ADHD: what made you decide to medicate?

[Anonymous]

I have a child in K who was diagnosed with ADHD midyear. We chose not to medicate at first, and are working with a psychologist to try to develop coping strategies for our child. Part of the decision not to medicate came from the fact that academically she's doing fine, although she's struggling somewhat socially (I think that part of that is genuinely just that she prefers to be by herself most of the time). it seems like she has been deteriorating, to the point where her teacher reports that now she is only mastering concepts when the teacher works with her one-on-one, because she is just not focused at all in any form of group instruction.

I was hoping for some anecdotal information about how you made the choice to try medication, and what factors may have triggered your decision.

Truthfully, I'm also hoping for encouragement, because even though intellectually I know this isn't my fault, it doesn't stop me from feeling like the crappiest parent in the world.

[Anonymous]

We are in the same boat with a 2nd grader. She does well in school and socially but you can see how she tunes things out and needs prompting to pay attention like during long lessons or during sports but if you ask her after she can tell you everything that was taught. During a game she might be kicking the dirt and then turn it on

[Anonymous]

Over 1 year and several thousand dollars trying the biomedical/diet approach.

DD was flailing around in her first grade class, barely able to handle the class schedule/routine halfwaly through and year and despite a lot of support not able to read yet at grade level (she does have LD's but medication has helped a lot with her ability to focus and improve her reading) was the final straw.

[Anonymous]

``even though intellectually I know this isn't my fault, it doesn't stop me from feeling like the crappiest parent in the world''

As a parent who is going through exactly this with my SN kid, perhaps I can help you untangle this -- why on earth would you feel like the crappiest parent in the world? What did you do? I bet this feeling wouldnt withstand the logic test (though i empathize since im going through this with my son as well).

[Anonymous]

Our DD was diagnosed with extreme ADHD at age 4 yrs 10 months. We tried meds but HATED them (she was so small, and it really affected her appetite and ability to sleep) so at our doctor's suggestion we switched to an over-the-counter DHA supplement (basically, fish oil capsules for kids, sold at Whole Foods). Her preschool teachers could not tell the difference between her behavior on Ritalin and the fish oil (we didn't tell them we were making the switch). Now, granted, we also took on two years of extensive therapy, including neurofeedback therapy in combination with CogMed working memory training (these two in combination have done more for our child than anything else -- her ADHD was really a working memory problem). She is now eight and thriving in second grade in FCPS (without meds) and will always have some ADHD behaviors but she can listen and learn, and knows how to manage her challenges. There is a light at the end of this tunnel for you, and none of this is your fault (or your chid's fault -- it can be easy to get frustrated by their inability to pay attention).

[Anonymous]

My oldest is off the charts ADHD. The psychiatrist said he was one of the most significant cases he had seen and even used my son in a paper. He was diagnosed in the beginning of his second grade year.

We held off medication until middle school. That's when we really saw him struggle academically, and it was affecting his self-esteem. We did medication along with therapy. He had a fantastic ADHD coach who taught him all kinds of coping skills. He went off medication his junior year in high school.

He is now 22 and a Junior in college. He obviously still struggles with ADHD. But he manages it without medication. It is possible. However, I think the reason he has been successful is because we were open to medication for a few years.

[Anonymous]

DS was diagnosed in first grade and hugely struggling academically. He got an IEP on account of the ADHD and we saw going back to preschool how this was affecting him. It was a no-brainer. That doesn't mean it was easy. It took some time to find medications that worked well for him and we probably will fine-tune before the next school year starts. We also have been doing extensive therapy. The therapy and medication combo has been shown to be the most effective and we've really seen a difference. A lot of people feel "bad" about medication or think that parents are choosing "the easy way out." Not the case at all - the different types of medication affect kids quite differently (DS did not do well on ritalin-based meds but has done quite well on dextroamphetamine-based ones) and it has taken a lot of work to figure this out. Medication helps DS be able to "attend" and absorb learning. The side effects vary widely - DS at times has had decreased appetite but has continued to grow at the rate he was growing pre-medication. Good luck!

[Anonymous]

DS is in fifth grade and we are still holding out without medicating. Teachers report that he is on task maybe 20% of the time except in math, which is higher. I can see when he gets home that not much was learned that day in most of the other subjects, so we go over things one on one (fortunately one on one takes a small fraction of the time things take in class) and he learns them and is still getting A's and B's.

We are not planning on medicating unless we completely run out of other options (lots of tutoring, homeschooling alternative schooling). The (probably odd) reason for this is that I grew up with a mother who was medicated throughout my childhood with various psychotropic meds (antidepressants and such) and long term, her physical and mental condition seemed to do nothing but deteriorate. She went from a woman who seemed just like any other to a wreck (too long to describe here). So I learned from age 7 or 8 to have an instinctive fear and hatred of psychotropic medication. Recently she went into rehab for addiction to these substances and the psychatrists who treated her told my dad the brain scans clearly show the damage the drugs have done over 30 years.

DH was also "a nightmare" by his own account and his mom's when he was little--in and out of psychologists' offices, mediocre student until he went to a non-traditional high school. He was never medicated though (I don't think they had as many substances back then) and today he's a successful lawyer.

