Considering to Medicate 15-YO DS for ADHD

[Anonymous]

Anonymous wrote:

Anonymous wrote:My DS started late because he was always borderline in academic impact, self-regulated through very hard athletics (exhausted himself out of impulsive behavior, essentially), and we were reluctant to medicate. So far my only regret is waiting as long as we did. However, one minor advantage was that he was over 6' when we started so I was not as worried about impact on growth.

Wait, there's an impact on growth??? I have 13 year old and we are considering medicine for ADHD. I had not idea it would impact his growth.

Sort of. It can suppress appetite, which can impair growth. But that can be dealt with by Big breakfasts before after big dinners later. My medicated DS is 6’3’’. DH is 5’9. I’m 5’6. Height was not impaired. He has been very thin, but no alarmingly so. Like a lot of boys who grew at lot, fast, he is starting to fill out in college.

[Anonymous]

Anonymous wrote:We should never has waited as long as we did to medicate. It is by far my biggest parenting regret with my hS senior. Not because of grades. There isn’t a disaster on his transcript. But because he was so clearly unhappy and struggling. He wanted to do things like other kids so badly and just couldn’t. But, I didn’t want to pull the trigger. A couple months after he started, he asked me why we had waited so long when his life had been so hard before. It broke my heart. And the answer is because I was scared. But looking at the difference and what we put him through by not acting. Forget grades. Screen are still a struggle. He’s happier, more balanced, more confident, less angry and less anxious. It's hands down the one parenting decision I know I blew.

OP— forget the Ped and do it right. Get an adolescent psychiatrist and work with them to get a valid diagnosis and Medicare if appropriate. ADHD meds are tricky. Some work for your kid, some don’t. And as a kid grows or hits puberty, what they need can change. But please do something. I’ve now learned that unmediated ADHD kids are at very high risk for anxiety, depression, suicide, substance abuse. And I see why.

This is me, and having now read the whole thread, I want to add a couple things.

First, ADHD impairs emotional regulation in a lot of kids. Our medication has been paired with a psychologist who works with my kid on managing emotions and understanding why he feels less centered as his meds wear off. He also had an executive functioning coach for 3 years and actively learned things most of us just know. Now a senior, college apps on track, demanding fall EC and good grades. And no longer needs the EF coach. He has the tools he needs to succeed in college. And I never thought I would see that. I am so proud of him. The point is medication is amazing. But also get your kid help learning to manage the ADHD himself. Maybe he never comes off meds. Maybe he does. But meds don’t solve everything, and many meds aren’t active 24/7.

Second, many unmedicated ADHD people do self medicate. Sometimes with actual drugs. But my DH did it with caffeine. 12 Dr. Peppers a day. Once DS was medicated and we saw the change in happiness, social relationships, and yes, work habits and grades, DH said— but our son is just like me. He saw a psychiatrist, was diagnosed, and takes a low dose med. and now drinks almost no caffeine. 12 Dr. Peppers a day may not be illegal. But it’s not healthy either. But that was how DH coped since he hates coffee. A pot of coffee every day is also common in unmedicated ADHD.

[Anonymous]

Op— realize you have a limited window to deal with this. Once your kid turns 18, if he doesn’t want treatment or wants to cut you out of treatment, that’s it.

You need to now work with your kid, as a partner, to help make his life better. So he trusts you while he is in college. And so he can establish a plan that he will follow in college. He may need to see a psych on his own, fill meds, take them, keep them safe in schools where kids want to bum study drugs, and develop academic strategies and screen control strategies that work. The window where you can influence how this plays out is closing.

[Anonymous]

This is such a great post, I am thinking about meds for my son who is in 8th grade. I read the all the postings and it is so supportive and informative! Does anyone have a pediatric psychiatrist or a pediatrician who has experience with ADHD medication to recommend? I happen to be in Fairfax, but I'm ok driving if my son gets to be seen by great doctor. Thank you!

[Anonymous]

Anonymous wrote:Op— realize you have a limited window to deal with this. Once your kid turns 18, if he doesn’t want treatment or wants to cut you out of treatment, that’s it.

You need to now work with your kid, as a partner, to help make his life better. So he trusts you while he is in college. And so he can establish a plan that he will follow in college. He may need to see a psych on his own, fill meds, take them, keep them safe in schools where kids want to bum study drugs, and develop academic strategies and screen control strategies that work. The window where you can influence how this plays out is closing.

