Son 16 and ADHD

[houghchrst]

I will try to keep this short and still give as much info as possible.

5 yrs old taken to therapy due to night terrors and anger issues told he has acute separation anxiety. Just do some therapy on and off told doing well move into family therapy until about 8. Not really changing much but this is my first child and I believe when they tell me he seems fine and to move on.

Back into therapy when a 3rd grade teacher asks me to have him checked for ADHD and basically he meets all the criteria according to teacher's paperwork. We do therapy, not a big fan of meds. This is sporadic, mostly for anger issues. Stopped approx. 2003.

Then in Dec. of 2004 child takes a knife from his collection to school and threatens a bully and a friend. Expelled. We start family therapy, him one on one, my one on one, and meds for both. His diagnosis is ADHD, Bipolar Disorder (they tell me but put II in the paperwork), Anger issues. He is given meds for ADHD, and Bipolar.

In the last four years he has been treated for ADHD and Bipolar and has never really been mentally stable. He has had good moments and I do mean moments.

He suffers from terrible anxiety and I can't seem to make this clear to his pdoc, he just keeps saying the Abilify is supposed to help that. His ADHD meds help to a point but only at first and only in school. He is still hyper and seriously irritating and picks until he pushes the right buttons lol.

Within the last few months I have been talking to John Hopkins University Hospital because I had put in for us to be part of a Bipolar study and after talking to them on and off for a couple of months they turned me down saying that my son sounds like he does not have Bipolar Disorder but more like Generalized Anxiety Disorder. This sets off bells and explains a lot of things because I have been wanting them to try an antidepressant and something just for anxiety for a long time and they won't.

Then after my son developing the beginnings of an ulcer in two areas we spoke to his pdoc and I told him what John Hopkins said and that the new Vyvanse was making him manic then we discontinued the Vyvanse, gave Klonopin, and halved his Abilify.

Now he is not exhibiting any signs of ADHD. Has no trouble concentrating on his school work, is very mellow, not that loud talkative, pacing, throwing himself around teenager that he was a few months ago. He still has the anxiety and depression but I am confused.

I am wondering if the ADHD could have been anxiety all along and triggered similar symptoms and now that the anxiety is being treated the symptoms are gone.

Even when he was on ADHD meds he was still hyper. I don't know, I am a mental head case myself and have been trying to keep this kids head above water for years and now after all of this time I hate to think that I let them, let him go this route for so long.

Does anyone have any ideas or maybe I should post in a different thread?

Thanks

[waves]

Now that i am feeling a bit better i will try to do some research for you.

would you mind sharing which meds your son was/is on for ADHD?

the way i see it, what you suggest is indeed POSSIBLE, but not necessarily the case. it would be interesting to know what meds he responded well to, and the behavioral changes. high anxiety creates the inability to concentrate, focus, as well as hyperactivity, hyper-reactivity, and all the consequences of those things. when anxiety is really high, a person's thoughts can even seem to be racing... tho usually racing thoughts are more jumbled. similarly the ADHD mind hops from topic to topic ... but i can tell you firsthand, i have been in anxious states before where my mind was just abuzz with stuff, and things do cease to be organized much.

so i do think you face a difficult differential dx here. I'm glad Johns Hopkins was at least able to advise on the bipolar. I might also suggest you take your son to a different pdoc and put it to him, that you are wondering how easy is would be to to mis-dx GAD as ADHD, considering the meds for the latter never really hit the mark, while he is doing it sounds much better with the anxiolytic. I do think a different professional is a good idea, since the one you have seems to be a bit of a stick in the mud, forgive me if i speak out of turn.

question... what about your son's current capabilities with structure and organization - is he able to manage his time well? break down problems, with home chores, homework, schoolwork, the works? the ability to perform structured tasks, and to maintain a schedule... those are frequent aspects of ADHD/ADD and that i do not think would resolve completely even if all anxiety were resolved. (my thoughts here. based on my readings. years ago, see, i myself was initially dx'd ADD (no H) so i read up a fair bit back then. my dx was changed tho.)

of course there's the other route: pull the plug and see who b!tches - remove everything but his treatments for Anxiety (tapered! gentle on the brain please!) Then see if old problems rear their heads again.

Anyway, if you feel inclined to share more on which meds, I would be happy to do some more specific research. i am still not very well, and so not very "busy" but my brain is not on the zombie level that it was a month ago, and i have resumed spending some of my time reading / researching.

i hope others who are specifically knowledgeable or have experiences with this sort of situation pipe up for you.

