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Parenting K-6 Kids/11 yo with Anxiety or Stress?


I have an 11 yo son. He is incredibly intelligent, sweet, kind loving, etc. However, he has been having behavioral issues since the age of three. Most of the time and the older he's gotten these aren't a major issue. At the age of 6 he was diagnosed with ADD and take Focalin XR 15mg. I am now concerned he may have been misdiagnosed. He does not handle stressful situations appropriately and I am beginning to think he has GAD. 99% of the time his reactions are small/mild, if he gets anything less than an A on something he will tear his paper up and ruminate and not be able to get back on task. The bad days are far and few between, but when they do happen, he will tray and pull his hair out, choke himself, and try and cause physical harm to himself until he calms down. We had one such incident this week. We haven't had an incident like this since he was about 7 or 8. I had thought he had finally grown out of it. I am at a loss. He is currently seeing a psychologist and He says that school stresses him out. He is always determined to get straight A's. We have changed his diet slightly, he is meditating everyday, and I am trying to get him to exercise on a regular basis. All of these are new changes, but I wanted to see what else I should be doing for him. I want him to grow up to be a well adjusted child. I worry about his mental well-being.

Your description of your son's behavior is, indeed, consistent with an Anxiety D/O. Both ADD and Anxiety D/O's can be inherited or can be situational. Both can be treated medically, but also respond to coping strategies. Such strategies are the focus of counseling and therapy. The most effective approach to managing both conditions is to employ both counseling and medication. Once a child, especially a bright child like yours, becomes a master of coping strategies, medication doses can usually be lowered or even eliminated. Counseling is available through school counselors and focuses on teaching coping strategies. Therapy is more intense, usually provided by psychologists or psychiatrists. The focus of therapy is uncovering causes for anxiety, then resolving them.

Focalin, like all stimulant medications, is given to improve focus and impulsivity, but also like most stimulants, it intensifies emotion. When troublesome emotions like anxiety, depression or anger are present, they are typically worsened. So the Focalin may be exacerbating the anxiety issue.

Counseling and therapy take time to become effective, whereas medications work more rapidly. Also, anxiety often makes it hard for a child to open up to a counselor or therapist. Using an antianxiety medication as counseling or therapy is begun  makes the process move faster.

There are some shortcuts to medications. Rather than using a stimulant medication to treat ADD, a "stimulant" antidepressive/antianxiety medication can be used to treat both conditions simultaneously while counseling or therapy is initiated. Thus ADD can be treated while anxiety is reduced.

Parenting K-6 Kids

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Alan M. Davick, M.D.


As a Johns Hopkins trained Developmental-Behavioral Pediatrician with 40 years experience, I have focused on distinguishing underlying willful, poor choice-making (like Oppositional-Defiant Disorder)from innate "conditions" masquerading as willful misbehavior (like ADHD, Autistic Spectrum Disorders, Bipolar Disorders, Cerebral Palsy, Developmental Delay, Epilepsy and "Behavioral" Seizures). Though I cannot act as a formal medical or psychiatric consultant, I will answer queries with generic information and suggestions for discussion readers may direct to their own professional advisers, including physicians, psychologists and educators.


I trained at the Johns Hopkins Medical Institutions in Pediatrics, Child Psychiatry and Behavioral-Developmental Pediatrics. Thereafter, I've continuously practiced Behavioral-Developmental Pediatrics and have taught the principles mentioned above to parents, colleagues and professional groups.

American Academy of Pediatrics SW Florida Sportsman's Association Florida Writers Association

First Travel Meds - 1987; Managing Misbehavior in Kids: The Mis/Kidding Process; Bullying: Rarely Travels Alone; Discipline Your Child (without going to jail); AD(H)D: What Every Parent Needs to Know

Undergraduate - NY University WSC Arts & Science, NYC 1959-63 - B.A. Medical Degree- State University of NY, Upstate Med Ctr, Syracuse 1963-67 - M.D. Internship/Residency - Johns Hopkins Hosp/University - Baltimore, MD 1967-70 Major, US Army Medical Corps, Chief Pediatric Section, Savannah, GA - 1970-72 Sp. Fellow, Dept Child Psychiatry - Johns Hopkins Hospital/University - 1972-73 Practicing Behavioral-Developmental Pediatrician, lecturer, author - to date Currently practicing Child Psychiatry - SalusCareFlorida, Fort Myers, FL.

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