Mental health appointment—what to expect? UPDATED 6/6

[MEmama]

DS suspects he may have ADD; we started to explore it last year with his physician but with services bogged down due an overwhelming demand during Covid, we ran out of time before taking a next step. The additional complications of Covid and taking Accutane made it difficult to sort through the ingrained and the temporary, but now that he’s on the other side of both it’s time to address some clear issues.

He has an appointment in a couple weeks, unfortunately with a doctor he doesn’t know. He trusted his other doctor completely and she understood him well so I know he’s a little apprehensive about what to expect from someone new. Can anyone provide some insights into the types of things he'll be asked, or what an initial mental health consultation might look like?
 

Even though he’s 19, I think he’s going to want me to go with him; his other doctor appreciated the insight I could provide—especially to lifelong issues he isn’t well equipped to recognize as indicators. Is it considered weird for mom to be part of the conversation? 
 

UPDATED:  DS was able to get in with his GP, who seemed up to speed with the conversations that had started last year. I was surprised I didn’t have to put up a fight to try meds, he actually suggested them first and that DS should start them right away. He’s prescribed Vyvanse, which I had not heard of. Does anyone have experience with it? He’s also referred him to a neuropsych for deeper evaluation.

Lots of relief that DS on the path forward. 🤞 

Edited June 6, 2022 by MEmama

[Katy]

You can probably find a list of screening questions online. Like any other appointment the doctor will ask about symptoms and discuss medication options. 

[fairfarmhand]

I’ve gone to appointments with my 20 yo dd, so I vote not weird. 

[bibiche]

Here’s the checklist:

https://add.org/wp-content/uploads/2015/03/adhd-questionnaire-ASRS111.pdf

[Toocrazy!!]

My DS is 19 and recently diagnosed ADHD, inattentive. He did the neuropsych evaluation appts by himself because we were out of town. Those were a long battery of tests - similar to IQ testing but longer. Once he was diagnosed, he had to visit his regular dr in order to get prescribed any meds. 
I have gone to all of those appts with him. Since he already had a diagnosis they trusted, there weren’t a lot of initial questions, but as he was given medications, there were a lot. And it was helpful for me to be there to offer observations on his behaviors on the meds. 
His regular dr pretty much gave up on him and referred him to a NP that specialized in mental health. I stayed back when he went in, but then was asked to join those appts too. 
It’s a long process. If your son can really drill down and specify his symptoms and what he wants to change or improve it will help. DS is so vague, and has changed his life so many times in the last year, it’s hard for him to tell if it’s working. There’s been no real aha moment like he was expecting. And every visit is asking- how do you feel? DS isn’t real talkative in most cases, general questions like that aren’t getting anyone anywhere:) 
 

I think your son is studying outside the  country? I’m not sure how that will work with mental health meds. Through this trial period, DS has never gotten more than a 30 day supply without having to do an in person visit. 

[MEmama]

1 hour ago, Katy said:

You can probably find a list of screening questions online. Like any other appointment the doctor will ask about symptoms and discuss medication options. 

Thanks. I just remembered that last year we both separately filled out questions and paperwork describing his symptoms. I hope this new doctor has access to it (same practice, so it seems she should).
 

I’m not one to jump to medication, but at this point it seems it’s probably the best way to go. Idk how to ask without sounding like I’m trying to take an easy way out or something and I’m a little nervous about it.

57 minutes ago, fairfarmhand said:

I’ve gone to appointments with my 20 yo dd, so I vote not weird. 

Thanks, that helps. I’m not a helicopter type parent and strongly believe in letting young adults fly, but this is an area where I can see him more clearly than he can, and I know he wants and needs the support. 

[MEmama]

9 minutes ago, Toocrazy!! said:

My DS is 19 and recently diagnosed ADHD, inattentive. He did the neuropsych evaluation appts by himself because we were out of town. Those were a long battery of tests - similar to IQ testing but longer. Once he was diagnosed, he had to visit his regular dr in order to get prescribed any meds. 
I have gone to all of those appts with him. Since he already had a diagnosis they trusted, there weren’t a lot of initial questions, but as he was given medications, there were a lot. And it was helpful for me to be there to offer observations on his behaviors on the meds. 
His regular dr pretty much gave up on him and referred him to a NP that specialized in mental health. I stayed back when he went in, but then was asked to join those appts too. 
It’s a long process. If your son can really drill down and specify his symptoms and what he wants to change or improve it will help. DS is so vague, and has changed his life so many times in the last year, it’s hard for him to tell if it’s working. There’s been no real aha moment like he was expecting. And every visit is asking- how do you feel? DS isn’t real talkative in most cases, general questions like that aren’t getting anyone anywhere:) 
 

I think your son is studying outside the  country? I’m not sure how that will work with mental health meds. Through this trial period, DS has never gotten more than a 30 day supply without having to do an in person visit. 

