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After three years of “issues” at school, a pediatrician suggested we take the test for our son.  It came back inconclusive/borderline (4 yes, 4 no).  This prompted the school counselor to say “I always suspected he might have ADHD”—which prompted us to ask why she never spoke up.  We’ve since had more testing/analysis done and have confirmed his ADHD diagnosis w/ oppositional and depressive hallmarks.  After 3 years of therapy we finally have somewhere to focus on.  But where do we go from here?  He’s 12 now and I feel we’ve lost valuable time b/c those in a position to see, stayed silent.  We do not speak with him w/o being yelled at or insulted.  We cannot have a pleasant conversation at all.  And don’t get me started on homework or school.  It is a volcanic subject as is his little brother.  The brother seems the crucible for all his feelings and is constantly physically and emotionally assaulted by his older brother.  My wonderfully sweet child is surly, angry, and says I am “evil and hateful and don’t show him an ounce of caring or understanding.”  Yet hugs are met with “why are you touching me you creep” and kisses are rejected outright (“your breath smells like a sewer get away from me”).  Just tonight, my offer to take him to a book store was met with such rage I cannot explain. While many of these are manipulative outbursts to evade whatever is frustrating him at the time (tonight getting caught playing video games after his max 1 hour was up), it is destroying what relationship we have left as we do not know how to deal with it.  He can’t talk to us to help us understand what he’s feeling b/c he doesn’t know either.  Therapy isn’t helping b/c he won’t actually engage in the process and “I tell him what he wants to hear.” House rules mean nothing because “they don’t apply to me b/c I don’t like them.”  And meds are limited as he has a slight tick and we can’t use stimulants (and so far Strattera has had no discernible impact).  At this point, ADHD is bleeding into puberty and I’m not sure who is going to come out the other side of the transition. Will I have a son or a stranger I need to fear? I know folks here have gone through this and I’m looking for tips on what I can do differently b/c speaking calmly oddly escalates his volcanic temper more than shouting (which he seems to crave like candy) and punishments don’t do anything b/c he never learns from them “b/c I don’t want to learn from them.”  Everything we have tried has failed.  Where do we go from here?  I need him to survive middle school and not destroy the relationships that matter most.

Tracy

Replies

Tracy, I’m so sorry that you’re having such problems with your son.

I have ADD and Dysthymia (low-grade chronic depression.)  I also have an 18 year old daughter. She was never diagnosed with ADD, but she’s a moody, morose, very intelligent bitchy teenager. High school was hell for us both.  In fact, it was because of her teenagery and my ADD that I even discovered - two years ago - that I do have ADD. Long story, lots of yelling and screaming and crying and an inevitable (non-phyisical) trip to the ER.

I’m not a doctor, nor do I play one on TV, but I have a couple of suggestions if I may.

First, puberty and ADD aren’t bleeding into each other. They’re turning into a Jackson Pollack painting if he was on acid.  What a mess!  But you need to understand that, in his mind, he’s crazy, he’s not your baby anymore, you like his brother more than you like him,etc etc etc.

First, have a talk with him and let him know that you’ll take a half step back and give him a little more of his own space. Try to not press him into talking to you if he doesn’t want to, but let him know you love him and will always be there for him to talk to. make sure he does know that he still has boundaries and rules he needs to respect though.

Take a break from therapy. Give him that for a little while. I know that there were plenty of times when i was in therapy that I just didn’t want to go. take him for ice cream instead, but explain that that won’t be the normal course of events. Just make sure he knows that you’re respecting what he feels he needs. And do things with just him sometimes, without the kid brother.

Most important, he could likely be on the wrong meds. Do a little research yourself and discuss what you feel will be best for your son. Also, perhaps a very low dose of an anti-anxiety drug will help take the edge off without getting him all doped up.

*sigh . . .* Kids.  It sure ain’t easy!  Just try to keep your temper in check, and do things for yourself as well. Pamper yourself when you can. You’ll get through this. It’s gonna be work, for sure, but you’ll get through it.

Perry

Posted by Addnjguy on Apr 29, 2014 at 6:22am

Oh, I almost forgot. I found that speaking calmly does seem to anger the angry, but I’ll be speaking calmly, softly and rationally, and when she gets that way she gets, I’ll hit her with a loud burst of yelling her name. The shock seems to break the thread of insanity they go through. Then I go back to speaking more softly. That’s part of the trick. go from here TO HERE, and then back down to here. And when you unish him, do it calmly and rationally, and when he says he hates you and hopes you die, just tell him calmly you’re sorry he feels that way, that you love him, but he still has to do what you tell him. Because you’re his mother. and because you said so.  And before you go to kiss him, start chewing a piece of really minty gum. Than when he says your mouth smells like a sewer, breath in his face and tell him you wished all sewers smelled so good.

Posted by Addnjguy on Apr 29, 2014 at 6:30am

*punish

Posted by Addnjguy on Apr 29, 2014 at 6:31am

If you’re pediatrician is the one who is prescribing meds right now, and you have other options, someone who is extremely knowledgable or who specializes in ADHD—neurology or psychiatry—is a much better bet.

Your medication options include guanfacine & clonidine, and also a potential trial of stimulants.  Search this site and the entire web for “tic,” and you will find that the data is not conclusive on whether or not stimulants will make tics worse.  You will find that some people can take stimulants without any worsening of a pre-existing “slight tic,” some claim that stimulants have actually helped tics, some will say that all stimulants except X made their tics worse.  It’s just a real mixed bag. 

