ADHD-- I don't want to medicate

[borninthesouth]

I have an older child that has been diagnosed with depression, OCD, and ADHD.  She is on so much medication and still can't get out of bed until after noon, still is depressed, has a very low appetite, and is underweight.  I have some control over what she is taking but because she is 19 she and doctor really decide.  My youngest child also seems to have ADHD.  After seeing this roller coaster of meds and side effects, I don't want to have the younger daughter take meds.  I am trying to work with her through other ways to help her not feel overwhelmed and focus on getting work done.  Does anyone have any recommendations that I could research to possibly help with ADHD?  Any day to day techniques?  

Thanks so much!

[kbutton]

If your younger child doesn’t have OCD and depression along with the ADHD, her response is likely to be quite different from the 19 y.o.’s. It’s like saying that you won’t give her eye glasses or thyroid meds because her sister’s depression is not responding to treatment.

There are lots of executive functioning tips people can use to help their ADHD, but most people need meds to learn those successfully, at least to learn them without tons of extra effort.

Others might have great ideas, but having seen what the right meds can do, I feel unethical offering support to a “meds are off the table” approach unless there is a medical reason the individual in question cannot take ADHD meds, or there has been some kind of really special circumstance.

Best wishes

[KSera]

48 minutes ago, kbutton said:

If your younger child doesn’t have OCD and depression along with the ADHD, her response is likely to be quite different from the 19 y.o.’s. It’s like saying that you won’t give her eye glasses or thyroid meds because her sister’s depression is not responding to treatment.

Agree with this. I'm very medication cautious, but put ADHD meds in a completely different category from SSRIs and other anxiety and depression meds. The risk/benefit/side effect calculation is quite different between these categories. That said, you don't say how old your younger dd is, and I haven't personally found it necessary for every kid of mine with ADHD to be medicated for it as soon as we knew they had it. As homeschoolers, we've been pretty able to structure our days in a way that works for my kids with ADHD. If/when it has reached a point that is no longer the case, that's when we have tried ADHD medication (successful for one kid, not for the other, so one takes and one doesn't).

[ScoutTN]

Agree that the older’s depression (and lack of effective treatment) is not a good reason to not consider ADHD meds at all for the younger, if you are at a point where something is needed.  You don’t know if meds will work, or not, until you try them. Would you deny your child medical care for a more physical condition? 
 

Maybe you want a different provider/doc? 
 

Edited January 20 by ScoutTN

[Lucy the Valiant]

There's a book with an often-misunderstood title that has a whole host of ideas for non-medical ways to address symptoms of ADHD. (The author is NOT suggesting that ADHD is a myth, but rather that it's a myth that ADHD *must define a child / person.) It's been a very helpful list of ideas to me personally and to a few others, though of course every child and every family and every situation is completely different. Maybe something in there would be useful? 

[freesia]

I also wouldn’t discount meds. You didn’t state how old she was when she started the ADHD meds—had her ADHD issues already effected her self-esteem? The younger one may be able to avoid that by the meds. I have seen this drugs/no drugs thing play out multiple times and the not medicating route always seems to turn into a character issue thing—if mom and dad and kid just tried harder or kept yo a special diet better or exercised more, etc….. Everyone ends up frustrated and discouraged especially the child. I have not seen medication lead to depression or what you are describing. OCD is the most likely culprit—not the ADHD meds. 

[EKS]

3 hours ago, kbutton said:

Others might have great ideas, but having seen what the right meds can do, I feel unethical offering support to a “meds are off the table” approach unless there is a medical reason the individual in question cannot take ADHD meds, or there has been some kind of really special circumstance.

 

To the bolded, same here.  My son went from non-functioning to functioning.  It was like a miracle.  Apparently, ADHD is the most treatable mental disorder because the meds really do work.

[ScoutTN]

1 hour ago, EKS said:

To the bolded, same here.  My son went from non-functioning to functioning.  It was like a miracle.  Apparently, ADHD is the most treatable mental disorder because the meds really do work.

