Ritalin and other medications

[Parents! Get help here!]

My dd22 (high functioning) is currently on anti-depressants (which both she and I've heard can be less than useful for someone with BPD) and Ritalin, both prescribed by the same psychiatrist that she's seen for the past 2 years.  It's my belief that her friend (with Bipolar) told my dd about Ritalin as a good way to lose weight.  My dd shopped around until she found a dr. that would prescribe it to her.  (We live in Australia.)

In some ways I'm really angry, and have expressed my concerns to my dd.  Her psychiatrist seems to be treating symptoms that my dd presents at a particular time.  My dd says she's discussed BPD with the T, but when I ask what the T says about that, there's not too much of a reply. I even think now the Ritalin may be the reason she's having these 'episodes' like feeling out of body/manic and banging her head with her fist.

I asked my dd why she's taking Ritalin, as she started it nearly 2 yrs ago when she was studying at university (she's dropped out of 3 courses.)  She now stays at home, unemployed, living in a hovel with other young people.  She say she can't 'concentrate' without it.  (Concentrate on what, I ask myself?)

I don't know a lot about Ritalin, but am currently doing some research. It seems to be addictive, and one reason I believe my dd didn't like the new psychiatrist she saw yesterday was he may not prescribe it to her.  She even expressed her concern about this to me before she saw him.

This is dangerous stuff, self-medicating and seeking out a dr. who will give you want you want, or believe you need.  My h and I are now getting our heads around the fact that dd may be dependent on Ritalin, and without addressing this, any T is going to be more or less useless.  It's effectively an addiction, and we all know how in line with BPD that is!

I'd love to hear other people's experiences with medication, and Ritalin specifically.  I'm sure it has it's place, but not to the point where the person thinks they can't function without it.  My dd is actively seeking a T after a huge meltdown after breaking up with her bf 2 months ago.

I've said to my dd that whatever counsellor gives her T, she's going to have to work with THEIR psychiatrist and whatever drug regime they recommend.  As I said to her, neither she nor I are experts in this.

I've been hopeful, but as Vivekenanda wisely told me, it's one step forwards and two steps backwards... .   feeling so over it right now.

[yogablue]

My dd22 (high functioning) is currently on anti-depressants (which both she and I've heard can be less than useful for someone with BPD) and Ritalin, both prescribed by the same psychiatrist that she's seen for the past 2 years.  It's my belief that her friend (with Bipolar) told my dd about Ritalin as a good way to lose weight.  My dd shopped around until she found a dr. that would prescribe it to her.  (We live in Australia.)

In some ways I'm really angry, and have expressed my concerns to my dd.  Her psychiatrist seems to be treating symptoms that my dd presents at a particular time.  My dd says she's discussed BPD with the T, but when I ask what the T says about that, there's not too much of a reply. I even think now the Ritalin may be the reason she's having these 'episodes' like feeling out of body/manic and banging her head with her fist.

I asked my dd why she's taking Ritalin, as she started it nearly 2 yrs ago when she was studying at university (she's dropped out of 3 courses.)  She now stays at home, unemployed, living in a hovel with other young people.  She say she can't 'concentrate' without it.  (Concentrate on what, I ask myself?)

I don't know a lot about Ritalin, but am currently doing some research. It seems to be addictive, and one reason I believe my dd didn't like the new psychiatrist she saw yesterday was he may not prescribe it to her.  She even expressed her concern about this to me before she saw him.

This is dangerous stuff, self-medicating and seeking out a dr. who will give you want you want, or believe you need.  My h and I are now getting our heads around the fact that dd may be dependent on Ritalin, and without addressing this, any T is going to be more or less useless.  It's effectively an addiction, and we all know how in line with BPD that is!

I'd love to hear other people's experiences with medication, and Ritalin specifically.  I'm sure it has it's place, but not to the point where the person thinks they can't function without it.  My dd is actively seeking a T after a huge meltdown after breaking up with her bf 2 months ago.

