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Old 09-27-2008, 11:20 AM   #1
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ADD or ADHD - Have teen with extreme anger issues, new to this need advice?

I have a 17 yr. old son who may have ADD or ADHD, we have him consulting a psychologist who is working on diagnosing him.

I'm new to this and I guess at times a little "old school" when it comes to understanding it. I look at the symptoms such as "procrastination, disorganization, difficulty sleeping, being fidgity, and difficulty concentrating" and I think, what teenager doesn't have some or most of this?

Of all the things that he may be displaying the overriding issue with us is his "anger". He is quick to anger, especially with me (I'm his father), he can anger over the smallest issues and of course larger issues. His anger is extremely explosive when it occurs and he seems to never get over it. His anger about various things just goes on forever, he'll get mad about something and be just as angry about it 6 weeks later as he was in the first 30 minutes. Several months ago I overheard him telling his girlfriend on the phone "that one minute I can be fine, even happy, then the next moment I can just snap over the smallest thing".

To compound the difficulty of our situation with him he broke his neck 8 months ago in a snowboarding accident. He appears to have made a good physical recovery but the accident seemed to serve as a flashpoint for his behavior. I believe that most or all of the issues that may indicate a possible ADD condition existed with him prior to the accident but were managable. It's as if things in his behavior, especially his anger have been magnified ten fold since his accident.

Needless to say I am so concerned about him and am lost as to what to do? We have gone from what I thought was a pretty good father and son relationship to where he just hates the site of me and refuses to even talk to me, this has been going on for months. Everything that is wrong in his life is my fault, I feel like I've become a punching bag for his frustrations.

I have read that anger and having a short fuse are common among ADD patients but has anyone shared this experience? What did you do? And does anyone have any thoughts on his injury and how it could relate to his behavior?

 
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Old 09-27-2008, 11:34 AM   #2
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Re: ADD or ADHD - Have teen with extreme anger issues, new to this need advice?

When he broke his neck I would guess he was on pain medications?...perhaps he develop an addiction at that time and have you drug tested him? All his symptoms also could suggest drug use.

 
Old 09-27-2008, 01:32 PM   #3
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Re: ADD or ADHD - Have teen with extreme anger issues, new to this need advice?

Anne - Appreciate your response. I don't believe he has access to anything prescription related, he was actually very good at minimizing there usage during his recovery, so I don't think that is a problem. He is a heavy user of pot though and we have had several episodes of abusive usage of alcohol, he may use alcohol more than we are aware. Are these things indicative of his symptoms??

 
Old 09-27-2008, 11:35 PM   #4
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Re: ADD or ADHD - Have teen with extreme anger issues, new to this need advice?

Because ADHD involves (possibly severe) impulse control issues, a short fuse can be a symptom of ADHD. However, it sounds like it's unlikely that ADHD is alone responsible for your son's behaviour. The fact that his anger does not subside over time, along with the fact that his issues have worsened so considerably after his injury make me feel that there is more involved in what is going on with him. Because the 'short fuse' associated with ADHD is an impulse control problem, the anger is likely to recede rather quickly. Did your son sustain a head injury in addition to the neck?

All that said, there are many disorders that may mimic the symptoms of ADHD, and may be treated in the same way. My advice is keep working with the psychologist and see what the results are.

 
Old 09-28-2008, 08:22 AM   #5
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Re: ADD or ADHD - Have teen with extreme anger issues, new to this need advice?

Thunor - Although I find myself pretty lost with this whole ADD thing because of it's subjective nature and newness to me, I just don't know if were dealing with a pure anger management issue or ADD. I have been leaning in the direction of your observation though. I came upon some limited information on Oppositional Defiant Disorder (ODD) yesterday, my son is extremely defiant of authority and certainly has a dislike for rules. He is very argumentitive and will pursue disagreements to the end, he will sacrifice greatly to "win", winning is extremely important to him, coming out on top of disagreements is paramount in his eyes.

