Anger and Hygiene : Hello, I have an... - CHADD's ADHD Pare...

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Anger and Hygiene

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I have an 8yo girl. Her anger has increased a lot to the point she is hitting me or throwing things. I keep bringing it up to the doctors, but they just tell me I need to be more stern or keep having conversations with her, or model the behaviour I want. I am at a loss. Our 2 yo is now copying her. She also refuses to do anything hygienic. She will try to wear the same underwear for days. She won't wipe herself. She wont wash her body or hair. She used to be so good at all these things. At first I wanted to say it was from regression due to being an older sister now and I do not to compare her to her little sister because I know that will only make things more unsettled for her. But for the sake of this post. Her two year old sister is taking better care of herself. Any advice or help would be appreciated.

19 Replies

My ADHD 5-year-old is now into the NOT washing or fighting me on doing it. I made it a game. see how quickly you can wash your (body part here.) Meanwhile, I am counting. Maybe NOT ideal but works for us for now.

As for the anger maybe she is getting frustrated at trying to do something and can't explain it to you or anyone else. So lashing out is how she is handling it? What my little one does She hits whatever she is "mad" at. Even I do it. I growl (or so I have been told.) Maybe could help by taking her hands and asking what the trouble is and how you can help? (what the doc told us. sometimes it works sometimes it doesn't.) Good luck!

Her anger is over everything. We aren't even allowed to speak to her without her blowing up if it something she does not want to talk about. For example she needed socks on because it was raining today and she didnt want to go upstairs so she started screaming and yelling at me. There is no middle ground. It goes from everything is fine to yelling. That is ow she talks to us now.

I am so sorry. That has to stink and be no fun. I don't have any other advice. Besides, breathe and count to 10.. or 100. (which I forget to do.)

Thanks for sharing your experience with the group. Having a child with ADHD is such a journey. A few thoughts...

What helped our family was having our son see both a child thearpist and a child Psychiatrist.

Children with ADHD don't want to be angry but this is a way for them to communicate the stress they are experiencing.

Also maybe you could watch ADHD Dude on YouTube to help learn more about how to mange some of these situations.

There are 3 tools that really help children with ADHD

1. Thearpy

2. Medication

3. An educational plan to help with the stress of school, peer relationship, etc.

Parenting is a tough job and then having to deal with ADHD adds more stress.

When times are good with her talk about the requirements and let her know that you will help her with these tasks if she is not going to do them.

Hope these suggestions help.

I completely agree with your thoughts. My 9 year old had horrible aggression issues but it took a lot of occupational therapy to learn how to regulate emotions. And medication. Is a game changer. Therapy can only go so far

What by medicine worked for you? Our son is 10 and extremely aggressive and disrespectful majority of the time. We are struggling worse than ever!

Intuniv- Guanfacine helps so much!

How is your daughter with other kids and at school? Does she have sensory issues (clothes she refuses, foods, etc.). I am sorry she is struggling. Has she been seen by a developmental behavioral pediatrician? They often have long wait lists but their knowledge and ability to refer to appropriate providers is often much, much better than an ordinary pediatrician or therapist.

Often kids with anger and defiance difficulties are actually struggling with anxiety. Using written/picture schedules, regular routines, and really focusing on positive parenting (marble jars, first this then that, setting aside daily time to just follow their lead in play without directing, etc.) can help reduce anxiety for some kids.

Guanfacine, a non-stimulant medication, can sometimes help with emotional regulation. You might also want to look at, a game and tool that pediatricians developed to teach kids how to recognize when they are becoming upset and how to self-calm—via a video game.

It never hurts to evaluate for speech and OT too. Speech can identify issues with pragmatic language that can affect understanding social rules and behavior. OT can assess for sensory issues causing oppositionality or discomfort. Most insurance will cover the eval.

So sorry you are struggling. It sounds as though you need to consult different doctors. The advice you are being given demonstrates a lack of knowledge of pediatric behavioral issues.

