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ADHD

Attention deficit hyperactivity disorder (ADHD)

Kids and Mental Disorders – ADHD

Children and mental disorders – when is too soon for diagnosis?

I spend a decent chunk of my time cruising chat boards and reading journals, news, social media posts and such about mental disorders.  My own “specialties” are Bipolar Disorder, Adult ADHD, Autism Spectrum DisorderBorderline Personality Disorder, Anxiety Disorder, Depression, Abuse Disorders, OCD… nevermind – I really “specialize” in them all, because I know most Attention Deficit Hyperactivity Disorderof these disorders within my social circle, and I know them on a professional level.

Anyway, I was on a Facebook page the other day for ADHD. (attention deficit hyperactivity disorder)  A woman posted a question about how to manage a kid with ADHD who wakes up and wreaks havoc within the house while everyone is trying to get ready for school and work.  Naturally he was disagreeable, confrontational, oppositional, had “meltdowns” – and it was all exhausting.  (pretty typical behavior for a truly ADHD kid)  A therapist once told me that the ADHD brain doesn’t “wake up” right away and cause all this trouble partly because their brain is not actually engaged yet.  The mom was asking for advice.

Comments on the page gave some really good answers. Some of them are common. Like plan your morning before you go to bed (get out clothes, get backpack ready, make lunch), let the kid make some choices – blah blah blah, stuff we have all heard.

Others were less common, but possibly better advice. Advices like; give the kid an extra 30 minutes to “wake up” in silence, give the child an incentive to get dressed NOW – like playing Minecraft after he is dressed.  I handle mine with the “don’t talk to him yet” option – waiting about 20-30 minutes before making him get busy.  His siblings aren’t allowed to bug him during this time either.  He can wrap himself in a blanket, stare at the wall or whatever – just don’t go back to sleep.

One lady suggested that the kid should be woken to take his meds an hour before he has to be out of bed. Then let him go back to sleep so that his medicines are working by the time he actually gets up.  I found that last piece of advice to be very helpful. My husband with adult ADHD takes his meds about 4 am and gets up at 6, ready to go rather than rude, obnoxious and unhelpful.

Mental Disorders - ADHDWhat troubled me was a comment from a woman who didn’t actually give advice, but chimed in to complain about how hard her four-year-old was to manage.  She said that he had been diagnosed with ADHD and was on meds, but also said that he had bipolar disorder, and still was a screaming banshee in the morning.  This gives me pause for concern.

I certainly can’t do anything about this particular kid, and I don’t really know the exact circumstances but I find the dual diagnosis with bipolar disorder very troubling for a four-year-old child.  Certainly, kids can exhibit ADHD symptoms at 4, and some will benefit from treatment.  But the medications weren’t working, and I am not so sure about the bipolar disorder.

Traditionally, until a few years ago, no one was willing to consider bipolar disorder as a pediatric concern.  Still today, though bipolar disorder obviously exists in childhood – most of the major issues don’t come out until adolescence.

The Diagnostic and Statistical Manual of Mental Disorders does not recognize the bipolar disorder in children under the age of 13

The National Institutes of Mental Health does acknowledge that bipolar disorder in children MAY exist but also warns that many children are misdiagnosed when the main problem is ADHDNIMH recommends that these children be labeled with Mood Dysregulation Syndrome until such time as a diagnosis can be relied upon.

The main problem in diagnosing young children with any mental disorder is that symptoms in children are vastly different from those in adults.  To complicate matters, symptoms of various Cerebrum Lobesdisorders in children are similar to one another.

Symptoms such as irritability, excessive mood swings, meltdowns, oppositional behavior, trouble in school, social inadequacies, explosive behavior, frequent frustration, and hyperactivity, etc. can point to a number of disorders.  Frankly the child may be ADHD, Bipolar, Depressed, Autism Spectrum… or even have food intolerance.

Because of our family history (not just mine), I watch my children very carefully.  I do analyze everything that happens, and I know that all of them probably have a disorder of one type or another.  Two may have ADHD, one is likely bipolar and one has Asperger’s or mild ASD.  I have sought treatment for some issues – but with others, I hesitate to run to a physician – likely a pediatrician who just doesn’t really know.

