Some random thoughts and rants I’ve had lately about parenting and ADHD…
(sometimes I think I should be making these stock answers when the subject of my child’s ADHD comes up)
Please stop telling me I should try changing what my kid eats: My child acts no differently (and I mean absolutely NO differently) when he has sugar, dyes (though this is something we have very little of anyhow), preservatives, milk, wheat (gluten), eggs, peanuts, or any other trigger foods than when he has not had them for any length of time. If you tried an elimination diet for your child, and it worked “miracles”, congrats. I am very happy that it worked for you.
I’ve read plenty of data (here’s an interesting meta-study) on the topic. To be honest, its spotty (and often poorly carried out, or a perfect example of correlation vs causation), and much of it suggests is that elimination diets help those children that have food allergies and/or sensitivities in addition to ADHD. We tried it anyhow–been there, done that, and it didn’t work for us (actually since Sharkbait is a picky eater (like many ADHD kids) and he ended up hungry and cranky–about 10 times worse, behaviorally).
Medication is not a last resort: Very often, I see or hear someone say something along the lines of “medication should be a last resort”. Sometimes its prefaced by an idea that ADHD isn’t “real” or ADHD is “over-diagnosed” or ADHD is a “natural variation that we shouldn’t be trying to change”* or ADHD can be “cured by (enter natural remedy of the hour)”. But either way, about 3/4 of the time, someone, in a conversation about parenting a child with ADHD (whether or not the conversation is actually between people actually parenting kids with ADHD or not) will say “medication should be a last resort”. I used to be guilty of this.
And now, having made medication the last resort, I wish we hadn’t. We spend a very hard, long year and a half doing everything else, and if we had been more open minded about medication, we could have saved a lot of stress, heartache and struggle for all of us, individually, and as a family. I’ve seen lots of people site bad experiences with medicating, but its has been my observation that “problem” often arise from any number of problems that aren’t generally the medication itself (for example, if a child is “a zombie”, its probably the medication, its the over-medication or the wrong medication that is the problem, or it might be the problem of allergies or a sleep disorder instead or or in addition to ADHD…and if a child isn’t helped, it doesn’t necessary mean that medication doesn’t work, but that a particular medication or dosage isn’t right).
Medication isn’t some sort of magic bullet either. You need a good doctor (preferably a specialist) that knows the latest information and is willing to help the find the right complimentary therapies and right dosing for their child. It can take time and trial and error to find the right medication and dosage. For many children, meds take the edge off, and make it easier to learn the executive function skills that come easily and naturally to the rest of us (which is why studies with meds and therapy show better results than just meds or just therapy). Overwhelmingly, studies show that proper medication in conjunction with behavioral therapy is the most successful way to teach kids with ADHD to cope with the differences in their brain and the demands of the environment that they live in.
With that all of that being said, I don’t think someone should automatically rush to medicate either. I think the decision to medicate or not should be made carefully with the assistance of everyone involved (from kid to doc), in conjunction with behavioral therapy, plenty of outdoor and active time, and with whatever other assistance the child might need. Medication takes as much time and tracking and adjustment as keeping a food journal for an elimination diet does…but it works for most kids with ADHD (when it is done well). But really, I don’t think my decision to give my child medication to help him learn to manage his behavior more effectively (or not) is anyone’s business but mine, my doctor’s my child’s and my spouse’s.
But. Whether you choose to give your child meds or not, the whole “medication as a last resort” phrasing can do more harm that good: This idea can create a mentality towards those families that have chosen to medicate that medication is unnecessary. It burdens the parent(s) and child(ren) in those families with the judgement that using medication equals failure. It comes off as not being good enough–either as a parent (in terms of parenting skills) or as a child (for not “trying” hard enough or having enough “willpower”.
I say this, not to blame or same, but because my brother, who has ADHD, told me, when I used that phrase in a convo with my mom about my son, that he found it hurtful, and that it felt like I was saying he wasn’t trying hard enough because he found medication helpful (he now self-medicates with coffee rather than the non-stimulant medication he was on before). I was pretty well floored, because I’d never looked at it that way…and, I’m pretty sure, that no one here has intended that meaning either, so I wanted to point it out.
And while I’m at it, on the subject of food and medicine and ADHD…if giving your kid coffee or another caffeinated beverage works (and it often does, I know more than one person with ADHD that effectively self-medicates with caffeine), I’m very happy for you too. But please, PLEASE, PLEASE, don’t go around saying that you aren’t medicating your child. Caffeine is a drug. In fact, caffeine is a highly addictive and habit forming drug. In fact, I am married to a (wonderful) man that is addicted to both caffeine and nicotine because he got in the habit of self-medicating his ADHD, rather than taking medication properly and (before it was the thing to do) getting behavioral therapy to learn to manage his ADHD behaviors.
*I have only one thing to say about this idea…I get it, I really do. I even agree with it to an extent. I fully believe that ADHD is a natural variation of the brain, and that having ADHD (despite its name) isn’t a “disorder” (in a negative sense) per se, nor a “disability”–that its just a difference. Unfortunately, our society is not built in a way that appreciates individuals with profound ADHD and no coping and social skills. And, rather than ignore that fact, I feel that it is my job to help my child deal with society as it is, rather than hope that society will adjust to his individuality. Because really, its far more likely that a person unable to adjust to societal expectations in a healthy way will get crushed than not.
For some parents, this might seem like an anathema. For some people, this might seem like I’m giving in to the man or the process or whatever and stifling my child’s creativity or individuality or whatever. If this is your opinion, you are welcome to it, I just happen to disagree…until society changes (which neither happens overnight or with one person), my job is to teach my kids to play the hand they’ve been dealt with WHILE they seek to further the change that they believe in.