Child with ADHD-- if you decided not to medicate, why?

[Anonymous]

My child is newly diagnosed. He's eight and in the second grade. Medication is a difficult decision for us and after reading the thread about how particular children benefitted from meds, I am interested to hear another point of view. Also, if this goes sideways, I want to say that I respect parents' who are doing their best for their kids, period.

That said, cogent statements on why you didn't opt for medication for your school age children? What did you do instead that was effective?

[Anonymous]

We needed to be methodical about routine, without slipping even once. Didn't want the risk of these meds, which have not been tested for safety on children.

[Anonymous]

We do have our child on meds now, but we tried everything else before meds. We tried structural routines, we tried diet, eliminating additives, fish oil,yoga and other exercise, tons of things. We even tried biofeedback which was crazy expensive.
Years of working with the school and IEPs. We were just afraid of the meds.

Eventually over a few years our child's ADD led to worsening grades alongside teen depression, which pushed us over the edge to meds.
Eight months later after juggling a few meds and dosages, she is much better and a happy, emotionally stable kid whose grades have totally turned around.

And we learned over time that really no meds are tested in children, so if we were afraid of the meds because of that we wouldn't give our kids many prescription or over the counter meds on the market today.
Basically over time the potential risks (like with any medications), for us, we felt were far outweighed by the benefit the meds provided to our kid. But it took us a very long time to get there. I feel we did a disservice to our kid during those years, looking back. I don't feel guilty because our intentions were good, but i do wish we came around sooner.

[Anonymous]

DC did not go on meds until 5th grade. He is on a non-stimulant medicine because he is allergic to the stimulant medicine. Medicine is not 100%. He has other issues that contribute to impact of the ADHD and are benefitted by the medication. He is in HS and we have started the practice of lowering the dosage. So far so good.

The things we did before medicine and continue to do after are:

Daily exercise. Very important. DC walks the almost 2 miles home from school. In ES, we walked to school in the am- it was about 3/4 of a ile. SOmetimes we took the longer way. We also have a treadmill and a elliptical. Others I know have personal trampolines- excellent investment. If your school does not have one, buy it for them. Put it into your DC"s IEP to have trampoline breaks as part of his routine, working to as necessary. A ten minute jump in the middle of the day can do wonders.

Set homework and set homework place. DC generally starts homework about 15 minutes after getting home from school. He has a desk set up in our family room. It is the homework room for both of our children. It is open to the kitchen, so I can get things ready for dinner and help with homework at the same time. (Not so much helping anymore, but in ES and MS I was his scribe and reader)

If he has trouble with getting his ideas down on paper. Use a graphic organizer and have him dictate to you. Then have him copy what you have scribed for him. This eliminated our son's tendency to self edit to the fewest words possible. It helped him concentrate on the writing aspect and the writing down aspect separately, until he was able to write/type as fast as his thought came. Get his keyboarding skills up to snuff as soon as possible. We found that summers were the best time to do this.

Sleep. Bedtime is solid here. Both my children are in HS and get up at 6:00am; so they go to bed between 9:00 and 9:30. Lights out. This means they have fewer ECs, but their grades are higher.

Eating- very little junk food. Family dinners. Breakfast and lunch. No skipping meals. Healthy good food.

Fidgets are great. They are inexpensive, buy a variety to see what he likes. DC uses a deck of cards that he shuffles.

Relaxation and guided meditation CDs. We use these during times of stress. We should do it more. Don't get the CDs with waterfalls/streams, it just makes have to pee. I taught both boys how to relax to sleep. "Quiet your body, quiet you mind, quiet your mouth....close your eyes. breathe in......and out....breathe in......and out.........tighten your toes, now relax them, tighten your calves, now relax them, tighten your thighs, now relax them.......tighten your shoulders now relax them, tighten your face, now relax........breathe in..............breathe out..............." Slow soothing voice. then have them do it on their own after they get the hang of it.


Good luck! Find what works the best for your DC. They are all different.