THIS my sil realized this too late. Wanted her ds to go to the dr at 18 but he refused.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My DS started late because he was always borderline in academic impact, self-regulated through very hard athletics (exhausted himself out of impulsive behavior, essentially), and we were reluctant to medicate. So far my only regret is waiting as long as we did. However, one minor advantage was that he was over 6' when we started so I was not as worried about impact on growth.

Wait, there's an impact on growth??? I have 13 year old and we are considering medicine for ADHD. I had not idea it would impact his growth.

It can suppress appetite. My kid was always always at 95-100% on the growth curve since he was 5 had this side effect. My other kid who runs at 50% on the growth curve did not have this side effect. You just have to be sure they are eating enough when the medication wears off or before they take it for the day.

This - they can eat constantly for 4 hours after medication wears off and get plenty of calories - it's just a matter of adjusting the family schedule to accommodate the child's need to eat.

That's not a great way to set up a teen for healthy eating throughout their adult life.

+1. This is hardly a no effect side effect

[Anonymous]

Anonymous wrote:This is such a great post, I am thinking about meds for my son who is in 8th grade. I read the all the postings and it is so supportive and informative! Does anyone have a pediatric psychiatrist or a pediatrician who has experience with ADHD medication to recommend? I happen to be in Fairfax, but I'm ok driving if my son gets to be seen by great doctor. Thank you!

Bump

[Anonymous]

Anonymous wrote:

Anonymous wrote:We should never has waited as long as we did to medicate. It is by far my biggest parenting regret with my hS senior. Not because of grades. There isn’t a disaster on his transcript. But because he was so clearly unhappy and struggling. He wanted to do things like other kids so badly and just couldn’t. But, I didn’t want to pull the trigger. A couple months after he started, he asked me why we had waited so long when his life had been so hard before. It broke my heart. And the answer is because I was scared. But looking at the difference and what we put him through by not acting. Forget grades. Screen are still a struggle. He’s happier, more balanced, more confident, less angry and less anxious. It's hands down the one parenting decision I know I blew.

OP— forget the Ped and do it right. Get an adolescent psychiatrist and work with them to get a valid diagnosis and Medicare if appropriate. ADHD meds are tricky. Some work for your kid, some don’t. And as a kid grows or hits puberty, what they need can change. But please do something. I’ve now learned that unmediated ADHD kids are at very high risk for anxiety, depression, suicide, substance abuse. And I see why.

This is me, and having now read the whole thread, I want to add a couple things.

First, ADHD impairs emotional regulation in a lot of kids. Our medication has been paired with a psychologist who works with my kid on managing emotions and understanding why he feels less centered as his meds wear off. He also had an executive functioning coach for 3 years and actively learned things most of us just know. Now a senior, college apps on track, demanding fall EC and good grades. And no longer needs the EF coach. He has the tools he needs to succeed in college. And I never thought I would see that. I am so proud of him. The point is medication is amazing. But also get your kid help learning to manage the ADHD himself. Maybe he never comes off meds. Maybe he does. But meds don’t solve everything, and many meds aren’t active 24/7.

Second, many unmedicated ADHD people do self medicate. Sometimes with actual drugs. But my DH did it with caffeine. 12 Dr. Peppers a day. Once DS was medicated and we saw the change in happiness, social relationships, and yes, work habits and grades, DH said— but our son is just like me. He saw a psychiatrist, was diagnosed, and takes a low dose med. and now drinks almost no caffeine. 12 Dr. Peppers a day may not be illegal. But it’s not healthy either. But that was how DH coped since he hates coffee. A pot of coffee every day is also common in unmedicated ADHD.

+1 - parent of an ADHD kid that realized "but that's me" and how much I had self-medicated with nicotine and caffeine over the years and used "strategies" to cope but some things are just sooo hard for an ADHD mind - and now with medicine - caffeine consumption way down (quit nicotine long ago when I had children and left much higher-stress job).

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My DS started late because he was always borderline in academic impact, self-regulated through very hard athletics (exhausted himself out of impulsive behavior, essentially), and we were reluctant to medicate. So far my only regret is waiting as long as we did. However, one minor advantage was that he was over 6' when we started so I was not as worried about impact on growth.

Wait, there's an impact on growth??? I have 13 year old and we are considering medicine for ADHD. I had not idea it would impact his growth.

It can suppress appetite. My kid was always always at 95-100% on the growth curve since he was 5 had this side effect. My other kid who runs at 50% on the growth curve did not have this side effect. You just have to be sure they are eating enough when the medication wears off or before they take it for the day.

