ADD and anger...

[Heather in VA]

Does anyone else deal with a lot of anger from their ADD child? My dd is becoming more and more difficult to deal with during school. She does everything in a bundle of anger. She is miserable through every lesson, even things I know she is interested in. When she gets really upset she tends to gouge the paper with her pencil as she writes. If I ask her a question I get answers through gritted teeth or I get an answer she knows is bad almost like she wants to provoke. Like this morning during our grammar lesson, I began the lesson by asking her the definition of a verb.. to prep for the lesson. She said 'it's a word'. Now I absolutely know she knows this. In fact after two more times of my telling her I expected good effort she told me the full definition completely and correctly but was angry about it. 

 

Her dad thinks she's just being a brat but even if he's right he has no suggestions on how to fix it because consequences are not making it better. I'm not convinced this is fully a behavioral problem. When not doing school she is the most helpful, soft-hearted child. I see none of this behavior even when I'm telling her to do things or giving her chores. So if it was solely related to not wanting to do something I would think I would see it other places, at least sometimes. 

 

I need to figure out what to do because it can't go on like this. She's 11.

[prairiewindmomma]

How is her processing speed and word recall?  Ds has gaps where he knows an answer but can't access it for a bit. 

 

I'd switch up school materials by adding in some really fun stuff she wants to do and see how her behavior is.   The fact that she is so soft-hearted outside of school makes me think there is something more going on.

[MomatHWTK]

It may be a combination of hormones and executive function issues.  If you two are locked into a bad pattern maybe change up the routine or take a break in order to reset everyone's brains.  One of my children actually works best if I just give her a list and leave her alone as much as possible.  I check her performance and progress and offer assistance and correction as needed but she really prefers to be on her own.  I guess even having me around is too much brain noise.  KWIM? 

[Lecka]

If you haven't tried it -- try ignoring the bad attitude when possible (maybe letting some things go).  Then when she does have an improvement, be positive yourself, even if the improvement is small.  Watch yourself -- do something to destress prior to working with her, so you don't start with her thinking, on some level, about how you have had an attitude from her and will probably keep having an attitude from her.  Take some breaths, stretch, take time for a favorite drink. 

 

If you haven't tried this yet -- it is worth trying.  It may not work, but can work sometimes. 

 

You also might try to change up the workspace in a little way, or add in positives to make things more pleasant as it is possible. 

 

If you are finding yourself getting more and more harsh, try to just get more and more pleasant. 

 

This is just one thing to try, and may not try, but it can work, and if you try some other changes, try to do this, too. 

 

As little as you may be a cause, you are still part of the dynamic, and you can do things on your half of the dynamic, that are worth doing, even if they are not guarantees to help her side of the dynamic. 

 

It sounds like you have a great relationship and dynamic overall ----- I would try to observe yourself for a few days, and try to see if there are anythings from your non-school dynamic that you could add in to your school dynamic, things that are working.  See if there are things on your side that are part of your school dynamic but not the non-school dynamic, and try to remove those things from your school dynamic. 

 

The other thing -- school could be harder for her than chores and cooperating in general -- it could be a lot of effort and be sapping her will, she could be getting demoralized.  So on that side -- you would change or adjust your teaching. 

 

If it is that you have gotten into a bad dynamic somehow, then the first things I wrote are things to try. 

 

If you have both things, then it can be both.  If things were too hard, that could have led to the dynamic.  If so -- it is two issues to work on, and I would try to think of them separately and come up with ideas/solution separately. 

 

My two cents ;)  I do not know about ADD/ADHD specifically but this is the kind of situation I have had, where there is a school problem, and it turns into a school problem plus an attitude-about-school (for him -- it is too hard, he can't do it, he worries as soon as he is getting started b/c he thought it would be too hard, etc, etc).  I had to address both. Just addressing one or the other would not work in our case. 

[Geo]

I'm ADD. I experience anger when there is a block or "wall" between me and getting a task done. It's like I need the extra adrenaline to force my brain through the process. It's definitely cognitive. Sometimes, I just can't get started. Period. Busy work is the pits. Time to re-evaluate the efficacy of the materials you are using with her.

