Hi All. I have a 16-year-old daughter that was diagnosed with severe anxiety and depression over the summer after completing a psych evaluation. Prior to the evaluation, she was convinced she had ADHD. She has had no behavioral issues or performance issues at school. In fact, she is an extremely high achiever taking several AP level courses. She is convinced that she works 10 times harder than her peers to maintain the grades that she achieves. A second evaluation conducted by a psychiatric nurse online this fall led to a diagnosis of ADHD. My daughter then started Adderall, but it did not help. It seemed that her anxiety and depression got worse, to the point where she was sleeping approximately one hour a night and forgetting to eat. In December she was switched from Adderall to Zoloft and we’ve seen a significant improvement. But she is convinced she still has ADHD and wants to resume medication for it. The psychiatric nurse is also recommending that she take Zoloft and Adderall together. I have read this can lead to things like serotonin syndrome. And I’m worried about adding Adderall back when I’m seeing her make so much progress on the Zoloft. I voiced my concerns to the psychiatric nurse, but she rushed me off the phone and I didn’t really feel heard. She sent me a link about medication which didn’t really help me. I truly want what’s best for my daughter, but I want to be careful with medication and make sure that we are an over medicating unnecessarily. Does anyone have experience with this? Have you given your teen both Zoloft and Adderall at the same time? How did it go? Thanks for any help you can offer.
Multiple Medications: Hi All. I have a... - CHADD's ADHD Pare...
Multiple Medications
While we do not have experience with those medications. Please consider Wellbutrin, which has really helped our son. It was recommended by his Child Psychiatrist due to the shortage of stimulants and it had replaced the stimulant. Good luck!
Has she ever been evaluated for learning disabilities? If she feels like she is working 10 times harder then others, sometimes it can be due to Dyslexia, Dysgraphia, Dyscalculia. Or it could be ADHD. Or it could be ADHD + learning disabilities.
My daughter tried taking Zoloft for her Anxiety, but it made her feel crappy. She is now taking Prozac for her Anxiety. She recently started on Focalin XR for her ADHD (after being off ADHD meds for over 1.5 years due to side effects and other medical issues).
I'm on 75mg zoloft, 70mg vyvanse, 10mg abilify, 15mg mirtazapine and not having any negative side effects. Also no signs of serotonin syndrome. I think it is good to listen to your daughter, ask her, what she wants to try.
This is not answering your specific question, but my DD 17 had several evaluations with none returning an ADHD diagnosis. I contcted a therapist who had been working with her over a period of time to express that I thought there was a piece missing in her diagnosis. Fortunately this therapist ahd a lot of experience with adult ADHD clients and shared that she had a suspiscion this might be the case with DD. Therapist administered a screener, to me, DD and herself. Yup, innatentive ADHD which was then confirmed by a Physcologist. Looking back at notes from school, there were definate signs - such as teachers noting she "doesn't pay attention, but seems to kno wthe material". She was also diagnosed as 2e, which helps her compensate. It's a big puzzle to get the correct diagnosis, so keep at it.
what is her diet like? Is she secretly starving herself? Could she have an eating disorder. At that age they can stop eating some things if they don’t like them much, and substitute with lots of junk food. She might not be getting enough vitamins and minerals, vegetables etc.
Thanks, she is a good eater except for when she was on the Adderall. She was forgetting to eat and had little appetite. Once she stopped the Adderall and started the Prozac, her appetite returned and she is eating healthy meals.
Ok good, it is good to keep an eye on it as at that age some with anxiety can develop anorexia so just make sure you see she is eating the food not pretending.
You can actually enter into chatgpt an estimate of what her daily meals are and ask it to tell you if their are any deficiencies it notices. It’s pretty cool. Prozac I think can make you crave carbs. My husband was on it and I couldn’t get him out of the pantry! He gained 10kg. If you can get her interested in gut health and eating a rainbow some kids can be quite interested.
My 16-year old daughter is also a high achiever taking AP classes and in several clubs, worked a part-time job. She was diagnosed with ADHD when she was 7 but we never medicated her as she was getting A’s at school. We finally realized due to her advocating for herself that she was depressed and had a lot of anxiety due to “just holding it together and getting by” for so long. She was started on Prozac by a psychiatrist but gained a lot of weight and seemed more impulsive. She switched to Wellbutrin and at 300mg after three months she is thriving and does seem a bit more focused. Wellbutrin may help with depression AND ADHD.
thank you for sharing! You should setup an appt with the doc instead of talking with the nurse about medication changes. Maybe write an email to get articles but be prepared to talk concise with the doc. Maybe ask for a neuro psychological examination. I wouldn’t go back on adderall if it did that. I wouldn’t ask to try a non stimulant. Stimulants are known to raise anxieties. They made mine worse, and I love the effects of my stratera.
Also, if she’s stressed in ap classes, go to less rigorous ones. I’m a teacher. I’ve been told by college people that good grades in regular classes are better than ok grades in ap classes.
Thank you so much. This is great advice.
A few things to unpack here:
1) someone can excel academically and have adhd. Often it comes at the expense of our mental health, as it did for me. Unlike your daughter, it didn't really hit me until my university years.
2) I can't tell you how frustrating it is to see other people doing things seemingly without effort that is like pulling teeth for me. Especially when I was frequently being told I was falling short of my potential (despite doing well academically) and being told I just needed to try harder when I put in immense effort every day.
3) with respect to adhd, we better understand now that it can present differently in girls than in boys. Instead of thinking about the stereotypes, look up "executive function" and see if your daughter struggles in those areas. You mentioned her doing well academically, but you didn't mention if she has friends, has been bullied, has emotional disregulation, or if her personal relationships seem particularly challenging.
4) more than one med is not the end of the world. I'm on two meds and have been for years with no issues that couldn't be resolved. The key is keeping an eye on things and addressing them early if they develop. Ultimately it will come down to what your daughter finds most effective at getting her life back on track. As someone else mentioned, welbutrin can be a good choice because it is an antidepressant that can also be used for ADHD. That being said, don't get rid of a med that works for something that might be better.
5) it is very much possible for your daughter to have a mood disorder and adhd. Comorbid mood disorders are quite common both due to our leaky dopamine bucket and the high levels of stress we experience trying to conform to a world not designed for us.
6) neither you nor your daughter should anchor yourselves to a particular diagnosis. Even for professionals with years of experience, differentiating between conditions with a very similar symptom profile can be challenging. As scary as the label is, consider the possibility of bipolar disorder. This often gets overlooked because hypomania can look like adhd, and some docs only see patients during their depressive cycle because you don't seek out a doctor when you feel awesome.
7) you can't see the mental effort your daughter puts in, so when she says she works 10x as hard, believe her. Adhd is a disorder of doing, not of knowing. You have no idea how frustrating it is to know exactly how to do something and be unable to make yourself do it. Or maybe you do (see my next point)
8) Look into getting assessed yourself. Often one or both parents have adhd when their kid has it. Not knowing you, it's possible that you could be downplaying her symptoms because you've lived with them all your life, so you just think your experiences are normal. I still fight against self-judgment over things that are adhd because I just thought everybody dealt with what I do and they just worked harder or were more disciplined.
I hope this was helpful. None of the above is a reflection on you. You are right to be concerned about making sure she has the right diagnosis and treatment, and I'm glad you decided to post here.
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