How to help an overmedicated teen?
September 10, 2017 11:46 PM   Subscribe

My 17 year old child has a friend of the same age who is a great kid but has some learning difficulties, including ADHD. He takes Adderall for that, which causes him anxiety and he takes Xanax to counteract the anxiety. He is also on antidepressants. Adderall has bad side effects for him, including persistent anxiety, irritability, insomnia (the boy takes sleeping pills for that), lack of appetite (lost a lot of weight) and does not seem to help the grades at school.

The boy suffers from the medications, does not like school and sounds generally miserable (my child relates this info to me). I think exploring other, less severe options/medications to deal with ADHD (so that there are fewer side effects and may be no need to take multiple highly addictive drugs) could be beneficial. I don’t know the parents of the boy, so cannot talk to them about it. I anguish over this situation and want to help the boy but don’t know how.
posted by anonymous to Human Relations (22 answers total) 3 users marked this as a favorite
You don't. My god, you don't even know this child personally and you think your second-hand account makes you informed enough to fix his medications? Firstly, the obvious and literally only appropriate way to do this for a child would be to talk to their parents. If you're not invested enough to ask your son to ask his friend to ask his parents to call you (see how ridiculously long that chain is?), then you do nothing. Secondly, if you think he is old enough to be making his own decisions about his medications, you would start by talking to him, not your son.

But unless you forgot to mention that you are an acknowledged expert on mental health and medication in teenagers, you do nothing.
posted by the agents of KAOS at 12:13 AM on September 11, 2017 [80 favorites]

I would respectfully suggest that you're neither the child's parent nor his doctor, and that you should mind your own business. I'm not sure why you would assume that they haven't explored other options, or why you would assume that the suffering caused by medication is worse than the suffering caused by multiple un- or under-treated mental health problems.

I am a mentally ill person and the parent of a mentally ill child. I assure you that if you or your child are mentally ill, dozens of people have already suggested that you try yoga/exercise more/cut out gluten/meditate/etc etc etc. People have already suggested that the medication that keeps you semi-functional is doing more harm than good. They have already questioned if this is really necessary, as if you would subject yourself or your child to the barrage of side effects and the social stigma for funsies.

The best way to support mentally ill people is to assume that they're making the best choices they can make for their own personal situation, and that they're doing the best they can with the options that they have. Stay out of it.
posted by mishafletch at 12:18 AM on September 11, 2017 [51 favorites]

How long have you known this boy? Does his behavior seemed to have deteriorated as his medications have changed? I think the only way you can approach this is if you have a relationship with this boy, i.e., you know him personally, you're not just relying on what your child has reported. Even then, it will be difficult.

The best way to support mentally ill people is to assume that they're making the best choices they can make for their own personal situation, and that they're doing the best they can with the options that they have

I understand that this is a difficult and sensitive situation and the advice to "assume that they're making the best choices" is probably the way to go in most situations. Nonetheless, I am forever grateful that my adult daughter's friends didn't do so when she had serious issues with her Adderall (for ADD) and Xanax (for anxiety) prescriptions.
posted by she's not there at 2:13 AM on September 11, 2017 [3 favorites]

This question is not going to go the way you want it to because not only is there nothing you can do, there's nothing you should do.

I would ask you to consider how well you know this child and his needs. How do you know the Adderall doesn't affect this child's ability to learn? Have you sat with him in school before he tried medication? Have you seen his transcript, pre- and post-medication? Do you really know how the medication affects him? Do you know what his life was like before he took antidepressants? Are you 100% certain he takes the meds your son is reporting?

What I'm saying is you've got a whole bunch of secondhand information. You can't vouch for any of its accuracy, yet you want advice on how to help someone.

You're wildly overstepping into something that is not your business.

You should stop anguishing over this kid and instead use this moment to talk to your son about respecting other people's privacy. His friend has his own needs and they're being dealt with; this is not your son's business.

As a family, you need to respect that other people have their own stuff to deal with and often have to make difficult choices; choices that are their business, not yours.

You should say nothing to this family and nothing to this kid.
posted by yes I said yes I will Yes at 3:01 AM on September 11, 2017 [10 favorites]

Hey, my kid is 8, suffers from extreme ADHD, takes an age appropriate similar cocktail in an extreme dose (he's considered one of the "most extreme cases of ADHD in MA" as written by his doctors). To the casual observer from the side, my son has some energy and some stuff going on (including weight loss, irritability and insomnia - at 8). More importantly, most folks see the medicated version which, frankly still isn't the societal definition of normal. Most folks don't see the rest of the stuff with him... the 45 minutes at the beginning of the day truly 'off' meds. They don't have a clue as to what a weekend day looks like when there's been a shortage for his meds and we can't fill his multiple high dose prescriptions at the 8 different CVSes or 7 different Wallgreens in my area - and yes... I'll do a mix of drive and call all of these to check, but even still - if we have to help him survive a weekend without meds - it is way more preferable than him trying a day of school without it.

