I’m Sad When Patients Won’t Try Medication for Their ADHD

By Steven J. Ceresnie, Ph.D., Plymouth, MI

The idea of using medication to treat problems of behavior provokes deep feelings and equally strong opinions in many people. They have these mistaken opinions even though the Federal Drug Administration first approved medication for ADHD in 1957, and significant research supports the effectiveness of treating ADHD with medication.

Their resistance is even stronger when the symptoms of ADHD are interpreted in moral terms: a pill for laziness? a pill to stop procrastinating? a pill for messiness?

It is difficult for most people to understand that ADHD is a neurophysiological disorder, not a moral failure.

When parents refuse a carefully monitored trial of stimulant medication to treat their child with ADHD, I bite my lip. I’m sad when parents don’t understand that medication for their ADHD youngster can be like “glasses for the mind.” I'm sad because I’ve witnessed hundreds of youngsters and adults benefit from ADHD medication., and I haven’t persuaded this family to try medication for their child. 

Medication is an ADHD treatment that can save a child from a life of problems, such as depression, anxiety, substance abuse, academic challenges, work and relationship failures, and unrelenting, harsh self-criticism. It is a treatment that guides adults with ADHD back to a more normal path through life, home, and work.

Besides medication, psychological education and psychotherapy are often required to treat ADHD effectively. Over the years, I have stressed the importance of medication AND psychotherapy. I’ve learned to take my cues from parents, youngsters, and adults about when they are ready for psychological treatment.

 I urge parents who are hesitant to medicate their child to talk with other parents about their experiences with their children taking medication, to consult pediatricians and child psychiatrists, and to talk with experienced teachers. I urge adults to consider attending a group for adults with ADHD.

I evaluated a 10-year-old boy and recommended medication to treat his ADHD. His parents were not open to medication. They said, “We know how the pharmaceutical companies are more concerned about profits than people. We are not going down that road.” 

These parents then had dinner with their long-time friends, Bill and Jane. At the dinner, the mother of the son I evaluated told her friends that she went to a psychologist who had the nerve to recommend her son take medication. To her surprise, Bill became angry, with veins popping out of his forehead, saying, "I recently started taking Adderall to treat my chronic, previously undiagnosed ADHD." In a loud voice, he described growing up with untreated ADHD and experiencing many side effects because his parents refused to allow him to take medication, side effects such as school failure, substance abuse, and years of relationship problems.

A thoughtful, well-educated teacher saw me about her 10-year-old son’s psychological difficulties. She said, “I heard an advertisement for a brain clinic on a Christian radio station. I went to their website and was impressed by their research and the testimonials of their patients.” She then took her son to this neighborhood brain mapping clinic, paying two-thousand dollars for ten treatments. When the brain clinic treatment did not work, the parents and youngster returned to me. The youngster experienced a successful trial of pharmacotherapy for ADHD.

Here is a list of the changes in symptoms when medication treatment is effective:*

• HYPERACTIVITY (trouble staying still): fidgetiness and restlessness decrease; patients can relax; they can stay at their desks or the dinner table or a movie or in church.

• INATTENTION-CONCENTRATION is greatly improved. It is not only that patients can concentrate better, but they can concentrate when they want to. Distractibility diminishes. Attention to spousal conversations improves, which frequently manifests in better marital relations.

• MOODINESS. Both highs and lows decrease, as do feelings of boredom, and mood is described as more stable.

• TEMPER. The threshold for outbursts is raised. Patients are less irritable, and angry outbursts are less frequent and less extreme.

• DISORGANZIATION-ORGANIZATIONAL ACTIVITIES. Patients get more organized at school, running a household, and working. Patients may spontaneously establish orderly strategies.

• STRESS SENSITIVITY. Patients describe themselves as having their thin skin thickened, having the ability to take life problems in stride, and feeling less hassled by daily existence.

• IMPULSIVITY. Patients report that they do not interrupt others while listening to them. They think before talking, become tolerant drivers, and stop impulse buying.

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*Weiss, Margaret; Hechtman, Lily Trokenberg; Weiss, Gabrielle. ADHD in Adulthood: A Guide to Current Theory, Diagnosis, and Treatment. Baltimore: Johns Hopkins University Press, 2001.