Better living

Alan's ADHD was really bad those past few weeks.  His teacher noticed it at school, we noticed it at home.  Especially weekends tended to be really terrible - I get so worn out by the sheer noise level that comes with his hyperactivity, and the repeated, ever louder commands we have to shout just to get him to put on his boots...

This morning was another really bad morning.  We're in Germany at the moment and both my parents were horrified.  There was no talking to him because he didn't hear us.  He had not been able to make eye contact with me all week long. 

"Alan, look at me.  Look at me!  LOOK AT ME!!!" 

A fleeting glance, not more.  On top of the hyperactivity, he's now also very forcefully angry.  He just can't control himself, at all.  It's always loud, intense, over the top.  More than you can take.  More than I can take. He makes me really angry, to a point where the intensity of my anger scares me.

Even when he's happy, he will hug you with such force that he will knock you over.  Imagine that with other kids.  We already had some feedback from other children that he hurts them (never intentionally, just by flailing his limbs around), that he never stops talking, that he's always so loud. Add two years and he'll be an outsider.

This afternoon, I couldn't take it anymore.  He was doing contortions under the dining table, again.  Unable to have his meal in whichever way, flailing, yelling, incontrollable.

So we gave him half a dose of Ritalin, for the first time ever.

I was quite nervous about this.  I've educated myself a lot on the topic.  I know how Ritalin works in kids with ADHD and how it works in kids who have no ADHD.  I know the anecdotal stories about Doug in his childhood and Ritalin and how it made him crazy.  That's why we held back for so long. 

During the next half hour, I felt sick to my stomach.  I'm so not a drug person that it felt almost like a crime to give him this medication.  What would happen?  You don't run experiments on your children, you just don't.  Right?

And then, my little boy, after twenty minutes, came up to me and asked me something. I don't even remember what it was.  I just remember that he looked me into the eyes.  An open, direct look.  Just like that. 

I nearly wept.

He played peacefully with the Playmobil toys afterwards, sat next to his Daddy on the couch playing SesameStreet games without fidgeting, solved math puzzles without apparent difficulties, interacted with his brothers in a normal brotherly way (i.e. fighting in normal doses).  He's not limp, he's not hyper, he's not compliant to the point of abulomania.  He helped me decorate the tree, and he put fifteen candles into candle holders - where he would normally lose interest after two or three at the most. He's happy, and funny, and cunning like always.  But he's not over the top anymore.

He's just - Alan.  And that's wonderful.

Better living through chemistry.

[I'm still conflicted about it.  But as the Ritalin wears off I see the difference even more.  It will be a while before I can sort out how I feel about this.]

Comments

[Christine]

My elder son was diagnosed with ADD when he was about 5. Not severe and not a lot of hyperactivity. We managed with help of teachers and behaviour modification until he hit high school. Grade 9 was hell. So that summer I talked to the doctor about ADD medications. Set up an appt with son for late summer. He discussed the options with the doctor, side effects, etc. He has two medications, Ritalin for when he wants relatively short (few hours) focus and Concerta for a full school day. Concerta is the same active ingredient, but is in a controlled, time-release capsule. HUGE difference. He can manage to pay attention in class. He is enjoying school.

I am glad we held off, I am also glad we decided to give this a try.

I've talked to other parents with ADD and ADHD kids who use Ritalin and who found it to be a life saver. Sure it can be abused and overused, but for some kids, it makes the difference between school being miserable and school being fun.

So, do you think that Alan was happier while on the medication? If so, then think about the times to use it when he will get the most from it, and not just make your life easier (although, that is important too). If you are doing it for him, should lessen any guilt feelings! Help Alan to be Alan!

Also, I remember reading somewhere that active, vigourous exercise helps keep the hyperactivity under control. Don't know if there are any safe parks around where Alan could run around, kick a ball, throw a frisbee, etc. Are there exercise videos aimed at kids that he might find fun?

[Natalie]

Yup, better living through chemistry. And I am a pusher. :-)

I think that Christine's question is the most valuable one you can ask -- did Alan seem happier? At his age, you can't ask him if he can concentrate better, remember his letters better, or be less emotional. All you can do is gauge the effect of the drug on his behavior, and I think that "happiness" is a good indicator.

Occasional use would be less problematic with respect to side effects, as well as lessening developement of tolerance. It is not as if the diagnosis is in questions (ah, genetics...) or you've tried behavioral modification techniques. Go with what feels right.

Hugs from weirdly warm Maryland

[Lorraine]

Oh, was I mentally hugging you while reading this, C!

I don't know if you were aware that Kipper is very ADHD and, as a baby and toddler nearly drove us out of our minds. Everything you described above fit Kipper at the time, also. We were forced out of a playgroup he loved because the other parents didn't want him around their children. We could never take him places...all this to say that I *really* do know how you feel.

Our doctor recommended testing at the local children's hospital when he was 2 and Alec was on the way. We tried behavioral modification for 6 months. Nada. He was the youngest child our psychiatrist had put on Ritalin, so he admitted him to be sure all would work okay. I was to leave him there for a few hours while they tested and observed him. Instead, they called me and said I could pick him up. "Guess what he's doing right now?" the psychologist doing the testing asked me. I was afraid to. He was putting a puzzle together. Before, he would have either torn the puzzle up, or thrown the pieces around.

I did cry. The difference for him was incredible. I'm so glad that Alan is having success with it, too.

Whenever anyone gave me a hassle about having a *medicated* child, I pointed out that I'd much rather have a medicated child who could learn and deal with life, than visit him at 18 in the local penitentiary, which is full of young men who had untreated or mistreated hyperactivity.

Go, you guys! With best wishes for all of you, but please give Alan a special kiss from me. He doesn't need to know why (g)!

[claudia]

I can't honestly say he's happier because he's definitely a happy boy in general. And it's been only twice so far - not enough data.

It makes us happier - it makes family life easier. Are these valid reasons? Less stress, less noise, less frustration, less yelling? Does that count?

I think in the long run, it will make his life [i]easier[/i] - better relations with his friends, no problems with sitting still in class, no frustrations over being different, being a problem. Living life to his full potential instead of to only three quarters because he's always getting lost on the way (both literally and figuratively). That, in the long run, will make him happier.

As I said, I'm still conflicted. The difference is just so obvious that it scares me. Is this the little boy Alan would be if his brain chemistry worked right? He would be such a joy, it's hard not to wish for that all the time.

(Don't get me wrong, I love him to death the way he is. It's just - he's even nicer, even cuter, even more his sweet and gentle self, perplexing me with his smarts. Oh, words fail me.)

[Christine]

Just catching up!
It makes us happier - it makes family life easier. Are these valid reasons? Less stress, less noise, less frustration, less yelling? Does that count?

Sure! That has to make him happier, too. Parental happiness is not unimportant, either for the parents or for the children.

My husband is self-diagnosed as an adult as ADD. When we were reading up when my elder son was diagnosed, Andrew kept saying "umm yup, umm yup", etc as he read through the list of symptoms. He strongly regrets not being diagnosed earlier as it would have made school a h*** of a lot easier of he knew what was going on, and not just that he had problems. He wasn't ADHD, so didn't have the hyperactivity to contend with, just the ADD portion. Bad enough.