Coming to terms with 6YO child diagnosed ADHD

Hi Everyone! 

We are a family of 3 (me, my husband and son) who live in the San Francisco Bay Area. Our kind hearted, inquisitive and energetic 6 year old is diagnosed ADHD-combined. We always knew that this might be something we would deal with as both ADHD and anxiety run on both sides of our family. 

We feel so blessed that our son has great social skills, lots of friends and has been able to use coping skills (fidgets, special seating and a TON of parental support) to be successful in school. In fact, the school originally declined to even test him and were unconvinced that he needed any additional support, or modifications, in school. 

However, fast forward to this year and it has been a whole different story. The demands of 1st grade and expectations of being able to sit for longer periods of time have been a huge struggle for him. We find that he often isn't able to stay focused in whole group learning for more a than a minute and it has become a distraction to him and others. Additionally, he has begun to notice that he isn't advancing as fast as some peers so he's resorted to becoming the class clown. 

After many long meetings with the school, plenty on funds spent on advocates, therapists, psychologists and lawyers the school finally recognized that our son does need some services to help him cope with his sensory issues, executive functioning and general attention span, so they did provide us with an IEP and 180 minutes per week of resource and OT time. We also saw our home life deteriorating into constant battles of will. We would never know if he could make it through bath, reading, dinner and bed time without devolving into pure chaos which usually ended in me yelling, "PLEASE LETS JUST KEEP IT TOGETHER". 

We began to seek out advice from our therapist, pediatrician and classroom teacher and after a long battle we decided that medication might be the best option for our son. He's now been on Ritalin (time released) for 6 weeks and we have seen so much improvement! I find myself feeling so relieved that his teacher writes me notes saying he was able to participate in classroom discussions, does his best to be an active listener and can be redirected back to tasks more easily. 

Now I find myself in a weird place between feeling guilty that I had ruled out medication for so long (In my mind I had made it akin to giving in or giving up on his ability to cope) and embarrassed because I never thought that I would have a child on medication. I realize that these are my own issues and adjusting my own expectations is something that will just happen over time, but I still feel bad. Am I making the right choice? Am I setting him up for a life on medication? Should we have tried more behavior therapy first? What if the side effects change as he gets older? 

Being new to all of this I guess I just wanted to see how other families have dealt with their own personal insecurities about their child's diagnosis and treatment. Did it just take time? Did you seek out help for yourself? Is it just an expectation/image thing? 

Any advice on the topic is welcomed and appreciated! This whole adventure is new to us and we just want to do the best we can for our son :)  

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I am not sure what there is to feel guilty about? You want to try everything that might possibly help your son's medical issue; Ritalin helps, so, great. My 9 year old with a wide array of neurological issues takes a LOT of medicine, and his condition changes with age so I'm sure we will be frequently changing it (increasing dosage and/or adding new meds). I feel grateful during the "quiet" times when the current dosage is working well enough to give him some inner peace and resilience, and I personally feel more anxious during the transition times when whatever he currently is taking is obviously not enough to help him through his day (and night.... we've had lots of sleep issues, sigh). Sounds like you are already aware on a theoretical level that adjusting your parental expectations is important, and my husband and I have to stop and remind ourselves, "he's not 'normal'" at least not as that is typically described. But with our help and his medical team's help, we can get him to a place that's normal *for him*. I guess it's true that when we first added Prozac, that was a "big feeling" for me as the mom; but after a few weeks when it's obviously helping my son... okay! It's okay to take the help.

You have nothing to feel guilty about.  His brain is obviously lacking some chemicals that the medication adds back.  Think of it this way, if he was diabetic and needed insulin, you wouldn’t hesitate. Mental health is just as important.  