[Anonymous]

There is a very robust trial published in the scientific journal Pediatrics that compared outcomes of young kids with ADHD in 3 arms: 1) treatment alone, 2) treatment and behavioral modifications/therapy, 3) behavior alone. They found that treatment by far was the greatest cause of successful outcomes. In the arm of the study that combined it with behavioral therapy, they found that the behavioral interventions were also very helpful IF your child had other comorbidities such as anxiety, etc... But for ADHD, medication alone made the measurable difference.

I think it makes sense to be slow and deliberate about this decision, especially because about a third of kids mature out of the diagnosis as adults. However, I also know many adults who went I diagnosed and looking back it clearly had a major impact on their grades and subsequent life choices. If medication will help, that's a very good thing (unless side effects are too great). There are many things our kids are exposed to daily that we don't know the exact long term side effects of.

[Anonymous]

We don't medicate our D because there's a history of addiction, including alcoholism, in our family. I didn't want to run the risk of having my child become dependent on medications and I was concerned that ADD medication might be a gateway to other types of medication.

Honestly, we have just accepted that our child is not likely to be a strongly academic person. She has fantastic people skills, a summer job that she loves, a rich history of volunteer and service work and she can pull B's and the occasional A in subjects that she is passionate about. She got into a decent college -- with scholarships -- and is planning on a career that doesn't involve a desk. She'd like to be a wedding planner, do something with hotels or the travel industry, possibly be a flight attendant.

We also have some ASD in our family and I feel passionately that there are lots of variants in human behavior and that everyone doesn't need to look alike. My son meets the criteria for HFA, as did my dad, and I probably do as well. I think it's pointless to try to fix people who aren't broken, just different. Mostly I'm interested in accepting my daughter and everyone who doesn't fit the norm for behavior and function. We are more than just cogs in the US productivity machine.

[Anonymous]

Putting aside the people that are just anti-meds generally, I think most people that opt against meds do so for a combination of reasons that have to do with side effects for their particular child and/or the severity of their child's symptoms. I have one child on meds and one that is not. The one that is not is very underweight and has significant sleep problems already, so I worry about the side effects. Also, she has been able to do well in school and have friends even without the meds. I'm constantly questioning whether this is the right decision, however, as I'm pretty confident she is not achieving at her capability level and her school performance has started to drop off as she hits the higher elementary grades and more sustained attention and nuanced social interaction is required.

[Anonymous]

We tried every medicine known for DS. They either gave him migraines or completely erased his personality. Yes, his grades were better on the medication, but we decided it was better to have him learn to live with it and be himself. DH has overcome ADHD to be a very successful business owner. DS is 18 now and in college. He has found several skills that ADHD enhances and has read about several olympians that have ADHD and credit it for their determination. I am glad we didn't medicate DS when he was younger.

[Anonymous]

PP here - skills that DS attributes to his ADHD include:
- being able to juggle 5 items at once
- riding a unicycle
- multitasking with ease
- solving a rubiks cube for speed, including the new 4 and 5 row cubes
- he is a D1 athlete that also competes nationally in triathlons (his sport is not swimming, biking or running)

[Anonymous]

We don't medicate our D because there's a history of addiction, including alcoholism, in our family. I didn't want to run the risk of having my child become dependent on medications and I was concerned that ADD medication might be a gateway to other types of medication.

We made the opposite decision. On my side there's a strong family history of substance abuse, depression and suicide as well as undiagnosed ADHD (they're dead now and can't be formally tested). I'm determined my kids won't go the route my siblings did. We talked to the kids from an early age about how our brains are wired and the dangers of addiction/depression. They also know about the suicides in my family and the role our brains play in it. We talk a lot about mental health and mindset. I think this is the best tool we have to help keep our kids healthy.

As far as medication goes, we avoided it for a while. We started out doing what PPs have suggested, structure/routine/exercise/diet, etc. But, our DS continued to struggle and it affected his confidence/esteem. He'd be so very hard on himself. It was hard for me to see, especially since I know that's the road to depression. It was even harder for DH because he recognized DS's struggles. DH was diagnosed with ADHD after our oldest was. Watching DS struggle was like re-living his own struggles and he didn't want DS to go through what he'd gone through. DH also suffers from depression and given my family history, the comorbidity of depression and ADHD, we have legitimate grounds for concern. Our oldest DS had too many negative side effects with stimulants so he's on a non-stimulant. We're not looking for him to be in the top of his class. We want him to enjoy learining and do his best. ADHD medication helps him with that.