The meds, although to an external observer seem to cause him difficulty, work... and the cocktail he gets has been tailored and retailored and reretailored to him as a result of meds ceasing to work, needing to be increased, being cycled to a different med, and so on and so on. And that's the part that has to be invisible to the outside world. Because as a society, we look at a kid and think "kids should be kids" and if the meds aren't working, no meds must be better because as a society we demonize mental health issues and the complicated process of medicating a child. It ain't easy.

Now, this is not an elaborate shaming of you for your viewpoint. But, I would suggest meeting his parents, not inserting your foot into your mouth and telling them how to parent, but meeting them - and learning about their relationship with their son, and getting a better understanding of their options. A community makes a child.
posted by Nanukthedog at 3:06 AM on September 11, 2017 [42 favorites]

As Nanukthedog says, a community makes a child and I appreciate that you are trying to be a part of this young person's community of caring adults. If you want to positively affect this young person's life, get to know them, not their medication.

Speaking as an education professional who works with young people whose mental health or other issues are a mismatch for mainstream schools, I see this young person you've described as succeeding with their medication. If they are socially engaged and attending school, then something is working. Please don't interrupt this student's functional regime. You don't know what their dysfunctional behaviour looks like, or what it feels like to be the young person, their parents, or their teachers and subject to an unmediated situation.
posted by Thella at 3:39 AM on September 11, 2017 [9 favorites]

Everything else aside, diagnosing someone's health issues through third-hand medical info (given the info went doctor > kid's friend > kid > you) is basically impossible.
posted by EndsOfInvention at 3:51 AM on September 11, 2017 [5 favorites]

One thing you can do is to be a positive adult presence in this kid's life as much as is reasonably possible. For a teenager that's miserable in general and hating school in particular, it can really help to have adults around who a) seem interested in them as people rather than a series of problems to be solved and/or b) can remind them that there's a better world out there on the other side. That doesn't need to be encouraging pep-talks or anything that specific - just getting to know him as a person in a positive way can help. (On which note, God what I wouldn't have given as a teenager to have an adult say "yeah I didn't like school/being 17/whatever at all", rather than every adult around talking about schooldays being the best years of my life.)

You can't know whether or not he is overmedicated, but even if he is (and I believe you that he might well be!) there's nothing you can do about that specifically. You can, however, be part of a supportive community around him as he grows into an adult who is best placed to make his own decisions about his health and welfare.
posted by Catseye at 4:05 AM on September 11, 2017 [26 favorites]

One other point that came to me while folding laundry for the past 3 hours, and this is directed towards the stigma of recognizing ADHD as a disability - and a question directed to the royal you not the specific you: If you saw a kid in a wheel chair, would you critique the wheel chair to the parents? Would you insist on pushing the wheel chair for the kid? What happens when the kid does need a new wheelchair, are you ready to fund raise? Are you ready to test drive a whole host of new wheelchairs site unseen? (because new/different meds are site unseen).

Meds are the equipment kids with ADHD use to get through life, just like someone that needs a wheelchair. Parents of kids with/and suffer from ADHD would gladly accept help with advocacy and recognition of the fact that we, as a society don't make sure we make the world 'mental health friendly'.
posted by Nanukthedog at 5:10 AM on September 11, 2017 [27 favorites]

I think it would be worth thinking about how the information in this situation came to you. Your child's friend has been telling them how they are feeling (bad side effects, insomnia, etc.)- essentially venting. The friend had no expectation that your child was going to intervene somehow and could/would "fix" their problems. Your child has now shared their worries for their friend with you- also essentially venting. They also had no expectation that you were somehow going to fix their friend's problems. They just needed to talk it out.