I've said to my dd that whatever counsellor gives her T, she's going to have to work with THEIR psychiatrist and whatever drug regime they recommend.  As I said to her, neither she nor I are experts in this.

I've been hopeful, but as Vivekenanda wisely told me, it's one step forwards and two steps backwards... .   feeling so over it right now.

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[femom]

Ritalin or any of the other similar stimulants are great if you have ADHD but should never be used for those who don't.  For someone with ADHD, the stimulants actually calm, improve impulse control and focus.  If you don't have ADHD, the same medications will give you the high that becomes addictive and very dangerous.

[jellibeans]

My dd16 when younger resisted taking any mads... . she was in that stage of there is nothing wrong with me... . so Ritalin is something she has taken on and off again but we never saw any real change or improvements... . I think is actual irritated her to some degree.

She now takes adderall (sp) and she thinks it helps her... . it does tend to keep her pretty skinny too so she likes it... . I have to lock it up about she would take more than she is suppose to when working etc... . My Dd16 has ADHD so I am not against her using it... . she will often stop in the summer and then restart before school starts.

[Thursday]

yogablue,

I certainly understand your concern. Our experience with Pdocs has not been very positive and part of the reason is the prescribing of meds that we have never felt my BPDSD22 needed.

She was first prescribed Ritalin for ADHD when she was only 7 (before I came into their lives) and according to her Dad her reaction was terrible- out of control tantrums... . my husband describes her laying on the floor and spinning around like one of the Three Stooges.

When in 9th grade her problems at school began to escalate and her Dad took her to see a Pdoc ( to get insurance approval for therapy and that MD prescribed patches for ADHD. I was unsure about the ADHD diagnoses... . she could sit still in front of the TV or computer for hours and never seemed particularly hyper but in addition to this I had seen her focus on things that she liked (such as straightening her hair- it's super curly and she hated it at the time and it was so thick it would take hours to flat iron it but she did this every time she washed her hair. I could NEVER sit still that long for such a mundane project and I don't have any type of ADHD or ADD)

But we gave those patches a try and by the time we discontinued having her use them she had gotten herself into all kinds of trouble at school and was amping up her illicit drug use AT SCHOOL, long story short, by the end of 9th grade she was kicked out of her high school for nine weeks and sent to alternative school. We sent her to a wilderness therapy camp that summer and she spent the summer hiking with a 50 pound pack, came home to a very firmly worded behavioral contract which kept her in line all of her junior year and most of her senior year. (things disintegrated again during her senior year but that is another story)

The only other psych med she has ever taken was recently, an MD prescribed Wellbutrin for weight loss. She is an adult and we cautioned her about side effects but she took it anyway (she is a recovered addict and won't take most meds... . including no pain meds of any strength) and now she reports she isn't taking it anymore. She didn't lose any weight.

I believe the ADHD patches (Daytrana) were responsible for her very out of control behavior in high school before wilderness camp slowed her down a bit.

I know there are those who benefit from pysch meds but if you don't really have the issue that is diagnosed I don't believe these meds are indicated and the PDoc who saw her met with her for only about 15 minutes... . he was really just taking a stab at a diagnoses. Prescribing meds was his JOB.

thursday

[BioAdoptMom3]

Our DD has never been on Ritalin (she is 14 so we still have control) but she is on Prozac and Abilify.  The med which seems to help the most, and it is significant, at least in our case, is Abilify!  It helps her to calm down quickly after a crisis or outburst of anger over whatever we just told her she cannot do, etc. I imagine you must be incredibly frustrated with her being a legal adult and taking something she obviously should not be taking.   

[yogablue]

Thanks for your replies everyone. It's great to hear of your experiences with meds.   I did ask my dd if she had ADHD to be described Ritalin, and her answer was 'I guess I must have'.  As you say femom, prescribing any drug for a condition you don't have is dangerous.

