Choosing not to medicate 7yo with ADHD

[rehearseit]

My son is 7, has ADHD, and is currently not medicated. More and more people keep trying to push me towards medication. I have done a lot of research and agree that it must be life changing for some people. My reasons for not medicating are due to the fact that he does a high intensity sport that is his sole focus outside of school. He eats, sleeps and breathes it. He's obsessed with it, and it regulates him to no end. He does ok at school and whilst he struggles with focus, the only thing he is behind on is reading/phonics, but not majorly. He has great friends, is super social, yes he has big meltdowns, but things are a lot better since I have been implementing coping strategies.

Despite this, my family and a couple of friends keep ranting on about how I should 'try some meds'.

It's making me question myself and my choice.

I worry about the affect on appetite and growth, and also whether he really needs it.

AIBU to not medicate?

The meds are there for if/when other strategies are no longer enough to help him thrive. Why would you medicate if he is doing well?

My son's consultant advised we think about medication because many children with ADHD do ok at primary school but really struggle at secondary. Not sure where you with CAMHS but the waiting list for medication (even after you've got the diagnosis) can be months to years, and then sometimes it takes a while to get the prescription filled.

We were unconvinced but he did a great job of talking us through the options and reassuring us that we weren't committing to anything - we agreed to carry on through the process, get the drugs, then decide at that point whether to actually try them.

The first line drugs don't stay in your system - you take them, they work for a few hours, if you decide against them that's it, you just stop. In DS's case we tried them and he immediately completely stopped eating and sleeping. We stopped after a week or two. We did try the next type of drug, but for those you have to take them consistently and he refused.

in my son's case his primary diagnosis is ASD/PDA and we didn't feel particularly strongly about medicating the ADHD so we're happy to have stopped going down that road, but also have no regrets about trying them out. At least we know they're not for him.

If you do have any thoughts of maybe eventually wanting to try medication and the waiting list is long, there's no harm in at least discussing it with CAMHS. It doesn't mean you're making a commitment and then if friends & family keep going on about it you can reply knowing you're fully informed. Plus, if you're on the system and you change your mind in a few years (e.g. fir secondary), it's quicker once you're already in the system

Not necessarily. Many people choose to say they are ADHD/ND rather than they have it, they see it as a core part of their identity rather than something to be fixed/cured/treated, like a fracture, or diabetes etc. Just like many people with autism prefer the term 'Autistic person' rather than 'person who has Autism'. You prefer it they way you stated it, and you have a right to be referred to in the way you chose, but I'm just pointing out there is no right or wrong, only an individual preference

He's still young yet, meds will still be there if he starts struggling more as he gets older.

What I would do though is be sure to read to him and listen to him read every single day. If you struggle with reading then it often makes everything more difficult at school.

I would also say though if he already has ASD and ADHD it's possible he's also dyslexic as ND conditions are highly comorbid. Just something to consider.

No, I wouldn't medicate if he is fine at school.

I think 7 is very young for medicating. And the fact is they really don't know what the long term effects of those drugs are on kids' brain development.

In any case there are a lot of other things I'd be trying before medication at that age. Lots of physical activity, which you are already doing. Getting rid of screens or severely restricting - especially video games.

Also, looking at the school environment or expectations, which I think are really inappropriate for many kids at that age. I actually home educated my son at that age who was not at all ready for sitting down seat work to the degree the school would have imposed. He was also a late speaker and reader so would have been set on a course to have issues that way. Home educating is impossible for many of course but I would absolutely be thinking about whether the school environment was creating problems.

You have to do what you think is right for your child but I have a few thoughts from experience.

• Is it possible that bigoted views around medicating adhd and parents who just want an easy life aren't clouding your judgement? The best parents in the world often can't solve issues that come out of adhd.
• When the physical hyperactivity is very prevalent its easy to assume this is the main symptom and its manageable through sport. You have to match that activity with what his brain is doing and wonder how you will help him address racing/obsessive thoughts. Its not as easy and potentially devastating to mental health. Maybe early medication will help give him tools later in life but children are too young to regulate their thoughts.
• There are many different medications. A non-stimulant might be more suited to you if you have concerns around weight and food.

