Dear Dr. Meeker,
We are a home school family. My twelve-year-old boy, number five of seven, is a one-of-a-kind boy. He’s extremely passionate about whatever he is thinking about, impulsive, lacks self-control, and is very athletic and strong.
We don’t do video games. We watch maybe three to five hours of TV/movies a week. He has lots of outdoor time, loves to garden, has his own lawn business, and read Hardy Boys mystery books. But we are about to rope him up and put him in the closet!! He argues, is selfish, talks loudly, and has to control the conversation. But then he will repent and feel bad about his behavior.
Our marriage of nineteen years has been strained. My husband was recently diagnosed with dystimia mood disorder. Though a faithful and loyal husband and father, he is emotionally detached from us. My twelve-year-old LOVES his dad and I believe is dying from an emotional depraved relationship with his dad. God is bigger than this and is going to have to come through on this one. There is nothing I can do to fill this void.
My question for you is this: Where do I begin with testing for ADHD? What kind of tests should I be seeking? What are the names of some OK medicines that I should be listening for if that is the route to take? Could my son possibly have dystimia too?
Dear Tired Mom,
First I want to congratulate you on doing many things right with your son! Encouraging him to have a job gives him a great sense of responsibility and boosts his self esteem. And keeping him away from video games and having him read keeps his mind stimulated. You are parenting very well.
It does sound as though you have your hands full. I would begin by taking your son to his pediatrician and telling him that you are concerned with your son’s impulsiveness, back talk, and argumentative nature. It’s hard to tell if he is experiencing hormonal changes due to puberty or if something else is going on.
You may want to make an appointment with your pediatrician alone first so that you can talk openly and then bring your son to him/her. This will help your doctor know how to direct his/her questions when your son comes in for a visit. Tell your doctor about what’s going on at home, what the family history is regarding mood disorders like depression and dysthymia and ADHD. You should have an exhaustive discussion with your pediatrician so that he/she can narrow what may be going on with your son.
You want to go to your pediatrician because it is important that you let your doctor, not you, diagnose your son. Your job is to be his mother, not his doctor. Of course, you know him better than anyone else, but it’s hard for you to be objective (I say this from experience with my own kids). Many things can mimic ADHD, and he may have one of these instead of or in addition to ADHD.
Depression, dysthymia (chronic low-grade depression), learning issues, thyroid disease, and other medical problems can look like ADHD, so it’s important that your physician explore these as well. If, after your pediatrician has talked with you and examined your son, you both feel that he needs further testing for ADHD, I recommend the following:
Find a neuropsychologist or psychologist in your area who tests for learning issues, depression, and ADHD. This will involve an interview with your son along with some testing. Then, you will sit down with the psychologist and discuss treatment options. This may include medication and it may not.
If your son has dysthymia (and it does run in families) he may need medication like Celexa, Zoloft or Prozac. Before your doctor prescribes them, be sure to go over side effects, etc. If he does have depression or dysthymia, I always recommend counseling with a psychologist who likes working with kids. Ask friends and your doctor to help you find someone experienced with kids.
If tests show that your son does have ADHD, the first thing I recommend is putting kids on fish oil. Go to the pharmacy and get fish oil (not flaxseed) capsules. Your son may need to take 3 in the morning and 3 at night. The omega-three from fish oil may have some anti-ADHD effects as well as anti-depressant effects and it is safe. The only negative is that kids burp fish oil and may not like it.
If your doctor recommends medication for ADHD, Vyvanse is a newer medication that is tolerated well and lasts longer than many of the others. Again, I would be sure to have a long talk with your doctor about side effects, things to look for and what to expect if you start medication.
Finally, remember that you are in charge. You can give medication or not, depending on your comfort level. You are your son’s mom so don’t feel pushed into anything. That said, if your son really is struggling with depression, dysthymia, ADHD, or a learning issue, it’s important that you offer him the very best help available and many times this is medicine.
Many Christians don’t want to give medications for problems relating to the mind and I disagree with them. There is a lot of misunderstanding about neuropsychology and neurophysiology and the brain is an organ with hormones that can be out of order. Correcting their balance can have a profound effect on a person’s mood. I have found that God answers prayers in many ways and we should never tie His hands. Sometimes the help comes in the form of a pill.