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Possible ADD in a teen


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I'm not sure if this is the right place to ask this question. If not maybe someone could direct me to the best place to do so. The reason I'm not sure is that my dd 16 is doing well at school in terms of grades and tests etc. However her doing well is at the expense of a huge amount of effort on her part. I should maybe add that she is bright and seems to catch onto things very easily, so I don't feel like she is trying to work above her ability.  She has had some difficulties with anxiety and depression for the last few years and I have been putting the issues she is having with school down to that. However today she said something that made me wonder if at least some of it is a degree of ADD.

 

She had an evaluation for her depression a couple of years ago, and  although the evaluation did show some fairly severe depression, the therapist mentioned that it also showed some ADD. As she does well in her school work I just kind of thought it must have just been a false result. I would really like to try and help her come up with some more coping skills to help her manage it if it is in fact an issue.

 

Some things I have noticed:

1. She is a good reader and has a good vocabulary but reading for her classes takes her a very long time. She frequently says that she keeps getting distracted while she's trying to read.

2. She works long hours and just doesn't get as much done as you would expect from the time she puts in. I know that teens get distracted but she does seem to be genuinely working much of the time.

3. Today we were sitting in a very quiet coffee shop, studying for an upcoming AP test. We were reading off the computer and watching a video on it. Afterwards she was able to tell me, in great detail, all that had happened around us and the movements of the people in there etc. I had not been aware of hardly any of it  because I was really focused on what we were doing. She said that she finds it hard to focus and just thinking and focusing on one thing feels kind of boring. She is concerned about the test and really wants and needs to study for it so it wasn't that she already knew everything and was bored because of that.

 

She is quite a disciplined and conscientious person and it's not usual for her to be messing around when she's supposed to be doing something, so I can't really explain the distractedness that way.

 

I realize how fortunate we are that she is able to do well in her studies and I know that some kids have to struggle with much more difficulties, and so I apologize if this seems a very trivial thing to post on this board. She seems exhausted from the effort she puts forward and I would so much like to help her figure it out if I can. I'm concerned that it will only get more difficult as the work load of college etc will be greater. She has a definite tendency to perfectionism, so telling her to ease off is difficult for her to do.

 

I've heard that drinking coffee is good for focus but she does not like coffee at all!

 

Thank you for any advice and any resources you can point me to. Again I apologize if this isn't really an appropriate question for this board.

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I have 3 kids; one had an easy time, one is one of the more impaired among regular posters here, and one is "compensating at a very high level."

 

Yours sounds like "compensating at a very high level."

 

Don't underestimate it. It is hard stuff.

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ADHD can present differently in girls than in boys, so it might not look like what you previously thought. Your concerns sound valid to me. You can make an appointment with the pediatrician or family doctor to talk about options for further evaluations and treatment. The fact that an evaluator brought up the possibility in the past, plus the problems she is experiencing now suggest it may be time to look into it.

 

 

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I have 3 kids; one had an easy time, one is one of the more impaired among regular posters here, and one is "compensating at a very high level."

 

Yours sounds like "compensating at a very high level."

 

Don't underestimate it. It is hard stuff.

 

That is what I wondered if she was doing. I'd like to try and help her compensate better or easier if possible so that it isn't such a strain for her. Thanks for your reply.

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ADHD can present differently in girls than in boys, so it might not look like what you previously thought. Your concerns sound valid to me. You can make an appointment with the pediatrician or family doctor to talk about options for further evaluations and treatment. The fact that an evaluator brought up the possibility in the past, plus the problems she is experiencing now suggest it may be time to look into it.

 

I have been planning on taking her to see someone again to try and get some help with the depression, so I can ask about this too. Are there many things other than meds that can help? I'm woefully ignorant about it all I'm afraid, and not really sure where to find out more.

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Not trivial, and yes you're good posting here! :)

 

 

I have been planning on taking her to see someone again to try and get some help with the depression, so I can ask about this too. Are there many things other than meds that can help? I'm woefully ignorant about it all I'm afraid, and not really sure where to find out more.

 

I'll just be straight, but why no meds? Your kid is about to flunk an AP exam worth $$$ and you don't want her on meds? She clearly has ADHD and was diagnosed several years ago. Probably the meds will help her anxiety as well. Depression and anxiety in ADHD are COMMON and part of the reason is simply because they're having such a hard time functioning! 

