ADHD: To Medicate or Not to Medicate?

The question of whether or not to medicate a person with ADHD or ADD is not a new one.  It is, however, still a controversial question, which I think is kind of funny.

In the name of full disclosure, I have ADHD.  It was diagnosed when I was sixteen and a junior in high school by the muckety-mucks at Children's Hospital in Boston, along with disabilities in both auditory perception and spatial stuff.  

   Myself, my brother, and my sister.  I had gotten us all in trouble with the photographer.  I look very sorry, don't I ;-)?

Prior to my junior year in high school, I was a mediocre at best student, except in English class and occasionally history.  I was tested in first grade because they thought I was gifted (and my IQ test bore that out) since I was caught reading Stephen King's Cujo under my desk instead of filling in the "J is for Jam" paper.  I was tested again in fourth grade because I had become an apathetic student, so my IQ was tested again; the number was almost exactly the same as it had been in first grade, meaning I was still of "superior" intelligence, so that's when I received the "lazy" label.  

That label stayed with me for a long time.  I couldn't articulate to the teacher why it was hard for me to stay in my seat, why I couldn't understand multiplication, why I knew my foot tapping irritated her and I didn't mean to do it but I just couldn't help myself.  If we were given four worksheets to do, I would get half of all four completed and receive no credit.  Even though I loved books, listening to the teacher read was torture for me because I couldn't understand what she was saying.

One of the most humiliating days of my life was when the teacher picked up my desk and dumped it out on the floor because it was so jam-packed with stuff.  I had no sense of where to put stuff, so I just crammed it in my desk.  To this day, sticky notes give me anxiety attacks, and binders make me cringe.  I couldn't finish anything I started, I couldn't complete a task without getting up to walk around, and I just in general made my poor teacher's life miserable.

And so my label as "lazy" became something of a self-fulfilling prophesy.

Until I realized the summer going into my junior year that I'd better get my ass in gear if I wanted to go to a good college.  School started, and I tried with all of my being to do well, but I could tell from the start that it was not going to make a difference.  I went home crying to my mom one day that I couldn't hear, that Mr. Smith gave us lectures in history class and quizzed us the next day to make sure we were taking notes, but I just couldn't *hear* the lecture.

My mom, who is a nurse practitioner, tested my hearing with her machine and it was perfect.  However, she also did something she'd never done before regarding my lackluster school performance--she listened.  

She set up an appointment at Children's, and I was diagnosed, and suddenly my entire pathetic school existence made sense.  The people there were great; they gave me some wonderful ideas, such as recording lectures to listen to later, finding an using an organization system that worked for me (in my case, it was putting everything in one folder so I knew exactly where it was and so I could go through and do what needed to be done), and so on.  

I got straight As my junior and senior year of high school. 

I should probably mention that my mother refused to allow me to have an IEP or a 504 plan or anything.  She did not want me treated as stupid, and she did not want me walking into college with a stigma (stigmas are the story of my life, apparently).  She also refused to allow me to be medicated for it.

One of my Facebook friends messaged me yesterday, and it really got me thinking.  

Here's the gist:

I've read in some of ur posts that you take adderral for I'm assuming ADHD. My 13 yr old son was diagnosed with that at the age of 6, I know some parents are against medicating children. We recently moved back to NH and the doctor he has has stated that just because he was on meds in the last state we lived in doesn't mean he will be on them up here. His behavior has been affected as well as his grades. What are your thoughts?

My thoughts are, of course, colored by my experiences, and I think it's especially significant to remember that I was not medicated for ADHD until I was an adult.

There is no question that my school experience would have been more positive if my ADHD had been diagnosed earlier and if I'd been treated for it.  I could have learned coping skills and strategies along with my ABCs and 123s, because the lessons that we learn young are almost always the ones that stay with us.

It is a disservice to just let kids (and especially teenagers) with ADHD rip.  Adults, too.  We are impulsive, we often hate ourselves for our actions afterwards but cannot explain why we (jumped out of a third floor window/jumped off a moving train/told your study hall teacher he walked like a duck/kicked your best friend in the face/smoked pot in the bathroom across the hall from the main office in high school/et cetera) and consequently find it hard to apologize, and there is a lot of loneliness associated with the condition because nobody truly gets you, or at least it feels that way.

