Another question-regarding ADD and the high schooler.

[Catherine]

My tenth grader likely has ADD. He was tested as a fifth grader in PS and the educational psychologist who did his testing confirmed it was very likely he had ADD. I went as far as obtaining a prescription and giving him one dose. My dh is skeptical of the diagnosis, or maybe it's fair to say, believes it's overdiagnosed, and I agree with him. However, if my child had really struggled, we would have done whatever was needed to make his life manageable. Blessedly, that has not been the case.

 

However, now that he is older and aware of the effects of caffeine, and has questioned me extensively about it, he is convinced he has ADD. Finally tonight I explained to him that his dad and I believed it was best, as long as he was managing OK, to help him learn strategies that helped him to manage his minor weaknesses, and that medication was not a good long term solution. He has learned strategies-he's very physically active and uses "fidgets" a lot when trying to concentrate.

 

I know he is digesting this but now I'm feeling some slight guilt about not "trying everything" when he was younger. This child is very bright, did very well when he was in brick and mortar school, and is still doing very well. But I also know how hard it can be for him to focus at times. I DO know as I'm pretty sure he gets it from me. Anyhoo---do any of you have children this age you've decided to try stimulants on? I fear he won't be able to maintain the therapy as an adult because finding a doc willing to prescribe these sometimes-abused meds may be very difficult. OK, what a disjointed ramble.

[katemary63]

Well, I do have a perspective to share. Our son has ADD. He is now 22. He is struggling through university and takes meds when he needs to. ( depending on the difficulty of the courses he's taking) What we believe now, is that it would have been better for him to have taken the meds in HS, or at least tried it. We regret at least not trying it. I think when a kid is struggling SO HARD all day to focus, a lot of growing, maturing and learning that could be taking place is not taking place. Using all those "strategies" takes energy and brain power that is then NOT going to some other task. This is just my after-the-fact observation, not a scientific fact. I see my son now, struggling still and I personally believe it would have been better for him to have tried meds in Jr. H or HS.

 

Another anecdote: One of my closest friends is a paster of a church, a graduate of Moody Bible Institute with an MDiv. and is about to receive his Phd. from Dallas Theological Seminary. He is a wonderful man, about age 40. He has had ADD all his life and has taken meds for it since HS. He says there is no way he could have gone to college with out it.

 

When my son was in school, I was against him taking meds. I regret it now. It might have helped him. He thinks so too. Yes, some kids are on it that don't need it. Some kids need it. It takes a lot of wisdom to know the difference.

[Mom2boys]

My 6th grader was recently diagnosed ADD. Dh and I are struggling with the decision to medicate or not. It is so helpful to hear your perspectives! Thank you for sharing your experiences.

[Laura K (NC)]

My youngest was diagnosed in 4th grade, and we spent over a year trying behavioral therapy before we decided to try a prescription. The psychiatrist who evaluated him came to the ADD conclusion apart from any premonitions on my part. We had taken my son in for an IQ test and tests for dyslexia and learning disabilities. No dyslexia, mild learning disabilities, high IQ, and we were surprised about the ADD, because I thought it was some other kind of processing disorder.

 

The psychiatrist spoke to us at length about long-term and short-term options. I specifically asked him about the college years, and the doc said that first and foremost, a young man in college with ADD has to learn coping mechanisms -- how to keep lists, use post-it notes, keep a meticulous calendar, and wear a watch with an alarm. He also said there's a high incidence of college kids not keeping up with their own medications, so the behavioral modifications are really important.

 

Given that, we tried behavioral therapy first and worked to teach our son how to modify his own study habits, etc. After a while we were very happy with the results of a trial of a low dose of Ritalin. The most important benefit of this drug, I believe, was to show my son what it was like to operate "normally." Eliminating the static that goes on in an ADD brain was a necessary part, imo, of training a child to know what the goal is, so he himself can work to eliminate that ADD static himself. The issue was not fidgeting (all boys fidget), but inability to finish what he started and to resist distractions. These are problems that could be fatal to a college career. My son won't be taking college classes for 5 years yet. I don't know whether he will be taking ADD meds in college. The goal is to be off them eventually, but ADD isn't outgrown. It's simply managed. Kids (and adults) learn more quickly or slowly to manage the problem, and I think that's an individual thing. At college age, I think my son should ideally have taken control of the management of the problem, even if it includes a prescription. The risks are either that he has no control of the ADD, and he flunks out of school, or he has no control over his body's dependence upon stimulants, and he develops a drug problem. Given the strictness I've seen in obtaining monthly prescriptions, I don't see much danger of a drug addiction, but I could be naive about that.