You know I see all this ADD, ODD, anger management and I find them difficult to sort out. I also look at the simple fact of this adolescent time period revolt that is common among kids combined with a serious injury recovery in a kid that is fueled by heavy pot usage and some undetermined alcohol usage level. I look at all of this and at times wonder if perhaps that is all it is? In AnnDs reply she felt his symptoms to be drug related, I wonder too? Going to ADD meds if he's not ADD does not sound productive? But the anger deal is very real and extreme with him, and as I said he just stays angry forever about thing's.

 
Old 09-28-2008, 09:12 AM   #6
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Re: ADD or ADHD - Have teen with extreme anger issues, new to this need advice?

Jr:

You havent' said much about what kind of parents he has. That might provide a clue.

What have you said to him about his partying?

It would be interesting to talk with him about why he is so angry. Have you asked him?

Have you asked him what you can do to better relate to him?

How do you react when he gets angry? Does he like the psychologist or even the idea of a psychologist.

What is his reaction to being told he might have ADD?

~S

 
Old 09-28-2008, 06:21 PM   #7
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Re: ADD or ADHD - Have teen with extreme anger issues, new to this need advice?

While your son may or may not suffer from ADHD, in my opinion (and keep in mind, I am not a mental health professional), the problems you describe are inconsistent with the symptoms of ADHD.

I would be very careful with the use of ADHD meds unless you've been convinced by your son's psychologist that he definately suffers from this disorder as most ADHD meds are stimulants from the Amphetamine line, and the possibility of abuse is very real. If you do decide to go with medication for ADHD, I would recommend keeping the meds yourself and rationing them out as directed, as your son does not need another way to get high (lets be clear, properly used ADHD meds are not dangerous and can make a very positive difference, it is only through abuse that they can be problematic).

Once again, I would recommend continuing on with the psychologist, as it's very unlikely that your son's issues will be simple to diagnose, or to treat. Remember, ADHD often presents in concert with other disorders, such as depression or ODD, as living life with undiagnosed ADHD can be very difficult and lead to feelings of anger, frustration and inadequacy.

 
Old 09-29-2008, 09:07 AM   #8
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Re: ADD or ADHD - Have teen with extreme anger issues, new to this need advice?

Thanks for your responses - Softcrush and Thunor -

Softcrush, you have asked some very good questions, will try to answer as best as possible in brief.

What kind of parents are we? Tough one but will try! We're a split family, our son is an only child spending (until recently) 50/50 time wise. Both very concerned and loving parents, I think were both very focused on his welfare.

He has not stayed with me or had any real communication for the last two months, he is very angry at me. I cannot explain his anger. The only matter of explanation I can come up with at this time for the state of our relationship is that I try hard to provide him with guidance, do occasionally try to institute some form of discipline for errant behavior (all pretty mild). I do insist that we maintain a dialogue, I try to talk with him about school, social things, future plans and try to get him to discuss problems he may be having - he HATES this. I feel that the biggest problem I have with him is, as I have mentioned he is extremely insistant on getting his way and prevailing in conflict, and he does win with me most of the time, but not all of the time! Those issues that he does not win are so hard for him to deal with.

As a typical example of recent conflict between us (and there have been many). His mother calls me and says he has a dentist appointment tomorrow afternoon. So I tell him that evening about it, he says OK, the next morning I go to his room to get his laundry and in passing I say, now remember your dentist appt. at 2 this afternoon, he says I know, I know Dad (a little irritated). At 1:15 he comes flying up the stairs and is on his way out the door telling me he's leaving with his girlfriend, and I say "hey now make sure you get to your dentist appt.". BOOM - he comes absolutely unglued, and this is just not for a few minutes either!

All I can really say about myself is I have tried hard to be a consistant parent with him, not perfect by any stretch and like most parents have probably made mistakes.

