Concerned there is more going on

[Gemstone1316]

For about the past year and half, my 9 year old has been getting more impulsive, more aggressive, and just overall developing a lack of empathy. It's almost as if he wants to cause pain to others (usually always emotional, mental) He shows no remorse for saying hurtful things. It is constant, especially to the people closest to him. I just feel like this is more than ADHD. Has anyone else experienced this?

[Nanchli]

Hi there, from my experience I can tell you my son used to be super sweet but he went out in outer world specially in bigger grades, he started to think more and more negative its almost like he thought it was better to be a bad person than good person, I feel like this came to him because he hated the fact how others are capable of doing things he struggle with, I seen people made fun of him in school because he was slow, he had no friends when he was little he would chase from one person to another to make friends So with son may be thats bothering him, keep showering him love and let him realize we all have weakness and strengths, and not to compare (easy said that done I know ) Best Wishes............

[Imakecutebabies]

My son was very much like this before we started him on medication. I was more concerned about the lack of empathy than anything else. I think it stemmed more from a natural defense mechanism--if I can't stop myself from doing these things, and feeling guilty if a yucky feeling, then I'm just going to not feel bad about anything I do.

[Hidden]

Yes, I agree with the reply about pre medication- it’s part of the brain that is responsible for impulse control is just not wired. However you didn’t say if your child is on medication. For example for my son all the behaviours and negativity and aggression and saying terrible things to his closest family, plus terrible anxiety actually started on Methylpenidate (stimulant ADHD medication). I think this was his way of telling us that he was very unhappy on this medication. A few times in anger he even told me that he ‘wanted to kill me’- this was coinciding with the ‘rebound effect’ when the medication comes out of child’s system. He was also sometimes shouting that he wanted to ‘kill’ whoever else… I mean, this is just so cruel to give children stimulants (which are addictive and drugs of abuse after all!) and make them suffer ‘come down’ every single day. Anyway, that’s my rant so apologies. But definitely for us this ‘change of character and something more going on there’ was caused by Methylphenidate.

Also with my son he was triggered to say those cruel things when we were talking about difficult things for him and things he couldn’t control- let’s say he started wetting himself during day time on Methylphenidate (at age 8/9- so you can imagine stigma). And it was time when he was being bullied at school as well but he wasn’t exactly telling us… Later he said that he was hoping that if he didn’t tell the teacher ‘boys would like him’.

It might be worth you probing your son about the situation at school with other kids. Bullying is covert and bullies are very skilled in presenting it differently to the teachers… Especially psychological stuff that children at about age of 8-9 start practicing. It’s kind of developmental that at this age they try to do ‘mini social manipulation’. Let’s say with my son it was stuff like ‘Someone drew something offensive about another child (who already children were orchestrating setting up my son and this boy against each other) in the girls’ toilet. Then the teacher would be trying to find out who did it. Then the girls (known bullies who were also bullying other children in the class) would go to the teacher and say that my son did it. Plus they would make sure that the child who was the object of that offensive drawing was also informed that my son did it. So then my son would be coming home and very upset and telling me ‘They on purpose want to put me in trouble with the teacher. They say I did it and they told that boy that I did it. Mummy I didn’t do it, why would I go to the girls toilets anyway?’ So this is one example, but it was all sophisticated and happening pretty much daily in various forms, where you could see that children had to actually pre plan it, and it was coming from various children, sometimes let’s say it was simple stuff like ‘a boy smashed my son’s lunch box by repeatedly throwing it about whilst all other boys watch and laugh’ and so on. And I am so proud of my son that even though he has ADHD and obviously it means that part of brain responsible for impulse control doesn’t work, yet still most of the times he didn’t react, he just would wait and tell me after school. However wait till Friday and he would react. It’s just you pull those strings Monday- Thursday and by Friday he would lash at people, not even those responsible.

So basically what I am saying- for us it was prolonged and various forms of bullying (and eventually resolving the bullying also made him back normal himself, empathetic and kind boy at home- not lashing at me and taking it on me at home and shouting that he wanted to ‘kill me’), and change of medication to a non stimulant Atomoxetine fixed his emotions, lifted his mood and helped with anxiety. Since we swapped to Atomoxetine, even though bullying still was carrying on for a good few months, these insensitive, maybe even cruel and lacking empathy outbursts and physical aggression at home towards his loved ones stopped. Kind of - we helped him by changing his medication and showing him that we are working with the teachers to resolve bullying for him and he suddenly became kind and stopped this lashing at his little brother and at us and saying spiteful, cruel and hurtful things to us at home.

