My oh my, I need some help!
My daughter is 6 and has been on Adderall XR 5mg for about a month. She has also had some significant upsets in school with her teacher leaving rather abruptly. She had been losing her self esteem before the meds and the Dr said it should/would get much better because of the meds. She has been going into these meltdowns and saying very disturbing things like we shouldn’t love her, she’s not pretty, she’s dumb and all this sort of thing. I am not sure at this point if it’s the meds making her more depressed or what.
I called the Drs office but her Dr is on vacay until Feb and the other Dr in the practice just said to take her off them for a week and see if the behavior changes. I know that sounds logical but I really didn’t want to put her on this med to begin with and I think if I take her off I won’t put her back on.
Does anyone have any experience with any behavioral therapy making the side effects or the underlying depression any better?
I would really appreciate any feedback
Thanks.
MH
Re: AdderallXR side effects
One side effect of stimulant medication can be depression, which may be what is going on with your daughter. Children with depression typicallyseem angry and defiant rather than sad. All depressed people harbor negative views of themselves, like your daughter’s “I’m dumb” and “I’m not pretty” comments. Depression and ADHD are also very often comorbid. Either way, it seems to me that more is required than simply taking her off the meds. That might even make things worse. Six years old is not too young to be depressed and it is not too young to receive therapy, either inter-personal or cognitive behavioral. You might take a look at the book “More than Moody” by Harold Kopliewicz. It focuses on adolescent depression but also gives good info in general on recognizing and treating childhood depression generally. You might also consider whether she has a learning disability that is contributing to her unhappiness in the classroom and making her feel that she is “dumb.”
Adderall and depression
There is no indication that medication has any positive effect on self-esteem in the long term. There may be some short-term benefits based on receiving more positve feedback in school. However, stimulants are definitely associated with increased depression as a side effect in some kids, especially during the “rebound” phase. There has also been some suggestion (without any quantitative research that I know of - just qualitative interviews with kids on medications) that the fact of having to take medication can sometimes be viewed by some children as proof of their inadequacy, and that any successes they have may be attributed to the medication rather than credited to their own ability to succeed.
I agree with the poster above - sounds like the Adderall is not a good match for her body. There are apparently about 30% of ADHD-diagnosed people that don’t have a positive response to medication, and a lot more that may improve attention span but have side effects that override the temporary benefits. Medication is definitely not a panacea for this kind of problem.
I doubt there is a behavior program that can overcome the depressive symptoms if they are a side effect. However, we have had tremendous success with our two ADHD boys using behavior programs. We have never put them on medications, though we chose to avoid regular public school classrooms, using homeschooling and alternative schools (and actually helping found a charter school!) to avoid what we consider the toxic effects of standard classrooms on our bright, active and creative kids. While they have had their issues, we have been able to teach them right from wrong and even to increase their tolerance for boredom and their sensitivity to others through creative behavior management. Very few people would peg my 9-year-old boy as ADHD, even though his nickname as a preschooler used to be “wild boy” and people wouldn’t babysit for him because of his behavior. I would be happy to share ideas if you want to give some more details on the kind of behavior the medication was supposed to be addressing.
Hope that is helpful!
Re: AdderallXR side effects
My son is 6 1/2 and takes Strattera and Metadate for his ADHD. Right around the time the Metadate wears off he seems to be sensitive. We have tried two doses, and the higher of the two caused awful meltdowns. The lower of the two just make him more sensitive and we try to treat him more gently at that time of day.
We were hearing a lot of the ‘I hate myself’ and ‘I can’t do anything right’ and worst of all ‘I want to die’ this past summer before starting medication. We wanted to try Strattera first because it is non-stimulant. It solved the majority of our homelife problems, but was not enough for school. But I have to say, that within 3 days of starting Strattera the self loathing stopped. It was quite a relief. You might want to give this medication a try. My son is able to take the lowest dose of Metadate in combination with this drug, and that seems to do the trick for school. On weekends and holidays he only takes strattera (it works much like an antidepressant, so you can’t just stop).
Hope this helps,
Hayley
Re: AdderallXR side effects
My daughter did not respond well to adderall at all. She does much better emotionally on concerta. Her academic performance and concentration is not as good but that’s okay. I’d rather have her happy. She was not only having meltdowns but was experiencing very intense anger with the adderall. She was not happy and was becoming withdrawn. She was not on it long before we switched back to concerta. However, it is real hard to know what is causing what sometimes. Right at the same time she was switched to adderall our dog died that we had from before she was born. It was very traumatic for my daughter and I do believe she suffered from depression following that event. She also has an anxiety disorder. She did start seeing a psychologist on a weekly basis in the beginning of October and started on celexa not long after that. The psychologist works on behavior training and anything else my daughter wants to discuss. She is seven and it has been a very positive experience for her. She looks forward to her visits and comes out visibly calmer and feeling good about life. She has learned to do some “normal” kid things in the past few months and it’s been terrific! Don’t get me wrong. We have our struggles but when she goes to her room by herself even when it’s dark out, or doesn’t act like an insect is killing her, or can walk in a crowd of people and feel safe I know that we have made progress! We still have a long way to go. She may be 30 and still have training wheels on her bike for all I know! But, we have been where you are now and many times we still are. To answer your question directly, yes, we have and still do behavioral therapy on a weekly basis and it has been great for the depression and anxiety.
Side effects are a whole other issue. If you think the medication is working in other areas then maybe it is just a matter of finding something that does work. In our case we had more meltdowns before starting meds. I don’t know how it was in your case. You would have to weigh out which is better for your daughter. If you did stop the adderall there’s nothing to say that you would ever have to start it up again. If you didn’t want to do it and it’s not working, or the side effects are worse than the benefits, then couldn’t the other doctor switch to a different medication? A month is a long time to wait!