*hug

~ waves ~

p.s. I would also cross-post this to our Anxiety Disorders (General) forum (http://brain.hastypastry.net/forums/forumdisplay.php?f=88)

[houghchrst]

Thank you Waves.

what about your son's current capabilities with structure and organization - is he able to manage his time well? break down problems, with home chores, homework, schoolwork, the works? the ability to perform structured tasks, and to maintain a schedule...

I am sorry but I had to laugh. None of these is applicable when describing him. It is one of the major reasons he is failing school, that and his attitude about if he doesn't like the teachers or thinks the amount of work is unfair, little things then he won't do the work. Is late for class a lot and has the couldn't care less attitude. I know that part of that is teenaged angst.

He started for ADHD on Concerta and we went from Risperdal to Abilify and while the Concerta worked for his concentration it really did little for his hyperactivity even though he said he felt more still inside. Now without it he is not even near as hyper as he was with it. When we reached a point where he thought the Concerta was doing no good for him and we discovered his stomach lesions the pdoc switched him to Vyvanse which is relatively new but he said it was making him a nervous wreck and depressed so off of it he went. The Risperidal I took him off in late 2005 because it was adding to his anger and violent tendencies. Those are really the only meds he has been on. Now he does .5 Klonopin 2x day and 2.5 Abilify 2x a day. Besides depression he is really more mellow than he has been in a while.

The thing about his Pdoc is that this man really is one of the best in my county. He really is good. Compassionate, he listens, he remembers things when we come to visit, he is highly sought after and we have already been through two bad pdocs there. The one we have now is a pediatric and adult pdoc. He understands the transition. He has been willing to work with us but he is really resistant to put my son on an AD. I know it is because of my son's dx of Bipolar and the tendency for ADs to cause mania or even suicide among teens and with my son that is something that is high risk but what if his dx is really GAD and he would benefit from an AD is my point.

I don't know I have to call them in the a.m. and reschedule an appt they cancelled and when we see him then I will talk to him about it.

[Zonulin]

Then after my son developing the beginnings of an ulcer in two areas we spoke to his pdoc and I told him what John Hopkins said and that the new Vyvanse was making him manic then we discontinued the Vyvanse, gave Klonopin, and halved his Abilify. - Houghchrst

Ulcers nearly always mean Helicobacter pylori, a bacterium that lives in the stomach lining. I think some real lab tests need to be ordered -

Immunoglobulin Panel Test (blood test to check the immune system)
Metallothionein Test (blood test - metallothionein does the primary filtering for mercury, lead and other metal toxins at the intestinal and brain-blood barriers and is responsible for development of brain cells and synaptic connections)
H. pylori Test (if testing for first time, blood test will do)
Copper/Zinc Ratio (blood test - there is 40 more times Copper in our water today than there was in the 1990s, so the Copper/Zinc ratio might be a problem. Dylan Klebold (Columbine) was taking Depakote, which removes Zinc from the body and impacts brain function.

Pediatrician Scott M. Shannon has written a wonderful book for parents, which is probably in your local library: Please Don't Label My Child, which is peppered with behavioral/nutritional connections. Small sample: "As with that of many American children, Josh's diet was seriously protein deficient. For the young brain, adequate amounts of protein are needed for proper function...I believe a lack of essential fatty acids, vitamins and minerals in kids' diets contributes to these symptoms (bipolar disorder, etc.). The fact that a nutritional supplement can be so effective in treating a serious psychiatric disorder in children brings up some complex issues related to labeling and medicating. If a supplement can eradicate the symptoms of bipolar disorder in a 10-year-old child within 5 days, does the child in fact have bipolar disorder, or is it a nutritional deficiency syndrome? This question merits a serious and sound answer from the medical community."

And William Sears, MD has found that children who have been labeled as having ADHD are suffering from what he calls Nutritional Deficiency Disorder: http://www.askdrsears.com/html/4/t042800.asp

At 9, my son was found to have H. pylori. He was vulnerable to H. pylori because his immune system was (and still is) pretty whacked (per lab test results). He is IgA Deficient, and IgA is the immunoglobulin that affects the mucosal membranes in the body (gut issues, ulcers, etc.). Maybe your son has similar vulnerabilities, which are triggering behavioral issues.

I'd say you've given the psych drugs a chance - now is the time to begin ordering real lab tests for a real diagnosis. Our children are being poisoned by our way of life (nearly 400 toxins found in newborns!), and their immune systems are overwhelmed. To get off the psych drug merry-go-round, your son will need your help to find a doctor who is more of a Sherlock Holmes and less of a Sigmund Freud. A DAN doctor would be a great place to start - these doctors are great at ordering lab tests to determine what is really going on (Defeat Autism Now - you don't need to have autism to see a DAN doctor).

