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momto2js
08-31-2015, 10:30 PM
My son is 8 almost 9. We have been trying to figure out how to help him for over a year. He has been diagnosed with ADHD inattentive type although there are some hyperactive features. We have tried both Focilin and Concerta. While both help with the focus issues, they make him so irritable. Today I didn't give the long acting dose but 1/2 way through the first hour I gave a short acting dose of Focilin. As soon as it hit his system, it was like he was a weeping, oozing mess. Nothing was right, his level of frustration was through the roof.

After our work was done I suggested a trip to the library, for a change of pace and he threw himself on the floor screaming. At this point I LOST it. I screamed back something to the effect of "well we certainly can not continue to be miserable here all afternoon long" at which point he stormed out of the room and retreated to his room where I found him napping 10 minutes later. He was so much happier when the meds wore off.

The meds are worse than the disease, but I'm not sure I have the patients to deal with him with out them. He is so intense all the time it is exhausting. I really think that CBT would be helpful but our mental health insurance sucks, and I'm not sure where to find the $600 a month to fund it. His behavior is beginning to impact my 6 year old in a real way. I have read the "explosive child" and just about everything else I can get my hands on. Should I go back to the doc and see if there is another medication that might give us some relief or try to manage without for a while. I am at a lose for what to do. Any suggestions?

pdpele
08-31-2015, 11:19 PM
Hi momto2js - Sigh. I am sorry to hear you and your DS are struggling. Just wanted to send you some camaraderie and good, peaceful vibes. My DS (8) has ADHD and...issues. We tried meds - Adderall, Concerta - short/long acting. They were awful. Focused, yes, but moody, cry-y, irritable and, in no time, scary aggressive. Stopped the meds and that was gone.

Psychiatrist switched to Intuniv - a non-stimulant. That didn't help much with hyper/focus issues. But didn't seem so bad in terms of side effects...until we took him off it (we decided to take DS off meds every 6 - 12 months to check if they were actually helpful). Took him off at 9 months and he was...better. Less sleepy, less moody, less cry-y and irritable. We decided to forgo meds for the time being.

Not that you shouldn't keep trying...but yes, I'd say go back to the doc and ask for another kind, dosage, etc. If your insurance will pay I highly recommend a Psychiatrist that you feel you can really talk to and trust. Not a 10 minute med check-up kind.

So now we deal with hyper and focus issues in other ways. They mostly work. We've also learned to accept his capabilities in certain situations and always try to help him slowly, slowly, expand them. We still struggle, though. With a lot of things. And believe me, I too, have lost my s&#! unfortunately, more times than I can count. So I now how lousy that feels.

On the other hand, my DS and DH and I have so much fun! DS is a constant ball of enthusiasm, positive energy, silliness, imagination, great questions, did I mention energetic (?!). DS invented "hug piles" and lots of games and jokes and routines that make us all laugh every day.

I'm sure you could make a list of the ways your DS is awesome. Do it! Do the things with him everyday that he is good at and you and he and your DC 6 really enjoy! I only say that b/c I have found it so important to constantly affirm how loved DS is...the older he's gotten the more we've understood he is very, very hard on himself and quick to intuit when people are unhappy with his behavior...which for a bouncy kid is...often.

Therapists...any willing to work with you on a sliding scale? Can't hurt to ask?

atomicgirl
08-31-2015, 11:25 PM
(((Hugs))) You are in a really rough place, and finding the help you need can be ridiculously hard. It sounds like you need a second opinion, and a fresh set of clinical eyes. There are other medication options and it may well be that any single medication isn't going to help your son. He may need a "cocktail" of medications, and it's not uncommon that finding a good balance takes time--years even. At the very least go back to your doctor and tell him/her what's going on and ask for help.

Then, there are therapy options that aren't as expensive, or time and energy consuming as CBT. If you haven't already, I suggest you find a GOOD OT and ask for an evaluation. They can really help a child develop self regulation skills that can cut down on the outbursts. They can also help you develop skills to effectively work with your son. We've had a tremendous degree of success with OT for our daughter on the spectrum (ADD as well), however it's taken years to see the whole scope of success.

Finally, take a look at your learning materials and see how you can tailor it to cut down on the need for medication. Kids with ADD can be really successful with academics, and wonderfully creative thinkers. They just can't work in the same way as their NT peers. When my daughter was that age I had her do all her math work on white boards I'd attached to the wall at her height. If it needed to be turned in I'd take a picture and attach it to the paper where I'd copy her answers. Her teacher was cool with that. We incorporated exercise into the day, and when possible into the lessons and worked in much smaller blocks of time. Now, at 13 she has a pretty good sense of what she needs to do to get through a school day. We still have issues, but our solutions can be much more collaborative at this point.

fastweedpuller
09-01-2015, 10:20 AM
8/9 is a tough age. How big is he, is he on the small size? The reason I ask is that it's such a pin the tail on the donkey thing, getting the meds : size of kid : issues thing worked out. DD has always been on the lowest dose of everything, mainly because of her size (she's tall and thin). But it tends to be a real balance...and moodiness is one of those side effects that actually do lessen with time.

And we love her kooky brain. But yeah, she does need to come down to earth enough to get work done. Meds have been key to her school success, and believe me I say that as having been the parents who have tried everything (OT/CBT/neurofeedback/testing and the regular old developmental psychiatrist).

Frankly we had her doc on speed dial until we were 100% sure about what we were seeing was the best result we could get i/r/t side effects, longevity, etc. So maybe another call to the doc about your concerns. They are working for you after all

Miguel'smom
09-02-2015, 05:25 AM
Is there any chance it's not adhd? I would say try daytrana if insurance will cover it with a prior athorization. Try community health because they usually take insurance then offer sliding scale fees for therapy. My son's therapist is a lifesaver. My son has to be on a mood stabilizer with adhd meds. I would go to a new psychiatrist for a full evaluation and new ideas. My son's first psychiatrist was treating him as he had both bipolar and adhd but only had adhd "on the books". It involves heavier medication but made my son happy. Then his new Dr came and only had him on adhd meds and that was a disaster. He became rageful on the meds, depressed, and suicidal when the meds wore off . We're in the process of finding a new Dr .

Elly
09-02-2015, 09:50 AM
I was teaching a psychology module on ADHD (and ASD) recently and I'm sure I read something, I think from Russell Barkeley, who's an important psychological researcher in the field, that inattentive type ADHD is less amenable to medication. You might want to check out his stuff and see what he says about it. He has written tons of books and has suggestions, too, about interventions that work from a psychological/evidence based perspective.

Just a thought,
Elly