Teenager daughter in total denial of diagnosis

[Westcoast2023]

My 15 year old daughter got diagnosed with ADHD Inattentive type this spring and summer by two different doctors. First through some cognitive testing (where mild dyslexia was also diagnosed) and secondly through a psychiatrist. For us the diagnosis was almost a relieve, as a lot of things started to make more sense, but unfortunately for her it has been devastating. She doesn't want to talk about, learn about it, or accept any outside help. We stress the positive sides of ADHD and her high intelligence all the time, but she just sees it as a disability that she wants nothing to do with.

So far we have tried therapists, a coach, and the psychiatrist prescribed Ritalin, which she only tried once and will never try again as she got dizzy and got blurry vision. Her opposition to us parents is also very strong, as she wants to be fiercely independent. Any question about upcoming school work, test, or a plan for the weekend, gets shut down by "I got this", "I do this later", "I don't want or need a plan" etc. And there are many emotional outbreaks, where there is no point of getting through to her anyways. She just wants to hang out with her friends and not think about any of these things.

But having read about ADHD, it seems to be very important to find help, so that she can learn to manage her emotions, behavior and life better. But she never liked to receive any help, neither from us nor from other people. She always wants to figure it out or do everything by herself. The problem with that is that she doesn't learn from her mistakes and keeps doing the same mistakes over and over again.

I want us to have a good relationship and I try to focus on the positive and praise her as often as I can, but she still feels bad about herself, finds me way too controlling and blames me for most of her misery. I don't know how to repair our relationship, and she really just wants to hangout and have fun with her friends and not spend time with us. But this leads to more sleep deprivation, bad food choices and her struggles and behavior just get worse if she spends a lot of time with her cool friends. I feel she actually is in better shape, when we force her to eat a healthy diet, take her supplements and when she gets enough sleep and some exercise. I don't know if she realizes this too, but she still keeps making all these "bad" choices for her wellbeing if we let her.

I fear that this pattern will just continue and any "failures" in school or in her sport will just add to her low self - esteem but not to change of behavior. Any ideas how we can support her, be there for her, without giving her the feeling that she can't take good care of herself and feel controlled by us?

Thanks!

[Pema20]

Oh, this sounds so much like our daughter in so many ways. It’s incredibly difficult. I recommend parent coaching. It has helped me learn ways to phrase and time my comments so they are digestible to her. It has also helped us build connection and, perhaps most importantly, it has helped me regulate myself. Therapy for our daughter has also been great. Ours also refused at 15, but eventually agreed. I recommend you look for three people now - therapists and executive function coaches - who you think might be a good fit. Ask her if she were to see someone what would she want them to be like. Then look for that. Takes a lot of time, but will pay off. If/when she says she might consider talking to someone, you can say, “well, it has to be someone that works for you. I have three people You can to do sessions with/interview and then You can decide if you think any can work.” This worked with our daughter. I now have her “interview” or test out anyone who is there to provide her service - MD, dentist, therapist, the person who helped her with SAT prep, etc. when it’s their choice they can be more amenable. Makes her feel like the decision is hers and gives her control. Guard rails, we have put in place some rules for major safety and security issues and we stick to them 1) we don’t condone drugs or alcohol and want her to avoid use, but she can call is any time anywhere for a pick up no questions asked, 2) no drugs or alcohol in the house and beware of addiction - avoid highly addictive substances like nicotine, never ever use anything regularly, ritualistically, or when sad, depressed or anxious; 3) curfew is 9 on school nights and 12 on weekends (ours is 17 now, was earlier at 15). If she misses curfew, the curfew is reduced by the minutes late for 2 weeks (so, if she walks in at 12:15, curfew becomes 11:45 and 8:45 respectively). She can negotiate extended curfew in advance for special events e.g. prom. When she has kept to curfew for 2 week, curfew is reset to 12 on weekends etc. 4) we set a digital curfew and downtime goes on her phone automatically to ensure she sleeps. 5) if she misses school - ours likes to avoid when stressed - and has to stay home, she can, but no TV or movies and phone is shut off for today. This is not a punishment, it’s to make home less easy to escape to for our anxious avoider. 6) location on all our phones is always on and can never be blocked. We don’t check it much, but it’s come in handy and she can see us as well so it’s not just about her. 7) work and exercise, ours needs to have a job or do volunteer work and play a sport. Helps build skills in other ways. If yours isn’t sporty, some other activity - art class, music lessons etc. are good alternatives.

Family therapy was also helpful. Mostly, I have learned to talk less and listen more, to not put pressure on as it sends her the other direction and she shuts down, and to accept that I can’t force her to do anything. I try to remember that she is not “giving me a hard time,” she is “having a hard time” and to be there for her. My husband and I try to support and model. Sometimes I still feel frustrated and fearful. Time goes so fast at this age and every minute they aren’t building skills feels like a minute closer to 18 and unprepared. Ours desperately needs executive function coaching, but won’t accept it and so struggles with some school work as a result. All to say the strategies I offer have been helpful, but it’s still a continuous struggle for us as well, I just feel a little better and more accepting of it at this point. A lot will happen with brain maturity, all we can do is provide as much support and love as we can. Sometimes that means just waiting and watching, which can be painful.

[Westcoast2023 in reply to Pema20]

Thank you so much for your detailed and thoughtful response, Pema20! I really appreciate all your tips and valuable advice. Many of those we are also trying to implement, which makes me the strict mom, compared to her friends.

