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Is There Any “Right” Age to Medicate?

Running into an old acquaintance in the produce aisle brought back all the difficult moments my daughter faced before I ultimately decided to treat her ADHD at seven years old.

I was wheeling my grocery cart through the produce section when I came face to face with Rita, a mom I hadn’t seen in over a decade, since our kids were together in elementary school.

“Jennifer…just the person I needed to see.”

She wasn’t exactly the person I wanted to see.  Rita’s daughter had been the honors student…quiet, polite, and shy.  I had the daughter with attention deficit disorder (ADHD or ADD) who struggled in school…loud, boisterous, and unable to sit still.  I felt the judgment emanating from Rita’s face every time Lee lost control of her impulses.  It’d made me feel like the worst mother in the world.

She motioned for us to move our grocery carts to the side of the aisle, and we squeezed between the strawberries and lettuce. In a low voice she said, “My brother has a three-year-old daughter, Caitlyn, who was diagnosed with ADHD.  Her doctor’s an idiot.  He wants to put her on medication!  At least you waited until first grade with Lee, right?”

I gripped the grocery basket. Calm down, I thought. Rita doesn’t have a child with ADHD.  She has no idea of what goes into the decision to medicate.

I thought back to elementary school when Lee was diagnosed with ADHD. What would it have been like if she had taken medicine before seven years old?

[Infographic: Take Charge of Your Child’s Medication ]

At three years old, Lee was in preschool. Circle time was prison time for a kid who couldn’t stay in one place for long.  By her second year, she had fallen behind in her reading development, and felt dumb compared to the other kids. Would medication have helped her sit and learn?

Kindergarten wasn’t much better.  One day, I was volunteering when the teacher made it clear that the students were NOT to call out a large capital “B” if they saw it hidden in the classroom. Two minutes later, Lee blurted it out. Tears slipped down her cheeks as the teacher gave her a lecture in front of the class. Would medication have helped her follow the teacher’s rule?

Her hyperactivity and impulsivity spilled over into social events, as well. At a friend’s fifth birthday party, Lee started a wrestling match with two boys, even after one of their moms pleaded with Lee to stop. I jumped into the melee and pulled her out, then took her home. She was furious, sobbing and yelling to go back. Would medication have helped curb Lee’s urge to tussle?

At seven years old, when Lee was diagnosed with ADHD, her doctor prescribed medication. I’d been wrestling with the idea for a long time, and the thought of giving it to Lee made me feel sick.  But Lee was having such a hard time in every area of her life that I gave in. If only I had known what a difference medication would make in her behavior and focus, I wouldn’t have waited so long.

[A Parent’s Guide to ADHD Medications]

Before I had a chance to answer Rita, she said, “I told my brother to wait until Caitlyn was 10 or 12 before he considers medication. What do you think?”

You’ve got to be kidding me, I thought.  The effect of waiting that long would have destroyed my child’s self-esteem, and broken my heart.  “I don’t think you can really judge by a child’s age if medication is appropriate or not.  I think it depends on the child, the severity of the ADHD, and the impact it’s having on the child’s life.  That’s a decision I think your brother wants to make with Caitlyn’s doctor,” I said.

She listened, but I could tell that her mind was already made up.  After a few minutes impasse, we moved our carts apart and went our separate ways.

Later that day, I was cooking dinner and thinking about our conversation.  Lee swept in the door and yelled out, “I’m home!” Loud and boisterous as ever.  I smiled, thinking some things never change, even at 19 years old.

She moved into the kitchen, skidding to a stop by the fridge.  “Lee,” I said, “…I have a question for you. What if you’d waited to take ADHD medication until the age of 10, or even 12?  What would it have been like for you?”

Lee looked at me for a moment.  Then she said, “Disaster.  I would have fallen behind in school, gotten in trouble for all kinds of behavior I couldn’t help, and been unable to function.”  She started to open the refrigerator, then turned back to face me.  “ADHD is a big part of who I am, Mom. Medication makes it manageable.”

Words of wisdom spoken by one who knows.

[Free Resource: How Do We Know the Medication Is Working?]

3 Comments & Reviews

  1. Thanks for writing this. My son has been adamant about not taking medication and we have respected that. When things happen I always wonder. I was 32 when I started medication and I think it saved my happiness… It gave me a gateway into the world where people manage to arrive on-time etc etc. However, I sometimes wonder if I hadn’t suffered and had started meds at a young age would I appreciate the change or would I have been much more successful. I don’t know and I vacillate on my conclusions often. That is why the medication decision is so individual and difficult. I depends on the person, the chemistry, the medication and luck. Thank you.

  2. I wish this article considered more than one perspective and personal story because there are so many different factors to consider. In the only example shared here, the parent felt like not starting medication at age 7 would have destroyed her child’s self-esteem but at this age, isn’t self-esteem mostly determined by our environment. I know kids can be mean but her examples were that by her second year of preschool (age 4), she was falling behind in her reading development and feeling dumb. Maybe before worrying about medication, we should first make sure our child is in the right educational environment for their learning style. Too many preschools are using inappropriate learning methods that aren’t good for any child and especially miserable for a child with ADHD. A great resource to learn about what is developmentally appropriate and to find an accredited school is Preschool kids should be learning through experiences (not sitting much) and learn to love learning!!! Even in kindergarten where this girl was shamed in front of the entire class for being so excited and blurting out the answer. Too often, our educational system wants to put every student into a box rather than embracing the enthusiasm and creativity often found in ADHD kids. Even with the right environment, medication may be necessary, but no amount of medication can make a bad environment work! it’s important we look at both and talk to our schools about how we can engage and channel these kids to make a difference in their schools and communities.

  3. Yeeeah, I appreciate her opinion but its also an opinion and not right for everyone. I was 16 before I was medicated.. sure I feel like maybe starting at middle school may have been better but I don’t know if it would have been good for me before then. I learned coping skills without meds that I wouldn’t have learned otherwise and make it very possible for me to live a live now as an adult free from adhd meds. Would they help me now? Probably. I’m a nurse and it does make me nervous to know I have a lot to remember on a day to day basis so I set alarms and leave myself a lot of notes. The thing that I think a lot of people underestimate in this entire thing is that stimulant drugs cause two things. Vasoconstriction.. which is okay in kids because their vascular systems are brand new and functioning great.. adults on the other hand are another story and these drugs can cause side effects — the worst being a stroke from high blood pressure/ vasoconstriction. Second.. these drugs can effect certain receptors in the long term which can perminantly effect motivation/ drive beyond what is already the problem, in other words you can make the problem worse with long term use of stimulants. People seem to not consider this when considering adhd meds and doctors dont often drive this point home to parents. I am glad I only took adhd meds for about 3 years of my entire ADHD Combined type life. I also had some pretty sad social moments dealing with my adhd that maybe could have been avoided.. but I learned from those events as well. Life is a journey. I just think parents should be really aware of the side effects of long term stimulant use. My 11 year old who has inattentive adhd and is on the spectrum started Concerta this year at 11 years old and it was a game changer. Am I sad we waited. NOPE. Is she sad we waited? NOPE. She has a wonderful self esteem actually. I’m not saying not to medicate because every child is different but thats my point. EVERY CHILD IS DIFFERENT. Undoubtedly, the authors friend who stopped her in the store should keep her nose out of her brothers kid’s business honestly and refrain from giving her opinion on kids that arent hers but I also felt the article was pushing medication earlier in a way which makes me as a nurse uncomfortable because the downside to starting medication earlier is not mentioned at all and its a HUGE choice.. and a personal choice that should be taken seriously given this is a schedule 1 drug with a high potential for abuse.

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