Ritalin, ADD, Parenting, and stuff

[Jaltus-bot]

Dear CAAers,

I recently came across a thread with a posted sign about parenting and Ritalin. I find this some how disturbing. Ritalin is used to treat Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder. ADD is not a matter of parenting, not is Ritalin a substitute for good parenting. I am offended by that post because I was on Ritalin, I have ADD, and my parents did a lot to parent my brother and I well.

At least three out of for members of my immediate family have ADD. I am a medicated ADDer. My mother was a speech and language pathology major, which while off the exact topic, did make her more aware of such things and how they were treated. This was helpful when she did research on ADD for my brother and I.

ADD involves a biochemical difference in the brain. Also, according to a show on PBS a couple of years ago, there is a small part of the brain which acts as a co-processor that is smaller in people with ADD. The greatest problem with ADD is the inability to direct attention as desired for periods of time. As a young ADD child, I struggled with the ability to concentrate enough to do what I genuinely wanted to do. The apparent difficulty staying on task may be caused by other things as well.

Inadequate parenting can be a problem. If a child is never told not to do something or never has boundaries enforce, how can a child know? If this is then mistaken for ADD or AHD, then a child could be put on medication without needing it. This is why diagnosis of it must be carefully done. Another problem is when parents use ADD as an excuse to allow their child to do whatever he wants. This keeps the ADD child from learning how to behave properly. Both of these reflect poorly on those where parenting is adequate and ADD is real. Again, I have ADD and there have been children acting in waiting rooms in ways that my mother (and a darn fine one she is) would never have simply tolerated in my brother or I. The excuse sometimes is that “oh, you have to excuse him. He has ADD. Bull! Bad parenting is bad parenting. ADD is ADD. It is important to both teach an ADD child as well as keeping in mind the struggles that the child may have and how to help the child cope to work around them.

Medicine cannot simply fix ADD, or a least should not be used for that. If there is not real ADD, then a child should not be medicated for it. Medicine should be used to bring the ADD down to a manageable level. At this point it should be easier for a person with ADD to do enough to develop coping skills that will allow him to succeed in spite of the ADD. My medication did a lot to allow me to do just that. ADD is just a behavioral matter, it is a medical matter. I could not choose to simply get my school work done when I was younger. Having the medication allowed me the choice to focus on what I what I wanted to. This is what Ritalin and other medications are for. It is such a shame that our society regards it so lightly.

As another matter of note:

The Feingold diet was at one time thought to help treat ADHD. Online resources will may say that the claim could not be substantiated, but some, especially preschoolers showed some improvement in attention. The Feingold diet reduces some of the excess chemicals that we take in from our lovely American cuisine. This means that the chemical input that the body must process. I am sure that there is research that can be done to link chemicals and attention. Chemicals may have more of an unexpected impact on you than you realize. A study by Cal Tech comparing chemically sensitive people to non-chemically sensitive people revealed that a surprisingly large portion of the control group (non-sensitive) in fact were chemically sensitive. (contact if you want to discuss chemical sensitivities further)

Further matters as previously discussed may be found at http://parents.berkeley.edu/recommend/medical/add.html

This site should have some information on what ADD and ADHD really are.
http://www.mayoclinic.com/invoke.cfm?objectid=FA1B63E9-643F-486E-B1B10D857F434410&si=2560&WT.srch=1

I apologize if this is overreacting, but I don't think that the attitude that was presented in the picture was right and it happens all to often

[Bobtheduck]

I've heard many many things about ADD, and the plain fact is, most of the people I know with ADD are more creative than my other acquaintances, so I think ADD just means the resources are allocated differently, and its only "bad" if the people around you can't adjust, most importantly your teachers and parents. The drugs not only don't help your attention that much, they hurt your creativity and hurt your logical processes. I'd say its not worth treating it at all, especially because it isn't a disease or even really a problem.

As for the sign, no one thought that sign was true... That sign was made on photoshop, and its a satire of the way some irresponsible parents treat it...