My DS sounds similar, it’s so hard to get him to open up and talk freely, it makes understanding his struggles so much more challenging. Your experience validates why I’m eager to get him started on medication sooner than later, to help monitor before he goes back to school overseas. Thank you for sharing. 
 

I know they have mental health services available at his university, and I’m pretty confident a prescription from the US will be honored by their medical care. It’s helpful to know he might need to check in regularly with a clinic.

[Ottakee]

Some things to ask for are full blood work, check for any sleep issues if that is a concern,   Our doctor also did an ekg before starting meds.

[Hilltopmom]

I go to psychiatrist and dr appts but not counseling/ therapy unless sometimes asked to join.
Dd doesn’t give accurate health info on her own as she has trouble with timelines and dates as well as not describing a good picture of events that happened in the past.

[MEmama]

48 minutes ago, Hilltopmom said:

I go to psychiatrist and dr appts but not counseling/ therapy unless sometimes asked to join.
Dd doesn’t give accurate health info on her own as she has trouble with timelines and dates as well as not describing a good picture of events that happened in the past.

Yes, that sounds like DS. Last year he told me it’s hard for him to know if something is more difficult than it ought to be or if he struggles because he only knows his own experience. I don’t like the term to “know someone better than they know themself” but in this case it’s true.

[MEmama]

53 minutes ago, Ottakee said:

Some things to ask for are full blood work, check for any sleep issues if that is a concern,   Our doctor also did an ekg before starting meds.

What do they look for in blood tests or an ekg? 

[Toocrazy!!]

DS also got some pushback asking to be diagnosed and for meds for the first time at 19. There was a lot of - you graduated with amazing grades, your SAT scores are stellar, you did all that without meds, why are you seeking them now. 
It was helpful for me to be there for that - corroborating his stories and how school really went for him. 

[ShepCarlin]

We did this last May with our oldest. I had thought for years he had an ADD/ADHD issue but it just wasn't "bad" enough to warrant investigating it further. But when he started taking DE classes his junior year, I could see that it wasn't just mom the teacher that he had issues with...it was everyone. So. He had a full psychoeducational evaluation with a psychologist recommended by his pediatrician. Lots of paperwork prior to the appointment for both us and him. Husband and I met with the dr via Zoom as COVID was still an issue. DS went into to her office for the testing as she needed to see his body language while he took the rest of the evaluations. Then we met with the dr over Zoom again to review the results. 

I am SO glad we did this...he does have ADHD. She recommended medicine. At first, I was hesitant for him to try it but as my husband pointed out, we had tried all the strategies over the years without success. As he said, we paid all the money for the diagnosis...why would we ignore doctor's recommendations? He is on medication, very low dose. Only takes it when he has class or knows he needs to focus. When he sat down with his pediatrician for a review of how the first month on medication went, he said that now he not only knows he has things to do, he has the focus and energy to DO those things. Before he was an epic procrastinator. His positive personality has stayed the same and his eating habits are still the same (I was worried he'd lose his appetite). 

Good luck!

[EKS]

If he wants you there, it doesn't matter if it's weird.  You go.

(Also, it's not weird.)

[alisoncooks]

Following. My 16 yr old dd just filled out the questionnaire at the peds office for a referral…

[Corraleno]

An ADHD diagnosis requires not only that a certain number of symptoms on the checklist are present, but that they have been consistently present over time and in multiple contexts. You can provide valuable information about how the ADHD affected him socially, emotionally, at home, with homeschooling, etc., as well as what kinds of accommodations you made for him. Some docs tend to be suspicious of people looking for a diagnosis and meds as adults if there's not a history of needing accommodations prior to that, so your help in providing that information can be really valuable.

I don't accompany DS to regular doctor's appoints, but I have always gone with him to any appointment that involved ADD or LD testing, and I even went with him to the disability office at his university because he is not good at advocating for himself — not to mention being super disorganized with the paperwork involved with getting accommodations. I found it strange that the accommodations process was so complex and required so many steps and so much paperwork to stay on top of each semester, when the fact that the student struggled with those exact things was a major part of the need for accommodations to being with!

