Unmotivated, down, anxious - ADHD/ASD?

[WeeMadArthur1]

DS (17) has always been very quiet and struggled socially, but he's become more withdrawn in the last couple of years. He doesn't see any friends, just goes to college, comes home and sits in his room. Comes down for meals.

He's also struggling with A Level revision - he's lucky as he's very bright and got excellent GCSEs with the bare minimum of work, but he's realising that just won't work with A Levels. We've always thought he was just a bit disorganised and lazy, and I've been trying to help him organise himself, helping to write a schedule, even sitting with him to help motivate him to get started on some work, which helps for a short time but as soon as I leave the room he loses motivation and stops.

Our previous approach was to remind him but then let him get on with it, and if he misses deadlines that's his lookout, but it's getting him really down. He's putting so much pressure on himself to do well but then says he can't make himself do the work and gets really upset about it.

I've started to wonder about ADHD as he genuinely seems to struggle with organisation, and breaking things down into smaller chunks. He often loses things, and he seems to struggle to 'get' things that his younger brother manages. Common sense type things.

Problem is as he's 17 there's no point trying to get assessed through CAMHS as the waiting list is two years where we live. We could pay for a private assessment, but it would be a struggle, and it may not result in any kind of 'answer'. We wouldn't be able to afford any ongoing private treatment. Also he's very reluctant to have any kind of counselling, he really struggles with talking to people he doesn't know (he won't buy things in a shop unless it's self service, even though he used to be able to). He had a few weeks with a well-being mentor at college but stopped going.

I just want to help him to feel better about himself. What would you do?

I have a similar child. I would go through your budget with a fine toothed comb and see what you can sacrifice in order to afford the cost of private prescriptions. Even going so far as considering a monthly delivery round or something to make it possible.
Besides that do look at the Connections in Mind website. They offer a monthly program of talks, activities, check ins etc with a 3 month introductory offer. The support would be useful and some of the issues covered may resonate with him.

I mean to say, by him gaining a better understanding of what his differences are and what’s driving them (ie which executive functions), he may feel more empowered and happier in his own skin

To qualify what i say, I work in wellbeing amd safeguarding at a large secondary with a big sixth form.

Your son might have learning needs. However, large numbers of bright but lazy kids (often boys) move up to A Levels and find the same as your boy. These are not all children with learning needs, just part of growing up and realising that some things in life are challenging and require putting yourself out in order to make the effort and do the hard work.

Some children have always had to work hard to get the grades. When you haven't, it can create an existenal and identity crisis. He's always though he was bright - now he's wondering if he isn't and tha knocked his confidence.

So rather than facing the very reasonable outcome that he isnt as bright as he thought he was (given he thought he was bright enough be able to ace A Levels without much effort, like GCSEs), he's decided not to try as a means to not have to face that about himself.

In short, it's all psychology.

This ultimately something he needs to face if he wants a forfilling life. Not facing it will mean taking decisions in the future which take him in the direction of 'easy', rather than challenging himself.

In terms of how to help, as his parent. I'd be focusing on building his self esteem and confidence. Help him accept who he is, so embedding that lower grades wont make him less of a person, that effort matters more than grades. Reframe A Levels as a "what else are you going to do?" Rather than the focus on grades, focus on the idea of doing subjects you love most and learning for the sake of learning, with nothing else attached.

Once that kind on mentally is established, the confidence amd effort should follow and actually his grades will start to matter again.

I taught A level for 25 years and have an Audhd dd.

This sounds like ADHD

Some boys find A level demands difficult, so do some girls. Not that many though.

My Dd needs someone to cheerlead work ( it’s called body doubling) this is why he loses motivation when you leave the room.

She puts off things she wants to do. It all became too much and she dropped out of school. Currently fighting for an EHCP.

He needs a diagnosis and meds if they work. Please try and find the money from somewhere. Otherwise he may not be able to turn things round.

Theres a massive difference in those who cba and those who are SEND. I disagree with the previous poster. Dh has adhd so does DSIL. I frequently have to kick Dh up the arse to stop him procrastinating.

Would he consider getting a Saturday job? For our son of a similar age it's really helped build his confidence and broaden his horizons.

