ADHD and Lacking Empathy: Was I Raising a Narcissist?

ADHD narcissist

What do the words ADHD, low empathy, and narcissist have in common? Potentially, more than many people realize. This knowledge should be more widely understood, including in the mental health field, because it could hold the key to a happier life.

In this post, I’ll explain with a short introduction before introducing an important first-person essay. At the end, you’ll find a link to my podcast of this post — and more links to my blog posts on empathy and ADHD.

A “Poor Prognosis” — In the Wrong Hands

These days, the Internet brims with lurid stories about narcissists.

Yes, it’s important that we understand what we’re up against when confronted with narcissistic behavior. But the psychologists in particular who are sensationalizing this topic might be doing more harm than good. They betray ignorance on the many potential factors that can underlie narcissism, some of which might be treatable mental-health conditions. Many also claim that the behaviors are intentional, volitional, displays of power over others. But that is not always true.

For example, many children with ADHD suffer cognitive impairments far beyond the classroom. Some of these impairments distort any reasonable person’s idea of a “happy childhood.”  I refer to impairments that, in fact, also threaten to negatively shape the course of their entire lives, especially their relationships. These include deficits in empathy, reciprocity, reflection, and remorse.

When we consider the negative chatter around “drugging children” for ADHD, what gets lost? Compassion—for these children and their families. Not to mention: a basic understanding of brain functions.

When your child is a psychopath article The Atlantic

It’s Open Season On Narcissists—including Kids

What’s more, in the wrong mental health professional’s hands, a child lacking empathy and acting with a sense of entitlement can invite a dire diagnosis: narcissistic personality disorder—or even psychopath.

For example, this article at The Atlantic’s website takes an extremely hidebound and punishing look at the phenomenon:  When Your Child Is a Psychopath. 

These diagnoses stick.  That’s because the mental health profession consider them “poor prognoses.” In other words, there is little hope for change. The behaviors are  viewed as part of personality, immutable.

But wait. If that child also has ADHD, there is a good chance that the first-line medication for ADHD, the neurostimulants, can enhance empathy—along with all the other “higher-order” brain functions.  This is not hard to understand. But it is not common knowledge. Far from it.  In fact, you probably read it for the first time in my first book, Is It You, Me, or Adult A.D.D.? 

To be clear: ADHD treatment can often help the narcissistic child have more reliable access to their innate brain functions, including empathy, conscience, and more.

Of course, narcissistic parents might also have ADHD or any of a  number of frontal-lobe issues. Imagine what that is like for their children, especially if the child also has ADHD.

But I suspect it feels even worse when therapists or pop culture tells those adult children that their adult problems stem from their parents’ narcissistic actions, motivated by control and power. Maybe they did. Maybe they didn’t.  That’s just one of the dangers of holding onto old psychological theories. Let’s face it, it’s name-calling.

ADHD, Empathy, and Raising a Narcissist

In fact, my friend Taylor J. was one of those children. Maybe you’ve read her essays in the “You, Me, and ADHD Book Club.” Here, she shifts from talking about her own and her husband’s ADHD diagnoses. Now she shares this story of her eldest child’s recent ADHD diagnosis and treatment.

This was big. Taylor had despaired that her daughter would grow up to resemble her own parents: narcissistic and lacking empathy. Generally speaking, empathy deficits form the foundation for narcissism.

Taylor and her husband tried to teach empathy to the girl, but the lessons never took hold. Or, so they thought.

P.S. You Read About ADHD & Empathy Here First

Please note: An earlier version of this post appeared  Jan 27, 2016.  This points to my being among the very first to write on ADHD and empathy. Probably the first.

It’s only in the last couple of years, that many have followed suit. That includes those who publicly lambasted my 2008 book (Is It You, Me, or Adult A.D.D.?) for “saying mean things about ADHD”. They claimed I wrote: “People with ADHD have no empathy.”  What I wrote was this: “ADHD can sometimes create empathy impairments.”

Moreover, I went on to say that medication treatment can often give the person with ADHD more reliable access to their innate empathy.

Why the latter-day conversion? They saw the high Google search rankings for this post, now that everyone can analyze any websites’ analytics. If that’s what creates enlightenment on this complex topic, so be it.

—Gina Pera

cause and effect

By Taylor J.

The Number One most profound thing I’ve learned about ADHD is this: It can create trouble connecting “cause” with “effect.” And that can create a world of trouble.

