ADHD: To Medicate or Not to Medicate? How You Can Decide
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When I got to my 8-year-old Clayton’s report, I looked over his grades then paused at the comments section. This is what I read:
Clayton excels in everything he attempts. You can always depend on him to follow my exact instructions and use the specific strategies he was taught to incorporate in his work. I use him as an example to the other pupils in class. He is a very insightful reader, writer, and thinker. He makes wonderful contributions to our class.
A tear came to my eye. It wasn’t because my son was doing well in school and I was proud (although those things are certainly true) but because not long ago, I was receiving very different comments about his behavior and academic performance in school.
I remember picking Clayton up from kindergarten one day. He’d been getting in trouble for his lack of self-control on a very regular basis. As Clay hopped into my car, I asked him, “Did you have a good day today? Did you get in trouble for anything?”
He responded, “Nope, I was good today.”
Before I could pull away from the car rider loop, I eyed Clay’s teacher walking out to my car. “Uh, Clay? If you had a good day then why is your teacher walking out to the car?”
Clay ducked down in the back seat and implored, “I don’t know, drive, drive, DRIVE!”
Now, my kids and I look back on that memory and laugh. At the time, however, I was frustrated. I didn’t know how to deal with the situation. I mean, I’d raised my 8-year-old the same way I’d raised all my other kids. I continued to teach him right from wrong. He wasn’t a “bad” kid. So, why was he always getting in trouble? Why was he so impulsive? He seemed to lack the mechanism in his brain that makes one stop and think before acting. He would run out into the street to chase a ball without looking for cars. He knew better than to do that, but in the heat of the moment, he seemed to forget everything he’d ever learned and he simply acted on impulse.
He got in trouble for poking other kids while standing in line. He got in trouble for flinging food across the table at his friends. He got in trouble for hanging from the partitions separating the stalls in the bathroom. He got in trouble for speaking out of turn in class. When another kid would instigate, instead of walking away and telling the teacher, Clay would deck the kid. And get in trouble.
Always present in the back of my mind was the question of whether or not I should look into ADHD meds for him. I knew he was a naturally bright kid and I absolutely believed he could do very well in school. But his impulsivity was holding him back. Still, I didn’t want to put him on medication unless I felt the benefits would truly outweigh the risks and side effects.
I remember exactly when I made the decision to use medication to help my son. One day, toward the end of first grade, Clay came home in tears and said, “No one likes me. I’m a bad kid.” That was it. Decision made.
Now, a couple years later and my son is getting all As. As you can see from the comments above, he’s not only not a behavior problem in class, but he’s a role model.
It’s especially tough for parents to decide because there’s still such a stigma attached to using medication to treat ADD/ADHD. Unlike other conditions, like diabetes for example, the symptoms of ADD/ADHD are behavior related. No parent would hestitate to give insulin to their child with diabetes and no one would question that mother’s or father’s ability to parent. But because, as we all know, our children’s behavior is a direct reflection on our worth as a parent (tongue in cheek), conditions like ADHD are a little trickier. Although a child’s brain with ADHD is wired a little differently and medication could help him to function better, so many parents hesitate to use medication because then they feel like a failure for not being able to “control” their child’s behavior. I’m not saying you should use medication or your shouldn’t use it. I’m just saying that you should be free to choose based on your child’s and your family’s needs, and you shouldn’t be made to feel ashamed or inadequate whatever your choice.
I’m not going to get into a whole lecture about ADD/ADHD, but I would like to give you my two cents’ worth of advice for parents considering medication for their child. How do you know if you should use medication to your help your child with ADHD? Consider these 10 things:
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1. BE PREPARED TO BE JUDGED
If you use medication, be prepared to be bashed by parents who think you should never medicate a child with ADHD. If you opt not to medicate, be prepared to be bashed by parents who think you should. Basically, there will always be those who think they know what’s best for you and who aren’t shy about sharing their opinions. Although it isn’t necessarily a bad thing to talk to other parents and get their opinions, don’t let them dictate your choices. You know what’s best for your situation. And develop a thick skin against those who would judge you without knowing anything about your family.