I think your role as a parent here is to be a good listener to your child, to offer support, and to allow for venting. You need to model for your child what your child should do for their friend. This is not the last time your child will have a friend who has a challenging medical situation. The last thing your child needs to get in the habit of is trying to butt in with alternative cures, less meds/more meds/different meds, etc. when most people just need a sympathetic ear.
posted by Mouse Army at 5:36 AM on September 11, 2017 [14 favorites]

I don't think you have a connection here between "the meds kind of suck" and "the kid is miserable and hates school"--the sheer fact that you think you do says to me that you're reading way too much into this without actually knowing the kid in question. I think Adderall's side effects suck, too, but I still took it for years and intend to go back to it at some point, and I still take other stimulants, and I've learned to just describe my sleep schedule as "erratic" if I'm not sedating myself regularly. It seems weird, but it's my normal. Being 17 and in high school and having mental health issues is more than enough reason to hate school, for exactly the reasons that make adults who barely know him "anguish" about his troubles. His future is not going to be damaged beyond repair by taking a few years longer than other kids do to get onto the right track. He has time. He has plenty of time. If you're going to do anything, find ways to reassure him that it's okay, that he doesn't need to have everything figured out this very moment, and that his grades and so on aren't going to doom him, and that a lot of the brain stuff will settle down at least a bit once he's properly past puberty.

(Almost didn't graduate from high school, three years late to college, wound up finishing that with honors, going on to do two graduate degrees, three career changes, now happily employed doing what I like doing in my mid-30s. A lot of debt to show for it, but there'd be less if the people around me had been generally more supportive of my needing time to figure my life out.)
posted by Sequence at 5:51 AM on September 11, 2017 [6 favorites]

As some people have said that if you do want to help, that you should start by trying to just open up a discussion with the parents, I'd like to caution you to not do that. My wife and I are the adopted parents of a sibling group. They were 4, 7 and 10 when we became a family. Yes, older adopted children screams attachment disorder, along with the trauma associated with being taken into care (and the reasons they were taken into care) and taken into a new family. Moreover, there's likely some undiagnosed (because the birth mother hasn't admitted to anything) fetal alcohol and drug effects that they're living with.

Now, our kids aren't medicated, but that isn't to say that they're without their problems. And it isn't to say that our homelife looks "normal" to other people. We've had family and individual counselling (for the parents and the kids), we've reached out to social workers, and we've had them reach out to us. The school administration for the most part has been pretty great; especially for one of our kids who's effects from the suspeted fetal alcohol present strongly enough that there are a lot of supports in place.

We've had teachers who've reached out because we're obviously doing something wrong, not realizing that one of our kids is a great story teller. Which isn't to say that he lies; however his selective not telling of some things, along with embellishing of other things can absolutely change a story. One teacher/coach insisted on us having an in-school appointment because said kid had too many chores and didn't have any free time. Ok, here's his chore chart. Suddenly the teacher/coach seems confused, as it's mostly personal things like "Do homework. Brush teeth. Fold clothes on laundry day." etc. He said clearly he didn't think this was Kid's chore chart as he was painting such a different picture, etc and left that meeting saying we should get together again after he talked with Kid. Of course, after he did talk with Kid, then he just needed to give us a phone call saying that Kid confirmed this was his chore chart and he didn't think it was worth having another meeting. No apologies, no statements about he learned a lot of Kid's past and that we've obviously put in a lot of work with him. No inquiries about if there's anything we'd like him to coordinate some care. Just a disappearance as this drive-by is finished.

And these meetings with teachers, or parents who have a drive-by "Hey, here's something!" but aren't willing to helpfully engage, and aren't willing to research and aren't there for the long hall burn you out.

How many books have you read already about childhood and young adult hood ADHD? If the answer is none, seriously (and I mean this as politely as possibly) STFU. One of Kid's friend's parents kept contacting F&CS (Family and Children's Services) alleging abuse absolutely refused to educate herself at all about any issues related to older child adoption. We even gave the F&CS worker who investigated the abuse allegations permissions to talk with her, and that still didn't help anything. "I don't know about this Attachment disorder you talk about, but all you need to do is X, Y and Z." This is the equivalent of "Nobody knew health care could be so complicated." Every and anyone who had done even a cursory investigation of health care in the US knew it was complex.

Even without knowing anything about attachment disorder, I'm sure you can imagine who much greater our home life was with Kid spending several hours a day with someone who fawned over him and told him how horrible we were. Guaranteed there was no more forward progress with him until he moved out at 18. And yes, having F&CS coming in to investigate abuse allegations affected the younger two giving them concern towards moving back into foster care.