[Citrusheights5]

My 11 year old has ADD and anger issues as well. It seams to cycle where he anger is directed too. Geo described it pefectly, and usually I will make him do 10 jumping jacks for each smart remark. Eventually he's getting the adrenalin rush from exercise, not engaging in an argument. We've done this for about a year, and sometimes he will jump up and do the jumping jacks himself, sometimes I have to send him.

 

I tell Miles often: I do not have to attend every argument I am invited to.

[Heathermomster]

My DS is ADHD inattentive.  He rarely gets angry, but I seem to recall in 6-7th grades, there were smart mouth moments.  DH and I spoke with him several times and I warned him repeatedly about his tone.  Somehow, DH and I roped him in and started using incentives.   I associate that time with hormones, and DS was always extremely remorseful afterwards.

 

Now that I think about it some more, DS tells me when schoolwork is extra difficult.   

[Ottakee]

how are you treating her ADD?  Is she on meds?  If so, she might need an adjustment to them (puberty and pre puberty and wreck havoc on meds/dosages).

 

If this is only during school it might be due to the increasing academic expectations and her challenges.

 

I will say that without meds, school was a disaster, with meds, a huge positive difference.

[Heather in VA]

Thanks everyone!! Such great information. I really appreciate all the ideas to try to help and change things up. I am definitely going to try them. We are not currently medicating. I am not against it. Her dad is less thrilled with the idea although he's not rigid about it. His brother has issues with anxiety and depression. At one point his meds got out of whack and he nearly committed suicide so he's understandably reluctant. He knows the meds aren't the same but he worries about it. It might be time to give it a try.

 

Geo - what you said really sounds like what she's dealing with at least some of the time. She just can not get started. I have cut busy work as much as possible. But sometimes she just sits there and it's like I can see her trying to move toward the work or answer the question but she just can't make herself do it. What do you do when you get like that? Should I just have her do jumping jacks and drink Mountain Dew? (I'm only 1/2 kidding - I hear caffeine can help). 

[PeterPan]

I'm ADD. I experience anger when there is a block or "wall" between me and getting a task done. It's like I need the extra adrenaline to force my brain through the process. It's definitely cognitive. Sometimes, I just can't get started. Period. Busy work is the pits. Time to re-evaluate the efficacy of the materials you are using with her.

 

 

My 11 year old has ADD and anger issues as well. It seams to cycle where he anger is directed too. Geo described it pefectly, and usually I will make him do 10 jumping jacks for each smart remark. Eventually he's getting the adrenalin rush from exercise, not engaging in an argument. We've done this for about a year, and sometimes he will jump up and do the jumping jacks himself, sometimes I have to send him.

 

I tell Miles often: I do not have to attend every argument I am invited to.

Hey Heather, long time no chat!!  Ds just got his 3rd round of evals and got aspergers added to the mix.  He definitely has issues with how things come out.  The more kinesthetic a child is (and yours is, right?), the more likely it's going to come out that way, as kicking, punching, etc.  They're just so kinesthetic.  So if it has been a while since thorough evals, that would be a thing to consider.  I'm not saying she needs more labels, just saying it happens.

 

I really like the others' observations about the initiation hump and how PHYSICAL and visceral this is and how people use anger, venting, hitting, etc. to get that rush to deal with it.  Have you read Love, Logic, Magic?  I think you might want a plan for a very logical consequences, not necessarily punitive but more problem-solving, no big deal, we'll change tracks kind of approach, kwim?  Like increase the pace and decide in your mind ahead of time that her expressions mean something is wrong that we just can't identify yet, not exclusively volitional.  So then your role becomes problem solver and problem fixer, NOT punisher, kwim?  Your initial feeling is to punish, but as you say punishment doesn't work if the child doesn't have the tools to respond and get there!  If they can't get there, the punishment is just all the more frustrating.

 

Have you looked into Neurofeedback?  Cogmed?  An OT eval?  My dh is pulling the "meds are horrible, like using your drugs, like NEVER do I want my kid on them" stunt, and I'm fine with that.  So fine, then you pay for an OT eval, get more sensory integration therapy, get neurofeedback, and do Cogmed.  These are well-recognized treatments with documentation and research.  And I'd do them in that order.  That's what I'm doing with dd now.  Actually I'm working on getting her an IEP to get the FUNDING to do that.  Anyways, that's my order.  And my goal (ambition, passion, volition) is to do those things, do as much with her body that can be done, see how functional she can get, and THEN demand meds for whatever is left.  

