Has anyone solved the escalating meltdown problem (teen AudHD)? Need hope/advice.

[Anonymous]

Anonymous wrote:You didn’t get the right therapy. You say you got “parent coaching” but what you needed was more intensive behavioral therapy. The idea that your reaction is reinforcing her behavior should not be new to you. At this point you need to get her into DBT with a parent component.

This poster beat me to it. I have an AuADHD child who doesn’t have behavioral challenges but did experience really highs and lows. We looked into DBT. You should get on this ASAP before she attempts college.

[Anonymous]

Anonymous wrote:

Anonymous wrote:How long have you been working with the parenting coach?

About a year but we’ve targeted other things (phone use, hygiene), that were higher priorities at the time because this had calmed down for a while. It can calm down for very long stretches.

DP. Have you tried family therapy? My son used to have meltdowns like this all the time - it was awful.

A parent coach wouldn't have helped in our case because my son needed someone to help him have hard conversations with us, and help us learn how to communicate with him. Our family therapist has been absolutely life changing for our family in so many areas. Meltdowns are one of the biggest changes.

[Anonymous]

OP, I can tell you’re a really caring parent, and you’ve tried many many things.

The fact that she is still struggling is not your fault. she may have underlying personality conditions that are going to make this tougher to tackle. The fact that she is still engaging in this behavior as almost an adult suggests that this could be the case.

Absolutely you should keep on working on it and offering her strategies and resources. But I would tell her, if you do this at a job you will be fired. If you do this in another relationship, you will be rejected. You’re almost an adult and it’s time that you learn to navigate the real world.

And then I’d just leave it. Because you’ve done everything you can you’ve done your job. The rest is up to her.

And I don’t know how to split the difference on this, but the fine line between validating a person struggles and enabling their dependence is very hard to navigate. And frankly many therapy approaches are going to make it worse.

[Anonymous]

Ugh, OP - you are not alone. My DD 16 is so similar but not really anything in public. Besides over talkative and slightly impulsive, she is very friendly, outgoing, plays sports, has friends and even a few boyfriends. Most people would never know. And for her these meltdowns are usually when she is caught in a lie or has to own accountability for actions. She is in DBT and is getting better. We have tried a lot of meds as you. Right now Lamictal seems to be helping. It is really hard because for us as these episodes are like 1-3 a month now, so trying to medicate for it is a struggle. Do I want to flatten her affect or do I want her to get the right therapy to help herself. It's been really hard. Trying to do both.

A few ideas:

A rubber band on her wrist she needs to snap if she is feeling herself escalate.

If you see her getting to the level before it escalates (I know it happens so quick) we say we will talk all you want after a quick shower or head plunge in ice water. That has stopped a few and I usually hear her crying in the shower.

Do they happen more around her PMSing time? My DD was diagnosed with PMDD and is on year round birth control (skips placebo week) and this made a huge deal. Like we saw 50% decrease keeping her hormones regulated all month and also a perk of no more periods.

There are emotional regulation workbooks for teens if you haven't done that yet. A bunch on Amazon.

Have you thought about a mood stabilizer. A lot of teens do well on Lamictal or Latuda.

And you said stimulants did not work, but have you tried Clonidine?

All of these meds help emotional regulation and impulsiveness. Sometimes these work on their own and other times it works to calm while starting a stimulant to focus and clear the overthinking

Has she been diagnosed with anxiety? It tends to go hand and hand with teen girls with ADHD. Maybe treating that may calm the meltdowns that may increase with internal anxiety. Buspar and Propranolol work really well to decrease anxiety without the terrible side effects of SSRI

Another idea is a teen girl therapy group. My DD was completely against it but now loves going each week.

Good luck!

[Anonymous]

If you’re texting her back intermittently then you are NOT ignoring her. Did you do an FA? If not, why the F not?

[Anonymous]

Anonymous wrote:If you’re texting her back intermittently then you are NOT ignoring her. Did you do an FA? If not, why the F not?

What is that?

[Anonymous]

Anonymous wrote:

Anonymous wrote:If you’re texting her back intermittently then you are NOT ignoring her. Did you do an FA? If not, why the F not?

What is that?

A functional analysis. If your provider tells you to ignore the behavior without first determining the function of the behavior then I’d fire them immediately and find someone that knows what they’re doing.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:If you’re texting her back intermittently then you are NOT ignoring her. Did you do an FA? If not, why the F not?

What is that?

A functional analysis. If your provider tells you to ignore the behavior without first determining the function of the behavior then I’d fire them immediately and find someone that knows what they’re doing.

Oh ok. If that is some kind of formal assessment or process, then we have not had it. We have talked extensively about the function of the behavior, and the parent coach and DBT individual work together and consult. I’m fairly certain they know what they’re doing.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:If you’re texting her back intermittently then you are NOT ignoring her. Did you do an FA? If not, why the F not?

What is that?

A functional analysis. If your provider tells you to ignore the behavior without first determining the function of the behavior then I’d fire them immediately and find someone that knows what they’re doing.