For example, a student will not see his poor study habits as the reason for his poor grades. Instead, he’ll blame a “mean” teacher. A wife will not see that her cutting, sarcastic words caused her husband to withdraw emotionally. Instead, she’ll call him “cold.” A young man will not see that his reckless driving and speeding caused a car accident. Instead, he’ll blame barely there weather conditions.

It doesn’t take a genius to see that continually failing to connect actions with consequences will wreak havoc on a person’s life. Worse, it can kill the potential for relationships.

I saw this play out starkly in my 10-year-old daughter. Let’s call her  The Firecracker.

is your parent a narcissist? Does your parent have ADHD?

I Vowed To Be Unlike My Narcissistic Parents

First, let me give you some background.

My parents are horribly mentally ill, and they refuse treatment. Instead, they blamed everyone else for their troubles—and drowned their sorrows in alcohol, drugs, and pity parties. Even when I was in the hospital—sick or with a new baby—my parents could only talk about themselves. I found their utter lack of empathy horrifying.

When married and starting a family of my own, I vowed to be different. Yet, in raising my first-born child, the oldest of four girls, I watched helplessly as every lesson about empathy I tried to impart seemed to bounce cleanly off her soul.

What do I mean by that? Well, for one thing, she would exploit others. She would set up games where everyone had to treat her like a queen visiting from another planet—or convince friends to “share” their favorite toys and clothes. Forever.

I even caught her in an elaborate kindergarten “protection racket” at one point: taking her sister’s money to keep monsters away. (She’d already made 6 dollars!)

She would take—but never give. Her friends would give her presents, invitations, or compliments. Yet she never saw any need to return the favor.

In fact, she would complain if a compliment missed a detail, or if the gift didn’t fit just right. She would even go to a friend’s house and critique their clothes or décor for them! “You really shouldn’t have that dollhouse—it’s for babies. You should get a Barbie dollhouse.” Seriously? Where did you learn this?

I was asking the wrong question. As I came to learn much later, hers wasn’t learned behavior. It was innate.

No “Cause and Effect”—Only “Mean Parents”

My husband and I explained, repeatedly, that her words hurt other people. We’d ask,  “How would you feel if Ginny came to your house and said your dollhouse was for babies?”

The confused-looking Firecracker would reply, “But my dollhouse is not for babies, so she would never say that!” We would punish her for saying cruel words—and she never understood why she was being punished. We were just “mean parents.” The type she might be complaining in the future to a therapist—who won’t have the full picture.

There was more. She would explode over the tiniest frustration. Itchy seams on her socks. Bedcovers not being straight. Her oatmeal being the slightest bit “too watery.” Her low frustration tolerance would set her off on an explosive tantrum—and others were always to blame.

I remember when she was only one year old, screaming at the shape-sorter because she couldn’t make the block go in the way she wanted it to.

Sporadic Bursts of Caring—and Low Frustration Tolerance

We did see sporadic bursts of caring from her. We could just never predict when they would happen.

Her first words upon meeting her sister: “I’m going to watch out for her, and make sure she doesn’t run out into the street without me!” At age 3, she started punching a preschool classmate who came up and shook her baby sister’s car seat carrier (while I was talking to a teacher). She was afraid he would hurt the baby’s “soft spot.”

When I was violently ill with another pregnancy, she proclaimed to her sister, “Don’t worry. When Mom throws up, I’ll make you a sandwich.”

Words, however,  rarely met actions.

The Firecracker screamed at her sister for adjusting her stuffed-animal display. My second daughter would dissolve into tears, and ask, “Why doesn’t she love me?” The Firecracker’s response?  Her sister’s sobs were disturbing her reading time.

Without the larger context, you might take this as typical sibling rivalry. But it was much more troubling.

I had started to wonder if I was raising a narcissist.

ADHD empathy narcissism

Shocking: My Child Has ADHD — Isn’t a Narcissist

My husband and I both have ADHD. We both take medication. I know full well the dramatic changes in cognition and behavior the medication provides.

But when The Firecracker was finally diagnosed with ADHD this past July and began medication treatment, even I was not prepared for the change that followed.

I gave her the first dose of Ritalin. Two hours later, as we were returning from the grocery store, she said, “Mom, you can’t carry all that. Let me help you!” She grabbed two grocery bags and the diaper bag. “You need to ask for help when you need it, mom!”

