19 yr. old with ADHD/OCD and transition...

[Serena92503]

My 19 yr old son, Frankie, has been on a variety of meds since the age of 7.  He has tried them all and had tremendous success on Adderall, until he developed tics and had to go on Concerta which made him very depressed.  He decided in high school that he no longer wanted to be on meds and went at it without.  Needless to say, by April of his Senior year, he was behind and did not catch up, nor did he graduate.

At 19, he is now trying to live on his own, is in a depressed state, cannot hold a job and has issues with his attention span, OCD and authority.  He has agreed to reconsider medication, but is afraid to do so because it exacerbates his OCD.  He haqs difficulty with transition and his current emotional state is not helping.

Has anyone out there had a child with a combination of OCD and ADHD?  What did you do for your child and how has it helped them?

[Jason Greenberg, Ph.D.]

Thanks for the followup.  Certainly, it would benefit him to be in treatment (psychiatric and psychotherapy) for his problems.  And right now he seems intent on wanting to "do it on his own," without the help of anyone or anything, and he may also be struggling with feeling "damaged" as well.  Your position is a difficult one; if you don't say anything to him, then you are going along with his inaccurate view that he is able to take care of himself without "help."  If you encourage him to go back on his medication and see a therapist again, then he may hear you saying that he is "damaged" or "weak" at a time when adolescents want to think they're invincible.  I think all you can do is continue to encourage him to seek help as a way to take care of himself the best way possible, and remind him of the potential consequences of his actions (or inaction) as you see them (he'll most likely disagree, that doesn't mean he isn't hearing you).  And hopefully, he will at some point (sooner rather than later) get the help he needs.

[Serena92503]

Frankie was seeing a therapist while on medication, but all the therapists said he didn't need to be in therapy.  I disagreed, but they said I was "wasting" my money by taking him.  Initially, at 7 years of age, when he was diagnosed, he was seeing a psychiatrist, but he also ended Frankie's sessions.

Frankie decided he no longer wanted to be on meds because he felt he could do it on his own, and he did not like the side effects (tics, insomnia, etc.)  He said he could "feel" the medication trying to control him and he didn't like how that felt either.  Honestly, I think he liked the feeling of being out of control, almost manic, more than anything.  I agreed to allow him a period of time off his meds, but if I saw he was struggling, then he would have to go back on meds.  WHen I saw he was having a difficult time, I put him back on meds, but he wouldn't take them.  The rest is history.

[Jason Greenberg, Ph.D.]

Before I respond further, why did Frankie decide he longer wanted to be on meds?  And was he ever in psychotherapy along with the medication, or was he only under the care of a psychiatrist?