Thanks for the thread. I have a very personal interest in this issue, because my daughter (age 12 1/2) has been diagnosed with ADD, and prescribed Ritalin. Her mother (we are divorced) didn’t bother to consult me. The problem I have with this is: my daughter is bright and curious-she is probably bored out of her skull by the mediocrity that passes for teaching at her school. Also, nobody made the least attempt to contact me on this issue-I guess fathers don’t count for anything today!
BigPoppa, if ADD is a useful genetic trait, why are we medicating it? If people with ADD are our adventurers, explorers, and leaders, why are we suppressing it? I thought that was an interesting point for someone who seems to be arguing for the treatment of the condition to make.
As someone who has taught kids with ADD who were being treated with Ritalin, I’ll say the following things:
- there ARE real cases of ADD/ADHD and these children can definitely benefit from medication
- there ARE teachers, school professionals, and parents who diagnose kids from the sidelines and think that every child who is a little more active than others needs to be drugged
- doctors are NOT infallible. Some kids may be taking medication that they don’t need; this does not mean the doctor is evil, he/she may have just made a mistake.
- this is a SERIOUS issue. Just because the drugs used to treat ADD/ADHD may be relatively safe and non-addictive, it is never good to introduce a chemical into the body that isn’t needed. Your children are important enough for the extra time and expense several (read: 3,4,5) opinions it may take to be absolutely sure that medication is the best route.
A damn good question, and one that should be asked before starting anyone on methylphenidate.
I am currently two years into medical school. I have known for some time that I was ADHD, but I did not start taking the medication until I started med school.
In my opinion, ADHD is a very desirable trait in a doctor. The “broad-range scan” aspect of ADHD allows the clinician to see the patient as a whole. Also, modern medicine involves doing ten different tasks at once, which ADHD folks do as a matter of course.
The first two years of med school, on the other hand, involve spending hours on end staring at gargantuan tomes like Robbins Pathologic Basis of Disease and sitting through one excruciating and minutiae-laden lecture right after another. It is ADHD hell, and I know because I’m living it. (Only six weeks to go. . .Only six weeks to go. . .) Quite simply, I could not have gotten through these two years without methylphenidate.
When I start my rotations next year, I will probably take the MPH far less often. (I seldom take it now when I’m not in school or studying, although that’s most of the time. :))
In my opinion, education simply requires prolonged concentration, no matter what the field. (Neil Postman, in his book Amusing Ourselves to Death, indicts “Sesame Street” for this very reason–it encourages us to break learning up into disconnected and easily digestible factoids rather than a coherent whole.) Therefore, ADHD is not a desirable trait when it comes to education, even though it might be in other pursuits.
In general, psychiatric conditions generally shouldn’t be treated unless they pose a potential danger or interfere with your normal function. My favorite example is the Asshole Pill–someday, science may develop a pill that keeps people from being assholes. (The day can’t come soon enough.) But what if you’re a trial lawyer, whose skill in the courtroom is enhanced by your ability to be an asshole? Similarly, many writers and artists with mild mood or personality disorders feel that their art is enhanced by the condition, and that no danger is posed. Should these people get treatment anyway? I think not.
Bottom line–ADHD is a good trait in some situations, and bad in others. If it’s holding you back, treat it. If not, don’t.
(Really long posts usually mean that Dr. J has a test coming up that he doesn’t want to study for. Pharmacology, Monday.)
Dr. J
Okay folks. I don’t post here often, but this is one that I couldn’t pass up.
To start with ADD is attention deficit disorder, and ADHD is attention deficit hyperactivity disorder. There is a difference.
While in kindergarten I had a big decision to make about my son. The teacher thought that although it was nice that Josh could be bouncin around the room, and still tell her what she was talking about verbatim, that he migh need a little help.
So, after seeing the school shrink went went to the MD. The MD was one who didn’t like to medicate children. Wonderful, I didn’t want him medicated! Anyway to avoid that was great.
We then had him evaluated by a professional shrink. Both he and the MD had some great non-violent parenting ideas such as time-outs and revoking priviledges. They ran blood tests for allergies to see if it was some sort of intolerance or reaction he was having.
Sadly enuff none of that worked. He became worse, and started to get a little to rough with the pets and younger siblings.
He is now in second grade and doing wonderfully with the help of ritilin. He is in the gifted classes now because he can slow down enuff to stop and do the work. I even had one teacher tell me that now his problem was that he was a perfectionist. Needless to say her and I didn’t mesh well.
Children with theses disorders are overly bright but just can’t sit still long enuff to show people and sadly get placed in behavior disorder classrooms with the rest of the troublemakers.
