Medical mystery: who really has the ADD?

Today was rough.

 

There are plenty of benefits to volunteering as an assistant instructor of martial arts: I get to live out my dream of being a teacher; I get to practice my own skills; I get to hang out with some real wacky kids and teach them how to take down a 300 lb man.

Sometimes – although rarely – I get to make a difference, too.

I’ve been assistant teaching since I was in high school, and have seen plenty of students come and go. In fact, I’ve watched a couple dojos come and go. Nowadays, my Sensei and I give private lessons in the comfort of musty basements and haphazard playrooms. He does it because he loves it; I do it because he loves it. Finances robbed us of a school (which is practically a place of worship for a martial artist), but not our enthusiasm.

Every Tuesday, we trek Lindenhurst to Bay Shore to teach two brothers who now stand as the longest-active students we have left (except for me, of course.) It’s been a strange experience in itself. The oldest had started at seven, and now is 17 and beginning to tower over me. The youngest is 13 and just starting the cussing-in-front-of-adults stage. I recovered an old Christmas card recently and marveled at how small they were.

Despite the rough year we’ve had with them, my heart still soared with the raging pride of a doting parent.

“Rough” is an understatement – this year has been hell. Initially, I thought my age was catching up with me. I figured I was a bitter old woman, likely to never have the patience I had as a high school student. But as time wore on, I knew deep down something was terribly amiss with the elder brother.

For privacy’s sake, we’ll call him Alex. Like many of our young students, Alex was doomed from the start – bright blue eyes peek out curiously from behind a platinum bowl cut, the color of which matches his skin tone. His limbs are perhaps just as wiry as they were when he was in grade school. If not for his height, he could likely dissipate into a ray of sunlight.

He is also awkward, and interested in offbeat things like anime and superheroes. It was clear from the start that the poor boy wasn’t likely to catch a break in a world full of rabid teens just starting to get a handle on their hormones. I empathized with him because he reminded me of myself- a nervous bookworm too smart for their own good. I backed him up when the other students would gang up on him in class, teasing his light hair or the immature way he argued with his little brother.

In the back of my mind, I knew he was medicated, too. The vast majority of our students were. The martial arts attracts parents with behaviorally-challenged children. For many of them, it helps. Martial arts are backed by centuries of ritual and formality – it gives them something to count on. When they hear the commands, they know what to do without thinking.

It helps knowing your teacher can kick your butt, too. What’s more, we train in partners – so if peers aren’t treated with respect, payback is a dish best served with a little extra torque behind an armbar.

But Alex was a special case – even on medication, he struggled to contain himself. It was clear as he aged that he was lagging behind the rest. Spontaneous crying was a viable reason to be excused from class at age 12. By 15 he wasn’t picking up on the other boy’s sex and drugs jokes (the ones they thought I didn’t hear, of course.)

When we’d transferred the brothers to private classes, I felt relieved on his behalf. No more tormenting. He was bullied enough in school. In the safety of a relative’s basement, he could be himself.

But then he became himself.

Sometime toward the end of August, I said to Sensei, “He’s off his meds, I think.”

“You think?” Sensei sounded surprised by my speculation.

“I think if that’s not it, then they changed what he’s on,” I hypothesized.

“How do you figure?”

“I pick up quick on stuff like that.” Having two medicated ex-boyfriends in high school taught me enough.

“Maybe his mother took him off for the summer. I think that happens sometimes.”

“I hope they realize what’s going on…” I wasn’t sure what was happening at home, but in class, the rambling was exponentially worse. The physical aggression towards his brother worried me, too. And one day, he would be even taller. If it wasn’t for how skinny he was, he could actually pose a threat with the knowledge he’d come to absorb.

By December, I’d become a bitter old maid. I couldn’t stand to talk to him, or some days even look at him. He rambled on and on all class without a care in the world. His ability to register people’s reactions dwindled. He ranted about anything – television shows, school, hobbies. It wouldn’t have been so bad if he didn’t lie about everything. The kid that I knew was pushed into lockers on his way to math class had fantasized an alternate universe where he was the cool guy in school. What’s more, he fantasized that he was all-knowing; he fabricated historical information like a Tumblr troll. My heart broke for him, but as a journalist, I couldn’t bear his insistence that “Samurai using three swords in their left hand was definitely written in a textbook, somewhere.”

The worst was the aggression. He taunted his brother, who was nearly half his size, and cranked armbars and leglocks with an alarming smirk. Without the formality of the dojo to back us up, it seemed our authority dwindled as quickly as his cognizance did. Slowly, Alex was starting to fantasize that he was better than everyone in the room. His stances were shoddy, at best. But if you asked him to repeat the technique, he rolled his eyes.