Then, when the baby started crying: “Oh, honey, come here and let me hug you! Don’t worry, mom, I’ve got her—I know you’re making lunch.”

When I had to change plans that she’d been looking forward to: “Aw, that stinks, but I know you didn’t try to make it hard for me. We can go tomorrow.”

To be clear: My daughter had not become some creepy “good child” automaton.  She was still herself.  But a better emotionally regulated version of herself. A more content version of herself.

This much was obvious: She was as relieved as we were with the changes.

hyperactive child empathy
Our Firecracker, constantly in motion. With her little sister

“It’s Going to Be Okay”

Five hours later, the medication had worn off. The Firecracker came to me, tears streaming down her face, screaming, “Mom! This is awful!!! The baby won’t stop crying! [The baby had cried for one minute.] Is this what it felt like all the time when I wasn’t on medication?”

I took her by the shoulders, looked her in the eye, lowered my voice, and said, “Don’t worry. It’s going to be okay. Yes, this is what it was like all the time. Take your next dose, then sit here and watch something on TV while I set a timer. When the timer goes off, your next dose will have kicked in.” I wiped her tears and turned on something funny.

Half an hour went by. When she felt better, she looked up at me, and said, “Mom, maybe you should get me a puzzle book to work on when I’m angry. Then I can calm down without yelling at anyone.”

I watched the rest of the night as she spoke lovingly to her sisters and forgave them when they committed the grave sin of touching her stuff.

ADHD child narcissist

Relief At Connections Made

As she was reading her favorite book before bed, she looked up and said, “Mom, now I understand why Eragon sighed so deeply when he saw his brother: He was afraid his brother would become a rider, too!” Even the stories were becoming more clear.

Remember, this is just the first day of ADHD treatment.

I asked my husband to tuck the girls into bed that night. Then I turned on the shower and broke down into sobs as the water washed over my face. With immense gratitude and relief, I finally realized that my daughter had ADHD but was not a narcissist. She actually did take in the lessons about compassion and empathy that we were teaching her. She simply couldn’t access them when she needed to.

My daughter had been suffering from a treatable brain condition, not an incurable evil that was lurking behind her smile.

Maybe my parents can be helped to change their narcissistic behaviors, too. I can only hope that they’ll reach a point where they’re willing to try treatment.

So, the next time you hear someone gasp at the thought of putting a child on medication for ADHD, please remember my Firecracker. Please know that it is beyond the control of many people with ADHD, including children, to make certain cause-effect connections. Whatever empathy they have can get lost in impulses and distractibility.

Please know that, since beginning to take stimulant medication, my girl is happier and healthier than she has ever been. (More about that in a future post from Gina.)

ADHD empathy


The Firecracker’s Comic: Overcoming a Struggle

I’ll close with this amazing comic that The Firecracker drew for school. I had nothing to do with this. My daughter loves graphic novels, including authors such as Raina Telegmar, and has created dozens of comics in that style.

Recently, her class read a story called The Dot, about overcoming a difficult struggle. In response, they were to write about a struggle that they overcame. This is my girl’s story.

The Research: ADHD and Narcissistic Traits

From Gina:

Again, this phenomenon is more common than the mental-health profession realizes. That is, the association among ADHD, lacking empathy, and narcissistic behavior.  You can listen to the podcast of this post:

This other post (ADHD and Empathy: A Study, Book Excerpt, and Empathy Defined) tackles the topic from several angles:

1. Defining empathy (it’s not what most people think).

2. Excerpting a passage on empathy and relationships from Is It You, Me, or Adult A.D.D.?

3. Sharing details from yet another study pointing to a connection between dopamine and cognitive empathy.

A sneak preview of the study:  It confirms my observation first observed 20 years ago: Stimulant medication often enhances empathy in people with ADHD.

But wait. This happens not because the medication “creates empathy.” Rather, as the study in the linked post above suggests, the medication enhances dopamine transmission. That, in turn, allows some people with  ADHD to focus on and access this “higher-order” brain function. In fact, they have always possessed empathy. But haven’t been able to reliably access it—or act upon it.

Empathy sounds simple. But it’s really a complex phenomenon. In fact, some people with ADHD have trouble reining in their empathy; medication often helps them, too. As with many ADHD-related challenges, it’s all about the self-regulation.

