Teenagers and ADHD

My 14-year-old daughter was diagnosed with ADHD at age 7. Shortly before she turned 13, she began self-injuring herself in the form of cutting. Her doctor put her on medication for depression and anxiety. I'm wondering if all of this could be part of the ADHD? And if maybe the ADHD symptoms are manifesting differently now that the hormones of adolescence are affecting her. Or is this genuine depression and anxiety, something completely separate from the ADHD?
Her doctor hasn't been able to answer my questions very well and I'm feeling frustrated.

Has anyone else experienced anything like this themselves or with their child?

ADHD has a high rate of comorbidity. If untreated, it can lead to anxiety and depression. In my personal experience, ADHD often can leave me feeling completely overwhelmed with life - everything just seems like complete chaos most of the time. It's really easy to find some way (possibly unhealthy such as SI) for feeling an ounce of control again. SI is not directly a symptom of ADHD. I do think that it is very plausible that it results from symptoms of ADHD that are not being treated and thus causing depression and anxiety.

Anxiety/Depression tend to go hand-in-hand with ADD/ADHD. Although A & D tend to be in flux while ADD/ADHD is constant(At least that's how it is for me, I was diagnosed when I was about 12 and been on and off medication since). I'm currently on 3 medications for all 3 disorders. However it's probably something I would not recommend to put that many medications on as some one as young as your daughter, especially since she's right at puberty age. I'm currently 23 and it took quite a bit of time for my body to outgrow the side effects for the combination I'm using.

Going through school with this disorder can be challenging. Not just with the focusing/concentration, but not many people clearly understand it and tend to mislabel or misjudge it. Sadly, there are some people who just put it off as laziness... which is nothing further from the truth.

I'll stop myself from rambling too much... Is there anything else you want to know?

Miswimmy,

I can see where a person might use SI as a way to feel control over something in a life that feels chaotic much of the time. That definitely makes sense to me in relation to my daughter!

I think I'll talk to her doctor about upping her ADHD medicine. She's been on such a low dose for quite awhile and I don't think it's helping enough. Maybe if we can get that more under control, she will feel better.

Thanks again!
Phela

Hi Xaldin,

My daughter is already on too much medicine. If the meds were truly helping, that would be one thing. But I don't think the combination she's on right now is all that effective.

It's interesting that you mention struggles in school and also laziness. My daughter deals with both of these issues. In school she can barely maintain passing grades. She hates school and it probably has a lot to do with always feeling "lost" there. As far as the laziness goes, I can see where to someone she might appear to be lazy. But I've never looked at it that way. I think of lazy as being like a couch potato. But with her it's more like she has a really heavy, invisible blanket holding her down, making every movement extra strenuous and tiring. So for her immobility is preferable to most anything else. Does that make sense?

I really appreciate your honest reply. And I do have a question for you... Having gone through this yourself, and looking back to when you were an adolescent, are there any suggestions you can make to me for how to help my daughter manage her ADHD?

Thank you so much!
Phela

What medication is she currently on?

Btw, if you curious, this is what I currently take.
[Stimulant]D-Amphetamine/Salt Combo(Generic of Adderall) 30mg x2 a Day
[Anti-Depressant*]Bupropion(Generic of Wellbutrin) 150mg x2 a Day
[Anti-Anxiety]Sertraline(Generic of Zoloft) 100mg x1 a Day

*(It's the favored Anti-Depressant for people with ADD/ADHD, for whatever reason it seems to have a stronger response than other Anti-Depressants.)

As for advice for school... I'm not really certain how to answer. Even today I'm still trying to address things that are still issues for me. Medication has definitely helped, but it doesn't take care of it completely. It does help manage the symptoms, but you tend to still have a bit of a handicap when it comes to mental energy for the day.
One of my biggest problems was finishing homework... its why I was typically a C or D student. It's not that I couldn't understand it... its just I had trouble processing information during class and when I got home I always felt burnt out and always wanted to do TV or Video Games because it allowed me to decompress.
If you believe in the IQ system, according to the test I'm quite intelligent. I scored 140. (90-100 is average, 160+ is genius.) Granted this test should be taken with a grain of salt...
The example metaphor I use for myself is this: "My brain is like a nice computer... but 50-60% of the CPU is being used for absolutely no reason. Which causes it to be sluggish."

Again I apologize for rambling so much, lol.

