<p>My 17 year old is a very bright boy with Asperger’s Syndrome and ADD. He has taken the same dosage of Concerta for years. When he brought home his report card last week, he had an “S” for a behavoir grade in one of his choir classes instead of an “E.” This should be his most fun class, so we started asking him questions and it seems that since about October, at that hour of the day he feels “sad” and can’t make himslef snap out of it. He describes it as a dial going toward sadness and he can’t make it go up.</p>
<p>This sounds like clinical depression to me since it happens every day at the same time and doesn’t depend on what has gone on (good or bad) during the school day.</p>
<p>Has anyone been down this path? Should we start with the school psychologist? I don’t want to just take him to some shrink who will automatically put him on more drugs, but I do want to help him. Adults with Asperger’s have a high incidence of depression and suicide.</p>
<p>How many choir classes is he taking?
The kids I know with Aspergers really benefit from physical activity is it possible he could take something more active at that time of day?
what time of the day is it? is it related to what he is eating at lunch?</p>
<p>At Ds school, seeing the school psych would be a waste of time, however they do have a health clinic on site that has counselors/psychs- that might be where I would start/</p>
<p>Maybe the Concerta is wearing off by then? Has he grown a lot since the dosage was last tinkered with? Is he eating lunch? I know Concerta can be an appetite suppressant, so maybe he’s running on low blood sugar if he’s not hungry, and that’s causing him to feel down.</p>
<p>so maybe he’s running on low blood sugar if he’s not hungry, and that’s causing him to feel down.
sounds possible- protein helps stabilize blood sugar</p>
<p>My own daughter who is on “the spectrum” has wheat sensitivity.
When she was younger, we took her off and noticed a huge difference in her behavior, pretty hard to stay off of it though, and when she went off to camp I let her start eating wheat again, and couldn’t get her back off when she came home.</p>
<p>Something to think about anyway</p>
<p>Also you might consider a light box.
[CET</a> - Center for Environmental Therapeutics - circadian rhythm - seasonal affective disorder lamp - sad light box - light box therapy](<a href=“http://www.cet.org/]CET”>http://www.cet.org/)</p>
<p>Getting sad at the same time every day would not be considered consistent with Major Depressive Disorder. Sounds more situational or like a side effect to me. Does be take concerts on weekends and does it still happen on weekends? If so, think about what it looks like to you. I don’t believe all “shrinks” would think of more meds first. How about starting with the person prescribing the concerts and having your son use his own words rather than tabling it “depression”?</p>
<p>But what kind of professional is more likely to correctly diagnose what is going on? (By the way, he’s on a block schedule, so he has a different set of classes every other day-is happens no matter if it’s an A day or a B day.)</p>
<p>He says he comes to class and sits and doesn’t want to talk to anyone. One day he has English class; it’s pretty easy to just sit there and not be noticed. The other day, however, is Jazz Choir, which is an auditioned ensemble of 15 people. It’s not a “sit at your desk” kind of class. It’s a stand up, talk, move around, be pals with the teacher kind of class. So just sitting there, not talking to anyone, is seen in negative terms.</p>
<p>My guess is it’s more likely to be the medication wearing off, or a combination of med wearing off & nutrition. Heck, I used to fall asleep every single day in my afternoon American History class. I remember it like it was yesterday … drool, pencil falling from my hand, etc. I just hope I didn’t snore! When I worked, I had trouble around 3:30-4:00. I don’t think it is necessarily a big deal. I would absolutely get your son checked out, though. Maybe a minor fine tuning of meds (or even a major change) is in order. Who prescribes the Concerta? That is the professional you should be talking to.</p>
<p>Talking TOO much can be a symptom in the hyperactive/impulive kids but “Talks less with others” is on my rating scale of stimulant side effects. I second ( or repeat) the idea of talking to the prescribing doctor. I believe Concerta absorption CAN be significantly affected by contents of the stomach.</p>
<p>P.S…Usual disclaimers about giving/getting medical advice on the internet…</p>
<p>I would not think depression would just occur at certain times of the day unless there is something particular occurring at that time. (just a parent viewpoint - not a medical one). Your first thing should be to talk to your doctor and see what he/she thinks - ie . if it could be a side effect of his other meds etc.</p>
<p>If your doc thinks it is a good idea please don’t be afraid to take your son to a child psychiatrist if you feel the need. My daughter went to one for several months (when she was 16 her boyfriend was killed in an accident at the place they both worked and she had a very hard time dealing with it). He did not put her on medications (other than some sleeping aids as she had barely slept in months). The talking therapy really helped her sort through things and she was able to stop going after a few months.</p>
<p>I was a little wary as my father was bi-polar and decades of treatment did not seem to help him. But I am really glad we did get her the help she needed.</p>
<p>It took 2 yrs. for my friend to find out her kids depression and anxiety stemmed from a hormone problem. I’d rule out physical causes with an appt w/an endocrinologist.</p>
<p>I would check it out but blood sugar highs and lows can effect some people’s mood dramatically…as hormones do. . But given he says an hour or so a day…makes me think either its between concerta doses or sugar drop …how about figuring when in the day this class is and maybe have him eat something before that class…? or drink something.? Hugs to you both!</p>
<p>If it is low blood sugar, then he needs to have some protein with his carbs. Carbs will allow him to perk up, only to drop again. </p>
<p>Kids tend to like string cheese, or the packages of peanut butter or cheese crackers. </p>
<p>As this happens at the same time everyday, it is not going to be depression. What does he eat for lunch, or does he eat? I know many students do not eat much at school, and many that do only eat junk. If he is just eating sweets, I would guess he is just having a drop in blood sugar.</p>
<p>I think a trip to the pediatrician is the best idea.</p>
<p>He’s a kid who actually thinks the school food is good. He eats the “$2 lunch” every day. It sounds like the food is high in carbs (pasta, etc.) so he may be needing protein.</p>
<p>Having a child who have taken Concerta along with almost every other ADD med I would first call the Dr who is prescribing the Concerta. Does he take Concerta on the weekend? If not you might see if the problem doesn’t surface on days he is off the meds.
My son took Concerta for quite a some time with few side effects other then low appetite. Then suddenly he started having anxiety and depression. He went back to his Dr who sent him to a Psychiatrist (Child). Went off the Concerta and tried some different meds. The anxiety went away. You might also look up side effects of Concerta and see if depression is one of them.</p>
<p>It might not be the Concerta but I think that might be the first place to look.If he is getting the Concerta prescribed my the family Dr or by a pediatrician I would strongly recommend a visit to a Psychiatrist. I was surprised at how educating it was. Also I feel like he really took the time to find the medication that worked the best. They tried alot of different things. My son did see a Psychiatrist who also did talk therapy. Not just med management.</p>