 

It is not just ONE parent in this scenario, kwim?  But sure, we can work with the opposed to meds position.  So tell him to cough up for the other therapies known to help.  

 

There *is* evidence connecting anxiety, anger, and the ADHD, and I think the neurofeedback can balance some of that.  The pattern of the brain waves for that form of ADHD is actually the inverse of the other, more typical type (inattentive) of ADHD.  In both cases though they can run the tests and sort it out and treat.  When you find OTs who specialize in sensory integration and autism/adhd, that's where you're likely to find someone doing neurofeedback.  I'm not sure there's necessarily a particular, preferred method or machine.  I was trying just to find a provider, mercy.  In our area I'd have to drive an hour and they do these sessions multiple times a week!  But now we have a closer provider, meaning I can make this work.

 

Demand fresh evals.  Or if she has had evals in the last bit but the person was looking only for ADHD, go get a 2nd opinion somewhere, looking exclusively at these additional concerns you have.

 

I found the puberty stuff with dd made her more tired, more hungry, more sluggish.  However her behavior improved when you worked on those things, handing her a snack, giving her a nap, etc., kwim?  So I'd definitely make free to hand her a snack or offer her a nap or solve those physical problems.

[Ottakee]

I agree with getting another eval and a full neuropsych is possible.  It could be more than just ADHD going on as well.

 

I would also have get a full physical with blood work done as around puberty kids can have trouble with blood sugars, thyroid, Vit B and D levels, etc. and all of those could affect the ADHD stuff.

 

I won't say I like having to use meds here but I do know that the difference in ability and attitude with school work is HUGE.  Whenever we start to struggle, I would go to the med sorters and 99% of the time, dd had not yet taken her meds.  I would have her take them, and then come back in 1/2 hour and it was like a different kid.

 

I do understand your worries though (esp. dh's) and if you decide to go with meds, I would see a pediatric psychiatrist and make sure to mention your BIL's diagnosis, meds, med reactions, etc.  A good pdoc will take that all into consideration when trying meds as many things have a genetic link, even to which meds work best.

[Targhee]

Geo - what you said really sounds like what she's dealing with at least some of the time. She just can not get started. I have cut busy work as much as possible. But sometimes she just sits there and it's like I can see her trying to move toward the work or answer the question but she just can't make herself do it. What do you do when you get like that? Should I just have her do jumping jacks and drink Mountain Dew? (I'm only 1/2 kidding - I hear caffeine can help). 

That is enough for me to want to try meds.  You are good to be cautious, and realistic about medication. Think of how a little help with her focus might change her interactions with people, which is so much more important than academic success IMHO.   The improvement in social interactions with peers, teachers, and people in general, after starting meds, did so much for raising my kids' spirits and self esteem! 

[Tiramisu]

I'm EXACTLY where the OP is. It's become our everyday recently. We are on spring break and it's been a wonderful relief not to have to fight about school. We are switching up the curriculum and have a well-check coming up to explore the health issues. She's had some minor medical problems lately, a traumatic incident over the winter, and hormones are kicking in so it's very difficult to sort it all out. But even other people are noticing her negative mood. Meanwhile, I'm trying to give her love, love, love. She goes crazy happy for games, especially Monopoly with dh, so that's happening almost everyday.

 

Meds are tricky with anger. Anger is often depression and/or anxiety in children. Generally, you want to address a mood issue first before deciding to medicate for ADHD. You might want to think about family history. Our family history is full of people with adhd-like symptoms, depression, anxiety, and alcoholism. One psych we used really feels that it's all tends to go together.

 

I have resorted to tea, or coffee with a lot of milk when she won't get started. I've also started staying out of her way with school work as much as possible, leaving her to do things independently since I often seem to set her off.

[Kanin]

I'm sorry you and your daughter are having such a hard time! Does she have activities or hobbies that she really, really loves? Could you put the hard schoolwork right before something that she likes? Go do school in a public place like the library or a coffeeshop? She might feel cool drinking a hot chocolate while doing math :)

 

I tutored for a wonderful family and one child had a lot of trouble with anger over schoolwork. They bought a giant, awesome trampoline and we ended up doing a lot of schoolwork out there. He could listen better when his body was occupied. 

