For years, my daughter has had trouble concentrating in school. Her attention often drifts when I talk to her, she forgets a lot of things, and is easily distracted as well. I know that other children in her school with the same behavior have been diagnosed with attention deficit-hyperactivity disorder, and are given medication to help. Should my daughter be taking medication, too?
There has been a lot of skepticism and unmerited stigma from critics who say that attention deficit-hyperactivity disorder is a vague, “made-up” disorder, an excuse for poor school performance, bad manners, and the general restlessness that all children experience to varying degrees. Other unscrupulous and unqualified physicians have taken to prescribing these medication for completely non-medical reasons, such as living in a certain school district or facing difficult family circumstances.
So let me put the argument to rest.
Attention deficit-hyperactivity disorder is a very real neurobehavioral disorder. It impacts millions of children, teens, and adults throughout the world, and a diagnosis is nothing to be ashamed of. And far from being vague, the diagnostic — and prescription — criteria for it are very specific.
To be diagnosed with attention deficit-hyperactivity disorder, a child must display a number of behavioral traits that differ significantly and negatively from those of other children at his developmental level. A child can spend years exhibiting almost half a dozen behaviors commonly associated with the disorder — including forgetfulness, difficulty sustaining attention in tasks and play activities, not listening when spoken to directly, inability to finish schoolwork, and being easily distracted by irrelevant topics and stimulus — and still not necessarily merit a diagnosis of the disorder. Only an expert mental health professional is qualified to determine if a child should or should not be prescribed medications.
The medications most commonly used to treat attention deficit-hyperactivity disorder are stimulants, either in the amphetamine (Adderall, Vyvance) or methylphenidate (Ritalin, Concerta) classes of drugs. As you and your daughter have experienced, for a child with attention deficit-hyperactivity disorder, working closely with a physician and taking her medication as prescribed, medicines like Adderall and Ritalin, do not simply improve schoolwork, behavior, or ability to concentrate, they can change an entire life for the better.
However, using these drugs unnecessarily, or under the direction of an unqualified physician, can have devastating consequences. The United States Drug Enforcement Agency defines many attention deficit-hyperactivity disorder medications as Schedule II drugs, the most tightly controlled substances that are still considered to have medicinal value. Other drugs in the category include powerful pain medications, such as morphine and Oxycontin. Schedule II drugs carry a high risk of physical and psychological dependence, and great potential for abuse. When attention deficit-hyperactivity disorder medications are abused, or taken in excess, side effects can include panic attacks, cardiac arrhythmia, and psychosis.
One of the true dilemmas the disorder is that a diagnosis may inevitably require the input of a parent, teacher, or another non-physician who is in the position to observe a child’s behavior over an extended period of time, someone who understandably wants what is best for the child, but is not an expert in the physical or psychological consequences of taking attention deficit-hyperactivity disorder medication when it isn’t needed.
Ethical considerations aside, if you encounter physicians who casually prescribe powerful medications knowing that the child does not have the disorder the medications merit, it’s perhaps the clearest indicator that those doctors are not qualified to manage the health of anyone, let alone your child.
