The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. It isn't intended as a 'containment thread' and any content which could go here could instead be posted in its own thread. You could post:
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Requests for advice and / or encouragement. On basically any topic and for any scale of problem.
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Updates to let us know how you are doing. This provides valuable feedback on past advice / encouragement and will hopefully make people feel a little more motivated to follow through. If you want to be reminded to post your update, see the post titled 'update reminders', below.
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Advice. This can be in response to a request for advice or just something that you think could be generally useful for many people here.
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Encouragement. Probably best directed at specific users, but if you feel like just encouraging people in general I don't think anyone is going to object. I don't think I really need to say this, but just to be clear; encouragement should have a generally positive tone and not shame people (if people feel that shame might be an effective tool for motivating people, please discuss this so we can form a group consensus on how to use it rather than just trying it).
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Notes -
Firstly, and probably the most important thing to say: I'm sorry. Both for you, and your daughter. That is a shitty situation to find yourself in.
I will preface this by saying that I'm not a child psychiatrist. I'm not any kind of psychiatrist at all, given that I'm still in early training. Caveat emptor, or perhaps caveat curator and you are best served by contacting one with the full set of credentials.
Were it that simple. The process by which humans impart their genes to their offspring, and by which genes then assemble a whole human being from very rudimentary code, is amazing, yet imperfect.
Even if you, and your husband's genes are immaculate, de novo mutations sneak in all the time. Or there might be recessive traits in hiding, which have evaded generations of selection against them only to strike seemingly out of the blue. In other words, bad things can happen to good people, or at least their blameless children. And then there's environmental factors.
Nobody evolved to need expensive chemotherapy medication for their aggressive childhood leukemia, but alas, it happens nonetheless. That line of thinking isn't productive, the question is what works.
In my case: Two of my grandparents, my father, and even my mother, were all top of their class in med school, and have the awards to prove it. Didn't stop my brother and I from having ADHD, and benefiting heavily from medication to help. My mother might have mild ADHD, but it's usually less bad in women, and it didn't really ruin her life.
(The genetics of ADHD are complicated, and not worth getting into right now. What's done is done, and your daughter's diagnosis fits the bill.)
Anecdotal evidence: I have ADHD. I drink green tea to curb the negative effects of my ADHD medication. I think it helps, a lot, but I've never taken refined l-theanine supplements. My optimism regarding l-theanine took a significant hit recently, but the more important question is:
Does it work? If the answer is yes, then don't change it. It's the opposite to that joke, where you tell the doctor that it hurts if you poke yourself somewhere, and they tell you not to do it.
Medicine is not nearly so deterministic, nor the human body not so, that we can predict in advance if certain substances will reliably cause/not cause certain effects. At most, we can give probabilistic answers.
If you think l-theanine helps.. Well, it's a safe chemical to ingest, even for children. It's not doing any harm, and is safer than most prescription anxiolytics. I would absolutely not prescribe her benzos, and I'd be scared to consider SSRIs.
The headaches are concerning though, and you're right to worry. While L-theanine is generally very safe, any substance that consistently causes side effects in a 7-year-old deserves scrutiny. It's possible she's getting rebound anxiety as it wears off, or there could be something else going on.
Now, the MTHFR rabbit hole. Oh boy. Here's what we know: MTHFR mutations are real and fairly common (about 40% of people have at least one copy). They do reduce the efficiency of folate metabolism. And yes, there does seem to be some correlation with ADHD and autism spectrum conditions, though the effect sizes are generally small and the mechanisms unclear.
But the Reddit methylation community you found... that's where things get genuinely scary. These people are essentially conducting chemistry experiments on themselves with minimal supervision, often at doses far above what you'd get from food or standard supplements. Some claim miraculous results, others end up with severe side effects. It's the supplement world's version of DIY hormone replacement therapy.
On PDA: You're right that it's not recognized in the US, and there are good reasons for skepticism. I've never encountered it even in the UK, but once again, I'm just a first year psychiatry resident, and there are many things I haven't encountered. The diagnostic criteria are frustratingly vague ("pathological demand avoidance" could describe half the children I know), and the proposed interventions often sound suspiciously like "never ask your child to do anything they don't want to do," which seems like it would create more problems than it solves. But - and this is important - sometimes unofficial diagnostic categories capture something real that the official ones miss. Before ADHD was widely recognized, plenty of kids were getting labeled as "lazy" or "defiant" when they had a genuine neurological difference. The fact that PDA isn't in the DSM doesn't mean the cluster of behaviors you're describing isn't real or treatable.
So what should you do?
First, the good news: you've found something (L-theanine) that helps your daughter function better, and you're being appropriately cautious about side effects. That's already more than many parents in your situation have managed.
For the longer term, I think the psychiatrist you found is worth consulting, despite the quack-adjacent discovery process. If she has an actual MD and hospital privileges, she's at least operating within some bounds of medical accountability. The worst case is you're out some consultation fees and get told your daughter is fine; the best case is you find someone who can help navigate this mess with proper medical supervision. Before going down the genetic testing route, though, consider getting basic nutritional bloodwork done - B12, folate, iron, vitamin D, maybe homocysteine if you're really curious about methylation. If there are obvious deficiencies, addressing those is straightforward and doesn't require diving into the methylation rabbit hole.
I'm personally tempted to consider stimulants, which I believe are appropriate even at that age group, given severe ADHD. Alas, I lack the confidence to make that recommendation, and my usual recourse, asking my bosses, doesn't work very well when it's on behalf of internet strangers.
Go see a child psychiatrist, preferably one with a penchant for learning or behavioral disorders. Maybe see two. Or three. Do what they say, and don't listen to anything I have to say beyond this very point.
I wish you, and her, all the best. ADHD sucks.
Thank you for your detailed and thoughtful reply!
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