[Jaltus-bot]

The sign just annoys me.

You have a good point and there are theories that it is just a different way of processing. The problem with ADD that I believe should be treated is when someone who has it cannot do the things that they want to do. I would have done much worse in school and taken a much longer amount of time to do it, that I would not have time to be creative. I could not have learned how to effectively complete even a creative project with the ease that I have learned. I do still struggle with ADD at times, but I can complete things that I want to do. I think that that is the value of treating ADD. I agree that just throwing drugs at ADD is a bad idea. I like that I am a creative ADDer. I am also glad that I can get that creativity out of me (meaning exercising the creativity). Truly, I could drive myself into some kind of dispairing insanity otherwise.

[Zilch]

The sign is sarcastic, and was made up in Photoshop. Hooters billboards, however, are not. Now, which of these is the greater evil, and really needs offense taken to?

Priorities, people, priorities...

[Kat Walker]

My brother is autistic (an entirely more serious affliction than ADD), and when he was on Ritalin he became extremely violent, depressed, and easily agitated. I'm no pediatric pharmacist, but this medicine tends to get misdiagnosed a lot.

I agree with Bob's stance on ADD, just being hyper does not make you some sort of clinical case. It's a bit more of a social challenge for some than a medical issue (simply learning to pay attention, concentrate a bit more, or for school-aged kids working on altering learning conditions to satisfy any conflicts). My mother is a sepcial education teacher, and she's seen plenty of smart and well adjusted kids, particularly boys, get tossed into her class because of allegedly having ADD. Some teachers will use any excuse to get rid of kids that compulsively "misbehave", talk too much, or seem a bit "overactive". Pretty stupid, really.

[Jaltus-bot]

The sign is sarcastic, and was made up in Photoshop. Hooters billboards, however, are not. Now, which of these is the greater evil, and really needs offense taken to?

Priorities, people, priorities...

1. We should take offense at any injustice. If something is not good and true, if it hurts anyone without do cause, if it makes anyone to be any less than the creation that God made them, is it not wrong? However small something is, if it is wrong and within our power to change it, should we not seek to do so?

2. I'll bet at least almost everyone here will already agree about hooters.

[shooraijin]

I have an MD, but these are mostly my own not-necessarily-medical observations.

If I had grown up in today's educational climate, my teachers would have probably labeled me as ADHD without a second thought. I got up in the middle of class without warning and wandered about (I still pace a lot when I'm mentally working on something), I blew through work much quicker than they were expecting (and since my grades were decent, this told me that the work I was given was more to keep me at my desk than teach me anything), and I have a thought and operation style where I like to focus on a large number of projects and multitask between them rather than sit down with a project, do it, and then pick up another.

None of these make me less productive, or less able to do the work, than any of the other kids in my class. However, because I didn't conform to the traditional model of how my teachers expected me to learn, that potentially made me unmanageable.

There's a fine line here between blaming the student and blaming the teacher. My mom's opinion at the time was this: he can do the work, and he's not hyperactive. I'll sit him down at home and make him. It's not a medical condition he has -- he simply has to learn how to sit down. At the same time, however, my mom had expectations that the teachers would provide me with appropriate goals to work for, and that if I needed more challenging but educational work, I should get it. (Thus a transfer to the GATE class for three years, where I was able to do stuff like pre-algebra and higher level science, but at the same time, learn to stay in a chair for more than five minutes.)

Do I think the ADHD diagnosis is a garbage can for unmanageable kids? No, but I do think the diagnosis is so overapplied that it risks stigmatizing the much smaller proportion of those diagnosed with the disorder who really do have an organic chemical instability that needs treatment. I think a great number of ADHD kids are kids like myself who need structured education *and* education that caters to a more creative (and most importantly *multitasking rather than sequential*) thought process as well as emphasizing the traditional three R's. The GATE class I wound up in was a good fit for me, made an even better fit by a strong parental commitment by my mom to SIT YOUR BUTT DOWN! and teachers who allowed me to proceed along a multitasking way of learning and still at the same time give me the essentials and most importantly SIT MY BUTT DOWN.

