When we put Andrew on medication we would tell him “The medicine doesn’t make you good. It allows you to choose whether to be good or not, the medicine allows you to have the choice. You have to make good choices and that we are going to hold you more accountable when you are taking your medicine.” So we tried to do that.
A mind blower
The medication was a mind blower. The child psychiatrist said to me, “You’ll know if it’s working. It’s not like you have to wait two weeks. I think you’ll really know right away.” So I woke Megan up on a Sunday morning early and said, “Just go ahead and take this pill now. I’m not going to send you to school unless I know what the impact is going to be. Let’s see if you have any side effects or what it feels like for you so I can be home all day with you.” I just thought this would be safer if I had my eyes on her. I gave her the pill at around 8:30 on a Sunday morning and then told her she could go back to sleep. I just wanted to be sure because the Concerta all day pill had a 12 hour window. I walked by her room about a half hour later and she was in bed reading. I said, “Oh, you didn’t go back to sleep.” She said, “No, I didn’t feel like it. I’m just reading.” I asked her what she was reading and she showed it to me and then she said, “What did you end up doing last night?” I told her that we had gone out to dinner with some friends and I told her what we had for dinner and some of the conversation. She looked at me with such amazement and I said, “What are you looking at?” She said, “Mom, I think this is the first time in my life that I’ve actually listened to anything you’ve said.” She was so focused and she could feel the difference immediately.
Talking in complete sentences
The first thing Emma did on medication was she started talking. I mean in complete sentences. Now this is a child who has a lot of different kinds of problems and one of them is that she really didn’t speak until kindergarten. She wasn’t really talking and certainly not in full sentences and certainly not several in a row. But on the first week on the Concerta she could tell us things very clearly. She had never told us about things that happened at school before; you would ask her and she would say “I don’t know” or “I don’t remember.” All of a sudden she was telling us about things that had happened at school and discussions that she had had with her teacher about certain topics. So that was the first week and so I thought, “Well, that is pretty amazing.”
Finding the right fit
We did have to try different medications before we found the one that fit. With Adam, we tried Ritalin, and he was really aggressive and moody to the point where I’ve never seen him like that before. And then my daughter Ellie tried Concerta, and she was really hyper. Not every medication works for every kid, but luckily Adderall does work for all three of my kids. It’s kind of trial and error–you do see a difference, and sometimes they do become a little bit more sensitive. And on days they don’t take it, they might become a little bit more moody, which is kind of frustrating, but kids do that, it’s just the age.
We had to switch a lot because Lindsay had a lot of problems with side effects from the medications. She’d pull out her eyebrows and eyelashes. But the medication would work for her, so it was kind of like we had to live with the side effects. And then she finally seemed to outgrow that only like in the last year. But there was a give and take. Some of the medications we haven’t changed, but we had to switch hit sometimes. But there was a big difference in her concentration with the medication. We needed to check with the teachers, and we’d see if they noticed any difference with one medication or another, and go by that.
No more summer break
I used to take Lindsay off the medication in the summer to give her the break. Around eleven, I ended up having to keep her on in the summer, because she was just a powerball. She was so impulsive, so disorganized–it was just a terrible summer. And at that point the doctor said it really wasn’t worth it for her taking off of it for the summer.
In terms of taking the medicine, Nick knows it helps him. You can tell the minute it kicks in with him. I mean, you can really see it. It’s like, twenty minutes. He can sit and listen to what you’re telling him to do. And if you give him a three step command, he can do three steps. If you give him that three step command without any medicine, he might do one and a half, maybe.
