Older teen with ADHD, Tourette's

[Beth in OH]

Hi--
I have a friend with a 17 yo dd who was diagnosed long ago with ADHD and Tourette's. I don't know if she has any other comorbid diagnoses. The ADHD seriously affects this girl's executive functioning skills and friendships. Her "flightiness" makes her uncomfortable to be around. She is very immature, heavily influenced by peers who are "accepting" of her (often kids who are low-achieving or those who get into trouble), and has been in some low level trouble herself. She goes to ps, but doesn't do any structured extra-curriculars or have a job (read: lots of time on her hands).

Mom and Dad are panicking about how to steer this girl in a forward moving, positive direction. Mom is trying to engineer new friendships for the dd, but as one might expect, it's not working out very well to do this for a 17 yo (nor should it, necessarily. 17 yo's can generally choose their own friends--Mom is grasping at anything that might keep her dd on the right path.)

I know a little about ADHD (I read Delivered from Distraction, and have a dd who is diagnosed), and I have weathered some challenging parenting a teen situations. I would like to help this mom with some resources. Do you know of any books/websites that would help a parent navigate the turbulent teens with the overlay of ADHD at the level that it seems to create a disability?

Thanks! Feel free to offer whatever pops into your head that might help--I'm not sure if I'm asking exactly the right question, so I'm open to everything.

Beth

[Orthodox6]

Assorted thoughts, typed as they pop into mind. . .

Unless the parents refuse to consider medication, the girl should be functioning better than you describe.

Structure is essential for ADHD people. Can't do without it. We (I'm one, and have 2 dc with it) have to impose structure from the outside because we cannot generate it from within. Even with medication (which I do consider essential for severe ADHD), one still needs external aids for organizing life and executing tasks effectively.

If her social skills are weak, a group coaching set-up should help.

The girls selection of friends very possibly relates to a low self-esteem.

Don't leave her floundering with seemingly endless hours of "aimless hours."

At 17, the girl should be brainstorming with her parents and teachers regarding possible "future paths."

[Beth in OH]

Unless the parents refuse to consider medication, the girl should be functioning better than you describe

I believe she is or at least has been medicated, but I was wondering whether she had checked in with her Dr. lately. I'll explore this with Mom.

one still needs external aids for organizing life and executing tasks effectively.

Any thoughts on how to approach this if the immature teen isn't interested? I think Mom is having a hard time walking the line between controlling a 17 yo's every move and giving her appropriate room to learn through experience. How did you handle this when you were an emerging adult?

If her social skills are weak, a group coaching set-up should help.

Is this something that a mental health organization or hospital might offer or are you referring to something more informal?

The girls selection of friends very possibly relates to a low self-esteem.

Don't leave her floundering with seemingly endless hours of "aimless hours."

Agreed. Mom has become inapproriately (IMHO) controlling in the friend area in an effort to get her away from bad influences. I'm not sure what the right approach is with a 17 yo who knows her own preferences in people, regardless of whether her choices are "good" ones.

Do you think Mom and Dad should insist on structured activities for a child this age, with this condition, if she herself isn't interested? Could a mental health organization coach Mom and Dad on some of these parenting tips? They might respond best to an expert's suggestions.

At 17, the girl should be brainstorming with her parents and teachers regarding possible "future paths."

This may be the crux of the problem. I think the girls is having a lot of trouble seeing or caring about anything beyond the moment. Again, her meds may be at issue here.

Thanks for thinking this through with me. Feel free to add if you think of anything. I value your own experience as a guide for the older teen/young adult stuffQ:D

Beth

[Orthodox6]

First, foremost, and essential: I am NOT an expert ! I'm just another struggling mom who has so much more to learn ! I do hope that other people will post, people who can help so much better than can I.

(I'll add inserts to your text, below, in red font.)

I believe she is or at least has been medicated, but I was wondering whether she had checked in with her Dr. lately. I'll explore this with Mom.
There are different kinds of ADHD meds. Some never work at all for an individual, others work for a while then need to be changed. They are not "magic", but are tools to enable the brain to take advantage of that "executive functioning".

Any thoughts on how to approach this if the immature teen isn't interested?
No good suggestions. Nobody can be helped who does not wish to be helped.
I think Mom is having a hard time walking the line between controlling a 17 yo's every move and giving her appropriate room to learn through experience.
Battering a person, of any age, with any condition, does not work. All it does is hasten deterioration of the relationship.
How did you handle this when you were an emerging adult?
I was not diagnosed with my "wrinkles" (ADHD, major depression, OCD and probable Asperger's) until I was 48 years old. At seventeen, I was a high-achieving, self-motivated person who was scrambled, underneath the surface, by multiple undiagnosed "stuff".


Is this something that a mental health organization or hospital might offer or are you referring to something more informal?
We have not used social skills groups, and these may be for younger people. A children's hospital and a mental/behavioural health organization would maintain lists of locally-available social groups, and of ADHD coaches.