Please note that I heavily respect teachers. I really do. And certainly with today's budgets getting smaller and class sizes getting bigger, teachers have a bigger load. That doesn't excuse them, however, from their goals of trying to forge individual bonds with their students to recognize their needs, and I think the ADHD diagnosis gives them too easy an out (and a straw for parents to clutch at) when the child is different from what they've been taught (or willing) to teach. Just the same as I think the ADHD diagnosis is real, I think there's a lot that can be fixed without *medication* and without slapping the label on so many people.

Speaking on a medical tangent, I don't like any of the pharmacological treatments out there now, though I can't argue with their effectiveness, of course. I think the psychostimulant family, of which Ritalin is a member, has a lot of problems with its psychiatric effects (which is a bad deal with ADHD, where there are probably some emotional issues [situational and intrinsic] which could be adversely affected), and it's an amphetamine, after all. On the other hand, Strattera is pricey and has some of the same limiting effects as other neurotransmitter-effecting drugs (and may not work as well).

All this to say, it's a difficult topic.

[Bobtheduck]

I took cylert for a while... I actually shut down and was unable to speak or react for a while, though I could see and hear everything happenign around me... It was pretty scary... My teacher thought I was just goofing off, but when I started speaking really slowly (and drooling) he figured out something was wrong... I just think its bad to try to throw medicine at something like that... Too dangerous...

[Jaltus-bot]

http://www.add-adhd.org/ritalin.html

People don't always work the same. In the past I've been more able to alertly respond and focus on cylert than off. You have to consider all of the treatment possibilities. Simply throwing medication at something and thinking that enough is highly irresponsible, but a little bit of medication to ease without completely covering it up for a time to develop coping skills and methods which will last longer can in some cases be usefull.

I remember sitting still staring at the same 2.5 pages for a whole hour before I went on ritalin. I didn't have to be told to sit there and do my homework. I just needed to be able to concentrate long enought to do it. When I first went on medicine for ADD, it was like I could suddenly control my attention better. It was like something turned on in me and I could do those things like spend less that 2 hours on 5 pages. I had the extra boost that I needed to learn how to pay attention.

Medication isn't the only treatment and it should not be used alone without considering any other ways of dealing with ADD. It does, for a few at least, have value. I think that the over use of ADD diagnosises and meds takes away from what is legitimate in this matter.

[Debitt]

I'm glad someone's speaking out against the mass prescription of ritalin. I have ADD myself and I refuse to take it because of the stories I've heard about the drug - stories that seem to include children as young as 6 becoming depressed and suicidal. A close friend of mine, is unable to recall her childhood because she was put on ritalin at a young age.

What so many people fail to realize is that children shouldn't be diagnosed with ADD/ADHD until they're older. Kids are kids, they're supposed to have boundless energy. They're supposed to want to go out and play. Between the ages of 3 and 10, kids don't want to sit still. Too often the playfullness of childhood is mistaken for ADD and kids who don't need the drug are put on it, something which needs to be fixed, and fast.

[Jaltus-bot]

Kokoro Daisuke, a lot of what you say is good, but please don't forget that there can be exceptions to it. Everytime someone says blanketly that it should not be used and that ADD should just be treated other ways, it hurts me because I know what I would have lost. I know that it is far to common to just use things like ritalin at kids. There are a few who would genuinly benefit from it in conjunction with other adaptations. These are the ones for whom it should be prescribed.

I have seen for myself what ADD is like without ever having medicine and after starting medicine. I have been given so much more potential that I can reach because I went on it. Every time someone says that it is just a bad idea with exception, I feel like so much of what I have been given because I had that extra help from the medicine is something they would just assume deny me because I should not ever need medicine to have that. But I could not get it. I could not have pretended even to think of doing the things I can now. I might even have not wanted to college. I am not a failure, but I could easily have been without it. I know, I've lived it.

