To medicate or not to medicate ADHD: One family’s story

ADHD medication. How do you decide if it’s right for your child? It’s a very personal decision that often takes time. Learning about the experiences of other families can help. 

In this episode, hosts Rachel Bozek and Gretchen Vierstra talk with Amelia, a mom whose son started taking ADHD medication during high school. Amelia shares the journey that led to the decision to medicate, including the worries she had. Find out how her son feels about taking medication. And hear Amelia’s advice for families who are making this decision.

Plus, get answers to common questions about stimulant medication from Dr. Kamille Williams, a psychiatrist who has lots of experience talking with families about ADHD medicines. 

Related resources

• ADHD medication side effects

• How does ADHD medication work? 

• Listen to this episode of Understood Explains Season 2 to learn more about medication: ADHD medication: What do I need to know?

Episode transcript

Gretchen: From the Understood Podcast Network, this is "In It," a podcast about the ins and outs...

Rachel: ...the ups and downs...

Gretchen: ...of supporting kids who learn and think differently. I'm Gretchen Vierstra, a former classroom teacher and an editor here at Understood.

Rachel: And I'm Rachel Bozek, a writer and editor raising two kids with ADHD. Today we're talking about ADHD medication and how to figure out if it's right for your kid.

Gretchen: Later, we'll be putting some questions to Dr. Kamille Williams, a psychiatrist in Atlanta who has a lot of experience talking with parents and kids about the benefits and risks of medication.

Rachel: But first, we're talking to Amelia. Amelia is the mother of a boy we're going to call Sam, who started on ADHD meds just before his first year of high school. Getting to that point was a long and winding journey, and Amelia's sharing her family's experience with us in the hope that it might help other families find their way a little bit more easily.

Gretchen: We were so happy to welcome her onto the podcast.

Rachel: Hello. It's really nice to meet you.

Amelia: Yes, you too. I'm so happy to be here.

Gretchen: So I think we're going to just start off by having you tell us a little bit about your son.

Amelia: He is 14, and he has just really started to become a teen. And what I mean by that is that the irritation levels that he has with his parents have really ratcheted up an extra notch in the past few months.

Gretchen: I totally get that.

Amelia: So, yes. So, he's 14. He's a freshman in high school. He's really into art. He's really into television and comedy and "The Simpsons" and "South Park" and all of that kind of stuff.

Rachel: So when did you first realize that he might have a learning or thinking difference?

Amelia: Really, really young. But I think we were kind of in denial about it for a super long time. But I remember in pre-K, he said that school was so boring that he spent time — they had like a letter border around the edge of the room, the ABCs. And he was very proud that he not only could do his ABCs backward, but he could do the whole song. And he's like, yeah, that's what I do with my time at school.

And we got called in frequently by his pre-K teacher — not because he was disruptive. He's always been very good at sitting in one place and focusing. But because he constantly asked questions. And we were young, new parents and we're like, oh, we thought that that was a good thing, right? Like kids, you know, smart kids ask a lot of questions. So we kind of like kicked the can down the road a little bit.

But he really hated school pretty consistently from kindergarten on. By the time fifth grade rolled around, things were not getting better. And I remember going in, like to a math class, you know, they did one of those, like invite the parents in for an hour in the morning things. And it was a math demo. And I could see immediately sitting with him that the other children — not all, but most — were doing, you know, one worksheet and then a second worksheet and then a second one. Like it was meant to be a fun math thing. And for my son, it was just not that way at all. He was stuck on problem one and two the entire time.

Gretchen: It was at that point that Amelia and her husband decided it was time to take Sam's struggles in the classroom more seriously. They set up a meeting with the school where it was recommended that they get him a full neuropsych evaluation, which they did.

Amelia: And that revealed, you know, the ADHD inattentive, also mild ASD — autism spectrum disorder. So mild that nobody had picked up on it prior. Oh, and also a processing issue with writing.

Rachel: All of this was a lot for Amelia and her husband to take in. But they were glad to have some answers. That said, they weren't sure how Sam would take it.

Amelia: When we told him, we really tried to frame it as, you know, this is actually kind of a superpower. Like people who have ADHD can focus so intensely on the things that they love and can be so good at the things that they love. And he cried. He cried a lot. And he — it was not, it was not sad tears. He seemed so relieved to have a name for what was going on with him. And then when he heard that there was medication available, he was like, "Oh my God. Well, you know, maybe I should take that."

Gretchen: So, Sam was all for trying the meds. But Amelia and her husband had a bunch of concerns.

Amelia: I sort of just thought it was like legal speed, right? I thought that he wouldn't sleep. I thought that he wouldn't really eat. I think I just really had a lot of biases around it. Like it's going to make him into, like, a robot who can do school, right?

Rachel: I think the concerns that you just mentioned are so common.

