I have been writing for the Winnipeg Parent for many years, and have avoided writing about the topic of medicating children for all these years. It’s a touchy subject, for a number of reasons. If you are leery about medicating your child – me too.. and, I don’t take the decision lightly. My motto is ‘meditation for the nation’ – not ‘medication for the nation’. I teach meditation as a tool for children in most all of our groups (especially the groups for children with Attention Deficit Hyperactivity Disorder -ADHD), and it is very effective. BUT, often the people who need to meditate the most are those that are least able to structure their day so that they can consistently do it. It’s like a comedian with ADHD said: ‘if I could remember to take my Ritalin – I WOULDNT NEED IT!’ Although it sounds funny, the truth is that sometimes, medication is needed to enable the individual to successfully implement the behavioural changes that they need to make. What I tell these parents is to look at medication like training wheels – once the behaviours are solidly established, medication can often be taken away. Still, the thought of medicating a child scares many parents. Here are some of the most common fears that I hear. By the way, I am speaking primarily about medication to treat ADHD, not antidepressant medication aimed at treating Anxiety or Depression (a more complex treatment dilemma).
First of all – let’s deal with the most serious concern. It’s scary to even think of giving your children something that affects their brain, especially when they are young and vulnerable. My thoughts: if treatment is needed because a child isn’t able to learn to read or their behaviour is out of control, there is something about their brain that needs changing. It is more effective to start an early course of treatment – before the secondary complications that develop from not treating the condition set in. Of course, the first intervention should be behavioural. However, if that does not work, you need to weigh the potential benefits and possible consequences of not medicating. Children with ADHD who neglect to look both ways before they cross the street or dash out in parking lots are at risk for accidents. It is rare that I suggest that parents of children under the age of six ask their Physician about medication. However, if this truly is a risk factor, I recommend that parents have that discussion with their child’s Physician. Here’s another FYI - adolescents with ADHD are much more likely to be involved in motor vehicle accidents, and medication lowers that probability. Other less obvious risks associated with inadequate treatment include: academic failure that occurs when the impact of Learning Disabilities is compounded by inattention; and, lowered self-esteem that arises from being identified as a ‘trouble-maker’ or losing friends because you are too ‘intense’.
Second concern: how do I, as a parent, deal with the fear of the unknown – and the guilt of giving my child a substance whose long-term side effects may not be known. Some parents say ‘how can I make that decision for my child’, and I tell them that they have to – it’s their job. My children all have Crohn’s disease and when they were young, my husband and I had to make the decision to follow their Physician’s recommendation for medications that have all sorts of nasty short- and long-term side effects – cancer, infertility, weak bones, stunted growth. It is one of the most difficult decisions we made – BUT, it became easier when we saw people losing their bowel to disease when medication could have prevented it, and years of happy life lost to months of being sick and in the hospital. As for the guilt? Here’s a funny story. Over the holidays, one of my children insisted that they wanted a higher share of their inheritance to compensate for loss of inches - because they had taken a medication that has known side effects of stunting growth. My children have inherited my extremely warped sense of humour, so I am pretty sure that the banter that went on for many days was in jest. Ten years ago, I would have felt EXTREMELY guilty and probably lost a lot of sleep over the fact that my child was troubled by loss of height. Not now – I know that it was the right decision – even if my estate does have to deal with a lawsuit. But by then, I won’t have to worry about it! So shed the guilt, read literature from reputable sources (not blogs that are funded by herbal remedies), and work in collaboration with your child’s Physician. There are ways to avoid potential side effects by planning pro-actively.
Third concern: medication is sometimes looked upon as a huge white flag of surrender and defeat – ‘if only we (or the child or the teacher) tried a little harder, they wouldn’t need medication’. I have two things to say about that. First – ADHD is often inherited (a little different from Insanity – which is also inherited - but you get it from your kids). Accept that fact, realize that you didn’t ask for it, and don’t beat yourself up about it. HOWEVER – do not expect that your child should be able to do better than you did just because you survived long enough to share your genes. We know that ADHD is a deficit in executive function of the brain – an area that is controlled by the frontal lobes. Children are not born with fully developed frontal lobes/executive functions (the areas that affect impulse control, emotional control, organizational skills, short-term memory). When children are born, parents have to loan them their own frontal lobes - until the child starts to acquire skills, and parents can stand fade out direct controls. If you yourself have executive function deficits, you don’t have enought to loan out. Sometimes, I half-jokingly tell my clients that at least one person in the family needs to be medicated. Not so funny…. But if you are having a hard time organizing yourself, maintaining emotional control, and parenting consistently - it’s something to consider. Once you yourself have your act in order – reevaluate whether your child is able to make the necessary changes when given every opportunity to do so. If not, medication may be a temporary set of training wheels - for both of you.