My wife and I have 2 children with ADHD. Our son is 10 and is having some very defiant mood swings. Usually every morning before his medicine and again in the evenings when his medication is wearing off. We are wondering if it is ODD or just mood shifts from the lack of medicine in his system. Consequences and punishment mean nothing when he spirals into an all-out tantrum/panic attack that could be brought on by something as simple as telling him to stop something or feeding him something he decides he doesn't want to eat. Very argumentative, and almost thrives on the chaos. We recently had an episode where he exploded, and I was able to keep my composure and talk him down and for the first time he became accountable for his actions and was sorry for the things he did and said. Needless to say, this behavior has been very stressful for our family. Just joining CHADD, I am hoping to learn more about behavior management, and I also hope to find some resources to locate a knowledgeable psychiatrist in our area (SW Missouri) that can help with these episodes and make changes to his medication if needed. He currently takes 25mg Adderall XR in the morning and another dose of 15mg after lunch.
Child with ADHD and Severe Mood Swings - CHADD's ADHD Pare...
Child with ADHD and Severe Mood Swings
Thank you for your post. This sounds very familiar. Every day is a struggle. I have one son with ADHD. He is 11, almost 12. I believe he also has ODD. We have tried medication and that works okay. I have considered a psychiatrist but don't yet have one. I hope you get some answers.
Thank you. Hang in there as well.
Yes.. I also remember those days. I strongly encourage he see a child psychiatrist. In addition what has worked for us is: therapy ( to help him hear things from someone other than parents), medication ( extended release and a short acting in the afternoon), exercise ( for us sports almost daily) and our 504 educational plan ( which helps since our son has never been a fan of school) he only tolerates school to play sports. In addition tutoring ( especially in high school ) in areas he struggles in, this online group ( Please read other previous post just like yours) which always made me feel like we would make it no matter how challenging of a situation we were in and always telling our son we love him.. we would tell him we do not accept the bad behavior, but we live him.
There are so many amazing opinions in this space and we are glad you came to join us. This is a long hard journey..
Big hugs for all your struggles...hang in there.
Thank you. We are looking for a psychiatrist and have done some therapy. Chadd has been a great resource thus far and we can only hope to find a Dr/therapist that actually understands ADHD. He actually likes school and does outstanding work. "So well behaved and polite".. When we went through our last blowup I actually told him I was sorry for what he was dealing with and kept telling him I he is a good boy and loved him, and that seemed to calm him down.
We had to add guanfacine with our 8yo sons adderall because the before and after the adderall is huge emotions. Guanfacine has helped take the edge off. Maybe discuss the emotions with your child's doctor- it's a huge part of adhd in some kiddos. Behavior therapy helps some too. I'm hoping they learn to regulate themselves as they mature because it's hard for so many of our adhd'ers
I hope you are able to see a child psychiatrist soon — they are a godsend! I know many in this forum sing the praises of a nonstimulant paired with a stimulant. It can help smooth out the times when the stimulants are wearing off as they stay in the body 24/7. They can also help some with irritability and impulsivity! Good luck!
Thanks for the info. Do you take it in the morning or before bed at night?
Our son took guanfacine (aka intuniv) extended release in the evening. I’ve seen some posts in here from parents whose children took immediate release versions in the morning.
To be honest, the guanfacine did not benefit our son and actually made him more irritable/lack any sort of pleasant personality. (However, there are *many* positive reviews on this site and I think a nonstimulant or a change in stimulant would tend to be the next move for a psychiatrist).
At the recommendation of our son’s psychiatrist, we started him on Abilify 2mg daily (evening) to help with agitation and aggression about a month ago. He takes this coupled with vyvanse 10mg each morning. We feel the Abilify has been the best thing to help so far as it really smooths out transitions for our son (he has always been resistant to transitions from one task to the next - doesn’t matter how fun the next one is!) so he is much more amenable and “mentally flexible” if that makes sense. He still has his fun personality and frankly overall is just more pleasant than he had been on guanfacine (so closer to his natural personality!)
Great advice above. We have an 18 year old now who went through so much. I’d like to say its better, but it’s just changed. We experimented a lot over the years. Keep in mind their needs change as they grow and go through different growing stages. A mood stabilizer, such as risperidone, helped decrease the aggressive outbursts that often come with ADHD. We also ended up changing him to a 811, then 611, school environment. The pressures just exacerbated his anxiety and aggression. If you can find an activity that he enjoys, it will be a great outlet for him. We tried everything but nothing stuck. Anxiety seemed to interfere with his enjoyment.Lastly, but not least whatsoever, make sure you take time for yourself and significant other! You need a break! Schedule them! Hugs!
This has been an issue with our son (7), too (Ritalin then Vynase then Focalin). Unfortunately, I think it's related to stimulants and gender, as our daughter (9, Ritalin) doesn't experience the same. We see a child psychiatrist and therapist regularly. Some of the strategies work but, when things get really wild, nothing really does. My wife and I have started doing more morning things for him, like clothing, which is a little regressive, but there are two other kiddos to be managed, too, so it works.
Hang in there! We've had a few weeks of this intensified behavior, and I also wonder if spring/end of school year triggers play a part. My biggest struggle is just not showing my own frustration during these episodes!