Amelia: Oh, can I just say one other thing I thought, which is actually opposite to the truth. I thought that it would be a gateway to relying on other drugs, self-medicating in other ways. That was another thing that I really, you know, just underneath it all, part of why I resisted. Because, of course, that's something you worry about when, you know, your kid is maybe not a big joiner anyway, and maybe has rebel tendencies anyway. right? It's in the back of the back of my mind. So that was another reason.

Gretchen: Despite all these reservations, Amelia and her husband were slowly coming around to the idea of trying the meds. And then midway through sixth grade, COVID hit.

Rachel: At that point, Amelia says the idea of having their son taking a stimulant while being stuck at home all day just seemed like a really bad idea. She was convinced he would be bouncing off the walls. So they put it off again.

Gretchen: Then a year later, Sam began having pretty debilitating health problems. He was ultimately diagnosed with Crohn's disease. And once again, trying out meds for his ADHD got put on the back burner while they adjusted to this new challenge.

Rachel: Throughout this time, Sam continued asking about the medication. And so finally, toward the end of middle school, with his health issues under control, they decided to give it a go. And the results were almost instantaneous.

Amelia: So he started the spring semester of eighth grade, and things improved so quickly. It was kind of a wonder. Not only was it not painful anymore for him to sit and do school, not only did he stop saying things like "I'm the dumb one in class," right? Because that had been going on since sixth grade. Like "I'm the dumb one. You guys think that I'm smart, but I'm dumb.".

But that was his first experience in all of middle school of having a real friend group. And I have to think that there's a correlation. I think him finally being able to focus on conversations and just sort of not dreaming the day away, let him tune in socially in a new way.

Gretchen: Wow. And what did he say about it to you? About how it was making him feel at school?

Amelia: He had a few rough days, like when we first started, where he's like, I feel weird. And, you know, even then I'm like, oh, do you want to stop? And he's like, no, I want to, you know, see how it goes. And very quickly, like once we got the dosage worked out and the type of medication worked out, he was like, oh, this is what it's like for other kids. Like, the teacher tells us what to do and they just hear it and don't have to ask three more times "What are we supposed to do?" So I think it was a really big relief for him.

Rachel: Have there been any negative side effects or anything you've seen that has made you second-guess this decision?

Amelia: I still, in the depths of my mind, I'm like, you know, I'll ask questions of myself, right? Like, is he going to be on this forever? And then I think, well, that wouldn't be so bad because he's so much more functional on it. He doesn't want to not take it on weekends, because he just simply functions better in every way when he is taking the medication.

One little concern we have because of the Crohn's just has to do with eating and growth. He doesn't have too much of an appetite during the day. So we try to get calories in first thing in the morning and at the very end of the day, you know, he'll eat a significant amount. So, you know, that's on my mind a little bit. But he almost slept better than before. It was almost easier for him to go to sleep, which shocked me. So I think that he could have had an easier road through middle school had we just started sixth grade having him on medication.

Gretchen: Well, just know that you're not alone in saying that. I wish we had done it sooner. There's so many families that say that. Because it's hard. I'm sure Rachel can attest to that too. It's really hard.

Rachel: Absolutely. I'm curious if you have any advice for other families, people who are going through this process and trying to figure out whether or not they should give medication a try for their child. Do you have any suggestions or recommendations for how they can think about it?

Amelia: I think it's really hard to see your child in pain, whether the pain is social or whether the pain is like "I'm dumb," or, you know, there is a pain inherent in "I hate school," right? That sucks. You spend all your time at school like, should you hate it?

So I would say for families who have this diagnosis or even suspect that this might be lurking, right? And maybe a teacher hasn't flagged it, but something's off? To just really kind of listen to that and think, you know, could my child's day-to-day life be sort of happy and manageable if it isn't now?

Not to say that, you know, it takes a lot of things to have a happy and manageable life. It's not only, you know, you take a pill and life is perfect. But to have this going on in your brain and have this possibility and kind of leave it on the table, if your child is really suffering with school, I guess I would just say to try to not pathologize what could be an amazing tool that will allow your child to sort of flourish instead of just avoid.

Gretchen: Amelia, we're so thankful that you were willing to come on our show and tell your story. Thank you so much.

Amelia: It's my pleasure. If it can help anybody, you know, I'm thrilled to do it.

Rachel: Thank you. Amelia's story gets at so many of the anxieties I think a lot of parents have when thinking about trying stimulants for their kids. We thought it might be helpful to add some insights from an expert to help us understand these medications a little better.

Gretchen: So we reached out to Dr. Kamille Williams. Dr. Williams is an associate professor of psychiatry and behavioral sciences at Morehouse School of Medicine.

Rachel: She specializes in child and adolescent psychiatry and in the assessment and treatment of neurodevelopmental disorders. She's also a psychiatrist with a practice in Atlanta.

