Thank you for the stories and the suggestions! We have a few more appointments before we make the decision.
Just to put out another POV. — there are therapy-based alternatives to medication that work, and work well – but they do require work and commitment. (For example, it might involve making lifestyle and dietary changes as well as participating in a therapeutic program.) The kid has to stick with the program, and the parents have to be supportive of that.
If you are interested, you can PM me and I’ll tell you what I know from personal experience. But you could start by doing a Google search for “drug free approaches adhd” – I just did that and the approaches I know about popped up on the first page of results, but so did a lot of other stuff – so you might get a better grounding.
Keep in mind that the stimulants often prescribed for ADHD are drugs of abuse for high school and college students. For example, see http://www.thedailybeast.com/articles/2013/12/02/7-things-you-need-to-know-about-adderall.html
Obviously this is a choice and one that each family needs to make on their own --but it just seemed that you were hearing only from those who were offering pro-medication viewpoints – and I just felt that you need to know that there is another side, and that there are some of us who have chosen not to rely on meds or give meds to our kids, and are very glad we made that choice.
@jym26 -
You are correct. I realized that I said that it goes away, but it never does. You just learn to cope with it better. I also think that outside of the realm of school, people can act differently. My son doesn’t have to force himself to read books he has no interest in, so he now reads a great deal for pleasure. He doesn’t have to sit still for hours like in school. His job as a mail carrier gets him moving and exercising, which are very important for ADHD.
@calmom -
My H was very anti-medication for our son. We tried the Feingold diet, we tried lots of approaches before, during and after his medication days, including the biofeedback that I mentioned earlier. I am not pro-medication per se, I am pro whatever helps my child.
calmom, I am going to assume the best, and say that you do not mean to imply that those of us who ended up with medications lack work, commitment, or are ignorant of the risks of medication. I am going to assume you don’t mean to imply that we are unhappy with our “choice” or have uncooperative offspring or are unsupportive ourselves.
I put that in parentheses , because “choice” is a misnomer. When I live in a town with no therapists, no biofeedback clinics, no alternative therapies; when I already have a semi-adult at high risk for many things and am running out of time to just keep trying something else, when I have googled and read and done due diligence but the doctor suggests let’s just try this med and see? There’s not much “choice” for some of us. But, I am glad we made that choice.
OP, other people’s experiences have a limited use for you – like pregnancy, sorta, adhd treatments are varied, with varying results for varied people. Don’t be afraid to try what seems a good idea, don’t be afraid to discard things over and over.
I’m also pro whatever helps the person. My ex-h also has been diagnosed with ADHD, and while the medications helped him stay awake, they did nothing for his organizational issues. So they definitely weren’t sufficient. He was highly resistant to behavioral therapy. The therapist attempted to provide coaching but ex-h wouldn’t do the assignments. My daughter has been much better about working on her habits in addition to occasionally using Adderall.
I’ll also chime in with the idea that ADHD is often over medicated. I am not commenting on the experiences of others here, so please don’t jump on me. Or if you want: jump on me. I don’t care.
IMHO there are many other options besides medication. One option is to support the child in other ways, some of which have been expressed here already. Another is to change the way you think about school, that your child has to be on a specific trajectory or his or her life is badly damaged. Maybe your child is meant for something other than college, as scary as that sounds. Maybe your chid can take a gap year or several, do something amazing, and then start at community college to raise grades and then transfer to a great 4-year college. There’s no need for a child to get As through high school. You may panic at that thought but maybe giving your child a pill a psychoactive pill while he or she is developing, is not the best thing IMO. The first answer to OPs question was a father saying: give him the pill. If you like what it does, give him another. If you don’t then don’t give him one. That was what led so many families to put their kids on laudanum in the 19th century–also a very addictive harmful substance, but it did make the kids more compliant. And now we know better.
I predict that the same will be true soon enough with this overmedication.
It may be that your child does not have ADHD but is a visual-spacial learner, for example, which is often misconstrued as ADHD, misdiagnosed. Visual-spacial learners are often late bloomers and school is crappy for them until they leave and find their talents appreciated. Mainly this is because school work is based on other learning styles.
It’s worth noting that the prefrontal lobe is not fully engaged in some kids – mostly boys – until age 25. That is the area that helps iwth self-control and executive functioning skills. These sorts of controls come on board for most people by age 25. This is so widely recognized that insurance companies change how much they charge for drivers under age 25 and over. The same with car rentals. Peoiple know this, I’m not sure why schools haven’t caught up. Also: there are many many programs for nontraditional students at colleges, for the late bloomers, because colleges are aware that kids – often the most brilliant ones-- can take longer to develop.