We have been through all the medication as well. Our daughter has ADHD and ASD and never had these episodes. Very discouraging at times but you are right about struggling to show your own frustration.
Have you considered the medication may be causing the issue? Sorry for the blunt comment but your situation sounds quite like ours did a few months back, going back years actually.
We had a similar situation with our daughter who is now 10. It was only after her psych mentioned that her Genesight results said that she was not a good fit for stimulants that things started to improve. We forgot that we had that done, previously it had been super helpful and fairly accurate as to what meds are good, and which ones are not.
We had increased the dosage of Vyvanse at one point which made her aggression and irritability increase, so then to combat that we added another med into the mix to calm her down. After we realized all that, we took her off all that and now she is now on guanafcine with no stimulant. While things aren't perfect, its better. At least we can work with her in this state and things are better at school.
Yes we have. Tried several different meds through the pediatrician. Looking for a psychiatrist that can dig deeper and make changes with the meds if needed.
I echo the idea of genetic testing to find the right meds. Saved us a lot of money, time and heartache. We did Genomind and found that methylphenidate was the right fit for him (also found MTHFR mutation). Atomoxetine was really hard on my little guy’s liver when we tried it, and the Genomind confirmed it wasn’t a fit. Also, random, but just learned, if your kids have adhd and/or ASD, don’t give them anything w acetaminophen (Tylenol). It apparently depletes gluthionine in the liver, which is essential for the brain and already commonly low in these populations. I hear your struggle on mood swings, same boat. We are now working w a functional doc. The idea is to repair nutrient deficiencies w supplements so that we can eventually wean off of traditional meds, which for us have detrimental side effects. A book our doc recommended is “Nutrient Power” by Dr. Walsh. I found it illuminating if you are interested in that route. May be worth looking into Pyrrole disorder, which is determined by a simple urine test from DHA labs. Sending you hope and support 🙏❤️
we had to remove Adderall and go to something else. As an adult with ADHD that was also taking Adderall I understand and felt the rage that came when the medication wears off. It is uncontrollable rage at nothing and everything. As an adult I had trouble navigating when my meds wore off, I can’t imagine a child navigating through it. So we both switched to vyvanse, the rage is gone, doesn’t work quite as well but they added guafacine in the afternoon to extend it at least through homework/evening.
Hope this helps.
While you are working on the medication shift, something that might help would be some form of parent training. Our kid’s therapist was really helpful teaching us how to deal with melt downs and we also got parent training through a program our kid was enrolled in. Of course all kids are different but this has worked for us: try to catch the meltdown before it happens and use calming techniques (breathing, ice, distraction). Acknowledge the feelings instead of trying to argue. “You are really mad” as opposed to “you need to get to school on time so you don’t get a tardy.” Once the melt down starts though, don’t engage other than being a safe comforting presence. Once the fight or flight kicks in, the kid is too overwhelmed to hear reason. Just be there as the child rides it out. Then you can circle back later after everyone is calm to talk about what happened.
Thank you, great advice! I’ve recently learned a lot of this and it is so true.
I saw it mentioned in this thread and I echo that adding a Mood Stabilizer might do the trick. If when calm your son cannot pinpoint WHY he gets so angry or triggered then he may need "help" to slow that process and give him a few moments to react and process before going full on fight or flight.
Also, we have a rule in my home that when we are running hot and triggered we all retreat to rooms and away from the other(s) until we are calm. THAT takes time to learn as they often want to engage in that moment and fight.
We also removed red dyes and even my son (he is 11 now - he was 9 when we really had a situation similar to your with the aggression and severe mood swings) has mentioned that he feels better without it. There are SOOOO many things that have it, but most of those are junk anyways LOL!
Thanks so much for the info!
It sounds like you found a great way to defuse the situation with your son with your calm reassurance and love. I don’t know if he is on the spectrum or not but it’s not uncommon for kids who mask all day at school (doing the hard work that doesn’t come naturally to read social cues and fit in) to melt down at home. Also, if he’s not eating well all day because of the medication, that combined with the stimulant withdraw could also be challenging. Now that our son is older he is able to tell us that he needs some time to decompress and just chill after school before re-engaging. He didn’t know to ask for or that his body needed that when he was younger however. Just a thought. Lastly, Lives in the Balance website and the Explosive Child by Ross Greene are great resources.
Awesome thanks. Our daughter also has ADHD and is on the spectrum. I understand what your saying, and he could be on the spectrum...
Wait, do we have the same son? Lol
Aspen took the words out of my mouth. We have 2 kids with ASD & ADHD. Our son is 12 & daughter 8. Our daughter was diagnosed with ASD at 18 months because of very obvious global developmental delays, poor eye contact, etc. Our son? Saw at least 8 professionals who had no concerns except ADHD. Fast forward to preteen when a nagging mom gut feeling (irritability, low frustration tolerance, history of severe temper tantrums as preschooler) made me get a 2nd opinion from an out of network psychiatrist. This after in network one blew off our request for med consult because his school Vanderbilt forms looked great & home ones looked awful. Turns out he has mild autism. And apparently was falling apart at home because he has been masking at school. Child psychiatrist for sure. Even if they’re not concerned for ASD they are so helpful for optimizing med management of ADHD. Ours added Intuniv to his Concerta & OMG it was so helpful. Best wishes for you and your son.
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