ADHD, To Medicate or Not To Medicate?

ADHD, To Medicate or Not To Medicate?

Q: Help! My child has ADHD and it’s literally making my hair fall out from stress. I’ve tried so many things, but nothing seems to make him slow down and focus. He’s constantly going and I can’t keep up with him. Dealing with him is also putting stress on my marriage, my husband and I disagree completely about how to handle his behaviors.  We also totally disagree on using medication with him, I think it will help him to do better in school and socially, as well as helping to reduce the stress in our family. My husband will not even talk about medication, I feel so helpless.

He: While it’s true that we have gone through time periods of over-diagnosis and overly prescribed medication for ADHD, there does in fact remain a substantial subset of kids that are actually very diagnosable and could be helped with proper medication. For a while, it seemed like every third kid was on Ritalin or Adderall, but the pendulum has swung back and now there has been a backlash towards these types of meds.  It’s kind of like the unfortunate trend of being “Gluten Free” going on right now.  This too shall pass, as the pendulum swings back and everyone returns to the business of gorging themselves with pizza and beer. But what will remain is that there are people that have gluten intolerance and benefit from avoiding it. Let’s not throw the baby out with the bathwater.

Is your kid really ADHD? It’s likely difficult for you to objectively make that determination.  All you see is your annoying kid doing annoying things, and have very little reference to which to compare him.  Young boys are maniacs. It’s in their job description.  As a young boy, all I did was run around throwing rocks, peeing on everything and hitting my sister with sticks- and I was a pretty mellow kid.  To get a better idea of your son’s relative behavior, a good place to start is with his school’s Assessment Team. They have backgrounds in assessing various levels of disability, have the added bonus of dealing with everybody’s annoying kids, and will have a good idea of whether your kid is substantially more unfocussed and annoying than most.  It sounds as if he is having some difficulty in school and if you initiate a request for assessment, the school is legally obligated to work with you. Additionally, a prescribing physician would very likely want to consider the information derived from a school environment before making a diagnosis.

Now let’s deal with the other annoying child in your life- your husband. He may actually turn out to be right about your kid not needing medication, but his refusal to even talk about it seems childish, uncooperative and unsympathetic to your feelings.  Try to explore where this anti-medication attitude is coming from. He may simply be misinformed. I’ve heard lots of parents rail against the evils of medication, meanwhile on a nightly basis, they tuck themselves in with two cocktails and 10 mg of Ambien.

See if you can reach an agreement to follow the recommendation of the physician’s and/or schools findings.  A six-month trial period with medication would give you enough time to assess the benefits objectively and move forward accordingly.

She: It is so disappointing when the stress of parenting begins to rupture the bond of the parents.  Maintaining this bond can be difficult for any parent, but becomes especially challenging when compounded with having a child with behavioral or mental health issues.  Recent studies indicate that parents of a child with ADHD are 25% more likely to get a divorce before the child turns eight. This is a clear indication of how stressful it can be to parent a child with this disability.

Knowing how effective medications (combined with therapy) can be for the treatment of ADHD, I would first like to understand your husband’s concerns regarding the medications.  I always ask my clients to clarify their opposition to medication and often find that their reasons are based on fear, misunderstanding, or societal/ familial prejudices.  After addressing these fears or resistance, I usually go to a therapist’s token response “if you had diabetes would you refuse to take insulin?”  Both involve a part of your brain/body not producing something that it needs in order to function appropriately.  I also like to refer to a Drew Pinsky rant about how we treat illnesses from the neck up with much more prejudice than the neck down (yes, I have a huge crush on Drew and long ago put him on my hall pass list, along with Anthony Bourdain and John Malkovich- circa 1988).

There can also be grave consequences of not giving him medication, if this is what he needs to function.  First, untreated ADHD can lead a child to have low achievement and low self-esteem, both socially and academically, that will follow your son into adulthood.  Second, you are running the risk of putting continued strain on your relationship, which, in turn, puts additional stress on your son.

My advice to you is get support quickly, both for your marriage and your son.  Find a therapist who has experience with kids with ADHD and is able to do family therapy.  Get a thorough psychological evaluation to obtain an accurate diagnosis, find a psychiatrist (note I said psychiatrist, not general practitioner) who can advise you on appropriate medication and carefully supervise his response to them.  And educate yourself on alternate treatments for ADHD (Dr. Daniel Amen recently wrote a great book on ADHD called Healing ADHD).  If your husband is unwilling to listen to you, surrounding yourself with professionals who can support your son and your family by offering an educated and unbiased approach… might be the only way to get through to him.

Dr. Jen Semmes and Andy Wilson have been (mostly) happily married for nine years (currently happily).  They are the owners of Coastal Counseling therapy center in Carlsbad, California.  Jen holds a license in clinical social work and a doctorate in psychology, and is a therapist at Coastal Counseling. Andy just tries to hold it together.

If you, or anyone you know, has a question for ‘He said, She said’ please send a private message to Coastal Counseling on Facebook or email the question to info@coastalcounselinggroup.com.

 

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