Hi,
I just read the letter from the mother of the 11 yr. old girl. I wonder if therapy might be in order first for the anxiety before medication. I think some thought should go into asking why she has anxiety. Don’t you? The mother refers to her daughter saying something to “my husband.” This makes me think that the husband is not the biological father. Otherwise, she would have said “her father.” Before loading this child up with meds, I wonder if the family, or at least the mother and daughter ought to get some counseling.

Aren’t a lot of kids anxious at age 11 or any age? I mean that is a time of change for most kids. I think more should be done to TALK with this child about the things she is anxious about. OK just my suggestion. Can you print what you think in your next edition?

Thanks,
A

Dear A:
Your response is a good one. Many children are anxious for various reasons unrelated to AD/HD and their symptoms may sometimes mimic those of AD/HD (lack of concentration, restlessness, irritability, etc.). This is why a diagnosis by a professional trained in diagnosing and treating AD/HD is so important.

For some children, anxiety is the result of having untreated AD/HD, for others it is a biological coexisting condition, and for still others it may be a response to something going on in their environment. One thing you should remember, however, is that many children with AD/HD have a coexisting anxiety disorder that is not related to environmental circumstances.

That being said, counseling is still an important adjunctive therapy in many cases of AD/HD. MTA study results showed us that behavior management can be extremely helpful particularly for those children with anxiety and AD/HD. Behavior management does help with coexisting anxiety when combined with medications for this group. Therapy may be helpful in other cases, as well. We have found that counseling for mothers and daughters with AD/HD is extremely important and can be useful in helping mothers be more aware of their criticism of their daughters, and daughters be more aware of oppositional behaviors. Thanks for reminding me to include this aspect of treatment for this case as well.