I suppose the main things would just be to have patience with her and always be supportive.
A dairy/journal can be helpful so she can put down her thoughts so it may stop looping in her head as much.
I'm a little bit of a skeptic of taking the routine/schedule approach. I mean it's fine to outline like a general idea of the day... but like doing it like to the hour or minute is a little too severe in my opinion. The repetitiveness can easily induce boredom and may even hurt her esteem or have feelings of inferiority because some one has to plan for her. Again lack of control can be a terrible feeling.

But like I said, that's just my opinion. Obviously different methods work for different people. There's really no cookie cutter solution.

EDIT: I suppose the biggest thing is to let her know that her disorder doesn't define her life. If you keep thinking because of it you'll never be happy or successful or normal... you'll start to believe it if you let it long enough. Just let her know that her ADHD doesn't run her life, it's just along for the ride.

Xaldin,

I like what you said about being skeptical of a routine/scheduled approach. I'm guilty of doing this with my daughter and I can see where it would rob her of the ability to feel capable and competent on her own. When she was younger it helped keep her connected to her day and her activities. But now that she's 14, it seems a bit excessive.

As far as medications go, she's on the following:

Trileptal 450mg/day (mood stabilizer)
Vistaril 35mg/day (anti-anxiety)
Intuniv 3mg/day (ADHD)
Naltrexone 50mg/day (to help prevent the "feel good" endorphins released when she cuts)

We also tried Risperdal, but it made her so sleepy that we stopped it after only a couple of weeks. Her doctor wants to try Abilify instead, but I'm hesitant to put her on something else. So I'm holding off for now.

As you can see she's not on an actual anti-depressant. When she was in 4th grade we tried Prozac and then last year we tried Wellbutrin. She did awful on both and I haven't wanted to try any other anti-depressants. This is why she's on the Trileptal (mood stabilizer), although I don't think it's helping all that much.

I also like what you said about not letting her ADHD define her as a person. It's so hard to not get caught up in all the unpleasantries of dealing with ADHD, so thanks for the advice!

I really appreciate you taking the time to visit with me. I feel so incompetent sometimes in my ability to parent my daughter with her ADHD struggles. It really helps to be able to talk to someone who has/is dealing with these same things. So thank you!

Phela

Growing up with undiagnosed childhood ADHD, I (I was officially diagnosed at 22-23) felt continually lost in my surroundings.
When I was in class, and I would be asked to read from a book, I felt stupid and would ask someone else to take my turn.
And it was interesting to read about destructive behaviours. I had totally forgotten when I was around 12, I tried to self injure my knee.
I think I was doing it out of frustration to my parents. I felt I needed to talk to someone, not a friend, but an adult I could trust. But
it just wasn't an option at the time.
Now, as a disclosure, I have never tried to cut or injure myself since, It was a very brief period in my life.
I think I was frustrated at my parents, or school. I cannot remember for certain as that was almost 25 years ago.
Perhaps I couldn't express what I was really wanting to say because of lack of self worth, or awarenss of my body, I was 12!

But anyways, I remember getting quickly frustrated at everything. I had a hard time focusing on any type of homework. At the age of 12-13 I had just
gotten off of medication for seziures, so I am unsure if the ADHD had came about because of the medication. To this day, i have a hard time with
controlling my temper. Although I have started to not let certain things get to me.

Aside from the seizure medication, I have never been on any ADHD medication. I will never go on medication.
However, there are times I wish I was. But, I have learned to meditate. And although it is for a very short time frame (2-3 minutes, because lets
be honest, my mind will see something shiney and I will be distracted), it calms me down. I also work out 4 days out of the week.

However, for a teenager, and it were me and I was told to meditate, I'd be like NO!
On the flip side, If I were told to go to the mall and have fun with my friends, and just hang out and not be around parents, that would be perfect.
And if my parents were willing to pick me up after my time at the mall, that would have been even more awesome (especially for you)
...but I would have never tell them that.
Or, go to the local trampoline place to burn off energy, or roller skating arena where energy can be burnt off.

I know now that had I had the physical fitness portion added into my life I wouldn't have been a ball of stress.

Please ask me more questions as so many things I have forgotten...and if you ask the question I may be able to help you understand what your
daughter is going through. Is there a chance that you could give her a reset? Perhaps take her off medication? Just curious!

How about exercising?

I loved sports when I was younger but due to my mum's (crazily conservative) views, I was not allowed to act in an 'unlady like' manner. In university (only diagnosed after I started working - and I was so unconvinced I went for a second opinion) I realised that I became so much more energetic, focused after going to the gym.

While I wish I've been diagnosed earlier, I think I m glad I didn't take medications as a child. It can't be that good. Even now I can feel the uncomfortable side effects