New York Times Magazine article questioning adhd commonplaces (including meds)

[Anonymous]

I think the article raises a few good questions about the role of medication but worry that it’s going to make it harder to treat ADHD , especially in the current political environment.

My kid is one of the ones with significant anger issues that the article only mentions in passing. They also have anxiety and autism diagnoses, and were diagnosed with a brain anomaly through a prenatal scan (agenesis of the corpus callosum). I found the dismissal of of co-diagnosis frustrating. It doesn’t make the issues any less real. And having a concrete brain structure issue to point to has done *nothing* to inform treatment.

We treated with a stimulant solely to improve impulse control, and I think it’s been helpful. We’ve also invested a small fortune and many hours in therapy, parent training, etc. I think the article way understates the long term negative experience of being the “bad kid.” The sole judgement for the usefulness of medication should not be grades.

[Anonymous]

I don’t give my son medication because of his grades (he always does stellar academic work/ then again, he is only 10, and smart). I do it because of the social struggles he has when he doesn’t take them - he talks over people, he is much too loud and bouncy compared to his peers, he can talk “at” someone for 20 minutes about something he is hyper focused on and not even realize the other kid is completely ignoring him. When he takes his meds, he is much more socially aware and while he is still loud and bouncy, it’s at a level that I’d consider in the range of normal (high range , hah) for a 10 year old boy.

These things were fine when he was 6, 7, and even 8 but he started to lose friends after that , and wasn’t even noticing. I didn’t want him to end up a middle schooler with zero friends, labeled as the kid who won’t shut up. I wanted to help him with emotional regulation , and with social skills. Maybe it’s the wrong choice, but it’s the decision I made for him, i hope it’s right.

He goes to therapy as well, to help learn and practice these social skills and executive functioning and emotional skills. So that hopefully they become second nature even when off meds as he gets older and gains more self control. We are all doing our best.

[Anonymous]

I wish the article/studies had addressed the idea that some kids need meds to be able to benefit from social skills coaching and other therapies. Not to complete worksheets in grade school, but to learn real skills that do impact long term outcomes.

[Anonymous]

Anonymous wrote:

Anonymous wrote:My son was diagnosed with "moderate to severe ADHD" and started meds in 5th grade. He went from failing to a straight A student. We were already a very education-oriented household who took learning seriously. He'd been tutored by me after school every day, loved to read, etc. The difference was solely the meds.

He needed them until 12th grade. By 12th grade, he was getting habituated and needed regular breaks from meds, because we couldn't increase the dose without triggering serious side effects (completely suppressed appetite, anxiety, insomnia, etc).

And now he's in college, and has been gradually tapering his dose to... nothing. In sophomore year of college, he takes nothing. He still has extended time on tests, and uses it. But no meds. It's a great relief to us that he can "function" without ADHD medication. He is often late, forgets many things... but before he could not function AT ALL without his meds! Now he can. Sort of.

My conclusion is that growing up and adolescence really does a number on kids with executive function disorder, and that meds are sometimes entirely necessary to get them through. But they don't need to use them for life.

Now I'm not saying that my son can be a homeowner, deal with chores, repairs, etc, and get married and deal with in-laws and kids and parenting, AND hold down a job successfully, all the while being unmedicated. Probably not. He will need to pare down his life and if he wants those things, he will need to disclose his limitations to any future wife so they're not left holding the bag resentfully. But he can have a low-key life that has some of those things, without meds.

As with everything in life, it's not all or nothing. You need to deeply understand the patient, his symptoms, the relief medication brings, deal with the side effects, and... know when to stop.

