Medication for impulse and regulating emotions

[Numberate]

Hi I recently posted about starting my son back up on meds. We had my son revaluated and his pediatrician put him on Concerta even though we tried it years ago and said focalin seemed to work best for him. Not surprised but the Concerta did not work and just made him more sensitive than anything. I love his pediatrician but he is a bit old school where it’s hard to ask for something different. I know that’s what we will have to do though. I had a moment where I thought maybe we could do without but the school year just wrapped up and I saw my sons report card. Grades have never been an issue. He finished with honor roll but his behaviors went down in score and the comment section said my son had a very hard time controlling his emotions during recess games to where he became very emotional and did not hold back with mean comments. He also went on a field trip where he made an extremely rude and disrespectful comment to an adult worker in front of the whole school and parents. He has trouble reading the room and there is something about losing that brings out the worst in him. I hear him react the same way with video games and am thinking of scaling back. I’m trying to figure out what changed. I started letting him play a game that I had banned before due to explosive meltdowns when he lost or got killed. I am thinking allowing him to play again is not helping him in real life in controlling his emotions. Any one else have similar experiences? Like he can’t differentiate video game life where he says something mean and it just gets lost in the game world vs real life where his words can really affect both him and peers. I know it’s not just video games but I am sure it doesn’t help. He has always struggled with his emotions. Meltdowns have always been an issue. Focalin really helped mellow him out his reactions so I am hoping his pediatrician will switch it to that. If not, I am going to have to find a pediatric psychiatrist. Sorry if this post is all over the place. One on one my son is amazing, but in group settings he gets dis regulated and impulsive. I want to make sure that I am doing what I can to help him be successful and people are able to see him for who he truly is. I guess I’m all over the place because I felt like we were doing great and all of sudden I realize that we need help again. Also, would it be beneficial to reach out to his school to go more in depth about his behaviors so that we know what’s best for him as far as medication and therapy?

[Onthemove1971]

If I were in your shoes I would seek an appointment with a Child Psycharist asap..A Child Psycharist is skilled at knowing and trying: type of medication that is best, dose of medication and timing of medication. They can also discussed what needs to change as your child grows.

As far as the school is considered, I recommend you bring a letter from the Child Psycharist saying he needs a 504 plan to support his needs in school.

Behavior ( good and bad) is a form of communication, which often children express.

One last thing.. to be honest school, peer relations and home life just becomes more complex so the need for medication to help decrease the symptoms he is experiencing.

What you are experiencing with your child is very similar for many of us.

Hope this helps.

[Numberate in reply to Onthemove1971]

Thank you! You have always offered sound advice and I appreciate the time you take in helping members in this forum. My son goes to private so I will have to look into a 504 plan and possibly IEP. Per his teacher, he is bright and catches onto new concepts very quickly. However, he tends to make a lot mistakes due to rushing and not taking his time. This is the first year where he was coming home with D’s on tests and assignments. And again it’s not from not knowing but him just not putting in the effort. I really had to be on him to do better. Again, thank you for your advice!

[Onthemove1971 in reply to Numberate]

Could you maybe bring a letter documenting what he needs ( our child psycharisit gave us this) then sit down with his teacher and ask for things like more time on tests and extra time to complete assignments. We had to pay for private on line tutoring ( VarsityTutor) 4 days a week to keep his grades up.

It is just so much work for out kids and such a roller coaster.

Big hugs for all your stress.

[Booksmart]

Hi!You were describing my 13 yr old boy to a T so I had to reply.

Yes- ask them exactly what behavior they are seeing- what is the precedent. For my son, it’s not being listened to- then he gets disregulated and defiant with teachers/adults working with him. He also does good one on one but not in groups. My son is also on Concerta and for us, that’s the one that medication for him so far. I would definitely push for that focalin as that is what worked for your son in the past-who prescribed that- go see who did. .

I have come to realize that my son will need medication to succeed in a school environment.

My son has one real friend and that’s it.

With gaming- my son is the same way and we end up putting time limits on certain games and when behavior hits- we take that certain game away for a break. If the behaviors get better, we do limited times for those types of games that get my son riled up.

To circle back- yes, ask about behaviors on school but realize that his behaviors at home also need to be considered. Medication is helpful for focus and calming but a good adhd therapist would be an asset for him. (I’m still looking for one). Also, this summer, we are trying lions mane mushroom and magnesium with B6 for supplements to see if that helps my son improve with focus and behavior.

Feel free to chat with me if you would like to-

You gots this and you are on the right track with your boy.

C

[Numberate in reply to Booksmart]

Thank you for sharing. It really helps to know that I am not alone. My son also has just 1 really good friend. He’s at that age where kids are branching out and forming other friendship and he’s having a hard time sharing that friend. I try my best to help him and we have great conversations of what we can do better to form more friendships, but that goes out the door once I’m not right by his side. My hope is that he’ll be able to do this on his own because he’ll have to. I’ve been wanting to try new supplements so thank you for the suggestions.