[TechWife]

5 hours ago, MEmama said:

...

I’m not one to jump to medication, but at this point it seems it’s probably the best way to go. Idk how to ask without sounding like I’m trying to take an easy way out or something and I’m a little nervous about it.

Thanks, that helps. I’m not a helicopter type parent and strongly believe in letting young adults fly, but this is an area where I can see him more clearly than he can, and I know he wants and needs the support. 

If she thinks it is called for she will recommend it, but she may recommend other changes (habits, environment, for ex.)  instead or in addition to, medication, to see if there is something else that can be tried. If she doesn't a simple question like: "If these stragtegies aren't effective, are there other options?" or "Would medication be appropriate at some point? What do you look for in making that recommendation?"

[Corraleno]

6 hours ago, MEmama said:

I’m not one to jump to medication, but at this point it seems it’s probably the best way to go. Idk how to ask without sounding like I’m trying to take an easy way out or something and I’m a little nervous about it.

Be prepared to discuss all the other things DS has tried to mitigate his issues, so if the doctor happens to be the type who is suspicious of adults seeking meds then you can demonstrate that this is more of a last resort, not an "easy way out." What kind of organizational systems has he set up, how does he handle time management, how has he set up his study space, how does he deal with distractions or inattentiveness, and are those systems working for him? If not, why not, and how would meds help more?

(IMO people with a diagnosed medical condition should be able to choose medication without having to justify that they tried everything else first, in the same way that someone with high blood pressure can choose meds without having to first prove they've totally changed their diet, joined a gym, and meditate regularly but still need meds. But unfortunately while some docs hand out Ritalin scrips like candy, others make patients jump through hoops to get them.)

[MEmama]

43 minutes ago, TechWife said:

If she thinks it is called for she will recommend it, but she may recommend other changes (habits, environment, for ex.)  instead or in addition to, medication, to see if there is something else that can be tried. If she doesn't a simple question like: "If these stragtegies aren't effective, are there other options?" or "Would medication be appropriate at some point? What do you look for in making that recommendation?"

Thanks— this wording is very helpful.

8 minutes ago, Corraleno said:

Be prepared to discuss all the other things DS has tried to mitigate his issues, so if the doctor happens to be the type who is suspicious of adults seeking meds then you can demonstrate that this is more of a last resort, not an "easy way out." What kind of organizational systems has he set up, how does he handle time management, how has he set up his study space, how does he deal with distractions or inattentiveness, and are those systems working for him? If not, why not, and how would meds help more?

(IMO people with a diagnosed medical condition should be able to choose medication without having to justify that they tried everything else first, in the same way that someone with high blood pressure can choose meds without having to first prove they've totally changed their diet, joined a gym, and meditate regularly but still need meds. But unfortunately while some docs hand out Ritalin scrips like candy, others make patients jump through hoops to get them.)

I dread these questions because the answers are brutal. He has no functional organizational systems, doesn’t handle time management well, gets lost in his obsessive mode to avoid difficult tasks and when he feels overwhelmed, his space is an absolute disaster and asking him to tidy up just a bit sends him over the edge. In this week he’s been home, I honestly wonder how he functions at all. His habits are really terrible but he seems unable to tweak or fix any of them, like doing so is the one thing too much. I feel like he’s walking on the very edge.

[Corraleno]

17 minutes ago, MEmama said:

I dread these questions because the answers are brutal. He has no functional organizational systems, doesn’t handle time management well, gets lost in his obsessive mode to avoid difficult tasks and when he feels overwhelmed, his space is an absolute disaster and asking him to tidy up just a bit sends him over the edge. In this week he’s been home, I honestly wonder how he functions at all. His habits are really terrible but he seems unable to tweak or fix any of them, like doing so is the one thing too much. I feel like he’s walking on the very edge.

Then I think the best approach is to just explain that he simply does not have the bandwidth to set up and manage organizational systems because he is too overwhelmed and distractible, and therefore he needs the meds to provide the focus necessary to even create and maintain the kind of supports he needs. And if that's not good enough for this doctor, I'd find a more sympathetic one.

We were lucky in that the mom of DS's best friend as kid was a psychiatrist so she knew DS very well and we never had to jump through hoops or prove anything, she was willing to prescribe multiple meds to see if something would work. But we were unlucky in that none of the meds DS tried worked for him, so he has had to get by with whatever systems he could manage, plus a lot more parental support than most college students would need or want (or be willing to accept). 