For another angle on this topic:  Empathy and Mirror Neurons: Or, Monkey See, Monkey Yawn

Gina Pera's online course

How about you? Have you noticed a difference in your child’s

expressions of empathy or mood-regulation post-treatment for ADHD?

I welcome your perspectives.

—Gina Pera

82 thoughts on “ADHD and Lacking Empathy: Was I Raising a Narcissist?”

  1. Thought I’d make a post : This article is BIG, and I thought so already when I stumbled upon it around 2 years ago.
    I was in a dire need of understanding “the human mind” after bumping into the wrong person, searching for answers beyond the different innate and acquired personality disorder diagnosis (as ADHD and ASD looked to similar to not have ties) I had narrowed it down mostly to theory of mind issues, executive functions issues, and alexithymia (that’s big as well), and this article was kind of the icing on the cake.

    I probably have a moderate condition of ADD/hypersensitive/giftedness, which give me a “rhizomatic thinking” so I have to be careful not to generalize too much (so as not to replicate with cognitive approach the mistakes that psychoanalysis has done in the past), but I really wonder if a good chunk of BPD, NPD and other acquired PD don’t stem in fact from undiagnosed innate atypical condition (issues with ToM, EF, alexithymia, empathy) more than from bad parenting/abuse (even though it surely doesn’t help of course).
    The egoistic trait displayed in “the firecracker” behavior could be the difference leading to a NPD rather than BPD.

    Imagine if she had grown up without being diagnosed and treated, what would’ve she turn into ?
    As a kid reaches teenage years he/she has to figure out his/her own way of how the “social world” works, and the emancipation process could carve the manipulative behavior as the most effective way to go through life.
    Then the most visible symptoms of hyperactivity/impulsivity may have toned down as a young adult (or be controlled in public), but the manipulative behavior would remain, and unleash at home).

    And when you think that the former POTUS may have an undiagnosed ADHD and was raised with a harsh education, you start to think that along with global warming, cognitive/emotional issues may be the biggest problem on our hands.

    This post is of public interest 🙂

    1. Hi Will,

      Thanks for your comment. I absolutely agree: This post should be required reading for everyone in the mental health profession. 🙂

      You wrote: The egoistic trait displayed in “the firecracker” behavior could be the difference leading to a NPD rather than BPD.

      Yes, that’s what I tried to explain in this post, especially these paragraphs:

      What’s more, in the wrong mental health professional’s hands, a child lacking empathy and having sense of entitlement can invite a dire diagnosis: narcissistic personality disorder—or even psychopath.  (When Your Child Is a Psychopath, an extremely hidebound and punishing look at the phenomenon.). These diagnoses stick.  That’s because the mental health profession consider them “poor prognoses.”

      But wait. If that child also has ADHD, there is a good chance that the first-line medication for ADHD, the neurostimulants, can enhance empathy—along with all the other “higher-order” brain functions.  This is not hard to understand. But it is not common knowledge. Far from it.  In fact, you’re probably hearing it for the first time on my ADHD Roller Coaster blog.

      To be clear: ADHD treatment can often help the narcissistic child have more reliable access to these brain functions.

      In case you hadn’t noticed, it’s “open season” on narcissists. Name-calling is permitted, from celebrity psychologists to the average therapist. And the best advice is: Run. Inquiry into cause? Of little interest. Perhaps because too few in the mental health profession have scientific training — or, in the case of psychiatrists, didn’t take to it very well.

      As for your many potential diagnoses, the confusion often comes from drawing “labels” from different disciplines. For example, “theory of mind” explains certain ASD traits (and the way that ADHD symptoms might appear but not have the same cause as with ASD), but it’s not a diagnoses. Alexithymia describes the behavior, not the cause. Personality disorders, same. Executive Functioning is a theoretical model, also not a diagnoses. EF can be impaired by many of the prefrontal lobe conditions.

      It could be the “big picture” i s….. ADHD. 🙂

      As for the “fake news” POTUS, most certainly he would have qualified in childhood for an ADHD diagnosis. At least, from the accounts I’ve read. There might have been more, though, such as conduct disorder — and there’s some evidence that this has a genetic basis in association with ADHD (that is, a subset). His father certainly showed little in the way of conscience or morality but showed greed abundantly.