I spoke to my dd yesterday about what Ritalin dosage she's taking, to try to get a handle on what's going on.  She says she takes 6 tablets a day of the lowest dose.  According to her, she is allowed to take more.  But at least, even though she only sees the T every 3 months, and is prescribed Ritalin for a 3 month period (!) she's only allowed to buy one pack a month so has to make them 'last.'

She told me she's seeing the psychiatrist again in 10 days' time and that's how the conversation started when she said 'at least I'll get the Ritalin again and be able to focus.'  I seriously wonder how these professionals ascertain how their patients require certain medications, and have half a mind to email her (my dd willingly gave me her name, which up till now I didn't know.)  But I won't.

I am worried that my dd has an addiction, but now have a vague plan in how to take this forward.  My dd rang me yesterday to say she's found a psychologist who she'll be seeing 2 days after the psychiatrist.  To clarify, we live in Australia, and psychiatrists (who prescribe meds) are covered here by govt. medical aid, but psychologist are not (they provide counselling, but can't prescribe meds.)  I'm not too sure how it works in other countries.

I have the email address of the psychologist my dd is going to see.  I'll wait a few weeks, and then think I'll email the psychologist to tell her what I know of my dd's Ritalin prescription, as I have a gut feeling my dd won't tell her about this.

Thanks for your comments Thursday and how it affected your sd.  It does make you wonder, doesn't it, what sort of a handle these professionals have on what's going on.  I'm not even sure at this point that my dd has ADHD.  My dd may have googled the symptoms and be presenting them to the psychiatrist to obtain Ritalin for her own reasons!

BioAdoptMom3, yes it is frustrating indeed.  I'm not sure what Abilify is.  Is it similar to Ritalin?

You're right, it 's a minefield when your child wDPD is an adult.  At the moment I'm trying to keep the communication lines open between my dd and not judge, and practice the lessons on here to help me listen.

[femom]

6 tablets a day seems wrong to me and I am suspicious of the doctor who is prescribing this for her.  There are  forms of ritalin type drugs that are extended release which might be more appropriate for your daughter if in fact she does have ADHD.  If she is taking this much, it sounds to me like she is seeking the buzz that ritalin provides for those who don't have ADHD rather than the calm that it produces for those who do have it.  Is ritalin a controlled narcotic in Australia like it is here in the US?

[qcarolr]

My BPDDD27 started on ritalin at a young age. When she came off of the medication she was very very aggressive. They tried to medicate this side effect. DD tried many different psych meds. during her life with minimal results. In the end she was off of it by 4th grade. She was dx ADHD at age 4 and at 6. I really think it is more related to her learning disability than to pure attentional issues. As an adult my DD has pursued stimulants, both street forms and rx forms, to lose weight and to have 'better focus'. I will not assume to read her mind or what she is seeking. She says she is not addicted, she does not need increasing doses, does not have any withdrawal when she is not taking meds., etc. She has a very complex combination of brain based and behavior based issues.

My gd8 has also struggled in school. Her pdoc is very cautious with meds. and I am very cautious with meds. . He began with Intuniv to help with her distractibility and anxiety. We did a very short trial of ritalin and saw an immediate increase in her aggression. This was when she was 6. IN 3rd grade this year she was making no progress, even with the supports provided in special education with IEP. So over the Christmas break we started a trial of Adderall. This is a time release version of the drug in Ritalin.

It was like a switch was thrown in her brain. She gained 8 levels in one month in her reading assessment. She is fully participating in class, with friends at recess, and continues to make progress. We see so much better organization and communication abilities at home. It shows me that the ADHD dx is very accurate.

