Good Intentions Won't Cure ADHD - Indy's Child Magazine
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Good Intentions Won’t Cure ADHD

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[Photo courtesy of The Lancet]

 “My son/daughter was just diagnosed with ADHD. [Insert variety of story lines which indicate said child is falling apart at the seams.] Medication is not an option. What other things can I try?”

I see this quote, almost verbatim, posted over and over on parent-based Facebook groups, advice forums, and via text on my phone. Please do not be mistaken, as I am not here to tell you to try medication first. A good “rule out” algorithm involving diet, parenting, and investigating underlying causes is always warranted. But once a true ADHD case has been identified, I cannot sit quietly by and hear parents tell of why they are “not currently considering medication”. Children who are failing in school, unable to make friends, and struggling to make sense of why they want to make good decisions, yet their brains do otherwise…and the most proven thing to help them succeed and overcome their disorder is NOT an option?

But perhaps “medication” should be clarified: these parents are often more than willing to try essential oils, vitamins, and other methods wholly unproven via the scientific method. They are simply not willing to try anything proven effective by the FDA, making ADHD a disorder unlike any other in pediatric medicine. This conundrum begs discussion, considering American headlines about the flu never refer to the “medication bandwagon” or a “chemically altered reality”.

I’ve walked this road. After years of researching ADHD as a profession, I gave birth to a child with ADHD. My view of ADHD changed swiftly the second I was handed the Conners Forms results and a box of medication. Suddenly, I didn’t see my complex-but-funny 6 year old: I saw a teenager wrecking her first car. I saw her struggling through school, year after year. I saw her making rash, unpredictable decisions, and developing an inability to learn from her mistakes. I saw the thousands upon thousands of children I had only researched on paper. I saw the really sick kids about whom I had consulted after they’d failed to respond to several medications. I saw the untreated children who lapsed into depression and insurmountable anxiety. My mind reeled from the stories of the Oppositional Defiant kids, the ones with comorbid…everything…and I froze. After years of standing for the ADHD child, I was completely unable to utter the diagnosis acronym.

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[Photo courtesy of Columbia University]

 

I sat the box of pills on a shelf, and tried everything else first. We bought parent training seminars. We read books. I called experts in the field. We added supplements and vitamins to a perfected diet. We hired a tutor. Our daughter repeated a grade, which desperately needed to happen, diagnosis or not. We went to Occupational Therapy and Visual Therapy and Counseling. We took full aim at her Dyspraxia, her Visual Convergence Disorder, and her Math-based Learning Disorder. She loves to swim, so we made sure she had access to a pool year-around. We made tons of headway with our complex-but-funny child.  But here’s the thing with “real” ADHD, and there’s no getting around it: she still had it, and it was still wrecking her life.

To give my precious Sara medication was to accept she had ADHD, and the boatloads of social stigma attached to these 4 simple letters. The people who protest on the steps on the FDA are protesting my decision. The celebrities testifying in front of Congress are testifying against me. (And why are celebrities given the national stage on mental health issues? Must be the years they’ve dedicated to the care and research of psychiatric disorders. Wait. No. That’s me.) The fringe religious groups, the counterculture parents, and sellers of Essential Oils everywhere…I’m their target. My sick child is their target.

After years of debate, trial and error, and living smack in the middle of the “medication bandwagon”, here I stand, tall and proud, so take aim: I GAVE MY CHILD PSYCHIATRIC MEDICATIONS, AND IT HAS MADE ALL THE DIFFERENCE. But hey, don’t take my word for it, let’s look at some data from the CDC:

– Kids with ADHD are 10x more likely to report social and peer-relationship problems than their peers.

– ADHD kids are more likely to be have non-fatal injuries, fatal injuries, ER visits, hospitalizations due to injury, become drunk drivers, and be in traffic accidents while driving, than their non-ADHD peers.

– In the year 2000 alone, ADHD was estimated to cost the US $31.6 BILLION dollars.

ADHD patients cost America tens of billions of dollars per year, and we think we can cure it with a better breakfast and some patchouli oil? Mental illness stigma is alive and well, my friends.