 

Edited May 26, 2022 by Corraleno

[MEmama]

6 minutes ago, Corraleno said:

Then I think the best approach is to just explain that he simply does not have the bandwidth to set up and manage organizational systems because he is too overwhelmed and distractible, and therefore he needs the meds to provide the focus necessary to even create and maintain the kind of supports he needs. And if that's not good enough for this doctor, I'd find a more sympathetic one.

We were lucky in that the mom of DS's best friend as kid was a psychiatrist so she knew DS very well and we never had to jump through hoops or prove anything, she was willing to prescribe multiple meds to see if something would work. But we were unlucky in that none of the meds DS tried worked for him, so he has had to get by with whatever systems he could manage, plus a lot more parental support than most college students would need or want (or be willing to accept). 

 

Thanks, this is helpful. If this new doctor isn’t amiable to trying meds I’ll insist on seeing the doctor he talked with last year—she’s a pediatrician and not actually his primary doc, but since technically he’s aged out of seeing her (and she was kind of accidental in the mental health stuff—she’s actually his asthma specialist but she really understands him) and getting an appointment with his GP is next to impossible, I think the scheduler heard “mental health” and slotted him in the next available spot. I’m probably more nervous than I need to be, but it helps to know what we might expect.

[Corraleno]

@MEmama If you provided a lot of help and scaffolding through high school (even if he went to PS, and you provided a lot of at-home support), but he no longer has that scaffolding since he is in college on the other side of the globe, and he is suffering because of it, that in itself is a strong argument for meds. Like he was only able to go without them while he was at home with significant parental support (which you can describe), but now that that kind of day-to-day support is no longer available, he is really struggling and needs meds to help him develop new, independent support systems.

[MEmama]

UPDATED:  DS was able to get in with his GP, who seemed up to speed with the conversations that had started last year. I was surprised I didn’t have to put up a fight to try meds, he actually suggested them first and that DS should start them right away. He’s prescribed Vyvanse, which I had not heard of. Does anyone have experience with it? He’s also referred him to a neuropsych for deeper evaluation.

Lots of relief that DS on the path forward. 🤞 

Edited June 6, 2022 by MEmama

[Kanin]

2 minutes ago, MEmama said:

He’s prescribed Vyvanse

I know lots of kids who take this with good results. It does mess with appetite, like mostly all ADHD meds. I think most of my students on meds eat a big breakfast, take the med, skip lunch or only eat a bit, then eat a big dinner.

[prairiewindmomma]

Vyvanse has been good here. ETA: I like it enough for my kid I would sell my plasma to pay for it if I had to, kind of good fit. Thankfully there is a manufacturer’s coupon you can pair with your insurance that brings the price down for many.

Edited June 6, 2022 by prairiewindmomma

[MEmama]

6 minutes ago, Kanin said:

I know lots of kids who take this with good results. It does mess with appetite, like mostly all ADHD meds. I think most of my students on meds eat a big breakfast, take the med, skip lunch or only eat a bit, then eat a big dinner.

Thanks! The doctor mentioned it might and I’ll let DS know your confirmation. 

[prairiewindmomma]

Also, fwiw, no appetite suppression here with Vyvanse, but it was an issue with methylphenidate.

[Toocrazy!!]

DS started with vyvanse. Looking back it was probably a decent fit for him, but they switched him to adderall at his request. Anyway, he lost weight- he never had a good appetite anyway and was already pretty thin. He also experienced what they diagnosed as covid toes, but seemed to be connected with the upping of doses. 
I think the low dose was a good fit for him psychologically, but I’m not sure anyone will try it on him again. 

I really hope it works for your son! It seems to work for a lot of people. 
 

[MEmama]

21 minutes ago, Toocrazy!! said:

DS started with vyvanse. Looking back it was probably a decent fit for him, but they switched him to adderall at his request. Anyway, he lost weight- he never had a good appetite anyway and was already pretty thin. He also experienced what they diagnosed as covid toes, but seemed to be connected with the upping of doses. 
I think the low dose was a good fit for him psychologically, but I’m not sure anyone will try it on him again. 

I really hope it works for your son! It seems to work for a lot of people. 
 

Can I ask why he requested a different med? And did it work better for him?

We have 3 months to figure this out as best as possible before DS leaves again for university. I know it’s a process so I’m glad he can get started right away (“right away”— I’ve been trying to convince DH for ages that something was going on with DS but he would have none of it. I’m kicking myself for not being more assertive years ago). 