 

Right now, meds would be your first, smartest choice. And personally, I wouldn't let her take the AP exam unless you do a trial run with old tests and know she's going to do ok. Since you haven't had evals yet, you don't know what her processing speed is. Many kids with ADHD will have low processing speed relative to IQ. They qualify for extended testing time, a limited distraction testing environment, etc. Without those accommodations, she might not do well on the AP exam EVEN IF SHE KNOWS THE MATERIAL. 

 

So think about how her self-concept and depression is going to get even worse if she gets a low score due to having no accommodations. You're hard-pressed to get them done at this point. I would do a sample test, see how she scores, and let that guide you. If she doesn't score well on the sample, I would tell her you realize now you missed some things, that you've decided it's ok, that she can CLEP or do something different. Take that pressure off.

 

You can also look into sam-E (a supplement, you can buy it at CVS, whatever) for the depression. But really, you're going to want to start with meds for the ADHD and see where that gets her. She has been fighting this long enough on her own. She deserves the chance to show how bright she is. You might find an ASTONISHING difference in her scores on meds. 

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Not trivial, and yes you're good posting here! :)

 

 

 

I'll just be straight, but why no meds? Your kid is about to flunk an AP exam worth $$$ and you don't want her on meds? She clearly has ADHD and was diagnosed several years ago. Probably the meds will help her anxiety as well. Depression and anxiety in ADHD are COMMON and part of the reason is simply because they're having such a hard time functioning! 

 

Right now, meds would be your first, smartest choice. And personally, I wouldn't let her take the AP exam unless you do a trial run with old tests and know she's going to do ok. Since you haven't had evals yet, you don't know what her processing speed is. Many kids with ADHD will have low processing speed relative to IQ. They qualify for extended testing time, a limited distraction testing environment, etc. Without those accommodations, she might not do well on the AP exam EVEN IF SHE KNOWS THE MATERIAL. 

 

So think about how her self-concept and depression is going to get even worse if she gets a low score due to having no accommodations. You're hard-pressed to get them done at this point. I would do a sample test, see how she scores, and let that guide you. If she doesn't score well on the sample, I would tell her you realize now you missed some things, that you've decided it's ok, that she can CLEP or do something different. Take that pressure off.

 

You can also look into sam-E (a supplement, you can buy it at CVS, whatever) for the depression. But really, you're going to want to start with meds for the ADHD and see where that gets her. She has been fighting this long enough on her own. She deserves the chance to show how bright she is. You might find an ASTONISHING difference in her scores on meds. 

Thanks for your reply. I probably didn't explain well in my post, but she actually scores really well on any test she takes. That's one of the reasons I was hesitant to post here. But it seems to take her so much more time and effort than maybe it should. Don't get me wrong, I'm not against time and effort but if something is hindering her and I can find a way to help then I would like to do it so that she isn't so exhausted by it. I'm not against meds but I guess I feel like she probably does not have a severe case (sorry not sure how to say it or even if there are degrees of ADD) and I wondered if there are things you can do/learn to help. Also regarding the diagnosis - it was a series of assessments for depression and not looking for ADD specifically. Also, I'm not too sure about the expertise of the tester.

I'm not trying to deny the problem but she does do very well in terms of scores, so I wonder if I'm seeing something that isn't really there, and that it's just a manifestation of the depression that she's experiencing. I should say also, that she is functioning ok despite the depression, but she does have low moods more of the time than I think should be usual for a teenager and I want to check into that again. I've tried 2 counselors for her, but we live in an area with limited options and, although nice, they just didn't seem to really get her and really help her find ways to cope better. I think some cognitive behavioral therapy might help the depression. She did have an IQ test at age 6, for a gifted program at school, and they didn't mention anything about processing speed - but then again, how skilled was the tester? We live out in the middle of nowhere and I'm just not sure how expert the people we've seen are.

I guess one of my questions is - Are there things we could try, like caffeine, that might help? And where can I learn about these things, if they exist.

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If the depression is due to the ADHD, why would CBT help? Why not actually improve the ADHD?

 

I wonder if there's sort of a gap between how your *dd* perceives the severity of her need for help and how *you* perceive it? 

 

Right now you're saying because she's super bright and works so hard to compensate, she doesn't deserve help for her disability. It's a really odd situation. I can't figure out if you think people who take ADHD meds are DUMB or what. 

