ADHD and the World of Pharmaceuticals

If you’ve read this blog before, which I think most (or all) of you probably have, you know that Theo has ADHD (along with autism and anxiety), and that up until now, we had opted not to use medication.

It’s not that I was anti-medicine. I mean, maybe before I had kids I was a little judge-y about it. Aren’t most of us? “I’d never medicate my children!” And then if you have children who have difficulties…well, maybe you change your tune.

But still, it wasn’t something we wanted to jump into at the first sign of difficulty. We wanted to exhaust as many non-medication options as we could before turning to pharmaceuticals.

This past weekend, we turned to pharmaceuticals. With Theo’s blessing—he has actually wanted to try them for the better part of a year, and we kept holding off. And now, I kind of wonder why we did.

The difference is amazing, even in just four short days. After discussing options with a child psychiatrist who will be managing Theo’s medication (because our pediatrician was more comfortable with his meds being managed by a psychiatrist, given his “complex diagnosis,” in her words), we opted to try a stimulant medication. There are nonstimulant medications on the market for ADHD, but the psychiatrist commented that children on the autism spectrum sometimes react differently to medications than typical children. In my autism parents group, there are many children on ADHD medications, because ADHD commonly co-occurs with autism. And in everyone I’ve talked to from that group, nonstimulant medications didn’t work, and they eventually had to switch to stimulants. Also, the psychiatrist commented that nonstimulant medications can take a month or so to take effect, whereas stimulants are short-acting and it is nearly immediately apparent whether they are working or not. Given that we didn’t necessarily want to do long-term experimentation with meds on Theo, something that we could see the effectiveness (or lack thereof) right away had great appeal.

So, we went the stimulant route. And, as I said, the difference is amazing. My fears of turning my child into a “zombie” were unfounded: Theo is the same old Theo, just much less stressed, much more relaxed, and downright pleasant to be around. He’s still friendly and talkative and active and fun—just without the explosive tantrums and the inability to complete even simple tasks without frequent reminders. In fact, he doesn’t appear to have any side effects from this medication yet, other than getting a little crabby right around bedtime, when it’s wearing off for the day. (He’s on a twelve-hour medication, and he takes it first thing in the morning.)

I can’t tell you what a relief this is—for all of us. Because as feisty by nature as Theo is, I’m quite sure he didn’t enjoy constantly being in battle with us. Over the past year or so, his difficulty with focus and impulsivity has made it so that he’s frustrated and angry nearly constantly—it’s been a vicious cycle. He would act impulsively, which often meant he had some consequences—and then he raged loudly and without end about the consequences. He couldn’t focus long enough to complete simple tasks, and then he would be angry with himself for being unable to complete the task.

It all turned into an endless cycle for him of disappointment, frustration, anger, yelling, and consequence. And it was making him very, very unhappy.

As for Chris and me, we went to bed every night physically and emotionally exhausted from trying to parent an explosive child. I cannot tell you how many times I broke down and cried because I just didn’t know what to do, how to help him, or how to keep my own sanity.

And Sam seemed to largely roll with it, but I can’t imagine the constant yelling and anger in the household was particularly good for him.

The last four days have been like a dream. I mean, don’t get me wrong: I don’t have a perfectly angelic child suddenly living in my house. And honestly, if I did, I’d feel like the medication had taken away my child. Because Theo is, at his core, a feisty sort—and it’s part of what makes him who he is. I didn’t want to take that away—I just wanted to strip away the constant cycle of frustration and anger he was locked in.

But the last four days, his frustrations are manageable. He seems able to accept and roll with them in a way he never could before. Last night he was irritated because his classmates had been loud during the day, which was distracting to him…but he was able to constructively think about solutions, rather than just raging and yelling about it.

And the morning routine? Sure, he still lollygags about, but he’s a little boy—little boys do that. The difference is that now he can focus on getting his shoes on. He might choose to sit and chit-chat instead of doing it, but it’s not that he can’t do it. And before, his executive functioning had gotten so rough that he could barely even manage a simple task without yelling in frustration.

It’s like the medication has helped strip away much of the frustration that was plaguing him, leaving the wonderful parts of Theo that I would never want to lose. It is, quite simply, a godsend.

Will it last? Who knows. I hope so—for his sake and for ours. We’ll take it one day at a time. For now, I’m just happy that he’s no longer living in constant frustration, and we’re able to relax and enjoy him.

Pharmaceuticals for the win…

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