[Toocrazy!!]

I think DS thought it was going to be an aha moment when he started meds, and he just didn’t feel that. I think his dr was not experienced with these meds, and started him too low and upped him too quickly. 
Then DS did some research and decided the delivery mechanism for adderall would be a better fit for him. I don’t know why he thought that:) Again, looking back, started too low and upped dose too quickly. I think if he would have stayed with one of them for more time, he would have noticed a benefit. I think they were good for him and I noticed a difference. But on the higher doses, he had the toe issue again, and because of that, his dr refused to give him more meds and referred him out of their practice. 

I think I said before- DS couldn’t really verbally identify particular things he was looking for improvement with, and drs would just say- how do you feel? 
 

Also, DS life when trying meds isn’t conducive to really seeing a benefit. He’s doing online classes in a subject he loves and can spend hours on, so no real schedule, no need to get up at a certain time, no required class work he struggles through. So, no real measurables. 
 

there was no real difference between vyvanse and adderall for him. He’s on something different now, which slows him way down and causes him to nap. It’s supposed to calm your brain as well. But he’s just noticing the naps:) 

[MEmama]

1 hour ago, Toocrazy!! said:

I think DS thought it was going to be an aha moment when he started meds, and he just didn’t feel that. I think his dr was not experienced with these meds, and started him too low and upped him too quickly. 
Then DS did some research and decided the delivery mechanism for adderall would be a better fit for him. I don’t know why he thought that:) Again, looking back, started too low and upped dose too quickly. I think if he would have stayed with one of them for more time, he would have noticed a benefit. I think they were good for him and I noticed a difference. But on the higher doses, he had the toe issue again, and because of that, his dr refused to give him more meds and referred him out of their practice. 

I think I said before- DS couldn’t really verbally identify particular things he was looking for improvement with, and drs would just say- how do you feel? 
 

Also, DS life when trying meds isn’t conducive to really seeing a benefit. He’s doing online classes in a subject he loves and can spend hours on, so no real schedule, no need to get up at a certain time, no required class work he struggles through. So, no real measurables. 
 

there was no real difference between vyvanse and adderall for him. He’s on something different now, which slows him way down and causes him to nap. It’s supposed to calm your brain as well. But he’s just noticing the naps:) 

I’m concerned we will have a similar experience, since he’s home on summer break and nothing much is being asked of him. I suppose if he cleans his room, I’ll know it’s working? Lol

He was started on 30 mgs daily. 

[Corraleno]

Vyvanse requires an extra step within the body to metabolize it, which results in a slower ramp up after you take it and a more gentle decline at the end of the day. That was definitely true for DS — he had a hard time with Ritalin because he felt like he went from 0-60 too fast and then the drop off at the end was really precipitous and unpleasant. Here's a quick blurb about the difference:

"Methylphenidate, the drug in Ritalin, enters the body in its active form. This means it can go to work right away, and doesn’t last as long as Vyvanse. Therefore, it needs to be taken more often than Vyvanse.  Lisdexamfetamine dimesylate, the drug in Vyvanse, enters your body in an inactive form. Your body has to process this drug to make it active. As a result, the effects of Vyvanse may take 1 to 2 hours to appear. However, these effects also last longer throughout the day."

DS tried all of the ADHD drugs (or at least what was available 5-6 years ago), and could not find anything that worked for him because the stimulants increased his anxiety more than they increased his focus, and the nonstimulant (Strattera) had no effect.

[prairiewindmomma]

6 minutes ago, MEmama said:

I’m concerned we will have a similar experience, since he’s home on summer break and nothing much is being asked of him. I suppose if he cleans his room, I’ll know it’s working? Lol

He was started on 30 mgs daily. 

Have him do some math for an hour or read a dense text. Odds are you can find something that will work.

TBH, though, the people with adhd in my family didn't have much self awareness about whether they were on meds or not for a couple of months. It was super obvious to everyone around them, but it took them a while to develop some self-reflection.