Yes I echo the thoughts of Aspen 797. My son was a lot like your daughter for a while. We had him evaluated by the right kind of doctor (pediatric neuropsychologist), he got a new primary diagnosis of ASD level 1, anxiety, and ADHD coming in third. So, this helped us better understand what was actually happening. I'm not saying that is what is happening with your daughter, but it does sound like your current doctors are not the ones to be seeing at this point. We were confused for the longest time what was setting our son off. We understand more now that alot of it stems from his ASD and the sensory issues/anxiety that goes along with it. There are attention deficits and hyperactivity as well so we've got it all cooking. But understanding him more, what is actually happening in his brain, we can help him so much better now. We have also had success with Guanfacine and Sertraline. These two medications, at the right dosage and under careful care of his psychiatrist who is really good at what she does, have helped tremendously. Medication doesn't solve everything but it makes it possible for other kinds of therapies and behavioral approaches to take hold a bit. Good luck to you! I know it is hard when you don't know what is causing what. Take care...

This is our son! A new doctor is saying the original diagnosis of ADHD may be there but he thinks it’s actually mostly anxiety. We have to finish school and then he wants us to try Sertraline. How old is your son? Does he take a liquid form or pill? Our son is a medication refuser so I’m trying to think of the best way to approach it. He can’t do a pill yet. Thank you for sharing your story!!

Funny you say that. My son doesn't swallow pills either. So yes we do the liquid, mango flavored. Mixed with OJ. Get instructions from the pharmacist on this as it can only be diluted with certain things. He's not wild about it but he takes it and gets a big round of applause after. It has really helped him. I was very reluctant to do medication. But I knew we needed to do it. I bit the bullet and it has been the right decision.

Oh awesome! My son likes mango stuff but doesn’t love OJ. Does the pharmacy add the mango flavor? I’ll look into what else we can mix it with. I think lemonade was one. We are in the same boat. We’ve been trying ADHD meds up until now. They do help with some things but we see other things we don’t like and sometimes loss of personality. Our new psych wants to stop the ADHD meds and treat the anxiety first to start.

Yes the pharmacy did the flavoring. They recommended Mango. The box listed the liquids that are allowed to be used with is. I think lemon/lime soda was one.

Ok thank you! He doesn’t do bubbles either so that’s why I was thinking lemonade. I’ll double check. Thank you again!!

No prob- good luck!

Our 7yo daughter w/ADHD and Emotional Dysregulation takes atomoxetine in the morning and guanfacine in the afternoon. It regulates her explosive mood really well. She had been seeing an Occupational Therapist for anger management until we moved to another state. That was great too. We still have some issues but it is loads better than it used to be. Once she threw a pair of scissors at me because she was frustrated with having to do homework. Thankfully they fell only near me to the floor. It is so frustrating. It is a daily battle. For her, motivators to do what she is supposed to include treats/dessert, going someplace fun, and taking away the privilege of screen time. But sometimes she is in a state that none of it works. I sometimes just try to sit with her if she will let me and let her tell me what is hard. That sometimes helps her see that I am on her side. We have to have many different tools in our belt to confront these challenges. Make sure you are getting sleep, proper meals, and breaks for yourself. If we dont have time to recharge, everything is that much harder.

Most doctors are not at all familiar with behavior therapy, and being doctors in North America means it's not safe to admit your ignorance. The fact that they're telling you to be more strict tells me they don't understand ADHD (or children in general if it comes to that)

Us the behavior evident at school as well? Has she had a proper psychological assessment? There are other things that mimic ADHD, and there are things, like autistic traits, that are commonly there alongside ADHD. Knowing, as best you can, what your daughter's situation is can go a long way in knowing what will work.

Consistency and routine are important, as it's hard for us folks with ADHD to mentally change gears (ADHD is arguably the worst named disorder out there.... It's not about attention; attention is a symptom of the underlying cause: reduced executive function. We don't lack attention, we lack the ability to control our attention). Your example with the socks is a good one. Mentally she was ready to get her shoes/sandles on and go. Now she needs to change gears, go upstairs, find and choose socks, put them on, then gear up to leave again.