[Fireproof]

I might have ADD. I don't take Ritalin; It might stifle my creativity and turn me into another non-unique normal person. Where's the fun in that? 'Sides, I talk with my parents and work things out instead of taking medication. I wouldn't want to take medication anyways.
Parent: Take your medicine, Fireproof.
Fireproof: Okay. *Drops Ritaling on floor*

[Yojimbo]

Well I used to take medicine for ADD. Ritalin and another type I can't recall and I don't think it helped that much. I've been off those types of medicines for months and I don't see much change from when I was on them. I was diagnosed for ADD when I was 8 but to this day I still am not sure if I really had it. I have my spurts where I can't concentrate but it goes the other way too. The point of whether I really had ADD or maybe minor ADD (if there is such a thing) has confused me this day. So I won't give an opinion on the subject either way.

[Jaltus-bot]

I might have ADD. I don't take Ritalin]talk[/b] with my parents and work things out instead of taking medication. I wouldn't want to take medication anyways.
Parent: Take your medicine, Fireproof.
Fireproof: Okay. *Drops Ritaling on floor*

This is the nicest thing anyone has said so far. Thank you.

Parents are great. I've learned a bit about how to deal with it from my parents and my mom is great if I need help getting organized to anything. My medication gave me the extra bit of help I needed to get here.

I am not normal in a monotonous sense of the word. Maybe you can be like me and be successful, flakey-for the sake of interesting fun, and creatively random. I used to chase our sadly now arthritic cat across the backyard. I sometimes watercolor or pretend my acrilics are watercolors. I like to stickytack all kinds of things on my walls. I sometimes write, especially recently.

[Fireproof]

I suppose you're right, but my ADD isn't out of control or anything.
Things would be really difficult if it were...
Fireproof: *Staring at fly on the ceiling* Sweet!
Teacher: Ahem.
Fireproof: *Still staring*
Teacher: AHEM.
Fireproof: *Still staring*
Teacher: AHEM!!!
Fireproof: You got a problem or somehting? *Goes back to staring at fly*

But seriously, I do sometimes get distracted, but it's not a big things. I'm normal too, it's just an odd kind of normal.

[ClosetOtaku]

I am the parent of a creative but ADHD-diagnosed child, and am among those who decided not to follow the medication route. I attempted counseling (to no avail), and now, several years in retrospect, I am wondering if I chose correctly. My child's behavior has taken an enormous toll on relationships both within and outside our family.

Our pediatric neuropsychologist diagnosed my child along several DMS-IV axis, including ADHD and several other personality disorders, and suggested a course of medication. I thought that putting a child of her age (she was 10 at the time) on medication was just too extreme. I took her to a family counselor who disagreed with the diagnosis (he is a PhD, not an MD), calling her a "normal teen-ager", but could not get her to cooperate with counseling efforts.

Since then, her behavior has gone downhill. She does poorly in school, is constantly getting in trouble with the teachers, and has been suspended several times. She terrorizes her younger brother and is completely disrespectful to her mother. All forms of punishment -- including taking away virtually every possession and grounding her to the house -- have had no effect. In comparison, her two brothers (one older, one younger) are both good students and have had no behavioral problems either at school or at home.

And yet - almost like flipping a light switch - she will swing from terrible person to calm, respectful, creative, and even funny young adult, immensely talented at art and music, sensitive... About a month ago, we were watching a Discovery channel episode on insects, and the TV showed one insect attacking and devouring another. She burst into tears. "What's wrong?" I asked. "That insect didn't do anything to deserve that!" she wailed. It is this part of her personality I didn't want suppressed by the medication.

So... I empathize with those parents who have struggled with the decision to put their children on medications. For some parents, it is a "no-brainer": medicate the kid and let me get on with my life. For others, like myself, it is the decision between attempting (and possibly failing) to deal with the real, unmedicated child, or medicating to save everyone (including the child) from the consequences of their behavior. It is not, and should never be, an easy decision.