      I found it unfortunate that the sister-psychologist called it a “learning disability” and recounted the father’s behavior, the. mother’s absence, etc.. as turning out the result we see today. More hidebound psychoanalytic narrative, imho. But hey, it made her name and lots of cash. I would not have wanted him to be the “AHDD poster boy”. ADHD has enough problems with stigma.

      As for the “harsh education,” as a young boy, he was pelting rocks at the toddler in the play pen next store. The military school seemed more external solution (if a poor one) than cause. Bullies always respect power. He loved his generals, didn’t he, until they didn’t do what he said.

      Elevating our collective human ability to access higher-order brain functions (e.g. cooperation, conscience, reflection, etc..) and think more deliberately, with consequences in mind, is a large part of why I do this work.

      Thanks so much,

  2. I am so thankful for this blog. I am starting to realize that maybe, just maybe, my low level of empathy isn’t because I am horrible person, but because I have a condition.

    I am 45 years old and went to school in 80’s and early 90’s, and back then unless you were hyper, ADHD wasn’t diagnosed. I was the forgotten about child who couldn’t focus, had no motivation, and got poor grades. Also to top it all off, I was frequently bullied, teased, and abused, both at home and at school. I also didn’t have a lot of friends. Even before my dad died when I was 13, my parents had no regard for my mental wellbeing, and that didn’t change. I was left to fail, and left to be bullied. Even without having ADHD-PI that would make it hard for anyone to learn empathy.

    I sought help for ADHD a couple of years ago after the realizing I might have it. Concerta did nothing but my GP was reluctant to try other things. He referred me to a psychiatrist who confirmed the diagnosis but he wasn’t very knowledgeable about ADHD. I begged for a Strattera prescription after I read it could help. I have been on it for about 3 weeks now and will up the dose soon. I will be seeing (at my request) a psychiatrist who specializes in ADHD who has agreed to find the right medication and dosage for me. Maybe I will try Vyvanse or Adderall in addition to the Strattera, if the 80mg doesn’t work for me. I am hoping that once I get the right meds and dose, that it helps with my lack empathy.

    I rarely ever raise my voice or get mad at anyone. I also do not wish anyone pain or unhappiness. However, I am very un-self-aware other people’s pain, even if I am the cause. People to me are only like background characters in this game of life, I am trying to fight my way through. I am glad I am not alone. thank you for this blog and your website.

    1. Dear Mark,

      I am so grateful for your comment, letting me know my work has meaning for you.

      You make a profound point. Even for a child who doesn’t have challenges with “higher-order brain processes”, rarely (if ever) receiving empathic caring provides no foundation for seeing how empathy works in practice.

      Many people confuse ADHD-related symptoms that mean not noticing facial expressions, not remembering what one did in the past that would bring such a big reaction now seemingly “out of nowhere,” etc. with poor empathy. It’s complicated!

      It’s hard to form strong attachments or have empathy for others when it’s hard to focus, organize yourself, watch out for the next invisible banana peel that will trip you up, and “fight your way through” the day.

      A couple of points:

      1. It’s all down to genes, as to which stimulant class will work best for an individual. So, if you gave MPH (methylphenidate) in the form of Concerta a good try without positive effect, that’s useful data.

      2. Did you try brand, though, and not one of the slew of inferior generics?

      3. Strattera doesn’t work as well as the stimulants for most people, research shows. But it does work well for about 1/4 of people with ADHD (as I recall, last I researched this).

      4. It’s a very different mechanism of action targeting different molecules.

      5. Many people with ADHD do well on a lower dose of Strattera (25 mg to 40 mg) and a stimulant.

      6. Strattera can have more urinary/prostate/sexual side effects. So, if that should happen, know that it’s probably the Strattera. You could try a much-lower dose or, at that point, move to Vyvanse.

      I’m not an MD. I just help people who have been ravaged by reckless MDs…by conveying the evidence-based knowledge.

      I wish you all the best. Stay tuned for the “soft launch” of my online training. I think you will find it very useful.


    2. Thanks for the reply Gina. It was definitely was brand name Concerta I tried, and tried many doses from 18-27-36. I am trying strattera to see if I’m one of the ones it works for, and because it’s also easier to get a Doc to prescribe that than an amphetamine. The new doc I will be seeing has no issues with it though. I know about the side effects with strattera and don’t care. Living with adhd-pi is pure agony and will gladly take the sides if it helps with it.