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2. DON'T AUTOMATICALLY REJECT MEDS
Don’t automatically discount medicine without really looking into the option first. Be open-minded. I know too many people who have made the blanket statement, “I will never medicate my child.” Working in a middle school, I see kids who could greatly benefit from medication. I see their potential, but it’s hidden under a layer of disruptive, unfocused behavior. Unfortunately, there are parents who frown upon it when teachers hand out Ritalin to their students. They also frown upon it when you keep a bottle of rum in your desk to deal with the student’s disruptive, unfocused behavior. (Kidding, totally kidding!)
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3. DON'T AUTOMATICALLY JUMP TO MEDICATE
Conversely, don’t automatically jump to put your child on medication. I see some parents who put their children on meds at the first sign of any unfocused behavior. You do not need to immediately medicate if your child is having behavior issues. Sometimes, those negative behaviors can be remedied by alternative methods. Perhaps the child needs to learn that there are consequences for every decision he makes. Communication with your child’s teacher may pinpoint where he’s having trouble at school. Moving your child’s seat from the back of the room by his buddies, to the front near the teacher’s desk, may eliminate some distracted behaviors, for example.
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4. YOU CAN CHANGE YOUR MIND
This is a big one that so many people overlook: the decision you make is not irreversible! If you try medication and then change your mind, there’s no rule that states you have to continue using it indefinitely. You and your child may find that the side effects of the medication are worse than any benefits you receive from it. If that happens, you may want to try a different medication (there are many different ones on the market now). Or you may want to discontinue using it altogether. That’s okay! This is not an “all or nothing,” “be all, end all,” one-time decision that will make or break your child’s future. You are allowed to change your mind in the best interest of your child.
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5. TALK TO THE TEACHER
Get input from your child’s teacher(s). My son was not a problem at home. Sure, he was very impulsive, but it wasn’t causing distress on the family. He’s a creative, energetic kid who is full of interesting ideas. I didn’t have behavior issues with him at home. However, in a school setting, where he was expected to sit still, focus on the lesson, listen without interrupting, and tune out all the distractions from twenty other students, it was an entirely different story. When your child’s teacher tells you that your son is disruptive in class, don’t dismiss it simply because you don’t observe that behavior at home. Your teacher is not “out to get” your child. She sees him in a different setting than you do. Listen to what she has to say.
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6. VISIT A PSYCHIATRIST
Meet with a pediatric psychiatrist. A good doctor will not meet with you one day and send you on your way with a prescription in hand. He will want to gather information about your child from you and your spouse or other family members, your child’s teacher, coaches, Sunday school teachers, or anyone else who interacts with your child on a regular basis. After reviewing all the information, the doctor may suggest trying medication and/or therapy to help modify your child’s behavior.
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7. MEET WITH THE PEDIATRICIAN
Make an appointment with your child's pediatrician. Your psychiatrist will probably suggest this anyway, but if she doesn't, have your child examined by his pediatrician to make sure there aren't any contraindications before starting him on any medication. Your pediatrician will want to check your child's heart and blood pressure. He'll also monitor your child's height and weight to make sure he continues to grow at the same rate if medication is started.
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8. CONSIDER ALTERNATIVES
Ask your physician about alternative treatments. I had some success with one of my sons by following the Feingold diet. There are some pros to this diet which basically cuts out all artificial additives and preservatives. It's always good to eat a healthful diet of whole, natural foods, and the entire family can follow the diet. Also, if you opt to try this instead of medication, you can avoid any potential side effects. However, there are some cons to following this diet as well. It's more expensive to buy whole, natural, organic foods. It's time consuming to cook everything from scratch. It's difficult to get a young child to stick to a diet where they can't enjoy the same foods their classmates are eating at lunch, after soccer practice, and at birthday parties. And you have to strictly adhere to the diet to see any real results. One cupcake with pink frosting and sprinkles can set you back with three days of poor behavior. Plus, it makes dining out difficult; not impossible, but difficult. I have a friend who swears by an herbal supplement that helps her son to focus in school. In my own personal experience, I’ve found a couple things that have helped a small amount, but no alternative treatment has been as effective as medication for my family. You might have different results, however. In my opinion, it doesn’t hurt to consult your doctor about alternatives.