[Sullivan47 in reply to Numberate]

Hydroxyzine is great for emotional control and impulsive behavior

[SecretAgentIEP]

My son has a similar profile and has done much better on a mix of Guanfacine and Vyvanse.

[Numberate in reply to SecretAgentIEP]

I’ve been curious about guanfacine and will bring it up at my sons next dr apt.

[yogimomi in reply to Numberate]

While not the exact same situation, my 6-year-old daughter has intense anger outbursts and emotional breakdowns. Mostly over frustration or boredom. Guanfacine has been a game-changer! She's much easier to talk with about strategies for managing her emotions in an appropriate way when on medication and her ability to not lose her temper is much better.

[Shortcake0681]

It's like reading my own thoughts! I am in a similar situation with my 6 year old son. We always knew he was neurodivergent, but he didn't have a diagnosis. When he started Kindergarten this year, we were able to find out he has ADHD (combined type). He started on Focalin and was doing well. But the aggressive behaviors and demanding attitude continued. At one point we switched to Vyvance and immediately took him off after a weekn due to worse emotional episodes and unable to focus.Now, he is on Focalin Xr in the morning and a regular release booster dose in the afternoon (on school days). This has helped keep the focus, but he still has his angry episodes. We recently visited a therapist (referred by pediatrician) and we have an upcoming appointment to discuss a mood stabilizer that he would take to help regulate his emotions.

So, I am right there with you! It is a continuous journey and most days are better than others. I recommend switching back to the Focalin if it worked. That's what I wound up doing...

Also, I've found that Lego sets help my son hyperfocus. Maybe that could be an alternative activity to ease from the video games?

[Numberate in reply to Shortcake0681]

I feel you on this. My son didn’t get diagnosed until he was seven at the end of first grade but I always knew in my gut ever since he was in preschool. Unfortunately at that age you’re often told that its too young of age to diagnose. But I feel like when you know, you know. My son was also on Focalin xr. For him, things that normally triggered him didn’t even phase him at all when he was on it. We had to take him off due to sleep disturbances and him losing too much weight. But I feel like I am better prepared to handle the side effects this time. Has weight loss ever been an issue in your experience?

[Shortcake0681 in reply to Numberate]

He sleeps well, as long as he doesn't have a tablet around. There's been a couple of times where he would have no idea it was so late and stay up watching Disney+ on his tablet. We've put a timer on it, so he can't stay on past 9pm.He has maintained and even gained a pound within a few months, regardless of his appetite loss. He tends to eat light or none during the day at school, but makes up for it with a large, nutritious afternoon snack. He loves Carnation instant breakfast. He thinks it's just a milkshake, but I feel better knowing he's getting nutrients. For dinner, it's hit or miss. Most times I don't mind making him something separate as the rest of the family, as long as he eats. His pediatrician thinks his eating habits are normal and is happy he isn't losing weight. Yes, the whole preschool thing was a headache. We all knew he was different. Yet it took 4 preschools to finally find one that met his needs and supported his sensory environment. Now that he's in elementary school, it is a whole different set of expectations. I'm glad he officially got diagnosed and was performing better with medication. Whichever teacher he has in first grade will be familiarized with his needs and we should have his 504 plan in place as well. 🤞

[julieboolie in reply to Shortcake0681]

Hi! My son is in kindergarten this year and it sounds much like your experience. May I ask if you were able to find a mood stabilizer? The outbursts and aggression are causing lots of issues at school. His anxiety is the trigger but he lives on the edge of anger all of the time. Just wanted to see if you had any update on that. Thank you!

[Shortcake0681 in reply to julieboolie]

His appointment got pushed back, so I haven't had any updates (they had double booked his appointment and I had to wait an additional 1+ months for a new appointment. His appointment to discuss a mood stabilizer is this Thu. I will update again lol.Meanwhile, he is doing so much better in school (1st grade now). He still has his anxiety and emotional overload when his Focalin has worn off (from 5pm to bedtime is the worst). So fingers crossed we will get some guidance in that area...

[Shortcake0681 in reply to julieboolie]

As it turns out, he does have mild characteristics of autism as well (not an official diagnosis, yet). As far as medication, we are trying a combination of his focalin with guanfacine. This is supposed to keep him from crashing from the Focalin in the late afternoon. It is also supposed to help with his anxiety and anger. So, we'll see how this helps...

[Auggie123]

So sorry to hear your struggles, I have been there and it's not easy- for you or your child. I would echo the above comment regarding working with a child psychiatrist rather than his pediatrician. Child psychiatrist is the better professional to handle the intricacies of medication and children. You'll be in better hands....this was our experience at least. A good pediatrician is great for some things, not to knock them at all. But in our experience we felt when medications entered the picture we needed someone else who had loads of experience working specifically with kids and meds. Actually our pediatrician recommended we work with child psychiatrist rather than him, so that helped. Good luck. Re: video games- were pretty strict about the types of games he can play. If they create anger/rage responses, then we know that's not the game for him.

[anirush]

Just FYI when my grandsons behavior started getting more complicated and needed medication changing, our pediatrician said this was beyond his expertise and recommended a psychiatrist.