It sounds like I'm advocating for medication - I'm not - but just suggesting its worth questioning why you are so against it and if thats really valid.

I think it’s great that you have put lifestyle strategies in place and it sounds like they are currently working well. This is actually the best foundation, with or without medication as even if you choose to medicate, the good habits; strategies, exercise and a healthy diet really need to be in place.

What I will say though is that the drugs are all short acting, even those referred to as modified release still only last around 12 hours. It also isn’t necessary to take them daily, so for example, some people choose not to take them at weekends. This means that if you decide to try meds, your DS doesn’t need to take them continuously.

Most people want the effect of the medication early in the day, but then individuals may choose short or longer acting treatments depending on whether they need the effect to continue into the afternoon, others choose to top up with a short acting drug to extend the benefits. It would be about what works best for your DS and your family set up and may take a little time to find the best regime. The key is that it’s not a permanent, fixed pathway but an individualised solution.

That still doesn’t answer the should you question and my advice would be to keep an open mind. It’s not unusual for bright ND children to cope well in primary and then struggle in secondary, but if your DS is dysregulated at times now, I would be honest with yourselves about whether he is truly coping well. If so, don’t discount a proven treatment, just because you didn’t take it.

I suppose I'm not sure why you wouldn't try it? I've know so many people with ADHD who say they didn't realise they were living life on "hard mode" until they tried meds, and were able to experience the difference.

Just something which stood out to me - you said he struggles to sleep and struggles to gain weight. There is a strong correlation (not causation) between ADHD and coeliac disease. My daughter with ADHD really struggled to gain weight. We thought this was because she struggles to stay at table to finish a full meal as a slow eater and gets distracted. But turns out she has coeliac disease and her weight went from 17kg before diagnosis to 25kg a few months post removing gluten. So just something to consider.

It's completely fine not to medicate. To use the illness analogy that some people have used (even though I think the comparison is dubious), you wouldn't take antibiotics for an infection that wasn't causing a significant issue. If he is doing well with the strategies you have then why would you medicate now? Yes, he/you might want to try it later, but that doesn't mean you have to do it now.

My DS (likely ADHD but we're on the waiting list for diagnosis) is unlikely to be able to take medication because of other medical issues. I find it really reassuring to hear about people doing well without it and using other strategies instead. Sometimes it feels like there's a huge mentality of "how do we fix this?" rather than how can we help you work with the brain you have.

Because many of us adults who did struggle as children because diagnosis in childhood was difficult found the opposite of this; "Maybe early medication will help give him tools later in life but children are too young to regulate their thoughts."

We developed skills and tricks, we appreciate the gifts that ADHD brings (although it takes a lot too). I have a job that requires a lot of adaptability, quick thought, emergency management. That's when I come into my own. I love travel to really far-flung and interesting places, which is genetically linked to ADHD.

And most importantly, I have shared all my tricks and tips with DD, so she is ahead of the curve with her ADHD symptoms.

I'm not sure that living life on easy mode appeals. DD feels the same.

Not to say that's true for everyone. But it is for us.

Lovely x-post. Yes, you can work with ADHD brains. It's really hard but very rewarding.

Sounds like you know then and don't need to do an AIBU on the internet?

Fair enough by the way - I have 2 ADHD kids, one we medicate one we don't. The one we don't is because I think he's OK without. Meds are a big deal and shouldn't be given if not needed.

Snap.

If you time travelled, diagnosed the schoolchild version of myself, medicated me… I might have be easier to shove in a round hole.

But then a round hole would have been the thing I’d be expected to shove myself into forever, because it was possible, with medication to make me who I’m not.

I knew I couldn’t be round, and so by trial and error I built a square peg life.

I like my square peg life. I don’t want a life that I’m not built to thrive in on “easy mode” because I’m medicated.

