(Editor's Note: This article has been edited for length with the permission of the author. The unedited full version of this article is available here.)
Should you medicate your ADHD child? In my opinion, it comes down to four factors:
- Is ADHD something that’s “wrong” with the child?
- Could something else be causing the ADHD symptoms?
- Does the child have significant comorbidities?
- Are the ADHD symptoms significant enough that they’re impacting the child’s quality of life?
#1: Is ADHD Something That’s “Wrong” with the Child?
Adult ADHDers and even researchers disagree on this issue.
ADHD is a developmental disorder. It is a fact that the brain develops in a different way and at a different rate. ADHD is not a psychological disorder or a mental illness. It is a difference in how some brains develop. ADHD has been researched and documented since the late 1700s, so contrary to popular belief it’s not a modern phenomenon. It’s not a disease or an epidemic that needs to be cured either.
It’s just a difference.
And differences are good.
Although fashion and trends make it seem like we need to all be the same, the truth is that our value is in our differences. I hire a plumber because I value the different skill he has and that I need. If I had that skill, I wouldn’t value it as highly. Differences make our world wonderful and beautiful! Many ADHDers from European and North American countries find that, upon visiting African or South American countries, the issues that cause so much stress in our fast-paced, Type-A society disappear, likely because the expectations here are so different, where it’s not socially unacceptable to be late, scattered-brained, or not detailed.
So, is ADHD a problem that needs to be fixed. . . or just a difference?
On the one hand, in our society having ADHD can be a serious disadvantage; I’ve compared it to having a mental disability. The fact is that an ADHD brain struggles to do what is required of it in our society. But does that mean that there’s something wrong with the ADHD person? Or is there something wrong with our society?
I’m inclined to think the latter.
For practical purposes, I usually suggest that parents think of their child as having a disability. Th is changes the way you address problems because then you don’t assume the child is being willfully disobedient. While I use the term disability to describe ADHD for practicality, to explain the severity, it is not actually a disability and should not be viewed as an epidemic or a disease that needs to be cured. It’s simply a different way that the brain has developed. The brain of the person with ADHD just operates differently — yes, delayed in some areas compared to one’s peers — but different is not necessarily a bad thing.
Remember: different is good. Diversity is good. We tell our children to accept people’s differences, but I wonder how long it will be before neurodiversity is accepted?
Do you know the “cure” for ADHD and autism?
That’s the cure.
That’s why I endorse unconditional love as a huge factor in your child’s healthy development.
The answer to question number one — is ADHD something that’s “wrong” with the child? — is complicated and the answer varies depending on who you ask.
ADHD only became an issue and required a diagnosis when our society and its expectations changed to the point that neurodiversity was no longer acceptable.
So while it may help you to think of your child as having a brain disability — 30% behind in any other area would be considered a disability — please don’t think of your child as someone who needs to be cured. Th at will not help anyone. It will make your child feel unaccepted and resentful, and it will make your job of parenting miserable.
Do you accept your child?
It’s an honest question you have to answer for yourself. And your answer will significantly affect your child’s life.
#2: Could Something Else Be Causing the ADHD Symptoms?
There are all manner of conditions that mimic ADHD, including traumatic brain injury, PANDAS, celiac disease, and numerous others. Your child could have been misdiagnosed with ADHD, or your child could have of one of these in addition to ADHD.
ADHD by itself isn’t usually as severe as it is for those who have both ADHD plus one of these other conditions. For instance, my oldest reacts to gluten with severely increased ADHD and anxiety symptoms — so much so that he chooses to not have glutinous foods as he simply doesn’t like how they make him feel. I think that the reason that so many ADHD patients react well to diet change is because these other undiagnosed conditions are complicating their ADHD by mimicking ADHD-like symptoms.
It’s important to note here the connection between ADHD and autoimmunity. Both are connected to leaky gut, and the brain-gut connection is one of the leading explanations of why both ADHD kids and people with autoimmunity respond well to diet change. Newer science research just this year has found evidence to support a reason for the rise in both autoimmunity and ADHD. The rise in autoimmunity is thought to be caused by added chemicals and toxins in our environment combined with genetic predisposition.
The truth is that we’re all victims of our environment and our genetics. What we can control, we should, and what we can’t, we need to not stress about.
I recommend being aware of other things that could be making your child’s ADHD worse. Diet, supplements, changed environment, de-stressing, exercise, limiting media exposure, counseling, behavioral therapy: as much as you’re able to, I recommend trying or altering these things to see if your child will benefit. (Our family has benefitted especially from diet and a slower paced life.)
These don’t help everyone, but if you could see improvement without adding chemical medications (some which can have serious side eff ects) into your child’s life, why not try?
#3: Does the Child Have Signiﬁcant Comorbidities?
A comorbidity is the simultaneous presence of two chronic diseases or conditions. Comorbidities are ADHD’s ugly cousins. By itself, ADHD can be a handful but is usually manageable. Add comorbidities, and it’s like the misbehaving cousin came to visit and the whole thing goes to pot.
I know many people who have only ADHD, and many of them seem to function okay even with the pressures of society. Add comorbidities, and all bets are off. Even if you don’t medicate the ADHD, most of the time the comorbidities need to be addressed.
It is absolutely necessary as a parent to be aware of these potential issues and watch for them in your child’s life. Be aware especially of the most common ADHD comorbidities: anxiety, depression, and Sensory Processing Disorder. Below is a poll* I organized in which 73 women took part, listing every possible ADHD comorbidity they could think of and had experienced. If you see a condition on the list below and you don’t know what it is, familiarize yourself with the symptoms so that you can watch for that problem in your child’s life.
