ADHD: To Medicate or Not to Medicate? How You Can Decide

“Bring me your progress reports,” I called to my kids as they walked in the door. I’d been checking their grades online for the past five weeks so I knew they were all getting As and Bs. Still, I wanted to make sure the progress reports accurately reflected the grades I’d seen online. And, of course, I wanted to see if the teachers had made any comments about my kids’ behavior or performance in class.

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:

    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.
    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!)
    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.
    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.
  • 5. TALK TO THE TEACHER 5 of 10
    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.
    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.
    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.
    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.
    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.
  • 10. DON’T LOSE HOPE 10 of 10
    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)!

Dawn is a mother to six kids (three of whom have ADD or ADHD) and a program assistant who works with low-performing kids at a middle school. To read more from Dawn, check out her hilarious books Because I Said So (and other tales from a less-than-perfect parent) and You’ll Lose the Baby Weight (and other lies about pregnancy and childbirth) here!

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