ADHD And Struggling

Design and Illustrations by Maya Chastain

I found much of this discussion helpful and so I am sharing it for today’s blog.

The original comment –

My 17 year old son adopted from foster care at 15, after 8 years in care. 2 failed adoptive placements before and he was living in residential treatment for 15 months before he transitioned to my home. He’s been with me for 2 years in total. He has not had contact with any biological family in 5+ years and did not have consistent care givers for the first 7 years of his life. He expresses hate towards his biological family and will not discuss with me.

He’s dealing with depression, anxiety, and ADHD. Although I believe the depression is very long term, today is the first day he has ever said it out loud. He had actively denied it previously. I also deal with depression and the sentiment he described of feeling like nothing even matters is something I’m very familiar with. He’s been let down so many times and I often tell him he’s had a very normal reaction to abnormal circumstances. He is so afraid to hope. He is in weekly therapy and working with psychiatrist. I feel like tonight him acknowledging his depression was a really big step forward. I am trying to help him navigate depression and be more hopeful. He is incredibly intelligent and capable and could really pursue so many opportunities and be well supported in whatever he chooses. He’s sabotaging himself instead. He is an older teenager navigating the transition to adulthood. Thank you for sharing any thoughts.

Response from an Adoptee with Depression and ADHD –

Just to translate some of what you’re saying here and how it may come across. You may not say these things out loud but “could really pursue so many opportunities and be well supported” tells me you probably imply these things:

“You could do so much more if you’d just apply yourself.”

*I’m never going to be good enough*

“Why are you struggling with something this basic”

*I’m stupid and can’t do basic things*

“You self-sabotage a lot”

*Push past burnout and ignore self-care*

My support network lets me move at my own pace. Also learning that I can’t brute force my way past ADHD by being “Intelligent” has helped.

No one really figures shit out until their 20s. Heck – I didn’t figure out anything until my 30s. Gen Z just has more pressure because you can’t live off the salary from an entry level job anymore.

The original commenter replied –

I definitely think this is something I’m struggling with and I appreciate your translation. I think what’s hard for me is that he is 17 but in many way operating as someone much younger. However he has the expectation the he be treated like every other 17 year old. We are fighting regularly because I won’t let him get a driver’s permit or I set structures around bedtime and Internet and he wants freedom. I’m very comfortable trying to meet him where he is and help him grow at whatever rate he grows. But he wants adult freedom and responsibility – he’s simply not ready for and it feels negligent on my part to just give him that because of his age. So I’m trying to help him set meaningful goals for himself, so that he can work towards the things he says he wants but it seems that his depression is a major barrier to working towards those goals.

I’m not rushing him to figure it out or trying to prescribe specific goals. I’m trying to support him in doing what he says he wants to do and having the freedom he wants to have. As a single parent, I’d love for him to have a driver’s license, just as much as he wants it. But how do I help him be ready for that, when the depression he’s experiencing seems to suck any motivation to do the work ?

Response from an Adoptee with Depression and ADHD –

Why can’t he have a learner’s, if you don’t mind me asking ?

People with ADHD (and often undiagnosed co-morbidities) struggle with being infantilized.

You’re talking about controlling bed time when ADHD can come with delayed circadian rhythm and insomnia.

Yes – ADHD often means you have issues keeping up with organizational skills, goal management, emotional regulation and peer relationships. That doesn’t mean you treat that person like a young child. In an environment where controlled exploration is allowed, you develop coping skills.

ADHD – ESPECIALLY as a teenager – means you’re fighting yourself for control of a brain that seems constantly against you. Emotions are hard to regulate. Your rewards system is fucked. Object permanence is a myth. Time is an abstract concept I’ve yet to grasp.

How can you expect a 17 year old to be motivated to control things that are hard and wield an intangible reward like “opportunities,” if he can’t have any control over what’s in front of him that matters.

“Opportunities” offers no tangible reward. My ADHD/PTSD/Depression brain looks at basic chores and goes, “I don’t get why that matters.”

I’m an adult. With therapy and support, I’ve found ways around that. But I also found it after I started having my own boundaries and stopped infantilizing myself.

Meaningful goals don’t work with ADHD. They just put things behind a glass wall you’ll never break. You get frustrated and give up easier.

You need to give him simple goals he can succeed at to build self confidence.

Don’t make freedom a “reward”. It breeds resentment. Work with him to set personal boundaries and schedules. Those won’t look like what works for a neurotypical.

I like “How to ADHD” for life hacks. I also really recommend Domestic Blisters but she’s more aimed at 20 somethings. Catieosaurus is great. She does talk about sexual health on occasion but nothing a 17 year old with Google hasn’t seen.