Used to dread public places
I used to dread taking Emma to a store because as soon as you went in a store she wanted to buy something for herself, normally some sort of toy. And you couldn’t do anything because she basically was beelining for the aisle that whatever she wanted was in. Many, many, many times I pretty much physically picked her up and took her out of the store screaming and kicking. If I really had to buy something I ended up physically holding her until I could pay for whatever I needed to buy and get out of the store. On the medication she was able to understand “No, we are not getting that today and you need to listen and please come with me.” And then we had to walk by the Rainforest Cafe, which is a little mall restaurant that has animals and screeching things. It’s like a kid trap and she loves to go there. Usually I’ll let her go in and walk around and play even if we don’t eat there. But I was able to get her to just look for a few minutes and then walk away when usually I am physically carrying her away screaming. And then that week we actually went out to eat, my husband and I and Emma. She actually sat in a restaurant for a whole meal and that was the most unbelievable thing. I was beside myself telling our child psychiatrist about her ability to sit there in a chair. I mean I’m sure you’ve heard this from other parents but it was just amazing. Normally within five minutes she is off the chair, she is running around the restaurant, and it is not a fun situation. We just don’t do it. And that was an unbelievable turn around. So we’ve kept her on Concerta since then.
Finding medicine that fits
We did have to try different medications before we found the one that fit. With Adam, we tried Ritalin, and he was really aggressive and moody to the point where I’ve never seen him like that before. And then my daughter Ellie tried Concerta, and she was really hyper. Not every medication works for every kid, but luckily Adderall does work for all three of my kids. It’s kind of trial and error– you do see a difference, and sometimes they do become a little bit more sensitive. And on days they don’t take it, they might become a little bit more moody, which is kind of frustrating, but kids do that, it’s just the age.
I had no qualms
I think medication is absolutely fine. I didn’t have any qualms with putting Stephanie on a medication, when way back when it seemed that all indications were that she would benefit from it. My husband felt exactly the opposite. She probably would have been on medication about 12 sooner than she was except my husband needed more time to be convinced that this was the way to go for her. Now my husband totally understands. He saw the difference with this newer medication. So when I speak to him saying like “Well, I’ve been hearing and seeing the flags and this is what I think so I’m having her re-evaluated today,” his response is very accepting of it, that “Oh yes, that’s what it sounds like from previous experience.”
Stephanie did OK on her first medication; for a number of years we were in a situation where we felt that things weren’t great but it allowed her to learn. Then she switched her medication maybe about four years ago and this medication is just a much better match for her. Along with allowing her to learn, it’s allowed her personality back. It’s as though the first one really changed her affect; it made her irritable.
I decided with Sam’s doctor that medication would most definitely help his behaviors. I find that it has helped him so much. He is able to focus at home and school, he is not impulsive, his behavior is in control and he is not so hyper. I did find that he had side effects that made matters worse but there are trials and errors. I really didn’t want to go to this route of putting him on mediation but he couldn’t learn or function without it and that mattered more to me.
I didn’t worry about medicating Nick…I had no problems with putting Nick on medication. Maybe that was because I am a psychiatric nurse, so I knew the ins and outs of the meds. It was just a matter of finding which medication worked…I knew that the medicine wouldn’t hang around in his system very long, and because we started with five milligrams a day, and gradually increased it. And he truly has never had a side effect. So it made it easy not to have any kind of trepidation with it.
One would hope that one’s child wouldn’t have to take anything. It is always better not to take any medication in terms of they aren’t exactly sure about long term side effects and that kind of thing. On the other hand if you don’t take medication and you have ADD and you do poorly in school, you don’t get it like your friends did–you start to get depressed. That’s not good either. In Julie’s case, I don’t see doing nothing as a benign alternative. I wish that it were not an issue and that Julie did not have to take stimulants. I’m not thrilled about that. I’ve gotten quite matter a fact about it because I can see how much better she does and how much better she is. She doesn’t take it on the weekends usually. If she has a big test she might take some on the weekend. She doesn’t take it all summer either. She really uses it to go to school. In terms of the general issue, I think it is a big problem. I think it is over prescribed. I think in general psychotropic medications are over prescribed. I think we are a pill popping culture looking for a quick fix. A lot of people really don’t want to slog through the hard stuff. But I do feel strongly that it can change your life when it is the right thing. Like everything it is overused, but I feel strongly that kids who need it should have it.
I was really hesitant about medication. I certainly didn’t want to jump into medication, but, I think if you’ve tried the other things and they don’t work, then I think it’s a disservice not to try medication.