TLDR - There's a lot going on that you don't see. Not only relating to the kid, but people that the parents already have had to deal with relating to the kid. They may quite likely be extremely guarded and hostile towards you "reaching out" as they're suspecting it's more drive-by "help". And seriously if you haven't done a lot of education on this subject but claim to be so concerned, maybe you should actually reconsider how concerned you are? And no, one or two quick reading of a few websites related to the topic (which might have been set up with a biased agenda) doesn't count as actual reseach.
posted by nobeagle at 6:49 AM on September 11, 2017 [25 favorites]

I have a mentally ill teen on a cocktail of meds who no doubt grouses about school to his friends. I would be BEYOND if one his friends' parents were to second guess our strategies. BEYOND.
posted by Biblio at 7:24 AM on September 11, 2017 [19 favorites]

Keep in mind he will be 18 soon, so if he wants to change his treatment plan without his parents' input, he'll be able to do that before long. In fact, your child should be on the lookout for sudden mood swings or changes in behavior, and be prepared to ask this friend if he has stopped taking his medications. Discontinuing psychiatric meds can be life threatening if a doctor is not supervising.

As far as what you can do to help him, you can always invite him over and make sure you're offering appetizing, filling meals and snacks, maybe as a scheduled sit-down dinner instead of 'help yourself to whatever is in the fridge.' Teens aren't always good at eating well or regularly, and hunger can make symptoms or side-effects worse.

If your child has a physical hobby they enjoy, they could invite their friend along on outings, maybe it's rock climbing or disc golf or even walking around taking photos; exercise helps a lot with symptoms of depression, anxiety, and ADHD.

You can also get this friend's parents' contact information, not necessarily to reach out and start pitching alternatives to medication, but in case you need to let them know your kid reported the friend is showing concerning behavior like suicidal thinking.
posted by castlebravo at 7:47 AM on September 11, 2017 [7 favorites]

It's great of you to want to step up when you hear about a child that's suffering.

I was an overmedicated teen. I have permanent, iatrogenic health issues from psychiatric drugs I was forced to take as a minor. I wish the adults in my life had let me know they believed my account of what was happening to me and supported me.

Some of these responses to your question are operating on the belief that ALL parents ALWAYS make caring and responsible medication choices for their kids and unfortunately that's just not always true. Some parents don't act responsibly. And, although it's an extreme scenario, it's not that hard for an abusive caretaker to exaggerate or lie about symptoms and doctor-shop in order to get prescriptions to "control" their kid. I'm NOT saying that's the case here (I don't know enough and neither do you), but that's what I went through. So I don't think it's right to immediately dismiss a teen's account of negative medication effects because "parents know best."

However, I don't think you're going to get anywhere by directly bringing this up with the parents and it doesn't sound like you have any real relationship with the kid either. I think the best you can do now is encourage your son to be a supportive friend. The most empowering people in my life when I was getting off of damaging medications were the non-judgmental ones that were essentially "pro-choice" about medication use and reminded me to trust my body and my experiences. This kid's a year away from making his own medical choices and your son (or you, if the relationship develops) can help support his choices and instincts as he gets close to that important transition.
posted by horizons at 8:24 AM on September 11, 2017 [20 favorites]

Your kid is telling you what this kid says. Your child is concerned. You're concerned. An unhappy kid on Adderall, Xanax, antidepressants, and sleeping pills deserves concern, so I think you deserve credit. Your kid can tell the medicated kid that you are available to listen, assuming you are. A caring adult who will listen is a good thing. The school almost certainly has a social worker, and Medicated Kid could talk to them. Unhappy adolescents are at risk for suicide, see what resources are available in your area. At, what, 17, he can probably go talk to his GP on his own to get his meds reviewed.

My son was a difficult adolescent. Several adults took him under their wings. They probably heard what a terrible Mom I was, blah, blah, but I was grateful that he had people to listen and care about him. A caring adult who shows interest in a kid and listens can make a very big difference.
posted by theora55 at 9:25 AM on September 11, 2017 [7 favorites]

You're coming from a good place. I would encourage you to keep being present and empathetic for this boy.

As is true in other situations when you may have disagreements with other folks parenting: getting in the middle of it is a recipe for heartbreak all around. If this kid is not being abused, please do not try to get involved in how he's parented. It's just not going to work out well. Not for you, not from the perspective of his parents, and certainly not for the kid.

Instead, you can be a safe, cool place and person for this kid to talk to. At 17, this kid is going to have to make his own decisions about meds soon anyway, so being a sounding board to let him brainstorm how he wants to manage his life could be valuable. Be wary of assuming you know what's best for him. Don't assume meds are a bad option for him - remember you don't know nor have any expertise or experience with this! Have humility and compassion and curiosity if you want to help.