Well, they do not create a night and day difference for everyone. They do help my Ds some and I am glad for that, but they do not magically make his EF deficits go away or eliminate impulse control issues. I am happy to have even marginal improvement, though. Clearer thinking and less mental “noise” are good!
 

He has been on multiple meds over a period of years and has an experienced psych. Meds were a lifesaver when he was early middle school age and couldn’t sit still! 

[kbutton]

2 hours ago, freesia said:

 I have seen this drugs/no drugs thing play out multiple times and the not medicating route always seems to turn into a character issue thing—if mom and dad and kid just tried harder or kept yo a special diet better or exercised more, etc….. Everyone ends up frustrated and discouraged especially the child. I have not seen medication lead to depression or what you are describing. OCD is the most likely culprit—not the ADHD meds. 

This. It’s the idea of holding things together, but at What Cost? 

And it’s my understanding that when kids take them, they tend to figure out how they are supposed to feel on them, and it becomes natural. For adults, they help, but it feels more prosthetic and clunky if they are new to meds.

That is one big reason that I just don’t get the wait and see thing unless there are major things to consider, which is rare.

 

[kbutton]

36 minutes ago, ScoutTN said:

They do help my Ds some and I am glad for that, but they do not magically make his EF deficits go away or eliminate impulse control issues.

Totally a aside…Not to put more on your plate, and you may have even tried it, but we find Concerta fixes the impulsive behaviors really nicely. I’ve been told that it’s known for that.

But I do know people who don’t do well on it either—everyone is different.

[ScoutTN]

30 minutes ago, kbutton said:

Totally a aside…Not to put more on your plate, and you may have even tried it, but we find Concerta fixes the impulsive behaviors really nicely. I’ve been told that it’s known for that.

But I do know people who don’t do well on it either—everyone is different.

We’ve tried Concerta; all it did was mess up his sleep and appetite, no helpful effects that he or we could observe. 

He’s on Qelbree now. 

[EKS]

6 hours ago, ScoutTN said:

Well, they do not create a night and day difference for everyone.

I get that.  But the fact that they can means that they are definitely worth a try.

My son is on Strattera and I was surprised that it worked at all, let alone to the extent that it did.

I will say that this was after being undiagnosed for 21 years and hitting bottom as an adult.  He was motivated to figure things out, develop better habits, that sort of thing, and the meds are what allowed him to do that.  So the meds were a miracle, but they weren't the only thing in play.

[PeterPan]

Observation 1: If they're over 18 their *medical bills* are their own. You don't have to fund the meds, which might cause her to re-evaluate how she approaches her medical care.

Observation 2: If you want different results, do something different. Since the meds don't typically actually deal with the underlying problems, you get these exaccerbations. If you run genetics, you can dig in on what is really going on, get some labs, do some targeted intervention, and then use less meds.

[KSera]

23 minutes ago, PeterPan said:

If you run genetics, you can dig in on what is really going on, get some labs, do some targeted intervention, and then use less meds.

I know we’ve had this back and forth many times, but it just isn’t that simple at this point. At this point, running genetics is not necessarily going to help someone. Sometimes people find it helpful (or they get lucky and what they try based on genetics happens to work for them), but I think it’s a false “easy answer” to always suggest people can just run genetics and know what is going to make their person better. 

[SFisher]

On 1/20/2024 at 11:23 AM, borninthesouth said:

My youngest child also seems to have ADHD

I noticed that you said your child “seems to have ADHD”

I would start intentionally observing your child’s behaviors that make you think this. Maybe write them down.

If you’re getting specific feedback from school/daycare/babysitter, put that in your notes.

Read a few books about ADHD. 

If you later feel like you need a diagnosis, you will have that background information.

Generally speaking, people perform their best with adequate sleep, nutritious food, sunlight and exercise. So, making sure those basic needs are being met is probably a good starting point.

