Need helpful advice before son's medication review


I have a telephonic appointment with the psychiatrist tomorrow morning to review my concerns about Son12. I'm frustrated because we have asked the Residential Treatment Center (RTC) staff for 2 months to let us know when the next medication review is scheduled. We kept getting told the doctor makes the schedule then advises the Residential Treatment Center (RTC), but that when the schedule is made, we will be notified. However Friday during our CFT, we were told the doctor notified the Residential Treatment Center (RTC) of the appointment the same day as the appointment. The Residential Treatment Center (RTC) staff said the psychiatrist was informed we wanted to be included, but he decided since the Residential Treatment Center (RTC) staff were not requesting any medication changes, we didn't need to be involved in the brief appointment.

We keep running into this type of behavior related to the care of our boys because 99% of the kids in our situation will never return to their parents and are in foster care, either because the parents were abusive /neglectful or because the parents / family don't want the kids back. That isn't our situation. So we informed the Residential Treatment Center (RTC) staff that the psychiatrist doesn't have the right to make the decision to exclude us and as their legal guardians and parents, we demanded another appointment.

We are being granted 15 minutes and I'm concerned that with the fuss that's been made, either the psychiatrist won't be open minded, OR I will be too brain fogged (as I am right now) to effectively communicate the issue. I wanted to do research and present him with facts, but the appointment was sprung on me a couple hours ago, and I haven't been successful in finding on-line the facts I believe will illustrate my point of view. SOOOOO I'm hoping one or more of you will be able to help.

The school psychologist recently told me that depression in kids presents as behavior issues rather than overall sadness like it does in adults. That made me think that Son12 might be experiencing a high level of anxiety. He is diagnosed ODD, ADHD, and Reactive Attachment Disorder (RAD). Even though he can stare right through you when you are talking directly at him, he does take what you say and follows through with it for a brief period of time. For example, he has not been doing his treatment work. When we can get him to talk to us honestly, he says he isn't doing it because he is playing with the other kids. He always worries he will miss out on something if he isn't with everyone else. Does he want to come home- YES. Does he know he can't come home unless he completes his therapy- YES. Does he do his therapy - no because it's too painful.

I don't know if I can express all the reasons I think it's anxiety, but even though he isn't diagnosed with Obsessive Compulsive Disorder (OCD) (psychiatrist said he has tendencies, but doesn't want to diagnose it because it could be PTSD), he does a lot of things that are ritualistic. For example: To go to the bathroom, he has to flip the light switch off and on multiple times before entering the room. Once in the bathroom, he has to lock and unlock the door multiple times before using the facility. When he's finished, he has to open the door before he can flush. At the Residential Treatment Center (RTC), he had a bedroom with a private bathroom. He was proud of it for a couple days, but eventually, the bathroom began to freak him out and they had to move him to a room without a bathroom.

On top of it all, when he was tested by the neuropsychologist, we were told he is very smart, but has a very slow processing speed and even slower working memory. So, to me that would be a reason for him to hate to write, especially if he has to identify and admit to painful memories and thinking patterns. In my opinion, by the time he gets ready to write, the other kids are done with their treatment work and homework and ready for leisure time, so he gives up and does the leisure activities.

I would like the doctor to put him on some kind of anti-anxiety medication to see if it helps with his control issues and lack of perceived effort in treatment.

Does it sound like I am making excuses or being reasonable? If it's reasonable, does anyone have any experience or know where to point me on the internet for information about different manifestations of anxiety?

Thanks for your help.


Well-Known Member
Does it sound like I am making excuses or being reasonable? If it's reasonable, does anyone have any experience or know where to point me on the internet for information about different manifestations of anxiety?
Well... I think you're a bit between a rock and a hard place. Reactive Attachment Disorder (RAD) sort of overrides most other dxes. As I'm not as familiar with that particular diagnosis (i.e. not dealing with that one myself), I don't know what other co-morbid things are likely. But if we put that aside for the moment...

I can tell you that there could be a whole long list of reasons why your son is anxious, and they may not be related to Reactive Attachment Disorder (RAD).

I think you're right on when you say he takes so much longer to do his "work" that the others are done long before he is, and he gives up. It might be appropriate for some accommodations? Especially if part of this is school-related home work - where accommodations would be expected. (less volume of writing, fewer exercises on a math sheet, etc.) Not being able to keep up with the others is a cause of anxiety. been there done that with mine.

If he hates to write, does he have any fine motor skills issues? like handling buttons, tying shoes? Motor skills challenges can be another source of anxiety. Kids tend to exclude anyone who can't "keep up" with the pace of play or the "normal" activities. Social exclusion also generates anxiety, no matter what the cause. (hating to write can also be a clue that he may have dysgraphia)

The school psychologist recently told me that depression in kids presents as behavior issues rather than overall sadness like it does in adults.
There is a lot of research out there into depression in males - any age. For a long time, depression was thought to be more common in females. Turns out, it can present symptoms that are very different between males and females. In particular, depression in a male can come out as anger or other negative behaviors. Try searching for "male depression and anger" on the net.


