd grade,  we finally sought help.  She was diagnosed with ADHD at that time.   We started her on Ritalin LA,  the behavior improved and 4th grade was a great year.   Things went down hill again in 5th grade.  With a change in medication to something that lasted longer (switched to Concerta/Tenex combo), increased dosage and worked with a therapist,  things improved.   It probably took 5-6 months to really turn things around.  

Fast forward to 8th grade - she is a doing great.   We have occasional bumps here and there,  but not radically different than most teenagers.  She well behaved,  a pleasure to be around,  great student and a kind caring kid (not that she wasn't before).   She deals with anxiety from time to time and is hyper as can be off of medications, but overall 100% improvement over where we were. 

She's still on a Concerta/Tenex combo that works well for her.  If someone told me in the midst of all of our struggles that we would be where we are today,  I wouldn't have been doubtful.   So,  don't give up hope.  It does get better.   

My suggestion would be to look at the medication.   Maybe you need to try something other than Adderal or look at dosages.  My daughter's behavior generally gets worse when her dosage is off.   She generally falls apart in the afternoons if the dosage is too low.   The other thought might be to take her off the Adderal,  she want she is like - do the temper issues less - and then try something new.   Adderal makes some kids really nasty.

I would be hesitant to jump to a bipolar diagnosis.   I think there are kids out there that fit that description,  but I also think there are some ADHD kids that just aren't getting the right help that could fit in this category.   With the behavior and swings that I saw - she did fit some of the criteria.   When when her ADHD was managed,  I had a totally different kid. 

If you'd like some suggestions from the behavior therapy side of things,  PM me and I can send you a list of some of the things we did that helped - or search from so my old posts.

Horsemom - Thank you.  Thank you.  We increased the medicine to 15 mg and we're watching at the moment.  I spoke with the doctor today about  several things.  He thought jumping to a mood disorder diagnosis was hasty.  We have some mitigating factors such as the onset of hormones, a touch of autism, and high intellect.  Not really the best combo for a calm and happy home.  (Although she did move up to the next belt in karate tonight - she's pretty proud of herself as are we...maybe we shouldn't be increasing her skills in karate?  - wow!  That felt really good to lighten up about this..) 

This medication management has me really rattled and confused.  I'm listening to you though.  You really touched me.

Looks like you got some conflicting info here on dosages. Based on what I have seen our child psychologist do -- which is literally have my child stand on the scale, and then use his calculator and then announce the dosage range -- I would say that this must be providing him with a general range, but individual responses can bring you below that range. He always starts below the range and builds up, but will not go above it.

You really don't need to figure all this out though, just make sure that a child psych or behavioral pediatrician is managing the medication.

Thanks Jessica.  There have been a fairly wide range of responses to my post.  Expectedly so - b/c my original post was pretty desperate.  The behavioral ped that we have worked with is pretty conservative in terms of med approach.  He gave us a range, but, actually started below it.  He said that some children need less or more med than others depending upon how their body metabolizing medications.  Weight is the most vital issue - but, the individual's response to medicine is another.

Anyway, I've got to hang my hat on their knowledge - you know how that goes.  Thanks for your input here - you've really helped me.

Hope things have settled down a little bit...we have walked in your shoes too.  Our DS, first was diagnosed with ADHD, then SPD (stimulus seeking) and then finally tourettes.  It was always confusing why we had so many behaviors that were not on the ADHD criteria.  Once we realized that our little guy had multiple "issues" it made alot more sense.

However, on a daily basis...things can get crazy..he is unable to take ADHD meds due to INCREASES in aggressive behavior and tics (TS).  We are working on techniques from both The Explosive Child and The Nutured Heart Approach...there are many days when I believe that our DS is just too intense for anything to work. But, there are some really great days too.

He, too, is very smart (IQ 160+), very loving and wonderful.  But, he uses kill/hate talk almost every day... and often we have at least one episode of him throwing books, knocking over chairs, etc.  He is chronically inflexible, severely impulsive and quick to anger.  He went through a time when he was very physical with me ... this was a scary time...but we seem to be beyond it for the time being.

Big time prayers for all of us that are dealing with this situation.  The stress is unimaginable (to outsiders).  But, at the same time we are our special children's biggest supporters and they truly need us so much!  I believe our son is growing up to be AMAZING!

Big hugs and prayers from a family that knows what your are going through.

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um, you wont like what I have to say but I am going to say it anyway......

There was a story on tv last week of a family that had the same issues in their house, daughter had add, violent outbursts, striking others, hitting, slapping, out of control.  They had her hospitalized several times and when that didnt work, for the sake of their other 2 kids, they placed her in a foster home.  They are still her parents, have all legal rights to her, but needed her to live somewhere else before there was a terrible tragedy.  Just saying......That girl was 6 or 7.