 

Another thought about tutors... if you have the extra cash, you could have someone come for an hour a day, or twice a week or whatever... sometimes it just really helps to have an outside person doing the cajoling. It could even be a highschooler (cheap!) to help with "homework."

[imagine.more]

Our DD13 was diagnosed with ADHD and since she's had issues like getting hyper and accidentally dropping her toddler sister and then crying all night long because she felt so badly (we didn't even reprimand her) we decided to trial ADHD meds (focalin). Before the meds we had been experiencing bouts of tantrums from her on a pretty regular basis. Usually no big deal, just tween attitude and stomping and slamming doors, but occasionally enough that she would work herself into hysterics and say mean things to us out of anger. On ADHD meds those don't happen like at all! Especially if I'm careful to only ask difficult things of her before 5pm when the meds wear off. I mentioned it to the pediatrician because I was surprised, that had really not been an effect we'd been expecting, and she said she hears that all the time from parents. Meds = far fewer angry and emotional outbursts and defiance. 

 

My theory is that with ADHD and the things that can come with those (processing issues, executive function issues, etc.) life is just constantly difficult and frustrating and darn confusing for our kids. I know I'm liable to get angry and say mean things when I'm frustrated and overwhelmed. I can't even imagine how I'd act if that's how I felt 24/7 over normal tasks others expected me to do (like say sitting and doing an age appropriate math problem). 

 

So I think for some medication can be the answer especially if it's uncomplicated ADHD. Like a PP mentioned of course if depression/anxiety are a concern you have to be really careful. And we suspect alcohol related disorder in DD given the family history so I researched which ADHD meds worked best with kids who have things like FAS because there are distinct brain differences there. So if depression is a concern AND you want to try meds I'd research and talk to the doctor about which are least likely to exacerbate depression. I'm typically one to be very slow to even consider meds but for us they have been wonderful, have zero side effects, and help DD focus better so all her efforts at schoolwork and good behavior actually have results. The poor kid was trying so hard before to be good but failing daily because it was just so hard. 

 

Also, as others mentioned teaching coping skills like using a trampoline, exercising regularly, using fidget or chewing items during schoolwork, etc. is great. And just keeping the environment ADHD-friendly. Anything to really truly help the ADHD and help her not be so frustrated all the time. 

[Mom22ns]

I'm ADD. I experience anger when there is a block or "wall" between me and getting a task done. It's like I need the extra adrenaline to force my brain through the process. It's definitely cognitive. Sometimes, I just can't get started. Period. Busy work is the pits. Time to re-evaluate the efficacy of the materials you are using with her.

 

Thank you for this insight. My ds is like this too, but I've never been quite able to grasp the "wall" idea. You description is succinct and clarifies something I've struggled to understand for years. 

[Junie]

FWIW,  I had a (non-ADD) child who had severe anger issues.  It seemed especially bad when it was time to do schoolwork.  She would scream, slam doors, chuck toys at my head, kick the coffee table across the room, bite her brother...

 

It turns out that she is allergic to Red #40.  Froot Loops for breakfast were a major contributor.

 

I don't know if this information will help you, but it's something to consider...

 

 

[Tiramisu]

FWIW,  I had a (non-ADD) child who had severe anger issues.  It seemed especially bad when it was time to do schoolwork.  She would scream, slam doors, chuck toys at my head, kick the coffee table across the room, bite her brother...

 

It turns out that she is allergic to Red #40.  Froot Loops for breakfast were a major contributor.

 

I don't know if this information will help you, but it's something to consider...

 

Of course, I've heard about bad reactions to red dye but I hadn't heard of any specific behaviors. Yesterday, a mom friend told me her kids would fall down backwards. And now this. Interesting. 

 

We don't normally have food with dye (that I know of) on a daily basis, but I have noticed that if one of my kids ever has a root beer float, she'd get uncontrollably goofy. I thought it was the sugar but I wonder if it's anything else.

