There it is again in my Facebook feed, the latest version of “In my day we didn’t have ADHD. We had parents who weren’t afraid to discipline, and kids who were sent outside to play until the lights came on.” Here I am again, trying to refrain from commenting, to keep from feeling insulted, to remember they haven’t seen what I see.
I’d love to pretend I was never judgmental about behavioral issues before our experience, but it’s not true. I’d more than once asserted that “some” kids just needed more firmly delineated lines, and I’d smugly assumed I’d never resort to “drugging” my own children. But the remarkable, wonderful thing about parenting is how often it flicks you off your pedestal.
As a friend recently mea culpa-ed: that pain-in-the-neck kindergartner in her daughter’s class last year? Happy as a clam, sharing lunch in the cafeteria with his father, who it turned out had been deployed the last 12 months. I completely understand this. That stranger’s kid I dissed on Facebook for behaving poorly at the pool? Wound up being the child of acquaintances, warm and generous people who had their daughter send me an apology letter. But the shame was all mine. Because guess what? All kids act bratty sometimes, even yours and mine; it’s part of growing up, of learning to navigate society. Our job is to facilitate such growth through correction and encouragement, not to undermine it with condemnation and finger-pointing. Imagine someone isolating one of your frustrated explosions, say, when your kid’s asked the same question 90 times in the car before you’ve even set foot in the grocery. To a passerby in the cereal aisle, you sound like a real jerk: “All that poor child did was ask for a box of Cap’n Crunch, and his mom totally flew off the handle!”
The point, of course, is that it’s impossible to know the breadth of a situation when we’re only glimpsing moments. Unless someone’s being beaten or seriously threatened, it’s probably prudent to withhold judgment, because it’s entirely possible you have no idea what you’re talking about. Sometimes it’s bad parenting. Sometimes it’s just a bad day. And sometimes it’s beyond either. So here’s my daughter A’s story (told with her permission), and my little plea for caution when playing the blame game.
Our daughter was diagnosed last year with ADHD, inattentive type. She has trouble staying focused and shifting between tasks, difficulty organizing and prioritizing, problems following multi-step instructions and a tendency to skip over details or make careless mistakes in assignments. Taken individually, these hurdles might not sound terribly unusual to parents of middle-school-aged children; your son’s locker is a disaster, your daughter starts a project the night before it’s due. But grouped, these obstacles form a more serious barrier to learning.
It reminds me of the time I attempted to learn to ski, in 12 inches of fresh powder, with a group of friends who already knew how; I would fall, dig around for my lost skis, pound off the snow and ice, struggle to get upright and back into them, then restart my slow descent. By the time I made it to the spot where my friends waited, rested and impatient, I was out of breath and exhausted. But the second they saw me approaching, they’d turn to continue their runs, effortlessly outpacing me. Then I’d fall again. And so it continued, until I began furiously waving them on, demoralized and ready to cry. I would never learn. Everyone but me could do it. I was an embarrassment. This is ADHD thinking.
Let me say here that I understand people’s reservations. ADHD may well be over-diagnosed. I concede that it’s a bit of a catch-all term, with a number of nonspecific, frankly somewhat subjective “symptoms.” This isn’t to say there are not standardized testing methods and strict guidelines, but still, the diagnosis is not as concise and therefore not always as reliable as, say, the detection of a cancer. Kids with a wide variety and intensity of issues fall within the ADHD spectrum, but there aren’t neatly laid-out “stages” of the disorder as you’d find with our cancer example. To complicate matters, ADHD is regularly accompanied by other conditions, such as anxiety or depression, OCD or sleep disorders, and, as in my daughter’s case, it can be extremely difficult to distinguish the horse from the cart (is the anxiety prompting the inattention, or is the attention fueling the anxiety?).
There are arguments over whether some ADHD “symptoms” are not just maturation issues that will sort themselves out with time, or environmentally based difficulties, the natural byproducts of dysfunctional parenting and/or non-supportive surroundings. There have been calls to throw out the term “ADHD” altogether as too broad and too vague to be useful without inviting abuse. If we can’t say precisely what makes a person ADHD, the logic goes, then anyone can be ADHD.
These are all points worth discussing, points I’m neither qualified nor inclined to hash out here. Of course we should safeguard against unscrupulous doctors doling out unnecessary pharmaceuticals to overeager parents. It should be and, in our experience, is difficult to acquire and sustain a prescription. Fine by me if someone figures out how to break down this disorder into more refined, regimented subcategories. For now, though, my daughter falls under the umbrella of ADHD, and for that I won’t apologize.
Personally, I don’t give a damn if we call her condition “Lunar Mood Ring Syndrome.” It doesn’t make her suffering a shred less real, a smidgen less legitimate. And it doesn’t change the fact that ADHD meds have helped her tremendously. I am deeply empathetic with societal reluctance to medicate children. In fact, the idea initially terrified me. For us, though, there simply came a point where it seemed selfish not to try the drugs.
As far back as second grade, I remember instances of teachers remarking on something unusual about A’s learning style, the way she processed, or sometimes didn’t process material. Some things came easily -- the lyrics to a song, a script in a play, the plot of a novel -- whereas others -- the locations of countries on a map, verb tenses in a foreign language, mathematical equations -- seemed virtually impossible for her to retain. An early elementary Spanish teacher described it as a “window shade being drawn” whenever he spoke to her in class. The next year, a different teacher showed us her unusual results from a spatial location quiz, where students had been asked to position items on a piece of paper (ex., draw a rectangle in the upper left quadrant). The requests increased in complexity as the test wore on, but for A, it didn’t seem to matter. Nearly every task was wrong. Nothing made sense.