 

My good friend has ADD and is medicated with it. She has found doctors to be very sympathetic, and she hasn't found any difficulty getting prescriptions written or filled.

[Catherine]

Yes, inability to resist distractions is a biggie and always has been. This child is rather oppositional and we've tried many times to put systems into place to help him manage but he strongly resists them, even as he is complaining about trouble concentrating and focus. Time for a heart to heart. Again.

 

I am thinking we need to try medications. He is pressing us to consider it. I'm not totally against it. I think it might be helpful to everyone if we set up some ground rules, including meds are only one part of an overall plan to manage it, the other components being lists, etc.

[Rebecca in VA]

and it has been a wonderful thing for her. She started taking it last fall after some of her outsourced teachers began complaining about her lack of attention. I was worn out from "managing" her all day long. The pediatrician prescribed a low dose, and we noticed an immediate difference. She has done consistently well -- actually, extremely well -- every day that she has taken the medication. Last week I delayed a bit in getting her prescription refilled (it was cold and snowy, and I just didn't want to go out to the drugstore), and she didn't have any Ritalin to take. Suddenly all her problems were back, and I remembered why she had had to go on Ritalin in the first place.

 

It is definitely the right thing for my daughter. Without Ritalin she's like a light bulb that's about to go out -- it kind of flickers, and burns low, though you know the light is capable of burning brightly. With Ritalin she performs at a steady bright level.

[Pamela H in Texas]

I FINALLY started my daughter on meds in August (she was 15, almost 16), just in time to start college. How she feels is so significantly different that I came on the board and announced that I needed the bad mother award for waiting so long to put her on it.

 

I was leary about it because my ds and I are SO sensitive to meds. The side effects are usually horrendous for us. DS was on meds when little for a few things but finally I got him off of them and he's been okay for the most part. I have been on and off meds as an adult. I hate them.

 

I'm now considering TRYING meds with my ds because my daughter has done SO well on them and I really think my ds could benefit from it if the side effects weren't so bad. Maybe it's worth trying another med or two? Especially if he isn't taking a lot of other things?

 

As for longterm? I'm not sure how necessary that is. A lot could change. Or maybe it won't. But they'll have a paper trail basically if you try and decide to stay on the meds as a teen.

[springmama]

My daughter is on a few meds for ADD and depression after years of trying to manage without. It has made a huge difference and I too feel bad about not trying sooner.

 

While I don't think ADD is something you can grow out of, I do think that as these kids get older and more mature it will be easier for them to manage impulses and will better be able to handle the ADD and function without meds. I think that if the meds help her get through her teenage years, then when she is older and more settled she can try to wean off of them. Being a teenager is hard enough without having ADD on top of it to make it worse and I really think my daughter's depression comes from the fact that we took so long to treat the ADD.

[Joan in GE]

Just thought I'd add in our experience...

 

My oldest is now 22. He started on Ritalin at age 19 on his insistence. We were so against drugs due to side effects, addiction possibilities, etc. Plus he'd gotten more than 1400 on his SATs with no medication and little preparation, so we thought his problems were related to rebellion, peer pressure, 3rd culture probs etc...

 

While he was able to concentrate better, he was still incapable of taking notes in university. He has graduated with a not bad GPA, but it was an easy school.

 

We have so many regrets about his schooling, but I'm still not sure that Ritalin is the answer. While we'd had all kinds of lists to help him, I think that he had too much on his plate (combining Swiss school with extra work afterwards).

 

Last August, he had this very interesting experience where he was managing all these voluteers for 400 blind participants in an international assembly....He was so concerned about their welfare, getting up early, working late, and had a very helpful older man who was mentoring him in a way that I hate to say it, neither his father or I ever had.

 

He came out of that experience completely off Ritalin, clear minded, full of all kinds of wisdom, compassion, etc. It was completely amazing and put into question his personal assumption that he would need Ritalin for the rest of his life (based on Dr opinion)...He was SO happy.

 

His perspective at that point was that the Ritalin did not really help his productivity that much, it just made him feel better about himself, and that it helped his short term memory. When he looks back at things he did, he says they weren't that good quality wise...

 

But then he went to work on the political campaign in the US as a volunteer, working 10 hr days, 6 days a week, during the month of October, came back to no job and few prospects, many other changes since he is no longer in school, etc. December was very bad. He ended up back on Ritalin. Now he's doing an internship but not confident about his capacities at all.

 

Behaviour therapy wise, he does all the lists and calendar things which are very important, but feels so hopeless about his ability to concentrate, even on Ritalin. (He's tried different doses, and some different drugs).

 

I think there are other issues related to his father...A close family friend with background in psychiatry says that there are things he needs to get sorted out which would help his ability to concentrate if they were solved...

