Just because a medication is a "non-stimulant," that doesn't mean it will work well for ADHD with co-existing bi-polar disorder symptoms.
It also doesn't mean it won't exacerbate bi-polar symptoms.
It can be very tricky to tease out what is bi-polar disorder and what is ADHD. While these are distinct diagnoses, our brains are not so neatly compartmentalized.
Many times, bi-polar disorder is misdiagnosed as ADHD, and vice versa. But the two can co-exist.
The basic approach toward treating these two co-existing conditions is to stabilize the bipolar disorder first and then address the ADHD. Contrary to your physician's opinion, the stimulants can be used successfully with stabilized bipolar.
Your MD sounds unfamiliar with the literature. I would ask him to research it. Or you could research it yourself. But please don't assume that a non-stimulant ADHD medication is the best strategy. "Non-stimulant" does not mean side-effect free. Strattera can exacerbate bi-polar disorder, too.
I wouldn't say that people with ADHD can "pick and choose" what they want to remember.
It is more that some things register higher than others. The things that are highly stimulating are rewarding are more likely to register in the brains of people with ADHD.
Neuroscientists call this "salience" -- that some things have more meaning for us than others.
In fact, research has shown that the stimulant medication can increase, in people with ADHD, the level of salience of things happening in their environment—the teacher/spouse/parent communicating, the dirty clothes on the floor, the child's request for help, etc.
Your question is one often asked among the public. But if you are a parent with ADHD, your question reflects that you and your son would greatly benefit from more education about ADHD.
CHADD, the national non-profit for ADHD, offers an online course called "Parent to Parent." And there are many books available.
First, your question: "Can a child switch gears so dramatically, between home and school?"
The simple answer is, yes.
In many ways, we can think of ADHD as a "contexual disorder." That is, it manifests more in some situations than in others.
For example, let's say your home is calm, there's not a lot of clutter, and there is an orderly desk where he does his homework. All that could help a child with ADHD to stay more focused on the task at hand. There aren't a lot of decisions to make, because the external environment is supporting good brain function.
Now let's look at the classroom. And, in kindergarten, it's more of a play-classroom, right? Some classrooms these days have so many distractions -- so many colorful things on the wall, tempting items sitting around, and....so many children.
All these distractions could be focusing your child's attention away from the classroom.
Of course, some of us happen to believe that kindergarten should be more structured play—a place for imagination and trying new things—than too much instruction. Many children's brains are not ready for too much instruction.
It's great that your grandson has good social skills. Many children with ADHD aren't so lucky. (I am not saying that he has ADHD, because I see no evidence of it; still, it's a possibility).
Overall, I'm sad that children in kindergarten are given grades. Personally, I think that's nuts. Definitely, it makes sense to gauge how he is doing, compared to other children. That's important information. But grades?
I guess if it were my child, I'd focus more on his happiness than "grades" at this point. He obviously likes to be around children--doesn't simply become distracted by them? Then I wouldn't take him away from that, with online schooling. Why create that kind of isolation for him? It might even seem like punishment.
I mean, really, a young child and online schooling? I just can't imagine how that's healthy. Especially as he has no siblings.
So, as far as helping your grandson in his current situation, I would continue to provide him the structure at home that it sounds like he is getting. And, perhaps help him to focus in that calm environment on the key things he might be missing at "school." Read with him, etc.
I assume that your education as a teacher included no classes in dealing with children with LD? I understand this is largely the case, but I find it very hard to comprehend.
If you are a teacher expected to handle children with LD, ADHD, behavior disorders, etc., I don't see how you can do it without a solid self-education.
If you don't know much about ADHD, you cannot really assume the child has ADHD. There could be some other issue. You don't mention the age. If it's a young child, perhaps she was scared on her first day. Speaking sternly to her is the doubtfully the most productive response.
The non-profit CHADD offers resources for parents and teachers. The resource you could start using right away is CHADD's Educator Manual.
P.S. And definitely, if you can prepare in other ways, that would be great. For example, setting up organizational systems, developing a list of resources (sitters, etc.). And definitely try to have some money in the bank.View Thread
Adult ADHD Expert And Author http://www.GinaPera.com
Great idea, grace. I also encourage you to make sure your nutrients are in good supply -- B vitamins (not just folate), minerals, essential fatty acids, etc.
The baby's nervous system forms soon after conception, and all the building blocks should already be in place.
You could try looking into amino acids for yourself. e.g. L-tyrosine. But I don't know of anyone with ADHD who finds that an effective alternative to Rx; only a supplementary strategy that might mean a lower dose of Rx is possible.
Also, you might want to read Patricia Quinn's book 100 Questions and Answers for Women with ADHD I think she talks about this topic in it. And she is a highly reliable authority. An MD and ADHD expert for decades. Very smart lady!
Unfortunately, this is more common than most people could ever imagine.
ADHD medication treatment is one thing, but no treatment is going to counter sitting at a screen all day, especially if gaming is involved. For many people with ADHD, that scenario can even worsen ADHD symptoms.
I would question why he's taking Adderall. It's an older Rx and has a high side effect profile, plus addiction potential.
Also, the sad truth is that for some adults with ADHD have to be faced with dire consequences before they are moved to action. For example, in marriages, they have to be presented with divorce papers.
If your son is living at home on your dime, you still have some control. If you are making things comfortable for him, there is no "urgency" about him finding a job.
Of course he's "happy with things the way they are." You're putting a roof over his head and, presumably, taking care of other needs.