Monday, March 16, 2015

14 yr old with ADHD and anger

I have a 14 year old grandson who was diagnosed with ADHD when he was younger (5 or 6). His doctor has been treating it with medication.

In the last few months he has had several outbursts of intense anger. He is all but uncontrollable when this occurs. So far we have been able to calm him down to where we can have a reasonable conversation with him.

They seem to occur when he is asked to do something he does not want to do. For example, he was asked to stop playing his video games and to pick up his sport equipment in the backyard. He did it begrudgingly and had to be asked to do it again because he only picked up that he felt needed picking up. When confronted he became sassy, disrespectful, and continued to make "the last comment."  It escalated to a point where he was told to shut down the video games and take his shower. He argued the shower over and over because in his mind he had already taken one earlier in the day before going to a birthday party. Since he played at the party and in the back yard after he got home he was asked to take another shower.  It escalated very quickly from there to another outburst.
What started out as what seemed to be an "isolated" incident has all but become a weekly event.  My question to you is it possible that the medication he is on for ADHD is contributing to these outbursts?
Hi, If the outbursts have increased in the last few months, think back about what might have changed in your grandson's life.  If the medication changed right before the outbursts started, then I would recommend you ask the doctor if he/she thinks there could possibly be a medication effect.  In my experience, ADHD medications do not generally lead to an increase in children's anger.  Actually if a child has ADHD, medication helps with distractability and impulsivity, and thereby make it easier for a child to learn strategies to cope with anger.
I wonder if your grandson has started puberty and is dealing with hormonal changes and new emotions.  Some children when they hit adolescence become more argumentative when adults ask them to do things.  You mentioned for example that he got irate when you asked him to take another shower after playing outside.  You explained that he had not expected to have to take another shower.  What I would recommend is to sit down with him when everyone is calm and explain your rules about showers.  The idea is to change your grandson's expectations ahead of time.  Another way you could do that is to remind him before he goes out to play that he will need to take a shower when he comes in. 
Some adults also limit game or television time in the evening until a child showers.  Then your grandson will have an incentive to shower.  If you can enforce that the television does not get turned on, then you do not have to argue with him, but let the potential consequence do the "speaking" for you.
If picking up things outside is another frequent issue, try to apply the same principles:  talk when everyone is calm, remind him before he goes out to play what you expect, and have something he wants to do later depend on his picking up outside.   I explain other strategies in my books on anger overload: such as a) emotional distraction, b) labelling levels of anger to develop self-awareness, and c) teaching him about other points of view. 
Best, Dr. Dave Gottlieb

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