[MEmama]

9 minutes ago, Corraleno said:

Vyvanse requires an extra step within the body to metabolize it, which results in a slower ramp up after you take it and a more gentle decline at the end of the day. That was definitely true for DS — he had a hard time with Ritalin because he felt like he went from 0-60 too fast and then the drop off at the end was really precipitous and unpleasant. Here's a quick blurb about the difference:

"Methylphenidate, the drug in Ritalin, enters the body in its active form. This means it can go to work right away, and doesn’t last as long as Vyvanse. Therefore, it needs to be taken more often than Vyvanse.  Lisdexamfetamine dimesylate, the drug in Vyvanse, enters your body in an inactive form. Your body has to process this drug to make it active. As a result, the effects of Vyvanse may take 1 to 2 hours to appear. However, these effects also last longer throughout the day."

DS tried all of the ADHD drugs (or at least what was available 5-6 years ago), and could not find anything that worked for him because the stimulants increased his anxiety more than they increased his focus, and the nonstimulant (Strattera) had no effect.

I’ll be on the lookout for increased anxiety— I’m glad you mentioned that.

Has yours been able to learn to cope? I think you mentioned you have to be more hands on than a young adult might ordinarily prefer?

[MEmama]

9 minutes ago, prairiewindmomma said:

Have him do some math for an hour or read a dense text. Odds are you can find something that will work.

TBH, though, the people with adhd in my family didn't have much self awareness about whether they were on meds or not for a couple of months. It was super obvious to everyone around them, but it took them a while to develop some self-reflection.

Asking him to make a phone call results in days of procrastination, no tough reading necessary! Lol.

Were you able to notice the difference pretty quickly, even if they couldn’t? 

[Soror]

It has worked for D's, the only drawback being the expense. With our high deductible plan (we pay 100% until we meet it) it was $250 or so after the coupon.

[Toocrazy!!]

DS noticed the difference AFTER he went off if that makes sense. He didn’t get a big AHA, but when he was off between changes, he did say- hmm, maybe that was working 🙂 so, longer for self reflection would have probably been key for him as well. 

He noticed a difference when driving. It’s something he didn’t feel real comfortable with, and medicated he did notice it was easier for him. And a general motivation to get out of bed and get his day started. They kept asking if that was depression, but I don’t think it was. Just a teenager with no schedule and procrastination issues! 

[TarynB]

If the prescription is expensive with your insurance, try using GoodRX. It's free to use and some meds in our family are WAY less costly with GoodRX than insurance. There have been threads here about it. Definitely worth checking.

Edited June 6, 2022 by TarynB

[MEmama]

23 minutes ago, Soror said:

It has worked for D's, the only drawback being the expense. With our high deductible plan (we pay 100% until we meet it) it was $250 or so after the coupon.

Yikes! It was $30 for a months supply for us. He will have to see a hospital psychiatrist every month for refills when he’s back in Ireland, so 🤞our insurance covers that kind of monthly expense. 

20 minutes ago, TarynB said:

If the prescription is expensive with your insurance, try using GoodRX. It's free to use and some meds in our family are WAY less costly with GoodRX than insurance. There have been threads here about it. Definitely worth checking.

Our doctor suggested GoodRx too, in case our insurance didn’t cover it. He did tell me to refuse the prescription if it was too expensive and he’d figure something else out. I appreciated that he was so upfront about it, but I wonder if some insurance plans don’t cover it at all. 

[ktgrok]

I take vyvanse, as does my son. It is a "pro drug" which means it has the precursor to the drug, and your body then over time breaks it down into the actual drug. For that reason, is is hard to abuse - your liver will only convert so much of it at a time, at a certain speed, so you can't just chew it to get it all at once or something. I think they tend to make it a first choice for adolescents and young adults simply because they are more in the age range to abuse ADHD meds, or sell it to others for recreational use. Vyvanse doesn't have the same value for abuse, so it is safer. 

 

[ktgrok]

Oh, one of the fastest things I noticed was when reading aloud. I HATE reading aloud as I always end up with my eyes/brain tracking ahead of my mouth. Then I mix up words from multiple lines on the page, etc. I can't help it, I just start scanning the page as I'm trying to read. The whole page. 

On meds I was MUCH more able to just focus on the actual line I was supposed to be reading, and stumble over my words much less. 

[MEmama]

6 minutes ago, ktgrok said:

I take vyvanse, as does my son. It is a "pro drug" which means it has the precursor to the drug, and your body then over time breaks it down into the actual drug. For that reason, is is hard to abuse - your liver will only convert so much of it at a time, at a certain speed, so you can't just chew it to get it all at once or something. I think they tend to make it a first choice for adolescents and young adults simply because they are more in the age range to abuse ADHD meds, or sell it to others for recreational use. Vyvanse doesn't have the same value for abuse, so it is safer. 

