ADHD and depression

[forkeeps251]

So lately my 7 yo difficult child has resorted to banging his head against any desk/wall/surface when he is in trouble or frustrated, and has been saying stuff such as "everyone hates me", "everyone wants me dead", "i should just kill myself", etc. Obviously this is heartbreaking and scary for me to hear, but according to his psychiatrist and therapist, it isn't that much of an unexpected progression. He has been put on 5 mg of Prozac, in addition to his 15 mg of Focalin XR and 2 mg of Intuniv. The prozac was started AFTER the head banging started.

I was worried at first about giving him an anti depressant, and I'm hopeful that some day it won't be necessary, maybe when he catches up in school or when we finally get his ADHD under control. For the first time we seem to have hit a dosage that might actually be working... on Sunday we got home after a weekend of camping and difficult child went to his room and played with his lego's for about six hours!

Also, I ran across a "video interview" I did with difficult child when he was four... I wish I could share it with you guys... and it has me realizing just how BAD his speech impairment was at that age. I don't think I realized it at the time. It has me wondering though when his doctors will consider doing another evaluation. Right now his diagnosis is ADHD, anxiety not otherwise specified, depression, and speech delays... and in his evaluation it was written that he does have some indicators that he could be on the autism spectrum but at this time they are going with the more conservative diagnosis. That was over a year ago and he still has so many problems and struggles, it seems as though we are just now beginning to make some progress. He is finally learning to read (almost done with 1st grade), but still has so far to go.

Oh, one other thing... difficult child started counseling and the thing that the therapist recommended was for him to take a deep breath and count in tens or fives. I'm hoping she has some more suggestions that this... we've been telling him that for the past year and a half!!

So, thanks for listening to my rambling... anyone have an ideas about the depression that difficult child seems to be going through?

 

[InsaneCdn]

My experience?
If you have ADHD plus anxiety or depression... then you don't have ADHD.
You either have ADHD plus other significant (but missing) dxes,
or... you have something else... such as Autism Spectrum Disorders (ASD) (for example)

In the ADHD-plus category, some of the missing dxes include things like:
- Developmental Coordination Disorder (DCD) (half of the kids with ADHD also have Developmental Coordination Disorder (DCD) - developmental coordination disorder, in fine or gross motor skills or both)
- many kids with ADHD have learning disabilities
- 70% of kids with ADHD plus a Learning Disability (LD)... also have an Auditory Processing Disorders (APD) - and there are at least five variations of this. APDs are not usually tested for until at least age 7, due to the complexity of the tests and of the communication required.

Kids with "just" ADHD/ADD... don't tend to end up with secondary dxes like anxiety or depression. I have one kid like that. Major focus issues without ADHD medications... otherwise, a pretty typical kid.

difficult child started with an ADHD diagnosis.
Ended up with anxiety diagnosis, then depresison diagnosis... and a very long road, before we finally got to the point of uncovering the missing dxes, and... dealing with THOSE is what made a major impact on the anxiety and depression. And yes, the anxiety and depression started YOUNG.

If he's actually Autism Spectrum Disorders (ASD), then the whole approach to parenting is significantly different. Autism Spectrum Disorders (ASD) kids are wired differently, think differently, and some intuitively know they are different... and fight against it but can't come up with the 'formula' that will make them like the "others"... which is part of the source of the depression.

Has he ever had a comprehensive evaluation?

 

[BusynMember]

I'm obviously not a doctor. I do have an Autism Spectrum Disorders (ASD) son and am in a large parent group where I see Autism Spectrum Disorders (ASD) kids all the time. ADHD is the usual first diagnosis. for our kids. So take my response for what it is...an opinion. From your description of him, it sounds like Autism Spectrum Disorders (ASD), not ADHD/depression. I'd take him to a neuropsychologist for a fresh evaluation. Autism Spectrum Disorders (ASD) is not treated with just medication like ADHD is and an early start on interventions id mandatory for a good prognosis.

Get a complete evaluation. Whatever is being done now isn't working. The poor thing is miserable and both of you need and deserve to know what is really going on and how to help him. There is no up side to a conservative diagnosis. It just delays badly needed supports and help and punts it to a later age when it is no longer possible to call it ADHD. Please...take him for a neuropsychologist evaluation. And while you wait for your appointment. to come up, it is always helpful to see an Occupational Therapist (OT) and PT as well. Autism Spectrum Disorders (ASD) kids DO improve in speech and may catch up in school, some only for a while, but they continue to face serious challenges and sometimes learning problems the older they get, such as meltdowns (some), inability to transition, inability to understand how to make and keep friends, there is a long list and, sadly, I saw it. The interventions we got were priceless and made all the difference for my son. He doesn't even need or take medications now and as a young adult he can hold it together easily, something we weren't sure would ever happen. He has friends. He has a job. He is happy and calm. This would never have happened if we had kept treating him for only ADHD and ODD, his first two diagnoses. Regular therapy and parenting doesn't seem to work well with our differently wired kids, regardless of their diagnosis.

Gentle hugs.