Some days it feels like every relationship is a power struggle. If I'm not engaged in a struggle for control/power with my child then it's his teacher or school. Every year without fail we seem to engage in a power struggle with our son's teachers about his medications. Of all people I understand that my child is VERY hyperactive and he is "easier to handle" while on stimulants. However, I still like (actually love) my child without his medications and prefer his temperament and personality off his stimulant medication. Sometimes I do wonder if the only goal of medicating is so he can be "handled" in a school setting. Like any busy family there is the rare occasion he goes off to school and we forget to give him his medication. As of this writing, this has only happened twice this year and yesterday was the second time. Clearly I know he didn't take it because I am the one who gets him off to school everyday. Without fail, at 8:30 am there was a message from his school asking that I bring his medication to school (20 minutes away mind you) because they couldn't "handle" him. I am at work seeing patients at this point and it is clearly not feasible for this to happen. When I return the call to say this the teacher is clearly ticked off, and when my son gets home in the afternoon he reports to me that she said to him directly, "I can't handle you today".
As a physician I am very aware of the positive aspects of medications, but at times I feel like the question of whether to medicate or not medicate for ADHD is somewhat trivialized and is much more difficult than it seems. When our son first took medications in 1st grade his psychiatrist used the analogy of a diabetic who can't get by without insulin. I personally have never bought into this analogy....my son is not going to die of ADHD where a diabetic will most certainly become quite sick without insulin. Also, the side effects of stimulant medication can often worsen the behavioral problems when the child is coming off the medication at the end of the day and in our experience clearly make him irritable.
Is it really that simple? Does a child with ADHD need medication the way a diabetic needs insulin? Over the years we've come to acknowledge that until our son develops maturity and some executive function skills to regulate his own behavior and it's impact on himself in others in group settings that the medication serves as a substitute. I am still hopeful that with time he will develop a skillset that will allow him to function without medication. Wishful thinking? maybe.
Enjoyed your post. What a quandary we're in with this med thing, aren't we? Insulin is life-saving and Adderall, while it doesn't save a life per se, I'll have to challenge the thought that it's not as important. I'd love to see my son OFF meds totally and as his skills mature & he makes positive progress I see it could happen in his future. But for now, without meds it's not fatal but it's FAR from anything even remotely easy. He can't sit for 1 minute, making learning nearly impossible. In a country with an education emphasis, his learning is imperative to his healthy future. Without the learning, he fails. I think we can link the needs of an adhd kiddo to those of a diabetic. I watch the adhd kids struggle ever step of their day without meds and the ones who need (really need) meds and get them...well, they begin to focus. 15 minutes in a classroom with a completely out of control child doesn't just tire the teacher. It saddens a good teacher because they know it could be different for this child. If this isn't brought under control, he/she suffers tremendously. That's my soapbox. (Just the other side of the picture.) Now, saying "I can't handle you today." Well, that's not professional or supportive. Are there any other schools? Private? Just a thought. ~Charlotte
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