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1920054 tn?1431630591

how to help my 8 yr old daughter, and myself

My daughter has ADHD and ODD. She's very impulsive, and has major fits of rage, to the point where sometimes she hits others. I feel bad for her sometimes for I know she sometimes can't help herself when she gets so angery. How to I help her to manage her emotions and anger? She doesn't have many friends for they don't understand her, she gets so sad sometimes.
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189897 tn?1441126518
COMMUNITY LEADER
   Thank you for your reply.  It is helpful.  I would think that some of my suggestions have already been tried since it seems like you have a pretty good support team - but who knows?
   Dealing with the anger - it could be caused by the meds or by not knowing how to really deal with the anger.  Lets deal with the meds first.
   My first thought is that she might be a bit overmedicated.   The Clonidine use makes me wonder if it was prescribed after the stim meds to help her sleep or if it came first?  If it was prescribed after the stim meds, that would be a sign that the stim dose was too high.   All stim meds have a duration.  If the med does not last as long as it should, then the child is typically underdosed.  And the opposite if it lasts too long.  Concerta should last 8 to 9 hours.   If it lasting over 8 or so hours and preventing her from sleeping, that would be a definite sign of an overdose.  Its pretty easy to find out what is happening.  Just ask your doc to drop the dose down and see what happens.  
     And, then there is the opposite effect.  One reason I asked you about WHEN was to see if this anger occurred more at the end of the day, when the meds might have worn off.  ADHD is extremely frustrating,  when the meds are working, the frustrations are less and the anger goes down a lot.  Also, since kids with ADHD are very impulsive - anger is easy to come by.  Here again, the meds tend to help deal with the impulsiveness.   And, here again, by talking with your doc and increasing the meds, or trying a different med.   Concerta is a methylphenidate which is typically used for ADD.  It is not as strong as the Adderall/Vyvanse medications which are used for ADHD kids.  
    So, it takes a bit of detective work to figure out if the meds are part of the problem.  It really means charting what is going on so that you have a time line.  And then doing some trial and error with the meds.  It probably is worth doing.  But I also have no clue what you tried before or what the Clonidine is for.  Hopefully, your doc followed the standard practice which is to go slow till you see a result, try a bit higher, and then back down if needed.  If you started with only one med and stayed there - well, maybe you got lucky.
   Here are several links on how to figure out what the therapeutic window is:      http://www.corepsych.com/2008/10/addadhd-medication-1-of-7-tips-on-bottom-of-the-therapeutic-window/
        http://www.corepsych.com/2008/11/add-adhd-stimulant-medication-dosage-the-bottom-bewitching-hours/
        http://ezinearticles.com/?ADD-ADHD-Treatment---7-Tips-on-Finding-the-Elusive-Top-of-the-Therapeutic-Window&id=1257427
       So, after all of that.  What if its not the meds or the meds are only part of the problem.   Kids with ADHD have tons of anxiety and frustration and anger.  It comes with the ADHD.  They need to be taught how to handle this.  I know you said she was going to counseling and her psyc - but are you also there?  All the good stuff they tell her has to be practiced at home.  An 8 year old cannot hear something and decide to do it.  It takes practice.   It takes a parent who can help her notice when anger is coming on and clue her in on dealing with it - before it overcomes her.  I have some very good links on dealing with anger.
     The first link is from our Child Behavior forum.  Even though it is aimed at a 4 year old the techniques are simple and very good.   The first answer by Specialmom is the main one to read.  She has many, many good ideas.  But the other answers are also worth looking over.  I will give you two more links on anger - but I like this because the others are a bit technical and this is very practical.  
     The link is :   http://www.medhelp.org/posts/Child-Behavior/4-year-old-son/show/2423496
      The second link is from CHADD and is a bit technical, but really covers and explains the whole anger management thing.  I think you will find it dovetails nicely with the above link.   it is:http://www.chadd.org/Portals/0/AM/Images/Understading/AUG01AngerOverloadinChildren-DiagnosticandTreatmentIssues.pdf
     And the final link is from one of my favorite places for ADHD information.  Feel free to click on the topics at the top of the page for lots more info.  This link is kind of an easy overall look at what the first two said in detail.  It is: http://www.additudemag.com/slideshow/42/slide-1.html
     Finally, the books I mentioned in the first link were aimed at the 4 to 7 year old crowd.  There is another set aimed at slightly older kids.  There are a couple sets of books aimed at this age group.  One is, " How to Take the Grrrr Out of Anger" (Laugh And Learn). That and several more are found here - http://www.amazon.com/Take-Grrrr-Anger-Laugh-Learn/dp/1575421178/ref=pd_sim_b_7
          Another good set is the," Don't Rant and Rave on Wednesdays!" The Children's Anger-Control Book. That and others in the set are found here - http://www.amazon.com/Dont-Rant-Rave-Wednesdays-Anger-Control/dp/0933849540/ref=pd_sim_b_1
          
