To Medicate or Not to Medicate

It’s 9PM and I’m sitting in bed, anxious about an appointment still two weeks away.

It’s a psychiatric evaluation for my youngest.

I scheduled it during a moment of utter exhaustion and helplessness, after three months of navigating an intensifying collection of symptoms that look an awful lot like ADHD.

You know, the mental health diagnosis that apparently came free with every member of my family.

None of this is surprising. We’ve joked about my girl having ADHD since she was approximately 18 months old.

Her impulsivity and hyperactivity have landed us in the ER twice due to severe injuries from ramming into things.

Her legs are perpetually covered in bruises from bike crashes and extreme falls and dancing in her adorable but violent fashion.

My body is her personal jungle gym. Sitting beside me apparently means doing handstands on my internal organs.

My oldest daughter takes medication, and it has been a game changer.

I’m a therapist who regularly encourages clients to consider medication.

I also take ADHD meds.

So why am I having such a hard time with this?

Because she’s six. And she’s wicked smart.

Maybe some part of me believed her smartness would somehow overpower the ADHD-ness, that we could just raw-dog this ADHD thing for a few more years.

Maybe I’m also worried about what other parents will think.

The ones who have witnessed her dysregulation and might assume we’re trying to sedate her instead of “changing our parenting style.”

Wake up, Kelly.

My innermost self knows this isn’t a parenting problem.

My wisest self knows that every time I’ve followed someone’s advice about “stricter boundaries” or “harsher discipline,” it has backfired enormously.

Not because my girl needs fewer boundaries.

But because you cannot discipline a nervous system into functioning differently.

You cannot consequence a child into having more dopamine.

You cannot put a six-year-old in time-out until her prefrontal cortex gets its shit together.

I know this.

And yet I still question myself.

I worry about other people’s opinions. I worry about being the family in which every single person takes medication: me, my husband, and both of our daughters.

What will people think?

 “Do you REALLY understand the risks of stimulants? Do you know what they might do to her?”

I anticipate this question from loved ones and friends.

And the truth is, I worry about those things too. I research the risks.

Maybe she’ll grow slightly shorter than she otherwise would have. I can swallow that.

Maybe she’ll lose her appetite - that would be genuinely challenging because she already eats approximately four foods and considers every unfamiliar texture a personal attack.

Maybe the critics are right.

But then I remember what stimulants did for me.

Before medication, I had multiple near-death car accidents because of inattention.

I spent much of my early twenties finding toxic ways to soothe a nervous system I didn’t understand.

I lost high school and college friendships because of impulsive behavior I couldn’t seem to control.

Medication helped me drive safely. It helped me regulate myself. It helped me maintain friendships.

It didn’t erase my personality or turn me into someone else. It gave me a little more access to the person I already was.

 And suddenly I remember something important:

Choosing not to medicate isn’t neutral. It isn’t the automatic safe option. It carries risks too… and real ones.

 We spend so much time talking about the possible risks of treating ADHD while barely acknowledging the concrete, currently unfolding risks of leaving it unsupported.

 What about the child who melts down constantly because ordinary demands overwhelm their nervous system?

 What about avoiding anything that requires sustained attention?

 What about receiving far more correction than other children? And the impact THAT has on one’s self-esteem?

 What about playmates becoming frustrated by impulsive behavior?

 What about overwhelmed parents who are trying their hardest and still losing patience?

 What about the child’s poor sleep, repeated failure, and the slow accumulation of shame despite their brilliance and creativity?

Those consequences aren’t hypothetical.

 They are already happening.

 Untreated ADHD is not the neutral, risk-free option.

I think it is wise for parents to carefully consider the risks of medication. I also think it is wise to carefully consider the risks of not using medication.

 But perhaps the wisest question is this:

 What is real right now?

If I temporarily set aside every imagined future (the best-case scenarios, the worst-case scenarios, and the opinions of people who do not live inside our home) and look directly at the impact ADHD is having on my child today, what do I see?

Is she thriving?

 Or is she overwhelmed?

Is she able to access her intelligence, creativity, and joy?

 Or is she spending much of her life being corrected for things her brain is struggling to control?

 What does she need from us right now?

 And then… after we answer those questions… we respond accordingly.

Maybe we try medication. Maybe it helps. Maybe it doesn’t. Maybe we adjust the dose, change medications, or decide the side effects outweigh the benefits. An evaluation is not a blood oath. Trying medication is not a lifelong contract.

 We cannot know the future. We can research, guess, and hypothesize, but we cannot ignore the reality unfolding in front of us simply because treating ADHD feels like the more active choice.

Sometimes doing nothing is also a choice.

And sometimes the gentlest thing we can do is give a child’s nervous system enough support that ordinary childhood stops feeling so deeply overwhelming.