Agreed. Mom has become inapproriately (IMHO) controlling in the friend area in an effort to get her away from bad influences. I'm not sure what the right approach is with a 17 yo who knows her own preferences in people, regardless of whether her choices are "good" ones.
You haven't discussed to what extent the Tourette's affects the girl's social relationships. I know but little about this condition.

As I wrote about the futility of "battering", same goes for too much interference in a teen's choice of friends. If the mother and daughter had a strong, positive relationship to begin with, then the daughter probably would listen, at least enough to understand what worries the mother.

If the mother is unaware of how "controlling" she is being, or if she denies that she is being so, . . . then you tempt me to wonder whether family therapy is in order.

Do you think Mom and Dad should insist on structured activities for a child this age, with this condition, if she herself isn't interested? Could a mental health organization coach Mom and Dad on some of these parenting tips? They might respond best to an expert's suggestions.
I'm not thinking so much of structured "activities" as I am thinking of the girl learning how to achieve and maintain the "internal structure" necessary for a productive adult life.

Certainly, a professional can guide the parents with "how to" suggestions. . . IF the parents are open-minded to receive constructive criticism about things which they, themselves, may be doing "all wrong" and which contribute, to whatever extent, to their daughter's problems.

Again, if the girl has no interest in changing herself, there is next to nothing that her parents can do. They may have to consult experienced and competent outsiders (clergy, counselors, psychologist, etc.) and construct a fluid plan -- ("fluid" because life and individuals change so rapidly) -- for their own role in their daughter's future. This plan may include elements such as at what age to require the girl to move out of the home, what level of monetary support is appropriate once the girl has been graduated from high school, what contributions to family life (chores, behaviours, attitudes) the girl should be offering consistently in order to receive any "benefits" beyond the receipt of "minimums", such as food, shelter, and basic clothing. And so forth.

This may be the crux of the problem. I think the girls is having a lot of trouble seeing or caring about anything beyond the moment. Again, her meds may be at issue here.
A lack of meds, or the absence of a better med might be at play. Anything else also could be at play, too. Drugs? Alcohol? Abuse of some type? Yes, I'm listing scary possibilities, none of which may exist. I'm just trying to think in detail.

If one is surrounded by unmotivated friends, one loses ones own motivation. The girl may have backed herself into a cycle.

Thanks for thinking this through with me. Feel free to add if you think of anything. I value your own experience as a guide for the older teen/young adult stuffQ:D

Beth

So that you will see that I, too, am struggling with my own family's issues with "young adult versus ADHD" . . . Our 20-year old ds -- a delightful, friendly, affectionate, A-grades-student -- came off his Concerta for the summer. He has been asleep in bed until early afternoon nearly every day (although he did make good effort to find a summer job in this hostile economy), or playing video games, or reading history books all summer. He feels miserable, he feels unmotivated, he feels extremely unhappy. (Yes, he has comorbid unipolar depression and anxieties.) I started to fall into "badgering mode", a few weeks ago, then remembered how counter-productive that would be. Things are no better, but I understand enough to understand that nobody feels worse about himself inside than does my dear son.

Believe me, that 17-year-old girl is a deeply unhappy person. Don't forget that depression very, very often accompanies ADHD. In fact, the two can be a "chicken-or-egg" conundrum of which one precedes which other one.

Well, I have rambled . . . .

Still hoping that other people step in with greater wisdom than I have.

[Beth in OH]

First, foremost, and essential: I am NOT an expert ! I'm just another struggling mom who has so much more to learn ! I do hope that other people will post, people who can help so much better than can I.

Thank you so much for your help! I am in the early diagnosis/treatment stage with my own dd, but your responses validated the very humbling parenting lessons I learned with her. I'm not sure I'm going to be able to do much to help my friend except listen and try to point her toward the med adjustment, exploration of other issues (I think depression is likely, actually), and family therapy. Other than that, I guess she'll have to walk it out daily with her dd.

If you ever come across a book that addresses how to launch a young adult with ADHD, please post!

Thanks again,
Beth

[SmokyJo]

I'm replying under the assumption that your child's friends are not a good influence - I've been there with my 19 yo ADD son who recently came out of the "OCD" (severe) closet. His self-esteem, everything, is a reflection of friends he's "hung" with since 14 - esp. w/boys, unless you can redirect her to education, sports, healthy activities with healthy friends, they will control her life, her self-perception and her actions. Friends are by far the most dangerous, or thinking positively, the greatest influence on what she becomes in the future. It's not to late - I know from experience...Best of luck!

[Beth in OH]

Friends are by far the most dangerous, or thinking positively, the greatest influence on what she becomes in the future. It's not to late - I know from experience...Best of luck!

:iagree: The girl I posted about is not my dd, but I do think there are some friend issues there. I couldn't agree with you more, though, about the impact of friends on teenagers with ADD, OCD, Depression, Anxiety, etc. Unfortunately, the self-esteem issues involved with these disorders often push our kids toward others who are underachieving or worse.

My own dd is at least stabilized in the friend area, although it has been hard to extablish new friendships while working and going to community college. I am hopeful it will be easier when she transfers to a university next year.

It's a daily challenge, isn't it?

Beth