Part I Choosing to medicate your child: ADHD – two stories from local families

By SARAH DOOLITTLE, Four Points News

First story

Christine always knew there was something different about her son, Jack.

“From the beginning, since birth, he’s been… he started out kind of colicy… there were sleep issues… (he was) easily overstimulated, crying excessively. It was just sort of a stressful parenting situation from the beginning.”

As a first-time parent, Christine, whose name has been changed to protect privacy, assumed she was doing something wrong. Her beautiful boy looked normal otherwise. Still, there were nagging questions. “Did I not put him in time out enough, or too much? Did I spank him too many times?”

Aggression

Though clearly intelligent, Jack couldn’t manage his own emotions. Frustration or simple lack of understanding manifested as aggression.

It caused stress in the family, even more so when Christine and her husband welcomed their second child. Christine felt isolated. What were they doing wrong? And what was wrong with their son?

With kindergarten came new issues. Jack was soon labeled by his classmates as “the mean boy.” He went to the principal a few extra times. Christine heard through the grapevine that parents didn’t want their kids coming over to the house to play.

“As he started to progress with friendships, I realized, you know, like his level of aggression, compared to the other peers — it was higher. There was something that was just a little different.”

Still, asking for help was hard. Jack looked normal, and rather than considering that he had a medical issue, school officials seemed to assume he was just a bad kid, or came from a problematic home environment.

Understanding

It was a Bible study group Christine joined by chance where she finally met and spoke with other moms who were struggling with the same issues.

Thus began the process that would allow Christine and her husband to realize that it was not their parenting that was different but their child.

At first they tried to go the all-natural approach. They had Jack see a child behavioral specialist to address his aggression. They saw a psychologist. But it was harder for a doctor to observe the behavior they observed at home. Certain triggers were consistent. Overstimulation was a big one.

After attending a seminar by Dr. Dilip Karnik, a pediatric neurologist in Austin (who will be featured in Part II of this series), Christine finally made the decision to explore the underlying causes of her son’s behaviors and to try and seek a more comprehensive solution.

Diagnosis

The diagnosis? Attention Deficit Hyperactivity Disorder, or ADHD, and an anxiety disorder, with an eventual diagnosis of borderline Asperger’s — a pervasive developmental disorder on the autism spectrum.

Diagnosis in hand, it was time to create a treatment plan. Would medication be part of that plan?

As Christine explains, “I did not want to put him on medication. I was the parent who, going right off the bat having children, was so against medicating children. I didn’t agree with it at all.”

Dr. Karnik assured them, however, that medication, in combination with other therapies, could help to break the behavioral cycle and would enable their son to be not only a better-adjusted child but a well-adjusted adult.

medicationMedication

As with anyone, it was a process of trial and error. In addition to an omega-3 fatty acid, magnesium and zinc, which Dr. Karnik recommends for all his patients, they first tried an anti-anxiety medication, an SSRI (selective serotonin reuptake inhibitor) and a non-stimulant ADHD medication, but the latter seemed to cause increased aggression. A stimulant medication came with even worse results, causing heart palpitations.

In time, and with the full supervision of their medical team, they found a non-stimulant ADHD medication that provided better results. Jack switched to a different SSRI. He has experienced almost no side-effects

Furthermore, the family uses Inspire Behavior, which works with kids with spectrum disorders, for in-home therapy and treatment. They also found electronics to be over-stimulating for their son and manage and restrict screen time as necessary.

Post-Diagnosis

Now that life has settled down somewhat and they have a diagnosis, Christine finds it’s much easier to be open about her son’s condition.

Reflecting on their lives pre-diagnosis, Christine wishes, “that in school I had been able to advocate for him earlier. I do think as early as possible if you know there’s a problem as a parent… Because there’s resources out there.”

She also wishes that parents or teachers had spoken to her about her son. “I needed more information. I didn’t know what was going on… And instead of worrying about hurting my feelings, I would have wanted a teacher or somebody to say, ‘Some of these behaviors are a little off.’”

“I had to open my mouth and ask people… That’s the hardest part. Because first you don’t want to admit that anything’s wrong with your child. And second you don’t want to admit that anything’s wrong with your family.”

Second story

Louise and her husband are both medical professionals and their real names are not being disclosed. She’s a pediatrician, in fact, but even she had the same reluctance to treat her son’s ADHD as a medical condition.

Her son, Ty, is creative, smart, and a non-stop bundle of energy. “He can’t sit still even to eat… He would half sit, half stand during meals.”

Louise really started to notice a problem once Ty started kindergarten. He couldn’t finish his work. He talked during class, blurting out answers. He got into a lot of trouble with other kids.

Still, Louise recognized her son’s talents. “He kind of has a mind that keeps going and is creative.” This wasn’t reflected at school, though, where he failed tests even when his mom could see it was work he already knew how to do.

By the first grade, Louise was alarmed to see her son display a key warning sign for kids with ADHD: his self-esteem began to plummet.

Ty would say things like, “I don’t know how to be good,” or “I’m just stupid.”

Plus other kids were starting to notice Ty’s behavior, to the point that it affected his social life.

Diagnosis

The family went to see their pediatrician. They received a written diagnostic test to complete along with two of Ty’s teachers.

The results showed that Ty scored high on both attention deficit and hyperactivity

Still the family tried everything but medication: a ball chair, sitting in the front of the classroom, having him work with more focused students, having his tonsils removed, changing his schedule and using charts for everything.

Desperate for a solution that could provide more consistent results, and having heard a lot of Dr. Karnik’s recommendations through her work, the family decided to try a stimulant ADHD medication under the supervision of their pediatrician. They also added omega-3 fatty acids per Dr. Karnik

Results

The results have been nothing short of dramatic. “He is now in Quest. He is now in Pace math. His second grade teacher had no idea he has ADHD.”

His mom says his self-esteem has improved, too. The ability to focus allows him to see results that reflect his talents and intelligence. He’s thriving socially as well.

The drugs do cause a decreased appetite and some sleep issues, which they treat with melatonin. “He doesn’t like to take (the ADHD medicine). He says it makes him feel sick.”

At the same time, he recognizes the benefits. “One time he told me thank you… for making him feel better.”

Medication

They have taken an approach to the medications that is not uncommon for families of kids with ADHD. “We leave him off of it in the summertime… I don’t want him to be on a stimulant all the time.” On weekends or during the summer if there is an event that requires increased focus, he is able to use 4-hour Ritalin.

Louise notes, too, that they are starting to see signs of possible ADD in their younger daughter, though not likely ADHD.

It doesn’t appear for now​—​at the same age when her brother first started having problems​—​that she will need medication. Louise is emphatic, however, that the minute there are self-esteem issues, parents should consider medication.

“I don’t want him to have a disease. I wanted the perfect kid,” she reflects. But, “Once he started doing well, that sort of balanced it out for me.”

She says that, “Trying the non-medicated (treatment first) is probably good,” but then catches herself.

Instead, “Maybe we shouldn’t be waiting for a problem to start medicating.”

Acceptance

Louise acknowledges that, when it comes to mental disorders, “We don’t know how to study it. There’s so little that we know.”

But as Christine and her husband learned on their journey toward mental wellness for their son, “The key for us is realized that God gave us this child… And it’s our job as parents to figure out how to be the loving parents that he needs us to be and to not expect him to be the child that we want him to be.”

Speaking as both a parent and physician, Louise wishes only that, “people could recognize and accept that it’s a chemical imbalance. It’s a physical ailment, not a (behavioral) one.”

Part II of this series will focus on advice and information from local medical professionals.