“My very well-adjusted 15-year-old has mild ADD. She is very bright and takes all honors classes. Recently, however, she is starting to have more trouble focusing and using the coping skills she has developed over the years. She has also shown signs of mild depression over the last few years, but appears to be managing this fairly well. How do we decide if she needs more than just behavior modification and organizational support?”
ADD and The Medication Question.
It is not uncommon for ADD children who are highly intelligent to develop their own coping strategies to compensate for deficiencies in certain areas during their earlier school years. Often times as the child reaches high school levels, demands, work load, expectations, and responsibilities become more taxing, while supervision, structure and monitoring at school decreases. As a result, ADD symptoms may be more evident. It sounds like this may be the case with your daughter.
Depression can commonly occur with ADD, as well. Sometimes the frustrations, social difficulties, and feelings that may result from struggles associated with ADD bring on the depressed feelings. Sometimes the depression exists independently.
Your main question relates to medication. Should your daughter try a trial of medication or is it better to continue with a more natural approach?
If you are hesitant about the medication, the first thing to do is to make sure behavioral and organizational strategies and supports are being implemented at home and at school. It seems like the issues right now are mainly school related. Your daughter is beginning to have increased problems maintaining her focus and attention in her school work. Sometimes simple accommodations in the classroom can help.
Accommodations may include short breaks throughout the day, preferential seating up front near the teacher or away from distractions, permission to take tests or complete work in a quiet area, visual cues and reminders, color coded folders, step by step instructions that are short and simple, immediate feedback, extra time on tests and assignments, etc. Does your daughter have a 504 plan in place that specifies appropriate modifications and services? If not, talk with school personnel about getting this plan in place. Just because your daughter is in honors classes and doing fairly well, doesn’t mean she is performing up to her full learning potential. Minor changes to her classroom environment may really help.
Sleep deficiencies can also cause increased problems with mental focus, so take some time to review other issues that may be exacerbating symptoms.
The other question to consider when wondering about medication is “would the quality of my daughter’s life be better if she is on medication?” In other words, would it help your daughter to feel better if she could gain better control over her ADD symptoms? Would relationships improve? Would self esteem issues improve? Would feelings of depression decrease?
Stimulant medication has been used to treat ADD for over 50 years. It is effective and safe when used as prescribed. The use of medication is a personal issue and your family must sort out together what approach feels most comfortable. Find a doctor in your area who specializes in the treatment of ADD and talk with him or her. Ask the doctor questions about the medications. Share your concerns. Do some research online. Continue to educate yourself all you can about ADD so you can make the most informed decision.
If you do make the decision and your daughter starts taking medication, remember it is only a trial. She may stop taking them at any time if things just don’t feel right or if side effects result or if significant improvement is not seen.