Scott,
Hmmm... while there are times when I think drugs are prescribed too often and too easily, there are also plenty of times when the drugs are useful for folks with ADHD in helping them to manage the symptoms. I think it should be an individual choice, based on individual experience, I don't believe that drugs are "the lazy persons way out". That would suggest that there really ISN'T a problem. All these folks need is a little discipline. And THAT is the attitude that sent hundreds of youngsters through military schools because discipline was seen as a cure all, and the symptoms of ADHD were seen as character flaws. I agree with your hesitancy to think of drugs as the overall answer, but I guess I have to reject the idea that they should NEVER be the answer.
Dr. Jane Jarrow
Boy, is this a loaded question, I'm old school and truly do not believe that drugs are the answer! It's easy to drug a person to keep their behavior in check but it is quite possible through training and engagement, to keep the person moving forward and learning every bit as much as everyone else. Drugs are the lazy persons way out and in no way should it be termed as the person "not doing their part" if they choose not to take drugs, there are better ways!!!!
Michael,
Absolutely. Let me add one to your list. Sometimes the medication may interfere with other meds. Just yesterday, someone mentioned a student with ADHD who also suffers from migraines. The ADHD meds aggravate her migraine condition. She can't take them both at the same time, and both difficulties interfere with her concentration!!!
Dr. Jane Jarrow
Students may decide not to take meds for a variety of legitimate reasons. Not all students have the financial means to purchase medications. They may not have prescription coverage or lack the money to purchase the meds. Taking medication may be contrary to the religious beliefs held by some students. Lastly, having to deal with the side effects of some of the medications may make a student decide not to take medications that might alleviate his or her ADD.
Daniel,
I'm with you on this one. (SMILE)
Dr. Jane Jarrow
Personally I don’t think it is fair to require anyone to take medication for anything, especially something like ADHD or ADD. The side effects of prescription drugs, as well as the cost, can be staggering and sometimes create problems far worse than the ones they are prescribed to solve. To assume someone is not doing their part because they choose not to take prescription drugs, for any reason, is illogical and very selfish.
I appreciate your feedback nevertheless Dr. Jarrow, however, I would like to be clear to the fact, that I do NOT give medical advice to any of my students in anyway shape or form. Being a physician or a nurse is also about being an educator. But in order to give medical advice, you must have an active medical license in that state or be involved directly in that patient's care. I am fully aware of the liability involved in giving medical advice so when students ask me for any medical advice, I say to them; "go see your PCP/doctor, he/she would have the best answer for you". Now, if a student asks me to describe the anatomy, physiology or pharmacology (including both benefits and side effects of meds)of a particular disease, whether it pertains to them or not, I will educate them on it. That fact IS in my job description. I teach medical law and healthcare ethics as well, so no overstepping of bounds here. I am well informed regarding the law and know my limitations. Thanks for the concern. I do not counsel students, I do not write/ refill their scripts, come up with diagnoses,conduct physical examinations, order labs/tests and certainly don't monitor their progress in regards to their mental or physical health. On top of being unlawful, it is also NOT in my job description as a health educator.
I graduated form medical school a couple of years ago and passed all the medical boards while working as a program director/adjunct professor. I will be applying to a joint family medicine/psychiatry residency next year and I hope my experience with working with a diverse group of students with learning disabilities will only serve me well in my chosen profession when it is time to help others through the practice of medicine. I'd like to do child and adolescent psychiatry with a focus on ADHD.
On a personal level, I was diagnosed with ADHD as a child when it was first called "executive functioning disorder" and have had to manage the disorder in my adult life. Its been a struggle but manageable. I feel very passionate about this disorder and its approaches to treatment. The whole debate on medicate, or not to medicate, to stay on meds or not to stay on meds is a lifelong struggle with someone with ADHD. So I do take the opportunity to share my personal experiences living with ADHD as an adult, if anyone asks or the opportunity presents itself. But what has worked for me, may not work for everyone else. Medications to treat ADHD are controlled substances, so the only one involved in that discussion is the prescribing physician and the patient/parent. No one else.
So these generalizations, stereotypes and opinions i've stated in the thread are FACTS based on a culmination of my personal lifelong struggles living with adult ADHD in both my career, personal and family life supported by research in evidence based medicine. Its an opinion like so many other participants on this thread. It should be welcomed not discouraged or criticized.
Thank you for the discourse, I just thought your post merited clarification on my part.
Dr. Rommel Gonzaga
Wow. Your post is full of so many generalizations, stereotypes, and opinions stated as fact that I really don't know where to begin, Rommel. You may have the medical background to be discussing the benefits of medication in the manner you do here, but I would venture to guess that your job description at the institution does not include USING such medical expertise to involve yourself in monitoring the health status of your students. I would be very careful, if I were you, about overstepping your bounds. This has little to do with disability, and a great deal to do with your role as an instructor.
Dr. Jane Jarrow
In response to your post Dale, I just would like to add that it may be an erroneous generalization to state that educators are not medical personnel. I have a solid medical background and teach for a health career school and nursing school for a university. The majority of my colleagues are nurses,MD's,EMT's, etc... I agree that we should be cautious in counseling our students in regards to their health issues to avoid liability issues. However I don't find anything wrong with saying to a type 1 diabetic student who just passed out in class after binging on junk food without taking their insulin: "Are you following your doctor's orders?" I often have to do this.