Being the bitch I’d become over time, I was much less forgiving than Sensei. I called him out on his inaccuracies. I hated myself for it – but some part of me knew he knew he was out of control. Sensei would report warily that Alex and his brother Ben had gotten into an altercation that left one of them with a bruise; my blood boiled.

“You can’t keep teaching him dangerous things. He’s gonna break Ben in half,” I insisted.

“It’s hard. I try to keep it as tame as I can,” Sensei said almost apologetically.

 

And then we snapped.

 

After completing a technique, Ben went to walk past Alex. Alex grabbed him and shoved him backward.

“Alex, cut it out,” Ben grumbled.

Again, Alex grabbed Ben by the shoulder and pushed him back.

“Seriously, cut it out!” Ben shouted.

“Enough,” Sensei warned.

Again.

“I swear, Alex,” Ben started.

Alex put both palms against Ben’s tiny chest and pushed.

“ENOUGH.” The sound that came out of me was masculine as hell. I took a warning step forward; Alex paused, looking at me dead-eyed.

“Let’s just get on with it,” Sensei groaned.

“No.” I stepped onto the mat. “Sit out. You’re done.”

Alex watched me, quiet for a change.

“Senpai, let’s let Ben have a try – ”

“No. You’re done, Alex. That’s it. Out. Sit.”

Still with that ballsy stare. I took a warning step forward like an animal challenging an opponent.

“NOW.”

An unexpected look of hurt crossed Alex’s face. I’d been being hard on him recently, I knew, and suddenly I felt bad for it. But I held my ground. He wandered over to the corner of the room and looked at the ground, hands trembling. I wondered if he would snap, and charge at me next.

“I know I can be a real asshole, Alex. I know it,” I said slowly, “But if it’s being an asshole or letting Ben get hurt, I’m not playing that game. You know that.”

The tears were unexpected. I turned away from the teen to face Ben, who was delighted to be able to go through techniques without having to worry about the aggression put out by his older brother. As we went through the techniques, the tears turned to sniffles. And then sobs. By the time we’d finished the routine, snot was practically dribbling out of the 17-year-old’s nose.

Slowly, the image of a small boy too smart for his own good flashed in my mind.

Something was amiss.

Ben stared awkwardly at his sobbing brother. Finally, I said,

“Alex, let’s go upstairs.”

He looked at me fearfully and shook his head, probably assuming I was going to bring him to his parents.

“Come on. As friends. I just want to talk.”

I coaxed him to the basement stairs, where he readily broke down into a sea of tears and snot. I tried not to cringe at the sight of it.

He said it all before I could.

“I just can’t do it anymore. I can’t control it. I can’t control myself. And that’s why I keep screwing up and- with school! – and I’m always in trouble! I can’t control it! I swear to God I don’t know what to do. I can’t do it anymore. I can’t stop.”

I let him go on for a while before asking softly, “How long has it been since you’ve been off your meds?”

He peered at me, incredulous. “How do you know?”

“I just know,” I said with a soft smile.

“Since summer.”

“Did the doctor take you off?”

A nod.

“He didn’t wean you off, did he?”

“Well, I took myself off and then – ”

“And that was over the summer?”

“Yeah.”

“And then they decided to let you go to school without it to see how it goes.”

“Yeah. It was a test but – ”

“You’ve been doing worse in school.”

“Only recently.”

“And you can’t control yourself.”

“It was getting harder and harder and then – now – it’s impossible. I can’t. I can’t stop the aggressive, and I’m always talking. And by the time I realize what I’ve done it’s too late. It’s always AFTER I realize! After! It’s always too late! And I’m already in trouble by the time I realize!”

“You don’t like the way it feels, to not be in control, do you?”

“I don’t even realize I’m not in control. But people… they think I’m weird. They think I can’t… control myself. They know I can’t. They see it.”

My heart was filled with overwhelming sorrow for the boy, and rage towards a system that failed yet another person I cared for.

Tentatively, I started, “Well if you spoke with your psychiatrist…”

“No. Never. I don’t want to go back on.” He looked at me as if expecting a challenge.

“Because you don’t feel right when you’re on it,” I finished.

Desperately, he choked, “I never knew what it was like to feel like me until I was off of it. But I can’t control myself. But I like feeling like me. I never want to feel like myself on my meds again. It’s… miserable.”

 

This is a defining moment for so many ADD/ADHD kids. This is hell, all done over 10 years to a boy who is now 17 and headed for his last year of high school with no mental structure.

