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Getting Closer to Medicating SD5

Learning to Stepparent's picture

So I had another discussion with DH yesterday about putting SD5 on medication for her ADHD. It wasn't something I entered into lightly or have been pushing for from the beginning. She is in kindergarten this year and academically is doing well though we are starting to have issues with behavior and attention span. Basically, she needs constant reminders of what she is supposed to be doing. It's not exactly a problem yet but it is an issue that her teacher is trying to work on and I anticipate this only getting worse as time goes on. I think most of the time she tries to listen and do what is asked of her, etc but she just struggles really hard with things like staying calm and behaving.

As background, BM put SD in counseling right around her 3rd birthday because she couldn't handle her behavior and tantrums. Shortly there after, within about 2 months of her 3rd birthday, BM called DH to give up custody because she couldn't handle her. Part of her giving up custody was financial but it was also that BM just couldn't handle SD's behavior. During a meltdown around Memorial Day last year BM snapped, backhanded SD, and gave her a black eye so we got the pleasure of dealing with CPS for 4 months and she has contact DH more than once during a tantrum saying she doesn't know what to do and can't handle it. During a meltdown a couple of months ago DH, the most patient man I know, snapped and kicked a hole in the wall. I am reduced, on a regular basis, to standing in front of SD with all wild eyed, crazy, and trembling screaming "you're driving me crazy" when I'm trying to get her out the door to school. I don't hate her but there are definitely days where I REALLY do not like her and can't stand to be in the same room as her.

She has started making comments that nobody likes her. I am unsure if this is a reflection of her self esteem taking a hit because she is always getting barked at or a bid for attention. Either way, I finally told DH yesterday that I know for damn sure my relationship with SD is not as good as it could be simply because I'm always coming down on her for her behavior. All of us are struggling to deal with it and I have been within a hairsbreadth so many times of telling him that I will no longer deal with her in the mornings that if he isn't home he needs to take her to his mothers for her to deal with because I can't take it anymore. Every morning is a battle and fighting with this kid every morning is both depressing and exhausting. Not to mention the fact that I have recently been diagnosed with MS and stress exacerbates MS. I feel guilty for using that as a reason to medicate SD but I'm doing it anyway. If DH and BM want to lay the bulk of the parenting at my feet then my health will be taken into consideration when making parenting decisions that can affect it.

Does anyone have any advice to offer regarding ADHD meds? SD will be 6 in 2 months.


SecondGeneration's picture

My BM has MS and my half brother is also ADHD. He was a nightmare to deal with from birth, literally, he was more demon child than anything else. My BM has a background of working with mental health but it still took her a long time to get the help and support she needed for him.
My BM was chasing support from when my half brother was 12-18 months old, by the time he was at school they had started medicating him. Ritalin because its short acting.
My step father was really against medicating him, but was eventually convinced into giving ritalin a try on the basis that they would only use it for school, so weekend and holidays they didnt give him his meds. Result? Within a year even my step father could see the massive behavioral difference in him.
Its not a cure but it just slows them down a bit, helps them concentrate that bit better in class, and basically keep a grip on their thoughts and start to be able to learn impulse control. Without ritalin my half brother has no impulse control, with ritalin he has some ability to think before acting (not alot but still, progress)

You are quite right in your stance that if YOU are responsible for the majority of the actual care of SD then YOUR health and YOUR opinion needs to be taken into account. If hubby isnt interested in pursuing help for his kid then he can make damn well sure that he is home dealing with her. And no, dont give him the option of dumping SD on his mum, because thats just passing the book some more.
Heck if hes that against it, id be tempted to tell him "Ok fine, you deal with her in the mornings and after school from now on, Im out"
If hes that adament that theres no big problem then he can use up a week or two holiday from work to prove it cant he? And then he can look for another job enabling him to be the main care giver.

Learning to Stepparent's picture

Impulse control is huge for her. She isn't so bad that she can't even sit down. The way I understand it girls tend to present differently than boys, they tend to fidget rather than be up running around....though SD does that too. For example she had to come to the pool for DDs swimming lesson yesterday. It was 45 minutes long and I brought a coloring book and crayons to give her something to do. She sat their coloring for maybe 10 minutes and then lost interest in that and the battle began. It starts with something like swinging her legs. Starts small but then escalates. She starts swinging her legs, then rocking back and forth, then add in the finger pointing (I swear it's like John Travolta in Saturday Night Fever whens he really gets going) then she starts singing and that gets louder and louder. Then, if I don't try to check it, she starts getting up and dancing around, etc. The thing is that once she gets wound up, she cannot calm herself down. I try to keep a lid on it but it's the constant reminders of stop doing that, sit still, color a picture, over and over again.