         Wow, I have probably completely overloaded somebody who already has a ton of stuff on her plate.  So take your time.   The anger stuff is really good.  The medication links are really for more clarification.  You only need to look at those if you want more info.   If you have any questions - don't be afraid to ask.   And, certainly, keep in communication with your doctors.
Helpful - 0
1029273 tn?1472231494
Well, thanks Sandman :) You seem very knowledgeable on subjects re. behavioral disorders ~ looks like you're a big asset in this community, and I hope that you'll be a to round in the future to lend me some advice.

Take Care,
Suzanne
Helpful - 0
1029273 tn?1472231494
After reading your 3 posts, it sounds like you're a very proactive parent, and doing all that you can for your daughter ~ you're doing a great job, in my opinion.
  You've got a lot of responsibility w/ 3 children to take care of on top of dealing with the added stress of an ADHD/ODD child.
I'm in the same boat as you are, so to speak ~ I'm a single mom of 2, with a 13 y.o. son and a 3 y.o. daughter.  Sometimes I wish there were just a few more hours in the day to play catch-up with my kids, unfortunately for my son, my daughter requires ( & demands!) so much of my attention because of her age.  Often, the time I spend alone w/ my son ( usually in the early evening) isn't what I would term as quality time w/ him because I'm either frazzled or exhausted ~ I look at it this way, I do my best and I hope that he benefits from it... I don't know if this helps, but my latest trick is to get my other child totally involved in a hobby (even if it's just for 30 mins. at a time) before I spend some alone time w/ my son...
My son has very similar issues w/ his anger, much like your daughter; he becomes so impatient w/ others around him and often lashes out verbally at them ~ I chalk this up to the ADHD.  When he was younger, his outbursts in the classroom would sometimes escalate to a physical level ( pushing & sometimes hitting) ~ this had " impulse control" issues written all over it!  Thankfully, he learned through many counseling sessions and discipline, that acting out physically had huge consequences.  Over time and with maturity, I've seen him improve ~ yet, he's still not completely out-of-the-woods... Something I learned years ago, was that heavy praise goes a long way during the rough patches; such as, 'Sweetie, I'm so proud of the way you handled yourself today' (followed w/a hug) ~ even though you might really be thinking the exact opposite ;)  

Sandman seems to be on the right track with his questions and comments about the meds.  I'm sure you are aware that there is no such thing as a 'magic pill' for what kids like ours have to deal with, that being said, I wonder if your daughter needs a change in her dosage, or time to try something other than Concerta?
Anyway, it's sounds like you're doing a great job so far, and I think in time you'll become a master at juggling all the hurdles that come with dealing w/ an ADHD child.
I've been thinking about posting a comment on what I've been struggling w/ lately regarding my son's latest dilemma ~ I hope that possibly you, Sandman, and others drop in to offer some advice!

