The whole process of using meds for kids is so complicated, so heart wrenching, but sometimes so thankfully simple. In my combination brain of pediatrician/mom/friend/Christian, I’ve gone through so many phases and thought processes about medication over the years. Early in my pediatric years, when I was still young and single without kids, I tried as hard as I could to stay away from learning about ADHD meds, or even worse, depression and anxiety meds. I didn’t want to become a psychiatrist…I had studied to become a pediatrician! If I wanted to be a psychiatrist, I would have been a psychiatrist! Honestly, on really hard days, sometimes I still think this way today.
But then, several years ago, during a career transition due to a location move, I was forced to once again learn about ADHD meds, as I knew I would be treating these patients again in my new practice. During that transition, I was blessed to observe one of my dear partners in my original practice, whom I now realize, truly saw these kids as the beautiful, full of potential kids that they are. Before I even knew how personally this would eventually affect my life, I was privileged to sit in on these few magical visits when he would speak to these kids so lovingly and patiently and positively, challenging them to own for themselves these years of their education, instead of simply obeying the commands and expectations of their parents. If needed, he would make subtle changes to their medications. He knew these medications in and out, and had taken the time and effort to learn more and more about each new variation that was marketed, in this field that many doctors, even in pediatrics, avoided or disliked. Now years later, as I read as much as I can, observe in my own home, and see in my own patients’/parents’ eyes and body language how difficult this disorder is to navigate, I can understand even more, the reasons why my young doctor self and many other doctors before me, have found these particular patients to be a challenge.
However, I am thankful that in time, the Lord gave me an eye and a heart to love these patients, and those with autism, as well. Again, little did I know, He was preparing me to be ready to face these real struggles on a much more personal level in my own home.
Over and over, I would hear the same stories, and see the same defeated faces of kids and parents coming into my office. It began to anger me even more when I would hear in the outside world, or even in the church, that people didn’t believe in this thing called “ADHD”. “That is just an excuse.” “Anyone could say yes to those criteria.” “Those medications are just used to make classrooms more tolerable.” My heart would break, as I would hear and see, literally, the same stories over and over again. “He just can’t sit still.” “He needs to be moving all the time.” “I have to tell her 27 times to brush her teeth in the morning.” “She’s not like my other kids.” “Homework time is a disaster. It takes 4 hrs for him to do one page of homework sometimes. And that is with constant exhausting battles. Even though I know he knows how to do it, he fights it–crumples up his paper, throws things, fights getting it done. It’s exhausting.”
And over and over again, I see it. This beautiful child sitting in my office (or more often, moving all around my office, touching things, interrupting with innocent inquisitive questions, non-stop insatiable curiosity that hasn’t yet learned boundaries or pauses or patience… And these tired, frustrated, out of ideas, teary-eyed parents, who are wondering aloud, “I don’t know if I can handle this anymore.” “I need help.” “I am out of ideas.” “I can’t go on like this anymore.” “He is disrupting our family so much.”
And we begin the process…which ultimately will lead to a decision about meds…
But before we move on, I have the privilege of pouring into them, encouraging them and lifting them up, during sometimes the most trying times of their lives, before we embark on this journey of evaluation together, most often to confirm what we already know…
So, I always try to take a moment, which become some of my favorite moments…when I literally see the child’s eyes, their soul, and their physical body lift back up as I look at him/her and say, “Having ADHD doesn’t mean you are dumb or stupid! I bet your brain is super creative, or you’re really good at seeing how things fit together. OR, I bet in math, you are quick to figure out/see the answer, but then you get frustrated because the teacher makes you show your work, right?” Sometimes I also get to see the eyes of the freshly diagnosed parent (who has been diagnosed in the process of having their child evaluated and is now looking back over their own life with new eyes, fitting all of the pieces together…), and I say to them too, ‘There is no shame in an ADHD diagnosis! You might just need a little extra help during boring meetings, right?!”
But, eventually, the questions will come and the fears will emerge… “Do we have to do medication?” “I’m not ready to start meds yet.”
And I get it! When I put on my mom brain, I get it. “Do we really want to start something at such a young age? Is he going to need this med forever? Have we tried everything we could possibly try? Maybe we just haven’t been parenting right. Should we be praying more? Is this a Christian thing?” I get it! It is terrifying and consuming and can break your heart if you let it. And honestly, there are some kids and some adults who have ADHD and can still manage in the right situations, adapting their surroundings to function without needing medication.
However, there are many who truly do need medications in order to function in their daily lives. Thankfully, there seems to most often be an obvious time to start. I think these moments of discovery are gifts from the Lord. When we’ve been agonizing over these decisions for weeks, months, maybe years, there is almost always an obvious tipping point…when the difficulties cross a line that we just can’t ignore…when maybe they’ve been managing, even if not easily, or neatly, but there comes a time that suddenly makes it undeniable in our minds…we need this extra help of medication. Most often, it has come to a point when the child is saying negative things about themselves, or they are now hating going to school, or they are losing friends because they are so impulsive they don’t realize they are saying or doing things that are driving even their super supportive friends away…Or worst of all, which has sadly often been a trigger for us, they have become a danger to the safety of the home–their fits of anger or rage or frustration have resulted in impulsive actions which have hurt us or siblings or even themselves…
And, it becomes clear. This is no longer an option. It is time to use this tool of medication.
