View Full Version : Counseling, anti-depresants or both for ds??

12-03-04, 06:42 PM
My ds is 13 and was diagnosed with ADD in 1st grade. He has been medicated since, tried all the different options...Concerta, Strattera, Ritalin, now on Adderall XR 30mg. I think he could be clinically depressed. I took the 'test' what I thought his answers would be regarding sleep, appetite, interests or lack thereof, etc. 9 out of 10 were a 'yes'. I answered 'no' to the thoughts of suicide one because I don't really know. He tells me he doesn't have thought like that, but I'm not sure if he's being honest. Anyhow, the dr now says "There's probably some dpression going on with him. Seek counseling." He's a lot less depressed seeming when he's not on his meds. He's A LOT nore animated, social, involved, energetic, etc. So do we need counseling or anti-depressants to counteract the Adderall?? To be honest, we cannot really affored counseling. Our insurance bene is terrible for mental health!!! I don't want the doctor to think I just want a quick fix though. What to do??

TIA, Alirudy

Trooper Keith
12-03-04, 06:52 PM
Medication is effective, and if you can, counseling is good too. The medication should be effective if the problem is caused purely by a neurological or physiological problem, while counseling is more effective if the cause is psychological (because of thinking patterns, depressive explanatory style, or things like this).

12-04-04, 12:16 AM
Often times children with ADHD ultimately become depressed due to the stress and strain of struggling with school and peer relationships. Throw in puberty and it gets a lot more complicated. Personally, you couldn't pay me to go back through those years again; with or without ADHD.

A depressed mood in a child can be situational ( and I'm throwing in just becoming a teen in this category ) or it may be an indication of an actual mood disorder like Major Depression for example. The majority of the research I've ever seen supports the combination of therapy and antidepresseants as being the most effective treatment approach for depression.

It gets even more complicated with the particular type of ADHD involved, because that ultimately determines the type(s) of therapeutic techniques that have been found to work. For example, Hyperactive- Impulsive and Combined types have been found to respond to behavior mod as the only (therapy) intervention that works.

My belief is that you have to take a multi modal approach to treatment and try and "throw" as many potentially helpful evidenced based services at an ADHD kid and see what "sticks."For example, screening for sensory issues could ulitmately lead to a (physician) referral for an Occupational Therapy consult. If the child is then found to have problems in that area, OT can become a very helpful component to an overall treatment plan of medication, therapy , and a healthy lifestyle.

Good luck.:)