This - they can eat constantly for 4 hours after medication wears off and get plenty of calories - it's just a matter of adjusting the family schedule to accommodate the child's need to eat.

That's not a great way to set up a teen for healthy eating throughout their adult life.

+1. This is hardly a no effect side effect

BS. You are teaching the child to eat when they are hungry - not just because someone is telling you to do so. You are teaching your child to listen to their body and understand it. It's not disorganized eating - it's not binge eating - it's what the child needs, and is exactly what the pediatrician recommends.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My DS started late because he was always borderline in academic impact, self-regulated through very hard athletics (exhausted himself out of impulsive behavior, essentially), and we were reluctant to medicate. So far my only regret is waiting as long as we did. However, one minor advantage was that he was over 6' when we started so I was not as worried about impact on growth.

Wait, there's an impact on growth??? I have 13 year old and we are considering medicine for ADHD. I had not idea it would impact his growth.

It can suppress appetite. My kid was always always at 95-100% on the growth curve since he was 5 had this side effect. My other kid who runs at 50% on the growth curve did not have this side effect. You just have to be sure they are eating enough when the medication wears off or before they take it for the day.

This - they can eat constantly for 4 hours after medication wears off and get plenty of calories - it's just a matter of adjusting the family schedule to accommodate the child's need to eat.

That's not a great way to set up a teen for healthy eating throughout their adult life.

+1. This is hardly a no effect side effect

BS. You are teaching the child to eat when they are hungry - not just because someone is telling you to do so. You are teaching your child to listen to their body and understand it. It's not disorganized eating - it's not binge eating - it's what the child needs, and is exactly what the pediatrician recommends.

Children with ADHD who take stimulants are more likely to be obese as adults, studies show, whether from poor childhood eating habits encouraged by their parents or from a metabolism issue or from the stimulants themselves which burn out adrenals or another reason. Just as children with ADHD who do not take stimulants are more likely to be obese as adults, studies show.

This doesn't mean that children shouldn't take stimulants or shouldn't pack in the calories in the 7-11pm window. But it means that taking stimulants doesn't "cure" ADHD for children or for adults, and doesn't reduce all of the well-recognized negative side effects of ADHD in adulthood.

And normal eating is better, in terms of a lifetime of eating, for children than skipping lunch and gorging on a bedtime snack.

[Anonymous]

Another comment on eating more in the evenings when it wears off - sports practices have become more frequent and later. He’s not as hungry before and eats a little before practice. He’s hungry later when he gets home, the medicine is long worn off and he’s done with practice. It actually works out well.

[Anonymous]

Anonymous wrote:This is such a great post, I am thinking about meds for my son who is in 8th grade. I read the all the postings and it is so supportive and informative! Does anyone have a pediatric psychiatrist or a pediatrician who has experience with ADHD medication to recommend? I happen to be in Fairfax, but I'm ok driving if my son gets to be seen by great doctor. Thank you!

Yes! Doug Tebor in McLean is amazing. Very thoughtful. Methodical. Cautious. But not so cautious he doesn’t help. Good manner with the kids. Takes his time. He will require a referral from your kids pediatrician or a specialist (psychoeducational tester, psychologist, neurologist, etc) . Not a diagnosis. Just a referral. It’s can be hard to find a pediatric/adolescent psych with an open practice. Strongly recommend.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My DS started late because he was always borderline in academic impact, self-regulated through very hard athletics (exhausted himself out of impulsive behavior, essentially), and we were reluctant to medicate. So far my only regret is waiting as long as we did. However, one minor advantage was that he was over 6' when we started so I was not as worried about impact on growth.

Wait, there's an impact on growth??? I have 13 year old and we are considering medicine for ADHD. I had not idea it would impact his growth.

It can suppress appetite. My kid was always always at 95-100% on the growth curve since he was 5 had this side effect. My other kid who runs at 50% on the growth curve did not have this side effect. You just have to be sure they are eating enough when the medication wears off or before they take it for the day.

This - they can eat constantly for 4 hours after medication wears off and get plenty of calories - it's just a matter of adjusting the family schedule to accommodate the child's need to eat.

That's not a great way to set up a teen for healthy eating throughout their adult life.

+1. This is hardly a no effect side effect

BS. You are teaching the child to eat when they are hungry - not just because someone is telling you to do so. You are teaching your child to listen to their body and understand it. It's not disorganized eating - it's not binge eating - it's what the child needs, and is exactly what the pediatrician recommends.