Especially with my first child I was really uneasy, because I was unaware of certain side effects, long term effects, if it would become addictive, if it would lead to addictions later in life. But I was told, and it did make sense to me, that sometimes not taking care of the problem could make kids so frustrated that it could steer them in the direction of doing drugs or alcohol to try to get away from it all.
Rather have her happy
I have a friend whose husband won’t allow their little girl to be medicated. She’s very much like Lindsay, and I see that she has such a hard time with kids, she has a lot of meltdowns, she’s very frustrated. My heart breaks, because I really think that if she was on the medication, her life would be a lot easier. Lindsay can get by without the medication, but is it worth it? I don’t think it is. She has a real hard time in school–she probably was in third grade before she could learn to read because she had such a hard time being able to concentrate, and she talked all the time about how stupid she was because she couldn’t learn to read. It’s not that she’s stupid; she just couldn’t sit and concentrate. I just don’t think that’s fair to withhold medication from a child if you can give that child the medication and help them learn, and help them feel better about themselves. I mean, Lindsay’s never been medicated to the point where she’s tired or mopey or anything she still has plenty of energy and she’s still very active. I don’t see any kind of personality change or anything with the medication. It’s just enough that I don’t even see change in her except that the teachers can see that she can sit and pay attention to her work. I don’t notice any change in her in her outside activity at all. She used to not be on medication during the summer, but she recently got to the point where she was evidently miserable without the medication, where she just couldn’t control her impulses. And that made her unhappy. I’d rather have her happy.
Wish he didn’t need meds
I wish we did not have to put Scott and Jason on the meds. But it makes their life a whole lot easier. It is scary to think what will happen to them someday. I always wonder if someday they will find out the meds cause cancer or something. It makes me sad that we have to make them fit into this world with meds. They did so well when they had a teacher willing to work with them. But if you get a teacher that doesn’t, and you’re not on meds it can be awful!
When parents disagree
Her father doesn’t like Julie being on medication. He never has liked it. She started in third or fourth grade– no maybe not that early– I can’t remember to tell you the truth. Maybe since fourth or fifth grade. He was always against it and I kind of overruled him. I just said to him, “Too bad– we are doing it my way.” I had a very strong feeling that it would be necessary. I guess he felt that somehow she could just learn to pay attention. I don’t think he saw it as I do. He’s a very accomplished writer; he has written ten books. He never did well in school and he doesn’t really care about that kind of thing. He doesn’t think that is what makes you smart or not smart. So it didn’t matter to him as much what her grades were going to be as much as it mattered to me. I don’t know why I won, maybe because I just wouldn’t take no for an answer. I’m sort of the person who organizes the children’s health care. I’m the one who takes them to the doctor, dentist, and therapist if they need one. So I just went ahead with it. He went and met the child psychiatrist and heard what he had to say and then he said, “Okay, let’s try it.” Sometimes, like when we go see the child psychiatrist, he’ll say when we get home, “Can she stop taking it?” It’s like a subtext. It’s not a big bone of contention, but I’m sure he would prefer that she not take any medication. But he can also see that she does better when she is on it.
Just because your child needs medication when they are younger it doesn’t necessarily mean–or not mean–that they’ll need it for whatever amount of time. I think some kids are going to have to be on it may be forever and some kids can handle behavior modification without any medication, and Andrew, maybe he’ll go back on it, I don’t know.