Whether the dose is too high or two low is determined by the patients clinical response, not WEIGHT. With stimulants, the correct med and dose is very individual which is why pateints are put through a trial of medcation. What is high for one patient may be low for another. Straterra, which is a non stimulant is based on weight and is also a blood level medication which stimulants are not. Speak with a psychatirst as others have suggested. I would definitely get  a second opinion because agressive,physical behavior is not symptomatic of ADHD and if there are other co existing condtions, dependning on what they are, stimulants can agitate the symptoms of another disorder. This is why a specialist is needed to make a differential diagnosis and med management thereafter needs to be followed by an expert. An expert many times can remedy the problems with a correct diagnosis and the proper meds without the parent having to take such drasic measures and whe they do have to take drastic measures, that means the child is dealing with far more than ADHD,The running will be good for you.

Our child psychologist does a mathematical calculation based on weight to determine the dosage range, which is not very large. As far as the type of stimulant, that is speculation, but with a child psychiatrist they are trained and experienced so their speculations are more on target.

It's been a bit since I've posted.  We've had issues with my daughter's medication along the short way.  She was diagnosed with ADD in June - and has had anger problems with terrible outbursts starting in May.  We've done counseling and been advised by good and trusted doctors as well as joined an ADD/ADHD support group.  She's on 10 mg of Adderal - we don't know if we should increase it or change the medicine.  And my husband and I both work full time at very demanding jobs. 

Things have been going better the past two weeks or so - no real outburst during that time - which is the longest period we've had the entire summer.  Until today - something silly and inconsequential set her off.    I've read all the books, tried the tactics, done rewards / planning / preparing for changes etc.  I've been operating as if she had ADD or ADD with features of Autism.  Sooooo...I'm exhausted, fatigued, and generally done.  The white flag is up.  I've had enough abuse and mistreatment to last a lifetime from my precious daughter.  She's wonderful, amazing, brilliant, and has a heart as big as the earth.  She concerned about others, the world, the environment, animals, you name it...

But, then she hates me, wishes I was dead, pulls my hair, slaps me in the face, and throws things at me.  I stay calm, avoid using judgemental language, and enforce reasonable consequences.  All the typical horsesh*t that I recomment to others myself.  Oh, hang in there and all that...She tries to destroy my things, and sends my 7 year old to hide under the kitchen table.  While I stay calm...as best I can.

Oh - and have I mentioned that she has life threatening food allergies.  It just doesn't end - it's like I've done something that requires some heavy punishment from God, or whoever you believe manages this world in some form or fashion.  Having said all of this - you won't believe this at all - I have a master's degree in education, teach children with special needs, and huge array of challenging behaviors.  I've had to use restraint techniques like the CPI child control position on my own child.  And, I've had enough.  Isn't that some sh*t?  I'm at the end of my rope. 

If she is an average weight, 10 mg of Adderal is too low for a 9 yo. Her range should be 15-20 mg. If you are not with a child psychiatrist for med management, you should head in that direction.

I would also get her on 1000 mg of high epa fish oil for the anger.Jessica N40449.8262615741Ellen,
I agree with Jessica, you should be using a child
psychiatrist for med management especially with the way
your daughter is acting. Meds such as Adderal and
Ritalin though helpful for focus can also cause anger,
agitation, and mood swings especially in children who
might also diplay bipolar tendencies.   We are forced to
think that a child is affected by only one condition
because it is easier for us to label and put our arms
around. Unfortunately, ADD/ADHD often coexist with other
conditions; some more obvious than others. When this
occurs, the treatment for one condition could exaggerate
another. Don't give up and more important make sure that
you give yourself a break by treating yourself to a
movie, a walk or an adult night out without the kids.

Paul

Thank you for the input - we're going to increase the Adderal to 15 mg tomorrow.  It's all so speculative...based solely upon trial and error.  Addressing mood disorders with medication makes us extremely nervous (as does any routine medicine to address any sort of behavior).  The potential side effects in young children seem unbelievably extensive and scary.

I'm training for a marathon as a means of giving myself some time.  I"m not sure it helps. 

I'm not sure what would help me feel less horrible than I do.  She was of course very regretful and sad later in the evening.  I'm getting tired of that.  She asked if I was mad because of my mood tonight.  I told her I wasn't mad, just sad.  I love her no matter wht etc. etc.  But, I need time to recover emotionally, too.  The things she did are irrelevant, but, the pain in my broken heart doesn't just diappear.  I know she may not be able to help herself, but, her actions have consequences in terms of how I feel and how our family feels.  I just can't lie to her.   

We'll address the medication issues and speak further to the doctor and get referred around to another doctor or child psyc.  And, speak to more "profesionals" about these vague, intangible problems, and how to attempt to treat them based on the softest of science.  I'll move forward because there's no alternative right now. 

Sorry for MY low mood.  I just need to find some more resolve within myself and be the adult.  I guess.

I feel for both you and your daughter.  I pray you find the right meds to help your daughter.  It seems you'll have a special place in heaven for what you've endured. 

Have you considered a mood disorder.  My daughter may possible have that.  She does not have all the signs of bipolar in children (which they say now are different than what adults experience, but she does have the all so common rages).  We are trying a natural suppliment but others have been successful on 1 or a combo of meds.  Good luck on your very difficult journey.