      This was all just initially for the adhd. Now that I know that it could help with empathy as well, I am even more optimistic. Thanks again.

  3. Wow, this is deep. I’ve just left a man because he gave off pretty bad NPD vibes. My mum I suspect is covert NPD. My youngest has adhd and I have always struggled with him showing empathy when one of his siblings got hurt by him. He has only just started on ritalin and I have noticed a big difference in his executive functioning but not yet his emotion regulation…I will keep an eye on him now.

    1. Dear Anna,

      Yes, I am for deep. Because that’s where the critical information is. The kind that can enormously effect the trajectory of a life.

      There are a lot of factors that determine how a person, especially a child, responds to medication. It might be that Ritalin is not the best choice for him, or that he needs better sleep or diet.

      But also, the example you mention is a complex one. Showing empathy when he’s hurt one of his siblings.

      It’s possible that he did not mean to hurt the sibling so he feels that since the intention wasn’t there, he’s not responsible for the aftermath?

      Poorly managed ADHD means that symptoms can get the better of a person.

      make sense?


    2. Wow, I never realized other kids went thru the same thing growing up. Thank you for this.

      I’m 16 and I remember being very bossy most of the time when playing with other kids. I’ve also never had any inclination to help others out with chores, or buy gifts for even my parents on their birthdays ‍♀️ (I started doing chores by “surprising” my mom @ 12yo by doing the dishes one time, and since then she’s expected me to keep it up).

      Then when confronted about it, I wouldn’t feel bad at all. I’d just pretend like I did.

      I’m currently waiting to see a psychiatrist because my family doctor thinks I have inattentive ADHD (formerly known as ADD) and even though I relate to so many things ADHD, I still doubt.

      My parents are convinced it’s just bad habits.. I don’t blame them because many people dismiss mental health issues and expect you to fix everything on your own.

      I took an empathy test and got 9 out of 80. Scary. Anyway, hoping by this time next year I’ll figure out what this is. Thanks again for your article! 🙂

    3. Dear Issy,

      Thanks for reading — and writing.

      How clever you must be, to not only find this post but to be so reflective about the contents as it might apply to you.

      I suspect that “being bossy” is a way for some children with unrecognized ADHD to “stay engaged” in whatever play that’s happening. Much harder to follow someone else’s directions and rules.

      It’s interesting that neither you nor your parents are prone to seeing that you might have it. But your family doctor does….

      If you do have ADHD, that is a very important thing to know how. It could affect the entire trajectory of your life.

      If I were you, I would not be passive about the evaluation. And it doesn’t sound like you are.

      I encourage you to write down snippets such as this….how the ADHD diagnosis might resonate for you.

      If you provide your writings to the professional, I recommend concise bullet points. More likely to be read!

      Good luck and know there is a TON of great information on my blog — the first and oldest on adult ADHD. 2008


  4. Wow – I would love to connect with you to talk about this more.

    I have been diagnosed with ADHD at the age of 29 and being treated. Safe to say, my life has changed. This entire article and firecracker resignate with me strongly. Thank you for sharing

  5. Such an interesting article – I’m glad to hear that Firecracker is doing so well.

    I believe that my parent in their 60s suffers from undiagnosed ADHD (the parent themselves believes so, as do others in the immediate family).

    I grew up with so much fear and anxiety around their erratic, angry outbursts. They are incredibly defensive about even the smallest things. They were either disinterested, or mean and critical. I wonder if ADHD is largely to blame, or if there may be other issues at play as well.

    I don’t know if they would be willing to see anyone or try medication, but is there any hope of change at this later stage in life?

    1. Hi Sam,

      It’s hard to fathom how many people have gone to therapy after growing up with such parents as you describe.

      It’s entirely possible that ADHD plus a lifetime of poor coping responses can credited with the behaviors.

      There is no “cookie cutter” anything about ADHD. Definitely, with impaired higher-order brain functions, some very hurtful, emotionally dysregulated, and narcissistic behaviors are possible.

      Yes, it depends on your parents’ attitude, but definitely: People in their 60s and older have found benefit from treatment.

      The trick will be finding a physician to treat ADHD in the 65+ set, especially if there is a physical condition (hypertension, etc.). Stimulant medications are not necessarily contraindicated for those conditions but many physicians will feel uncomfortable, given poor knowledge of ADHD treatment.