[drjuliadc]

There is another option besides meds.  I know the meds help many times, but using natural things that do similar things to the meds have less, or often no, side effects. Very few medical doctors are aware of these alternatives.  Dan Amen has ADD books that talk about them a bit and so do Billie Jay Sahley's books, http://www.amazon.com/Heal-With-Amino-Acids-Nutrients/dp/1889391204.

 

Always look for magnesium deficiency first with any learning disorder.  Just a trial of it is often the best way to tell if someone needs it.  I make lemonade with two scoops of InGear magnesium powder, lemon juice and stevia in a 28 ounce jar and have one child drink it throughout the day.  Magnesium is calming and helps anyone sleep more deeply and wake more rested.

 

Next, if a person would do well with a stimulant drug, often the amino acid Tyrosine will help instead.  Tyrosine is a precursor to Dopamine, the neurotransmitter that stimulant drugs attempt to increase.

 

If a person has anxiety issues, 5-htp will help to raise serotonin that antidepressants tend to attempt to increase, or calming herbs will help to raise GABA, which benzodiazepams attempt to increase. Calming herbs include lemon balm, melissa, valerian root, theonine.  You don't have to take them separately.  There are many formulations that have them together.

[drjuliadc]

I forgot to mention that movement is the ultimate brain food and the trampoline idea and jumping jacks ideas are great.  Getting that proprioceptive input in is vital for proper brain function. The brain is extremely dependent on movement.  So much so that if a living thing doesn't move, it doesn't even need a brain.  Living things that don't move and don't have brains are called plants.

[Heathermomster]

There is another option besides meds.  I know the meds help many times, but using natural things that do similar things to the meds have less, or often no, side effects. Very few medical doctors are aware of these alternatives.  Dan Amen has ADD books that talk about them a bit and so do Billie Jay Sahley's books, http://www.amazon.com/Heal-With-Amino-Acids-Nutrients/dp/1889391204.

 

Always look for magnesium deficiency first with any learning disorder.  Just a trial of it is often the best way to tell if someone needs it.  I make lemonade with two scoops of InGear magnesium powder, lemon juice and stevia in a 28 ounce jar and have one child drink it throughout the day.  Magnesium is calming and helps anyone sleep more deeply and wake more rested.

 

Next, if a person would do well with a stimulant drug, often the amino acid Tyrosine will help instead.  Tyrosine is a precursor to Dopamine, the neurotransmitter that stimulant drugs attempt to increase.

 

If a person has anxiety issues, 5-htp will help to raise serotonin that antidepressants tend to attempt to increase, or calming herbs will help to raise GABA, which benzodiazepams attempt to increase. Calming herbs include lemon balm, melissa, valerian root, theonine.  You don't have to take them separately.  There are many formulations that have them together.

The book you linked is over 13 years old.  Do you have any more specific and up to date recommendations?

[drjuliadc]

I probably read that book 13 years ago.  Although it is probably wise to think that way, for example, the concepts of neuroplasticity barely existed 13 years ago, using amino acids to increase neurotransmitters hasn't changed at all since then.  I still use the same protocols now that I did then.

 

Specific: Start with Magnesium first, it has 300 known functions in the body, then, if low serotonin - use 5-htp, if low gaba, use herbal calming formulas like Apex Energetic's Gabatone, if low dopamine - use L-Tyrosine, if low norepinephrine, use SamE.

 

A clue to whether someone is low in these neurotransmitters is which drugs help them.  Otherwise, Eric Braverman has questionaires.  It can be difficult to determine if someone's anxiety is low serotonin or low Gaba or both, but the others are easier to ID.  I am oversimplifying the concept of "low" neurotransmitters. It may be receptors that are blocked rather than being actually low.  Otherwise it is a very simple system since there are only 4 major neurotransmitters and two minor neurotransmitters that are being targeted by drugs.

 

Dan Amen's books were very medication oriented 13 years ago. His more recent editions are way more "orthomolecular" or nutritional supplement oriented.

[drjuliadc]

Since I read Billie Jay Sahley's book, I would say I have learned not to use GABA, which she recommends, for low GABA because it only works if someone has a leaky blood brain barrier.  I like Gabatone instead, but there are other calming multi-herbal formulas like it.

 

That is the only update I can think of, but I did read it a LONG time ago.  I also don't remember if she was very magnesium oriented then (I know she is now).