My son takes medicine for his ADHD (Guanfacine) but I’m seeing an increase in his anxiety. When do doctors start treating that?

[Jewelrymom]

I do not want to start him on more meds!! He is only nine.

[anirush]

My seventeen year old grandson was on more than one medication by age nine. He's the most stable he has been in years right now. His anger is finally under control. He is a smart kid and medication has done more to help him than harm him.

Talk to your doctor about his symptoms.

[FanTheFlames in reply to anirush]

I have a lot of “what if” concerns and questions about our 5 yr old starting two medicines. As soon as anxiety issues manifested, the doctor was ready to address it, but not realizing how quickly was appropriate, we waited over a week to ask the doctor after symptoms manifested. The experience was horrible for everyone.

I have abstract concerns about the medicine. The negative effects of not treating all his symptoms/conditions are concrete.

They are existing barriers I can remove for him. They are impediments to him learning fundamental coping mechanisms that could minimize his need for medication later. Our kids have legitimate medical problems that medicine can address.

I resent my personal need for medication, but not as much as I am disappointed in my own parents for not helping me find the ones I needed sooner in life.

P.S. Props to you for recognizing your son’s needs, regardless of how you decide to address them

[Lillianmcmcl]

It sounds like you might start with talking to him about anxiety and getting some children's books about it. I would start with some stories with characters who deal with it and possibly an informational text that talks about it, normalizes anxiety, and offers strategies like breathing or visualization. Go to your local library's children's department and/or Google for recommendations you can borrow.

It can be so hard when what worked for us as kids doesn't work for our kids. But giving them information, strategies to help themselves and a safe person to talk to (maybe a therapist as well) is a great place to start. My daughter also needs multiple medications. But I have seen that no one thing is a magic solution. Prozac made a huge difference for my daughter's anxiety and the outbursts that it can cause. But talking about how her body feels and thinking through her feelings and actions was the next step, which we couldn't do without the calming support of Guanfacine and Prozac. Best of luck to you.

[Mamamichl]

my kid started anxiety meds at about that age. He’s 15, and it’s been so helpful! To be honest, the anxiety meds are more helpful than the ADHD meds at times.

Guanfacien is initially a blood pressure med, so his blood pressure could be lowered and he could be anxious because he is light headed, which could be making him more anxious. A different med could be needed instead. Talk to him about how his head feels. My stepkid tried that one and he was super tired, then feinted.

You can also take a gene sight test to find out which mental health meds wil have adverse effects on his body. Not invasive and has been super helpful for my partner and me with our meds.

[Onthemove1971]

Just curious are you guys working with a Child Psychiatrist? Having them on your team is so helpful. Medication changes.a lot as they grow. Most regular doctors do not have the skills and training to manage medications. Have you guys considered Wellbutrin? It is helpful instead of a stimulant. It does take a few weeks to work, but has worked well for us.

It also may not be increasing the dose, but giving him 2 dose ( am and pm).

Hope you find what works.

[Jewelrymom in reply to Onthemove1971]

We tried therapy but he just wanted to play. He is very “young”.

[Onthemove1971 in reply to Jewelrymom]

So was ours..When he was young I went in and had the session with him so I could twll.the therapist all that he was doing and we talked about ways to do it different. This helped the most. Now he goes on his own without us.

[Nats2005]

My son is about to turn nine and he's been on multiple meds for a few years. We just added Prozac to the mix to address anxiety and depression. While we just had a significant setback that may have nothing to do with meds (but everything to do with a couple of frustrations including kids making fun of him), we had been seeing some progress with the Prozac.

[Peerandparent]

I had my first panic attack at age 6-7, and my first suicidal thoughts at 8. I'm now doing well.

As far as medication goes, I can't tell you what's right for your kid. At the same time, I can provide you with a framework to think about things.

1) Medication is morally neutral. You are not a good or bad parent regardless of your final decision, nor is your son a good or bad kid for needing medication. It's no different from insulin or anti-seizure meds.

2) Make sure you consider the risks and benefits, and compare those for adding the medication with those for not doing so. Different meds carry different risks, and not addressing his anxiety can carry severe risks for his psychosocial development, education, and happiness in general.

3) Recognize and honour the reasons your child experiences anxiety. You may or may not be able to relate, but you can validate what he's going through.

4) Even the best medication is a tool, not a fix. See it as a way for your son to access and practice the other things he needs to do in order to address his anxiety.

5) Make sure he knows he's a good kid, and that his struggles are not a lack of effort, nor are they a character flaw.

6) I'm a big proponent of practicing self-compassion. Much anxiety for people with ADHD at his age stem from social challenges. Reminding him that he is loved, and that he is deserving of love is important. Help him learn as much as he can about ADHD so he can work to separate things he can control from those he needs to work around, and help him learn tricks to better communicate with his peers. One strategy for me is to ask people to be direct with me, as I can sometimes miss more subtle social cues, especially when I'm hyperfocussed and/or super excited about something.

Hope this helps! I am living testimony that even with some severe mental health challenges growing up, I've still managed to secure two university degrees, a job I love, a wife that's absolutely amazing, and two wonderful kids who drive me nuts.

Your son will figure things out, and with luck will do so with not only your support, but with that of his teachers and friends.

[Aspen797 in reply to Peerandparent]

Wow! So much great advice and insights here. Thank you.

[Mango1611 in reply to Peerandparent]

I've read 2 of your responses so far, and have been encouraged. I am a wife and mom to husband and son with ADHD, Bipolar and Anxiety - thank you for your wise words of wisdom and sharing your experiences.

[Highlysuspect99]

You don't really treat childhood anxiety, there really aren't any safe meds to give at that age for anxiety. A stimulant typically lowers it. I think I'm familiar with every medication used by psychiatrists and neurologists and I know of none appropriate for children aside from guanfacine or clonidine, which can decrease and increase anxiety, just depends.

[Aspen797]

Such great ideas above. Curious- what signs of anxiety are you seeing? Sometimes anxiety crops up in areas where supports are needed (e.g., social situations with peers and pragmatic language is poor; during writing activities and fine motor, dyslexia, etc are interfering; loud, noisy unstructured times of day and sensory issues interfere or need for added structure). A great author, Jessica Minahan, talks about how anxiety is often at the root of ‘bad’ behavior and that the anxiety can often be traced to an unmet need/underdeveloped skill.

That being said, there is definitely a role for anti anxiety medication for children too. This booklet put out by the American Academy of Child and Adolescent Psychiatry goes into detail about treatment options for anxiety in children, including medication: aacap.org/App_Themes/AACAP/.... Do you have a child psychiatrist or developmental pediatrician? They should be able to point you toward the right treatment path or at least the right assessment options.

[Highlysuspect99 in reply to Aspen797]

It's not safe to give any child anxiety meds or even worse tricyclic anti-depressent's. Considering my dad and sisters are physician's I know whats appropriate

[KayRay5]

remember, guanfacine is largely harmless. It’s not a stimulant. It’s not anywhere near as potentially problematic as the stimulants are. I would be glad that you can treat the ADHD with just the guanfacine. We have to go with guanfacine and methylphenidate.

I wouldn’t worry too much about adding another medicine if it’s correctly prescribed obviously. And I am an anti-medicine person.