The impulse control is what also gets me. I have seen her draw on the carpet with markers despite there being ample paper for her to use, she will smear poop on the bathroom wall, put stickers on the carpet and wall, need constant reminders to do what she is supposed to do, etc.

It's driving me crazy.

moeilijk's picture

I don't have experience with ADHD, so I may not have pertinent advice. But I have some ideas anyway.

I am sure that SD isn't happy, and feels unloved - and unloveable. That is to be expected when she can't do anything right. The problem is, given her multiple issues, your expectations are unreasonable. But this is also a super-common issue when raising kids, just because their abilities and our expectations rarely match up, and if they do, it's time to raise the bar anyway.

So as a parent, I'd look to reduce our family stress by lowering expectations and increasing praise-worthy moments. In my situations, I've got totally normal DD2, who has tantrums from time to time and doesn't listen or do as she's told in a timely fashion regularly.

For the tantrums, I do not address the 'issue' (like she does or does not want raisins, for example), other than to repeat what she says and agree with her. "You don't want raisins, no, no raisins. No raisins." Then I name her feelings and talk about it. "You're really angry. You just woke up, you're still a bit tired, you're not feeling happy at all right now. You're angry. You don't want raisins, and you're angry." Sometimes she lashes out, "Mummy, go away. Go AWAY!!!!" So I say, "I'm not going anywhere, if you feel angry and want to calm down by yourself, you can go in your room. That's why you have a nice room, for you to use when you want to be by yourself. But I stay here. Because I love you." (And then we have quite a back and forth where she says I don't love her, she's not a nice girl, yada yada yada and eventually comes and gets a hug.)

Her tantrums are just her standing, sometimes walking a bit or stamping her feet, but mostly yelling and crying and looking at me. In the past, when I've walked away or put her in her room/chair, that increased her negative emotions and prolonged the tantrum. And the behaviour (banging things, kicking, walking/running towards what she wanted) was worse. When I have tried to 'force' her to do whatever it was... that really escalated things. Sometimes that can't be helped, but if it can, I work on helping her identify and manage her feelings. And to teach her that negative feelings are ok, but she is still responsible for her behaviour.

TBH, I cannot imagine things getting so out of control that I would hit her, hard enough to give her a black eye. Perhaps bad parenting gets you to that point, perhaps that's the ADHD part I don't understand.

You've posted here for a while now, and you seem like a nice person, well-balanced in your parenting approach, and you're dealing with a challenging situation not only with being an SM, but also a very high needs SD and a terrible MIL. I think you can probably work wonders with this kid, but with so little support and needing to take care of yourself and your own newly-high needs yourself, maybe that just has to go on the back-burner.

Learning to Stepparent's picture

I think the terrible parenting has quite a bit to do with it. The first 3 1/2 years of her life there was no discipline at all for that child. Absolutely none. So part of it is us making up for lost time and trying to catch her up.

For the longest time I thought her seeming inability to learn/follow rules was some sort of learning disability but now I don't think that is the case. It's not that she doesn't know what the rules are it's just that she won't follow them. For example, running in the house. That was a rule from the beginning because she would run through the house looking behind her and run head first into the wall so hard she would ricochet off and land flat on her back. It took almost 2 years of putting her in time out every single time she did it for her to learn not to do that. And time out for her is not a 4 or 5 minute ordeal. We're talking 20-45 minutes because she would just scream the entire time and she is not allowed out until she is calm. We have tried what you suggested about talking to her to try and help her calm down and we learned early on that trying to interact with her at all when she is like that will illicit a full on meltdown. It just doesn't work with her.

I do realize part of the problem is my expectations are potentially higher than what she can meet. I have been working with her teacher and her OT to figure out where the bar can be appropriately set at so hopefully I am getting better at that. I am actually surprised at times how high the OT sets the bar. She is on the autism spectrum but it is mild and high functioning. To look at her on the playground or something you wouldn't really know there is something going on. Her sings are more subtle than that.

As soon as we got the diagnosis a year ago the psychiatrist was ready to write a script for ADHD meds but BM refused. Well, to be fair we all did, we wanted to try other techniques first. However, I told DH that BM sees SD 4 days a month, sometimes less. She doesn't deal with it on a day to day basis like we do. If she is going to refuse to let SD go on ADHD meds then she can darn well move back here and take custody back so she can deal with her but I will be damned if she is going to sit on her high horse when she is a mother 4 days a month and make a decision like this when I'm the one that has to deal with the consequences.

moeilijk's picture

Obviously I don't know what hoops you've already tried jumping through, so apologies if I'm asking questions about stuff that you've tried and had to abandon.