Unfortunately, most ADHDers do have comorbidities, and often the comorbidities are more severe than the ADHD itself. ADHD is so much more complicated than just attention. In fact, ADHD isn’t even really about attention. It was mislabeled. ADHD would be better labeled as Regulation Deficit Disorder (RDD). Not everyone who has ADHD is hyperactive, but everyone who has ADHD has regulation problems as a result of the development problems in their brains; attention problems are merely a byproduct of poor regulation. The name is a disservice to those of us with ADHD because it misrepresents the actual issues and adds to the belief that the disorder is fake. Every time a child has a problem focusing you hear, “Oh, he just has ADHD.”
But what if his grandma just died and that’s the reason he’s not paying attention?
Not every distracted child has ADHD. You have to figure out what’s causing the distraction. It could be a regulation problem and be ADHD, or it could be a plethora of other disorders that also cause attention problems. Nearly every childhood disorder includes attention problems. Th is is why we need a better, more full understanding of the actual causes of ADHD.
Even if your child’s ADHD doesn’t need to be medicated or treated, more than likely the comorbidities will need treatment. Anxiety, dyslexia, hair pulling, skin picking, and more — these will most likely need to be addressed in one way or another.
#4: Are the ADHD Symptoms Signiﬁcant Enough that They’re Impacting the Child’s Quality of Life?
If you needed to get a diagnosis, it’s a fair guess that the symptoms are significantly impacting your child’s quality of life. If so, you need to do something. Seriously. Even if you don’t want a label and medication and stigmas, do what’s best for your kid. You think parents of kids with Type 1 Diabetes wish needles and insulin on their child? Of course not. But you do what you gotta do.
I did not want my children medicated. But my child with ADHD and anxiety finally climbed a tree for the first time in his life in his 9 (almost 10) years, because he was at last no longer terrified of climbing a tree. Yeah, you better believe I cried. Children should not spend their childhood terrified of playing and being kids! Medication improved his quality of life. He is a teen now and not taking medication anymore, but it really helped him at the time.
I have Hashimoto’s Thyroiditis and require medication. Without it, I risk diminished quality of life, and even death. I don’t want to take medication. But I do anyway because it’s necessary.
Science also shows us that ADHDers have diminished neurotransmitters compared to neurotypical people. If you can’t make insulin, there’s no shame in supplementing it. If your brain doesn’t make the neurotransmitters you need, there’s no shame is supplementing that either. The shame should go to those who have the neurotransmitters they need but feel the need to shame others for buying the neurotransmitter to replace their missing ones. Imagine the outcry if we treated Type 1 Diabetes kids like that. That would be despicable.
As I mentioned before, I’m a big advocate of trying other treatments before, instead of, or in addition to medication, because I firmly believe that other conditions either exasperate ADHD or mimic ADHD symptoms. More than likely, finding a combination that works for your child will not be simple, but it is so important!
Remember: You are your child’s advocate to the world around you. Along with accepting him, you need to fight for his mental health and emotional security.
But most important: you need to do so without excusing actual issues in his life.
There’s a fine line between being a supportive parent and being an enabling parent.
I try to err on the side of assuming that the child is struggling and that it’s not willful.
If the child struggles, they will most likely be apologetic about the chaos it’s causing and feel bad about you having to make accommodations and grateful when you do accommodate. On the other hand, if the child is being manipulative, they’ll act like they won if you accommodate rather than being grateful. Attitude is key. (This is more challenging to navigate when the child has certain disorders like Oppositional Defiance Disorder.) When in doubt, pray for wisdom.
Basically, your choices when dealing with an ADHD child are as follows:
- Change expectations;
- Find support systems;
- Establish coping skills;
- Medicate; or
- Some combination of the above.
If you choose not to medicate you absolutely, mandatorily, surely must accommodate.
Without some kind of support, you child will not thrive, and they absolutely will be damaged by your expectation that they be something that they cannot be.
It’s cruel. Don’t do that to your kid. That’s like scolding a child with no leg for not running. He cannot do what he is not equipped to do.
When in doubt, love them, accept them, believe in them, help them, accommodate them. Be the crutch they need, because no one faults a child with a broken foot for using a crutch. Your child needs a crutch because to the world around him, he is broken — even though we know it’s a diﬀerence, not a disease. If your child is going to even remotely function in this Type-A society, you’re going to have to be their crutch.
Or, if you dare, you can rewrite the rules and create your own micro-society with new rules that work for you and your child. That’s what homeschooling is: it is a new micro-society in which accommodations are made so that the neurologically different child can thrive. A homeschool group, when ran properly, can be that also. Th is is why I endorse homeschooling, especially for kids with ADHD and autism. This is why these kids — like me — thrive in homeschooling and do not, for the most part, thrive in other forms of education.
So to answer the original question that prompted this post: should I medicate my ADHD child? Maybe, maybe not. But no matter what, medication isn’t all you should do. Seek to understand what’s going on, try support and accommodation, and above all, make sure you love that child unconditionally. Th at single choice to love your child unconditionally will affect your child more than any medication, treatment, coping mechanism, or accommodation ever could.
When in doubt, give love and grace.
Again, I’ll say it in case you didn’t get it yet: your child needs unconditionally accepting love.
There’s nothing in the world like it, nothing can replace it, and there’s no damage like the damage of not having it.
Sarah Forbes is a follower of Jesus, the wife to her college sweetheart, and the homeschooling mom to two growing boys, as well as a chronically ill and introspective teacher and author. This article has been reprinted with her permission.
You can find her website here: https://graceunderpressure.blog