 

You've got a definite gap in how you're perceiving things and how she is. What about getting to a psych, getting a full, proper eval and diagnosis, and then talking the meds thing through with the ped? Sounds like she'd benefit from a combo approach. ADHD meds have a very short half-life, so you can take them for a month, say yes/no, and move on. Anti-depressants have a much longer half-life in the body and have very ugly stats for suicide in teens. Like I really, really would want to try the sam-E and ADHD meds before anti-depressants. But that's something you talk through with the ped.

 

If your foot is chopped off and bleeding, you don't tell someone try harder. If you have cancer, you don't tell someone try harder. But your dd has depression and ADHD severe enough that she's in multiple offices for it, and your answer is try harder? How is CBT actually reversing the problem at the brain level and giving her a chance to do better??

 

I don't know, seems like just really blatant bias against the gifted. She's so bright she can compensate really well, so she doesn't deserve help.

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Caffeine reduces Attention Deficit Hyperactivity Disorder (ADHD) - DrClydeWilson's NUTRITION BLOG

 

Here's the article on how I dosed the caffeine with my dd. It's a start. It only activates one part of the brain, not all the parts that meds do. It's fine for a trial, but I would then move on to meds.

 

Imagine the hypocrisy here. I'm from a church background where people slam ADHD meds and psychs up and down. Like literally every Sunday it's oh those horrible secular psychologists, ADHD is a discipline problem, blah blah. Those same people are morbidly obese and drink coffee! So they can be addicted to stimulants and self-medicate THEIR ADHD with caffeine, but a dc shouldn't take a small amount of a controlled, carefully dosed stimulant? Really? Even though caffeine and prescription meds, at the most basic level, work very similarly in the brain???

 

So anybody who drinks coffee or tea with caffeine or eats chocolate to perk in the afternoon but says it's horrible to put kids on ADHD meds is blind to their own hypocrisy. 

 

I'm a long-standing advocate of having ALL the options. I'm not in favor of medicating to avoid curriculum changes and lifestyle changes. But I'm also really strongly in favor of empowered children who are able to be what they're trying to be. I think it's a very serious, serious thing to have a teen girl suffering with depression. That's a really high priority thing to solve, and putting meds on the table is probably going to need to be part of the solution. It has to be part of the solution BECAUSE she's so bright, because she's not happy with the answer of how she functions without them. She can't tell you that because she's a kid and doesn't know. As adults, we can look at them and see what's going on. It's not that she's not trying hard enough or needs to think herself out of it. She really, really has significant issues going on.

 

Fwiw, the stats of drug abuse in *unmedicated* ADHD are actually kind of shocking. If you DON'T help her with these issues, she WILL be looking for answers. She's so bright, she's not going to leave that depression without some attempt to help it. How about alcohol? What is she going to get into? You can't let that level of hurt go on and not have her try to solve it somehow. THIS is the outcome you want to avoid. 

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Caffeine reduces Attention Deficit Hyperactivity Disorder (ADHD) - DrClydeWilson's NUTRITION BLOG

 

Here's the article on how I dosed the caffeine with my dd. It's a start. It only activates one part of the brain, not all the parts that meds do. It's fine for a trial, but I would then move on to meds.

 

Imagine the hypocrisy here. I'm from a church background where people slam ADHD meds and psychs up and down. Like literally every Sunday it's oh those horrible secular psychologists, ADHD is a discipline problem, blah blah. Those same people are morbidly obese and drink coffee! So they can be addicted to stimulants and self-medicate THEIR ADHD with caffeine, but a dc shouldn't take a small amount of a controlled, carefully dosed stimulant? Really? Even though caffeine and prescription meds, at the most basic level, work very similarly in the brain???

 

So anybody who drinks coffee or tea with caffeine or eats chocolate to perk in the afternoon but says it's horrible to put kids on ADHD meds is blind to their own hypocrisy. 

 

I'm a long-standing advocate of having ALL the options. I'm not in favor of medicating to avoid curriculum changes and lifestyle changes. But I'm also really strongly in favor of empowered children who are able to be what they're trying to be. I think it's a very serious, serious thing to have a teen girl suffering with depression. That's a really high priority thing to solve, and putting meds on the table is probably going to need to be part of the solution. It has to be part of the solution BECAUSE she's so bright, because she's not happy with the answer of how she functions without them. She can't tell you that because she's a kid and doesn't know. As adults, we can look at them and see what's going on. It's not that she's not trying hard enough or needs to think herself out of it. She really, really has significant issues going on.