[Debitt]

Kokoro Daisuke, a lot of what you say is good, but please don't forget that there can be exceptions to it. Everytime someone says blanketly that it should not be used and that ADD should just be treated other ways, it hurts me because I know what I would have lost.

I never said it shouldn't be used, I was getting at the point that many (not that I say many, not ALL) children are prescribed it far too early - kids who are 6 shouldn't be on a drug that's closely related to speed (I believe that's what it is, correct me if I'm wrong), and today there are other drugs on the market that may be better for a young child. Yes, there are always exceptions - there are people who do need it because of the way they're anatomically put together, and there are people who can go through life just fine without it. I'm not saying that it should stop being prescribed, I'm saying that doctors shouldn't jump all over young kids who may or may not have ADD and pump them full of ritalin.

[shooraijin]

> My child's behavior has taken an enormous toll on relationships both within and outside our family.

This is probably going to be a strange consideration, but some of the things you're describing almost sound like bipolar disorder. How old is your daughter?

Bipolar is one of the differential diagnoses for ADHD, and in younger ages it can be very difficult to tell the difference.

[Saint Kevin]

One question, more towards Shoo cause he's an MD and might know: Are there consequences of using a stimulant like Ritalin for a long period of time?

[ClosetOtaku]

> This is probably going to be a strange consideration, but some of the things you're describing almost sound like bipolar disorder. How old is your daughter?

Bipolar is one of the differential diagnoses for ADHD, and in younger ages it can be very difficult to tell the difference.

Not strange at all; in fact, we'd suggested that to both the MD and the PhD. The MD said it was possible; the PhD didn't agree. I can see just how difficult it is to diagnose these ailments with any degree of certainty!

My daughter is 14. She hasn't seen a mental health care professional in about a year, but I am thinking it is about time to have her seen again. This time, if medication is indicated, I'm thinking I will agree to it on a trial basis. Whether she'll cooperate, of course, is another question...

[shooraijin]

My daughter is 14. She hasn't seen a mental health care professional in about a year, but I am thinking it is about time to have her seen again. This time, if medication is indicated, I'm thinking I will agree to it on a trial basis. Whether she'll cooperate, of course, is another question...

Quite. It will be very interesting to see what they say (and very important what she says).

Are there consequences of using a stimulant like Ritalin for a long period of time?

There are no good prospective controlled studies on Ritalin long term use. The only one I've run across that even made some attempt to derive a conclusion is a 2001 University of Buffalo study that looked at mouse exposure to Ritalin, and discovered certain genes were being switched on -- the same genes that would be turned on by exposure to cocaine and street methamphetamines. This study has several important criticisms, however: 1) it was on mice 2) the dosages were far in excess of the mg/kg dose typically given to patients 3) the study wasn't long term -- it was a derived conclusion looking at gene expression known to occur from drugs like coke and meth, but any additional novel genes, or any gene turn-*off* that might occur from Ritalin's formulation, wouldn't be known because the exposure and observation period was only about 90 minutes. Basically, the study only managed to prove conclusively that ... more studies are needed.

On the other hand, there are a number of retrospective case analyses that are coming to light. These studies, looking at people who took Ritalin as children, generally concurred that 1) the risk of growth suppression, an earlier feared adverse effect, is a very small risk made smaller with drug holidays 2) appetite suppression tends to improve after several months and can be minimized by timing meals around drug levels (... !) 3) there was no generally recognized increase in substance abuse, although studies disagreed on what substances, and what counted as abuse.

There are small but known risks of leukopenia (low white count) which has occurred in some patients on Ritalin, and more worrisome are the psychiatric issues that amphetamines can *induce*, including frank psychosis. This is a small percentage of patients, but the risk is not merely theoretical. Patients may also become more depressed on the medication, but whether the Ritalin is causing this, or merely unmasking a comorbid psychiatric condition, is unclear.