I think the bigger point is that society should be more accepting and forgiving of kids like your son. They should not be forced to conform to the narrow path that our culture has deemed acceptable. For example, there are cultures where being late is not a cardinal sin and being busy and productive for 12 h every single day is not admired for its intrinsic value. The expectations placed on kids are unrealistic for many of our youngsters. Perhaps we need to rethink our expectations and make sure there are many on-ramps to a successful and sustainable life rather than forcing kids to take medication and adjust to our narrow set of priorities

100% agree with this. Also maybe one reason kids are acting out in school is because school is so boring these days? I don’t have any direct experience in ADHD but I moved my kids to private for that reason.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My son was diagnosed with "moderate to severe ADHD" and started meds in 5th grade. He went from failing to a straight A student. We were already a very education-oriented household who took learning seriously. He'd been tutored by me after school every day, loved to read, etc. The difference was solely the meds.

He needed them until 12th grade. By 12th grade, he was getting habituated and needed regular breaks from meds, because we couldn't increase the dose without triggering serious side effects (completely suppressed appetite, anxiety, insomnia, etc).

And now he's in college, and has been gradually tapering his dose to... nothing. In sophomore year of college, he takes nothing. He still has extended time on tests, and uses it. But no meds. It's a great relief to us that he can "function" without ADHD medication. He is often late, forgets many things... but before he could not function AT ALL without his meds! Now he can. Sort of.

My conclusion is that growing up and adolescence really does a number on kids with executive function disorder, and that meds are sometimes entirely necessary to get them through. But they don't need to use them for life.

Now I'm not saying that my son can be a homeowner, deal with chores, repairs, etc, and get married and deal with in-laws and kids and parenting, AND hold down a job successfully, all the while being unmedicated. Probably not. He will need to pare down his life and if he wants those things, he will need to disclose his limitations to any future wife so they're not left holding the bag resentfully. But he can have a low-key life that has some of those things, without meds.

As with everything in life, it's not all or nothing. You need to deeply understand the patient, his symptoms, the relief medication brings, deal with the side effects, and... know when to stop.

I think the bigger point is that society should be more accepting and forgiving of kids like your son. They should not be forced to conform to the narrow path that our culture has deemed acceptable. For example, there are cultures where being late is not a cardinal sin and being busy and productive for 12 h every single day is not admired for its intrinsic value. The expectations placed on kids are unrealistic for many of our youngsters. Perhaps we need to rethink our expectations and make sure there are many on-ramps to a successful and sustainable life rather than forcing kids to take medication and adjust to our narrow set of priorities

100% agree with this. Also maybe one reason kids are acting out in school is because school is so boring these days? I don’t have any direct experience in ADHD but I moved my kids to private for that reason.

There's not enough money in public education to change that.

To target the learning needs of kids better, so they're not bored, you'd need much smaller classes. There's too much variance in a normal large classroom. Even then, you'd still have many kids like mine that struggle with impulse control. Aids in every classroom, two in the younger years, could help for that, but both of these changed would be expensive. It's not realistic.

The answer isn't as simple as building in more active time or doing more fun projects. Even if you reduce sitting time to a couple hours a day, many kids with ADHD still can't do that without help.

[Anonymous]

Anonymous wrote:I wish the article/studies had addressed the idea that some kids need meds to be able to benefit from social skills coaching and other therapies. Not to complete worksheets in grade school, but to learn real skills that do impact long term outcomes.

Given that the meds don’t improve academic learning, I don’t see why they would improve social skills, except to the extent that they make kids appear calmer in the moment. Lots of anecdotes about this, would be good to have actual research.

[Anonymous]

Anonymous wrote:

Anonymous wrote:My son was diagnosed with "moderate to severe ADHD" and started meds in 5th grade. He went from failing to a straight A student. We were already a very education-oriented household who took learning seriously. He'd been tutored by me after school every day, loved to read, etc. The difference was solely the meds.

He needed them until 12th grade. By 12th grade, he was getting habituated and needed regular breaks from meds, because we couldn't increase the dose without triggering serious side effects (completely suppressed appetite, anxiety, insomnia, etc).

