The Bitter-Sweet Reality of Medication

ADHD is hard to manage, but making the choice to medicate takes time.

Sonia Billadeau April 14, 2014
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justin_personalityJust last week, my 8-year-old started ADHD medication. My older two (15 and 13) had started in junior high. Neither of my older two are hyperactive, so there were no behavior problems in school (other than my 13-year-old talking too much to all her friends). But they couldn’t focus, organize, remember, or discipline themselves to stay on task in a six-period day.

I had been hoping against hope that my youngest would never need medication. He has had some behavior problems in school (chatty, lots of energy, seeming unwillingness to buckle down and work), but I was hoping they were just normal little boy problems. I told myself I wouldn’t medicate him unless he wasn’t able to function in school and that we would tolerate whatever we had to at home.

That decision was very hard for us to bear as a family because, cute as he is, Justin never stops talking, moving, or making trouble and messes. Unless he is parked in front of cartoons on a Saturday morning or in a movie theater, he is a cross between the Energizer Bunny and Tigger. He has lots of opportunities to “get energy out” as we call it, but he seems to have a bottomless pit. It would wear anyone out, I think, but we have just done our best for seven years.

When I took all three kids for neuropsychological testing last week, Justin was unable to complete any of the testing satisfactorily. Some of his tests were actually invalid because he made such an over-the-top zany-yet-unengaged effort. When the neuropsychologist told me Justin was one of the most unfocused and hyperactive boys he had ever seen in his office, I decided to try medication.

It broke my heart to think that my parenting hadn’t been enough to save him. I got the older two when they were eight and almost six, so I knew they came with virtually full slates. But Justin was only 16 months, so I was hoping that he still had enough of a blank slate for me to write on. I’ve read that ADHD is most likely primarily genetic, but I was still hoping in that mother-can-fix-anything mindset that I could heal him from his early life.

The first day I gave Justin a pill, it killed his personality. Although the pill was a stimulant, he fell asleep right after and then didn’t smile or laugh for the rest of the day. That’s like saying the sun didn’t shine. Justin is so FULL of personality, annoying as all-get-out sometimes, but unique and appealing and funny. He has got to be the happiest person I have ever met. The pill did seem to calm him internally and he wasn’t such a motor-mouth. When I asked him how he felt with the pill, he initially said he felt better, then later said he felt worse.

Sometimes it’s a mistake to talk to friends about things happening with your kids, especially unless they’ve adopted a sibling group of three since there is very little comparison. I mentioned to a couple of friends that Justin was “gone” and I missed him. They each weighed in with personal stories about their own kids and how doctors had recommended ADHD medication that had flattened their personalities as well. My friends chose to take their children off medication, and I respect that they made the best choice for their child. Hearing their stories made it harder for me to consider making the opposite choice, especially if they would judge me for it.

My husband and I had been discussing the possibility of medication for Justin, and I had asked his teacher for her opinion while he was still in school. I appreciate that she took her time and gave a very thoughtful response. Without giving an opinion on meds, she just listed out some of his behaviors and how she was trying to work with him.

I forwarded her description to the psychiatrist who treats my older two children and asked his opinion. He responded that Justin sounded a lot like him at that age and that he wouldn’t worry too much about it.

But when the neuropsychologist wasn’t able to complete Justin’s testing, I took Justin to my older children’s psychiatrist and asked for a medication trial. I describe this process in detail to indicate how measured the decision to medicate Justin has been. It wasn’t a knee-jerk reaction to difficult behaviors.

The next two days, I gave Justin half a pill and could see some positive benefits without the heavy flattening effect of the first day. He was calmer and was able to spend longer amounts of time at activities. Most striking, he was able to have what I call a “reasonable” conversation where it felt like he was really present and his eyes weren’t darting all around as I tried to talk to him.

To give Justin the maximum benefit of the pill with the minimum negative side-effects, I gave him a full pill today on the chance that his physiology had adjusted somewhat. In church this morning, my husband and I kept looking at him and at each other because we had never seen him behave so appropriately. It was so out of character, I found myself thinking that a whole pill was just too much and planned to go back to half a pill tomorrow.

By the time we got home, however, Justin was smiling and playful like he usually is, but in a more normal range of behavior. At dinner, he was his usual charming self, full of fun and jokes and personality. So with all my fingers and toes crossed, I’m going to give him another whole pill tomorrow and hope that the calm and “reasonableness” continues without impairing his uniqueness.

It is bitter-sweet to medicate Justin. We may have found the middle ground where he is helped by the medication without killing his personality, but after seven years of over-the-top energy, it’s a little sad to see it go. I so identify Justin with that life-of-the-party behavior. Of course, that behavior also killed the party because it was uncontainable and required constant oversight and correction. He was almost constantly in trouble and would get so upset when he wanted to do good things but couldn’t stop himself from doing bad things.

While I was typing this, Justin just came up to me excitedly asking me to smell his skin and his hair because he actually did what he was supposed to in the bath. He rattled off a litany of all the things he’s going to do as soon as he wakes up tomorrow: make his bed, brush his teeth, pick up his room. To quote Justin: “the pill makes me be gooder.” He seems so happy that he’s able to be good. I almost feel guilty for waiting as long as we did to try medication.

With a little bit of that craziness gone, a slice of Justin is emerging that is able to express thoughts and feeling, and I feel like I’m getting to know him for the first time as a person. I wonder if this is who he has been all along, but the racing thoughts and energy hid it. Wherever this medication trial takes us, I’m confident that we are trying our very best to give Justin what he needs. If he needs to be a little less crazy, zany and out-of-control so that he can express who he really is, this mom can handle the sadness of “losing” her baby. The joy of seeing him emerge as a person is worth it.

Photo Credit: Donna V

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Sonia Billadeau


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