His mother is a softer person than I am and in my opinion, in most cases he seems to prevail over her, she cares very much for him and is a very loving and attentive mother.

The situation with our son, has had us both at witts end a lot of the time. She trys very hard but has (in my opinion) had a difficult time being consistant with him. In March, she stated that she felt she was his "safety net" and wanted to let him go his own way and act as his "Cheerleader", in May she said she was "at the end of her rope with this kid" and didn't know if he ever told her the truth about anything, when he got drunk and tore his car up she said he needed to "feel pain" for this and be responsible for his actions. Currently he stays with her and and now she says she is just trying to keep him safe, healthy and happy on a day to day basis. Last fall, in one of his rare moments my son had a very emotional conversation with me where he confided to me that he couldn't control his anger and he didn't like it and said that I was the only one who could "make it stop" (pretty heartbreaking to listen to). In that conversation, I asked him if he argued with his mother and he told me yes, more than I do with you. I asked what happens and he said, I just keep arguing until she lets me win. Now, when I try to discuss this with her she says he doesn't argue with her and she does not see any anger in him. His psychologist told me that my son has no concept of the value of money (my opinion for some time), when I mentioned what he said to her she took issue and said she believes he has a good concept of it's value.

A statement that he made to me says a lot. He told me that he hates staying and his moms house and he hates staying at my house but he prefers staying at his moms house because he doen't have to talk to anyone there. Go figure? Both homes are very good homes, he is treated well at both and lacks for nothing.

All I can say for both of us is that we both try, we may see things differently but we both have the same goals for our son and try to be good parents??

Have we talked to him about his partying? All the time, has been a source of considerable conflict.

Have I talked to him about what he is angry about? I've tried, he is not very open and says he likes to deal with his problems on his own. When he provides answers I can't tell if they are the real issues or what? It seems that everything is so petty and it leaves you thinking, there have got to be deeper issues.

Have you asked him what you can do to relate better to him? Yes and No. This has probably been a failed point from my end, I have not made a good enough attempt to this end.

How do I react when he gets angry? There have been times I have reacted with anger in return (this has gotten ugly), but mostly and more frequently I have reacted with patience and tried to reason with him, this has been ineffective. More often than not when he gets angry with me it's not just anger, it goes into rage and it just seems impossible to deal with.

Does he like his psychologist? I think so. To my sons credit he has agreed to go to him and has acknowledged his anger problems.

What is his reaction to being told he might have ADD? He was the one who oringinally thought he may have ADD, he does not seem uncomfortable and has spoke to the fact to me that he's thought a low level dose of medication might help him. I think he is dealing with a very difficult situation for him and is in his own confined way screaming out for help. We as parents want so much to help him, we just don't know what's wrong and do not want to make the mistakes asscociated with mis - diagnoses.

Thunor - I appreciate your comments, they are pointed and well thought out. I believe I mentioned reading recently about ODD. I have an appointment with his psychologist today and intend on discussing all of this with him and addressing whether his symptoms are truely syptomatic of ADD.

 
Old 09-30-2008, 04:13 AM   #9
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Re: ADD or ADHD - Have teen with extreme anger issues, new to this need advice?

jr2212,

I think you are right to trust your instincts that there is something more going on here than a teenager having hormonal problems. Most teenagers go through a period of trying to act out against authority while they're trying to figure out how to change from being children to being adults. But I don't think that's what's happening here. If it were just a matter of a defiant teenager and weak parents, then a bit of family counseling can help both kid and parents to learn to communicate in a more constructive manner.

As our wise and thoughtful Thunor says, this doesn't sound like just ADD symptoms. It's possible that your son has residual physical problems from his accident, such as brain damage or damage to some other organs that make it difficult for him to control his rage.

It may be that he needs further physical testing, such as an MRI or hormonal testing, in addition to the psychiatric help that he is getting.

You are a good and caring father -- you want your son to be a success in life, and you are concerned that something is hindering that process.