Guanfacine is considered by some to be a first-line treatment for the oppositional component. 

You’re correct in that right now you are getting ready to embark on an incredibly formative time—middle school.  You really need an expert in psychopharmacology to help you manage that aspect of treatment better.  Pediatricians, IMO, are rarely experts on the medical management of ADHD.

Posted by BC on Apr 29, 2014 at 6:56am

I can relate to a lot of what you’re saying.  However, with proper help our wonderful son has emerged.

It sounds like you need to get another opinion on the meds.  Your son may not be getting the right dosage.
We tried varied meds and on Concerta our son also had tics, which gradually subsided.  However Vyvanse seems to be the med that worked best for him.  Every child is different.

What worked for our formerly angry, surly son is a discipline plan that rewarded positive behaviors, no matter how small.  He had a small list of goals each week and earned points whenever he met one of the goals.  It’s written in more detail in “The Kazdin Method for Parenting the Defiant Child”.  Our son had seen himself as a bad person.  Turning around his self perception was critical, which we did by focusing on his strengths.  Focusing on his strengths more than on his weaknesses was the start point of turning thing around. It took many years, but he has made huge progress. 

For long term homework writing projects we hired a tutor who was knowledgeable about working with kids who have executive function weaknesses, which is common for ADHD kids.  It saved my relationship with our son and I could start giving him positive feedback on his improvements.  These kids get so much negative feedback on a daily basis that it’s not surprising they become completely discouraged and angry, and strike out at the person who they feel safest with, which is usually their mother.

No child wants to do badly, but our son has a neurological disorder which is not his or our fault, but it is his responsibility to cope with our help by learning as much as possible about ADHD and it’s treatment.

Having a complete evaluation by a neurological psychologist helped us understand our son’s challenges and strengths.  The meds helped to make his mind available for all the challenges he had to work on.  Though our specialist was a therapist he said that therapy is not usually the most effective way for treating ADHD.  He referred us to a psychiatrist for meds and
referred us to parental training classes for handling ADHD kids, plus recommending a school which has been wonderful in helping our son.

After six years, our son has started to like himself and
with our very consistent structure is making big strides in self-managing his tendency to be impulsive.  It’s never perfect, but rather ups and downs but the long term trajectory is improvement.

Wishing you well,
Lande

Posted by Lande on Apr 29, 2014 at 9:41am

Tracy,

You need to read the book, “The Explosive Child” by Dr. Ross Greene. It will explain why your son acts the way he does, AND give you a solid plan of action to make a difference. You can check out his website too (http://livesinthebalance.org) and listen to an archive of a webinar he did with ADDitudeMag.com recently (http://www.additudemag.com/RCLP/sub/10272.html).

Two things to remember as you work on this:
1) Remaining calm and emotionally detached (when he tries to hurt your feelings or rile you up) is PARAMOUNT. If you get upset or hurl back at him, you are providing the sensory stimulation he needs, and that is not a productive way to do so.
2) Changing this will take time. Yes, it’s a shame the school didn’t mention suspicions sooner, but you can’t change that. Behavior modification takes a lot of time and consistency in the best of circumstances, and it will require more of both when starting at your son’s age.

You CAN turn this around, and, believe it or not, your son wants to do well.

Penny
ADDconnect Moderator & Mom to Tween Boy with ADHD and LDs

Posted by adhdmomma on Apr 29, 2014 at 5:41pm

The 5 Love Languages of Children by Gary Chapman also helped to me relate to my child ADHD just by observing her and learning which love language she responded best to and brought us closer together.  I was able to find a free audible copy thru the library and was able to listen to pretty quickly.

Hang in there your not alone.

Posted by pretty_eyes on Apr 29, 2014 at 8:07pm

Thanks for the book recommendations and the “useful tricks” everyone.  I will also speak with his psychiatrist about the other med options.  I’ve got a lot of reading to do and a lot of learning to do.  I’ll be back here often for guidance.  Thanks again….and keep the advice coming.

Posted by TDR on Apr 29, 2014 at 10:52pm

I totally agree with adhdmomma “Explosive Child” is a MUST READ for any child with ADHD/ Developmental Issues. I have 2 ADHD boys, the eldest of whom is also on the Autism spectrum. this book has changed our lives and parenting styles dramatically, we no longer have constant power struggles, and everyone in the house feels like their needs are being listened to and met, Something I would have thought was impossible a few years ago….

Another book which which has been recommended to me by almost every professional we’ve worked with, and I also highly recommend is “how to Talk so your kids will listen, and listen so they will talk” It is basically the same principal as explosive child (empathy, collaborative problem solving), but more geared toward “average” kids, and can be very helpful once you have better communication/less explosions.

Posted by shalombard on Apr 30, 2014 at 6:07pm

In addition to The Explosive Child I also recommend Transforming the Difficult Child by Howard Glasser - his Nurtured Heart Approach has been very helpful for us in dealing with our 12 year old son with ADHD, mood disorder, and ODD.  Check out http://www.childrenssucessfoundation.com

Also, has a psychiatrist ruled out a mood disorder?  My son has not been able to tolerate any ADHD medications (stimulant or otherwise) but a mood stabilizer has been very helpful.  Hang in there Mama, there are a lot of us out there who have been and are where you are, so you are not alone!

Kelly in OH

Posted by krtsinohio on Apr 30, 2014 at 7:48pm

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