 

His doctor said most of these words, but the way you phrased it makes so much more sense to me! Thanks for the clarification! 

[prairiewindmomma]

1 hour ago, MEmama said:

Asking him to make a phone call results in days of procrastination, no tough reading necessary! Lol.

Were you able to notice the difference pretty quickly, even if they couldn’t? 

Lol, we've struggled to get over the phone thing, even medicated. That's more anxiety than ADHD driven here.

So, kid1:

I noticed a strong shift, day 1 of meds. I could give multistep instructions, and he could do all of the steps. It was that simple. Before, if I had sent him upstairs to start a load of laundry and clean the bathroom, I swear he got lost as soon as he left the room. 😂  On meds, he is stellar. Off meds, he's like the absent minded professor...still bright, but not quite functional.

This kid went through several different meds before we got to the right blend.  Anything that was not mediated through processes was just too strong. He dropped 20 lbs through appetite suppression and he got irritable when they wore off. We were hesitant to go to Vyvanse, but it was absolutely the right call.

Kid 2: 

Short acting meds didn't work, but long acting extended release do. It took us about 3 months to get dosage and timing sorted out. It wasn't as obvious day 1 that meds were working, but by the end of the week I could see when they had worn off. Interestingly, meds make them more engaged in conversation and they have a bubblier personality. Without meds they are quiet and lost in their inner thoughts. On the short term downside, this sudden ability to string together one's own thoughts kind of brought anxiety and other issues to light. We put them in therapy, did not switch up meds, and now things are ever so much better than they were before we started meds. The anxiety was always there---even before meds--it's just that meds helped enough that other issues could even be brought up to be dealt with...if that makes sense.  It's like having a broken leg and a bruised shoulder. Once we fixed the leg, then we could deal with the shoulder.

 

[Corraleno]

40 minutes ago, MEmama said:

I’ll be on the lookout for increased anxiety— I’m glad you mentioned that.

Has yours been able to learn to cope? I think you mentioned you have to be more hands on than a young adult might ordinarily prefer?

TBH the "learning to cope" part is still a work in progress. A week ago he woke me up at 3 AM to tell me he'd left his carryon, with his laptop and his boarding passes, on the plane in Munich and was probably going to miss his connecting flight. <head desk> So he still loses things, but it's nothing like when he first went to college, when he was losing his backpack weekly and a new jacket pretty much every semester. And for the first few semesters, I did go over his schedule with him on a regular basis, to make sure he was on track and help him prioritize tasks when he was getting overwhelmed. He tried to get help with that through the disability office, but executive function tasks were the one thing they would not help with (which made no sense to me!).

Making him set up organizational and time management systems has been a real struggle, but he's getting there. I think the problem is that precisely the kinds of systems that he needs to function in a non-ADD world are foreign to the way his brain works, so in the beginning, trying to remember to set up and use the systems takes more time and effort and brain power than just flying by the seat of his pants, kwim? It takes a few big screw-ups, that would have been avoided by having a system, to recognize that maybe it's worth the hassle and extra work to set the systems up ahead of time. And even with very detailed systems in place, life is still a struggle for an unmedicated kid with severe ADHD, there's just no way around that unfortunately.

[MEmama]

21 hours ago, Corraleno said:

TBH the "learning to cope" part is still a work in progress. A week ago he woke me up at 3 AM to tell me he'd left his carryon, with his laptop and his boarding passes, on the plane in Munich and was probably going to miss his connecting flight. <head desk> So he still loses things, but it's nothing like when he first went to college, when he was losing his backpack weekly and a new jacket pretty much every semester. And for the first few semesters, I did go over his schedule with him on a regular basis, to make sure he was on track and help him prioritize tasks when he was getting overwhelmed. He tried to get help with that through the disability office, but executive function tasks were the one thing they would not help with (which made no sense to me!).

Making him set up organizational and time management systems has been a real struggle, but he's getting there. I think the problem is that precisely the kinds of systems that he needs to function in a non-ADD world are foreign to the way his brain works, so in the beginning, trying to remember to set up and use the systems takes more time and effort and brain power than just flying by the seat of his pants, kwim? It takes a few big screw-ups, that would have been avoided by having a system, to recognize that maybe it's worth the hassle and extra work to set the systems up ahead of time. And even with very detailed systems in place, life is still a struggle for an unmedicated kid with severe ADHD, there's just no way around that unfortunately.