If meds are doing something to make your child focus, therefore the child does have ADHD: this line of logic is badly flawed. Anyone taking a stimulant will focus better. If you give any child a stimulant, they will focus better. Do you want to place your child on stimulants? Do you want to give your perhaps misdiagnosed child speed?
Diagnosis for ADHD is super easy to get. Basically you can walk into a room and say that you’re bored or can’t focus and poof you have a prescription. It’s that easy. And that accurate in many cases.
Also, as well intended as the fine parents are on this forum, they are doing a disservice if they don’t tell the side effects: sleeplessness; stunted physical growth; having to take additional meds for the side effects; lack of appetite. etc. Then there are the things that may be happening underneath: are you keeping your child who is gifted creatively from his or her natural tendencies to be creative? Are you telling them that there’s something wrong with them when in fact they are different perhaps in a wonderful way? Giving kids meds isn’t a cureall. It’s another complicated path that you have to negotiate. It might be the right path, but there are other paths that you can take, IMHO.
Studies do not support efficacy of the Feingold diet; that does not mean that it won’t work with some children.
The best studies show meds with or without behavioral modifications works best for ADD; that does not mean that some kids might not do well with beh mod only. I’ve supported families who want to try anything but meds. I will tell you that most of those families will eventually make the decision to try meds and are happy they did.
The prefrontal lobe is indeed not totally mature in many males til the mid 20s (it sure isn’t in my son!), but that information may be of little comfort when your boy (or girl) struggles in school in 3rd grade or 6th grade or 10th grade.
When I counsel families about ADD, I frame it as something that interferes with school success, which is a narrow parameter and a product of our society in the last hundred or so years (that is, in the 19th century, kids might go to school for a few years then become an apprentice and build ships, or learn to be a blacksmith, or farm. We didn’t expect children to sit in a desk for six hours a day until fairly recently in our cultural history, and those are the kids that have trouble with ADD. ADD doesn’t have anything to do with intelligence, or drive, or trying hard. It just interferes with what we call success in school.) Kids with ADD are often very cool kids-- they are innovative thinkers, they’re creative, they’re inventive. The best treatment helps them succeed in school but doesn’t change them in any other way. Meds are a tool like any other.
My D2 received a different (but somewhat overlapping) diagnosis in hs and her meds were changed several times in the first few months and then at about a year. (Depending on the particular Rx, the prescribing doc should know at what point certain meds or combinations need to be evaluated, whether it’s 3 weeks, 3 months or more.) A dosage may be increased, decreased, supplemented, until you find what works with the least other effects. In college, they were modified twice. All this can be very individual.
It can be confusing for a young person to know if an Rx is working or what’s what. It helps if you can keep the lines of communication open, as they learn a new skill at self observation. In that respect, not different than a physical ailment.
There are some for whom alternatives to meds may do the trick. It’s just that you have to be very open to watching and assessing and wiling to face that meds may, in fact, be needed for that individual.
Best wishes.
[qiuote] Studies do not support efficacy of the Feingold diet; that does not mean that it won’t work with some children.
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This
Most studies show that a combination of medication and behavioral intervention is the most effective treatment.
I don’t know if it is helpful or not in the discussion but my D is not struggling with academics or grades. The reason we went asking for help was panic attacks which I thought had to do with stress about her sports (ok totally clueless). I don’t want to put all the details out but what my D, her therapists and her doctor say makes sense now about the ADD. She is going to a very average school by the way, not a pressure cooker. We will continue with the therapist as D finds very helpful. Medication was also suggested.
Ritalin is in and out of the system. Niece uses it to study and attend some classes. She was diagnosed ADHD-combined type in first grade. Everything she learned in first grade she learned in the last 6 weeks of the school year on medication. She was going to be held back and moved to special ed-- but for her Ritalin was night and day. She suddenly learned to read because she could focus, and she turned out to be very bright once she could pay attention. She’s a junior in college now.
School is an artificial environment. Niece wouldn’t have made it through without Ritalin. Now as an adult, she knows what it feels like to be on it and off it, and makes smart, personal decisions about when to use it.
There are 2 families of stimulant drugs that are used the most–the Ritalin family and the Adderall family. Many of the other names are simply varied delivery systems for these two families, although occasionally a minor molecule is changed so a drug company can secure a new drug patent, such as Focalin (Ritalin family). A good psychiatrist can explain it best.