And it is pushing her mood when the drug wears off in the evening. The pdoc is very concerned by this as over time this tends to get worse when pushed by the stimulants if not treating the mood issues. We will work with this as we go along. No easy answers.

qcr

[yogablue]

Yes Ritalin is a controlled narcotic here in Australia femom, which is why if my dd is given a 3 month prescription, she can only fill her script once a month.  General practitioners can't prescribe it, only psychiatrists.  It's also called a 'cheap man's drug' as it's inexpensive and has a high street value, something like $20 per tablet.  Some people snort it or inject it, but as far as I know my dd doesn't do this (but what would I know.)

qcarolr, thanks for your insight into Ritalin.  My understanding is it's often prescribed in young children for behavioral disorders, lack of sleeping etc.  My dd went through primary and high school with none of these issues nor learning difficulties (although she had many other issues from the age of 11/12.)  To date, I don't even know if she has ADHD, or was seeking Ritalin out as a known aid to weight loss, and this is what concerns me.  I would like it if one T oversees her treatment, including counselling and drug prescription, which is currently not occurring as here they are two separate things.

As others have said, Ritalin or Adderall can be extremely useful, like in the case of your gd, qcarolr, if they have ADHD in helping them with their learning at school and to socialise.  But if the person doesn't have ADHD and has BPD, it could be a recipe for disaster.

A week ago my dd quietly told me she's been having 'manic' like episodes where she can't control her movements and has been punching herself in the head.  She says this occurs when she's been through days of 'feeling nothing and then everything comes flooding back'.  I'm starting to wonder if this isn't some kind of psychotic episode, caused either by the Ritalin (or withdrawal from, as she has currently run out of the medication).  Perhaps she is developing Bipolar, as she's at the age when it is commonly diagnosed in females.

As I always maintain, I am a mother, not a psychiatrist, but it makes it very difficult to know what's going on and the best way to support my child.  Even more so that now my child is an adult, in Australia we have very little rights as parents to information due to privacy laws, which I respect but it leaves us in limbo land much of the time.

I think those of you in the USA are fortunate as you seem to have a system where there is access to psychiatric care, or I could be wrong?  Here the govt. will only pay for psychiatrists, for those without private medical insurance.  When it comes to counselling (through psychologists etc) we have to pay upfront.  For BPD T, if we're looking at 6 to 12 months treatment, each consultation is Aus$210 per session!  If T is once a week, that racks up pretty quickly and neither my dd nor i can afford it.

Like you qcarolr, from what I read my dd could benefit from mood stabilisers, but she's not currently getting them.  Sometimes I just think, 'what would I know.'  It's very frustrating, thanks for listening.

[qcarolr]

My experience in USA is if you have money, you can get access to lots of resources. Insurance is private with high premiums or provided by your employer. My DD is considered disabled and without income, so she qualifies for government supported medical care. She is very limited on who will accept this. She has only had this for about a year, and we are grateful. Often the self-pay part of what is covered by insurance is high with coverage very time limited.

qcr

[Googie]

hi Yogablue,

My DD16 took a few different ADHD meds over a 6-7 year span including concerta, adderall, ritalin, and straterra.  When she was in elementary there was a marked improvement that allowed for her to process the lessons and be able to apply what she learned which made her grades soar and she really benefited from the natural consequence reflected in her grades.  It boosted her self esteem and confidence.  But after a while the medication would become less and less effective and was usually caused by a change in her mood stabilizer.

In 7th grade we all noticed, family, friends and teachers, that she was irritable and had increasing difficulties being able to control her mood.  Her psychiatrist and I decided to stop the ADHD meds after straterra was a total failure which I was told was more the norm that not.  We did however, attempt to help her concentration for the week prior and week of end of grade testing since she doesn't do well taking long exams and has a touch of performance anxiety for the "big deal tests" as she called them.

Well... .  I totally did not expect a call from the vice-principal (who adored her and was her #1 cheerleader) called to tell me that there had been an incident on the bus where Ehit__ chose not to inform the bus driver that an 8th grade boy was making inappropriate gestures to her and her friend and decided to "jack the kid up" were his words, in which he was injured and a parent had to take him to seek medical treatment.  

The first thing I thought to myself was "I bet that kid will never do that again" but really, how bad was he hurt and why did she react so much differently than she has in the past with similar incidents... .  So, she was suspended off the bus for two weeks, the boy's testicles survived to ensure a future generation, and her psychiatrist and I agreed to continue the meds as they were and start focusing anger management skills into her therapy sessions.  