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9. DON'T LET SIDE EFFECTS SCARE YOU
Let the side effects of medication caution you; not scare you. The most common side effects of ADHD medications are headache, stomachache, and loss of appetite. The headaches and stomachaches my children experienced when they first started taking the medication went away within the first couple weeks. The loss of appetite continues. We combat that by making sure they eat a good breakfast before taking their medication. Although they usually aren’t hungry at lunchtime, the meds have worn off by dinnertime and they eat a normal dinner. To make up for the lack of food they consume during lunch, I let my kids snack all evening. I also give my kids a break from the medication on the weekends, school holidays, and summer vacation. And remember that some medications will affect a child more than others. If one isn’t working or is causing too many negative effects, speak with your doctor. There are other medications out there that can be tried.
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10. DON'T LOSE HOPE
Don’t lose hope. Although Clayton’s behavior didn’t cause problems within our family, another son’s behavior did cause distress. I know firsthand how frustrating it is dealing with a child whose actions can make it difficult to enjoy being with them. You love your child with all your heart and want only the best for them, but some days, you don’t really like that child because their behavior can be so irritating. I understand. BUT, kids with ADHD can be amazingly successful. If they’re handled with patient instruction and understanding, they can be taught to harness all their energy and creative (yet scattered) thoughts for good. Think of Ty Pennington (ahhhh, I love that mental image). What an impressive example of what a kid with ADHD can grow up to accomplish.
Whether you opt to medicate your child or not is a personal decision that should be based on research, information about your child, and a knowledgeable doctor’s recommendations. There is no one-size-fits-all answer. We all make the best decisions we can for our children based on our knowledge and abilities, then we hope and pray for a progress report that states our child is a role model (or at least that he’s not the kid who flings corn across the table at his peers)!
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Debates over decisions we make for our children are everywhere–even those not involving meds. My oldest son has a late summer birthday (end of July). I send him to Kindergarten right after he turned 5. I heard from sooooo many people who just knew that was the WRONG thing to do. *rolls eyes* I prayed hard about that decision and felt it was right. Now, he’s in 8th grade, getting mostly straight A’s (usually one B on the report card) and taking Freshman Algebra. He also started puberty right before 7th grade (on the early side). Can you imagine if I had waited a year to start him in school? He’d be a couple of years ahead of his peers puberty wise and bored to tears in school. Only we can decide what is best for our family.
Oh, and regarding meds–I have an anxiety disorder. I get a lot of opinions regarding taking meds for anxiety too. And like you said, only I know what is best for me and my family.
I agree with you whole-heartedly. When you were describing all the things your son would do, I was nodding my head because my son was exactly like that. I asked one of his elementary school teachers if she thought he had ADHD and she said no, because he does complete his work. So we just plodded along for another 7 or 8 years. Finally, he got arrested for spraying painting on a church wall – very impulsive. It was the best thing that happened to us. He went to a psychologist who diagnosed him with ADHD (after interviewing us, teachers, him). He has been on medication for about 3 years now. He graduated with honors and is attending a community college where he received a full scholarship. He is like a different person.
I can definitely see the good (being diagnosed and put on medication) that came out of something bad (being arrested and on probation). It has also helped me see how God loves us so unconditionally. You love your kids and know their heart and what they’re like inside, but they really test you. I think that helped me see how I try God’s patience constantly, but it’s easier for me to see how he loves me through all that.
Yes, my son loses his appetite during the day, but like you said, we encourage him to eat breakfast and snack at night. And the results far outweigh the side effects. But I think I was hesitant to put my son on medication, that people would think I was taking the easy way out or jumping on the bandwagon. I regret all those years of not getting help for my son earlier.
