I have a stepson in his early teens who stays with us part time, and who was diagnosed with ODD/ADHD as a young child. He was on Strattera until the family doctor took him off of this medication approximately 6 months ago because his concentration had improved. I have seen no change in behavior since the medications have been eliminated, but I suspect that the pills were not being taken regularly during treatment.
This child is always negative, causes arguments between his father and myself, gets his father upset with his mother, takes no responsibility for anything (and frequently breaks things around the home), steals food, makes messes and deliberately manipulates. In addition, he lies, has few friends — and has accused several friends of stealing things when he himself misplaced them — will not perform standard hygiene tasks such as brushing teeth, showering and changing clothes without being repeatedly told to do them. He also shows anxiety/panic attacks, sees himself as a victim (e.g., does not understand humour at all, thinks people are against him, laughing at him) and seems extremely depressed at times. He has also tried to bully my son who is a year younger. He also has no motivation, hobbies or interests at all beyond video games — he plays them the entire time he is not in school, sometimes more than 8 hours in a day, and he eats continually.
My problem is that this child is receiving no medical attention at all for this. His mother seems really to not want to do anything that requires effort, and my husband, the child’s father, won’t do anything to upset the mother. I had my husband convinced to take his son to a psychologist when he visits with us, but the son threatened that he would not come to our house anymore if he had to go to an appointment, so my husband backed out. I have read a school psychologist’s report from a couple of years ago recommending a psychiatric assessment — but this was not done.
What can I do? This child needs help, and I have had all that I can take emotionally and due to my own health concerns. I hate seeing him come for a visit because it upsets me, my husband and my children, and the stress level is crazy. I actually think about divorcing my husband to get away from his son it has gotten so bad.
Let’s start by reviewing the faulty reasoning regarding Strattera. We typically don’t want to stop a medication when it’s working, as when his concentration was improving. ADHD children do not outgrow their symptoms with puberty. While the physical hyperactivity seems to decrease with age, the mental hyperactivity, poor impulse control, and poor concentration continues. I recommend reconsidering the Strattera as that medication also has an antidepressant action.
I think your assessment of the teen is totally correct. This is a socially miserable, depressed, and oppositional young teen who is likely controlling both family locations with his bad behavior. He has so many bad behaviors that adults at both locations are hesitant to do anything for fear of increasing his bad behaviors, something he actually threatens. As a result, he bullies younger children and controls and intimidates the adults, allowing him to do what he wants to do. What do we do in these situations?
- Recognize that his biological mother is probably incapacitated and overwhelmed. She is unlikely to take any action that would make her home life more miserable. Therefore, she may not be helpful as you try to obtain help for his teen.
- Recognize that you and your husband must make decisions as a team in the best interests of the child. While you are thinking as a competent and concern parent/adult, your husband is trying to avoid difficulties and confrontations. That won’t work in this situation. He must accept the fact that his ex-wife will be upset. The son will also be upset when you try any intervention. I would reconsider an appointment with a mental health professional. The son is emotionally and socially moving in a very bad direction and without intervention, the situation will become worse.
- In all interventions, you and your husband must work as a solid team. All decisions are firm. As a team you approach the child and the mother. Understand that when you make a decision, both the mother and son will emotionally pressure your husband, using everything from threats to guilt. Some children actually use misbehavior in an effort to break up remarriages, hoping their parents will reunite. You and your husband must demonstrate a solid front as you face his misbehavior.
- Set basic rules in your home. Inform the son that he is expected to meet minimum standards of behavior, personal hygiene, and family involvement. If he meets minimum standards, he will be allowed limited videogame privileges. To have more hours of video, he must improve his behavior and his standards. That’s the way the real world works. No efforts, no payoff. Simple as that.
- Allow the son to experience the consequences of his behaviors. At present he is acting as a bully, thief, and irresponsible person, yet experiences no consequences. In an unfortunate situation, the more he misbehaves, the more people allow his misbehavior. If he misbehaves, it will cost him something, such as video time or privileges. If he doesn’t like the arrangement, he can return to his mother’s. He is likely to threaten never to return to your home, a very common bluff in teens. In truth however, his mother wants him to visit — see needs the break — and he needs the additional support. Call his bluff and remind him that when he behaves appropriately, he can return. This will be difficult, but if you don’t correct the situation in his early teens, you won’t be able to correct it at 17!
- Consider family therapy/counseling as well. A family needs to revolve around the family — not the immature demands of one family member.
- Consult with the school administration and teachers. If these behaviors are also present in school and creating difficulties, it’s more likely a significant psychiatric issue. If his school behaviors are acceptable yet he operates as described in your home, then his behaviors are likely very purposeful and have a hidden goal which may be revenge, dislike of the marriage, etc.
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