Not convinced on medication
You see so much on the news and in the media; so many kids are on these medications that they shouldn’t be. Society is trying to put all these kids in the same box and if the child is the least bit out of step with everyone else, it’s “Let’s just put them on medication.” That is a concern for a lot of parents; I know I was concerned about that. When my first son, Andrew, went on medication I felt that we were sort of railroaded into putting him on it and I really didn’t want to do that. I didn’t think he needed medication. But I was getting a lot of pressure and this was preschool! So we took him into the doctor and he said, “Well, yeah, he’s got these kind of tendencies.” You do all the little checklists and they send the checklists to the teacher. And the teachers do the checklists and they send them back. They say yeah we can put him on this– whatever low dose of Ritalin was at the time. That seemed to help him a little bit, but I wasn’t convinced that medication was the way to go. He was my first child, so I read all the books and did all the diets they recommended– no red dyes, no preservatives– we did everything. When he changed schools, I started him in the classroom the next year without telling the teacher anything and I thought, “Let me just see what happens.” Well, within like a week, I’m down at the school about why my child can’t sit still and we got that same pressure thing again. So we put him back on medication then in kindergarten.
Then we moved, and I decided to go talk to the new teacher. I said to her, “Look, my son’s been on and off of Ritalin the last couple of years I’m not convinced that’s what we need to do, but I’d like to have you keep an eye on him and let me know what you think.” The teacher seemed pretty good. I thought “Let’s try this out and see.” She worked so hard with him and then she said, “If you don’t want to put him on medication, I’ll do everything I can to work with him.” She was really great, but it was so sad because he couldn’t sit still in his chair, and he kept knocking his chair over, so they took his chair away and he would stand and work. Then he was bothering kids around him so they put his desk off somewhere else and finally something happened and he came home after a couple weeks into first grade and he said “Mom, can I take those pills again?” He’s in first grade! I said “Well, Andrew, what’s wrong?” He said– and it will just break your heart– “When I used to take those pills I had friends and now I have no one.” So I thought I don’t care what anybody says; this is a child that needs medication. For all the kids that are on Ritalin that don’t need it, he needed it.
So we went to the doctor and she was wonderful and totally understood. She did a bunch of stuff and she went back through Andrew’s records and said, “Here is a case of a kid who probably does need to be on Ritalin. He was on it until seventh or eighth and then he didn’t want to be on it anymore. We tried a couple of other things like Adderall and Concerta. Then eventually somewhere between ninth and tenth grade he stopped taking everything and he’s doing wonderful.
An Uncle’s Letter
November 27, 2001
I know that your father and grandmother had spoken to you about taking a medicine called Concerta. I wanted to write you a short note as you probably heard that it was my idea. Well, in fact, I think it was. So, you might want to know how I came up with it.
First, remember that I am a child psychiatrist. I have been one for over 20 years. This means I see all sorts of kids for different problems or things that get in their way. I have seen many kids who have trouble with being too active, too impulsive, and trouble concentrating. They are not “crazy” kids. They are just kids that have trouble in these areas. I have seen all sorts of people with this problem including “A and B” high school students, doctors at my hospital, and a number of businessmen. When I have seen you I have always noticed how smart, funny, and loving you can be, but at the same time I have noticed that you could benefit by being less impulsive (such as when you interrupt or intrude on others or blurt out responses without thinking).
When I see this pattern at work (or even with my friends), I know there is a good chance that a stimulant medication can be helpful. This kind of medication works by stimulating areas of the brain that slow down activity and impulsivity while increasing concentration. It does not “drug” people, but helps them be more effective. It does not mean people are “crazy,” but actually can help them be in better control. I thought that a medicine like this would help all the good sides of you come into more focus so that others can see you much better.
I suggested to your father that you try Concerta It is a medicine that lasts 12 hours. It is taken in the morning prior to school so you don’t have to take it at school (and no one really needs to know there if you wish). One begins by taking 18 milligrams, but often doses of 36 or 54 milligrams may be needed. All the kids to whom I have prescribed it have had no significant side effects. There are other similar medications (such as Adderall, Ritalin, or Dexedrine) used, but I thought Concerta was a good place to start.
Anyway, those are my quick thoughts. I am glad to talk to you further. I had heard that you do not want to take the medication. I certainly can understand that no one ever really wants to take medication. However, I would strongly urge you to give it a trial. Once you have had a trial then you and your father can decide if you want to stay on the medication. I have seen so many wonderful kids (and adults) benefit from stimulant medication use. This has nothing to do with being “crazy,” but everything to do with helping you put your best foot forward.