Dear Teen Parenting Coach

Q: Why Does My Loving Son Fly Into Fits of Rage?

The stress of real life can cause anxiety. For this college freshman living on his own, that anxiety explodes periodically in screaming fits of rage that impact family, roommates, and driving safety. What can a parent do? Here, learn techniques for helping a young adult better manage the emotional components of ADHD.

Q: “When he’s under stress, my college-student son is prone to these fits of rage where he screams, hits things, and has even threatened to hurt himself. He rages through the house switching between anger and sadness and is completely inconsolable. He has never hurt or threatened to hurt any one of us, but the police were called once, and he’s gotten two speeding tickets in two months — accused of reckless driving. When he is his normal wonderful self, my son is funny and sweet. Very loving to me, his brothers and sisters, his grandparents and animals. In high school, he was diagnosed with attention deficit disorder (ADHD or ADD), attentive type and a non-verbal learning disorder. He took medicine for a couple of years and then decided he was done with it, as it made him too anxious. He stopped seeing his doctor at the same time. He refuses to get any kind of help at all, despite his college roommates’  and girlfriend’s complaints, and I think this is where we are all stuck. How can we help him?”

Stressed Teen Mom

Dear Stressed Teen Mom:

I understand why you feel stuck. When grown-ish children don’t take care of themselves and struggle in their lives, it’s really tough to know what to do. When your son was younger and living under your roof, you could take him to the doctor and insist on psychotherapy. Now that he’s independent, what can you do?

You describe a friendly, caring young man who may have bitten off more responsibility than he can chew. Many first-year college students don’t live on their own because it’s too much for them to juggle everything. For kids with ADHD who constantly deal with executive functioning challenges, living in an apartment and managing everything that it entails is a really big step. It makes sense that he’s feeling stressed.

Like many of his peers with ADHD, your son wrestles with managing his intense feelings — whether it’s anger or anxiety. When he’s triggered by something, no matter how small, his reactions go from zero to one hundred in seconds. His strong emotions wash over his thinking brain like a huge wave, drowning all rationality. When this happens, he needs tools to get the thinking brain back in control so he can manage himself.

Understanding and noticing the internal signals that he’s becoming activated — tightness in the chest, a knot in the stomach, rapid heart rate — can slow down the escalation process and lead to better outcomes. If he can catch himself before the intense feelings become an explosion — and then use tools such as breathing exercises, going outside or listening to music to re-orient himself — he may teach himself to sidestep an outburst. But most people with ADHD can’t learn these tools on their own. They’re too busy trying not to drown in the emotional flood.

[Self-Test: Oppositional Defiant Disorder in Children]

Like you, I am concerned about your son’s emotional reactivity combined with his reckless driving. His safety seems to be at risk and his run-ins with the law are certainly worrisome. I bet that he doesn’t like them either. This is where the two of you can work together to create positive change.

In a calm moment, sit down and discuss this issue from a practical position. What will happen the next time he’s stopped by a police officer? What might he like to avoid? Dr. Russell Barkley has done a lot of research about the relationship between ADHD and reckless driving. I would suggest reading it and sharing it with him. Figure out how the two of you can collaborate to avoid a legal or even tragic outcome. Don’t try to convince him of anything. Just provide the information and brainstorm solutions.

Your son needs to learn more effective skills for managing himself and his life. While you can’t really make him do things differently at this age, you can become his ally in tackling the demons he himself dislikes. If he can identify one or things that aren’t working in his life, listen and offer your empathy before any suggestions. Living with the volatility and anxiety he experiences must be really tough, and he needs to know that you’re on his team.

Offering compassion, though, doesn’t mean withholding information. The fact is that medication can be very useful in assisting teens with ADHD to improve their judgment. A good ADHD coach who focuses on building a collaborative action plan can also help him build the skills he needs to do that. If conversations are too prickly, send him an email or text with a link or two. Let him know that his previous experience with medication and the anxiety it caused indicates that he probably wasn’t on the right medication and/or dosage.

Meeting with an ADHD expert would likely make a difference. Similarly, coaches can be less pejorative to some people, so direct him to a site that explains it. He may not cooperate, but you’ve laid the groundwork in case he changes his mind later on.

Lastly, family therapy could really help you. Since the likelihood of your son working with a coach or psychiatric prescriber seems small, you could take a different approach. He seems to care a great deal about your family and enjoys being with you. Family therapy with the goal of reducing conflict and improving closeness among all of you would take the focus away from him and put it on everybody. This would increase his willingness to participate because he’s not the ‘problem.’ Over time, he may even become amenable to getting some help on his own when he sees how his actions negatively impact everyone else.

[Recommended Reading: Safe Driving Tips for Teens with ADHD]

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The opinions and suggestions presented above are intended for your general knowledge only and are not a substitute for professional medical advice or treatment for specific medical conditions. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your own or your child’s condition.