Our understanding of mental disorders is still evolving

I was personally diagnosed with the wrong disorder for over 15 years – and I was an adult.  How damaging would it have been if I had been labeled with a disorder that I did not have when I was only four years old?
The particular woman I described with the dual diagnosis child was beside herself.  Despite the fact that the four-year-old was receiving medical treatment for both disorders – it wasn’t working.  To me, this means that the treatment was with the wrong meds and for the wrong disorder(s).  In addition, her management skills weren’t the best.

As I said, I know that my children are likely to have disorders of their own but I don’t want to treat them for just any disorder.  I will want them to be treated for the right disease.  My advice to this parent, or any parent whose child had been put on medication that wasn’t working would be to seek a second opinion.

I am more emphatic about that advice if the doctor was willing to “add” a diagnosis to provide more medication; she should definitely seek another opinion.  Preferably the opinion of a pediatric Ritalin - ADHD Medicinepsychiatrist – or even a pediatric behavioral neurologist.  These specialists are few and far between, but it isn’t worth doing anything, but suffering through all the misery because the treatment isn’t working.

Medications are beneficial in the treatment of some types of mental disorders, but they do “change the brain”.  That is how they work – changing the brain can be harmful if you are changing it in the “wrong” directions.  Just seems like common sense.

Melissa Lind

Adult ADHD

Adult ADHD – when you know but they don’t

I have always known that my husband has Attention Deficit Hyperactivity Disorder (ADHD) but he hasn’t.  Over the 20 plus years that I have known him, I heard stories about his childhood “antics” which were much more than cute, some of them were downright dangerous.

I heard stories about him taking the neighbor’s swing set apart, about how he and his cousin tried to stop a car with ropes tied around their waists, how they would ride their bikes all day – even into Mexico, and how they could be leaving the house in the morning finding things to do all day, and not returning until nightfall.  When he grew up, this type of behavior was “kind of” normal – the kid goes crazy, we throw him outside.  Today, parenting is different.

Cure for ADHD

When I met him, he was near 30 and had all ready had jobs in at least seven different industries, some of which required education, some of which didn’t.  He had been a taxi driver, carpenter, a pipe-fitter, a purchasing agent, a chef, a plastics technician, a shipping agent, a firefighter and was in school to become a Paramedic.  He was broke but had impeccable taste.

He was brilliant but couldn’t sit down and read a book; in fact, he couldn’t sit down at all.  He was often late to work and even late, very late to dates.  His car was a trash pit.

We got married anyway, and he settled into a fast paced career as a paramedic – which suited his personality because there was always an emergency.  When we started discussing children, I approached the concept of “treatment for ADHD” – believing that my children would likely have it.
He was adamantly opposed.  His idea was – kids will be kids, and I did just fine.  They won’t need medication because there is nothing wrong, there won’t be anything wrong.  Stop talking about treating ADHD.

He quit working as a paramedic and went to work in automotive parts – after he went back to cooking, and then into construction, worked at a biotech company, made some jewelry, setup traffic surveys… He had a lot of jobs and didn’t keep any of them.  His car was still a pit.

ADHDHe could do laundry – but would forget to put the clothes in the dryer and could never find any underwear.  He could start the dishes, stack them all up, organize and sort everything –  but would wander off before he actually washed them.  He “meant” to clean out his shop, repair the dryer vent, put gutters on the house… He went to the hardware store for one thing and came back with three bags full of stuff – but not what he went to the store for.

One afternoon we were watching public television, and a documentary came on.   He didn’t know that it was about adult ADHD until he was already interested.  I heard him saying out loud “I do that”…. “That is me.”
Despite the psychology classes he took, despite his internship in mental health treatment, despite raising five kids, despite knowing that several of his relatives had been treated – he really didn’t think he had ADHD (ADD) and didn’t identify with it at all until he heard it on TV.

He had new insight – but still couldn’t take the step to go to the doctor.  I had to make an appointment; I had to make sure he got there – and guess what?  The doctor agreed.
He is now on medication, and though he will never be the most organized guy, he will probably always get distracted by shiny stuff – and will probably always have a hundred projects going but when he takes his medication he can actually get some things accomplished.  His shed is clean – cluttered but clean, he can usually find his underwear.

He even agreed to have our kids evaluated for the alphabet soup of mental disorder that is our family – some have ADHD, some have other disorders, but at least they have access to treatment and his car is no longer a pit.

Melissa Lind

Some adults will not admit they has Attention Deficit Hyperactivity Disorder (ADHD)!