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Bipolar Disorder (Children and Adolescents)

Does Teenage Son Have ODD?

04/01/2008

Question:

my son was 17 two years ago. He was diagnosed with ADD and depression, he was put on adderall and celexa. We went to a phychatrist who did not seem to listen to the concerns we had, so we changed to a family counselor and things have not improved. Through my own research I have found that he may have oppositional defiance disorder as all symptoms point that way. Since his behavior was not the issue to begin with (it was more problems keeping his grades up ) could the medication be causing the recent problems and how common is it for ODD to "start" at this late stage? thank you for your help

Answer:

Thank you for your e-mail and excellent questions. I'm sorry to hear that you felt your psychiatrist did not listen to your concerns. I'd certainly encourage you to talk to him/her about this and to ask whether he/she conducted a comprehensive assessment of all the possible psychiatric disorders your son could have and what are his/her findings.

It is possible that your son has Oppositional Defiant Disorder (ODD). However, as you note, it is not very common for it to start at this age. The main symptoms of ODD, those of anger and defiance, could also be related to his depression or ADD or for that matter triggered by Celexa. Because of your son's depression, your description of ODD-like behaviors and query as to whether it is the medication causing the ODD symptoms, I'd also ask your psychiatrist about the possibility of a medication-induced mood disorder as stimulants like Celexa and antidepressants can sometimes trigger manic behavior in individuals with a family history of mood problems.

Once again, the ONLY WAY to know if your son's behavior is caused by his medication, ODD, other psychiatric disorder or other situations in his life is to get a comprehensive and detailed psychological assessment from a trained mental health professional. Because symptoms can mimic several other disorders and many disorders occur together (comorbidity), it's essential that a comprehensive and detailed psychological assessment of ALL the psychiatric diagnoses be conducted to identify which diagnoses and symptoms are present and which can be ruled-out and any other conditions that may be triggering this behavior.

If after sharing your concerns with your psychiatrist you are still unhappy with his/her service, I'd suggest calling your local university, community mental health center or National Association of Mentally Ill chapter to ask for names, locations and phone numbers of mental health professionals who have expertise assessing and treating adolescents.

I hope this answer is helpful.

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Response by:

Nicholas   Lofthouse, PhD Nicholas Lofthouse, PhD
Clinical Assistant Professor of Psychiatry
College of Medicine
The Ohio State University