Hi Jen,
One side effect of stimulant medication for some kids is emotional difficulty. While this most often happens as the medication is wearing off, for some kids the medication increases emotional sensitivity. Perhaps you can explore a different medication (as well as dose) - for instance he is on Concerta, switch to Adderal.
Actually, since he started the medication, his outbursts have gotten better. We do tend to see increased sensitivity, however, when we increase the medication. Without it, he can hardly have a conversation due to distraction and lack of focus. When this happens, we see even more meltdowns. So, the key I think is finding the right balance/dosage.
We have tried multiple medications, and Concerta seems to work the best without increasing emotional lability or causing emotional meltdowns. For him, it doesn't last long enough, and he has to take a short acting booster (Ritalin) in the afternoon, but that's another topic.
Some of the meds made him cry all day, as in sad, weepy, and clingy. He could never put his finger on why he was sad. Concerta doesn't do this at all. It just doesn't seem to help him control his frustration.
As your Dr suggested, perhaps there is something other than ADHD going on. Are you sure the diagnosis is correct and or complete? Things like anxiety, OCD, Bi-Polar often look like ADHD or often present along side ADHD. Could this be a possibility? What about undetected learning disabilities? Sometimes very bright kids mask LD. But, as they are working so hard to overcome, they can get frustrated and overwhelmed. Sometimes they benefit from a structured, explicit teaching approach to help them cope.
I honestly believe he has ADHD. What I'm not sure about is if he might have something else going on as well. My husband and I have researched symptoms of everything we could think of, and what seems to jump out at us repeatedly is generalized anxiety disorder. I just hate to over-diagnose him, ya know, especially if it's something he could grow out of or learn to manage. I feel like we've tried everything though. We've also looked into OCD, OCPD, and Aspergers, but the symptoms do not describe him. Anxiety fits the bill, but is it because he is just generally anxious? Is it because he's gifted but also has ADHD so he gets frustrated? He certainly suffers from perfectionism which I know is often linked to anxiety. I just don't know if it makes sense to treat the anxiety or try to "reverse" the perfectionism. Can we even do that?
How is his sleep, diet, exercise?
Sleep is good, diet is ok (he eats healthy foods, but the stimulants affect his appetite a little. He eats a good breakfast and a good dinner, but he only eats so-so at lunch and rarely snacks unless he is home and I can push them.), and exercise is not that great. We can't seem to find anything that he's really into. He's active when given the opportunity, but as for extra-curricular sports, we've yet to find the one he likes and doesn't trigger major meltdowns. He says, "organized sports are just not my thing, Mom." I'm not sure if that's it or if he can't tolerate not being good at something immediately. Also, because of the ADHD, he needs it to really be "organized" or he gets lost. And, if it's too large of a group, he seems to get lost as well. He may just not be ready for team sports at this time. We do try to provide opportunities for exercise though. He gets to swim on a fairly regular basis. He has recess every day at school, although this is his least favorite time of day. He feels like an outsider with the other students during athletic activities. He's pretty small, not all that tough, and gives up way too easily.
I'm glad to hear that you are working with a cognitive specialist and developmental pediatrician. He or she may be able to help you understand the triggers and teach your son to recognize when outbursts are coming on and find strategies to deal with them.
Thanks, I am excited to start this. The therapist is someone I've seen for years (off and on since my first husband passed away 7 years ago), and I really trust him. He's wonderful with children and has become a family friend. He used to be a priest, and he even married my second husband and me.
Does anyone know of any books that you'd suggest for practical strategies we can implement at home and that I can go ahead and recommend at school? I am looking for strategies to help my son with ADHD, anxiety, and emotional hypersensitivity.
Thanks Mich! I appreciate the support and advice.