For the timeout, in my house, after being told what she did to warrant the timeut, DD has to stay in her chair in her room for 2 minutes (how old she is). Sometimes she puts up a fuss which I ignore as long as she stays in the chair. If she gets out of the chair, I tell her that I will close the door - she hates that. Sometimes I have to close the door, hear her crying about it, and then through the closed door ask her to tell me when she's back in her chair so I can open the door. Then I remind her again to stay in her chair for 2 minutes. She can yell her head off as long as she stays in the chair. When we're out and about, I just find a somewhat out-of-the-way place to have her sit down.

After the 2 minutes, I go back in and ask her if she's ready to talk about it. Sometimes she says no or otherwise doesn't pay attention. So I go to leave. Usually she calls me back pretty quick. Only if she's continuing to escalate (one time she hit me) do I re-start the 2 minutes, this time for the hitting.

So the talking about it is where I ask her what happened. When she's older, I'll expect an answer, but now I sometimes get one sometimes not. I then tell her what happened to warrant the timeout, and explain that it's not allowed. I tell her that it's time for a hug and a kiss and a fresh start. And I totally let it go.

If she's still obviously angry, when I come in, then she's not ready to talk about it. If she's sad... then more comforting before we talk about it. After we talk about it, she might even get some praise for staying in her chair if it was really hard for her to do that day.

I wanted to post about the timeouts to explain - it's not about getting her to be calm (for me), it's about teaching her that there are consistent consequences. We have insisted that she stay in her room/high chair when she had a tantrum in the past, and we named her feelings and told her she was doing a great job of calming down, and once she's calmer we can talk about it and work together to try to help her... yada yada. We have also talked about feelings in other situations - when she saw another kid being naughty, getting scolded and then being angry, we talked about what was happening, etc.

I had forgotten you had your own child to attend to. I am a full-time SAHM to an only child. I have health issues of my own that make me very tired, but I do have help around the house and DD has various activities without me so I have about 1.5 days of non-mommy time per week. Obviously I have *way* more opportunity to invest in working with DD's behaviour, and she's NOTHING like your SD.

She needs someone to work with her very intensively. If you had zero other obligations, you would most likely be very good at helping her. But that's not your situation, and she's not your child. Don't feel responsible or guilty or anything that it's just not possible for you to help this girl as she needs. Truly, you aren't failing her or anyone by attending to your own situation first.

Learning to Stepparent's picture

Everything I have read about time out says they stay in for a minute per year of their age but the time is not supposed to start until they are calm. Not throwing a fit, not screaming, not crying, they need to be calm. And it takes her a minimum of 20 minutes to stop throwing a fit. That is in a room, by herself, no interaction with anyone, door closed, everything. Minimum of 20 minutes to stop. It took more than 18 months for the time to start to diminish and even now we have only had a handful of times where she doesn't throw a fit when put in time out.

We don't normally use time out anymore because it does not work as a punishment type of thing for her. The only thing it works for is to get her to calm down and really, I think that may just be because she pitches a fit and wears herself out. We have had to keep finding different ways to discipline her because the usual methods just don't work with her.

moeilijk's picture

I don't have the same information about timeouts, and our goal was not to punish her with the timeout. Out goal is to remove her from the situation and make her a little bit uncomfortable so that the behaviour we don't like becomes less attractive.

If you're using timeout as a punishment, then of course she's going to get angry about it - you're using it to 'attack' her, so she reacts with anger and aggression herself. My own DD accepts being put in timeouts because the process is clear and there are no surprises, not because she's able to calm herself down at all. There's no aggression or anything, just a consequence.

But honestly, why would you be putting her in a timeout if she's having a meltdown? Is she being punished for the meltdown? Or are you trying to get her to take time for herself to calm down?

Getting her to calm down is a different issue, one that I continue to face (omg, a 90 minute meltdown tonight). I am aware of the circumstances that contribute to her getting so upset, so I try to manage those (again, she's 2, not 5, so there's a different parenting responsibility there). Things like, if she's fallen asleep more than 10-15 minutes during the day, being a bit ill, being tired, having to pee, being hungry, a lot of change/excitement - she spent the night at her grandma's and then went to the zoo, big happenings for a little girl! But preventitive maintenance only goes so far at the best of times anyway.

Willow2010's picture

It sounds like every adult in this picture needs to take a parenting class before drugging up the kid.

Kids are difficult. My son was a terrible child. 1-6 years old. I am soooo thankful that I never put him on those drugs. Never even thought about it. It was not the "in" thing to do back then. You parented your child until they straighten up.

You may want to rethink being the main caretaker for this child.

DarkStar's picture

Willow, I used to think the same way you did....until I met my SSthen6.
Then I realized that my way of thinking was narrow-minded and judgmental and I had NO IDEA what the hell I was talking about....and neither do you, Willow.

95% of the time, I would agree that 5 is way too young for meds. But then, there's the other 5%.