Sorry for the ramble, but I appreciate all you said.
It is a hard decision whether to medicate or not. When we were considering it for our son, a friend suggested we consider how he feels constantly being told to sit still, don’t climb on that, be quiet, etc. It was a good decision for our family. After we started him on meds, another friend asked if we had him on valium. My response: “No, the valium is for the parents!!” heheh!!
Thank you for this post. I shared it with a couple of friends, both of whom have kids with ADD/ADHD. They both really loved and appreciated all that you had to say — a reflection of their own experiences. One even posted it to Facebook and it has generated a good (and supportive!) conversation thread there too!
I appreciate this post, my own daughter has been medicated for ADHD since half way thru kindergarten, she is now in 6th grade. I know all about the comments from teachers. I also wanted to add that parents should understand that it can take a while to find the right med and the right dose to help their child and so they should not get discouraged if meds do not help right away, especially if they have family members who are giving them a hard time about medicating their child. My hubby was not in favor at first and when the first few meds and doses did not help he was less than supportive, once we found the right combo it was much better.
My daughter is 14, she was diagnosed about 4, she is ODD, ADHD and Bi-polar. It is a crazy life! I can tell on the weekends when she doesn’t take her meds. Drives me crazy. She is still defiant with some teachers – gyn teacher right now, thinks its fun not to bring her tennis shoes! Dad’s on the the list to call over this, done with that one! The only thing I have a problem is with the school – they took her off of her 504 because they said she is acting just like a normal teen. Not happy.
One last thing on the medicine part, some kids really do not need to stop the medicine during weekend or summer, it was explained to me by a teacher once that it takes a few days to get them back up to speed and misses with the work at school. Besides my can’t go without! I would be in a mental hospital if she did.
Oh my gosh. As I was reading your post I was nodding my head in agreement. Everything you were saying was true for my husband, me, and our son 14 years ago. I am happy to say that he is in his senior year at college and he just called me tonight to tell me that he scored a 32 on his MCAT. Looks like there is going to be a doctor in the family. You are absolutely correct about how imperative it is to do what is best for your son regardless of what kind of grief you get from other people. We tried the behavior modification in the beginning, but it wasn’t until we started the medication that things took a turn for the better. I hope other parents who have children with ADD or ADHD don’t take it personally and are able to see that having a child on medication for ADD is the same as a child who has to take medicine for diabetes.
I have a totally different perspective. My 3-year-old is exactly as you described your 5-year-old prior to medication. He’s impulsive, physical, prone to running, refuses to listen to adults, disrupts activities he’s a part of — if he actually participates at all. But rather than viewing *him* as the problem, I view the situations he’s in as a problem. If he doesn’t do so well in a large group setting, then I remove him. I don’t think it’s fair to expect a 3 – 7 year old child to sit still, follow directions, and use their words instead of hands all the time! Especially since you say he wasn’t causing problems at home at all. He’s different and has different needs, but there is nothing *wrong* with him. Just like there is nothing *wrong* with my son. I would never choose to medicate him. And we already eat an organic, chemical-free diet so there’s no other “alternative” intervention I could try. It’s simply who he is. Groups make him anxious and strict rules do not mesh well with his personality. Adults who are angry or punish him in anger do not go well for him. Yet, if he’s in a situation he’s happy about (most of the time), he’s generally well-behaved and can focus for long periods of time. There is *nothing wrong* with him. It’s my job as a parent to help find the right situation to fit him, not to force him to fit into a typical situation. Thankfully when the teachers said I had ADD 20-odd years ago, my mom believed the same thing, I was never medicated, and I am a productive functional adult today. Maybe I wasn’t the most popular kid and maybe I had my struggles but I was simply a different person. Different, not wrong. We have to change the way we talk and stop trying to push our kids into the same mold, to get them to fall in line and behave “properly” based on what the rest of the world thinks is right. I’m homeschooling my kids so that I can provide them with the right environment for them and so I don’t have to listen to teachers telling me my kid won’t sit down, shut up, and follow directions to the letter. I don’t want that for them anyway. Total mindset shift….