It seems like you got quite a good system in place and are also good with following through on it. We have a hard time being consistent with the consequences (ie being late in the evening) and often give in to extra hang outs and sleepovers. Somehow her friend group does slumber parties and sleepovers every weekend, and as she really wants to belong, it is hard for her to miss out. I get that! But she can't keep up with the school work, continue her competitive sport which she wants to play in college and be part of every hang out. And she doesn't have the self discipline or the time management skills to make it happen.

I will look for a parent coach, as clearly what I am doing is not helping. Each day I start with such good intentions of spreading positivity and compassion, but it rarely works and the day just ends in another emotional outburst.

At the moment, I can't mention ADHD to her without her starting to scream and cry. So I will stop the coach (whom she also doesn't like) and look for a new therapist again, who might help her with accepting and dealing with these strong emotions.

Did your daughter try medication? We are very hesitant, also because of the possible side effects (she is anxious to start with), and she doesn't want it anyway.

Good luck and thanks again for your support and sharing your story with me!

[Pema20 in reply to Westcoast2023]

Ours tried both classes of stimulants but she completely lost her appetite and had trouble sleeping. The Adderall class of drugs did it increase her anxiety, but the methylphenidates did big time. From what I understand every person is different. The trial process was not fun. She dropped weight fast and after about 5 months she stopped and we have been careful not to push. She did focus better and completed her work more on the stimulants but hated the side effects and said she did not feel like herself. She is on an antidepressant and the psychiatrist has her on 1MG of Guanfacine (one of the non-stimulant ADHD meds), which seems to help a bit with mood dysregulation. The psychiatrist wants to try to get her to try the stimulants -in some form - again eventually, but is not pushing it now. The good thing about the stimulants is they are fast acting and leave the body fast, so she can just test them out for a bit and stop with no major issues (unlike antidepressants).

I have been attending some free online executive function Summits. Many of the people who do these also do parent coaching. I have found Impact Parents, Tilt parenting, Order out of Chaos and Seth Perler to have useful perspective and resources. You may want to check out their parenting groups or see if they have one-on-one people they recommend. There is a whole industry out there. Both the CHADD website and ADDITUDE magazine have a list if registered professionals. All of this comes at a price, but I am at the point where I feel the investment now may save us money later.

Finally, our system is still Rocky. we still make exceptions and a whole lot of mistakes. It’s difficult and exhausting. But we’ve found a few basic things we stick to and that does help. We have found that drafting contracts and having her participate in the drafting and setting consequences helps a lot, she hates it, but it certainly makes things clear and it gives us something to hold ourselves accountable to. I don’t believe there is any perfect way to do this. We just have to do our best.

Hang in there!

[BrainFood in reply to Pema20]

I’m in the same boat as you and it is reassuring that there are others who are trying similar strategies and finding some success.

[HoldingonLou]

I feel for you. I know you just want to help her but she is a teenager first. Any diagnosis is just adding to the rebellion of wanting to just fit in as most teens do. I have a daughter who disagrees with anything I recommend as well. I read the book "Feeding the mouth that bites you" and it explained planned emancipation to me. I remember as a teen thinking I knew it all and I didn't need parents telling me what to do. Do you remember being a teen? Do either of you as parents remember going through emotions like this or challenges? Could be a way to relate to her at some point.

Have you asked the school counselor if there is an adhd support group within the school or in the community? I know I had a hard time getting my son to listen to me but they had a speaker at the school one evening and I told him we had to go this event. He sat quietly and I saw the light come on in his head and the wheels turning. He was relating to the speaker's story. After that he started taking his medicine but only after eating because it will mess up your stomach.

[STEM_Dad]

It sounds like your daughter's ADHD is causing ODD (Oppositional Defiant Disorder) or DMDD (Disruptive Mood Dysregulation Disorder). She may also be experiencing anxiety or depression, since they are fairly common with ADHD.

My eldest daughter acted much the same as a teenager as what you've described. She wasn't diagnosed with ADHD back then (and still isn't now, at 30 years old), but her current doctor has suggested that she be assessed for it. (After my own ADHD diagnosis a few years ago, once I learned to recognize the symptoms, I realized that she get likely does have ADHD.)

• Her choices in friends did seem to influence her behavior, particularly her boyfriend at the time. But I think that mostly, her behavior was due to her own personality & likely ADHD & opinions & decisions. However, it did not help that her mom and I sometimes reacted to our daughter's reactivity.

It is very hard to deal with a child who is being oppositional, and my heart goes out to you and your family for the turmoil you must be going through.

~~~~~

What can you do?

Continue to be loving and accepting of her. Continue to be firm but fair about expectations and discipline.

• Expectations and discipline should be reasonable and responsive, not reactive.

• The medication she tried might not have been the best for her. Maybe the dosage was not right, or the type of medication wasn't. But medication is still one of the most effective ways to treat ADHD. Treatment might even require other medications besides ADHD medication, and she might also need some form of therapy.

Talk to her psychiatrist about her behaviors and responses. Ask if it could be ODD or DMDD, or some other mood disorder.

[Westcoast2023]

Thanks HoldingonLou! I will definitely look into that book - the title seems to fit perfectly

I will look into the ADHD support group from the school, but I doubt that she will be willing to go. It is definitely something to keep in the back of my mind for the future. Maybe she just needs time to process and accept it?

I do remember going through big emotions and rebellion against my parents. But neither of the two of us, had to struggle with these kinds of extreme executive functioning challenges. So it is harder to relate and as we got the diagnosis pretty late into her teenager years, there were already a couple of years where I critized her too much. Now she sees every word I say as criticism, and her self esteem seems pretty low. Hopefully, a parent coach can help me communicate and deal with it better, as I would really like to keep a good relationship with her!

Thanks!