 

Fwiw, the stats of drug abuse in *unmedicated* ADHD are actually kind of shocking. If you DON'T help her with these issues, she WILL be looking for answers. She's so bright, she's not going to leave that depression without some attempt to help it. How about alcohol? What is she going to get into? You can't let that level of hurt go on and not have her try to solve it somehow. THIS is the outcome you want to avoid. 

 

I just wanted to address the question about just making her try harder. I tend to think of medications as being shorter term solutions I guess, and so am looking for ways to help her address things that may be long term solutions. I know that CBT helps depression and I don't look on anti-depressants as long term solutions for most people. I may be wrong in that but just wanted to explain my point of view. I had not thought about the depression as coming from ADHD, as we have had some difficult circumstances within the family that have been hard for her and I have thought that the depression was from this.

 

ETA: I don't think that people with ADHD are dumb at all. I think the fact that she is able to be successful with her school work makes me question myself in thinking that she may have a problem.

Edited by tcb
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Hmm, definitely don't want to argue on that. There are always more perspectives. I get what you're saying about long-term, like wow do you want to be on meds your whole life... 

 

A trial of sam-E would let you sort out what is causing what. Low cost, low side effects, and low risk statistically.

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Perhaps this might be helpful:

 

ADHD Anxiety Symptom Checklist for Children

https://www.additudemag.com/adhd-anxiety-symptom-checklist-for-children/

 

Thanks, that was very interesting to read and has given me lots to think about. I am going to have her see a psychologist and see what we can find out. I've already made the call - just waiting for them to call me back.

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Thanks, that was very interesting to read and has given me lots to think about. I am going to have her see a psychologist and see what we can find out. I've already made the call - just waiting for them to call me back.

This is the best way to get some answers.

 

I think it is good for all of us to remember that if the professionals sometimes get it wrong, how much more likely are we, when all we have to go on is a snapshot of what someone is willing to share about their child on a public board!

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It doesn't have to be either/or with CBT and meds. Both/and is okay too!

 

I personally think that ADHD meds can help a person well enough to learn coping techniques for the distraction and disorganization (or however it presents besides distraction). If it's ADHD, it will take a toll at some point. I don't know many adults with ADHD who are not suffering some kind of frustration with tasks, and there are many ways they cope including ADHD meds, hiring help, etc. The ones that do not, spend a lot of time locked out of their car, missing deadlines, struggling with money management, etc. (I seem to have a lot of friends, acquaintances, and other contacts with ADHD, lol!) At some point, most people hit their limit for coping with something in life, even if it's temporary (ADHD or no ADHD involved). It can really knock confidence on it's rear to hit your limit at a crisis point vs. a "safe" point. Now is a good time to help her learn to know what is typical or not and then how to use tools (meds, CBT, organizational skills, routines, whatever) to manage the ADHD and the depression.

 

The distraction level your DD describes doesn't sound typical to me. 

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The distraction level your DD describes doesn't sound typical to me. 

 

I was just reading through your post again and I wondered if you could clarify the above for me. Is it that you don't think her level of distraction is typical of ADHD, or not typical of a normal teen? When I re-read I realized I wasn't sure. Thanks

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I was just reading through your post again and I wondered if you could clarify the above for me. Is it that you don't think her level of distraction is typical of ADHD, or not typical of a normal teen? When I re-read I realized I wasn't sure. Thanks

 

I think she meant not typical of a NT (neurotypical) teen. 

 

Responding to Kb's point about adults. Just to play devil's advocate, I too know a lot of ADHD people, and they don't lock their keys out of cars. Some people blame things on their ADHD when they're just plain disorganized. ;) Lots of people have problems with keys, money, keeping their house clean, etc. The real curiosity to think through is what the difference is, why some people with ADHD have their lives together ANYWAY and others don't. 

Edited by OhElizabeth
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Yes, I meant that the distraction is not typical of most kids. It sounds more typical of kids with ADHD. And OhElizabeth is right--some people with ADHD have things together. But, most of the ones that I know who do have done some major work to get there, and it often includes meds or hiring people to keep track of details. The successful people are those who recognize their issues and have a plan. In some cases, it's come together with age, but it's not been without some rifts with jobs or spouses. People who don't have a plan (and backup plans) seem to struggle more and are less cognizant of their issues overall.

 

I don't mean to be bleak. I mean for it to be something you take seriously even though she seems to compensate. I would assume she's working harder than you know. 

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