Well-Known Member
I don't think you are stretching or reaching at all. These children are very complicated. As InsaneCdn said, Reactive Attachment Disorder (RAD) does sort of override all others because of it's complexity. I think the anxiety sounds reasonable given your son's actions.

The first symptom that manifested in my son's depression was anger. That's a really common sign in boys.

There is a learning issue called dysgraphia. It affects the physical ability to write. This was a major issue for my son in his earlier elementary years. He was given accommodations through school like the use of a scribe, the ability to use a computer in the classroom, use of a pencil instead of a pen, oral review rather than written, etc. These accoms varied depending on his age. Overtime he was able to "work around" his disability and it often gets better with age.

It's a shame that you don't have more time to prepare. It used to take me weeks to prepare for IEP reviews and such. Here's a few links that might help you on the anxiety issues: and

If you are looking for more specifics in regards to dealing with these his issues in social settings, like school, check into (this was my go to during my son's school years - a plethora of great information!)

Also, the wrights law site; they have a lot of information on modifications and accommodations as well as great links and resources.

Keep us posted.



Well-Known Member
I think sometimes we think medications are the answer to a lot of stuff that can't be helped. I take medications. I had depression as a kid and Learning Disability (LD) problems.

While medications, and only if the medication jives with the person, can help depression, it can't make anyone less Learning Disability (LD).

If the problem is Reactive Attachment Disorder (RAD), there is really no medication for that. The kids are damaged because of the hello they went through in their early years and above and it's too intense and complicated for medications to change. This is more a therapeutic issue. My experience with RTCs and foster kids has been very negative. I did not find the kids to be getting better. Yes, some did better just so that they could come home, but then they just went back to it once they got home. The attachment disorder and PTSD, which is a part of attachment disorder, both need to be addressed or the medications are a band-aid and will not fix much. Being on high alert/anxiety is a part of Reactive Attachment Disorder (RAD) because Reactive Attachment Disorder (RAD) kids are abused or neglected kids, usually both. But the cause of their anxiety is not just biological anxiety disorder...real, horrible things happened to them. They may not have had anxiety without those things having happened. That also needs therapy. Just food for thought, no answers here.

On the handwriting bit, they don't even teach it any more around here. I was alarmed when I heard this, but it's true. Cursive is gone. School is going to be computerized and so will the workforce by the time our younger kids get there. It's actually almost like that now. My son, who is on the autism spectrum, can print neatly, but he can't write. It's something about his learning processes or eye/hand doesn't matter. Even working at a restaurant, everything is on computer. His Autism Spectrum Disorders (ASD) rigid thought processes have held him back, but not his lack of handwriting.

If your kids have been drug/alcohol exposed by bio. mom, I'd be cautious about using any controlled substances, even for ADHD. We did try Sonic on ADHD medications and he flipped out on all of them. Knowing what I do now, which Princess having told me how much those drugs are abused on the streets, I would never have tried him on ADHD medications. He had enough drugs in him before he was born. I think our drug exposed children respond differently to medications than those who have had a better start in life. I think it's sad too, but your kids are in a good place now...with you! My son is doing very well as a young adult and I am confident your kids will do as well as they can since they have you in their corner.

Anyhow...wish I had answers for you, but all I can tell you is what I'd do if I were you and you can take what you like, if anything, and leave the rest.


Thank you InsaneCdn, LittleDudesMom, and MidwestMom. Your responses were all helpful to me. I need to take my youngest to the medical doctor right now- acid reflux- probably as a result of anxiety? She didn't fall asleep until 4am. I wonder why I'm in a brain fog :yawn:

I will post more after I talk to psychiatrist.


Well-Known Member
Mominator-I hope everything works out for your son12, as well as your youngest. I know about acid reflux poor thing! Wishing you all the best!


Sorry everyone for not posting yesterday. Sometimes I feel like those little cars that kids rev up by pulling them backwards repeatedly on the floor before letting them go. Except that sometimes I rev myself up so much that when I stop, I'm stopped for the entire day. That's what happened yesterday and most of today.:halfdead:

So, the results of my appointments:

The medical doctor appointment went well. We're going to try her on some medication. She went back to school today after being home for 2 days and seems to be in good spirits.

AND the phone call with the psychiatrist went extremely well also. I briefly and concisely presented my logic and description to the psychiatrist and he said it makes perfect sense to him, so Son12 is going to be put on Lexapro to see if it will calm some of the anxiety and help Son12 participate in and benefit more from therapy. Also got to talk to the psychiatrist about not being present at the last medication review. Don't know what the Residential Treatment Center (RTC) staff are talking about because the psychiatrist said a notification is sent out a month in advance of the appointment, and now I will be included in the email distribution. He also said he has no trouble with me being present for the reviews and that what we were told was wrong and would be looked into. He seemed genuinely sincere, so I believe him.

Thank you to everyone for your support.:grouphugg:


Active Member
I'm glad the medical appointment and the phone call with the psychiatrist went well. I hope the Lexapro works for him and helps to alleviate some of his anxiety.