I was about to say that. A summer job worked wonders for my 16 yr old son. He’s been asked back to cover a week over the Christmas holidays and that’s been a boost to his self esteem.

Long sharing of experiences coming up!

Main point - Get a private diagnosis, depending on where you live you may be able to get any prescriptions you might need on the NHS. ( We do)

We delayed getting help for DS1 as he decided to try the armed forces ( he thought he would be able to manage in a structured, practical, active environment as he likes team sports and struggled with studying despite being reasonably intelligent) and a diagnosis would have meant that was out. In reality he was too anxious and introverted to cope with the lifestyle and left after passing basic training.

I regret waiting, he is doing quite well now ( ADHD dx and medication ) but is at least five years behind his peers as he had to go back to college and do access courses and recover his mental health and self esteem from all his " failures". We learned from that, DS3 was diagnosed earlier, passed all his important exams and had more choices and better self esteem, he only took meds for about 18 months in the end, he is studying a creative subject and somehow makes it work with his off the wall brain.

Counselling and specialist life coaches are available but to be honest they seemed like an expensive luxury of dubious usefulness as so much good info is available online and the knowledge of why he was struggling was the most important thing. Of course you can access all the useful and often quite amusing info without an official DX and that can be very helpful but being allowed extra time in exams and other accomodations have made a big difference to DS1's confidence and performance academically. I have "diagnosed" myself and my self esteem has improved from understanding my difficulties better.

He's still not brilliant at organising across the board, he tends to be selective eg. Keeps on top of uni work but his room is like a bomb site as he tends to focus on one thing at a time, but he is gradually increasing the amount of " adulting" he can handle.

Still hates leaving the house and dealing with people in shops etc. but plays a team sport and has friends he sees in RL ( although they are all getting to the settling down and having proper busy jobs stage now which is a bit difficult as DS1 is still at home).

Anxiety levels and ability to cope with set backs and stress much improved, a combination of the meds and life experience/ maturity, this has made a big difference to everybody in the families quality of life, especially mine!

It's been a journey as the cliché goes. To follow with another cliché; as regards getting help for possibly neuro diverse young people " a stitch in time saves nine".

Thanks all for your helpful replies. We've suggested a Saturday job but that really does seem beyond him. At college if there are things that are different (eg a careers fair, rather then his usual lessons) then he can't make himself go into the room. He gets to college with good intentions, but just can't seem to make himself go into the room for fear of having to talk to someone unknown.

If we go for a private assessment, where do we start? Do you have to be referred by a GP first? I've been reading about Right to Choose, how does that work? If he was diagnosed privately with ADHD, how do we know whether the NHS would prescribe medication? Could anyone explain the best process?

Look at Right to Choose as NHS referrals to private companies, such as psychiatry UK, are often much faster.

It sounds like there may be ASd mixed in with it.. The fear of having to talk to someone.

We found a private adolescent psychiatrist. Pyschiatry U.K. charge for dispensing prescriptions and letters. Ours just charged for the assessment and we pay the cost of the prescriptions.

Regarding the process for private assessment, I can only tell you my experience which was for inattentive ADHD (bright DS [16], but fails to listen or follow instructions or organise himself). I don't believe you need to go to your GP first generally (The Priory is an exception we found, they required a GP referral). As far as I understand, Right to Choose is for adult referrals only. When we were choosing a psychiatrist, we were advised that some but not all NHS practices will take over medication after 6 months of private treatment, but the best chance was to find a private consultant who also works/has worked in the NHS as this would give more credibility. We chose someone with these credentials, and they seemed very good, not sure if I can post recommendations here (DM me if needed), they were more thorough than the NHS paediatrician we subsequently saw after waiting on NHS list for 18 months. DS decided not to go down medication route, so we haven't discovered how easy it would be to hand over to NHS for ongoing medication. The psychiatrist diagnosis was helpful in terms of better understanding what DS is facing and we are just trying strategies ourselves based on that. It has shaped what he is doing education-wise and is very different to what we envisioned for him. The psychiatrist also recommended Connections in Mind, which we could not afford.

If he is anxious then GP may be able to prescribe anti-anxiety drugs. This would be NHS so free.

I found the GP very helpful with my DD in a similar situation,