      I hope this helps.

  6. Great article. I was like your daughter growing up and really damaged my family relationships. I had rapid mood swings, a nasty temper, and it was hard to genuinely connect with people (and engage in the give and take the defines all relationships).

    Junior year of college I was diagnosed with ADHD (inattentive) and went on adderall. After my first dose kicked in I immediately felt “warmer” towards people. It was easier to empathize with them, my mood swings stopped, and I actually wanted/could help people out. If I saw my mom needed help (even drying the dishes) I wouldn’t help because it would be painfully boring.

    Soon as I went on adderall I found I could do things I don’t “enjoy” (basically anything that would involve helping someone else) without feeling painfully bored. It also helped me listen to other people and remain engaged.

    1. Hi Jake,

      Thanks for sharing your experience.

      As I read it (as I have read many others like it), I thought, “This is why so many people remain skeptical (including mental-health professionals); it just sounds ‘too easy’ and changing behavior should be haaarrrrddd and takes years of therapy and “processing.”

      good for you.

  7. Hi,

    I came across your website whilst trying to calm down from another very angry outburst from my 22 year old son.
    He overdosed about a fortnight ago, and on the back of that the Dr said he thought he has adhd, depression and anxiety. He prescribed antidepressants and asked my son to come back in 2 weeks.
    He has taken the meds for the 2 weeks but due to covid19 and all the uncertainty he did not return for his appt or the next 2 weeks meds.
    Life really is a rollercoaster, his moods are either loud, angry or stoned. He has no concept of consequence or responsibilities.
    I was so hopeful when he had seen the Dr, but I also knew that the biggest part would be to see if he kept the 2nd appt,, he doesn’t finish anything.
    I’m struggling between having had enough and wanting to see him better.
    I don’t think I can take anymore of his angry outburst and always being the one to blame, when he was at school it was the teachers who were at fault, through his teens it was his dad, there’s always somebody else at fault and I’m just so tired of it all, I just feel so tired of it all like there is no end in sight.

    1. Dear Fran,

      I feel great sympathy for parents in your situation. I hear from them quite often — and several have attended my local group over the years.

      It’s very hard to get on top of ADHD treatment once bad habits and patterns have taken hold, over years. Finding competent medical care is one problem. But their wanting independent is another.

      Then there is the mental healthcare professionals who fail to see the importance of third-party feedback, who don’t want the “controlling” parents to have any say.

      I wonder why the doctor would prescribe antidepressants if the doctor thought the primary condition (based on the listing) is ADHD.

      You are trapped now. Maybe best to, in your mind at least, call a truce. Don’t try to make him be more responsible now. That’s a losing battle.

      If you haven’t already, I encourage you to read my first book. It’s really important that someone (the patient or loved one) be educated and able to help guide treatment.

      While it’s no answer in itself, the chapters on “denial” might help you to understand the scape-goating.

      I wish you some peace and healing.


    2. Fran,
      My daughter is much like your son. She had severe ADHD and ODD at an early age. She went on Ritalin in kindergarten because she was too disruptive for school. At 14 she was bigger than me and began to refuse her meds due to kids teasing her. She had to take it 4 times a day. She became very combative and even physically abusive towards me.
      I have tried repeatedly to have a relationship to no avail. She is 35 and EVERYTHING is still MY fault.
      I live in California and she is in Washington state, thank god!
      I have my own mental health issues. I have anxiety, PTSD, depression and at 58 finally getting my own treatment for ADHD.
      My guilt that I wasnt a “good enough” mom is just bull. My therapist does not want me talking to her because to add to her problems, she is self medicating with alcohol and it just makes it worse. She is in denial that she has any responsibility in any of this. Highly verbally abusive towards most everyone, violent outbursts, she can be quite frightening. I cannot help her. She thinks she is fine. I can only address my own mental health at this point. God bless you and your situation. It’s very difficult.

    3. Dear Penny,

      I can only imagine how difficult it’s been for you.

      “Denial” is real — and it can be devastating. That’s why I included three chapters about it in my first book. It’s critically important and so little understood, especially by the mental-health profession.