If you think he has no idea there are other options out there besides meds, and he's given you some indication he's interested in that, you could, at most, give him some books to look at from folks who are dealing with depression or ADHD about how they manage it. Very likely most people will talk about using some combination of meds and other interventions. Or sharing a book like, Neurotribes about neurodiversity could help him have some context. But really, do your best to come from a place of not assuming you know what's best for the kid.
posted by latkes at 10:48 AM on September 11, 2017 [1 favorite]

The best way to support mentally ill people is to assume that they're making the best choices they can make for their own personal situation

This is somewhat in conflict with the other horrified advice to keep one's hands off someone else's child's mind, the way one would be told not to key someone else's car. that is -- the quoted line above is about him being a free and autonomous individual; all the advice about him being someone else's kid, and therefore none of OP's business, is about him emphatically not being one.

which is, unfortunately, true. If he's a minor child being taken to the doctor by his parents, he is not actually making many/any choices of his own. If he is a "good" child who takes the medicine he's told to take, because he's told to and he trusts his personal authorities, even though it doesn't help him and he hates it, even more so.

OP, you may think a little judicious med noncompliance would do him some good, but there is absolutely no way you can suggest this, either yourself or through your child, that would be helpful. If he wants to stop taking any or all of these drugs, which he may or may not want, he needs professional guidance because all three of them would probably make him feel lousy or worse to taper off of even individually. unless he is taking the adderall and xanax on an irregular schedule as-needed, and that is its own problem.

So he should go to a couple more psychiatrists for second and third opinions, and to explore the idea of different or fewer meds, not because xanax and adderall is a ridiculous combination, but because -- if the secondhand information in the question is true -- they're not fixing the problem they were prescribed to address. He probably can't do this until he's 18. If your own child is pestering you for ideas of what to say in response to his complaints, this would not be a harmful suggestion to offer at that point. (It would not be harmful for someone to suggest to him right now that different doctors might have different ideas -- if he asks for suggestions -- but if he's not in a position to make his own appointments and pay his own co-pays, it won't help him at all either.) So right now, there is nothing good you can do.

Be nice to him if he comes over.
posted by queenofbithynia at 2:12 PM on September 11, 2017 [3 favorites]

Being 17 is hard. Being 17 and being treated for mental health challenges is really hard. But neither this kid, your kid or you have any idea whether the medication is the problem. It sounds like you have a good relationship with your kid. I'd encourage you to help your kid adopt habits that will protect his mental health - eating right, getting enough sleep and exercise and doing something to deal with stress, whether that's journaling, talk therapy or whatever. Maybe it will rub off on your kid's friend but even if not, it will be good for your kid in the long run.
posted by kat518 at 3:30 PM on September 11, 2017 [2 favorites]

Your question... I'm sorry, there's just nothing here to suggest that you are working off anything other than compassion (great!) and an uninformed and instinctual suspicion of psychopharmacology (not so great.) You have no idea whether he is "overmedicated." You literally have no information about the boy's health, issues, why his team has him on this mix of drugs, what would happen without them, etc.

Anyway, go with the compassionate instinct, not the other one. Be kind and welcoming to the boy. Get to know his parents; be a support to them too. Encourage your son to be compassionate and kind, and model not rushing to judgment about issues about which you have no knowledge.

It isn't about "minding your own business," necessarily - I'm all about interceding where there is abuse, for instance - but it it is about recognizing the limitations of your information and acting with kindness, not arrogance.
posted by fingersandtoes at 3:42 PM on September 11, 2017 [8 favorites]

Be present in your child's life and encourage your child to be present and understanding in their friend's life. Being there is much more important than trying to fix a situation that is not yours to fix.
posted by Aleyn at 5:18 PM on September 11, 2017

I'm not sure why you're assuming this teen is unaware of the non medicinal "treatments" for ADHD. From personal experience, I can tell you that people love to give you endless unsolicited advice about these strategies. The same (well, usually better) advice is also in every book, website, etc about ADHD. My psychiatrist also pushes me to do a bunch of those strategies, and checks on my progress every time I see him for a refill.

I mean, I know you just want to help, but can you see how condescending it is to assume you know more about this disorder than the guy who actually has it? Even if you do have ADHD yourself (which I doubt, since if you did you would know first-hand how annoying this is) you still don't know as much about his ADHD as he does.

If you want to help, be generally supportive and approachable. If he wants advice on managing his meds from someone other than his doctor, he can always ask.
posted by randomnity at 1:26 PM on September 12, 2017 [2 favorites]

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