Struggling with 17 year old with late diagnosis of ADHD(primarily inattentive) .

[Madeamom]

My daughter has had undiagnosed mental health issues since middle school , maybe even elementary. At a random Pediartic appointment she answered the question that she had thoughts of suicide with no plan. The answer was to “ stop thinking bad thoughts. “. I finally got her a mental health appointment and she was diagnosed with major depressive DO at the age of 15. She was started on prozac and completed 16 weeks of therapy. She was unable to complete any of her goals which were basic such as coming down for meals and putting phone up at night. She kept taking meds and she did not feel any better. Fast forward………. Then covid. Home for 2 yrs, even though she could have went back for one semester. She barely did any work. GPA went from 3.5 to 1.8. Now senior in H.S. Basically able only to go to school and come home to bed. Quit seeing psychiatrist and taking meds. Therapist dismissed her for missing most therapy sessions. Her grades have improved but executive functioning has not improved at all. She wants to go to a university art program. The problem is she is not ready. How do I stay positive and help her realize that she needs more time to get her act together?

[Goofy1]

What other things did they test her for? Hypothyroid can cause some of those issues.

[Harnessinghope]

Sorry in advance, I am a mom of a child with ADHD and youth mental health professional.

- How does one define “readiness” for college? It is an unknown experience. Meaning many youth have no idea what they are walking into, they test the waters and adjust. I know several people with executive function issues that excelled in college, it was that adjustment piece above that helped.

- Was ending all therapeutic interventions better for her? It sounds like she took one medication but there are so many out there that focus on different illnesses and areas of the brain. Perhaps having that kind of support would give her a reprieve from her symptoms, so she can focus on college preparation.

- Outside of medication interventions, are there any mentoring programs or services near you? Maybe even a college readiness program? Sometimes a local community college has something like that.

- Any friends modeling behaviors? Sometimes it is as simple as seeing your friends prepping for college and feeling like they’ll be left behind. She may need to expand the friend network and social networks. How is her cheerleading section?

I also agree with Goofy1, perhaps a complete bio-psycho-social work up could yield areas to intervene. For me that would include a medical check-up and a psychological evaluation.

It says a lot that you are here. She has a greater chance for success with you reaching out. Go get ‘em, mom!

[ASLCODATerp]

Of our five children, four have adhd-our oldest two went undiagnosed until their late teens, one not until college, because they have inattentive-type. We have dealt with depression, suicidal ideation, general anxiety, and social phobia. Our oldest one in college sought out a therapist on her own on campus, because of the anxiety and she also felt depressed. Then was referred to a psychiatrist. She has been working through medicine to find what works for her. After a year and a half her grades went down a point and she lost her scholarship. She just decided to withdraw from school completely and take a “gap year”.

Our son just younger than her has always been an anxious kid but developed social phobia in 7th grade. In 9th grade he was severely depressed and making suicide plans. Luckily he reached out to me first and we began a very long road to recovery. He does struggle with some executive function skills but because he was undiagnosed and untreated for so long, the biggest concern is the anxiety and depression.

After three years, a week in a psychiatric hospital program, months of therapy(he also dislikes going to therapy), two psychiatric providers, and trials with five different medicines, we have finally landed somewhere. He should be graduating from HS this year but he never could keep motivated to keep going. He decided to skip ahead and take the GED last year in June. Then he enrolled in an online college with a computer program that interested him.

He takes medicine for his attention and for his depression. Taking Ritalin(methylphenidate) and Zoloft(Sertraline). Both of these meds are essential. He has been doing so well that in 8 months he has completed 30 percent of his degree program. We do work on getting him out of the house as a separate goal. But I feel like he has his education under control and almost automated. He also has hygiene and household chores as an automated part of his daily routine. That automation is important so that those things are not a stumbling block to his progress outside of the house.