 

What would I do differently? I would have made it more a priority to get help, the best help possible, earlier. Once they go through their teen years, they can get some very bad habits and self perceptions which are hard to get rid of later on...

 

The doctor he ended up with was bad in that he did not offer anything but medication. No behavioural guidance, etc. Yet exercise definitely is extremely important.

 

Yet it took my son ages to accept that idea. When we tried to get him to exercise before just as a healthy thing, he would not accept. He had bad knees from an accident, hated running, fairly uncoordinated, etc...Yet now that he has personally had the experience that it was possible to be off Ritalin, he has made more of an effort to do the behavioral things of his own volition and has started running with his younger brother!

 

I also gave him way too much paper work and too many chores, not working alongside him so to speak....I was very unaware of learning styles and had little info over here when he was at home in his younger years.

 

I find it all very complicated - the human brain is complicated...

 

I would not be closed to medication, but as others have posted, try to work on other personal skills so that they can be off it.

 

FYI, there are consequences re high blood pressure, and other cardiac problems long term...

 

He does blame us for his high school experience because he wasn't on meds. He is jealous of his younger sibs who can concentrate so well and work so hard.

 

I have recently read about some neurofeedback things which are supposed to help with handwriting issues, but it is hard to see anyone here...

 

There are some interesting websites about matching adults with ADD to jobs that are suited to their capacities. And some about adults who have made it big because their creative energies and ADD worked well in some professional pursuits....

 

Best,

Joan

[Anna]

Please, please, PLEASE get a proper diagnosis and then give your ds the meds he needs. It will likely involve seeing a psychiatrist. A big word of caution--- Taking the wrong meds for any condition can be fatal. When my youngest was younger we were told she was ADD and tried meds for it but they didn't make a dent. Then a year ago we discovered that she was dealing with depression and on the advice of a FP, we put her on Wellbutrin. BIG MISTAKE. What we didn't know was that our dd was/is bipolar and putting her on meds for depression only made the depression worse. She began getting suicidal thoughts and fortunately told us about it. Long story short, we finally saw a psych doc, found out she was bipolar and put her on bipolar meds. Now she is doing wonderfully well.

 

Regrets? I wish we had been more aggressive about finding the correct diagnosis many years ago. It's hard to diagnose these things when kids are young but it can be done if you're working with the right doctor. Emotional/mental well-being is just as important as physical well-being. Be proactive. Be aggressive in working with the right doctor. Don't waste time messing around with a doctor who really doesn't know what he's doing.

Edited February 12, 2009 by Anna

[Joan in GE]

four different psychiatrists now based on various recommendations - we did as much research as possible - the last two even with the advice of our friend who had been the head of psychiatry in the nursing school or something similar...

 

but it still seems like my son is not happy with the last one...yet not feeling enough energy to try again yet...still on Ritalin...tried antidepressants...

 

finding a good psychiatrist is extremely difficult....

[mama26]

When I got on the boards just now this thread popped out at me because I'm dealing with this very issue with my 15 year old dd. I have been very hesitant to put her on medication, as I believe she is ADD. She is very oppositional and I believe her when she says she really wants to do right, but can't seem to make it happen. I sense her frustration. She has lately been saying things like "Everyone in the family would be happier if I was gone". She is depressed and frustrated. Her school work is very minimal. She is doing 6th grade math, but reads well and seems to enjoy it. Forget having her answer a question that requires her to give an opinion on anything. She doesn't seem to have abstract thinking ability. She can read a book though and tell you what it was about.

 

Anyway, I have recently reconsidered taking her to a doctor and getting meds. She really wants to be happy. Also, if anyone can give me suggestions on what I can really expect her to accomplish in high school. I have tried to make it as easy as I can for her. Writing a paper is also hard for her. Should I just have her read good books and get as far in math as possible.

 

Sorry I am rambling. Please help!

[Catherine]

It causes inattentiveness. Any kid who is hinting they are suicidal merits immediate intervention, IMO. Yes, teens can be dramatic, but I still would err on the side of taking it seriously. I had a seriously depressed child (he was only 11) and it was h*ll for the child and for dh and I. Thank goodness, it is better.

 

I would seek help, now.

[Anna]

I sense her frustration. She has lately been saying things like "Everyone in the family would be happier if I was gone". She is depressed and frustrated....... Anyway, I have recently reconsidered taking her to a doctor and getting meds. She really wants to be happy.

 

mama26,

 

Your dd is already showing signs of suicidal thoughts. Please, PLEASE, get her to the doctor ASAP!!!! She will probably need to be evaluated by a psychiatrist to be properly diagnosed and put on the right meds. Seriously, this is nothing to wait around and consider. Just DO IT!!!!