I mean, he is still a rude and selfish little boy at home- replying rudely to me, not tidying and arguing and trying not to do any work, but that’s unfortunately ‘underdeveloped ADHD brain’ and even Atomoxetine can’t fix that 😄

My son started to tell me more about the bullying and now we have some measures at school- I take him daily out for the long lunch break to minimise ‘unsupervised, free time’ (well supervised by 4 staff in the playground watching like 200 children…). He stopped shouting in anger that he wants to ‘kill everyone’.

Apologies it’s a bit of a ramble but I’d check your son’s meds and also his situation at school.

[Ewashandzow]

We are currently going thru the same thing ... At home and at school..

[Kkoelle]

my son started doing this around 7-8 years old and I thought he had no empathy for saying hurtful things…until he made me cry. One day I lost it and couldn’t stop crying because he was saying such horrible things to me. After a few minutes he came on the floor next to me, put his arm around me and apologized. This opened the door for shared dialogue about how I felt at his age and how I struggled with ADHD and that it’s not his fault. I also said, “but that doesn’t give me the right to lash out at people when I am hurting and there are always consequences we must face for our actions.” I reinforce that I am never mad for his mental health problems, because that part is out of their control. I also believe the impulsive behavior is not in their immediate control at that age at least. I make him aware that if he misbehaves in school then the school will take their own actions. If he says something mean to me at home I remain calm and just say “hey that hurt my feelings” and he generally stops as long as I don’t step in the ring lol. If I lose my calm it winds up in a screaming match and he will throw furniture. So it’s in everyone’s best interest to always remain calm. I also shower him with constant positive reinforcement because his self esteem is very low…which also fuels that negative self talk followed by an outburst of him saying everyone hates me. Also proper meds are key. Now school on the other hand…. 🤦‍♀️

[Angelsoh555 in reply to Kkoelle]

Thank you so much for this reply, Reading this I feel like I am in my living room as I went through this very scenario as recently as this morning. I am curious as I read this and other replies as to what medication works for your child that tempers this behavior. I know these meds are not a one size fits all, but at my sons request and knowing deep down myself that it wasn’t the right medication for him, I stopped the concerta/methylphenidate he was on but we have not had him on a new medication since then because I am so confused as to what would best help him. I think a lot of his behavior is anxiety induced but I want to find a specialist that I can trust to put him on something that will help him cope and grow versus cause all of these mood swings ultimately making things worse for a temporary fix that gets him through the school day (at best).

[Kkoelle in reply to Angelsoh555]

it might be helpful to get genetic testing done. My sons psych practice recommended it. They mail a kit to your home and you swab the inside of your child’s mouth and mail to the lab. The testing breaks down what medication classes would be best based on their DNA. My son was on a class of meds that only showed minimal benefit on the genetic test and we haven’t switched to the one that showed he would do the best on. So far the testing was pretty accurate on the ones he has failed on. So we are somewhat hopeful. The test isn’t covered by insurance and costs around $300, but the benefit of having that data outweighs the cost in my opinion. Every child is so different and there is no one size fits all for the meds

[Sy5636 in reply to Angelsoh555]

I’ve stopped my sons meds also at his request and my concern that a lot of his behavior is from the coming down from the stimulant and that a lot of his depression is coming from him linking his size to taking this medication (he is 11 years old, 4 feet tall and 56lbs). Because of his size he gets bullied a lot and that’s a trigger for his rage and anger. Which he then puts a lot of blame into taking the medication and a lot of blame on me for letting him take it. I feel for him since he does not eat when he is on the meds and I see how much it’s changed since we stopped. He is very impulsive, shows no empathy, argumentative & so much more now that his stimulant has stopped. But what I do see is how happy he is that he is off it and feels better than he can eat. I see that he is less angry and has less meltdowns. We have tried everything os what I feel like. We tried stimulants (2kinds), non stimulant, and a combo. I still feel like even though he himself is happier that he can eat I still see the benefits of taking meds will help him in the future like high school when things will be much harder for him. How are you dealing with your chid being off medication? Pls let me know if you find a different one that works as well

[MaryJane09]

When my daughter was that age we had very similar experiences. It has gotten better over time. She is now 12 and takes Concerta and Zoloft as well as meeting with a therapist a few times a month. Now this type of behavior happens way less. We are in a "manageable" time. The kids will always hurt the ones they love the most because we are also their safe place. I feel you and I hear you. It is so hard some days.