Take Care,
Suzanne
Helpful - 0
1920054 tn?1431630591
I forgot to add, what gets her angry, is when she can't have what she wants, another child is telling her what to do, her sisters or other children antagonizing her. She has no patience whats so ever, which also makes things very difficult for myself being a single mom of 3. I do try my hardest to give her special time with just her and i but sometimes its just not always possible for longer periods of time.
Helpful - 0
1920054 tn?1431630591
Thank you all for your input, yes she is on 27 mg of concerta a day. She also takes half a clonidine after school and the other half at bedtime. As for her fits of anger, it does vary with her sometimes i can see the triggers and other times it is out of no where. It doesnt matter if she is at school or not when she gets angry she just flies of the handle. She goes to counseling once a wk, and sees her psychiatrist every 2 months. Her, counselor, dr, her sisters and i all try to help her deal with her anger, it is definitely not easy. She is so loveable and sweet st times, and she knows when she does wrong. Se tells me sometimes, "i didnt mean it mmy, i just can't help it sometimes. I just get so mad"
Helpful - 0
189897 tn?1441126518
COMMUNITY LEADER
    Wonderful reply!  Thank you for contributing.  Hopefully she will get back to us so we can give more specific help.
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189897 tn?1441126518
COMMUNITY LEADER
   Very, very good comments by Suzanne.  
Yes, the tools are out there to help you.   And its kind of sad that your doc has not been more helpful.  Not unusual if you are going through a pediatrician - they tend to be very overworked.
    Anyway, the questions I asked above will help us help you.  Medication can be either helpful or if overdosed - hurtful.  And whether medication is being used or not, there are techniques that both you and your child can learn to help.  That is also the reason for my second set of questions.  I am trying to find out if there are "triggers" to her outbursts - or if it is medication related.
Helpful - 0
1029273 tn?1472231494
Hi,
Your daughter actually sounds much like many of the ADHD & ADD children I've met at my sons school ~ my son was diagnosed with ADHD & ADD when he was 7 years old, he's now a teen.
Prior to his Dr. prescribing my son any medications and therapy, our family went thru some pretty rough scenes while dealing with my son's rage and frequent outbursts.  I know for some people it's hard to believe that a little kid could cause such chaos, but for those of us who have children with ADHD (etc.) it can become a daily struggle just to try to maintain peacefulness within the family unit. Like your daughter, my son never had many friends, which often made him feel left out at school ~ this could also be a huge source of where the anger may be coming from.  My son was an "A Student", but due to his fits he was getting suspended from school almost weekly.  I felt so terrible for him and helpless, that I had to seek help from somebody, so I called his Dr. ( in tears no less).
Does your daughter take any medication? Have you met with a Dr. regarding her latest episodes?  I highly suggest talking to a Dr. soon, if you haven't already.
My son was prescribed a few different types of medication over about a course of a year or so, before we decided that Concerta was the best med for him. Also, he attended monthly therapy in the beginning, now he goes maybe twice a year or when needed.
Another very important thing that I learned, was that my son needed a lot more one on one time with each parent, everyday ~ an hour each day alone w/ him makes a big difference. Also, structure on a daily basis really helps our kids; this may sound boring at first, but it does help big time. There are quite a few tips that I've learned along our journey that have made our lives more stable and far less stressful thanks to counseling.  My son will always have to deal with ADHD/ADD for the rest of his life to some degree, but at least now we have the tools to help him lead a happier life.

Hang in there, there is help out there, and you & your daughter are not alone!
~ Suzanne
Helpful - 0
189897 tn?1441126518
COMMUNITY LEADER
   Oh, and when she hits others,  Is this at school?  or on the weekend at home?
     And more importantly, what seems to make her the most angry?   Can you see her anger building up, or does she just explode out of nowhere?
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189897 tn?1441126518
COMMUNITY LEADER
Do these fits of rage come at certain times of the day?  Of so, which times?  Is she on any medications and, is so are they extended release?    And, I will round up some links that will be helpful  and get back to you
Helpful - 0
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