And now he's in college, and has been gradually tapering his dose to... nothing. In sophomore year of college, he takes nothing. He still has extended time on tests, and uses it. But no meds. It's a great relief to us that he can "function" without ADHD medication. He is often late, forgets many things... but before he could not function AT ALL without his meds! Now he can. Sort of.

My conclusion is that growing up and adolescence really does a number on kids with executive function disorder, and that meds are sometimes entirely necessary to get them through. But they don't need to use them for life.

Now I'm not saying that my son can be a homeowner, deal with chores, repairs, etc, and get married and deal with in-laws and kids and parenting, AND hold down a job successfully, all the while being unmedicated. Probably not. He will need to pare down his life and if he wants those things, he will need to disclose his limitations to any future wife so they're not left holding the bag resentfully. But he can have a low-key life that has some of those things, without meds.

As with everything in life, it's not all or nothing. You need to deeply understand the patient, his symptoms, the relief medication brings, deal with the side effects, and... know when to stop.

I think the bigger point is that society should be more accepting and forgiving of kids like your son. They should not be forced to conform to the narrow path that our culture has deemed acceptable. For example, there are cultures where being late is not a cardinal sin and being busy and productive for 12 h every single day is not admired for its intrinsic value. The expectations placed on kids are unrealistic for many of our youngsters. Perhaps we need to rethink our expectations and make sure there are many on-ramps to a successful and sustainable life rather than forcing kids to take medication and adjust to our narrow set of priorities

The American college system which requires kids to submit their GPA from 9th grade is crazy. It places years of relentless stress and pressure on kids and ignores the academic, social and emotional challenges that can arise in the transition to high school and during adolescence. It penalises the kids that struggle at first for any reason but then turn their performance around.

Do any other countries do this? I think most only focus on the final year or two of high school, acknowledging that it is performance and aptitude at that point which determines suitability for further studies and the likelihood of success.

[Anonymous]

Anonymous wrote:I wish the article/studies had addressed the idea that some kids need meds to be able to benefit from social skills coaching and other therapies. Not to complete worksheets in grade school, but to learn real skills that do impact long term outcomes.

Fwiw, my kids with ADHD have friends who mostly also have ADHD. Their friendships are dramatic and they trigger each other but they also forgive/forget and move on quickly and easily.

Medicating for social reasons may be missing the point, IMHO. Ftr, we gave DS stimulant meds for the purpose of keeping him in his seat in 2021, when schools were reopening but no longer allowed students to wander around the classroom. It works for that. I hope to get him off meds at some point. Fingers crossed.

[Anonymous]

Anonymous wrote:

Anonymous wrote:My son was diagnosed with "moderate to severe ADHD" and started meds in 5th grade. He went from failing to a straight A student. We were already a very education-oriented household who took learning seriously. He'd been tutored by me after school every day, loved to read, etc. The difference was solely the meds.

He needed them until 12th grade. By 12th grade, he was getting habituated and needed regular breaks from meds, because we couldn't increase the dose without triggering serious side effects (completely suppressed appetite, anxiety, insomnia, etc).

And now he's in college, and has been gradually tapering his dose to... nothing. In sophomore year of college, he takes nothing. He still has extended time on tests, and uses it. But no meds. It's a great relief to us that he can "function" without ADHD medication. He is often late, forgets many things... but before he could not function AT ALL without his meds! Now he can. Sort of.

My conclusion is that growing up and adolescence really does a number on kids with executive function disorder, and that meds are sometimes entirely necessary to get them through. But they don't need to use them for life.

Now I'm not saying that my son can be a homeowner, deal with chores, repairs, etc, and get married and deal with in-laws and kids and parenting, AND hold down a job successfully, all the while being unmedicated. Probably not. He will need to pare down his life and if he wants those things, he will need to disclose his limitations to any future wife so they're not left holding the bag resentfully. But he can have a low-key life that has some of those things, without meds.

As with everything in life, it's not all or nothing. You need to deeply understand the patient, his symptoms, the relief medication brings, deal with the side effects, and... know when to stop.

