3 Reasons Parents are Reluctant to Treat their Child’s ADHD with Medication

Your child has been diagnosed with ADHD, now what? Maybe it confirmed what you suspected for years and you have a name for your child’s atypical behavior. As easy as it is to focus on the problems, the struggles, and the battles, you might have already realized that there are many strengths that come with ADHD.

While treatment of ADHD is a multifaceted approach, the scope of this post will focus on parental reactions to the diagnosis of ADHD and how best to move their children forward to get the help they and the entire family needs.

I’m addressing parents who have actually received a formal diagnosis from a psychologist or neurologist.  I hear parents tell me that they think their child has ADHD but have not sought out an evaluation for various reasons.  Such assumptions can unjustly label children with a neurological diagnosis where none is warranted. 

 

What exactly is ADHD?  Here is an excerpt from an article in ADDitude magazine:

“ADHD is a neurologically based disorder, resulting from the deficiency of a neurotransmitter, or a group of neurotransmitters, in specific areas of the brain. Neurotransmitters are chemicals that transmit signals between nerve cells by bridging the synapse (or gap) between them.2The key neurotransmitter involved is norepinephrine, along with its building blocks, dopa and dopamine. In theory, the primary medications used to treat ADHD stimulate specific cells within the brain to produce more of the deficient neurotransmitter. That’s why these medications are called stimulants.”

Unless you have been living under a rock you’re probably aware that ADHD is overdiagnosed and children are overly medicated. This is a problem in our school system and pediatrician offices. Active 8 year old boys who have trouble sitting in a classroom does not warrant an ADHD diagnosis. It is so much more than that!

Diagnosing ADHD is a lengthy comprehensive evaluation that must be completed by a psychologist or neurologist. It is not a simple internet check list.

However, with that being said, most parents who question ADHD diagnosis are usually right. These are the parents who usually do some research and see that their child’s behavior is more than just struggles with inattention and impulsivity.

The classic symptoms of ADHD, inattention and hyperactivity are at the tip of the iceberg that penetrates above the water surface. 

They’re so much more below the surface. If you’re one of these parents who have read and researched I strongly suggest you seek out a diagnosis so you know exactly what type and severity of ADHD your child is struggling with.

If your child has untreated (not necessarily unmedicated) ADHD, then I can assure you they are struggling not just in school, but in life as well. They are probably struggling with social interactions as well.

As with most mental health or neurological diagnoses, a two-prong approach is necessary: counseling and medication. Moreover, ADHD is a neurological disorder. The brain is not functioning as well as it should, could, or can. 

 

Now, on to the top three reasons parents are reluctant to utilize medication to treat their child’s ADHD.

Natural Treatment

My guess is if you are reluctant to try medication with your child, you have probably tried other natural remedies and supplements (If not see sources section below). How effective have these remedies been? Did you give them a long enough chance to work (three to six months)? Are you seeing any improvement in the most problematic symptoms? 

For example, if sleep issues have slightly improved but focus is still just as problematic, then your child is still struggling at home and school. 

The road to finding natural solutions and waiting for efficacy can be a long and winding road. 

There is so much misinformation on the internet and anecdotal stories that it can be hard to know which remedies or supplements to try.

In his book Finally Focused, Dr. James Greenblatt emphasizes that the vast majority of children diagnosed with ADHD are deficient in the mineral magnesium. Once supplemented symptoms can drastically decrease, and it can mitigate side effects from ADHD medication as well.

I know a newly diagnosed family who was really struggling with ADHD symptoms during  break periods such as weekends and summertime. While the neurologist gave the green light to stop medication during those times they couldn’t imagine life continuing with such unmanaged symptoms. They were still in the process of finding a therapist and getting educated themselves about the diagnosis through books and ADHD websites that they weren’t sure what to do.

The weekends were a frequent struggle constantly managing their child’s behavior. They were baffled as to what to do which led to frustration and short-temperedness. The child was frustrated with himself, questioning why he couldn’t have more self-control, questioning what he can do with his restlessness. As much as they were hesitant to use medication during those non-school days for the sake of family unity they used it until they could learn more. Family relations improved.