Even as an ADDult I struggle sometimes with broken routines; if the phone rings while I'm getting ready for work, you know that's the day I forget my keys... And my lunch... And my bus pass... And if something interrupts my routine when I get home, that's when I spend a half hour the next morning looking for the same things... It wasn't that long ago that I found my tv remote in the freezer, and my keys under the backup toilet paper in the bathroom.

Try to remember that even with a neurotypical kid it's hard sometimes to tell if they can't do something or if they won't do it. Doubly so with a child with ADHD.

Another executive function piece, and therefore something ADHD folks struggle with, is future thinking (e.g. anticipating consequences, delayed gratification). The hygiene issues could be related to this, it could be a sensory thing, an aversion to getting her hands dirty, or a million other possibilities. We struggle with the "why" with our son. A lot.

While figuring out the why, we can still figure out what to do. Attaching a reward to addressing her hygiene, and heaping on the praise when she talks to you about how she's feeling will likely tell you how much control she has. For our son, screen time is gold, and Minecraft in particular is diamond. If we offer him Minecraft time for doing something and he still doesn't do it, either he is incapable of doing it or there are monumental barriers in the way.

Also, make sure to engage in some self-compassion as well. Pull in every resource and support you have available. Try to never turn down an offer for help. If you notice your patience wearing thin with your daughter, ask your partner to take over. If you're like me and don't notice right away, having your partner keeping one ear tuned to the situation can be helpful.

With my son, if I try to talk to him when he's angry or upset, it can escalate quickly. If I just tell him to let me know when he's ready to talk and then let him be upset, it's often as short as 30 seconds before he has self-regulated and brought himself down to a state where his rational brain kicks in again. Granted, those are 30 looooooong seconds...

We still have a number of things we struggle with when it comes to our son. We have to come up with new strategies frequently as he grows and his behaviours change. The rewards and consequences might change slightly, but we try to be consistent with our expectations so he knows what he can expect from us.

Because if all this, I also have to constantly reinvent what taking care of myself looks like.

If you have access to it, get your daughter some proper therapy. Your doctor either is dismissive of your concerns, or they really don't understand ADHD, or they don't have time to get into it in more detail, or it's possible that the doctor simply doesn't understand the extent of the problem. As best you can, paint a picture instead of just stating facts. By that I mean stating the behavior, what you've done to try and address it, and at least as importantly, how it impacts the whole family.

Also try to remember that your daughter is likely frustrated by this situation as well. I know growing up I was always much harder on myself than anyone else was.

I will share what I discovered on this site about a week ago.

In the UK they have a dx called PDA - Pathological Demand Avoidance (not recognized here in the US). Someone described it on this site (comorbid with adhd and anxiety) and it was everything I had been experiencing with my daughter her entire childhood. She has adhd and anxiety. It felt like the moment when you insert the last piece of a puzzle. It makes sense like nothing else has.

PDA is under the hood of autism in the UK and there is a spectrum of low severity to high severity. My daughter’s previous psychologist said she has suspected high functioning autism in my daughter (not officially tested) and my discovery of PDA has been nothing short of eye opening. I hear the symptoms in your post (lots of anxiety).

It’s frustrating that it’s not recognized where I am, and to my knowledge there is no specific medication to treat it, however there are books available! I found this book with strategies that might help you deal with what you’re describing. I’m reading it right now as I learn about this condition. “Pathological Demand Avoidance syndrome: My Daughter is not Naughty,” by Jane Alison Sherwin. Ms, Sherwin is a mother with real life strategies you can start using today. Her daughter has adhd, anxiety and asd, specifically pda. She is in the UK.

You are not alone!

There is a lot of impulse control and lack of filters that accompany ADHD. I went through this a few years back with my now almost 17 yo. Getting with a good therapist and the right medication can help a lot. Also parent training can help you learn how to manage your responses. It is very hard, stressful and draining. Good luck.

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