How can you blame the kid? He was asked to use a muscle he never had to use before.

 

Alex was medicated at seven, and stayed medicated until he took himself off just shy of 17. And when he took himself off, a lot of things happened – he started feeling again. His brain chemistry changed, and it changed fast. He was a boy high on life for the first time in as long as he cared to remember.

Ten years. Ten years of a mental crutch.

How can you expect someone to run when they were given a wheelchair so early in life, they never had to learn to walk?

This is a typical scene in the alphabet kid epidemic.

There are three players in this act:

The child /

The parent /

The doctor

The child cannot control impulses or retain an attention span long enough to function at the rate of his peers.

Is it his brain? Is it his environment? If you asked some people, they would tell you there’s a symbiotic relationship between the two. I favor that notion.

The parent is usually alerted by someone in the education system that their child isn’t functioning ‘normally.’ There was usually a sign beforehand that behavior was bound to be a problem – the parent just never knew when the right time to tackle it was. As any loving parent would do, they get their child tested.

The doctors run tests, refer to a list of diagnoses, and slap some letters on a page. Some doctors go through extensive testing. Some go through minimal, relying on their instincts from years in the industry.

Congratulations! You have yourself an alphabet kid, but don’t worry – like any other illness, there’s a pill for that.

The rest is easy – parent and child go to a specialist every once in a while. The dosage is raised; the dosage is lowered. Any parent of an ADD/ADHD child knows all about the lack of appetite, attitude changes, and mood shifts. Sometimes the parent wonders if the dosage can be changed. Sometimes, it is. Other times, doctors insist on maintaining regularity.

“We finally got the dosage right,” they’ll say.

The parent, not in the medical field, nods in agreement. The child is, for a time, at the mercy of their parents’ and doctors’ competency.

 

The problem is, with puberty comes a new compulsion – to come off the drug.

 

Alex is a classic case of trial-and-error. It’s been nearly 10 years on the meds, and he’s at the peak of his high school career. He’s been doing great, and everyone else has been affirming that with their praise.

“I’m cured,” he says, and one lazy summer day he ‘forgets’ to take his pills.

Gradually, his mind is opened. His emotions are unhinged. For the first time since he was a child, he can FEEL again. It’s intoxicating.

The parent discovers the change – perhaps they even allowed it – but eventually they consult the doctor.

“Well, it’s too late now to start him back on what he was on before,” they’ll say. “Let’s give it a few months and see if he does well in school.”

It’s a slippery slope that ends so often where Alex was at 8:30 tonight – in tears, realizing that he can’t function. Realizing that he doesn’t want to take the drug that helps him function because he FINALLY found out what it’s life to function without a guard, and even if it’s ruining his life, he can FEEL it, and that’s almost worth it.

Kids like Alex have three options: go back on meds, keep quiet, or talk to a psychologist to try therapy without drugs.

Meanwhile, the parents have a ticking time bomb. By age 18, they  can’t legally force their dysfunctional child to medicate. And deep down, they want to believe their child is cured – even considering plummeting grades and erratic behavior.

Really, it’s not until your child is rambling a monologue for five hours before you start to realize maybe YOU should have been checked for ADD, too, because you clearly weren’t paying attention to the downward spiral your child has headed toward.

Maybe the doctors should be checked for ADD, because they were so busy analyzing years-old brain scans and shallow psychology reports they didn’t think to analyze how critical the weaning-off process is for these pills. Maybe they should’ve mentioned it to the parent early on – or to the child, when that fateful age comes around.

Do you know how strong these medications are?

Strong enough for college students at top universities to pay top dollar for them.

This isn’t your everyday happy pill. This is a heavy-duty concoction that has been building up in your child’s brain for years.

 

I don’t believe in extremes. Some children sincerely need medication for ADD/ADHD. Some children sincerely don’t. Some children may need it for a short while – others may be on it for a lifetime. Some go on and off seamlessly; but from what I’ve seen, coming off is a make-it-or-break-it moment in the child’s life.

I’ve seen kids make it. I’ve seen kids break it. I’ve seen all three players at the root of every outcome. It’s not luck – it’s logic.

These are things that should be discussed at length BEFORE starting medication – or coming off of it, for that matter.

And for the love of God, stop putting seven-year-olds on mood-altering medications. The “bad behavior that is negatively affecting the classroom” will stop for a while. But the effects of a label, a chemical, a confused parent, and a prescription-wielding doctor?

Those last a lifetime.

 

 

 

 

 

 

 

 

 

 

 

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