I think the bigger point is that society should be more accepting and forgiving of kids like your son. They should not be forced to conform to the narrow path that our culture has deemed acceptable. For example, there are cultures where being late is not a cardinal sin and being busy and productive for 12 h every single day is not admired for its intrinsic value. The expectations placed on kids are unrealistic for many of our youngsters. Perhaps we need to rethink our expectations and make sure there are many on-ramps to a successful and sustainable life rather than forcing kids to take medication and adjust to our narrow set of priorities

DP here with a DS. This would put us into #boymom territory with nothing but excuses for our “lazy and wild” boys. I doubt any acceptance is happening any time soon.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My son was diagnosed with "moderate to severe ADHD" and started meds in 5th grade. He went from failing to a straight A student. We were already a very education-oriented household who took learning seriously. He'd been tutored by me after school every day, loved to read, etc. The difference was solely the meds.

He needed them until 12th grade. By 12th grade, he was getting habituated and needed regular breaks from meds, because we couldn't increase the dose without triggering serious side effects (completely suppressed appetite, anxiety, insomnia, etc).

And now he's in college, and has been gradually tapering his dose to... nothing. In sophomore year of college, he takes nothing. He still has extended time on tests, and uses it. But no meds. It's a great relief to us that he can "function" without ADHD medication. He is often late, forgets many things... but before he could not function AT ALL without his meds! Now he can. Sort of.

My conclusion is that growing up and adolescence really does a number on kids with executive function disorder, and that meds are sometimes entirely necessary to get them through. But they don't need to use them for life.

Now I'm not saying that my son can be a homeowner, deal with chores, repairs, etc, and get married and deal with in-laws and kids and parenting, AND hold down a job successfully, all the while being unmedicated. Probably not. He will need to pare down his life and if he wants those things, he will need to disclose his limitations to any future wife so they're not left holding the bag resentfully. But he can have a low-key life that has some of those things, without meds.

As with everything in life, it's not all or nothing. You need to deeply understand the patient, his symptoms, the relief medication brings, deal with the side effects, and... know when to stop.

I think the bigger point is that society should be more accepting and forgiving of kids like your son. They should not be forced to conform to the narrow path that our culture has deemed acceptable. For example, there are cultures where being late is not a cardinal sin and being busy and productive for 12 h every single day is not admired for its intrinsic value. The expectations placed on kids are unrealistic for many of our youngsters. Perhaps we need to rethink our expectations and make sure there are many on-ramps to a successful and sustainable life rather than forcing kids to take medication and adjust to our narrow set of priorities

DP here with a DS. This would put us into #boymom territory with nothing but excuses for our “lazy and wild” boys. I doubt any acceptance is happening any time soon.

DP. I don’t make medical decisions for my child based on hashtags.

[Anonymous]

Anonymous wrote:TLDR; ADHD meds keep teachers happier but don’t actually result in better learning outcomes for kids at school.

This is bull sh*t. For my kid and the other kids I know with a similar diagnosis it makes all the difference. I can't believe more parents aren't calling this out for the crap it is.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My son was diagnosed with "moderate to severe ADHD" and started meds in 5th grade. He went from failing to a straight A student. We were already a very education-oriented household who took learning seriously. He'd been tutored by me after school every day, loved to read, etc. The difference was solely the meds.

He needed them until 12th grade. By 12th grade, he was getting habituated and needed regular breaks from meds, because we couldn't increase the dose without triggering serious side effects (completely suppressed appetite, anxiety, insomnia, etc).

And now he's in college, and has been gradually tapering his dose to... nothing. In sophomore year of college, he takes nothing. He still has extended time on tests, and uses it. But no meds. It's a great relief to us that he can "function" without ADHD medication. He is often late, forgets many things... but before he could not function AT ALL without his meds! Now he can. Sort of.

My conclusion is that growing up and adolescence really does a number on kids with executive function disorder, and that meds are sometimes entirely necessary to get them through. But they don't need to use them for life.