PP why are you talking this way? Just be nice - dang

[Anonymous]

Anonymous wrote:DD (now 17) has made *incredible* progress in the last few years through therapy, medication changes, and us having excellent parent coaching. We finally got her showering, she's in the right school for her and doing well, has career goals and a few close friends at school (although she rarely sees them outside of school, etc.)

But the one persisting issue is horrible meltdowns she's been having since she was a toddler. They have had a similar pattern since then: something triggers her (usually a reaction to her behavior), she escalates which begins with yelling and evolves into throwing/destroying things, hitting people, etc. They last about 20 minutes but are incredibly disruptive/destructive, then she feels remorse and starts to cry, and then it's over. The frequency has varied over the years from once a week to once every few months. The hitting is infrequent but the throwing/destroying things is more frequent. She very rarely does it at school and has never hit anyone there. Although she has thrown things in a mild way (flipping her lunch off her desk once, and throwing a water bottle once but not at anyone). She does cry and get upset at school fairly regularly but it doesn't escalate like it does at home.

I have been practicing a different reaction per my parent coach's instructions, and I believe her that part of this is that our reaction has inadvertently reinforced this behavior and it is "relational" rather than "regulational." But yesterday and the past few times I felt myself thinking "will this EVER end?" It started with her asking me over text while I was at a meeting to take her to the doctor because she thinks her vocal chords are strained (as background, her vocal chords are strained from her last meltdown a week ago and she's a singer so she is very anxious about it). I replied that if her voice isn't better in two weeks (and gave a date) I would take her, but that I think she just needs to rest it a while. I put my phone back into my bag because I was at a meeting. When I took it back out 30 minutes later she had written me 42 texts and called me several times - screaming and crying over voicemail, texting that I'm a horrible mother and person, etc. This is the common reaction. I tried to ignore it because that's what I'm told by the parent coach. I intermittently texted back "honey, I answered this already, I can't text anymore." My husband was home and she proceeded to throw things down the stairs, hit him when he tried to stop her, broke a picture frame, etc. About 20 minutes later she was remorseful and calmed down.

She's on no medication. We tried 9 different ADHD meds over the years (stimulants and non-stimulants), and all of them made this worse and more frequent, and did not address the inattention or impulsivity related to her ADHD. She was also on a SSRI for many years that made her sluggish and gain weight, and this got a little better but didn't stop completely. We eventually changed to Effexor (we also tried Prozac and Abilify during that time which she didn't tolerate at all). She was on Effexor for a few years but lost ALL motivation. She didn't melt down quite as much, but sometimes, and stayed in bed a lot of the time and was negative and didn't care about anything. It was a bear to get off of and she now doesn't want to go the med route again and frankly neither do I.

Has anyone experienced this with their teen/adult child and found a solution? Did changing your reaction work? My biggest fear is if she can't stop this before it escalates this severely, she will lose relationships, jobs, etc. when she's older. I also just feel like I can't take it anymore, it's so upsetting.

NP My DH still throws stuff including at me and rages to this day. He is mildly abusive. Please make sure your daughter does not end up that way.

[Anonymous]

Look into the Matthews Protocol for medication.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:If you’re texting her back intermittently then you are NOT ignoring her. Did you do an FA? If not, why the F not?

What is that?

A functional analysis. If your provider tells you to ignore the behavior without first determining the function of the behavior then I’d fire them immediately and find someone that knows what they’re doing.

PP why are you talking this way? Just be nice - dang

I’m so tired of this board, if you want nice and sugar coated pay me for my services. I told the OP the truth. She either does it or not, but it’s 100% what is needed in this situation. I don’t particularly care if you like my delivery or not.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:If you’re texting her back intermittently then you are NOT ignoring her. Did you do an FA? If not, why the F not?

What is that?

A functional analysis. If your provider tells you to ignore the behavior without first determining the function of the behavior then I’d fire them immediately and find someone that knows what they’re doing.

PP why are you talking this way? Just be nice - dang

I’m so tired of this board, if you want nice and sugar coated pay me for my services. I told the OP the truth. She either does it or not, but it’s 100% what is needed in this situation. I don’t particularly care if you like my delivery or not.

I’m so tired of people like you. If you really want to be helpful, say helpful things in a helpful way. If you just want to lurk to be a know it all, go away. Aren’t you the “FA why the F not?” Poster too? Did you really feel like that was “the truth?” It was just rude and unhelpful.

[Anonymous]

Could anyone who has found a helpful provider for this behavior please share names? I have a 10 year old with a similar profile. She’s in therapy but it sounds like she’s just getting validation not actually making changes, and the parent part has been very disappointing (“have you tried ignoring the behavior?”). I’ve done tons of parent training and am looking for someone to help her or us jointly.

[Anonymous]

OP, would she understand if you explain the risks to her--that as she gets older, if she hits and throws it's not just a tantrum but a crime? She could get arrested, go to jail, get tased or shot by police. It's deadly serious that she learn to control this. And start planning with her for how she is going to work on building this skill--both for your own safety so you aren't injured by her, and for her own.