No motivation or attempts to complete schoolwork or any task beyond...

[foreverbeagle]

The struggle is getting worse for my 18-year-old daughter. She was diagnosed with depression, PTSD, anxiety, and ADHD a year ago. Medication for depression appears to be working. She has bounced from Adderal to Strattera to Ritalin currently to treat ADHD. Failing 3 classes presently her senior yr and is a bright, talented girl. 504 accomodations are not helping. We have never felt so helpless or saddened about her future. Counseling for her as well over the past years. Where to we turn for help and much needed support?

[Neurolancer]

Dear foreverbeagle,

I am so sorry to hear of your daughter’s suffering and yours as well. I understand the pain of your experience as a parent. I have three children with ADD/ADHD—two having Crohn’s. They all battle with depression and anxiety, and yes, one also has PSDT from a car accident. One recently graduated from college, one is in his fifth college year, and the third is a junior in high school. Like your daughter, they are very bright and talented. But living with executive functioning deficits plus the psyche disorders has been grueling and they have all gone through implosions. Here are things that have helped us:

— Make sure that your daughter’s 504 actually contains the support that she needs, Not just extra time on exams. Does she need a quiet place for taking exams, does she need more time on projects, does she need someone to work with her on her organization?

— Make sure that your daughter’s 504 is well documented as colleges will base their decisions about accommodations in large part based on this.

— My kids all ultimately needed a private school setting where there needs could be met. Two of them made use of a School that uses a one on one teaching model and mastery model. Only one student per teacher and a student must be achieving a grade of a B or better to move forward in the class. The teacher truly teaches to the child.

— My daughter took a gap year before she even apply to colleges. My older son did not want to take a gap year but during his freshman year told me that he was she had. My highschooler has already told me he wants to take one. These kids need the break from the relentless pressure of high school and the college game and they need a chance to heal. But the time needs to be spent productively. Help them choose a passion to pursue plus an experience that will help them develop their independence. My daughter participated in programs in classical music and German in Berlin and Vienna, and spent time traveling on her own (after first getting her feet wet traveling with me). She also spent time working, which also helped with her sense of independence, competence and organization.

— Stick with the therapy. Make sure it’s really targeted to her diagnosis. My son with PTSD has a therapist who specializes in treating PTSD. Has your daughter tried group therapy? I hear over and over that it’s very powerful; my high school son is doing it now and really likes it.

— How are things going with you as a family structure? Could you use family therapy? We are doing that right now and it’s improving our communication and understanding of each other‘s needs and motivations.

— We ended up hiring ADD coaches/tutors, some with subject matter expertise as well, to tutor our kids after school. Much of the time they were simply babysitters to help our kids stay on task and complete their work.

— If there’s something that gives your daughter joy, milk it to the nth degree. Do everything you can to support that interest even if you drop other activities or it doesn’t seem to advance your daughter. Playing the sax (good), woodworking — taking apart all of my vintage furniture without asking (bad), LARPing (weird), Japanese street fashion (expensive). These things helped my kids survive.

— if your daughter doesn’t exercise then do whatever you can to help her establish a regular exercise routine. Support any kind of movement. The science is clear – exercise helps with ADD and depression etc. as much in some cases as medication. A work in progress in our household.

— When it’s time for college applications find a college advisor who gets kids with ADD and knows what they need to fit in and succeed.

— It is said over and over again that the ADD/ADHD kids all find their way eventually but may take a circuitous route. I have heard many stories of this kind from people who I know and trust, so I know that this has to be true. I’m not a faith-oriented person, but I’m trying hard to believe that ultimately my kids have the wisdom, heart and drive to carve their own unique paths in their own time.

— Lastly, don’t compare yourself to other moms or your daughter to other kids. Don’t buy into the traditional labels of success. Just ignore it all. Concentrate on what makes you and your family special and love each other very much.

Feel free to reach out more. I wish you the very best.

[foreverbeagle in reply to Neurolancer]

I want to thank you for your reply. You certainly appear to understand and I appreciate all the personal insight and suggestions you shared. Of all our children, early on we thought this child would be the one we did NOT need to worry about in the adult world. She was always so productive, industrious, and motivated. We never saw this coming as her behavior has taken a complete turnaround in the past 5 years. We recently had a set of tests completed through a nearby university. We wonder if there is something missing that has not yet been diagnosed. We are looking for guidance for "next steps" and hope we will find it here.

[Neurolancer in reply to foreverbeagle]

Hello! You are very welcome! It’s a pleasure to be able to help another parent with similar challenges. I can’t see your original post so I don’t recall it 100%, so forgive me if I’m off base at all.

What do you think about the findings of the evaluation? Was it a full psycho-educational evaluation? This typically takes several two hour sessions plus teachers, parents and chid interviews etc.

My high-schooler just did a full one as part of his IEP process and it made a few of his key cognitive deficits very clear as well as identifying a few key strengths. Did someone walk you through the results in written and oral form? The specialist who did my son’s evaluation had a lot of good observations and suggestions.

Was there any diagnosis? As you already realize, this is very important so that you can hone in on the right treatment. We recently started wondering if our high schooler is autistic and that we weren’t approaching his social-behavioral issues correctly. However his new therapist and the psycho-ed specialist feel clear that he isn’t, so we feel confident about putting that to rest.

Do you have GOOD psychiatric, therapy, and ADD related resources in your area eg organizational skills support? You probably know that many mental health disorders cause a lot of symptoms that look like ADD/ADHD. Your daughter’s reduced executive functioning could be amplified by her mental state. It’s hard to know which is the cart and which is the horse. A good psychiatrist could help untangle this perhaps or explain it to you clearly. Also, there are a few ADD/ADHD centers in the US; one in particular is run by a highly regarded Harvard educated doctor with ADD. I believe Dr. Ned Hallowell or something close to that. His books on ADD/ADHD are outstanding — on Amazon.

Have you registered with CHADD, the advocacy and educational organization for people of all ages with ADD / ADHD? It is very valuable — it distributes a magazine covering highly targeted topics, has online resources, etc. It also sponsors an educational program. It also helps with organization of support groups. This can be helpful.

Please let me know if you have further questions or just need a sounding board. I’m always happy to share what I know.

All the best to you!

[foreverbeagle]

We have not yet received the results of the assessment. I know the evaluator is working on the findings this week and hopefully, we will be getting news soon. It's interesting that you mentioned that many mental health disorders produce symptoms of ADHD. I really want to know what we are dealing with. Is it strictly mental health, or is it ADHD? I don't feel confident that we have ever had a clear answer. In my heart, I feel she has been so devastated by the lack of friends and social acceptance since the beginning of school, that she is depressed. School is a trigger and she can't function in that environment. I hope the test results can lead us to the next steps. My heart breaks on a daily basis. The SR year is supposed to be one of hope and excitement. Currently, it is one of sadness and worry. We have to find a way to stay positive and do everything we can to better the situation. I hope this full Psyco and cognitive assessment will lead us all in the right direction for the next steps. Thanks again for your reply.