So, we begin those talks…and trials. We begin to discuss potential side effects and things to watch for. And we take the scary step in beginning this journey. But, unfortunately, it is not always simple. These medications are used for ADHD, or depression or anxiety, or aggression, and are often also used in autism as well. So many of these entities occur together in many children. And, unfortunately, these medications don’t have the same easy formulas that antibiotics or other medications have–plug in your weight, and here is your dose. With these medications, it is more often trial and error, using lots of educated guesses in how they have worked with others in the past, knowing as much as we can about each medication profile, and watching closely for signs of effectiveness, then making fine toothed changes when needed, so that these kids do not become the stereotypical “zombies”, or have “changed personalities”. (Side note from my pediatrician brain–if they do cause these things in your child, it is not the right med, or it is not the right dose or combination of meds!!) These meds are meant to become simply an oftentimes amazing tool to help organize their brains, to calm them, thereby allowing these kids to finally shine in ways they have not yet experienced.
Then come the really fun visits in my office, with the amazed reports from parents and teachers and grandparents and friends and neighbors, who can’t believe the changes they see in these kids! And again, the immense joy in seeing these kiddos come out of their shells. The relationships between the parents and the child, are now able to see some light, a glimmer of hope, that maybe this can get better.
Those are amazing moments. And every time I see these kids, we find reasons to pause and celebrate, even if they may be small during some intervals. “What is something you are proud of?” “What has gone well?” “You should be so proud of that accomplishment!” “Aren’t you so glad you were able to work so hard at that?” We also try to find ways to look ahead and see new possibilities that they may not have even imagined before…things to strive for both in school, in relationships, and even in thinking about future careers.
We pause to celebrate… because it isn’t always perfect…And these medications aren’t miracles…
Often, there are still plenty of challenges, especially with ADHD, since the medications tend to only last a certain amount of hours, and then they wear off, and then those difficult to control impulses come back, along with the moments of conflict and hyperactivity that result in not always easy to deal with, or lovable, behaviors.
Sometimes we end up talking about adding second meds, or even third meds. And again, the Lord has brought me through these cycles of overcoming previous stereotypes in my own brain about kids who are on multiple meds. Back in my young pediatrician, single, no kids brain, and even later into my practice, and even if I am honest now…in weak or tired judgmental moments…I can fall into those same patterns of seeing a list of medications that a child is on and quickly think, “man, this must be a difficult child” or a “disturbed child”. And then I remember my own son’s list, and realize it is long. And I’m thankful again, that similar to the very first time we decided to put him on medication, each time we have needed to add another med, the Lord has brought us to an obvious undeniable fork in the road, that made us face his need for an additional tool, and helped outweigh our fears of adding yet another medication to his young body. Without these meds, we have seen the pain that he suffers in his inability to control his impulses or his worries or his obsessions. We have seen the dangers that his lack of control could, or has caused, our family, either physically–bringing harm to his siblings, or emotionally–flinging stinging, tormenting words to his brothers, or saying things that break our hearts as parents–how can he think that? Or why is his brain going there? We realize that we, as a family, are exhausted, and it cannot, should not be this hard. Those are the times we know it is time to seek help. “The rain is falling, the floods are coming, and the winds are blowing, and are beating on our house…”
So, we have again prayed, and we trust, that the Lord made him just the way he is.
He is “fearfully and wonderfully made” (Psalm 139).
The Lord has a plan for him, and for us, through all of this (Jeremiah 29:11). We do not and cannot understand it. (Isaiah 55:8-11 “For my thoughts are not your thoughts, neither are your ways my ways, declares the Lord. For as the heavens are higher than the earth, so are my ways higher than your ways and my thoughts than your thoughts. ‘For as the rain and the snow come down from heaven and do not return there but water the earth, making it bring forth and sprout, giving seed to the sower and bread to the eater, so shall my word be that goes out from my mouth; it shall not return to me empty, but it shall succeed in the thing for which I sent it.’“)
And we trust the He will be glorified through all of this. (John 9:3 “Jesus answered, ‘It was not that this man sinned, or his parents, but that the works of God might be displayed in him.“)
And we seek the wisdom of those He has brought into our lives…our amazing pediatrician, who is so knowledgable and has so much experience both professionally and personally with all of these things, and who sees, as we do, the beauty and potential in our kids.
And we surround ourselves with friends who understand and who have been through the same things. It is a small community who truly knows and has experienced how difficult it is to live through and function well in the midst of the ups and downs of these behaviors, getting used to the medications, and knowing the heartbreak of watching your children struggle, or watching your marriage struggle, as again in your weakness and fear you turn against one another instead of building each other up or leaning into one another. We know we have to surround ourselves with friends and family who are safe to be real with, who will walk with us and cry with us and will lead us back to truth. Sometimes, especially in difficult times, that means we intentionally avoid those we know who do not understand, or who make us feel judged–who may or may not realize they are doing this. Sometimes even those who are trying to be loving, will at times be hurtful or cause more pain or frustration in our weak and trying times.
So, we surround ourselves with those who will lead us back to truth…to scripture, to worship, to songs that speak truth…all of these leading us back to our one true Rock, who “…sees our sadness, He feels our sorrow, and in weakness, He is strong. (2 Corinthians 12:10) He holds the weight of all of our failings. Great is our sin, but greater is the cross…For every heart that is breaking, for every soul that is shaken, for every sickness, there is healing in your hands. Let every heart awaken to see it is You who saves us. You are my help and the Rock on which I stand…I know the answer to every question, the one solution to every fear. I know my help and where it comes from…Jesus, He is the Answer.” (From Jeremy Camp’s song, “The Answer”)
We know there will be moments of great joy and great peace and great celebration in our lives with our boys. And we will do our best to pause and teach our kids to see and celebrate these moments!
But, we also know there will be storms of difficult moments…
When again, the “rain will fall, and the floods will come, and the winds will blow, and beat on that house…”
And we hope to then be able to cry out together…
But it did not fall... 