Treating ADHD without meds
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Anonymous
Obviously this is very personal to you and triggers a strong reaction. None the less, the poster is not an idiot or a fool. Some people with depression treat with meds and think there is no other answer (and for some there isn't). Others treat with cognitive behavior therapy, heavy exercise, a combo. ADHD may be a medical issue but like with mental health in general treatment options are more complex. Acknowledging that doesn't make someone else stupid nor does it undermine that you made a solid choice for your own children. The question I have, is what happens when your teens go out at night, after their meds wear off, and have to make social decisions? No one has answered that part. Do you medicate 24/7? |
Both our kids have ADD and we also thought they were fine handling it organically without meds. At 14, things went to hell.
Anonymous
OP I'm a 52 year old person with adhd. As a child I had terrible nightmares about thing like forgetting to feed my gerbil and finding his skeleton months later. Fast forward to yesterday, I accidentally took my son's last antibiotic because I wasn't paying attention when I took my vitamins. Adhd isn't a minor problem because the adults are inconvenienced by you. ADHD is a life limiting disability that brings social rejection, tremendous anxiety and yes even life threatening situations. Imagine if a took my husband's blood pressure pills instead of an antibiotic accidentally? It is not uncommon for people who do not receive the proper therapeutic interventions for adhd (which means stimulants first and foremost according to the American academy of pediatrics) to end up self medicating withe drugs, alcohol and nicotine. You would not deny a child with a broken leg a crutch, it is the same to deny stimulants. Probably worse because it effects every corner of their life |
Anonymous
And this, ladies and gentlemen, is a classic example of the stigma and discrimination against brain disorders and mental illness - the belief that because they often to not have a clear physical diagnostic test like a blood work result or a lab culture or radiological evidence, they are not "really" illnesses and thus don't deserve treatment (and the full range of access to social supports - disability insurance, medical insurance coverage, school and work accommodations). PP, your analysis is wrong on two dimensions: 1) you seem to believe that most medical illnesses have some kind of real, physically tangible sign. This is not true. There are many illnesses that have no "test", so we diagnose by exclusion and treat on the basis of trial and error. Lupus, PCOS, IBD and spring to mind. 2) you also seem to believe there is no clear diagnostic criteria for ADHD - there is, and this is much like the "test" you seem to think doesn't exist. There is an official diagnosis in the DSM with criteria that must be met to qualify for the diagnosis. There are checklists like Connors and Vanderbilt that must be filled out by teacher, parent and child. There are also various computerized tests of attention and other tests of executive function. All these tests and checklists are standardized and normed and validated by data from studies. In addition, in the last 10 years there is a growing amount of data from FMRI that shows how ADHD brains are develop differently, have some atypical chemistry and have brain networks that operate differently. ADHD has been a diagnosis for more than 50 years (it use to be called minimal brain dysfunction). Ritalin, still one of the major treatments for ADHD, has been approved since the 1950s. It has a relatively low side effect profile, most of which can be managed pretty easily. Yes, Ritalin is a schedule 2 drug with "an acceptable use and a high potential for abuse", but even the US Dept of Justice says, "When taken as directed by a physician to treat a legitimate medical condition, Ritalin has proven to be a safe and effective medication. Medical studies have shown that individuals who have ADHD and who take Ritalin orally in proper dosages do not become addicted to the drug." https://www.justice.gov/archive/ndic/pubs6/6444/index.htm In fact, there is some evidence to believe that kids with ADHD who do not take medication ultimately have a higher risk of substance abuse. See more here. https://www.additudemag.com/the-truth-about-adhd-and-addiction/ PP, if you really don't think ADHD is real and there are not physical signs of it, go to PubMed and search for ADHD. You will find a plethora of papers going back decades detail all kinds of real ADHD differences in the brain. |
Anonymous
DP - I'm not sure of your point - are you saying that because ADHD brains are exhibiting disorder 24/7 and medicine is not 24/7, that there is no point to medicine? Stimulants cannot be taken 24/7 because of their effect on sleep - but many people take an extended release version so that the medicine coverage extends as far as possible throughout the day. There are other non-stimulant medicines like Strattera which extend 24 hours. Or is your point that kids have to learn behaviors to cope with the unmedicated portion of their day? OK, but the thing is that medicine has been shown to be effective in clinical trials for about 80% of people. The psychosocial interventions really don't have robust data showing they are effective, except for behavioral modification therapy. NIMH's MultiModal Treatment Study from 2009 says, "the MTA study demonstrated that, on average, carefully monitored medication with monthly follow-up is more effective than intensive behavioral treatment alone, for up to 14 months.". https://www.nimh.nih.gov/funding/clinical-research/practical/mta/the-multimodal-treatment-of-attention-deficit-hyperactivity-disorder-study-mtaquestions-and-answers (Although the study did show meds + behavior therapy is similarly effective) |
Anonymous
The defensive here is understandable but also something else. Saying ADHD should not be compared to diabetes is NOT saying ADHD isn't real. The rest of the post you quoted was pretty clear the poster was focused on complexity of diagnosis..not realness. |
Anonymous
Truly I didn't have a point..I have a question. My child is already very thin (thanks hyperactivity) and small..so a key concern is appetite. I've been told you handle that with schedule adjustments so then I wonder how my kid will feel and behave weekends and nights. Will school go better but not sports? Etc. |
Anonymous
As a parent of a thin child with ADHD - there are non-stimulant meds that don't affect appetite. Stimulant meds can be given after breakfast. You can have 2 short acting doses so that kid is hungry at lunch or afterschool, our kid did second dinner for a time. There's also high calorie drinks. And one can take weekend, holiday and summer breaks depending on what else is going on. A good psychiatrist can help you work through many options. Also, look at the MTA study data - I don't think the overall height/weight effect was that great and certainly something that didn't, IMO, outweigh the real benefits in a wide academic and social domain. |