Meanwhile,they supplemented their child’s diet with magnesium and within 3-4 months their child no longer took their prescription medicine during weekends or Christmas break. It wasn’t a cure-all but it definitely helped.  Medication was still needed to focus and manage impulses during school days. It made all the difference in the world. 

Before diagnosis, this same child described getting through his school day without medicine as walking through molasses or quicksand.  They harder you try the deeper you get and the more you struggle.

Without the medication, everything took so much longer, learning wasn’t taking place, and he was so frustrated and discouraged. It is estimated that a child who has untreated ADHD is only retaining about 10 to 15% of what is presented to them in school. Asking a child with ADHD to try harder and focus more, is like asking someone who is bound by a wheelchair to climb the stairs.

Rigid Beliefs

Often times I hear parents make blanket statements that they will never put their child on medication. Upon further probing, these hard-and-fast beliefs are usually rooted in the inaccurate belief that ADHD is a behavioral disorder and not a neurological one.

 They still think that if their kid tries harder and is properly motivated than they can overcome their “laziness”. Often times parents mistakenly believe that they will outgrow ADHD. Children with ADHD grow up to be adults with ADHD. AS an aside,adults usually have found many ways to compensate for their symptoms and their hyperactivity usually morphs into restlessness. 

There is no buy in that ADHD is usually genetic and not something the child can help. This usually stems from parents unwillingness to read and learn about what ADHD is and what it is not. They are just stuck in their unexamined beliefs.

I get it, most adults don’t want to have to take medication let alone give it to their still- developing children. A medical analogy that lends itself well to ADHD is a child diagnosed with diabetes. A diagnosis that is devastating for any parent. The pancreas is simply not working as well as it should be. A two-pronged approach must be utilized. Insulin is a necessity and a modified diet is in order. Just as the pancreas does not always work the way it was designed to, so it is with certain areas of our brain sometimes.

Side Effects

Most parents have heard that stimulant medications have undesired side effects, such as decreased appetite, headaches, or agitation. While it’s true that those are some common side effects, there are options which do not always involve taking another prescription. There are two classes of stimulants, amphetamine and methylphenidate. 

 In addition, non-stimulant medications are available when stimulants are not well tolerated (Silver, 2019). Switching medications or class of medications can help reduce or even eliminate side effects.

Supplements can also be useful in managing side effects. For instance, the vitamin riboflavin, (commonly known as B2) can be taken to prevent headaches. It is a capsule that can be swallowed or sprinkled in applesauce. 

To address the decrease in appetite, it is recommended that children eat a full breakfast then take their medication. Lunch is inevitably going to be their lightest meal of the day. Their appetite is usually restored by dinner time. It is important to allow children to have a snack after dinner because they are usually hungry and it makes up for the missed calories from earlier in the day.

Medication should not make a child into a zombie. 

If that is the case, they are on the wrong medication or the wrong dosage. They should and can still feel like themselves only much more focused and confident because they are able to do what they know needs to be done.

In children (and adults) with ADHD, the pre-frontal cortex (the area of the brain behind the forehead), is underactive and therefore underfunctioning.  Dr. Amen, author of several books on ADHD refers to the ADHD brain as a “sleepy brain”. This is why a stimulant medication is usually the first treatment protocol, because it wakes up this part of the brain so that it can function as well as it should, could, and can. It engages the brain’s ability to focus, sustain attention, increase self-control to manage impulses, and decrease restlessness.

For most children, stimulant medication is metabolized by the end of the day. Think of taking a Tylenol to alleviate headache. It is short-acting. You don’t need to take it everyday. 

With an open mind and a collaborative effort between parent, child, and prescriber side effects can be easily managed.  Often times the benefits greatly outweigh mild side effects.

 Simply put medication for ADHD works. It is quick and effective.

 

Sources

Amen, Daniel, M.D. (2013). Healing ADD. New York, NY:The Berkley Publishing Group.

Greenblatt, James, M.D. (2017).  Finally Focused. New York, NY: Harmony Books.

Silver, Larry, M.D.(2019, August 30). ADHD or ADD Medications for Adults and       Children:  Stimulants, Nonstimulants & More. Retrieved from https://www.additudemag.com/adhd-medication-for-adults-and-children/