Every parent with whom I’ve consulted overwhelmingly loves their child, hence their persistence to try every available option. Unfortunately, many options for ADHD lack evidence-based data, and we’ve been told the FDA treatments are the enemy. The media has pounded us with the message that if we love our children we won’t “steal their personalities with medication”. (Notice to America: the disorder stole their personality first, not unlike depression stealing happiness, and schizophrenia stealing sanity.) But when I take out a pen and paper and sketch out the basic neurobiological underpinnings of ADHD, lights come on around me. “This irritating disorder is more than a behavior problem? We know the chemicals which aren’t doing their job and the part of the brain not working? The medications put the chemicals where they are supposed to be?” Yes. Yes. And, yes.

And thereby “yes” to the simple truth that you cannot love a child out of mental illness. Love doesn’t give the prefrontal cortex neurotransmitters it simply does not have. The world’s best reward and behavior chart will not stimulate the reticular activation system in the brain. I’d love to quote the SPECT scan and functional MRI data regarding dopamine transmission while on essential oils, but it doesn’t exist.

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[Photo courtesy of Denise Reynolds]

 

Speaking of data, Dr. Russ Barkley, internationally recognized as one of the premier minds in ADHD, followed the same cohort of ADHD kids and their control peers for 3 decades. Only 28% of the ADHD kids were medicated in high school, and below is how they fared into adulthood:

– 32 of the ADHD kids dropped out of school, as compared to ZERO of their non-affected peers.

– 22% of the ADHD cohort entered college, as compared to 77% of their peers. College seems like a far away dream when only 60% of the ADHD kids even graduated from high school.

– At age 27, the ADHD group had a 34% chance of being unemployed, as compared to 9% of their peers.

– If they are employed, ADHD adults are far more likely to be fired from their jobs than their non-ADHD peers.

– 40% of the ADHD group had 2 or more automobile crashes by the age of 27, as compared to 6% of their peers.

-Approximately 23% of the ADHD group had their license suspended or revoked, as compared to 4-5% of their peers.

– The teen pregnancy risk ratio between ADHD and healthy peers is 37:1, with 54% of the ADHD patients not retaining custody of their children.

– Finally, this group had a much higher incidence of eating disorders, smoking, drinking, cardiovascular risks, and therefore, a shorter life expectancy.

Perhaps my reasons for flag-planting in the field of FDA-approved treatments is more transparent now. Maybe my ire at non-healthcare professionals treating this serious disorder is more rational. But more so than my frustration at the media’s distortion of mental illness, is how these anecdotal treatments dishonor the children who have it. Rubbing oil onto a child’s scalp ridicules the depth of their risks. The cancer kids get telethons. ADHD kids get shamed and punished, and are consciously and subconsciously told their struggle is their fault. “Try harder to focus!” I’m not throwing a stone because I’ve said these exact words, but no one says “You’re not trying hard enough to get rid of this strep throat. I rubbed oregano on your feet, now do your part and meet me halfway!”

Zametkinslide

[Slide courtesy of Dr. Zametkin]

 

The parents who seek my advice are overflowing with wonderful, God-blessed intentions, but those intentions will not cure ADHD. Medications may not either. They are complex to administer, and finding the right medication and dose can take months. Some children can’t tolerate the side effects, while others have too low of a seizure threshold to take them safely. Some kids have long lists of comorbities (Autism, Dyslexia, Anxiety, Depression, etc), taking straightforward treatments right off the table. And some kids just flat-out don’t respond. Mental illness is a serious business, and treating it successfully takes highly-skilled professionals, parents who are willing to do the legwork on educating themselves about the disorder, and kids with resilience beyond their years.

Believe it or not, I’m not a rabble-rouser. I steer clear of politics, debates, and protests. But put one child struggling with mental illness in front of me, and I turn into the world’s loudest advocate. If your kid is drowning inside their own childhood, WAKE UP! Check out some books on ADHD. Ask for help from someone who doesn’t have a financial interest in your decision. Get a second opinion. Ask for help again. And most importantly, talk to your child frankly about their disease. Tell them what’s going on inside their brain, and let them know you are working to understand their struggle.

Set aside your good intentions, and study the underpinnings of your child’s good intentions. And to the celebrities who so easily capture the national stage protesting the “mind-altering medication of our youth”? THANK GOD for those medications. They saved my child. My beautiful, funny, bright, thriving, healthy child. Godspeed to my Sara, her fellow ADHD buddies, and to all of us. Godspeed.

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[Post and picture courtesy of My Sara, who tells us she’d never undo her ADHD. She feels the disorder made her creative, and the medication puts her in control of it. She hopes ADHD kids everywhere can someday feel proud to share their story.]

 

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