Anonymous
Your post illustrates a problem I have with, frankly, the over medicalization of everything. As if people WITHOUT ADHD never have absentminded moments, or make stupid decisions, or otherwise cause accidents. There is not one “correct” way to be human. |
Anonymous
This post is a great example of the ignorance people have about adhd. Yes everyone has brain freezes. When you have them several times a day. When your earliest childhood memories are fear and anxiety about your own inability to function correctly. When you unintentionally do harm to yourself and your loved ones because of it, it's a disorder. |
Anonymous
Thank you for replying. Did you find your child struggled during those off times. Weekends are very sports filled and social for us so I just wonder about the contrast of interacting with friends during school, when medicated and then on the weekends when not? Also, my kids hyperactivity is so baked into him, that part of me worries I'll miss him and the fun super creative part. All this would be much clearer if the need was super clear but for us its very border line. (Which is why some of these replies are so off putting to me...not this one of course!) |
Anonymous
DP. Most of us posting on this thread (and this forum) have personal experience with ADHD. We aren't ignorant. We just don't agree with the catastrophizing. |
Anonymous
It has not been my experience that the ADHD kids find each other. One of mine is annoying but fun, also low frustration tolerance. Outbursts which were acceptable at 7 were not acceptable by 9/10, and social groups begin to set in by then, so when you anger your friends it’s not as easy to find another group as when you were younger. My oldest DC has pretty significant ADHD and they have done therapy (twice), OT, social skills group, and medication. We have also done parent training. Things are good now, but we have invested significant time, money, and tears to get to a point where DC can manage their frustration, maintain friendship, and feel good about themselves. Academics have never been the driver of any of this - DC was aware of the impact of their behavior on their relationships but couldn’t manage to change it easily, and internalized it (self harming, negative self talk, in addition to acting out). |
Anonymous
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There are a three different “types” of ADHD (inattentive, hyperactive-impulsive and combined) and obviously very different levels of severity. There is no one right answer when it comes to medication. However, what many of us have been told, and it’s been true in our own experiences, is other than medication not much else helps at the early ages.
If your child is presenting mildly and doing ok with out medication, great! You don’t need to be willing to put up with the known side effects or the possibility of long term problems later. Some of us don’t have that luxury so we do our best knowing there may be some trade offs. It’s impossible for any of us to know what the deal is for your child, which is why I would re-iterate my earlier advice to find a reputable pediatric psychiatrist to help you understand the risks and benefits. It’s very hard to make these decisions for another person. I have a chronic painful medical condition and I take every new drug as it it hits the market. Some have been wonderful and have really changed my quality of life. I would take them even if I knew I was taking 15 years off my life. But it’s much harder for my kids. Thankfully many of these medications have been around for a while and don’t rule out non-stimulants! For my child they helped a lot. |
Anonymous
But not every weekend is full from morning to midnight with soccer and social events. Again, the best is to consult with the psychiatrist and try different strategies. If my kid need to play soccer on Saturday, I might give a short-acting stimulant to get us thru the game - he'd have a big breakfast and a big dinner and eat what he could for lunch. TBH, we found that soccer required a lot of executive function to be good as the boys grew older. My DS was very athletic and great at soccer until about 8 or 10. But, as other boys could settle and practice boring repetitive drills to gain ball-handling skills my DS fell behind. He was unable to keep several people in his mind and remember where they were to pass to. He sometimes missed social cues from coaches and peers. Medicine might help but we just chose to try other sports - rock-climbing, swim team, rowing, long bike rides, etc. were better fits and brought better fitting friendships. And, certainly, my kid's friends are better able to tolerate ADHD behavior on the weekend when he has been able to build a foundation of friendship for the week. ADHD stimulants wash out in a day and don't need to be taken daily. Also, meds don't change their essential nature. If anything, I got my optimistic, creative, funny, loving boy back when he went on meds. |
Anonymous
Your post illustrates the problem I have with, frankly, people dismissing ADHD as merely over-medicalization of typical behaviors, when it is clear that those people being dismissive have no real knowledge about ADHD diagnosis or behaviors. In order to be diagnosed ADHD Inattentive a parent or teacher must answer "often" or "very often" - to 6 out of 9 criteria: Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities. Often has trouble holding attention on tasks or play activities. Often does not seem to listen when spoken to directly. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked). Often has trouble organizing tasks and activities. Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework). Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones). Is often easily distracted Is often forgetful in daily activities. Can you imagine being that child? Can you imagine how "often" doing these things is going to impact the child's life? This is not about taking the occasional forgetful moment and over medicalizing it. Of course there is no one "correct way" to be human. People with ADHD have tremendous strengths. They can hyperfocus in areas of interest and learn very deeply. They are creative thinkers, putting together ideas on non-traditional ways. They often thrive in high pressure, constantly changing environments. But they can also be side-tracked by unmanaged illness. Adults with ADHD are more likely to be in financial distress, have trouble paying bills, getting credit, planning foe retirement, get more speeding tickets have 4 times the risk of suicide, change or lose jobs more often, have more relationship difficulty, etc. https://news.osu.edu/financial-distress-linked-to-suicide-risk-in-people-with-adhd/ https://www.ajc.com/lifestyles/teen-drivers-with-adhd-get-more-tickets-have-higher-crash-risk-study-finds/rfxErGMpSmbx940QtMVVYL/ https://www.cnbc.com/amp/2022/07/18/adults-with-untreated-adhd-lose-jobs-more-frequently-says-nyu-psychiatrist-heres-what-you-need-to-know.html |