Now I'm not saying that my son can be a homeowner, deal with chores, repairs, etc, and get married and deal with in-laws and kids and parenting, AND hold down a job successfully, all the while being unmedicated. Probably not. He will need to pare down his life and if he wants those things, he will need to disclose his limitations to any future wife so they're not left holding the bag resentfully. But he can have a low-key life that has some of those things, without meds.

As with everything in life, it's not all or nothing. You need to deeply understand the patient, his symptoms, the relief medication brings, deal with the side effects, and... know when to stop.

I think the bigger point is that society should be more accepting and forgiving of kids like your son. They should not be forced to conform to the narrow path that our culture has deemed acceptable. For example, there are cultures where being late is not a cardinal sin and being busy and productive for 12 h every single day is not admired for its intrinsic value. The expectations placed on kids are unrealistic for many of our youngsters. Perhaps we need to rethink our expectations and make sure there are many on-ramps to a successful and sustainable life rather than forcing kids to take medication and adjust to our narrow set of priorities

DP here with a DS. This would put us into #boymom territory with nothing but excuses for our “lazy and wild” boys. I doubt any acceptance is happening any time soon.

I have a daughter and sons. School is made for girls and also the majority of teachers are girls (there's not one male teacher in my elementary school). Girls who sit still, are creative, and people please. If we had same sex education, we could have more teaching to how boys learn best and also A LOT more physical activity.

My daughter could easily sit all day in school and color, read, and craft. She's not the most well behaved in her classes, nor is she low energy. I think she's a pretty typical girl. She actually has ADHD but because she's not wild, disruptive and makes good grades no one even noticed that she was unable to focus. Her distraction looked more like her staring out of windows. The entire classroom is structured around the needs of girls to sit and learn, but dominated by boys who can't sit still- it's the worst of both worlds. Their class is evacuated once a week and there are constant disruptions. The boys who are being medicated are doing so for the sake of the other students, not their own learning.

[Anonymous]

Anonymous wrote:

Anonymous wrote:TLDR; ADHD meds keep teachers happier but don’t actually result in better learning outcomes for kids at school.

This is bull sh*t. For my kid and the other kids I know with a similar diagnosis it makes all the difference. I can't believe more parents aren't calling this out for the crap it is.

DP. Meds can make a kid finish more school work. Learning unmedicated is idiosyncratic and learning medicated is idiosyncratic. Completing school work and learning are not the same thing.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:TLDR; ADHD meds keep teachers happier but don’t actually result in better learning outcomes for kids at school.

This is bull sh*t. For my kid and the other kids I know with a similar diagnosis it makes all the difference. I can't believe more parents aren't calling this out for the crap it is.

DP. Meds can make a kid finish more school work. Learning unmedicated is idiosyncratic and learning medicated is idiosyncratic. Completing school work and learning are not the same thing.

I've been thinking about how much my son learns in school medicated vs. non medicated (probably about the same - quite a bit) and how much work he completes medicated (a lot more) vs. non medicated (hit and miss). His grades are definitely higher on medication, his learning isn't necessarily higher.

The one caveat might be math. He NEEDS to do the homework to have more than a conceptual understanding of the work. We could make him do the homework when he wasn't medicated, but there was lots of yelling. Much less yelling on Ritalin and much less homework because he does more at school.

The social situation improved after medication but mostly because he withdrew socially and so was no longer a target. I have mixed feeling about that

[Anonymous]

Anonymous wrote:

Anonymous wrote:TLDR; ADHD meds keep teachers happier but don’t actually result in better learning outcomes for kids at school.

This is bull sh*t. For my kid and the other kids I know with a similar diagnosis it makes all the difference. I can't believe more parents aren't calling this out for the crap it is.

Calling out a very well reported news article based on … what exactly? The article doesn’t dispute that stimulants show an immediate impact on behavior for younger kids in the short term.