We have this weird idea in our country when it comes to disorders that affect the brain. We don't expect a diabetic to be able to "pull himself up by the bootstraps" to avoid medication, etc., etc., but, for some reason, we do if something affects the brain. We can't just "will" our bodies into working the way we want them to. You've found what helps your son. There is no shame in that. I hope that you can get yourself to a place where you feel no more shame for having a child with ADHD taking medication than you would if you had a child with asthma taking medication. There really is no difference. Shift to remembering that the brain is an organ, a part of our bodies, just like all of our other organs. Sometimes our organs work the way they are supposed to, and sometimes they don't. In the cases where they don't work the way they are expected to, we have medications that we can take to help. Feel confident that by taking care of your sons medical problem with medicine that you are doing what you need to do.

Do not beat yourself up for one second. We actually regret the two years of therapy, supplements, etc., that we wasted due to our own 'tude about "never medicating our son." The alternate therapies didn't work, and Ritalin really helped him. We finally realized -- it's about him, not us, and when he professed to enjoy his school day more with the medication, and his self esteem went up, we never looked back.

Ritalin has been around forever, and doesn't seem to do any long term damage. Our son is now a reasonably successful college student who went off his meds, claiming that they were starting to make him logy, in his freshman year. Kids' brains mature as they reach young adulthood, and some no longer need the extra help.

My personal opinion is that losing self esteem at an early age -- well, it's a hard road back from that. Please don't worry. You did good.

--Mom of Combined ADHD Son

Sister, sometimes I feel like motherhood is one long series of managing our own guilt. This is such a loaded issue right now - the minute I raised the question of my daughter having ADHD with a small group of close friends, I was barraged -- by close friends -- with well-meaning "warnings" about medications and all the alternatives I could try, all of which I was, of course, already trying. That nattering voice in your head? Just tell her to shut up. You can't change the past, and the guilt will hinder you as you go forward to the future. You did a great thing for your kid, and if there's some kind of splash-back from how long it took (hell, I have friends who didn't get diagnosed till adulthood, and they mourn for a lot more lost years than your son), then address that as it comes up -- don't go looking for disaster, as my grandma used to say. You're doing a great job. You made a tough decision. It turned out to be the right one for you and your fam. That's GOLDEN. 

Hi,

Parents of a child diagnosed with ADHD here.  I believe you've answered (some of) your own questions.  You've seen the improvement yourself, as have others.  ADHD is a medical diagnosis; feeling guilty about medication for it seems possibly analogous to feeling guilty about providing insulin to a person with Type 1 diabetes - I assume you would not feel guilty about that?  With ADHD, there is no way to know whether he will be on medication for his lifetime, or a portion of it.  The statistic we heard is that about 1/3 of people who received ADHD diagnoses as kids stay on the same medication(s) after they reach adulthood, 1/3 no longer need medication, and 1/3 will need different (or lowered) medications.  You're treating his medical condition which is something you can feel more proud of, than guilty, at least the way we see it.  Good luck with it all, and so glad you made it through the school "battles" that it sometimes takes.

I have had a similar ADHD journey with my son (now 12), and felt many of the same insecurities early in the process.  ADHD is a moving target, and you will make hundreds of various decisions during his young life with regard to medication, IEPs, therapies, etc.  Remember that no decision has to be permanent. Trust your gut, do what you feel is right, then change course if you need to.  With regard to feeling guilty about giving your child medication, think of it this way:  If he had diabetes, what would you do?  Ride it out and hope it gets better on its own?  Tell him to just "try harder" to create insulin in his body?  No - you would give him the medication he needs to be healthy and happy.  Ritalin and other ADHD medications can vastly improve an ADHD kid's life in so many ways.  If it works for him, it's worth it.  Lastly, you didn't "wait too long" to put him on meds.  You prudently waited until you had done your research and tried other options. Be kind to yourself, mama. You're doing great. It could be a long road ahead - don't waste time making yourself feel bad!

I would love to talk more! Please contact me! 

