I'm so confused

[flutterby]

difficult child and I saw therapist together. The ADD questionnaire that difficult child had completed last week - and which therapist did, in fact, tell difficult child that I would have to complete it as well - rates difficult child as "classic" ADD. therapist said she scored over the top. She also said that our responses to the questions were very close. She used the Amen Clinic ADD Questionnaire.

So, now therapist thinks that the anxiety and panic may be from ADD due to the results from the questions that had to do with the limbic system. I don't know. I really don't know how to put it all together.

For some reason, the school psychiatric called therapist a few weeks ago (no idea why) and she owes him a phone call. She is going to share this information with him and hope it will help at the IEP meeting. She also recommends trying Adderal (sp?), seeing what happens, and go from there on whether we continue to treat the anxiety separately.

I'm so confused. I'm so tired. I don't know what to make of this. All along, everyone has said it's not ADD, it's anxiety. I don't know what to think or what to do. In my gut we need to treat the anxiety, but therapist is saying that treating the ADD may also treat the anxiety. Her anxiety just seems way too severe for that, though.

 

[klmno]

Honestly, I'm losing faith in profs ability to diagnosis kids anymore. Too many times it goes back and forth and I hate those questionaires because it seems that most difficult child's would meet the criteria for no matter what the questionnaire was checking for. How does any parent answer questions like "has your child ever..." when they know it will be written up the same in a report whether the child did it one time 5 years ago or has done it 5 times in the past week. And for what? To get the same trial and error approach with medications no matter what diagnosis gets written down and which medication gets tried first. It's not that I don't understand the profs difficult position, but as psychiatrist told me once, learning to understand how a brain functions doesn't mean he has a microscope and can look in difficult child's brain to know for sure what is going on in there.

 

[AnnieO]

The forms that we have had to fill out have answer parts like, has your child ever... and then the answers are, never, once or twice, occasionally, often.

What worries me most about them is that if I follow the forms truthfully, I'm seeing textbook issues in Onyxx and a few small ones in Jett. But he is the one who was medicated before. And I am not a doctor, so of course I am seen as overreacting.

From what I understand, a lot of children with ADD have anxiety issues; and a lot of children with anxiety issues are mis-diagnosis'd as ADD. So... FWIW, seems it could go either way.

HUGS. Lots of them.

 

[flutterby]

She did only want information as it pertains to right now, not 5 years ago.

I called my mom crying. I don't know what to do, what to think, where to go....

 

[julie]

I am so sorry, maybe you could find out what the phone call was all about.Hang in there and listen to your gut.It sometimes is so difficult to sift thru all the info given to make some sort of decesion.How bout a 2nd opinion. My son had adhd/anxiety is on Concerta 27mg and buspar for anxiety seems to be helping.Take a bath and try to get some peaceful sleep

 

[Wiped Out]

Hugs, the diagnosis rollercoaster is so difficult.

 

[flutterby]

I keep thinking that the neuropsychologist evaluation stated anxiety, not ADD. At that time, it wouldn't have been ADD, it would have been ADHD - extremely hyperactive. But, that was over 3 years ago. therapist said the MMPI (I think that's the abbreviation) personality test thingy is to be redone every 6 months, so how often do you need to redo a neuropsychologist evaluation?

therapist said she's also going to get difficult child's IQ from the school psychiatric as it wasn't provided to me, and if he doesn't have it she'll do that test. Another tool to use for the IEP as her grades do not match her ability. Not even close.

I just keep feeling like I can't take one more thing, yet one more thing keeps happening.

In the meantime, regardless of the diagnosis today, she is falling apart and no one seems to have any answers on what to do to help her. We've been doing this too many years to have something new thrown at us and to have a child falling apart yet again, and I don't k now what to do.

 

[smallworld]

With all due respect to therapist, kids with ADD don't panic and catastrophize until the wee hours of the morning. Taking Adderall will only exacerbate her anxiety and not help her sleep one iota.

by the way, neuropsychologist evaluations should be updated every 3 years.

 

[flutterby]

I don't like the idea of Adderal at all. Or any stimulant for that matter.

Given that I have a serious lack of confidence in the ADD diagnosis and the confusion it brings, I'm going to look into getting another neuropsychologist evaluation. Have to figure out if the insurance will cover it, or MR/daughter, or the SD, or what.

Does Strattera help with anxiety/panic? I'm just thinking about covering all the bases until we get this ironed out.

 

[smallworld]

In the psychopharm book I checked, Strattera is said to help with depression (as well as attention span and concentration). It didn't mention anxiety. It is only effective in 40 percent of AD(H)D cases. Side effects include anxiety, agitation, aggression and irritability.

 

[flutterby]

So that's a no-go. Thanks, SW.

I really hope the psychiatrist helps us figure this out. At least for the short term, while we redo the neuropsychologist evaluation.

 

[flutterby]

Well, I found this:

In two post-marketing, double-blind, placebo-controlled trials, it has been demonstrated that treating patients with ADHD and comorbid anxiety disorders with STRATTERA does not worsen their anxiety.

I'm still researching. I'm just trying to find something that covers both bases. And I really don't want difficult child to even trial a stimulant.

 

[smallworld]

Then Strattera might be a better choice than a stimulant because stims often exacerbate co-morbid anxiety. Unfotunately, Strattera doesn't kick in for 3 to 6 weeks. And one side effect can be stomachaches (but don't tell difficult child).

 

[flutterby]

I wouldn't tell her, trust me.

She still, after all this time, does not equate her stomachaches/pain to her anxiety. When I was telling the therapist how much school difficult child had missed because of her anxiety in recent weeks, difficult child interrupted me and said it was because she was sick. Completely dismissing the night after night, and day after day of obsessing, catastrophizing, and completely shutting down. She did the same thing with the GP. GP even commented on it after difficult child left the room. It makes me wonder how aware she is when she is in that state.

She also does not address her anxiety with the therapist. And difficult child never wants me to go in with her. I took her to my appointment today so that we could address it, but then got sidetracked for the rest of the hour on the ADD questionnaire. I wonder if she isn't aware when she's not in the episode of how intense it is, or if it's too much to talk about, or if it's just that she wants so much to be 'normal' that she refuses to discuss it. She is, however, willing to talk about it with me and PCA. I don't understand it.

 

[flutterby]

by the way, what are the typical PRN's for adolescents with panic disorder? I think that is something we need to look into, as well.

 

[gcvmom]

difficult child 1 was given Ativan PRN for his anxiety -- he only had to take it for the panic attacks he had associated with blood draws. And honestly, after the first 3 or 4 times he took it, he decided he didn't want it at all because he didn't like feeling loopy. It DID help the anxiety of that situation a LOT. And if he hadn't tried it and gotten through the experience whole, he probably wouldn't have had the confidence to say that he could do without, Know what I mean?? We also used some guided imagery therapy about a half dozen times -- learning those skills helped a lot, too.

 

[DammitJanet]

They now make a long acting xanax or one of those. Im not sure which one but I know its an extended release. I saw it on a stand up poster in the psychiatrist waiting room. Never used them.

They also have a klonopin melt tab which is fast acting. I used to use those. I liked the melt tabs for bad anxiety that came on suddenly...like omg there is a major bridge coming up in 10 miles and I have to cross it!