[amewhit]

My 12yo son was/is the same. Stimulants made it worse. I would highly recommend full neuropsychological testing to make sure there are no learning disabilities or other things going on. My son went through and IEP and then an IEE because I disagreed with the IEP results (saying he didn't qualify). I thought all of his negative behavior was due to a undiagnosed learning disability, but turns out he has bad ADHD and he is one of those kids who don't respond to stimulants. He was also diagnosed with a mood disorder through the IEE, but I'm still a little unsure that I agree with that (however he IS moody and has been since he was little). The IEE got him an IEP and he now gets more help in school. We switched psychiatrists and he firmly believes with need to treat the ADHD first if possible. So we started on guanfacine, and it's made a WORLD of difference. It gives him pause before reacting. We have also done extensive parent training, read the Explosive Child, and are setting boundaries but also COLLABORATING with him to solve problems. It's a big change, still hard, but it helps. We just started Strattera to try and help with focus, so far its made a small difference but we are working our way up to a therapeutic dose based on his weight. Try treating the ADHD with non-stimulants, and getting an evaluation and maybe a family therapist. I have learned on this journey that with especially with more difficult kids, you have to treat it with a multimodal approach. My 14yo daughter also has ADHD but it took about one week to find the right dosage of Concerta and she is doing great. ADHD is such a spectrum...

[Sy5636 in reply to amewhit]

I am going through the exact same thing right now. My son’s primary IEP was for educational help with ADHD But now his primary is emotional disturbance. So we switched schools that has less students, 4 counselors, and a therapist on the classroom. We did a combo of Focalin & clonidine which was working fine until now. The crash is really bad and I think a mix of going through puberty is not helping.

We did PMT but I feel like there’s a lot of gray area or areas we are weak on such as consequences. We are comfortable and good at rewarding positive behavior though…I feel like that’s our strength. Is there anything you can to share with me on how you deal with consequences?

Did the explosive child boom help you and did it align with your parent training?

Do you have any advice on collaborating with your child without him trying to control the situation?

Thank you

[JamB11]

I have been there. I highly, highly recommend subscribing to the parent courses from the ADHD dude. It has changed my sons behavior tremendously to follow his guidelines. That paired with the stimulant medication seems to really be helping. My son is 12 and we had years of ups and downs with his behavior and following the wrong advice on how to handle it. I promise you will not be disappointed if you seek out his resources. There are free videos on YouTube and the subscription courses are only $20 per month.

[Enrisner]

Yes! We are still dealing with that with our 12 year old. It's extremely frustrating and you feel like you're going insane. It's possible that your child is dealing with ODD. That was what I thought our son had and I'm not fully convinced it's still not but we have seen a psychiatrist a few times and she stated she felt it was actually untreated anxiety and ADHD and his trauma history. His real dad wasn't very nice and he saw a lot. The Additude magazine has a podcast that is very helpful and atleast makes you feel like you're not the only one dealing with it. He's on very low doses of medication because I'm fighting to have him on anything with his real dad. But I definitely feel that's going to make a big difference. I would suggest finding a psychiatrist and scheduling with them so that you atleast know your options.

[Fish1fish]

Echoing what others have said. Get Genesight testing done. We had incidences of mania with with some meds with our 9 year old so we changed things up. Ends up the testing said these meds were not ccompatible. We had her tested while attending a php program and were glad we did as the info is quite helpful.

[penn_adhd]

As an adult with ADHD and a parent of a child with ADHD - this isn't the ADHD. There is another underlying issue. ADHD doesn't cause you to be cruel. It doesn't cause you to lack empathy. What it does is impairs your impulse control and your ability to control your reaction, i.e. you can't calm down as easily as someone else and you may react stronger than someone else would. The medication doesn't control your emotions, it helps you focus.

I'm not a fan of Additude Mag, but what I've read by Dr. Russell Barkley I agree with very strongly. It matches my experiences. I have a copy of his book Taking Charge of ADHD. russellbarkley.org/books.html

[epiphany75]

My friend has a 6 year old son and diagnosed with ADHD, as of now they have done an evaluation and started with only therapy and no medication. It's important to track the child's behaviour and figure out if there is any underlying issue which needs to be resolved.

Also the parents should be aware of ADHD symptoms and behaviour so they can understand the child at a deeper level which would help in diagnosing the correct treatment or medication.