If you’ve read my blog for some time, you know The
Princess is going through, and dealing with, a LOT of trauma stuff these
days. She is diagnosed with PTSD
(post-traumatic stress disorder), anxiety, attachment issues, and ADHD
(Attention Deficit/Hyperactivity Disorder) – emphasis on the H! It’s never dull around here, and I am quite
literally EXHAUSTED from it all. Lately,
my patience is so thin, and my therapeutic parenting tool box is so scattered
about my brain, that when I need one of those therapeutic tools, I really have to root around my head to find it.
This is especially true when we’re out in public.
Last night at Applebees, The Princess was as animated as a
3-year-old on steroids that were washed down with a 2-liter bottle of Mountain Dew. She was like that going into the
restaurant. She was like that all
through the meal. She was like that when
we left, as she bounced backwards into two people coming into the restaurant while we were going out. She was like that when she ran out into the parking lot, in the dark, in front
of a car driving way too fast for a restaurant parking lot. (Thankfully, Hubby grabbed her.) She was also like that as we were getting
into the car -- until I yelled at her, “I. have. had.
E-NOUGH!” (No, this is not a therapeutic parenting
technique.) Strangely, I think it
shocked her because she stopped, doe-eyed in her tracks. Still, the shock broke the craziness and she
was (mostly) quiet on the ride home.
I’m sure most people who witnessed The Princess’ behavior
last night would have either agreed with her ADHD diagnosis or thought we were “those
kind” of parents -- the ones who allow their children to behave poorly. (For the record, I am not one of “those”
parents. I am a “mean mommy,” and I am proud
of it.) The thing is, when it comes to
that ADHD diagnosis, I’m not so sure all the craziness The Princess
displays in public is due to hyperactivity as much as it’s due to hypervigilance.
The next time we go out (and it won’t be any time soon), I
will spend some time preparing The Princess for our family time. She needs to be reminded she’s safe. She needs to be reminded she’s a big
girl. She even needs to be reminded that
she will be protected and not abandoned.
We will take care of her.
ADHD is the most commonly diagnosed disorder in adopted
children. Articles I’ve read suggest children diagnosed with ADHD often have a biological parent (usually the
father) with ADHD. Research suggests environmental factors also play a significant part, including prenatal
exposure to alcohol and drugs, a mother’s smoking while pregnant, and low birth
weight. Lead poisoning also seems to
play a role in a great number of children diagnosed with ADHD. Kids coming from orphanage backgrounds, like
my kids, are even more likely to be diagnosed with ADHD.
However, I’ve also read some adopted, hurt kids
diagnosed with ADHD may actually be hypervigilant due to past trauma. There’s an article on Boris Gindis’ website
here that explains this observation. The
more I watch my daughter and get to know her, the more I believe she is hypervigilant more than ADHD. She
is able to focus and settle down when she is motivated to do so. She loves to read books for long periods of time. She can sit still
when she feels safe.
The things that make her seem hyperactive include the
behaviors she displayed last night at dinner.
When I yelled, she snapped out of it.
I believe she was still hypervigilant after I yelled; her behavior just
changed because she was afraid of my reaction.
As my kids have gotten older and have begun to try to reason (even if
they’re often not all that successful at it), I can see how “snapping them out
of it” works sometimes.
Now, I’m NOT saying the WAY to do that is to yell. However, I am saying a little bit of understanding
of how others perceive your behavior isn’t such a bad thing. Some may call it “shaming.” I call it “awareness.” If my child is stuck in asinine, annoying,
anti-social behaviors, she needs to be made aware those behaviors are
unacceptable. Sometimes, that awareness
needs to happen sharply and quickly.
Otherwise, you’re paying for an ER visit for some poor
guy who just wanted to have a nice dinner with his wife, or you’re scraping
your kid off the macadam.
Still sometimes, I think it’s all just a crap shoot. What works one time doesn't work the next and I'm always trying to figure something else out to do.
Sudden “awareness” can sometimes trigger hurt kids into full
out rages. This happened with The
Princess at the zoo back in December. Thankfully, this is very rare for her. (A public, full-on rage has never yet happened with Youngest Son.) Usually, “awareness” works to stop extreme animation in The Princess. Some
may say, “Yeah, but you pay for it later.”
I’m not so sure I wouldn’t be dealing with something later anyhow. If it gives me a relatively quiet ride home
after a dinner that four out of the five of us did not enjoy because The Princess was
the star attraction of the Applebees’ Review that night, then I’ll take it.
I've had many of the same thoughts lately. Then I took my kid in to the psych yesterday. I asked lots of questions, she made lots of observations. We talked about what is going on and the behavior manifestations we're seeing (would never want to make a Dx or concrete assumptions over the internet, but what you're saying here sounds a lot like the convo I had with the psych yesterday...just sayin') Hypervigilance is a given, we all know that, but what she said kind of surprised me. She said it sounded like the biggest problem we're dealing with is most likely ADHD that isn't being completely or appropriately addressed (wrong med, wrong dose, or a big part might be jolts with the meds going in or out of the system) And so a med dose and timing change was made. Her thought is that if we can get a handle on the ADHD, we'll have a better idea where to go with the anxiety and other issues which she thinks will settle some as we find a more appropriate treatment for the ADHD.
ReplyDeleteOne of the big things we talked about is how it feels when these meds rise and fall in the system (even some of the long acting/slow release ones can cause jolts to the system) and how it can make them feel really jumpy and edgy and then the hypervigilance takes over. The hypervigilance is there. We all know that. But, I was quite surprised to hear her thought on this...that it's the ADHD feeding the hypervigilance rather than the other way around, which is what I've always thought it was. She feels if we can get the ADHD better controlled and managed that the anxiety and other issues will lessen as well and we'll utimately be more successful in being able to treat the whole package.
After my chat with our psych yesterday, I'd definitely recommend having a similar chat with your doc about her meds and see if a timing, dose, or formula change might be in order. There's also a new one out that I've never heard of...very likely we'll try it with my older son and possibly both kids, esepcially since even at regular price, it's quite a bit cheaper than concerta!