We are actually contemplating having Ariel tested.  There is definitely a genetic link, and she exhibits many of the symptoms (I see them with both my mother heart and my teacher eyes).  Jeff used to scoff when I mentioned it, but he's starting to notice it, too.  Because she does so well in school, though, a doctor would be hesitant to medicate.  It's important to remember that only surveys given to people that see a child in different atmospheres are truly accurate.  If they surveyed Jeff and I, the results would be very different than what her teacher and her gymnastics coach would say.

I should mention that many non-medicated children with ADHD find ways to "hyper-focus" as it's the only way they can rest their brains.  For me, it was reading; I could sit and read for hours without stopping, without moving, without jittering.  A lot of ADHD kiddos fixate on video games.  For Ari, I suspect that gymnastics is starting to serve this purpose for her.

Anyway, what I responded to my friend was:

If the meds help, he should take them. I mean, I wasn't on meds until I was an adult (my mom didn't believe in ADHD lol), and it's a lot easier to learn coping skills as a child with the help of meds than as an adult (speaking from experience). Do you mind if I write a piece on this? I won't use your name.

Ask for surveys to be filled out by three if his teachers, and you should fill one out, and if he's on a team or club than the coach should, too. That gives valuable info. Sounds like you might need a new doctor

So what are your thoughts on this very timely issue?  Did the advice I gave my friend make sense, or am I full of manure?  

Living With Learning Disabilities as an Adult

There is a basic assumption that I am intelligent because
a) I'm a teacher
b) I have an advanced graduate degree
c) I'm a writer (not prolific, true, but one of these days ...)

This is kind of a difficult topic for me to get into because it crosses into the personal more than I'm necessarily comfortable with, but I strongly believe that this is a topic that is under-addressed in society.

I found out when I was a junior in high school, after eleven years of public education, having my IQ tested numerous times (it's in the "superior" range, but I miss out on "genius" by a few points ;-)), and being dismissed as lazy and academically apathetic by virtually all of my teachers, that I have two specific learning disabilities. Several years later, ADHD was added to the mix.

I never had an IEP (special education plan) because my mother did not want me to be enabled. Her philosophy was that life was not going to make accommodations to my disabilities, so I might as well get used to it. Furthermore, I was pretty much about to graduate high school by the time anything would have been in place, so what was the point?

My disabilities were identified through an assessment done at Children's Hospital in Boston, and I cannot say enough good things about that experience. The staff there gave me specific ways that I could take control of both my education and my life (such as recording teacher lectures with a tape recorder, taking tests in silent locations, and so on), and I was a straight-A student my senior year of high school (good thing, too, considering the spotty transcript that preceded that year).

What I had that many students with disabilities don't is an exceptional strength that offset the weaknesses to a degree that I could function to some degree. In my case, of course, it was in the area of reading and, even more so, writing.

I could write an essay about something that I had no idea about, and my teachers would read them aloud as gold standards. I always felt a little guilty about this, but it was how things rolled.

I also have a quasi-photographic visual memory, which has probably been an even greater boon. If I see something, I will remember it with almost total recall, which is kind of a cool skill, I suppose. I am the master of the game Memory ;)

As an educator, I know that there is a label for students like I was--"twice exceptional", which basically means that I had both disabilities and areas of incredible strength.

But my intent with this post isn't to talk about my educational experiences, which would be, I suppose, kind of an interesting post in its own right and might happen one of these days.

No, it's to contemplate how my abilities, much as I know and understand them, have impacted me as an adult. This is an important discussion, I think, because schools today are actually really quick to identify students as disabled, to mass produce IEPs and 504 plans that provide what amounts to "blanket coverage" to ensure a degree of success in school but does not necessarily prepare a disabled child for real life.

I can't speak to a lot of disabilities, but I can bring up the three areas that I have personal experience with.

#1: Auditory Processing
There is absolutely nothing wrong with my hearing, per se, but I miss a lot of what I "hear" because there is a crossed wire (or something) in my brain that doesn't allow me to process what I hear.

