Depression and ADHD

[ovr40mom]

My 16 year old is a great kid with a great heart. He goes to a very competitive school where he has maintained a low B average with the help of a resource program, a tutor and monitoring by his parents to make sure he is doing the right assignment (not that he is doing the assignment correctly) as he is very disorganized. He has been medicated for ADHD inattentive type since the age of 11. We are 2 weeks into the new school year and he has failed his first major paper in one subject his first quiz in another and gotten a very low grade in a written assignment that is usually a strong subject. He is also complaining of headaches (only on school days) and is exibiting symptoms of hypocondria, worrying about this lump or that bump daily. All his siblings have ADHD. There is also a family history of anxiety and depression and I am concerned that may be going on although I do not see other indicators of depression like loss of interest in activites or change of appitite. I am not exactly sure where to start. Pediatrician? His neuoroglist? Or do we head off to a psychiatrist. He also obviously comes from a spelling challenged mother. Thank you.

[Mike Bradley]

Dear Mom,
If this was my kid I'd get him hooked up with a good adolescent therapist who can coordinate the treatment for this complex young man. A child/adolescent psychiatrist should take over the medication duties and do an initial evaluation to see if your son needs a dosage adjustment in his ADHD med (if he is taking one)or perhaps requires a replacement med. Kids can outgrow their dosages quickly in adolescence and sometimes find that old meds suddenly stop working.
But the somatic complaints concern me. Your son may have hit a level of coursework demand (in his competitive school) for which he may not be equipped, given his learning challenges. The therapist can help you sort that out, as well as check to see if any depression/anxiety disorders are emerging.
Please move quickly on this. I worry a lot about the high levels of demand that we place on many kids these days, and his aching head is likely a kind of stress "smoke detector" that is warning everyone that something is wrong here.
Stay close to this boy with lots of hugs until things ease up for him.
Let us know how things turn out.