Yes, some boys are just rambunktions. I say boys because it is a predominately male trait. Not that girls don’t deal with it, just not as many as boys.
One major problem with this disorder if untreated is that these children run on impulse. They lack the concentration to decide that maybe burning a house down might have consequences to deal with, it just sounds fun so they do it. Do not chalk this up to bad parenting.
I did everything in my power not to medicate Josh. It was not possible. He at one point in time started in with self mutilation. That is pretty scary with an eight year old child.
Please do all the testing neccesary before medicating. Testing for allergies, MD’s, talking to shrinks, and talking with teachers.
Be also warned that with a few cases they also will carry other tendencies such as manic depresion, or violent tendencies.
This is going to sound strange, but I do feel that ritilin has become a catch-all cure. But, there are children out there who really do need it.
It is a great thing that you are seeking peer opinion, and I hope that I have helped in all of my ramblings here. Between myself and my husbands ex-wife we have tons of information. If you want any of it e-mail me and I will scan it and send it out. If there is anything else personally you would like to know I will be more than happy to tell you my trials and tribulations with dealing with ADHD. I won’t answer too much medically because I am not a doctor, nor do I claim to be. I am just a mother concerned for her sons wellbeing.
Mistress Kricket
Sorry about the spelling. I just re-read what I wrote, and besides being long, I didn’t spell Ritalin right.
I have been home from the hospital only about 12 hours, and have been awake for 48 with my second youngest out of five. His throat decided to try and close on him. What fun that was!
15 minutes of sleep after a 12 hour shift only to rush him to the hospital in my pj’s.
Once again sorry, I know that spelling mistakes are a big no-no around here.
Mistress Kricket
Kricket–thanks for sharing your experience.
One small nit to pick–it’s now all called ADHD, either primarily inattentive, primarily hyperactive, or mixed. I am ADHD, primarily inattentive. (I don’t have a DSM-IV handy, but that’s the way I remember it.)
Dr. J
aha, I am concerned about your dilema. Have you gotten anything figured out yet, and have any of our thoughts helped in making a tough decision.
Let us know how things are going for you. And if you need someone to lend you an ear, let me know.
Thanks DrJ, I hadn’t realized that they had lumped them together like that. I kinda defeats the purpose if you ask me. It makes it seem like it is a catch-all phrase with a catch-all cure. That doesn’t seem to be such a good thing today. As we have all brought up in one way or another, some of these children actually benifit from Ritalin, and some are just put on it to deal with them, and not find the root of the problem.
It is truely sad when people can’t stop and listen for a minute instead of just medicating.
Another turning point for my decision was when my son asked his kindergarten teacher to make it all stop because it was moving too fast.
She immediately called me so we could stay on top of things. This woman in my book is one of the best teachers I have come across.
Mistress Kricket
Are you stuck on stupid?
Kricket:
I wouldn’t be too quick to condemn her on that point. One of my son’s biggest problems is that he is a perfectionist. This is not overtly bad, of course. However, it does mean that there are tasks he will refuse to perform and new things to learn that he will refuse to study because he fears that he may not perform or learn them perfectly.
I’m not going to try to speak for the teacher (who may have been the wrong one to try to deal with the issue), but if she has seen him as a perfectionist, you may want to be sure that that trait is not hurting him in some areas while it helps him succeed in others.
For example, he may be ahead of everyone three years older in subject A while lagging a bit behind kids a year younger in subject B. There can be a future problem if the problems in B are simply glossed over with the idea that he will “obviously” catch up since he’s so smart. Some courses require enough groundwork that missing stuff in grade 2 can really hurt in grade 4. That can’t be treated by medicine, although a little bit of counselling and some good teaching techniques may help him work past it.
I’m not claiming that the teacher was dead on, but she has identified (correctly orincorrectly) an issue that truly is a potential problem. As long as he is doing everything to grade or above, it just may make him a bit difficult to deal with (bad on the teacher if she was complaining); if he is falling behind in a few areas because he does not want to fail, then you really should address it (and good on the teacher for catching it).
Tom~
Excellent topic, some great discussion!
- Yes, Doctor, it is currently called ADHD, with several subtypes: Hyperactive, Inattentive/impulsive, or Combined. I hope the DSM V goes back to ADD, just because it’s easier to say and write. Actually, I hope it gets pulled into a larger umbrella classification called Inhibitory Disorders.
- Yes, C3, I agree, and it is a painful paradox. When I’m in charge things will sure be different… meanwhile, like the good Doctor, I’ll do whatever I need to be successful in whatever environment I’m in. So, if I were blessed with an abnormally large cranium, I would probably disguise it by wearing a hat in public. KnowhatImean?