This is one of the reasons that I avoid the telephone. It's not that I don't want to talk to people, but if there is any sort of background noise whatsoever (other people talking, the television being on, even something as simple as a fan or a car's engine), I'll more often than not let an incoming call go to voice mail.

It's kind of embarrassing to say, "What?" every time someone else talks.

I also have a tendency to avoid loud crowds of people for the same reason. I have to really struggle to follow conversations (I learned some lip reading through the staff at Children's, but I'm not great at it), and sometimes it's just not worth the trouble.

What I most enjoy, though, is that most professional development offered to teachers is of the "stand and deliver" school of thought. If I don't have something visual to follow, it's sort of like being back in history class listening as hard as I could to a lecture that went in one ear and out the other.

I am not a quiet person by any means (heh heh), but I often come off this way to people I first meet because I am very aware of my auditory processing issue and don't want to be remembered as the chick who kept saying, "What?! Say again, please? What did you say?"

#2: Spatial
Perhaps ironically when you consider my exceptional visual memory, I have virtually no spatial skills.

My mother is very into moving furniture around, for example, and she'll say, "What if we moved this coffee table there and swapped the couch and the loveseat around?" then get very frustrated when I explain that I can't visualize it.

In fact, she'll often try to draw me a map, which makes the situation even worse.

I cannot read maps. I have absolutely no sense of direction--I still get lost in my hometown, and while it qualifies as a city, it's not exactly huge. I think Mapquest, with its breakdown of how many miles you're on each road, is one of the best inventions ever.

I live on a state road that runs all the way to the beach. I once asked my mother if a certain city that was also on "Route 69" meant going east or west. She looked at me as though I was dumb and said, "Um ... what happens if you go east all the way to the end?" When I looked at her blankly, she elaborated, "You hit the ocean. If you don't want to go to the beach, you'd go the other way. That would be west." This was about six months ago.

And then, of course, there's math, which is virtually impossible if you have essentially no spatial skills. How do you explain the concept of a coefficient to someone that doesn't understand numbers? I walked into Algebra I thinking that X meant multiply.

When I took the GRE before applying for grad school, the results were almost funny. Almost. Verbal: 91st (I think ... it was ninety-something) %ile. Analytical: 75th %ile. Math: 3rd %ile. Third. That's kind of embarrassing ... but I was accepted to graduate school and maintained an A average, so I guess it doesn't really matter.

But when my students ask me to help them with math and I just look blankly at the problem, when I'm trying to calculate how many weeks away the first day of school is and I literally need a calendar in front of me to accomplish this, when I get lost on my way to the next town over ...

#3: ADHD
ADHD, perhaps the most misdiagnosed conditions in the world, is probably the condition that most identifies me as a person. Like, my ADHD is kind of a schoolwide joke at work.

Like most adults with ADHD, I
* live in a state of organized chaos. My desk at work, for example, is a landmark ... yet I have the distinction of being a teacher known for not losing student work.
* cannot sit in a meeting for extended periods of time without resorting to annoying habits like tapping my feet, moving around like I have ants in my pants, sitting backwards and sideways in chairs, shuffling papers around, and so on.
* have a fairly extensive history of impulsive, self-destructive behavior. I cannot say no to a dare, for example, because I'll be doing whatever I've been dared to do before my brain says, "Whoa, this is maybe not such a great idea" ... but I've gotten better about this.
* self-medicate (it's caffeine these days, which is far better than some past bad habits)
* need to multi-task, almost to a fault
* hyper-focus on certain things to calm myself down(I learned from a very young age to almost hypnotize myself through the act of reading)
* struggle with finishing what I've started. I have made tremendous progress in this area, but it still exists.
* am either adored (because I'm funny and endearing and goofy and all that) or the source of frustration (because I'm not always serious and am often loud and goofy and need to be reminded to get things done and such)
* am kind of a good time.

Although my disabilities have been the source of a great deal of frustration throughout my life, they are as much a part of who I am as anything else. I've reached a point where I like who I am in general, and I would not be me, the kind of person who enjoys the odd whipped cream fight and appreciates the better parts of myself all the more because of my deficiencies, if I was "normal" (which does not, in my opinion, exist anyway).

Uh ... squirrel!!!!!!!!!!!!