Ask Dr. Meg: ADHD—To Medicate or Not to Medicate?

Dear Uncertain Mom,

If your son shows signs of ADHD, it is very important to understand what is going on with him. You say that you have mixed feelings about getting a diagnosis, but I  encourage you not to be afraid. One of the most important things you can do for your son is to understand what is happening with him so that you can help.

CONSULT WITH YOUR DOCTOR‍

I would begin by going to your pediatrician. Tell him or her exactly what your and your son’s teachers’ concerns are. He should not recommend medication right off the bat; rather, he should recommend further testing.

There are certain medical conditions, which mimic ADHD. Learning disorders like dyslexia and mood disorders like depression can look just like ADHD. Your doctor will give you some questionnaires to fill out and then ask you to return with them. So, simply going in to discuss the subject with your pediatrician is just a means to better understand what is going on with your son. If your doctor prescribes medication on the first visit, get another opinion before you do so.

If you and your doctor decide that your son needs more testing, make arrangements for this. There will be professionals in your area who do this testing. You may go to a neuropsychologist, an education specialist, or whomever your pediatrician recommends. This will involve a battery of tests to determine whether your son is really struggling with attention/hyperactivity issues or something else.

Once the testing has been done (and I strongly recommend it before considering medication), then you will go back to your pediatrician and discuss treatment. This may include medication and it may not. Remember; you are in charge of the final decision with your son, and you must be comfortable with the plan.

LIVING WITH ADHD

If testing shows that your son does have ADHD, here are some things that can help.

• Make sure that he has a solid routine to his day.

Kids who have a predictable rhythm to their days do better. This means, same awakening time, same meal times, same bedtime.

• Make sure he spends a lot of time outdoors.

Boys with ADHD need trees to climb and ample exercise.

• Minimize video games.

Fast-paced video games undo what you are trying to teach his brain to do. His brain is like a Porsche engine but his body is a VW. You need to slow his brain, not rev it up and loud, rapid-paced video games are too stimulating.

• If you decide to use medication, make sure to use it first on the weekend when you can see how he responds.

You don’t want to give him medication Monday through Friday and never see what it does to him. Ideally, the medication should help him concentrate and quiet his hyperactivity and impulsivity, but it should never change his personality. If it makes him sleepy, dull, or not himself, I wouldn’t use it.

Remember that your job as your son’s mother is to give him every help he needs to live a happy, productive life. If your son really has ADHD and it is severe (he can’t get along with friends, get his homework done, or is getting in trouble at school), then medication really may help him.

Whatever you decide, do so with the guidance of a good physician. You can always try something and stop; nothing is permanent. I encourage you to not be afraid, but to be wise as you make these decisions.