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Message to the ADHD Medical Community: Is Medication the Only Answer?

Professionals know that there is no magic formula for "fixing" ADHD, and that active management is key for long-term success. Let's share that little secret with parents, shall we? The futures of their children are at stake.
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My heart goes out to the parents I have the privilege to talk with every day. They are conscious, engaged, wanting desperately for their kids... and all too often at a complete loss as to how to help them find success, independence, a sense of peace.

These parents have one thing in common: They have a child with ADHD. Maybe they've known for a decade or more, or perhaps the condition has been recently identified. Either way, they're searching for guidance when they call me, and I'm filled with gratitude that I can help. There was no one like me to call 15 years ago, when I needed it. The world is a much better place for families living with ADHD.

But sometimes I come across a parent who just wants to "fix" her child, and frankly, it makes me a little crazy. Our kids aren't a paint-by-numbers set, and there's no single one-size-fits-all formula for achieving adulthood in tact. Don't they know that ADHD is complicated? That these kids are wired differently? That it's going to take more than a magic pill to manage their lives?

This week, though, it hit me. No, they don't know. My anger has been misdirected. Sure, there are always going to be "fix-it" moms and "in-my-day" dads. But too often, these parents actually don't know that they've been lulled into believing that they can give their child a magic bullet -- in the form of a patch or a pill -- and that is sufficient to manage his/her ADHD!

Now, here's where I'm going to surprise you, because this rant is not about to go down that ridiculous dark alley that condemns parents for medical choices and accuses the entire medical community of fabricating a disease. No, I am not about to deny the value of medication in treating ADHD. I've seen it save too many lives. For some families, medication is a critical aspect of treatment.

But here's the truth. Medication is not enough. It's not a panacea. It's an incomplete solution, and it doesn't even work for everyone. ADHD is a condition that requires conscious, relentless management.

Dr. Tom Brown, one of the leading researchers in ADHD and Executive Function at Yale University, was generous enough to provide me with some mentorship, recently. He helped me understand that "management" is not separate from the treatment of ADHD. In fact, when dealing with a chronic medical condition, ongoing management is a critical component of a comprehensive treatment plan, though it's importance is all too often under-recognized.

We understand and accept this idea in the treatment of chronic conditions, such as diabetes or allergies. So why is it appropriate for the endocrine system or the immune system, but somehow foreign in the realm of the brain? What is it about a condition affecting the brain that scares the hell out of us so much? So much so that denial is institutionalized and treatment is limited to a prescription bottle and -- if you're really lucky -- a few great books!?

I'm reminded of a time not long ago when cancer was only spoken of in whispers, its utterance from a physician a sure sign of defeat. Now, as we fight cancer proudly on our wrists and on our clothing, we can't imagine the denial that would have us face a cancer diagnosis with resignation. No siree. A cancer diagnosis is like a call to a duel.

And so, too, must be the diagnosis of ADHD. I can see a time when parents aren't simultaneously giving their children medicines while telling them not to tell their teachers or friends. When parents are routinely learning about the ADHD brain, and coaching their children to improved self-management. When the public's denial will be replaced by a universal passion for empowering these bright, creative young children to achieve unparalleled success.

So, I've come to some acceptance with the "fix-it" moms and the "in-my-day" dads. They don't understand that ADHD is a condition to be actively managed. They have a thing or two to learn, and I can help them with that.

But I do have a message for the medical, insurance and pharmaceutical communities: It's time to take a more active role in guiding parents of kids with ADHD.

For all the good docs out there who are doing the difficult work of identifying and diagnosing ADHD -- and let's be clear, when done properly, an ADHD diagnosis is no easy process:

  • Take the next step and embolden parents to take on the complex nuances of ADHD management.

  • Explain to parents that they are in it for the long haul, that there is a lot for them to learn and a lot for them to manage.
  • Teach them that they can make an enormous difference in the outcomes for their children, but it requires direct action and intervention.
  • Give parents more than a signature on a prescription pad -- offer medical leadership and critical guidance.
  • To the insurance companies:

    • Cover the thorough process required for accurate diagnosis.

    To the pharmaceutical industry:

    • Educate parents that medication alone is an incomplete solution.
  • Direct parents to independent support structures that will help them take a comprehensive approach to the chronic management of ADHD.
  • Bottom line: Parents need to know that management is a critical aspect of the treatment of any chronic medical condition, including ADHD. They need to hear it from the doctors who are giving them the news in the first place. And they need to hear the whole story, and be encouraged to reach out for training and support.

    Professionals know that there is no magic formula for "fixing" ADHD, and that active management is key for long-term success. Let's share that little secret with parents, shall we?! The futures of their children are at stake.