I'll try to keep this brief as I can but would really appreciate some (kind!) advice.
DS is 7 and was recently diagnosed with ADHD (moderate/severe combined). ASD has been queried as a possibility and we will seek an assessment for that too. He has issues with anger and emotional regulation resulting in outbursts and self harm at times (biting, hitting, scratching self) and physical acts (throwing things, knocking things, slamming doors...)which we are working with school under a TAC and IEP to support. We are also awaiting a medication review. It's a significant challenge in his life currently but this post is about his self esteem and mental health. The dysregulation is managed much better at home than at school but I don't feel like I'm containing his mental health all that well despite vest efforts.
His self esteem has been poor for a couple of years, but particularly since he moved up to year 3. He is academically extremely able and actually in the top of his class in all areas. He is a perfectionist though and is quick to announce that he can't do something or will get dysregulated if for example he gets 1 question out of a whole test wrong. He has a supportive and close family (immediate and extended) and has not had trauma in his life.
He will often identify that he is in the "blue zone" but not know why. He will vocalise that he doesn't like himself or has always hated himself. He is an anxious child and currently is particularly worried about global warming and how this will impact him as an adult. He's popular and well liked but percieves that his friends don't actually like him, particularly after a recent meltdown at school where a peer was hurt unintentionally (I'm not excusing that, it shouldn't have happened, but he didn't target this child which I think is relevant) - he feels like other children are scared of him.
We have tried:
- acknowledging the feeling, eexplaining that's its ok to feel sad sometimes.
- giving space for him to self regulate
- exploring what he means when he says he hates himself or he's not a good person - asking what it feels like when he thinks this
- listing all of the ways that he is wonderful and why we love him so much when he verbalised negative feelings about himself. He finds this difficult and will often counter with a negative feeling about himself.
- in general life making sure to praise or highlight good behaviour, good choices, positives and helpfulness. We identify how proud we are of x y and z
- we don't put pressure on him from an academic perspective - we explain that we are always proud of him if he tries
- try to demonstrate emotional intelligence by identifying our own feelings in an age appropriate way when relevant
- gratitude journalling. This was originally general emotion journalling which he enjoyed but would end up focusing on a negative from the day, however minor, and this would result in unhappiness
- bought and ready books on emotions as well as ADHD to help him to understand himself
- at school ELSA as well as private therapy focusing on emotional literacy
CAMHS have been involved from an observation point of view but seems limited on what they can offer him.
DS is wonderful. I know I'm biased but he is, he's funny, kind, clever, gentle, empathetic, witty and generally great. Of course he has his difficulties in relation to his ADHD but that's not how I would ever define him as a first thought.
I just want him to know how absolutely brilliant he is and it breaks my heart to hear him say negative things. Has anyone got any wise words of advice as to what else we could do?