Unmedicated, SSthen6 was like a wild animal. The only way I could get him to sit still was to sit him on my lap and wrap my arms and legs around him to hold him still. Soiling his pants EVERY DAY. Writes on the wall, gouges furniture, eating, yes EATING parts of the wall, taken out of class every day for disruptions......
You cannot take your eyes off this kid. If the house is quiet, that means SS was getting into some kind of trouble.

He is now 10. You still can't take your eyes off of him. He can't even walk to school (4 blocks) by himself, because he would either run out into the street and get hit by a car, or get distracted by a squirrel and end up playing in someone's backyard instead of going to school.

There are situations, where PARENTING IS NOT ENOUGH. It's very easy to sit back and point fingers when you have not walked in their shoes. I used to nag at my SO for not having SS bathe more than once or twice a week....until the week that I watched the skids while SO was out of town for work.

I spent 45 minutes just trying to get the kid undressed and in the tub and the water turned on, then another 45 minutes yelling at him to wash up and rinse. 1 1/2 hours on ONE KID showering. There are 2 other kids in the household also. After just ONE WEEK of watching the skids and trying to keep up with their schedule, I was an exhausted wreck.
He is a single Dad with 3 kids, BM sees them on weekends. SO also is an IT director at a very large brokerage firm...very high stress, very intense work. He sleeps about 4 hours a night.
He does his best, but he is not Superman. He is human, and in the mornings, just getting the kids up and out the door for school is a challenge.

This is something recent that my SO emailed me......and there was no house fire, this is just one of the many LIES this kid tells......

From SS10's Teacher:

SS has been telling us that he does not have any socks because they burned up in the house fire. I am guessing that there really wasn’t a house fire since I haven’t heard anything about it from you. I have been trying to stress the importance of him wearing socks so that his feet stay warm and so that his shoes will not have an odor. Could you help us with this? I can bring some extra socks for him to wear in case he forgets them for the day.

SO responds to me (not the teacher):

So this morning, SS was late to school yet again. Probably the 20th or so time he's been late to school. Why? I had him go back and change his clothes 4 times. Why? Because he wouldn't pick clean clothes. He kept pulling clothes out of his dirty clothes pile. Did I go in and dress him? Nope. But I did make him change. No, I didn't check his socks. I rarely check socks. Why? I gave up on that. He wears the same socks for days and days. At that point, it doesn't even matter if he has them on or not. Why don't I check for clean socks, you ask? Well, it's because he needs to remove his shoes for me to check. Why don't I check before he puts his shoes on, you ask? Because he's not 3 years old and I have other things I need to do in the mornings to get myself ready to go. And it takes him 17 minutes to put on a pair of shoes. The less I have to wait for to get him out the door, the better.
Lazy of me, you say? Don't really care the teacher's or anyone else's opinions of me in that respect. If anyone thinks they can do it better, then they are more than welcome to try. The teacher should be thankful he even shows up to school, medicated and with clothes on.

Now, my point here is that it is very easy to look at this story and sniff, "Well, he IS the PARENT, it is his RESPONSIBILITY to do all this." Yep, and he is doing it the best he can. Some mornings it's either getting socks on or getting breakfast. Clean socks seems like a small petty thing when you are trying to get one kid to Jazz Band on time, SS to get dressed and eat breakfast, and make sure the teenager doesn't sleep the day away.

Sorry, OP didn't mean to hijack, but I feel for you. Such a difficult thing to experience and a horrible decision to have to make.

LikeMinded's picture


We put my SS on the ADHD meds and it was the best thing for him. His is so severe that he can't sit long enough on the toilet to finish his poo, and he finishes in his pants (still does this at age 10).

Without the meds, he simply can't function at school. With the meds, he's able to study (and get ok grades). He's able to stay seated during class. He's able to maintain friendships.

When they are out of control, they get rejected by their friends too. So, she is feeling that nobody likes her, because the other little girls are likely starting to shun her.

For tantrums, the best thing that worked for me with this child was to say "I DON"T LIKE THIS! I"M NOT DOING THIS" and then leaving the room for them to finish on their own. It stops really fast when there's no audience.

I would try to disengage from the situation. You need this kid's family to step up. You should not be handling the morning routine. Get out of there when DH is kicking walls. Handle him the same way, take away the audience.

The key to the ADHD meds is to keep going back to the pediatrician until the right does is found. We had to adjust the medication 3 times.

I can honestly say that the meds have significantly improved my SS's life and he suffers much less. There's nothing wrong with giving them a try. Give them a good six months beffore you make up your mind. If they don't help, just stop.

You can't parent mental issues out of a child anymore than you can parent diabetes out of a child. Mental health issues are due to genetics, brain chemistry, hormone regulation, sometimes even the immune system is involved.

HappilySelfish679's picture

My SD 8 takes abilify and a low dose anti depressant combo and her behavior has improved a lot from what I can tell ( I am disengaged , spend minimal time with her and her parents handle anything health related for her )