Teen ADD

[Kelly]

Dear Dr. Bradley,

I have noticed my daughter having symptoms of ADD since she was much younger - in 2nd and 3rd grade. However at the time I wasn't sure. She is so smart, and when she was interested in something she could focus to the point where you couldn't distract her. Over the years I have read more and more about ADD and have now come to the conclusion that my daughter does have ADD for sure.

I began seeing the effects of this when she was in 3rd - 5th grade and didn't want to go to school. People were pretty hard on her about her school work. We all thought she was so smart but she just didn't seem to care about her school work - hurrying through it, bad handwriting, keeping focused to do the work, unfinished work, careless mistakes, etc. It got to the point where I had to practically force her to go to school.

Now she is 14 and I am seeing more and more bad effects from her ADD. I see her lack of self esteem, she hangs out with a really bad group of kids (telling me that she can be herself when with these kids) She says that most of the kids find her stupid, annoying, etc. She has tried to develop this view of herself as a rebellious bad kid. She has anger and impulse control difficulties. She is very mean at times with her 2 year old sister. Her grades are bad and she doesn't do alot of her homework assignments and projects. Projects have always been torturous for her and me because she doesn't know how to organize and plan.

I could go on and on. The point is that as her parent, and as a parent who has read a whole lot on ADD, I am positive that she has this.
My daughter is seeing a counselor now who thinks that she is depressed and I think the counselor is right. There are alot of things going on with my daughter that would cause her to be depressed...
We saw a psychiatrist also who I wanted to test my daughter further for ADD. He looked at the forms that my daughters teachers filled out and seemed to push aside the idea that my daughter has ADD. He instructed me on behaviour modification methods which I have tried and they don't work with my daughter. She doesn't care or think about consequences with the things she does. I tried to tell the psychiatrist this but he kept cutting me off and wouldn't listen.

The counselor and the psychiatrist don't seem to believe that I've seen the ADD symptoms since she was little. They want to think her problems are all due to other more recent things.

I want my daughter to get tested for ADD. I think it would help her so much to get treatment for this. My daughter thinks she has it also. She told the counselor the other day, "Well something had to be wrong with me." She probably also needs treatment for depression. How can I get the mental health workers to listen and believe my concerns? I just want her to get officially tested.
Thankyou for any suggestions and comments that you might have.
KElly

[Mike Bradley]

Dear Kelly,
Quickly get your daughter to a licensed and school-certified psychologist (a different specialist than a psychiatrist or counselor) to best make this diagnosis. Be sure that you first meet with the psychologist to give a full history on your daughter. You are correct in noting that depression and acting out behaviors are often secondary outcomes of pre-existing and undiagnosed ADD. If the psychologist agrees with you, your pediatrician might be willing to provide a medication. If not, see a pediatric neurologist or psychiatrist for a med consult.
Involve your daughter in this process. Tell her that you are not going to quit until you get her some relief.
Keep us updated.

[Kelly]

Dr. Bradley,

Thankyou for your advice. I will be looking for a psychologist for my daughter.

In the meantime the counselor is suggesting that I get my daughter to a doctor to get medication prescribed for depression. I was wondering though if I should wait until after my daughter sees the psychologist to do this. If she is on medication for depression, will that affect her testing for ADD in anyway?

[Mike Bradley]

Dear Kelly,
You and your counselor must weigh out the pros and cons about medicating now or later, a decision mostly dictated by the severity and nature of her depression. Here are few facts to consider as you decide:
-Most anti-depressant meds used with teens minimally require 3 to 6 weeks of dosing (and often a few months) to see what help they can be.
-Some meds can be used to treat both depression and ADD (two birds with one stone).
-Often the physicians must try various meds until they find one (or a combination of a few) that work.
I wish I could be more helpful but this is a complex and critical decision that must be weighed out by folks who know your daughter first-hand.
Please keep us posted.