Question about medication
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Question about medication
| Wed, 11-29-2006 - 1:17pm |
I was here a while ago asking how to convince a teen to try medication. We are passed that point, and now trying to figure out WHAT to medicate. I just assumed that a doctor would make the final call on that, but it turns out that it's a little more complicated than that. He was diagnosed with ADHD, and there are some professionals involved who think THAT is what we should be medicating. On the other hand, his two current counsellors think that what would should be medicating for is ANXIETY. They've gone so far as to suggest that perhaps the ADHD is a misdiagnosis. See, he's got Post Traumatic Stress Syndrowme, and suffers significant trauma issues due to many, many years of loss and abuse. The counsellors think that the stres and hypervigilance of anxiety and PTSD can mimic the symptoms of ADHD. We CAN'T get him into an actual Child Psychiatrist until at least spring- so our family doctor, who has some training in mental health and psychotropic meds in children is who we are going to be seeing in a couple weeks. HE is willing to go either way on this one, according to what I think we should be trying first. OMG - that's a heck of a burden! And I know I'm only going to get one good shot at this, because if his first experience with medication is negative, it'll be impossible to get him to try anything else. I know what my gut feeling is, but does anyone else have any thoughts or insight?

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IMO - I would go with treating the anxiety, as it can be so debilitating and stressing. Treating those symtoms may help with the ADD. This is coming from someone who's dd is add - but we choose not to medicate her.
Does DS have an input as to what he thinks is in his best interest in this case? I remember vaguely that he was dead set against all of it???
Since some of his ADHD symptoms could be brought on or exacerbated by anxiety, I would probably treat the anxiety PTSD before anything else. Once the anxiety is somewhat or mostly controlled, you can always add an ADHD med later. Be warned, however that some ADHD meds can increase anxiety, so obviously you would try to go with the lowest dose possible to acquire the most desired benefits.
Hasn't the DR recommended any particular course of action...what to treat first, with which drug, etc? I think having too much input can be a dangerous thing, personally. I feel confident in getting one or two recommendations but no more than that. Each DR has his/her own way of dealing with issues and each take thier own approach. Having too much input could really have you feeling confused and questioning your next course of action with your son. Listen to your gut, listen to your son...the symptoms that are most intrusive in his life are the ones which should be treated first.
Best of luck.
My dd's initial "official" diagnosis was tourette syndrome which manifested itself through ADHD and OCD behaviors. So, they initially treated her ADHD with a low dose wellbutrin in the AM and afternoon and Zoloft for the OCD behaviors which her DR felt were brought on by anxiety. It totally helped - a lot. Eventually, however, the wellbutrin caused her tourette's tics to become worsened, so they added clonidine for those. At one point in time dd was taking 3 different meds for 3 different issues, however all were related somehow. She can fortunately get by on the lowest possible dose with desired results. Eventually, she asked to drop parts of her meds. We did and she was okay. Then she asked to drop them all - well, she didn't ask, she threw a fit and refused to take them. She wound up in a really bad way - too many details to list. At that point only the antidepressant to relieve anxiety and depression along with the tic med was added back. She did very well on those for a very long time. The combo simply worked for her and she did not require an ADHD med. Now, however, it seems her ADHD is in full bloom again and we're considering tackling that, but with all the recent spiraling stuff going on, it's not a priority.
I sure hope you find what's right for you/your son. Just remember, you can always change your mind if it's not working out and there are so many meds out there - not any one of them is a one size fits all.
She didn't want to take them because she felt it made her stick out as being abnormal. One time when she was having a complete meltdown she screamed from her room, "Why didn't you tell me I was retarded??" That was a shocker to hear since we'd always had open discussions with her about her diagnosis and subsequent care. She even was included on her very own treatment along the way, even as early as 10 when she was initially diagnosed.
Her bio-dad's family was not very supportive of anything. They didn't believe her diagnosis and they only went along with her med regime because *I think* they feared I would keep her from them. Her bio-dad was very open about his negative feelings of her taking meds and would openly say things that I was just lazy or that it was easier to have dd pop a pill that actually change the way I parent....which was essentially crap since I was the ONLY one parenting at the time and sought counseling for myself because I really did think that I was doing something wrong, after all, there was nothing wrong with older dd, so I though I was messing up somehow. The counselor is the one who suggested dd get tested, etc. It took about a year for exh to see dd in a full blown meltdown and from one state away and 150 miles between us, he called me asking for help over the phone! He couldn't handle it at all - that was when he stopped complaining about the meds.
The night she decided to stop her meds she threw the bottle across the kitchen and said she's sick and tired of having to take meds, that she felt 'fine' and could she stop. We reluctantly agreed but told her that we'd be watching very closely for signs of depression. Within 4 months she wsa walking around the house crying for no reason and later confided that she'd thought of hurting herself. That night I made her start her meds (thank goodness I had saved them) and within a week she saw her DR and began feeling better. We were able to help her recognize that her illness, if you will, was the same as my asthma and her grandma's diabetes - it was something that she had to try and control with the help of behavioral changes and meds, but it didn't need to define who she was as a person. She was still creative and loving and funny and so many other wonderful things. I think that feeling such despair and then feeling better after taking the meds helped her to realize that this was just a small part of her, so she accepted it. Since then, she has never complained about taking meds except recently when she needed an antibiotic and we changed her multi-vitamin - it seemed like she was swallowing quite a bit of meds all at once!
I hope that your son has some breakthrough so he is not so resistant to at least try the meds. Along with other methods, they can really be the difference he needs to feel more secure and capable.
Wow! I went to a training on mental health this morning and this sentence from your post was like a direct quote from my morning
"The counsellors think that the stress and hypervigilance of anxiety and PTSD can mimic the symptoms of ADHD."
I would say the ADHD dx is in question not only with this kid but it sounds like a 'field wide' questions nowadays. So Id rank the ADHD low. I'd recommend medicating a little for anxiety(some drugs are known to treat both BTW) IF he will indeed put up with it but lets face it, its a band aid. What this kid and all the kids like him need is serious one on one therapy to help them acknowledge and accept the past and go to the future. And spring really isnt that far away
JMHO
EMDR is actually a great form of therapy...I used it a few years ago when it was cutting edge for old trauma and dd also used it when her feelings about not seeing her dad surfaced. You don't necessarily have to be completely open to it, as long as you're willing to give it a shot, it can help if the therapist is certified and knows what he/she is doing.
I missed that the first time I read your post - I would definitely give it a try. And, along with any anxiety meds, you should see some success. Again, best of luck.
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