Children with ADHD who take stimulants are more likely to be obese as adults, studies show, whether from poor childhood eating habits encouraged by their parents or from a metabolism issue or from the stimulants themselves which burn out adrenals or another reason. Just as children with ADHD who do not take stimulants are more likely to be obese as adults, studies show.

This doesn't mean that children shouldn't take stimulants or shouldn't pack in the calories in the 7-11pm window. But it means that taking stimulants doesn't "cure" ADHD for children or for adults, and doesn't reduce all of the well-recognized negative side effects of ADHD in adulthood.

And normal eating is better, in terms of a lifetime of eating, for children than skipping lunch and gorging on a bedtime snack.

Did anyone make the claim that stimulants cure ADHD? I don’t recall reading that claim. Stimulants are a tool that help control symptoms for hours after they’re taken. When you stop taking them, they stop helping. The old theory was that kids outgrow ADHD, so they don’t need stimulants as adults. I don’t believe that’s the current thinking.

Could it be that adults with ADHD (who did or didn’t use stimulants as children) have impulse control issues and might be seeking the same highs from eating that other people with adhd seek by self medicating? Also we live in an obese country. Maybe it’s not related to stimulants. You seem to be trying to suggest adult obesity is related to childhood stimulants, but you’re also saying that not taking stimulants gives the same result.

[Anonymous]

Anonymous wrote:I think there is a lot of hysterical over-reaction on this thread around using meds. However, having said that, you shouldn't take any medication with out being sure it's appropriate. (Just like you don't rush to take antibiotics.)
We did a full evaluation with a group practice (not regular pediatrician) that offered psychological and psychiatric services for children. It involves a number of tests and questionnaires filled out by child, parent, and teachers. Only once we received that diagnosis did we proceed. We did a combination of therapy and medication for a while. The therapy helped tremendously we getting some important techniques. We also had to do a fair amount of adjusting of medication--both type and dosage.
We are now at a great place, but it does take time and money.

+ 1

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My DS started late because he was always borderline in academic impact, self-regulated through very hard athletics (exhausted himself out of impulsive behavior, essentially), and we were reluctant to medicate. So far my only regret is waiting as long as we did. However, one minor advantage was that he was over 6' when we started so I was not as worried about impact on growth.

Wait, there's an impact on growth??? I have 13 year old and we are considering medicine for ADHD. I had not idea it would impact his growth.

It can suppress appetite. My kid was always always at 95-100% on the growth curve since he was 5 had this side effect. My other kid who runs at 50% on the growth curve did not have this side effect. You just have to be sure they are eating enough when the medication wears off or before they take it for the day.

This - they can eat constantly for 4 hours after medication wears off and get plenty of calories - it's just a matter of adjusting the family schedule to accommodate the child's need to eat.

That's not a great way to set up a teen for healthy eating throughout their adult life.

+1. This is hardly a no effect side effect

BS. You are teaching the child to eat when they are hungry - not just because someone is telling you to do so. You are teaching your child to listen to their body and understand it. It's not disorganized eating - it's not binge eating - it's what the child needs, and is exactly what the pediatrician recommends.

Children with ADHD who take stimulants are more likely to be obese as adults, studies show, whether from poor childhood eating habits encouraged by their parents or from a metabolism issue or from the stimulants themselves which burn out adrenals or another reason. Just as children with ADHD who do not take stimulants are more likely to be obese as adults, studies show.

This doesn't mean that children shouldn't take stimulants or shouldn't pack in the calories in the 7-11pm window. But it means that taking stimulants doesn't "cure" ADHD for children or for adults, and doesn't reduce all of the well-recognized negative side effects of ADHD in adulthood.

And normal eating is better, in terms of a lifetime of eating, for children than skipping lunch and gorging on a bedtime snack.

Did anyone make the claim that stimulants cure ADHD? I don’t recall reading that claim. Stimulants are a tool that help control symptoms for hours after they’re taken. When you stop taking them, they stop helping. The old theory was that kids outgrow ADHD, so they don’t need stimulants as adults. I don’t believe that’s the current thinking.

Could it be that adults with ADHD (who did or didn’t use stimulants as children) have impulse control issues and might be seeking the same highs from eating that other people with adhd seek by self medicating? Also we live in an obese country. Maybe it’s not related to stimulants. You seem to be trying to suggest adult obesity is related to childhood stimulants, but you’re also saying that not taking stimulants gives the same result.

That is still the current thinking, that some children outgrow their diagnosis, irrespective of stimulants.