Overcoming Medication Reluctance
My son was diagnosed with Attention Deficit Hyperactivity Disorder last summer. His kindergarten teacher, who was wonderful, urged us to have him officially diagnosed so that the school would be obligated to accommodate him in first grade and beyond.
I was reluctant to start giving him the medication, but after the first two weeks of school it became clear that we had to. His first grade teacher was inexperienced and insecure, and seemed to see his ADHD behavior as a deliberate challenge to her authority. And there was no question that he was having trouble concentrating, especially as the length of his school day had essentially doubled from the length it had been in kindergarten.
When I approached Lawrence with his first dose, I found that I was more ambivalent about the medicine than he was. He accepted it without any problem, and told us that he helped him to focus. He even wanted to take his medication on the weekend, because he said he liked feeling calm. I was only inclined to give it to him if he was going to a birthday party or had a playdate, or we had to work on a project for school. I kind of missed some of the goofy, crazy aspects of his personality. But he asked to take it on the weekend fairly frequently.
I was thrilled. I had been anticipating some resistance from him, as it’s fairly common for children to balk at taking medication. But we went through the whole school year with him taking his medication before school and at lunchtime without a murmur.
I should have known it was too good to last. As I approached him with his medication on the first day of camp in June, here is what happened:
“Okay, honey, time to take your medicine.”
“I don’t want to take it.”
“I just don’t want to.”
“Has something changed? Why don’t you want to take it all of a sudden?”
“I just don’t want to.”
I finally told him that he didn’t have to take it in the summer, unless I started hearing from the counselors about problems. He readily agreed, which should have made me suspicious.
During the first camp he went to, we didn’t have any problems. It was a pretty active camp - swimming, hiking, etc., so it was a good fit for him. Then he started the second camp. The program was three hours of science in the morning, and then after lunch the kids went to a place called Athletic Playground, where they learned gymnastics and also circus activities. The circus activities included some aerial moves that required quiet from the onlookers and the total concentration of the teacher on the student who was performing at that moment.
I heard on the fourth day from the camp director that Lawrence had actually been sitting on the sidelines most of the week because he was so disruptive that neither the teacher nor the other students could concentrate, and of course, this created a potentially dangerous situation with the aerial activities.
I told Lawrence that he had to start taking his medication again, because it just didn’t make sense for him to sit on the sidelines all afternoon, and he was missing out on an activity that he really enjoyed.
“No, I’m not taking it.”
“Honey, what’s the problem? What has changed from when you were in school?”
“Is it something about how it makes you feel? Is it making you feel crummy?” I persisted. (Badgering our children - what fun.)
“I don’t feel like…” He hesitated. “I don’t feel like I should have to take it.”
Aha. Light dawned. It wasn’t the medicine per se. It was the disorder, or rather, his feeling that he should be able to control it.
“Honey,” I said. “I know you don’t like having something that makes you different in any way. But I can promise you that there are other kids at that camp who have ADHD. And there are kids who have to take medication for other things. There are kids who have to take insulin for diabetes and kids who have to use inhalers for asthma.”
This did not get us anywhere. Did I mention that he is very stubborn? He comes by it honestly, as my husband and I are both pretty obstinate if you push us.
“Okay, here’s the bottom line,” I said. “You told me that you hate being the ‘bad kid,’ the one who’s always in trouble. Which do you hate more? Taking the medication or being the ‘bad kid’?”
That did it. He was still reluctant, but he did recognize that, while he might resent being dependent on his medication to control his behavior, it was preferable to disapproval from both adults and other kids. However, he still refuses to take it on the weekends. I don’t insist on it, unless he’s extremely hyper or we have to go somewhere where his behavior would be an issue.
Now, you know how it is with children. It’s like peeling layers off an onion. You think that you’ve uncovered the issue and dealt with it, and then later on you find out that there’s another layer underneath. He might not even really know why he doesn’t want to take his meds all of a sudden. So I’m not totally comfortable that I really uncovered the issue. But all you can do in this situation, as far as I can tell, is wait and see. And hope that you spontaneously get a blindingly brilliant insight into what makes your child tick. Somehow.
Deborah Gray wrote about depression as a Patient Expert for HealthCentral. She lived with undiagnosed clinical depression, both major episodes and dysthymia, from childhood through young adulthood. She was finally diagnosed at age 27, and since that time, her depression has been successfully managed with medication and psychotherapy.