Dialectical Behavior Therapy

I came across the letters DBT in an adoption discussion group and as I had no idea what it stood for, I do what I often do in such cases, google it. It started with this comment by an adoptive parent –

“I just had it click in a deeper way yesterday that I put a lot of thought and effort and will into trying to heal my kids. As if I’m a savior. As if I can. But in DBT, it talks about creating a change ready environment for your kids. By the way, if you can find a child DBT therapist, do it! Its expensive and it involves individual and parent and group sessions, and its work and learning, but its SUPER effective. All kinds of stuff prove its effective. Back to my point, if I’m trying to create a change ready environment, a calm and consistent environment where mean words can roll off my back, and I’m working on me setting the example that self care is important and I’m working on me so that I can hold all the pain they send my way, that’s where I make the most beneficial impact for all of the family and that’s where I love my kids the best.”

DBT stands for Dialectical Behavior Therapy. Dialectical behavior therapy is an evidence-based psychotherapy that began with efforts to treat borderline personality disorder. There is evidence that DBT can be useful in treating mood disorders, suicidal ideation, and for change in behavioral patterns such as self-harm and substance abuse. Many of these issues are aspects experienced by adoptees due to the trauma of separation from their original mothers.

One woman commented – “DBT absolutely SAVED MY LIFE. The skills helped me stop with SI and I then went on to lose 140 pounds.” I had to google SI too. Introverted sensing (or Si for short) is one of the most misunderstood cognitive functions in the personality community. Introverted sensing is a perceiving (information-gathering) function. It focuses on the subjective, internal world of personal experience and compares and contrasts new experiences to past experiences and memories. Si-users tend to notice patterns repeating themselves and are quick to spot changes or inconsistencies in their environment. They trust personal experience and subjectively explore the impact of current events, choices, and consequences.

So back to DBT . . . .

Its main goals are to teach people how to live in the moment, develop healthy ways to cope with stress, regulate their emotions, and improve their relationships with others. DBT can help people who have difficulty with emotional regulation or are exhibiting self-destructive behaviors (eating disorders and substance use disorders). DBT is sometimes used to treat post-traumatic stress disorder (PTSD).

DBT incorporates a philosophical process called dialectics. Dialectics is based on the concept that everything is composed of opposites and that change occurs when there is a “dialogue” between opposing forces. The process makes three basic assumptions:

All things are interconnected.
Change is constant and inevitable.
Opposites can be integrated to form a closer approximation.

Mindfulness skills help you slow down and focus on using healthy coping skills when you are in the midst of emotional pain. The strategy can also help you stay calm and avoid engaging in automatic negative thought patterns and impulsive behavior. BTW, I am a BIG believer in mindfulness.

Distress tolerance techniques help prepare you for intense emotions and empower you to cope with them with a more positive long-term outlook. There are 4 techniques – distraction, improving the moment, self-soothing and thinking of the pros and cons of not tolerating distress.

Emotion regulation lets you navigate powerful feelings in a more effective way. The skills you learn will help you to identify, name, and change your emotions. When you are able to recognize and cope with intense negative emotions (for example, anger), it reduces your emotional vulnerability and helps you have more positive emotional experiences.

Interpersonal effectiveness helps you to become more assertive in a relationship (for example, expressing your needs and be able to say “no”) while still keeping a relationship positive and healthy. You will learn to listen and communicate more effectively, deal with challenging people, and respect yourself and others.

How Confusing And Upsetting

In a private group I belong to, this story was shared –

“I’m at a loss. We have a Foster Son age 2 and a Foster Son age 5. The 5 year old will not listen at all. We ask him to do something and he acts out or does the opposite. We have had them for a week and I have cried every night I am so stressed. I have thought of everything. I reward him for being good and it doesn’t help. I need help please.”

~ desperate Foster Parent

One of the responses was this – Seriously? You’ve had them a week and you’re upset that they are having a hard time adjusting? If you don’t have the decency to understand that these kids go through absolute hell when they are removed and placed into your home you shouldn’t be allowed to foster. Who certifies these people/trains them? Who ever it is needs to be fired.

Did you know that there are hundreds of thousands of children in the US foster care system? Some recent data indicates that 690,548 children spent time in the foster care system during 2017. Many children in the foster system demonstrate post-traumatic stress like symptoms. This affects their development, coping skills, emotional regulation, relationships and attachments.

When the child has had some time to process the situation, learning meditation, relaxation and breathing techniques may be a method of learning to calm their own self, under their own control. A lack of control over their circumstances is one aspect of their acting out behavior.

Learning to replace negative thoughts with more positive ones can help the child develop a more healthy sense of self. These children need a safe play area and a nurturing environment. Over time, the children will need to learn to recognize triggers in order to gain control over their emotional states. Foster parents need discernment to ignore minor behaviors. By improving this parent-child relationship, the child may feel more supported in their everyday life.

Nothing a foster parent can do beyond patience, love, acceptance and an attempt to understand from the child’s perspective will work miracles overnight. The trauma suffered will be deep and unfortunately, to some degree, last a lifetime.