I hope that you are able to track down what the problem is.

--Rheanna

 
Old 10-02-2008, 10:37 AM   #10
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Re: ADD or ADHD - Have teen with extreme anger issues, new to this need advice?

Really appreciate everyones thoughts and advice.

Had an appt. with my sons psychologist this week. Wish I had better news. He said he doesn't really believe that my son does not want me in his life. As he explained it, he said people who have long fuses to anger get time to consider their decisions and actions prior to doing them. He said my son has a very short fuse and consequently makes many decisions based more on impulse rather than rational thought. He says that in relation to me, my son more or less has himself cornored, he's made a decision based on impulsive anger at me and has drawn a line in the sand, although his psychologist doesn't believe this is what he wants, he says that my son does not have the ability to cross back over that line. He did say that he would guarantee that my son would come back to me, he couldn't say how long, he said it could be six weeks or it could be as long as till he finishes college (five years or more). Not very good news for a dad who treasures his son and really likes being a father. Have always looked forward to the day my son would go to college, and to think of not being to share this with him or let alone be welcome at his HS graduation is pretty tough. Feel like I'll be the one needing the therapy before this is over.

As far as diagnosing my son, he isn't sure that he has ADD. I talked with him about ODD and he thinks that is possible but wants to spend more time with him and do testing on him.

I will be contacting his neurosurgon to talk to him about his injury. I don't know where this may go, when you have injuries involving the spinal chord I would think that anything could be possible.

Once again, thanks for everyones insight and support.

 
Old 10-02-2008, 02:57 PM   #11
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Re: ADD or ADHD - Have teen with extreme anger issues, new to this need advice?

You have gotten alot of GREAT advice here. One thing I would like to recommend your looking into is the possibility of you son having signs of Bipolar Disorder.

I have one daughter (17) who has BP/ADD and another (20) with ADD/Mood Disorder. Like you have described here, as parents we saw big changes in them once they reached prepubescence around 13 or so. In elementary school they did have problems with organization skills and also inattentiveness but were both honor students so it wasn't anything their teachers or we were concerned with.

Our older daughter became quite argumentative, didn't like our rules or being told what to do without that setting her off, she was angry and things escalated to the point that she began using alcohol and then kicking her dad where it counts when she lipped off at him one day. Eventually she moved in with a neighbor for a few weeks and at that time we discovered that she was using Stackers with Ephedra to keep up with school and a job. She was 14 at the time. Things worstened and she was increasingly angry and argumentative and eventually moved in with my brother, her godfather. Demogaphics didn't make a difference for after the honeymoon period she started getting into more trouble and making stupid impulsive decisions that ended up having her suspended from HS just weeks before graduation and her first choice college not accepting her after learning of her suspension.

Younger daughter was quite irritable and also defiant......unlike her sister she had obvious depression with a suicide attempt after some problems with friends. She was a totally different kid and for 7 months we tried to get to the bottom of it. She was hospitalized 3 times and had and arrest for shoplifting....ends up that she had been having an induced mania from the antidepressants they put her on (SSRI's). She was then diagnosed with BP and treated with meds with great improvement. Within a week of her being on her first med we saw significant improvement in her agitation and irritablity. And after 7 months of finding the right meds we had our daughter back.

We then realized that something had to be done with our older daughter. She had already completed her first year of college but in the summer following it her behavior worsened....the lies were unbelievable and she would do some impulsive things that had us fearing that she would either be incarcerated, in a rehab unit, hurting herself or perhaps somebody else or even dead. We knew that we had to do something and worked more aggressively to do so. We had read about Dr. AMEN who did extensive diagnostic testing, the same that all board certified psychiatrists do and also uses SPECT Imaging to further pinpoint a diagnosis and specific treatment plan.

My husband and I KNEW that there was definitely something going on with her but it was different than our younger daughter. She didn't show the obvious depression that our younger daughter did but did have the anger and irritability issues as well as destructive behavior in terms of impulsiveness.

