My 6 year old has been having adhd traits. The doctor here has given a medicine 10mg -2 tablets in the morning and 1.5 tablets in the evening. As a mother I can see he is losing appetite. I have also heard from one of his teachers that ADHD medicine taken for too long can cause adverse effect- nervousness in the child. Can we avoid medicine ?. Will therapy help.? His school here in kolkata (India) doesn’t have a counsellor. Does he need to shift to school with a counsellor?

However completing my degrees was ALOT harder I couldn’t study up until the very last night before an exam and would stay awake all night studying the entire syllabus in one sitting. As ADD sufferers know, tryin to concentrate is physically difficult, frustrating, so imagine forcing yourself to read textbooks, case law, articles. I was literally screaming to vent. But, being of a very determined nature I always battled through and I achieved good marks in my undergraduate Law degree.

The masters was equally bad and it culminated in having a week to write my 15000 word dissertation on International Finance Law, which I have to say was HELL, I was broken after that and decided I cannot continue simply forcing my way through life relying on my memory to do last minute work. Even though I did well in my Masters I was very frustrated, and eventually all previous determination dissolved and I was at a loss of what to do, because my confidence was so dented I wasn’t looking for work as I didn’t think I could handle it. It was then that I went to a doctor to tell him about all of this, and he immediately suspected ADHD. When I had all the tests and psychiatric consultation, the condition was confirmed.

I have been prescribed with Concerta and I went through trial periods of 18mg, 36mg and 54mg. 18 + 36mg had no effect whatsoever. However, 54mg was such a revelation that at the time I became emotional and cried. I can now sit calmly and have conversations all the time, and actually be interested in what people are saying, rather than thinking in my head “what the hell is this guy on about..” I am now outgoing all the time while I am on the drug, without being hyperactive. I started reading books + articles for fun rather than forcing myself. I am now looking for work in London as a solicitor as this medication has given me the confidence + determination I had before as well as the ability to sit and work all day long. I am even helping out with an academic at my university as a research assistant for a book he is writing. I am LOVING developing a work ethic that is not concentrated into one impossible task, loving finally being able to organise my time without despairing or thinking that I have a million things to do and not knowing what to prioritise. Previously I would waste time playing my X-Box, going out and getting drunk to try and forget the stress + frustration I felt every single day.

I have no side effects other than insomnia sometimes, however I attribute this to taking my tablet later than I should. The other thing I noticed is that sometimes I feel the effects waning a bit when they shouldn’t be. I am not sure why this is, I try and drink water to increase the reaction rate (this is my own theory and it may not have any basis in science whatsoever, still, drinking water is never a bad thing !). Also, and I am not sure if this is wise or not, but I have a small amount of tea sometimes or lucozade, and the caffeine seems to increase the power of my concentration.

The other thing is the comedown, sometimes at the end of the day I find myself being VERY irritable…however, I do not wish to be a slave to this drug and even though it is difficult I tell myself that I have to behave and have some discipline towards my actions. Even though it is close to being a miracle cure for me, I know it isn’t perfect. But we have to work on ourselves WITH the help of the medicine in order to live the normal life that we crave.

The reason I am writing this is to show that its not just people who fail at school or are constantly hyperactive who suffer from ADHD. I also want to show that even if you are suffering, there is NO subsistute for spirit, determination to not be beaten, and DISCIPLINE!! And of course I am aiming this at adults like myself, not children. I keep thinking how my life would have been different if I had been diagnosed as a chile. My ‘good’ results might have been ‘outstanding’, and maybe I would still be with the girl I loved. I have no regrets however. Finally I just want to say, good luck to everyone, I hope my story ends out well and I achieve the lucrative job that I dream of, and maybe I can portray that no matter how hard it seems there is ALWAYS a way through if you are willing to work hard.

Thanks for reading,

F

The thrust of thought in ADHD management has been to avoid blaming anyone ( which is a good policy) but this fundamentally ignores the fact that the perception of the ADHD sufferer is that significant parts of their daily experience are pretty horrible. I still remember how much I hated school how much I thought many of the teachers were hostile aggressive monsters who hated me and how badly I suffered from bullying at school.

My diagnosing psychiatrist comments that hating school is almost diagnostic of ADHD.

Medication is a vital part of treatment, but treatment that is not holistic will be hit and miss. I guarantee that those studies you quote will not have been sufficiently holistic or sufficiently focussed on allowing the child to deal with the parts of his environment that he finds distressing.

As a rule kids have great difficulty verbalising their dissatisfaction with their environment to people in authority ad as a result they are often not properly or effectively consulted as to the nature of their own experience. It is much easier for us adults.

Going on to medication was like the difference between night and day.
Certainly I had a few side effects- but they were minor and could be worked around. The real effect was that the improved focus produced dramatically better performance at work but much more importantly as a husband and father.

After I had a neck problem treated ( which improved my concentration by a number of mechanisms that are too complex to detail here) I was able to learn meditation. The result of that was that about 19 months after starting treatment (dexamphetamine 50mg/d in divided doses, with valproate for my irritability) I was able to cease medication. I have been off all medication now for 9 months and can honestly say my focus and attentiveness is better than it ever has been on or off medication and continues to improve daily with ongoing meditation.This should not be taken as any form of disparagement of medication- none of this improvement would have been possible without being correctly diagnosed and treated.

I now treat a significant number of ADHD people- and would comment on the above debate that the suitable dosage for methylphenidate (ie Concerta) and other stimulants is a highly variable and individualised affair. Though it is not common to exceed 60mg of methylphenidate per day in Australia, I certainly know of people who have done very well on double that dose and would question the company concerns about a dose of 72 mg.

As a more general comment I would suggest that pharmaceutical companies are very conservative on answering inquiries about unusual variants of usage of their o=products and that conservatism often reflects medicolegal fears rather than realities. If in doubt about higher doses – check with your prescribing doctor. As a rule you will be likely to find that the unusual dose is supported by personal research and clinical experience. That is, after all, what any worthwhile doctor is good at.

SOme people say that their kids appear “glazed” or subdued on stimulants. To me they have been a liberation from a really awful experience that lasted many years. What’s even better I am now often just as good without medication- and I mean really good- attentive, engaged, contributing- alive.
Certainly there are a few challenes yet to be beaten, mostly old wrinkles in relationships. Nothing seems insurmountable now though.

A small comment for Melissa- when we aare not totally decompensated our ADHD symptoms are usually worst in areas of greatest emotional challenge. I see my ADHD as having arisen from possessing more emotional sensitivity than I could handle. When the symptoms are very situational it pays to look hard at the situation in which they arise.

I often thought when we were struggling that I needed to set up a wecam at home so I could go back and look at where I was going wrong. I wish I had- it was not a bad idea at all. Mind you I was so disorganised that a webcam would have been too hard!