ADHD Ritalin or Relationship?

From the minute of his early arrival into the world, my fourth child seemed to be one ceaseless motion of eating and crying, all mouth and thrusting extremities. Michael slept well, at inappropriate times, rarely at night.

Michael never walked. At eleven months he ran. And climbed. And threw. And hit. And eagerly, joyfully grabbed each day as his, rather like an exuberant, enthusiastic puppy. His sunny nature and good spirits were contagious, and during the first few years, the comments from friends and neighbors were amused and appreciative. "Never stops, does he?" "Wow, look at all that energy!" "No grass under this one's feet!"

The tenor of the comments changed as time went on. "Please, we expect that as a kindergartener, Michael should be able to lie quiet on his mat." "Michael is constantly interrupting." "He can't sit still." "Please can he come to daycare with empty pockets, as he keeps distracting at story time with his pocket contents." (This in spite of the fact that we patted him down every morning, removing bits of string, wires, dead batteries, and assorted pebbles, before leaving the house.) "Why can't Michael cooperate when we do circle games? He always has to sit out, and he won't stop dancing?"

As parents, we often felt exhausted, inadequate, stressed out. Our two other sons had never demanded so much. Why was this child so incredibly active? It simply was not just a matter of getting our act together, of aligning our expectations to those of his teachers or babysitters; this kid was different. He was quickly labeled a troublemaker, and our parenting skills were frequently questioned, not least by ourselves. He seemed unable to get from A to B without going off on at least five tangents.

Concerned kindergarten teachers suggested we consult our family doctor, who suggested a one-month trial of Ritalin. Our son, the doctor said, more than met the definite diagnosis of ADHD (Attention Deficit-Hyperactivity Disorder). As parents, we were unsure, hesitant, worried that any drug might change our son's bubbling personality. But what if it would mean that he would stop dancing on the table, throwing things, climbing walls, and disrupting story time?

So, we gave it a try-and it worked. Michael could sit quietly at the table, stopped throwing things, could focus on one occupation instead of flitting from one to another, and stopped hitting things and people. In short, he could behave relatively normally in a group setting. Oh, we had plenty of battles remaining; he was still a normal (oh-so-blessedly-normal now) boy. But now, suddenly, the teachers' comments were approving, and the whole family seemed to collectively breathe in and settle down. At the next scheduled PTA, his teacher was ecstatic. We had told no one of our decision to start Ritalin, as we were keen to see if it made a noticeable difference before deciding to continue it.

In school Michael was bright and attentive; academics were no problem. The hyperactivity and attention deficit were well controlled with occasional adjustments of his Ritalin dose. People still commented on his enthusiasm and abundance of energy, but he no longer stuck out. Occasionally, we inadvertently missed a dose, and the ramifications were so immediate and obvious that it reinforced our increasing reliance on the pills.

Just before Michael started fourth grade, our pastor asked, "Is it right to sedate children with ADHD so they fit in? Are we not ready to accept these children as they are? Can't we find creative ways of channeling their unique energy and force?"

We were skeptical, yet agreed to give it a try and stopped the Ritalin. Instantly, the extremes were back. He was once again the dynamo of those early years-the constant hyperactivity, wild naughtiness, and bright exuberance were back in a heartbeat. One glance in the classroom would show him swinging on two legs of his chair, tapping his plastic ruler to a rhythm of his own making. Wires and batteries again emerged from his pockets in math class, his concentration was short and divided, his body never still. He interrupted constantly, disturbing, distracting, once more a bundle of explosives in a chronic state of spontaneous combustion.

We were immediately inundated with floods of well-meant advice and reflections on our parenting from friends, neighbors, and teachers, who had been unaware that he was on Ritalin, and were equally unaware of our decision to withhold the drug. "Shouldn't he be able to sit still?"

I was always exhausted, always on the defensive. Fortunately, my husband does not share my volatile temper, and his steady insistence that we stick to our plan of action kept me from despair. Soon, we noticed that the zest and enthusiasm Michael brought to each day remained undiminished; he seemed unmindful of the constant disciplining and correction from teachers and parents alike.

Do we regret our decision to discontinue Ritalin? No, we'd never go back there. Five years later, we are still thankful to our pastor for changing the way we looked at our son. Who knows what facet of our son's childhood and growth we might have missed in our mistaken effort to make him fit in by medicating him? Would we have suppressed some of the uniqueness so evident in Michael, and thwarted what God had meant him to be, in our attempts to make him more manageable?

Do others regret our decision? It often seems so. Our highly structured society and increasingly regimented standardized schooling do not allow much room for the Michaels of this world. It takes a big heart to manage such a child within the limits of the daycare or classroom setting.

Today Michael has settled down tremendously. One thing that we have never regretted is that Michael never knew that he was being medicated for hyperactivity. We let him assume that it was one of his asthma medications. We felt that if he did not know that he had a specific diagnosis, he would never excuse his own behavior, and would be treated as normally as possible.

We still have occasional contact with old friends and teachers, and it is always Michael whom they ask after, although we have four kids. "Is he still the same?" is their invariable question, and we know all too well what they mean. No, he's changed, and so have we.