So, what I have learned is there are so many ways to approach a child’s education, and untreated ADHD causes mental health issues. I have also learned that at times my son needs to take control over some things, as he needs to practice independence. I used to speak for him when we do a med check with the psychiatrist, because he just wanted to keep his hoodie over his head and look at the floor. But now that he is 18, I have told him he needs to engage and talk to the doctor about what is working and not working because he is an adult and needs to take on that responsibility. At our last appointment the psychiatrist was shocked that my son could speak for himself! It also gave my son confidence to talk to the oral surgeon when we went for a wisdom teeth consult!

Get your daughter started on either methylphenidate (try this first) or atomoxetine(Strattera). If the ADHD can be addressed first, she may begin to feel some relief. But needs to take an anti-depressant as well. The ADHD meds will show an effect almost immediately. The antidepressant as you know takes at least a month or two to know if it is helping. And it may take s year to find the right medicine and dosage. But it is important to keep going and work with a psychiatric provider as long as it takes. If you feel you dont work well with one doctor, find another. She needs medication to get her head above water. And she will need to take it for a long while-maybe indefinitely.

There are different kinds of therapy. My son had three different therapists all approaching his issues differently. I have learned he cannot handle someone asking questions of him all the time to talk it out. He wants a classroom style that teaches him solutions. But he has still been unwilling to go to therapy since the pandemic-even virtually.

It is a long and exhausting road. Some days I have really felt so alone in it all. Somehow, we are still here, and pressing forward. You are strong, and so is your daughter-more than you know. Keep fighting and praying. You have support here. You are not alone!

[jolinn]

Hello,

It sounds like it is really important to find out the cause of her depression. In reading your post I did not get a sense of why she is so depressed.

I suggest enrolling her in a community college art class. My son (a junior in high school) does dual enrollment classes at a community college. If she is not ready for college after high school, community college may be a great place to start for her to build a portfolio and then apply to a 4 year college.

I would start first with why she is so depressed. I am sorry she is going through this. It sounds like she needs some time where she is making her own decisions more. School does not necessary afford this opportunity. It sounds like school does not provide any joy for her. She may need to take a year off after school and be given the time to just "find herself" (perhaps take no classes for a while). She needs to be given the opportunity to find out what motivates her and makes her happy, without pressure, even if it is something seemingly very insignificant. Like a well tended seed, it will grow; she will grow.

[Bootsie1]

Madeamom I’ll try to keep my daughter’s late diagnosis journey brief, as you have gotten some solid suggestions already. Late diagnosis, 3 separate therapists, suicidal ideation, self harm and a diagnosis of MDD (major depressive disorder.Failed two separate antidepressants, both stimulant molecules as well as Strattera … each one causing increased anxiety and mood lability.

Finally, thank goodness she had a life changing response with Guanfacine (non stimulant Alfa agonist). She literally went from total isolation in her bedroom to fully functional and somewhat of a social butterfly. Figuring the dosage did not smoothly but once we did, the change was dramatic.

We also had genetic testing done (somewhat late in the game) and the results explained quite a bit of her medication failures.

Medication response is so individual. I just wanted to share what helped my girl as I did not see mention of Guanfacine in previous responses.

As a side note, whenever my daughter shows interest, initiative or desire for a thing… I fully support her. I’ve noticed she learns best by doing and also successfully tackles goals that are of personal interest to her.

[Madeamom in reply to Bootsie1]

Thanks. Now I will have to find a new psychiatrist , since the last one dismissed her because of missed appointments. That also makes it hard. I do not have a willing participant.

[Bootsie1 in reply to Madeamom]

linkspabh.com/

Dr Caroline is wonderful

She answers text and returns calls personally. We see her via telehealth appts. I found her on a CHADD webinar

She cuts right to the chase and is diligent

In her approach to treat and diagnose. Best of all she has a real gift for connecting with her adolescent patients!

[jolinn]

For some reason she is an unwilling participant. What is that reason? What does your daughter want in her life? What makes her happy? This is important.

[Madeamom in reply to jolinn]

She wants to go college and study art therapy. Grades much better since back in school instead of virtual. She needs to be motivated to take care of of herself and immediate environment before . Motivation is the key missing factor. She suffers from depression as well,