Believe in your child – and yourself – before you believe in medications

Many parents that I work with ask the same question: “Should we medicate our boys?” Here are the basics you’ll want to consider:

• There’s no way to predict what being on medications will be like for any particular child. There’s also no way to know ahead of time the side-effects beyond those that most of us already worry about: sleep problems, attenuated height, decreased appetite, weight loss, possibly mood swings. Some parents (and older kids) have reported to me a dampening of personality, and rarely, I’ve encountered cases where there was a cardiac concern. I don’t say this to frighten or discourage parents, but to make certain we all appreciate that these are significant medications. Always check with a pediatrician, and if possible a psycho pharmacologist. Most kids do tolerate side-effects well – or the side-effects are minimal. Go into this with your eyes wide open!
• Keep in mind that psycho-stimulants are performance enhancing drugs. That means, they work on everyone. Kids will likely focus better and be less impulsive on these meds. We would, too, so don’t think the diagnosed of ADHD is confirmed because you see a change. Also keep aware of unanticipated problem that might come up down the road. I’ve seen many young men who started to use medication as a psychological “crutch.” That’s their word, not mine. They said they came to believe they “needed” meds to do homework, sit in class, to get themselves into college, get through college. Many have had a hard time dealing with the demands of their first job and rely on medications so much that they panic at the idea they won’t be are to face work without them. Dependence can happen on any mind altering substance.
• This is why I recommend parents never use meds alone. People should always be working to improve themselves, identifying strengths and weaknesses, and nourishing their development – at any age! Believe in your child and believe in yourself first before you believe in medications. In fact, the treatments of choice (what is now recommended at the start of an ADHD diagnosis) are non-medical. These are behavioral training/tutoring/organizational types of interventions. All of those work better than meds for the long haul, according to research. Maybe that’s because, unlike meds, these interventions develop new skills. They change the brain for the better via learning and new ways of adapting. Pills tend to suppress the unwanted symptoms, in my experience, mainly impulsivity and motor movement. Focus improves too, but once off meds, kids fall back to where they started from.
• If your child takes psycho-stimulants, you might very well see a sudden boost in their grades. Sounds great – but beware. Evidence shows that a boost in grades may not be about better learning – but rather – kids are performing better on tests that don’t translate to long-term gains. Also, the way in which teacher’s grade can be biased, based on behavior rather than true achievement.
• Finally, if you try meds for ADHD, always have an exit strategy in place. Try to see this as a time-limited intervention. Try to have time off meds as well (e.g., not on weekends, not on holidays, or not during summers).

Those are my general (behavioral psychologist’s) take on the role of meds. I’ve seen some kids do better and some worse on meds, and it wasn’t entirely predictable ahead of time. I do have many other caveats I ask parents to consider. Ask if there’s anxiety at play, or some other underlying emotional issue that masks as ADHD. Is there an educational problem – bad school fit? Learning disability? Is there family conflict, parenting stress, marital stress, or is there a dietary/sleep issue which we now know have been correlated to ADHD symptoms? And always, make certain your kids are getting enough vigorous daily exercise and movement of all sorts – outdoors preferably – which have been shown to substantially lower ADHD symptoms.

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