Karen

[houghchrst]

OMG I am so glad you said this because since this all happened with his stomach, and I left out the part where he was on an antibiotic for over 2 years for his skin and it was only that long because I just wasn't thinking and he had a doc changeover in there, anyway we stopped the doxycycline because he was starting to show signs of toxicity and he was put on something else for a short period. Also he was having trouble with his bowels that were so backed up it was showing up on xrays and the person reading them commented to the doc on it.

So I put him on Omega 3, a Multivitamin/Multimineral, and daily probiotic. Is it possible that there may be a correlation between his lack of ADHD symptoms and this new supplement regiment?

It never even occurred to me until you brought this up. It was recommended to me at one point to have him see a doctor who has a more holistic approach. It has also been recommended that he be tested for pyroluria. So since then we have been using the probiotics. I will do some research on the H. Pylori and and mention to his doctor. Where exactly would I look for a DAN doctor?

Thank you, for your answer, I posted in so many places and I don't know if everyone was at a loss or what but your answer set off so many bells I don't know why I didn't make the connection.

[houghchrst]

Okay I just read the first page of Dr. Sears about Omega 3 fatty acids and ADHD and I know I must be headed in the right direction.

thank you.

[Zonulin]

Oh thank GOODNESS! :D:D Here is some really wonderful information (published research) compiled by jcc (Cara) here about pyroluria: http://jccglutenfree.googlepages.com/pyroluria And DAN doctors can be found using this link: http://www.autismwebsite.com/practitioners/us_lc.htm

Dr. William Walsh of the Pfeifer Clinic in Illinois told us in an all-day seminar on "mental illness" that all mental illness is caused by some type of environmental insult AND the inability of the body to cope with it (be it an overwhelmed immune system, combination of genetics, etc.). The website www.tacanow.org has some excellent information regarding testing, foods, etc. which anyone can follow to lead a more healthy life.

My son had major gut issues (chronic nausea, vomiting, diarrhea, weight loss) and after 2 years and 22 doctors :eek: we figured it out. :( Let's hope your search for some real answers does not take as long as ours did!

Karen

[Zonulin]

Ugh - those antibiotics kill ALL the bacteria in the gastro tract, so probiotics are GREAT at re-establishing the good bacteria that makes us healthy. Good, nutritious foods and Omega 3s are so important for everyone (my son at 110 pounds takes 1,000 mg a day or 4 Nordic Naturals Soft Gels, as recommended by his doctor). Because my son had elevated lead and mercury, we eat mostly organic fruits, vegetables and meats - also a gluten-free diet. Lab tests show that he STILL has immune issues, but he feels healthy and the gut issues are gone. Because of his genetics, his body responded with gastro problems; it sounds as though your son responded with behavioral problems (probably some gastro issues there, too).

Of course you don't HAVE to pursue a DAN doctor if you can find a doctor who will LISTEN and then order the right tests. The immune system continues to be a mystery to the medical profession - the Mayo Clinic gastroenterologist my son saw told us somewhat defensively, "We still don't know much about the immune system." :confused:

Karen

[mrsdoubtfyre]

take the growing number of posters here as an encouragement to the post I originally answered for you at NeuroTalk, when you first joined there.
I am no longer the lone voice on this subject. That is why I don't post more often, since this is accepted good practice by doctors and nutritionists.

Omega-3s are essential, that means we cannot live without them. If you don't eat them, you eventually fall apart. Our bodies cannot make the omega-3 Alpha linolenic acid and linoleic Omega-6. We have to eat them and in a ratio of 1:1 to 1:5. The average ADHD kid tested out at Purdue in a study years ago at
1:25.

The damaging transfats are being removed from our foods now, finally. It took over a decade to accomplish this. Many mothers consumed high transfat diets and unknowingly damaged their fetuses. This may be a thing of the past as transfats become history. There are many studies on PubMed showing maternal consumption of transfats impact the size and functions of the growing baby's brain.

[houghchrst]

Mrs. D you were a tremendous help that is one of the reasons I added the Omega 3, probiotics and the multivitamin/mulitmineral to his diet. He really does not eat that healthy and his staying at his grandmother's she buys a lot of fruit and veggies but she also has a lot of snack cakes and such.

Now if I could just find a magic combination for his depression.

[peglem]

You might also try an antifungal- my daughter always gets extremely hyper when she is yeasty.