 

[Malam]

On 1/20/2024 at 9:23 PM, borninthesouth said:

I have an older child that has been diagnosed with depression, OCD, and ADHD.  She is on so much medication and still can't get out of bed until after noon, still is depressed, has a very low appetite, and is underweight.  I have some control over what she is taking but because she is 19 she and doctor really decide.  My youngest child also seems to have ADHD.  After seeing this roller coaster of meds and side effects, I don't want to have the younger daughter take meds.  I am trying to work with her through other ways to help her not feel overwhelmed and focus on getting work done.  Does anyone have any recommendations that I could research to possibly help with ADHD?  Any day to day techniques?  

Thanks so much!

You can try supplements, like Vayarin - it's a prescription phosphatidylserine-bound omega3 pill. Taking PS-bound DHA improves brain bioavailability compared to ordinary omega 3. I'd also suggest D3 and Magnesium. I recommend clarimag since it has both plus some other goodies.

[drjuliadc]

Sleep, nutrition and exercise first, then consider supplements. getting to bed early enough, reducing then eliminating artificial food colors and flavors, especially msg, yeast extract and hydrolyzed proteins that raise glutamate, increase brain inflammation and lower gaba. Eat more zinc based foods like pumpkin seeds, cashews, pine nuts.

Fish oil or omega 3 supplements,Tyrosine supplement as the precursor for dopamine, 5htp as the precursor for serotonin, calming herbs (lemon balm, melissa, l-theanine, chamomile) as aids to make Gaba and supplements with choline to increase acetylcholine, SamE to support norepinephrine.

Designs for Health (DFH) has Neurolink, which has dopamine, serotonin, gaba support all in one supplement. Brain Vitale also by DFH would be support for acetylcholine.

We ran genetics and had two different people interpret the same test. One person was much more helpful by a long shot. He is hard to get into but Dr. Bob Miller with FGA is phenomenal. I wish we had used him earlier. He is commonly thought to have the best genetic test but he will interpret 23 and me or Ancestry’s data also, they just test many fewer snps.

He recommended 3 supplements for my son and the first one I used on him relieved his moderate anxiety by 70% at least, within a week. Maybe he was moderate to severe but he never took a medication for it. He recommended 5 things for my daughter and I have done 3 and I can’t tell a difference yet. She is dyslexic, and is just more emotionally sensitive than I think she should be.

[SFisher]

 https://www.additudemag.com/natural-remedies-adhd-children-nutrition-exercise-sleep/?utm_source=eletter&utm_medium=email&utm_campaign=parent_february_2024&utm_content=021724&goal=0_d9446392d6-36b3616b35-321577749

[Sycamore]

I like the book Finally Focused.

We also have a prescriber who is integrative and will use both meds and supplements, so you might want to find someone integrative/functional.

I have one child who benefitted greatly from stimulants--wish I hadn't held out for so long and deprived him of that help--but then we discovered that they caused long QT (heart rhythm anomaly) and he now can't take any medication that lengthens the QT interval. Now we use guanfacine, which helps with impulsivity and a bit with focus but is nothing near as effective as the stimulants were. We're also using Rhodiola in the morning and LIthium Orotate, Magnesium, and Theanine in the evening (under the advisement of our prescriber). I would give him the stimulants again if I could.

I have another child who tried several stimulants and then tried guanfacine plus stimulants and it was all disastrous and we gave up on meds for her. However, I think her focus issues, while neurologically based in part, were greatly exacerbated by situational depression. So we worked on that with an herbalist, exercise, and changing her sitution, and now the depression and concentration issues are largely resolved. 

Stimulant meds leave the system quickly and are easy to try and stop. SSRIs are a whole different ballgame.

[KSera]

47 minutes ago, Sycamore said:

Stimulant meds leave the system quickly and are easy to try and stop. SSRIs are a whole different ballgame.

QFT