Recently there has been a spate of articles in the media (eg. NYTimes, PBS) about the shaky grounds for many of these treatments and the flimsy foundations DSM rests on and I also recently came across a book entitled "Anatomy of an Epidemic: Magic bullets, psychiatric drugs, and the astonishing rise of mental illness in America." Some of the long term experiences that the author describes in the book mirror the devastating experience I had growing up with my mom. Obviously, these have done nothing but reinforce my own biases. Note that I don't believe in conspiracy theories, I have a science degree, and I do vaccinate my kids. But it's going to take a lot more evidence to convince me that these substances are safe and effective.

A lot of parents swear by their kids' medications and feel they are a lifesaver. Obviously, every child is different and if they are, more power to you. But this is my alternative view.

[Anonymous]

We were faced, in first grade, with the need to either seek a school just for special-needs kids or try medication. Since our child has no LDs and really loved the school they attend already, we chose medication. The medication works well, though not without side effects.

Tell me more about the cogmed training? Where would we go for that?

[Anonymous]

Anonymous wrote:DS is in fifth grade and we are still holding out without medicating. Teachers report that he is on task maybe 20% of the time except in math, which is higher. I can see when he gets home that not much was learned that day in most of the other subjects, so we go over things one on one (fortunately one on one takes a small fraction of the time things take in class) and he learns them and is still getting A's and B's.

We are not planning on medicating unless we completely run out of other options (lots of tutoring, homeschooling alternative schooling). The (probably odd) reason for this is that I grew up with a mother who was medicated throughout my childhood with various psychotropic meds (antidepressants and such) and long term, her physical and mental condition seemed to do nothing but deteriorate. She went from a woman who seemed just like any other to a wreck (too long to describe here). So I learned from age 7 or 8 to have an instinctive fear and hatred of psychotropic medication. Recently she went into rehab for addiction to these substances and the psychatrists who treated her told my dad the brain scans clearly show the damage the drugs have done over 30 years.

DH was also "a nightmare" by his own account and his mom's when he was little--in and out of psychologists' offices, mediocre student until he went to a non-traditional high school. He was never medicated though (I don't think they had as many substances back then) and today he's a successful lawyer.

Recently there has been a spate of articles in the media (eg. NYTimes, PBS) about the shaky grounds for many of these treatments and the flimsy foundations DSM rests on and I also recently came across a book entitled "Anatomy of an Epidemic: Magic bullets, psychiatric drugs, and the astonishing rise of mental illness in America." Some of the long term experiences that the author describes in the book mirror the devastating experience I had growing up with my mom. Obviously, these have done nothing but reinforce my own biases. Note that I don't believe in conspiracy theories, I have a science degree, and I do vaccinate my kids. But it's going to take a lot more evidence to convince me that these substances are safe and effective.

A lot of parents swear by their kids' medications and feel they are a lifesaver. Obviously, every child is different and if they are, more power to you. But this is my alternative view.

With all due respect for you, because I know you are doing what you feel is best for your child, I just don't understand this. If your child is only on task 20% of the time and many does learns nothing in school, how can you justify not trying the medications?

I think, contrary to what you say, that there are many many studies showing that the meds are safe and effective when properly prescribed and monitored. Can you direct us to the NY Times and PBS articles about this?

I think you have to separate out ADHD meds from other forms of medical treatment for mental illness (I don't think ADHD qualifies as a mental illness). Getting worried about things like schizophrenia meds which do have many bad side effects doesn't allow you to make a clear decision about treating your child.

[Anonymous]

Sorry for the type above I meant to say "many times learns nothing in school."

[Anonymous]

For me, it came down to one thing. Difficulty in school that could not be effectively handled through behavioral means. It took us a long time to make the decision, but honestly, we did our child a disservice by waiting. He was seriously depressed about his inability to function in school and his inability to do the work. Within a day of starting medication, you would have thought I was sending a different kid to school. Even now, people at his school talk about how hard his life must have been for him before the medication and they are right.

[Anonymous]

If your child is only on task 20% of the time and many does learns nothing in school, how can you justify not trying the medications?

I thought the PP you are asking did a very good job of laying out her reasoning -- giving both anecdotal (her mom's results from spending years and years on psychotropic meds) and epidemiological evidence (the book referenced).

Fwiw, I have looked and looked and despite the fact that I am an above-average researcher, I have yet to find even 2 or 3 studies assessing actual, quantifiable, long-term effects of common stimulant (ADHD) drugs on the developing mind. I assume there never will be such studies because it is unethical to ask one group of children to reject meds and act as the control group for 25+ years.

Point being, I have never understood the parents who assert that the common ADHD meds have "been shown" to be "safe." What does that mean, beyond that the child does not quickly die of an embolism after a few months on, say, Ritalin? "Safe" for the brain 40 years down the line ... how, exactly? And compared to what group? I assert we don't actually know this.

[Anonymous]

My ds (9) is on meds. We tried many different ones before finding one that works. I view the meds like glasses. He needs them to get through the day. I respect the people who choose not to medicate but his life would be miserable without his medication.

[Anonymous]

My nine year old saw how much the meds helped a friend and asked to try them. So far, so good.

OP, I understand what you mean about feeling like a crappy parent. I felt the same way. Logically I knew I couldn't "fix" my child, but emotionally I wanted to make it all right without putting my DC through any of that.