It sounds like you made the right medication decision for your family. Our situation is a little different with the history of depression/suicide. We see ADHD medication as a tool to mitigate the propensity for depression and self-medication.

[Anonymous]

OP, we have 2 kids with ADHD, and two diifferent approaches. Older child had big emotional swings and anxiety attacks triggered by ADHD. She needed meds, and we sent the last few months of 2nd grade and the summer finding the right combination. PP 9:07's post about side effects is correct, those are some of the common side effects. We were lucky to find something that worked *well enough*. Low-dose, long-acting ritalin.

With this in place, meltdowns have disappeared, her sunny personality is filling the house, she has friends, is working on advanced math, reading many grades beyond level and all this time, we've been working on building the skills she needs to taper off the meds. We plan to do that this summer and into the next school year, with the help of her doctor, a coach and hopefully the cooperation of her teacher.

Our other childs's ADHD manifests itself mostly as the H - hyperactive form. A side effect is dyslexia -- he has no patience for listening closely to words and has a hard time with fine sound discerning. He bounces off the walls, but we're not seeing a need to medicate. Instead, we just give him space to run and be tired. PP 8:16 has a good list of strategies, and they work well enough for both kids.

Bottom line is -- if your child is well enough to learn the skills they need without meds, then skip the meds, even if it feels a bit messy. But if you find that you really can't get through, then the time for meds is now -- you want to build those skills while they are plenty young, rather than having to teach them to a pre-teen who already had a taste of their limitations and has lost confidence.

The meds are not forever. They are just a temporary support while your child learns some skills that come naturally to his peers. And only if he needs them. They are a crutch while walking to the physical therapist, not a permanent wheelchair. That's why there are no longitudinal studies on the effect of long-term medication on children. Because all doctors will recommend you use them sparingly, not long term.

[Anonymous]

OP here. Wow. So far, this is the most constructive and helpful thread I have seen on this topic.

I love that you included concerns, things you tried the did and did not work (sadly, there is a lot expensive quackery out there), and future issues like depression, school failure and risk taking (obviously more of a concern with ADHD).

I am still reading the responses and taking all of this into consideration. Thank you, thank you, thank you.

I was especially interested in people who opted out early and started meds later. That could very well be our route.

[Anonymous]

My child was willing and capable of trying other things without the meds. My child's self esteem was not being destroyed, he was on board with our other attempts. We're in the tricky middle school years right now, and I occasionally see hints that he might need meds but so far so good.

If my child was miserable, if his ADHD was causing poor self esteem, if he wasn't responding to or capable of fully participating in handling the condition without medication, we'd go to meds.

Choosing to use meds or not is not a one-time thing. You have to keep evaluating the situation and be willing to take another path when it's time.

[Anonymous]

We are one of those families that opted out early and then went to meds.

We started medication at 14, my daughter began to describe her symptoms very eloquently and what was surprising to me is that ADHD has a profound effect on every aspect of a child's life. We tended to think about it only in terms of academic performance but that is only one piece of the puzzle. My daughter described her difficulty in being able to carry on a conversation (which she hid beautifully!), the anxiety she felt when she knew she had to go to a party or a movie because it was so difficult for her to sustain attention when there is noise and light. She always had a ton of friends so I didn't think of her as having social difficulties, she also didn't have abnormal levels of anxiety so I mistakenly thought that she had no anxiety. And of course I recognize that some anxiety is normal and helpful.

So I asked her if she wanted to try meds and she jumped at the chance because she wanted to see if things could be better.

She is on Adrenal and she tells me now that she can't imagine how she got through life without it. Her grades are somewhat improved but better than that, she feels "normal" when she is with her friends.

[Anonymous]

she's on Adderal. hate spell check!