Trust me, I know how you feel. I watched my child beat herself up one day. She pulled her own hair, punched herself in the face, smacked herself repeatedly while screaming how much she hated herself and didn’t know why she did the things she did. It was awful and I truly hope neither of us ever experience that again.
Re: AdderallXR side effects
JenM,
” I watched my child beat herself up one day. She pulled her own hair, punched herself in the face, smacked herself repeatedly while screaming how much she hated herself and didn’t know why she did the things she did.”
My daughter is doing this now, she bites herself,pulls her hair, hits herself and does tell me she wants to die.
We really didn’t have these meltdowns until about 2 weeks ago. Well a few when she was about 2 but that’s it. They have reappeared worse than I ever imagined they would.
The only reason she is on the Adderall is because she can’t swallow pills and is deathly afraid to try. I tried to gear her up with tic-tacs but it doesn’t work so her Dr said the only one that can be opened and mixed into anything was the Adderall.
I can’t thank you all enough for sharing your thoughts and comments with me I sincerely appreciate your help!
More on side effects
Hair pulling is also associated with stimulants, btw. Not real common, but not rare, either. Just thought you should know this.
Re: AdderallXR side effects
I think there are side effects like “loss of appetite and difficulty falling asleep”
To me, what you describe is a whole different ballgame!!!
We have never experienced anything close to that with either Adderall or Strattera in the past 4 years
Kids who have mood disorders will worsen when given stimulants
I would stop and seek further medical advice
Re: AdderallXR side effects
It does sound like there may be some mood disorder aside from the ADHD (if it ADHD at all). Stimulants can make mood disorder worse. You should check into that.
Also, Metadate CD (which is in the methylphenidate (ritalin) family, different from Adderall) is in a capsule form and can be opened (if pill swallowing is not possible).
My son had anger issues on Adderall, but not on the methylphenidate class of meds. He is currently on Metadate CD and doing very well. It is long acting and lasts 8 hours (not the 10-12 hours of Adderall). He has no appetite issues and no emotional rebound.
Re: AdderallXR side effects
Guest, I am assuming that you are the one “trying…” who posted the original message here. If your daughter is doing the things you described you cannot wait until your regular doctor is back in the middle of February to do something. The other doctor should be able to see you! Or, maybe you can even speak to your regular doctor on the phone. When those kind of things happening it’s a crisis situation for your child. It’s awful for her and it’s awful for you as well. Not much can break your heart as much as watching helplessly while your child hurts herself.
By the way, applesauce took care of the pill swallowing for us. I don’t know if that will work for you. Maybe it could be with a treat like pudding or something!
Re: Adderall and depression
[quote:d999f19bb4=”Steve”]
I doubt there is a behavior program that can overcome the depressive symptoms if they are a side effect. [/quote]
Cognitive behavioral therapy is not a “behavior” program. It is a kind of therapy that focuses on teaching depressed or anxious individuals how to deal with and stop the negative thoughts associated with those conditions. It is quite effective for adults and children.
please re-read Steve's comment...
Steve wrote:
I doubt there is a behavior program that can overcome the depressive symptoms if they are a side effect.
“Guest” wrote
Cognitive behavioral therapy is not a “behavior” program. It is a kind of therapy that focuses on teaching depressed or anxious individuals how to deal with and stop the negative thoughts associated with those conditions. It is quite effective for adults and children.
Guest, CBT is a WONDERFUL therapy for many problems — but Steve said: ‘if they are a side effect’. No amount of CBT will help with medically-induced depressive symptoms!!! This is as serious as telling someone with severe chemical depression NOT to take their med, and just find a good therapist…just wanted to make sure readers don’t mis-understand…
Re: AdderallXR side effects
Elizabeth — thank you for clarifying this.
I personally have an autoimmune/thyroid problem, and one of the side effects of not having enough thyroid (which means you *cannot* burn energy, no matter how much you eat or how hard you try), and of autoimmune digestive disorders, can be depression, since there is no energy resource for the brain either. The thing is, the depression is a *side effect* of the real medical problem.
Treatments which try to address only the depression are actually dangerous, because they can cover up a life-threatening disease — and also can lead people to hopelessness and suicidal thoughts because they can’t even get better with the “best” treatment.
Always try to avoid the one-track diagnosis. Look at all the options, measure results as objectively as possible, be ready to go back and try again, and keep an open mind.
CBT vs. side effects
I’m a big fan of CBT, but physiological side effects have to be eliminated first, otherwise, you are asking a person to counteract the effects of the medication, which is definitely going to be tough! Victoria is right - medical issues MUST be eliminated first before concluding that CBT is the primary intervention. Seldom done, but good advice in the end.
Re: AdderallXR side effects
I agree with all that IF the medication is inducing depression, then it should be discontinued and that CBT alone would not be enough. The question is whether the medication is causing the symptoms or if the child is depressed for other reasons. None of us here can say what the answer to that question may be. Depression is often co-morbid with ADHD and LD, whether for biological reasons, the stress that arises when schools do not address issues appropriately, or both. On the other hand, stimulant medications can cause or contribute to depression because of their effect on dopamine transmission and serotonin. For example, some patients taking SSRIs who begin stimulant therapy will need to increase their SSRI dose. This mom should make sure her child is immediately seen by a mental health professional. Medication issues should be explored as should other possible contributing factors. Some kind of therapy may be necessary, regardless of the cause of the depressive symptoms.
It looks like adderall is not the med for her. Did she have all these meltdowns before medication?
For more people who have experience and advise/support on medication, pls go to:
http://www.millermom.proboards23.com
There is a troll here who attacks people who use medication or ask medication questions and I don’t feel comfortable answering questions here or have you be attacked by this “troll”.