I’m not broken, just different. Which may yet turn out to be a blessing since we are going through the equivalent of the Industrial Revolution at warp speed nine. My capacity to duck, dive and innovate is not just intact, but finely honed. Because it had to be.

I’d also be a bit fucked if medicated into a more standard life, because I still work, but now also have conditions that means ADHD meds could come with side effects that affect my heart. That wouldn’t be a fun place to be. Stay medicated, keep life, potentially damage heart, or choose heart and lose standard looking life. Starting all over again as I pootle towards my sixties.

Thanks, but no thanks.

Get a book called Toe by Toe and work though it at least 5 days a week with him at home. I used it for my daughter at a similar age and it’s a fantastic resource.

Has anyone explained the impact of this common occurrence though?

It is quite common for some students with ADHD to do well at school, hold their emotions together, but then have bigger meltdowns at home.

Imagine being a kid, trying to learn, trying to please people, but also trying like hell to hold all your emotions together all day. It's both physically and mentally exhausting. Then they go home and erupt, like mini volcanoes.

I don't think that anyone wants to give their child any sort of medication that they don't need, but imagine being that child, the hard work they have to put in, just getting through each day, without their emotions exploding, now, imagine if the medication took that issue away and just allowed their brain to relax, to get through a day without their bodies almost being on high alert to defeat those big emotions. I'd want that for my child.

Would you think about trialing the medication for a few months and see what sort of a difference it makes?

i dont know what is the right answer, but i just got diagnosed and medicated at 36. I cant believe the difference. I can now sit down and read a book. it is such a bitter sweet feeling, I wish my parents noticed and given me medication when I was at school. It would've probably changed my life. But on another side I am not going to lie, stimulants are a little heavy on the system. I would say tiresome so I can see why you are reluctant. Personally, my child is likely to also have adhd but she is still little so not on the waiting list yet, but when time comes I will try medication, because I know the alternative.

You shouldn't start them until both you and his dad are 100% on board, DS' doctor said he wouldn't start unless I was 100% sure so if youre not there, youre not there

DS has ASD as well and medication has been life changing in a way none of the other strategies, interventions and practitioners were but it can be a trial and error so it's pointless starting until you are all ready

Good for him! You might find he needs protein shakes or Greek yoghurt or veggie sausages for snacks. Just more of everything he does eat!

I'm a retired secondary school teacher.

I've seen some children where the medication seemed to be to the detriment of the child. I recall one boy who came off it when he was 13 and blossomed, academically speaking.

His mother told me that she'd reluctantly placed him on it at the insistence of his primary school. (I only have her side of things, of course, and I'm aware that staff wouldn't have the right to insist on a child being medicated.)

ADJD meds were the difference between my highly capable dd dropping out of A levels with burnout and taking up a university place via an access course.

Gamechanger. .

AdHD has wrecked all my dc’s education and life and mine. I am very much under achieving in my line of work and not earning what I should as I’m in a role that is way under what I am qualified for. Think minimum wage. I have a degree.

All my dc are bright and were way ahead of the curb at 7, things were ok at 10. Same with me.Transfer to secondary was when the wheels stayed falling off, big time! ADHD then had a catastrophic impact as regards mental health difficulties and on education. 2 are now medicated in late teens and the difference has been astounding. I feel so bad I didn’t sort it before. Another can’t have ADHD meds just yet because he is being treated for something else. I’m unmedicated as feel it’s too late( late 50s) but so so wish I’d started at year 7 as I feel my outcome in life would have been very different.

It’s fine if the time isn’t right just now but OP you are going to have to be very proactive come secondary school. The wait just for medication reviews to start meds are now insane so even if you decide you want to start in year 7 you may have a long wait.

I've not used it myself, but I had colleagues who recommended it.

Ditto. Dd wasn’t in school for much of secondary due to MH struggles as a result of her ADHD. Now getting consistent distinctions on her ACCESS course and applying to uni.