Thursday, July 28, 2016

Adult not previously diagnosed with anger issues

I was told that I had ADHD as a child, but from what I have found out I also had anger issues. I also had learning problems. I don't know what all was done to treat this since this was in the 70's and I am now 50 years old. I have no memory of much of my childhood and I only know things that my sisters have told me. I still have many issues and I would like to know if there are any treatments that help adults with these issues because they didn't go away with age. Some days I think I'm loosing my mind. I have been on an antidepressant but it doesn't seem to work because I still have these issues.  I can control them until I get home and then I loose it. My husband tries to help but he doesn't understand how. If you could give me some insight to this and how l can get treatment for this it would mean the world to me and my life.  Thank you for taking time to read this.

Yes, it's not unusual that many adults in their 50's were not diagnosed as children with ADHD, learning problems, or anger overload.  More children are getting help today than in the past. But adults today can also get help for these issues.  I would recommend you meet with a psychologist who works with issues like ADHD and anger overload.  You can ask the doctor who has prescribed the medication who he/she would recommend, or you could call your state's psychological association for a referral in your area.  

The three issues you mention--ADHD, anger overload, and learning problems--can occur together and each one can impact the other.  For example, people with ADHD are sometimes impulsive, so that when they get frustrated it can be harder to stop and think before saying something they later regret.  Learning problems often co-exist with ADHD and can cause frustration and anger.  Children and adults who have trouble writing or reading for example can get frustrated when faced with a writing task in school or on their job.  A psychologist can help you strategize about how to deal with any of these possible issues.  

My anger overload workbook can help with anger issues.  While written with children and teens in mind, most of the exercises and strategies can be used by adults as well. It is available online at Amazon.

Best to you, Dave Gottlieb, Ph.D.

Tuesday, July 5, 2016

7 yr old removed from day care

Dr. Dave,

I saw your blog on the Internet and thought I would ask you for advice, honestly because I feel as though I have run out of other options. By the age of one, my son was kicked out of three daycare centers and working on the fourth. He would bite, hit, pull other children's hair, and so on. The teachers never recognized triggers that set him off and the acts seemed to always be random. Half of his first month in kindergarten, my son was suspended due to his aggression once again. He was finally old enough to be evaluated at that time and was diagnosed with impulsive ADHD.  The medication prescribed certainly helped with his level of energy because he could never sit still, but it did not help with his anger. 

Now at the age 7, he is looking to be removed from yet another daycare center after spending only three weeks there. From what the teachers say, the smallest events such as a kid not sharing a toy can lead to him being enraged. He throws chairs, punches other kids on the face, calls the teachers names, and so on.  Once he calms down, he realizes what he has done and feels guilty.  He can clearly verbalize what he did wrong and how he could have responded differently. 

Sometimes when I talk to him after school about his actions, he tells me he feels he is the worst child in the world and that I don't deserve to have a child like him. He has even gone as far to say that he wished he was dead. My heart absolutely breaks when I hear him say such hurtful things to himself.  He should not be saying these things especially at such a young age. I have taken him to see child psychologists before in the past to help him develop better coping skills but there was no improvement. 

I actually had a child psychologist tell me that he didn't even know what else to do to help. I read your article about anger overload and really feel that this could be the reason for his actions. The problem is I don't know how to help him. I am a single parent that has to work so he has to go to daycare. With that, he cannot get one on one care at daycare or school with a hundred other children running around. How would you recommend teachers, daycare providers, and myself working together to ensure we help him make better decisions even though they have other children to look after? I'm just not sure of what proactive measures to take. I would greatly appreciate any tools or advice you have to offer to help. He is really a sweet and loving boy but I want others to see that as well, to include himself. Thank you.

Hi, I outline some ideas for schools (that would apply to daycare as well) in volume two of my parents' manual that focuses on strategies for schools. You are on the right track about the idea of working together with the teachers and daycare providers.  A coordinated approach will work best.  First, everyone should observe for a week or more, and make a list of situations when he becomes extremely angry.  Then try to identify some themes.  You mention one in your email:  sharing toys.  

One strategy would be to try to change your child's expectations about sharing in daycare. You would create a short saying, or mantra, and say it out loud with him each morning and night. You might even have him draw a picture of it and put it on the refrigerator at home.  An example of a mantra would be:  "I'm 7. I'm old enough now to share toys."  or "Can I learn to share toys?  Or "Am I going to hit someone who wants to share?"  Or write a mantra with your child.  Pick one that he likes, so that he will be more likely to remember it.  The reason you practice saying it out loud twice a day at home is to increase the likelihood your son will remember it at the time someone wants to share.  It would also be helpful to have the day care adult remind him of the saying before he starts playing with toys each day. 

I write about other ideas, such as emotional distraction and relaxation stations, in the blog and in my parents' manuals.  You might also ask your son every day to tell you if he shared toys, and put a star on a calendar every day he shares at least once.  In addition, ask your town librarian for suggestions on children's books about sharing.  You make a big deal out of sharing, in other words.  

I would recommend focusing on only a couple of themes (or triggers) for a month before working on others.  You want your son (and the day care staff) to taste some success and feel good about him having self control, and if you try to do too much at once, it will be harder for your son to focus on what he needs to do.  As he gains self control, he will feel better about himself.  In the meantime, you might also "reframe" what he says when he says he wishes he were dead.  You could say, "You feel awful when you hit someone, but we will work together so that you can learn to control your anger."

Best, Dr. Dave Gottlieb