When did they change it all to ADHD? Why didn’t my doctor know of this? (or at least tell me)
My brother was diagnosed with ADHD I think when he was 8. He has had many problems over the years (he is now 18) and while meds help him in some areas…it certainly is not a cure all. My sister, who is 10, was diagnosed last year with ADD. She shows signs of a learning disability (like my brother did) but my parents refused to let the teachers put her into special education, as they lumped learning and behavior disorders together (some of my brother’s problems might have been learned there) It has had good effects on her, which changed her from being an obnoxious brat who refused to put away her Barbies, to a little girl who will straighten the kitchen tupperwear cupboards on her own to please mommie. Now, in recent years we have been suspecting I also had ADD. (I am now 20) I was probably the model child of the three, being intelligent, mature, and creative, but I had problems in school with turning in schoolwork. My report cards always said I was capable of A’s, but didn’t apply myself…I could pass tests (with the exception of math) with A’s, but fail the class due to not turning in homework. When I got to middle school, we tried behavior modification, being rewarded when assignments were turned in, being punished when they weren’t…despite my desire to be organized, and do the homework, it was so hard to just <i>make</i> myself do it. I got through highschool barely, and after promising my parents to do better, I still failed a couple classes, couldn’t manage my money, forgot to check work scheduals…in turn, causing problems with my family, with friends, my boyfriend…all resulting in depression, which lessened my desire to get things straight. Avoidance was a better option. First time my parents sent me to the doctor to find out if he thought I should be medicated, he refused to medicate me based on what my mother wanted, and told me that I was an adult, and should make a solid effort to do better…to <i>really</i> try, rather than try half-assed. Some areas improved, others didn’t…I finally decided that I was ruining my life, and wanted help. He asked me a whole checklist of questions, decided it was worth a shot, and prescribed Adderral for me. It has only been about a month, but it has helped so much…I can now sit down and work on a music theory assignment for 2 hours between classes (I used to go to my dorm and play on the computer) it has reduced my appetite and I don’t eat when I am bored either (I am overweight, and have lost 10 lbs. so far…) And when I am singing in choir, I can concentrate on being musical, and just <i>singing</i>, not worrying about other classes… Adderral has made me more ambitious overall. I read some information when I started taking it. I was concerned of the addictive effect, but I do not experience the “need” to be on it, and I don’t crash when it wears off…often, a behavior change kicks in that I have accomplished so much that day, that I want to continue it into the evening…
I also know that should I decide to have kids (in like, 10 years!) I cannot be on the medication…I think that once I graduate college, I might go off of Adderral, because I will have accomplished my goal (becoming a choir teacher) and the ADD probably would not be a problem then. Well, of course, it is too soon to tell…but YES, I have ADD (never been hyperactive) and yes, medication is working for me. But everyone is different…
<End long boring post>
Well since my original post I made the decision to give my son the lowest prescribed amount of ritalin and after 3-4 weeks here is the results. His grades have come from D’s to B’s. His behavior is much improved in the classroom and he is enjoying school much more now. We give him 5 mg twice a day with…and I think this is important…“holidays” on weekends and any day that he is not in school. He will not get the ritalin this summer either.
This was also the teacher who had a thing against step-parents. She didn’t feel that in any situation that they treat step-children as well as “real” children. Because of course she had been there and had a bad expirence.
With Joshs’ perfectionism it was in spelling and penmanship during timed tests. She actually came up with the idea of rewarding him for leaving mistakes alone. I guess I don’t really think it was the fact that she mentioned it, it was the way she went about it.
aha, have you talked it over with your doctor about the affects of taking him off and on a controled narcotic? If Joshua misses a dose it can get pretty ugly.
OTOH I am very happy that things are going much better for you. Does he feel a sence of acomplishment with his grades and his daily routine now? I loved that feeling when I saw my son feeling good about himself!
The sad news in all this is that he is starting to act out again. The doctors evaluate him every six months for weight and tolerance and I think we are going up in dose. He is on a fairly low dose right now. 10mg three times a day.
Keep up the good work, and keep the faith. Let you son know that I am wishing him well. It is hard to medicate your child and it takes a lot of courage.
Mistress Kricket
Are you stuck on stupid?
Kricket you ain’t nothin but a sweetie.
We have him on “holidays” on our doctors advice… Seems he has a son that is also on that regiment.
PS I will relay your kind thoughts to my son.
They May Put Me In Prison, But They Can’t Stop My Face From Breakin’ Out
- famous C&W song *
Yours truly,
aha