      Take care of yourself,

  8. I should leave an update, lol!
    After The Firecracker had stabilized on her current medication, our pediatrician was happy to take over prescribing duties for only the $15 copay. 🙂

  9. My 13 year old son is doing so well on methylphenidate and wellbutrin ! My problem is the Dr doesn’t want him on methylphenidate during the summer (or weekends). Dr doesn’t want his growth to be stunted. My son’s “selfish, wild” behavior is so disturbing to all of us when he isn’t taking that. It’s hard to remember his bad behavior isn’t because I’m raising an “awful” kid. What do you suggest?

    1. Hi Lori,

      Sigh. The nutty things that physicians say.

      Can you find a more competent physician? I am serious.

      1. IS your son’s growth stunted? Is there any evidence of that?
      2. Is his appetite suppressed?

      If so, that is an indicator of poor prescribing. Meds can be adjusted or replaced to eliminate that side effect.

      If the prescriber is also failing to treat co-existing conditions such as anxiety, depression, etc. (which can be exacerbated by the stimulants and thus can affect appetite), that’s a problem.

      You are your son’s mother. He is counting on you to protect him from incompetence. Whether he realizes that or not! 🙂

      Be strong! Demand better! Find better!


    2. Hi Lori!
      This is outdated information that, unless your son is showing SIGNS OF APPETITE SUPRESSION AND STUNTED GROWTH, should truly not be an issue. 🙁

      Doctors who don’t specialize in mental health have *fear* drilled into their brains about stimulants and abuse. In the last ten years, I’ve never had a single doctor or pharmacist focus on the benefits before the supposed risks.

      So, yes, as Gina said, GET A DIFFERENT DOCTOR. Get a psychiatrist or psychiatric NP, and be prepared to show him or her, “My son has shown ZERO growth retardation, and eats like a horse. He’s under an immense amount of distress without the meds. I want him covered on weekends and summers.” Get one that you have to **pay out of pocket** if you must.

      I do. 🙁 Tomorrow, I get to go pay $500 to a psychiatrist for The Firecracker, because the wait would be almost a year to get her into a practitioner on our insurance plan. It’s worth every penny. She’s worth every penny.

      I’m so glad you found us. 😀

    3. Thanks, Taylor.

      You have to pay $500!!!???

      I’d appeal that. In the strongest possible terms. GRRR


  10. I had a child so much like yours, and medication was a godsend. When she was young, some people would tell me she just needed to be disciplined, not medicated, and then would accuse me of bad parenting. Only I had two older ones who weren’t ADHD, so I understood this one was different. So I began social training by using the TV to freeze expressions on faces, and then we would talk about what she saw. When she was angry, I had floor puzzles, a puzzle book, and washable markers for a wall so she could scribble out her frustrations. She also has a co-morbid condition, NF1, along with some learning disabilities, but the research on the brains of kids with NF1 showed they could develop new pathways to learning over a long period of time. It was hard, as I was by then a single parent with a child who looked and acted younger, and who blamed everything that happened on outside events. So I started teaching that every choice had a consequence, and she needed to think about the consequence and whether or not she was willing to accept the consequences of her choices. She is 25 now, has finished 2 years of college, has a great job with benefits, and no longer takes medication. Instead, she comes to me every time something upsets her, which is every day, and we talk through possible solutions. She is highly empathetic, literally giving away what she owns. She gives money to good causes, like providing wells and cows to remote villages in Africa, and she can be counted on to be the first to help me as I am aging. She is a godsend. She is still energetic, impulsive, passionate. But all those lessons from so long ago? They worked. It wasn’t a quick or easy process, but it was worth the time and effort. I applaud all the families who have ADHD members for your love and compassion, and I will be the first one to back you when you turn to meds for help. If your child is in public school, I would recommend They helped me so much in the beginning, and were part of what helped my child graduate high school with the Regent’s core requirement. I didn’t try to raise her by myself, and would encourage all of you that there are resources out there for you, too. Thank you again for an incredible article. It was a blessing to read.

    1. Hi Lily,

      Thanks so much for taking the time to write this thoughtful comment. I know that it will help others.

      And yes, is an excellent source.

      How fortunate your daughter was to have you as her mother — and for you to have such an empathic and energetic daughter.

      If I may be so bold, perhaps you want to think about encouraging your daughter to try medication again. There are many good options. If the reason she stopped the medication is side effects, the plethora of options and our level of knowledge these days mean that she might have a better experience now.

      It might not be the best long-term strategy for her to rely on you to “talk her through” daily upsets. What will she do when you’re not around?

      My best to you both.


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