Expert: Joyce A. Anthony - 5/31/2009

Question
Hi, After reading your profile, I thought you would be a great person to answer some of my questions.  I have an 18 year old daughter who was diagnosed with add in the 6th grade.  We did not medicate her until 12th grade as my husband and I were on her 24/7 to make sure she did what she needed to do. Even with that, she did not do a lot of what was expected and only did the bare minimum. She is very bright and ended up with a 3.0 high school gpa and went to her first choice college in the fall of 2008.  Unfortunately, she flunked out after 1 semester, never took her meds, and missed weeks of classes.  Since Dec. she has worked at a restaurant, tried community college but stopped going after 2 months and has lived home with us.  To say the least, it has been a train wreck having her here. Her anger outbursts are out of control, and she's moved out twice in the last month with people she has known for less than a week.  each time, the move only lasted less than a week. She has no regard for the rules that we set for her and she can't seem to manage her space (bedroom, kitchen, etc.) at all!!!! She could live in a pit with moldy food next to her bed and not even seem to notice.  This is putting it mildy.  Her medication (when she takes it) is adderal xr 20 mg.  Could this be bipolar and the add medicine is not working? Please provide with any of your professional insight as I would greatly appreciate it.  Thank you so much in advance,
Liz

Answer
Hello, Liz:

I think what you may be dealing with is rebellion.  If this were bipolar disorder, the medication your daughter is on would have her literally climbing the walls and unable to sleep or function at all. I believe that first she needs to take medication consistently and two, she needs some ground rules-she's testing you.

Set down some ground rules for her. If she is to live with you, she has to take her medication and if she chooses to leave again, she can't return for a set period of time. I know that sounds harsh, but she is 18 and needs to be made aware that actions have consequences.

Many kids go through this stage at this age, especially if they have had parents who do keep after them.  The beak toward independence is difficult at best. When you have an added issue like ADD it makes it even more so. While these kids seem to want no limits, they actually do quite well with more structure and clearly stated rules and consequences. That is why so many gravitate toward the military.

Set some house rules with pre-determined consequences. Let her know she needs to deal with anger in an appropriate manner, follow the rules regarding cleanliness and medication and any other rules you find necessary for your home.  Let her know it is her choice-she either follows the rules or has to get her own place.  I believe that she may test your will a time or two, but when she sees you following through, she'll comply.

               Joyce A. Anthony