Niece’s psychiatrist liked the Adderall family because there were so many options of dosages. Niece first tried 5mg and it was amazing. It was the first time she could express memories, because the cloud of ADHD cleared in her brain. But the rebound effect was disastrous. She saw crawly things on the wall and went to a very dark place. Only happens to a very small percentage of Adderall users. But fortunately it was in and out of her system quickly with the short acting pill.
Ritalin wasn’t quite as effective but it still made a huge difference in the quality of her school life and learning, and there was no rebound effect. For delivery systems she used long-acting granules (generic) in elementary school, and later, Concerta in H.S. She uses short-acting pills now (generic), controlling the timing for optimal studying and sleeping, as she loves to go to bed early. She works out regularly and has a healthy appetite.
I think an ADHD student has to be offered the option to try medication, and make their own decision, especially in H.S.
It’s not just school. Some issues may manifest there, in those confines, but the struggles can extend beyond. D2 functioned at her optimum, did her best, the year she was massively overloaded. A normal reduction in pressures and the cracks appeared.
I resisted a diagnosis. We tried various DIY avenues, kinda sorta. But there’s nothing like when your kiddo says (and shows) she feels like herself now. Not some A grade machine, but normal. I do advocate that the therapist be the one prescribing, to get the full picture. But certainly, “best” is what works for our individual kids.
Not treating my D’s ADHD resulted in a serious depression. We had tried therapy and other natural approaches, and I waited too long to try medication when she had very obvious signs from day one.
Anxiety and depression can be the result of untreated ADHD, and is often discovered when teens (especially girls) go for help for anxiety and depression.
We had one trial with a med that very obviously didn’t work and then we tried a second. Within an hour, we knew without a doubt that it worked for her because the result was so dramatic. It gave her immediate control of her behavior that she herself recognized and that was the start of healing the emotional part.
I might medicate ADHD for academic reasons if things were bad enough to significantly impact the future, but I would not hesitate to try medication if the untreated ADHD had caused or contributed to emotional issues like depression, anxiety, severely damaged self-esteem, stained relationships, or if other kids become overly stressed by the behavior.
People have such a limited understanding of the long-term consequences of untreated ADHD on the individual and the family. But feeling like you are screwing up everyday and can’t do anything right really has serious effects. Not that every kid will take it that way but some certainly do.
Meds are not the only option but one tool.
I really recommend Interactive Metronome as an effective therapy for better control of attention. Occupational therapists offer it and it can be covered by insurance.
We also saw attention benefits after vision therapy with a pediatric optometrist for convergence issues in another child. Some health insurance plans will cover vision therapy for convergence. It’s physical therapy for the eye muscles. It can be expensive so make sure you go to a developmental optometrist who is highly recommended and gives a clear treatment plan. When eye muscles tire easily and lose focus, the result is inattentive symptoms.
You might find the chart on this page helpful:
http://www.healthline.com/health/adhd-and-anxiety#symptoms2
Panic attacks can be a symptom of ADHD, but they are not listed among the diagnostic criteria under the DSM 5:
https://princetonnassaupediatrics.com/files/dsm-criteria-for-adhd-handout.pdf
You said that your daughter has been diagnosed with inattentive type ADHD; here are the diagnostic criteria:
Unfortunately there are a lot of behavioral symptoms that can have many different causes.
I’m glad that your daughter likes her therapist, because therapy might help her figure out what triggers the panic attacks and take measures to address that problem, if there is an identifiable pattern. (I realize that sometimes panic attacks can also seem to occur out of the blue, for no particular reason). There are also a variety of stress-relief techniques that can be learned to help stop panic attacks when a person feel them coming on, and meditation and relaxation techniques that might reduce the frequency of such attacks.
Did your daughter’s therapist suggest the typical stimulant-type medication that others have been discussing here (such as Ritalin or Adderall)? Common side effects of Ritalin include nervousness,agitation, anxiety, dizziness, palpitations, increased heart rate, sweating, tingling – all of which are also common symptoms of a panic attack. See http://www.rxlist.com/ritalin-side-effects-drug-center.htm & http://www.webmd.com/anxiety-panic/guide/panic-attack-symptoms. Same deal with Adderall - http://www.rxlist.com/adderall-xr-capsules-side-effects-drug-center.htm
In other words, I think that a stimulant could make things worse. There are some non-stimulant medications available for ADHD but I think most are SSRI’s. There are various precautions you & your daughter need to be aware of before beginning to take SSRI’s, mainly because once on them it can be very difficult to get off of them.