Good for you for seeking out the support your child needs, including medication. Our son also started medication in first grade after being diagnosed with combined type ADHD. He is now in fifth grade and it has made all the difference in the world. He is able to interact with friends, participate in extracurricular activities, and succeed in school, all things that were difficult or unattainable before. We have had to change his medication several times over the last five years and each time we worry, however in the end it is always worth it. My spouse also struggles with ADHD and his parents were unwilling to seek out medication when he was a child. He was determined not to let the same thing happen to our child. You wouldn't require a child to manage diabetes with dietary changes, if the doctor said they needed insulin, would you? Of course not. Medication has been so demonized by the popular press, but you can see the difference it makes for your child. We still use a variety of other supports and it is amazing you got an IEP and other from the school for ADHD. You are doing everything right.

Parenting is the most difficult job in the world!  And when you are the parent of a child with a particular challenge or challenges, even more so.  Some of us are more prone to second guessing and doubting ourselves than others.  I'm the parent of a 2e now teenager - gifted with ADD and anxiety.  I also have a second teenager, more "neurotypical".  I've definitely second guessed and doubted myself with both.  The best you can do is seek out people and resources you trust, do your research, constantly evaluate and adjust as your child develops, and most importantly take care of yourself and parent with love.  There's no right or wrong route, there's just moving forward (sometimes two steps forward, one step back).  There will be those who support you and those who criticize you, but only you know what's best for yourself, your child, and your family at any given moment.

Medication is a highly personal decision with no right or wrong answer.  It works for some and not for others.  A person's response to it changes over time.  If it's helpful now, great! Go with it.  Medication is not a magic bullet, so continue to work all fronts in parenting your child toward increasing independence.

Good luck and be kind to yourself.

Your story sounds very familiar.  My kids are 17 & 15.  We have seen it all & done it all.  We agonized over the meds for the 17 yr old when she was 7 & ultimately it wasn't for her...we worked it out without meds...we decided our 15 yr old was too sensory & needed to figure out how to self-regulate before we went down that path but it got to that point that he really needed it & he's on meds.  I don't think it's about being right or wrong...it depends on your kid & the situation and what their needs are.  You should not feel guilty for doing what your kid needs and not what others who do not have a measure of your kid say he needs.  You know him better than anyone else thinks.

I think I understand what you are going through.  I am a psychologist and my now 12 year old son was professionally diagnosed with ADHD combined in 1st grade. I always knew it give his extreme energy.   For example, in kindergarten, I took him and his friend to the Zeum in SF via BART.  After 3 hours there, the other boy fell asleep on the ride back while my son was asking if his friend can stay and play for a bit at our house. He had a very tolerant 1st grade teacher and he is very intelligent (as assessed by IQ testing) so issues were not huge at school.  Jump to winter break where we visited with friends on the East Coast and he had a  meltdown in a bowling alley because he lost but did not realize he was losing due to how the score was displayed. I always had battles at home for him to do chores, be calm and less disruptive and accepting limits so he had been in on simple then more complicated behavior plans from age 3.  But after the public meltdowns, I sought medication.  After 2 different tries, we found the med and dose that fit after barely 4 weeks.  I don't usually give it on weekends although there are times that I do.  He eats less and his friends are not the coolest kids in class but they are active like him and he has more than just the core 2 so it's good.  He was a cub scout all the way through, played baseball in a league and bowls.  There were issues at times, such as the scout leader being used to much calmer children so reprimanding him more than I though necessary and the coach thinking he wasn't paying attention because he was kicking dirt but 5 years later, he's well adjusted and decides for himself if he wants the medicine to work on a school project on a weekend. 

Try to think of it as helping him be a better him.  His brain is wired a little differently and meds help him function better in certain situations.  Schools now are trying different seating and methods of teaching since many children can't learn the old fashioned way of sitting all day.  He's still a great kid but he needs help.  Asking him to do talk therapy or a behavior plan only may not be what he can do.  It's challenging but they mellow and we get used to it.  I try not to get upset when I tell him 3 times what to get from his room since he doesn't always remember after walking in there.  Ask for help, support or just an ear to listen if you need, it helps us too.