It wasn’t as if A were slow; she was bright as a button, which made the “holes” all the more maddening. She could hold her own in any debate, write short stories in her sleep, come up with witty retorts on the spot. Her intellect and her work product just didn’t match up. Nor was she lazy. She would (finally, painstakingly) memorize items for a test, then inexplicably, a mere 12 hours later, be wholly unable to access these answers. It pains me to think of the times I said “Just pay attention!” or “You’re not trying!” because she was desperately struggling to do both. As far as she was concerned, I was really saying, “Why are you too stupid to get this?” By fifth grade, we took her for extensive (and expensive) testing to try and figure out what was going on. The testing came back inconclusive, a generalized “math disorder” with results indicative, but not definitive, of attention issues. It was strongly recommended we retest in a year or two.
We finished elementary school without much incident, then junior high hit with the force of a nuclear bomb. Small daily failures mounted, as did my daughter’s dread surrounding the school day. Multitasking skills, such as listening to lectures while simultaneously taking notes, proved nearly insurmountable for A, so she’d simply shut down, accomplishing neither. Thus began a cycle of frustrated intentions, aborted attempts, reactionary checking out and full-blown panic. The harder she tried to concentrate on one thing, the more her brain focused on what she was missing. Anxiety smothered curiosity.
For nearly a year, we did everything we could think of to shake off the weight. We hired math tutors and organizational tutors. Teachers worked one-on-one with A in after-school sessions. School counselors listened and offered encouragement. Friends soothed tears in the girls’ bathroom. Her piano instructor stopped mid-lesson to teach breathing and relaxation techniques. I took her to mother/daughter sessions with a yoga instructor. My husband took her running. We considered hiring a “life coach,” the sort of thing we would have snorted at in our old life. Nothing helped.
Countless hours, sobs, words of support and frustration passed across our kitchen table, sprawled on our bed, parked in our driveway, the ignition long-since turned off. Desperation, self-loathing, and hopelessness for her; determination, aching worry, and helplessness for us. Our other children suffered, too. We had no time for pedestrian tales of their days, no time for basic homework help, no time for pre-bedtime stories. When one kid is drowning, you can’t worry about perfecting another kid’s strokes. The days fell into a pattern. She’d be tense, moody, silent on the way to school, fretting about the day before it began. I’d fight rising panic on the way to afternoon carpool, squinting to see her expression, searching for body language clues as she approached the car. The flood of tears, the gush of words, usually began before the door fully closed. She would never learn. Everyone but her could do it. She was an embarrassment.
I began to dread teachers, their purposeful strides toward the carpool lane, their hushed tones at the window, their concerned emails and well-meaning phone calls. I already knew what they wanted, found it nearly unbearable to rehash A’s day, to hear of the panicked breathing, the distressed expression, the inability to take in their words. Her homebase teacher’s eyes were soft, almost pleading, when she finally said, “She shouldn’t have to work this hard.”
Things had gotten out of hand, yet I’d steadfastly refused to even consider medication. Why? It’s true I worried about side effects on her growing, hormonally charged body — I still do. But in retrospect, I have to acknowledge that the stigma of ADHD as some sort of con game, a “lazy” way out, played a huge part in the delay. I loathed the pop-a-pill ignominy of it, thought of it as giving up somehow, avoidance rather than confrontation. It’s horrifying to me that I let my pride prevent me from seeking out the help my child needed, help it was my sole job to demand. I’d let her sink down in Georgia red clay, caked and cracking, dabbing with a sponge when I needed a pressure washer.
We found a psychologist, conservative in her approach and indisputably ethical, with whom A developed an immediate, easy rapport. We took her to be retested (again at great expense). Her anxiety levels were off the charts, so much so that they overshadowed clinically significant ADHD red flags. The results were murkier than we had hoped. Either it was an anxiety disorder at root, or the ADHD had elevated anxiety to the point that it now eclipsed the original affliction.
The dreaded subjectivity had come into play, a hallmark of ADHD criticism. In the end, it was indeed a bit of a judgment call. The clinical observations of her psychologist, the personal observations of her parents, the self-reflective observations of the patient, all pointed to attention as the primary culprit. By this point it was nearly summer, which gave us time to reflect on next steps while continuing intensive therapy. A’s anxiety subsided, not all at once, but progressively, and significantly we felt, with the retreat of the school year. A few weeks into summer, our old daughter reemerged, happy, funny, free. We agreed to try ADHD medication at the start of the new school year.
The turnaround has been monumental. This year, as an eighth grader, she is making A’s — high A’s, for the most part, and more importantly, she seems to enjoy school (as much as an eighth grader can) again. The dread has vanished. While I don’t attribute this solely to pharmaceuticals, I’d be a fool to deny they’ve helped. They aren’t magic, but they’re another tool in her arsenal. I often think that for her, more than anything, the medication, the diagnosis, signified hope. Giving a name to her condition gave her a way out. She could learn. She could do it. She didn’t need to feel embarrassment.
So she’s seized this momentum, laboring impressively, and with ever-increasing confidence. The first few weeks she seemed tentative, “I got a 93 — but Mom, seriously, it was just an easy test,” as if acknowledging firm ground would cause it to sink beneath her. With every triumph, though, she’s learning to trust her weight. It’s true there are still fissures, but somehow they no longer threaten to crack open and swallow her whole. Regular therapy sessions, dedicated study habits, improved organizational routines, committed teachers, devoted parents, and yes, pills, keep the earth solid, at least for now.
I don’t care if I change your mind about ADHD, but I’d like to think you might pause in the future before openly calling blanket bullshit on any psychiatric disorder. And I’d ask that you check that flicker of an eye roll I sometimes detect when I tell people my daughter has ADHD. She’s “earned” this diagnosis, and she deserves your respect.