Well... .  every single day she was either getting into a fight verbally, or acting like she wanted to punch something or someone.  I asked her what was she feeling and to describe it if she could.  She said "it feels like I want to come out of my own skin and all I want to do is take it out on someone".  Psychiatrist and I decided to stop the med temporarily to see if her mood improved which it did immediately.

Two years later attempted to do the same for testing and it was an epic failure.  No one got hurt but we were aware of what to look out for otherwise she could have absolutely seriously injured someone.  She is a powerhouse when she attacks when she is escalated which makes her very dangerous so ADHD meds are and will always be off limits.

There have been very cocky psychiatrists that insisted on having her try another round to see how it affects her, but since they need my approval (which they never got) we avoided a number of very serious behaviors that have only been caused by stimulant meds.  And of course on her own when she cycles into her escalation period where she always ended up hospitalized due to her aggression or suicide attempts.

Stimulants for me, cause I started taking adderall when I went back to college, worked wonders and did what it is designed to do.  Although after 3 years I no longer had the same effect and became irritable on a lesser scale than my DD, its a drug.  :)rugs, especially stimulants, narcotics, opiates and benzodiazepines can be seriously dangerous drugs period, for anyone.

There's a saying that is used in 12 step groups... .  a drug is a drug is a drug.  Anything that is mood altering can be addictive, even mouth wash for an alcoholic, NyQuil for an addict.  Its what the drug does to a person's ability to function normally without causing symptoms or effects that are negatively impacting their personality prior to taking the drug.

It sucks when addiction becomes an issue, myself as well as many family members have struggled with addiction.  Thankfully, I was spared a lifetime of pain and suffering by finding the 12 steps and really wanted to stop living the way I was (alcohol, no drugs).  My older daughter is in her glory since she moved out of my home and into her boyfriend's where she can use substances and experiment without hearing my lectures.  I worry all the time.  It is out of my control.  I am powerless over everyone and everything except my own self.  I know what you are going through and I want you to know that there is help out there through Alanon meetings and literature that teaches how to detach with love.

Is there anyway the medication could be secured and dispensed by a responsible adult?  Everything seems so easy to suggest and I know it is never simple task when dealing with a BPD especially when there is a substance issue.  

You can always contact the prescribing doc and alert the pharmacy to inform them about your concerns.  They can not talk to you, but you can give them pertinent information that might give them a reason to suspend medication management for any controlled substances.

I wish you all the best and please feel free to PM me if you need to vent... .  cause I would be needing to vent and vent and vent some more if I had the addition of addiction with my BPD.

((hugs))

Googie

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[qcarolr]

Googie - I really worry about this scenario (mood escalation toward impulsive,violent behaviors) with my gd, yet I yearn for her to find success in her daily life that the Adderall has given her. There are days I just don't want to be a mom/grandma at all. Have to not think too much about the years ahead with either Dd27 or gd8.

qcr

[theplotthickens]

I have not read the whole thread, so I apologize if this has already been mentioned.

My dd is AD/HD and reacted with rageful fits to stimulants from age 7 on.  I know know that that is typical of bipolar disorder.  Of course, the professionals didn't inform me of this at the time.  Intolerance to stimulants secondary to bipolar, does not mean that a child does not have ADHD.  It just makes the ADHD really hard to treat.

Just wondering if your child has any other bipolar symptoms such as mania or hypomania?  Just wondering if mood stabilizers had been tried and what the result was.

My dd has ADHD, bipolar with ODD, AND emerging BPD.  Without the correct meds, she would not be able to live at home.  They have been a God-send for us!

[qcarolr]

Gd's pdocc has talked with me about the other classes of meds. Her mom was on so many as a child with all the dx you mention. She also has serious learning disabiliy similar to aspergers which complicates it more. We are hopeful gd will do better. Gd is having more success in her life. Dh and i are also in a different place in parenting gd.

Try to live present in today as the future is such an unknown. Easy to say. Hard to do.

Qcr