ADHD medications can be very helpful – I have four kids, three of the four are on different types of ADHD medications. We have adopted kids with special needs so it kind of goes iwth the territory. The fourth has behaviors very similar to those described above, but he has brain damage which has led to sensory processing dosorder, auditory processing disorder, and probably visual processing disorder, though we haven’t gotten to that yet. Putting him on medication will probably just make things worse. A child who doesnt need ADHD medications will generally get more hyperactive and less attentive on the medications. He doesn’t have the acting out unless he is bombarded with sensory, auditory, and visual input. I can hope parents are not thinking they should run to the nearest doc for ADHD medications without checking out all the other possible causes. Those medications, though effective in the right situations, have some possibly serious side effects – most notably the fact that we don’t know how they effect the immature brain. We need to help teachers to be aware of all of the issues that kiddos bring to the classroom so that they don’t overwhelm young brains with too much input. Sadly, my son’s teacher is sloppy and has her white board filled with writing at all times. There is no where in the class for kids to take a sensory break becaue there is stuff everywhere. Getting back to basics in the classroom will help all kids, but especially the children who have trouble attending with a lot of input. If your child only has difficluty attending at school, not at other venues (like dance or karate classes) then consider consulting some experts about how to make the classroom more amenable for learning.
This post is really resonating with me – my oldest son sounds so much like yours (bright, impulsive, tendency to be disruptive in class, etc. – but also a really good kid at heart)! He was diagnosed with moderate/severe ADHD last year (1st grade) via a very comprehensive testing process administered by a local clinical psychologist. I wasn’t surprised with the diagnosis at all – it is pretty clear what he’s dealing with and, after a lot of research and consideration, we decided to try meds this year. He was struggling so much with his behavior, feeling really poorly about himself and exhibiting clear signs of anxiety related to this downward spiral of low self esteem. He’s been on the meds about 3 months and I’m still struggling with the decision, but largely because I feel like a failure as a parent, because I think they are working for him. Right now, he only takes them during the week (at the advice of our doc) and is definitely better able to focus in class; however he’s lost 5 lbs and that is concerning me. We are trying different options to improve his caloric intake (protein heavy breakfast options, healthy snacks and dinners), but it still gives me agita. Just last week I had to remind myself that, if we want to, we can stop the meds. Fortunately, his teacher is great and very supportive – so if we decided to change or stop his doses, she’d be on board with it, but I definitely worry about the impact on his self-esteem when he’s not getting the medication help.
So – thanks so much for your post. It is good to hear other stories like ours.
I had ADHD as a child and my mother chose to medicate… in ways it was good however i was ridiculed by other children and made fun of I hated my mother for puttin me through it because i had no friends cause everyone made fun of me for having to take meds, i never had friends til middle school when i got off my meds and started at a new school
So coincidental that I discovered this post right now. My son just turned 5 and has been having these problems (poking, not standing still, not finishing his work, wanting to swing on doors, calling out) since he was 4 in his preschool/daycare. I’m not ready at his age to medicate but I see it happening sometime in K. He’s going next week to his 5 y o check up and i had been planning to bring up his behavior then.
I also just wish his teacher would recognize that he’s only 5! From the notes home, it seems like all she does is nag at him and snap at him. It breaks my heart. He’s also not terrible at home. There are issues with following directions without getting distracted but it’s not a disruption to us although I can understand how it might be a disruption with 18 other 4 – 5 y o’s in the room. The hardest part is being a single mom (to the 5 year old and an 11 year old girl) and not feeling like I can involve my ex with these issues because he’ll most likely blame me (he’s lives out of state and doesn’t see them more than 1 or 2 times a year, so he’s not aware of our day to day activities). Of course, like so many others, I also blame myself. Maybe if I had done this or that…
I know medication is not the end of the world but knowing you have to give your child chemicals to allow him to function in a school setting is a tough pill to swallow, so to speak!
He’s in bed asleep now and I just want to go in hug him forever. :’(
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