Gretchen: Before we turn to Dr. Williams, we want to make clear to really important things. One is that ADHD medication is not the only way to treat ADHD. There are absolutely non-medication ways to help kids with ADHD. Families can work with a doctor or therapist to figure out what's the best path for them.

Rachel: And two, if you do decide to give medication a try, remember that it may take some trial and error to find the right one and the right dose for your kid.

Gretchen: OK. So getting back to Dr. Williams, the first thing we wanted to ask her was, what do you say to parents or caregivers who aren't comfortable with the idea of giving their kids a stimulant because they think of it as an upper? You know, the type of thing some folks take when they need to pull it all-nighter to finish a project?

Dr. Williams: I would say that their concern is definitely valid and especially with this off-market use that getting it from doctors who prescribe it. But in reality, individuals who have sort of ADHD have an imbalance that that medication actually corrects. So for them, taking the medication will actually regulate the symptoms.

Rachel: So it's like they have a different starting point.

Dr. Williams: Exactly. If we compared it on a scale, they would be at a two for the type of neurotransmitter that the medication regulates, whereas average people could be like a five or six. And so taking the medication will boost them to the five or six. Whereas someone who's already out of five or six would just go straight to a ten.

Gretchen: Dr. Williams also confirmed what Amelia said, that while we may fear that these medications could serve as a gateway to drug abuse or addiction, research shows the opposite. Generally speaking, she says, those who deal with addiction are actually trying to self-treat for what they're dealing with.

Rachel: For those families who are trying one of the stimulant medications. Dr. Williams has some advice. First of all, as was the case with Sam, they may affect a child's appetite.

Dr. Williams: Let parents know when they're prescribed stimulants that it's good to have a hearty breakfast when they take the medicine, because usually around lunchtime, they're not going to have that desire to eat because they're not going to feel hungry. And then once the medicine wears off towards the afternoon and evening time, it's going to ramp back up that they're going to try to catch up on the calories that they didn't get throughout the day because of the medication.

Rachel: What's right could change over time.

Gretchen: Yep.

Rachel: As your kid gets older and they're in high school or college or maybe working a job, they may need to take a booster dose, which is smaller than a regular dose, to help them focus in the evening.

Gretchen: But it also means that kids can take a break from the medication if they want to — say, on the weekends.

Dr. Williams: Definitely. We promote the idea of having what's called drug holidays. So the weekends, spring break, holiday break, things where they don't have to be focused to perform their best and do things, to not take the medication, just be. Because it works in the body for the amount of time that it's designed and it doesn't have like lingering effects compared to other medication.

Gretchen: OK. So some families might wonder this: Is medication a cure-all for someone with ADHD? Like if their kid finds the pill that works best for them, do they just take it for the rest of their life and that's it? ADHD is no longer a thing to think about.

Dr. Williams: I like to tell my parents and families that ADHD, like anxiety, is like diabetes, like blood pressure. You manage it. It will ebb and flow and change. The older you get, certain symptoms sort of resolve itself, but they're certain symptoms that will continue to stay. And that — it just depends on how life goes for a person if they decide to take medications versus not.

There's ebbs and flows where there's periods of like I want to try without being on medications versus like, I think I want to restart medications again because it's been helpful. So I wouldn't call it a cure-all. This is a form of treatment that helps manage symptoms so that you're able to be your best self and be stable and do the things that you like to do.

Gretchen: Well, we want to thank you so much for answering all our questions about medication today.

Dr. Williams: Yes, of course.

Rachel: Thank you so much.

OK, so we know that was a lot of information and we just hope that it was really helpful to you, whether you are thinking about trying medication for your child for the first time, or maybe you've tried something and it doesn't seem like it's working and you want to look into something new.

Gretchen: Yeah. And of course, a reminder that any decision about taking a prescribed medication should be made together with a doctor or psychiatrist who can help you figure out what's going to work best for your child.

Rachel: And if you still have questions about ADHD medications, we have an excellent episode of "Understood Explains" where Dr. Roberto Olivardia gets into all of it. We'll link to that episode in our show notes.

Gretchen: You've been listening to "In It" from the Understood Podcast Network.

Rachel: This show is for you. So we want to make sure you're getting what you need. Email us at init@understood.org to share your thoughts. We love hearing from you.

Gretchen: If you want to learn more about the topics we covered today, check out the show notes for this episode. We include more resources as well as links to anything we mentioned in the episode.

Rachel: Understood.org is a resource dedicated to helping people who learn and think differently discover their potential and thrive. Learn more at understood.org/mission.

Gretchen: "In It" is produced by Julie Subrin. Briana Berry is our production director. Justin D. Wright mixes the show. Mike Errico wrote our theme music.

Rachel: For the Understood Podcast Network, Laura Key is our editorial director, Scott Cocchiere is our creative director, and Seth Melnick is our executive producer. Thanks for listening.

Gretchen: And thanks for always being in it with us.