I’m trying to learn as much as I can about this disconnect so I can help scaffold in any way possible this summer while he’s home. Of course I’m kicking myself for all the times I’ve yelled at him about how he “just” needs to do X or that doing Y is “so easy!”. An entire lifetime of wondering aloud why he insists on self sabotaging himself. 😢🤦‍♀️
 

Mostly I’m really, truly angry at DH for not taking my concerns seriously, and that I didn’t know how to advocate harder when my mama gut *knew* something was amiss even as he insisted nothing was. So.much.regret.

 

[Lady Florida.]

On 6/6/2022 at 12:34 PM, MEmama said:

He’s prescribed Vyvanse, which I had not heard of. Does anyone have experience with it? 

Lots of relief that DS on the path forward. 🤞 

I'm glad he's moving forward right away. Getting diagnosed as an adult can be difficult because a lot of doctors, unless they specialize in adult ADHD, don't want to deal with it especially where meds are involved.

Ds was dx'd as a child and has been on different meds over the years. Vyvanse didn't work for him. He said it actually made him feel tired. He's been on Adderall since he was 15 (he's 24). TBF he has moderate ADHD, combined type so he's always needed stronger meds at higher doses.

I hope your son can get settled on the right medication this summer. Since ADHD affects all aspects of life he should look at how he feels doing everyday things like laundry, driving, reading, etc. 

Different people with ADHD respond differently to various meds and it's not uncommon to have to try different ones and different doses at first. Hopefully your ds will find out quickly what works since he has a limited time to get it sorted out. 

Edited June 8, 2022 by Lady Florida.

[MEmama]

13 hours ago, Lady Florida. said:

I'm glad he's moving forward right away. Getting diagnosed as an adult can be difficult because a lot of doctors, unless they specialize in adult ADHD, don't want to deal with it especially where meds are involved.

Ds was dx'd as a child and has been on different meds over the years. Vyvanse didn't work for him. He said it actually made him feel tired. He's been on Adderall since he was 15 (he's 24). TBF he has moderate ADHD, combined type so he's always needed stronger meds at higher doses.

I hope your son can get settled on the right medication this summer. Since ADHD affects all aspects of life he should look at how he feels doing everyday things like laundry, driving, reading, etc. 

Different people with ADHD respond differently to various meds and it's not uncommon to have to try different ones and different doses at first. Hopefully your ds will find out quickly what works since he has a limited time to get it sorted out. 

I’m honestly surprised his GP suggested meds right away. I’m sure he had read the notes from previous conversations we had had with a different doctor and probably spoke to her as well, but I went in to the appointment expecting to fight for them and instead they were just offered up. I don’t think he did so lightly though, he knows DS and our family well and knows he’s on limited time this summer to sort out as much as possible. He’s not a medicate first type of doctor (which we appreciate since it’s usually our last ditch effort).

First day on the meds went well, and coincidentally DS was offered a job the same day so suddenly he’s under a lot less pressure. I’ll be interested to see how this week goes. 

[wintermom]

So glad to hear that your ds is getting treatment that seems to already be helping. I hope that the neuropsych can add in something useful as well. My ds really benefits from regular chats and check-ins with his clinical psychologist as well as his GP. There are lots of new challenges as uni, work, friends' lives crashing, come along over the months, that meds alone can't always do the job effectively. 

[SanDiegoMom]

My DD22 is very adhd, combined type, and is on Vyvanse and Strattera.  Strattera she says helps her working memory. She does well enough on Ritalin, but greatly prefers Vyvanse.  She compares it to a big hit (ritalin) vs a steady drip, and she doesn't get much rebound anxiety/adhd when Vyvanse wears off.  She would usually get irritable after Ritalin wore off.

Meds help, but maturity has really helped more.  She really is just emotionally maturing slower because of the adhd, which has always been tough to understand as she's so academically talented.  It's such a dichotomy.  She did start cleaning her room finally around age 20 I think, so there's hope! But it's still not perfect -- the closet is a disaster.  

I have struggled with guilt for years not understanding.  My husband STILL doesn't quite understand.  

She would also probably say that her own anxiety is inextricably linked, and sometimes it is hard to tell what is causing the disfunction.  She has worked tirelessly the past couple of years on her own mental health, perfectionism, self acceptance, etc.  She hardly ever wants my help, even though there's so often a situation that could have been avoided and that I end up helping her get through.  I could include so many examples, but I won't because I'm sure anyone with a loved one with Adhd could give very similar ones!