I know when my daughter was in high school she had issues with stress & anxiety, and got a prescription for something from her doctor. Unfortunately I don’t know what it was she got - by that time she was old enough to see the doctor and get a prescription filled on her own – but I’m guessing most likely Xanax or the equivalent. Xanax is also very commonly used to treat panic disorders. (But for obvious reasons, could make things worse for someone whose needs help sustaining attention - this is not an ADHD medication – but the problem now is that you are describing a primary symptom that is not by itself indicative of ADHD).
Medication got my son through elementary and high school but now that he is working and doesn’t have to sit at a desk and learn new material all day every day his anxiety is in ascendance and he feels that ADHD meds exacerbate it. So he has stopped the ADHD meds. He’s 23 and can make that choice.
I was on adderall for a while and it helped with my anxiety. But it also made my heart race so I often felt like I was starting to have an anxiety attack. I got used to it pretty quick.
I wasn’t using it to treat anxiety but that’s what they tried first given my history of anxiety and depression.
My S19 was diagnosed at age 7. His extremely experienced second grade teacher practically diagnosed him. He’s actually been on the same low dose of Adderall XR since second grade. In elementary school, he just couldn’t follow some of the class rules without it - he became a new kid practically overnight. We did a trial run of taking him off it in 6th grade (he did outgrow the hyperactivity) but he was off to la la land during class. He’s never been in the habit of taking it on weekends. It’s definitely made a huge difference - we had concerns about him not eating when he was little, but being a teenager took care of that.
Next year will be the first time we discuss the possibility of an after-school supplement due to junior year courseload. This year, he seems to get most of his HW done at school but when he does have a lot, it’s a bit of a struggle to get him to settle into it and stick with it unless it’s a class he likes. Forget about studying for a test beyond maybe skimming the material for 10 minutes. Fortunately, he pays attention in class and remembers everything.
My D16 exhibited some ADHD symptoms but was diagnosed with an anxiety disorder. SSRI’s did not work for her. She has a beta blocker (often used for stage fright) for the occasional panic attack and uses an anti-seizure/neuropathy medication for her anxiety.
My daughter has both ADHD and anxiety. I was very, very concerned about putting her on medication. We tried Feinagold, therapy, parenting classes, etc. At the time I was working at UCLA on an ADHD study and we saw kids day in and day out with ADHD. I knew the research said the most effective treatment was medication plus behavior modification but I still resisted. Finally, in 7th grade she was falling apart-crying because she couldn’t focus on her school work, getting in trouble at gymnastics for not focusing, having trouble socially because she was so impulsive. It was awful. That’s when we decided to try medication. I was still worried so I had a sonogram of her heart to make sure she had no structural defects and an EKG/stress test (btw, the doctor did this because I insisted but made sure I knew it was not necessary). All came back normal and we started a low dose of the medication. It made a huge difference in her focus and impulsivity. She was able to focus on school work and her grades went from Cs to As and A-s. That said, it has not been a cure-all. She’s still messy and disorganized and still procrastinates. She’s 3000 miles away at college and I don’t know how religiously she’s taking the medication. But I do know it made a positive difference in her life.
I understand people not wanting to put their children on medication, and that is their choice. Each family has to decide for themselves. And I do think that ADHD is likely being overdiagnosed and would want something other than a pediatrician going down a checklist for a diagnosis. But for kids who truly do have ADHD, medication can have a positive effect. And as for abuse, studies have shown that kids who are medicated are actually less likely to abuse drugs later in life.
**I mean kids with ADHD that are medicated are less likely to abuse drugs later according to research.
Another physician here, not my area of expertise- I bow to what seems excellent advice from Jaylyn. My younger brother was diagnosed in the 1960’s- well before it became a popular diagnosis.
Gifted son is introverted and his first grade teacher was concerned about ADD. With my family history I got materials from his pediatrician and had the school psychologist do an evaluation as suggested (the same PhD who did his early kindergarten entry, btw). I also was on a parent committee for gifted education and was learning a lot. It turns out that one can be gifted, have ADHD or both (some parents discussed their own issues). Kid is gifted and some of the traits overlap, but a list of them shows easy differences. Teacher was seeing a young, bored child- which she wasn’t used to.
All of the parent comments here point to good evaluations and diagnoses. Using drugs does free up the person to function better. Physicians do not push drugs, they have a lot of knowledge about what works well. The decision to start something while still in HS makes sense to me- as a previous poster stated.
OP- so many good words here. I also like following your own physician’s suggestions. There are often several ways to approach a problem. There are even books about adults with ADHD that I read years ago. The brain’s functioning is so interesting in variations of how it works (or has problems). Best wishes- things will work out.