If you are leaning towards ADD, Dr. AMEN has had a great success in treating ADD because he found that there were 6 different types of ADD each requiring a specific treatment plan. He claimed that too often people treated ADD with the same conventional ADD meds but with little improvement. And that if the type of ADD were identified that there was more success in which type of treatment would yield the greatest success. He not only treats and diagnoses ADD but many other problem in the brain such as injury, drug abuse, alzheimers, Parkinsons, and so many others.

We brought our daughter to one of his clinics....it was a trip and wasn't covered by our insurance but the way we looked at it the cost would be far less than if we went on without getting the help that our daughter needed.

Ends up she had a type 6 ADD otherwise referred to as the RIng of Fire along with a Mood Disorder. What was most impressive is that he utilized a far more indepth psychiatric evaluation and testing than we had seen with our younger daughter AND the scan provided a visual much like an Xray which allowed our daughter to see how he had come to the conclusions that he had in diagnosing the ADD. Her entire circumference of the brain was ignited and overactive as well as the mood centers. She didn't show a true BP with her testing because she never had a cycle of depression and mania which often presents in the form of irritability in adolescents rather than the high that most attribute mania with.

So being that her mood center was involved and she had BP tendencies DR. Amen found that treating the ADD with a mood stabilizer first and then seeing what symptoms remained would be the plan of action. He said that if she still had that "being stuck" mode in which it was her way of thinking and nobody elses that a conventional ADD med added in would help. And that is exactly what we did and the improvement we have seen is unbelievable.

ADD and BP have very similar symptoms which leaves room for diagnostic errors. Many times the two disorders run comorbidly with a dual diagnosis. And many times if either is left untreated many will turn to drugs and alcohol as a form of self medcation which was clearly the situation with our older daughter. She is in college and still parties but after she was diagnosed and treated she admitted that she didn't go out everynight to drink or party and no longer feels the need to.

The feeling of having these two girls untreated was of always walking on eggshells, of encountering them in what I would call "viper mode" in which they would strike at anytime, of lashing out "verbal vomit" that hurt to the core, and of being the masters of manipulation of running you down until they got their way.

NOw that they are treated I can reason with them, there is no more wearing me down, when I say no it's okay, no more screaming or dreading who was going to walk in the door. Instead I have a high school senior who is smiling, working a job, applying for colleges, taking 5 college level courses and has a wonderful boyfriend. The oldest is on the Dean's List in her Junior year of college, is working a part time job, is a delight to talk to on the phone often checking in with us to see how we are rather than calling to ask for something unreasonable and screaming and hanging up when she doesn't get it. It is so nice to finally be dealing with the normal teenage behavior which is surely a piece of cake compared to what we were dealing with before we got down to the bottom of things.

I apologize for the length of the post....I just remember the desperation I had to find out how to help my daughters and the only regret that I have is not having gotten to the bottom of it sooner. We lost about 3-4 years and so did our daughters to these disorders. But from what I hear the average is often 10 or more years so I guess we did okay.

Keep forging ahead and in my opinion I would go to a board certified psychiatrist that specifically deals with adolescents to figure this all out.

Keep posting and asking questions....a parent's intuition is usually right on.

Good luck and keep us posted.

~ IG

 
Old 10-04-2008, 10:27 AM   #12
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Re: ADD or ADHD - Have teen with extreme anger issues, new to this need advice?

Wow Ivorygirl - Thanks for taking the time to reply, your post was very informative. Have been reading about SPEC scans and Dr. Amens program, all very interesting. My sons psychologist is going to test him. I think a scan to serve as a secondary opinion would be very useful.

Was particularly glad to hear a story of such success with your daughters. With all the fear of mis-diagnoses and inappropriate drug treatment it was great to hear of someone who got it right. Congratulations on having your daughters back, hopefully I can get my son back too.

 
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