The same applies with mental health disorders. We are not their physicians, however, if the symptoms that lead to constant classroom disruptions are due to a student who is non-compliant with her/his medications. I don't see anything wrong with telling the student to follow up with their mental health provider. Managing a patient with ADHD/mental health disorders is often two-fold; involving pharamacotherapy and psychotherapy. Whatever the reason, these students need to take care of their mental health same way the diabetic student needs to take care of his/her diabetes.
Bottom line, Mental health disorders should be managed equally in the same way a patient has to deal with physical complaints.
Often times, the layman finds it hard to understand the neurobiology or pathophysiology involved with mental health disorders. So it is easy for one to say; "you don't need meds", "just study harder, their is nothing wrong with you". It's like this; If a diabetic lacks insulin then the same goes with someone with major depressive disorder or ADHD, lacking serotonin and epinephrine (neurotransmitters which are chemicals in the brain responsible for mood and attention)respectively.
In regards to meds, would you tell a schizophrenic or someone with bipolar disorder to stop taking their meds because they experience too many unwanted side effects. No, thats not how it works. The patient needs to see their prescribing physician and have the meds tweaked (either lowered, substituted for another med). Certainly, we know what happens when these patients,especially the violent ones are off their meds. The results are disasterous and often is the subject of a major headline in the evening news. So what effect would a child/adult have not being on their ADHD meds?
So, why should a kid or an adult with ADHD, be weaned off their medications? The ADHD mind, when properly treated has the capacity to achieve unlimited success. Why should we hinder this potential? I personally know many doctors, lawyers and professionals who had ADHD as a child all the way throughout their adulthood who could not have made it without the help of pharmacotherapy. If a child/adult experiences side effects, then its time to visit the MD. All medications have side effects. Every human body is different and the body reacts to the medications differently depending on the individual. It could be dosing or the meds need switched.
I personally, have seen remarkable improvement when college students fill/refill their scripts in terms of behavior and academics in the classroom. As health educators it is our duty to promote overall good health both physical and mental to our students. Because we want our students to do the same when their time comes in the field.
Ryan,
One of the long held understandings about accommodations for students with disabilities is that the same strategies and accommodations that are necessary for students with disabilities are often good teaching practice for ALL students. You have just given us a great example!
Dr. Jane Jarrow
There is a sizeable percentage of learners, myself included, who have a great deal of trouble maintaining focus for extended periods. Just as many students lose focus, "daydream", get bored and start to talk or fall asleep, I find myself losing focus ocassionaly and the lecture I'm giving suddenly veers off in another direction entirely and I usually don't even notice immediately. My students joke that I must have seen a squirrel or something shiny. Anything that can be done in class to break up the monotony of lengthy lectures, while still remaining on topic, always seems to help.
David,
It is great that you are willing to explore options with your students. I am sure your time and caring is appreciated.
Dr. Jane Jarrow
Very True Meds are not always the answer. I've found this out with some of my students, they are the ones trying to work through this, So I'll work with them to find another way of studying or testing that they can try. the student then can feel better with them selves to have accomplished a task. and not relying on a cushion to say its one step for the student in a long process. each and everyone is different. its getting them to try something
Ruth Ann,
There's nothing like hearing the voice of experience. The most important thing is that they are both achieving!
Dr. Jane Jarrow
We as instructors cannot "force" anyone to takek medication. With that being said, I have found that students who do take medication for ADD/ADHD perform better in the classroom becuase the medication helps the student to focus better. I also have seen this first hand with both of my children (one child was adopted the other was not). When our oldest was placed on Ritalin in Kindergarten I had my doubts but we saw dramatic improvement in a matter of days. She is now in Graduate School, still taking meds but is being weaned off. The other important piece is counseling.
With our oldest we did everything and it helped but while she was in college found out that she had Aspeerger's not ADD. 20 years ago Asperger's wasn't really tested for and it is very close to ADD. Our youngest has ADHD with Development Delays (take about two sides of the same spectrum!) Both are doing the best of their ability and the teachers at the public school as well as our daughters colleges have been Great!!
I have also worked with adults in my classes who have ADD/ADHD and can tell who takes meds and who doesn't. Those that don't, have to be refocused a lot and don't do as well on Certification exams.
Chris,
For some, yes. For others, no. I would caution against generalizations about what will and will not be useful or helpful for folks, based on personal experience or a limited sampling. You don't know what their own experience, issues, or concerns might be.
Dr. Jane Jarrow
I understand the struggle to decide between the side effects of medicatiion and the benefits. but it is more managable.
Chris,
That is both the promise and the problem with medication. For some, it makes a TREMENDOUS positive difference. For others, it proves no solution and, potentially, masks other possibilities. As parents, it is our job to evaluate the possibilities and do the best we can in determining a path.
Dr. Jane Jarrow
Wilfred,
Strange as it may seem from a practical standpoint, from a legal standpoint the student is not required to "do his best to overcome a disability". That would suggest that the student has to earn the right to equal access. That's not how it works. The student is entitled to equal access (and to reasonable accommodations to assure that access). We HOPE the student will make good use of the access we assure. That having been said -- I agree with you. It is not up to us to tell a student HOW to make the most of the opportunity, and we have no right to insist on medication because WE think it will help.
Dr. Jane Jarrow
I have two sons with ADHD and for a long time I did not want them taking medication because i thought it was to make it easier for the parent to deal with their child. It wasn't untill we tried it that i reaized it was to improve his life not mine, he is happier and doing better in school.
