Thursday, October 25, 2007

And the Doctor Said

First, let me thank those of you who commented on yesterday's post. I think if I hear enough voices telling me not to feel guilty, then I may just believe it one day. I'm going to skip over the talk I had with H last night because it will upset me again. Needless to say, she was upset, afraid, and confused. She explained how she doesn't want anything "to be wrong with her," but she understands that we're going to figure out a way to make things better for her. The language she uses is "to help keep me from going to La La Land," a phrase her teachers have used.

At today's visit with H's pediatrician, we learned several things:

- all signs point toward her having ADHD - Inattentive Dominant

- girls are more likely to have this type, and they usually go undiagnosed because they're not disturbing anyone. Rather, they sit quietly at their desks, concentrating on something else, playing with a toy in their lap, etc. Because they aren't bouncing off the walls, the teacher doesn't always notice a problem

- comparatively speaking (b/c of the above), we are catching this early in H

- in our doctor's experience, medication is the most effective treatment, though he also recommends other coping skills (for example, instead of telling H to clean her room, I will now ask her to do one thing at a time, like picking up her shoes. Then, I can start her on a new task.)

- the psychologist's testing process will take about two hours, and the results will then be sent to our doctor, who will consult with us about the results and discuss treatment options

- there are two types of medication: stimulant and non-stimulant. Regardless of which one she may use, chances are high that she'll be on the medication until she's out of high school

- whatever prescription option we choose, our doctor will absolutely begin with the lowest dose possible

I feel like I have a bit more focus on this today, but my main concern remains on H and how she will cope with what she sees as a "problem" with her brain. Of course, I'm also worried about the possible side effects of any medication, especially after all the horror stories I've read about kids being turned into Ritalin zombies. The doctor gave us some pamphlets and other material to read through, so I'll tackle that tonight while she's in dance class...

Which makes me think: do I now need to tell her dance instructor about this? Will all of her teachers need to know? What about the parents of her friends when she has a sleepover? I get the impression she's embarrassed, and I don't know how to get her to understand this in terms of quality of life and health, as opposed to normal/abnormal, right/wrong. I'm really overwhelmed by this all, so I'm hoping my husband and I can have some evening time to ourselves tomorrow to unwind and talk about this together. On the other hand, I just want to hold H in my lap and hug her forever.


Psych Postdoc said...

Definitely be in touch with your daughter's school about this, if not the individual teachers. There are usually established procedures in case your daughter ever requires additional academic support.

As for telling friends' parents for sleepovers... there's probably no need. Strattera is generally administered in the morning, or stimulants 1-3x per day at various intervals. If your daughter ends up taking a stimulant, she won't want to take it at night UNLESS she really doesn't want to sleep!

One of the most important pieces of your daughter coping with this is how you and your family all deal with it. There's nothing *wrong* with her brain (and FYI... tread carefully here, because many folks in the ADD community find this notion very offensive!). It's just wired differently, and these differences make some things harder and some things easier and richer.

It sounds like you're still overwhelmed, but you mind find some peace of mind by learning more about the disorder & its treatment from high-quality sources (e.g., the book Driven to Distraction, for starters). There are good internet-based resources out there; feel free to contact me if you'd like more information.

Speaking as a developmental psychologist who has ADD (inattentive)... relax, and know that the earlier you start addressing the problem, the better off your daughter will be in the long run.

Psych Postdoc said...

P.S. The 'ritalin zombies' thing shouldn't be a problem provided the dosing is titrated properly. Stimulants are very safe when used as directed. There are long-term concerns for children's growth, but these risks can be minimized (e.g., by not taking the medication on the weekends or during school holidays).

In my own experience, ritalin is far, far more effective than Strattera, and has many fewer side effects.

mgm said...

I hope there's a sense of relief knowing that there's something that can be done to help H cope with the different way her mind works. Psych is right that there isn't anything "wrong" with her and this isn't about finding something wrong.

It's going to take some time for all of you to adapt to this. It is definitely better to catch this now. It wouldn't be as easy if she were 13 or 14 and dealing with all the trials and tribulations of adolescence along with learning to manage meds and whatnot.

I wish you all the best in learning how to manage H's ADD.

mom said...

Wow - psych is the right commenter at the right time - no? I was really interested in that response, even though I am not dealing with this (yet).

Glad you are getting help from a good, supportive doc - so nice to be given info instead of just handed a scrip.

This is a step toward good things. Hang in!

AcadeMama said...

Psych - Thank you for the tips, especially on the book. The dr. gave us a very helpful brochure, but I need more than that. Since her teachers are the ones who speculated this might be the issue, I presume they've taught children with ADHD before and that they're familiar with some of the coping skills our doctor recommended. We'll be working & conferencing with them closely, though, just to make sure things improve.

mom & mgm - Thank you for the good wishes! And MGM, you're so right about the teenage years. The information I've read suggests that diagnoses is very difficult between 12-17, and that treatment sometimes has to be adjusted to address co-existing conditions that may develop such as depression or anxiety.

Psych Postdoc said...

You're welcome! I hope the book is helpful as you, your daughter, and family go down this path.

Not to plug my blog or anything, but it's about my experiences as an academic with ADD. It's pretty focused on the job search at the moment, but there are some tips in there that might be helpful down the road.

Best of luck!