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This is what worries me after 10 years of medication.

When the action of neurotransmitters is artificially stimulated for a long time, might the brain eventually slow down its own production of these chemicals? By giving a child stimulant medication, you are €œfooling € the brain into thinking it makes more neurotransmitters than it really does. Might this interfere with the neurological system €™s ability to regulate itself?
What happens when the effects of the drug wear off and the child €™s €œtrue self € reappears? (Or, is the medicated version the true self?) If they had never been medicated would they need it now after ten years of medication?

Replies

My son’s true self is present everyday - when he has taken his medication and when he has not.  His non-medicated approach to tasks and impulsivity is also present each day as his medication leaves his system.  The stimulant medications we have used do not build up in the child’s system over time.

Posted by momtodom on Apr 11, 2014 at 9:10pm

The stimulants do leave the system but has the brain learned not to produce the chemicals needed because it has been fooled into thinking it has enough. It may take years to learn how much it needs again.

Posted by leslie 1 on Apr 11, 2014 at 10:33pm

Leslie :  I am new in ADHD.  so my suggest maybe just my personal opinion.  Should you consider to see a Naturopathic physicians to take supplement to help to build up your neurotransmitters?  supplements take time to do the work.

My son has been taking supplement for 2 months.  For sure he has calmer body and have a better response on people around him.  Unfortunately, his focus and impulsive behavior are still need to work on…..

Posted by Louisa_Leo on Apr 12, 2014 at 12:26am

What would you base your questions on?  In everything I have read and been told by doctors, I have never heard of the brain getting lazy about producing chemicals.  In fact, I’ve learned that there is neurotransmitter dysregulation with ADHD… that it’s not necessarily the amount, but how they work (receptors/transporters, etc.)

The other thing I’ve heard from recent studies is that the brain will actually grow (physically) and develop faster/better on medication than it will without.  So it’s not getting lazy, it’s actually improving.

I still wouldn’t put a child on medication who didn’t need it, or did well without it, but it’s reassuring to me that it’s helping in more ways than just focus and behaviour.

Posted by Rai0414 on Apr 12, 2014 at 5:33am

I have never heard about any function of the body getting “lazy.” The brain doesn’t have what is needed to function properly and the medications provide it. ADHD brains never grow into normal functioning brains. They are what they are.

There are side effects to medication that doctors and patients need to be aware of (kidneys) but not what you are talking about.

Best to speak with a neurologist or a doctor to get your answers.

Posted by momodoodle on Apr 14, 2014 at 7:07am

My understanding from what I have read is that the stimulants cause the chemicals in the brain not to be absorbed into the reuptake process. The brain thinks more chemicals are not needed because the brain is using the chemicals longer than normal.
  I know when my son stops his Concerta there is a big change the first couple days that eventually where’s down. He still has ADD but not as dramatic as when he first starts the medication break.
We are meeting with a new Doctor psychiatrist this week and I will ask him about this. I am hoping what Rai0414 is correct. It would be great if we could post this question to a neurologist. I just don’t want to cause any harm to my sons brain.
  Also they can grow into normal functioning brains. There are many people that grow out of ADHD. Sometimes kids with ADHD are just behind and eventually catch up. They learn from life experiences how to handle their challenges as most people do.  I have noticed that now that my son is older 16 he now has ADD instead of ADHD

Posted by leslie 1 on Apr 14, 2014 at 5:13pm

Leslie, you probably should ask the psychiatrist about the question of growing out of it.  I think you would be surprised at how low a percentage that is, and it is mild, very mild ADHD that is grown out of.  Maybe he can point you towards research so that you have an understanding of the real numbers.  It is more like nearsightedness or diabetes than a stage. 

And the reuptake process IS the problem with or without the medication - that is not going to get better as their brain ages.  It is disappointing to think that your child’s brain will never be normal, but better to deal with reality than wishful thinking.

Posted by YellaRyan on Apr 14, 2014 at 10:56pm

Actually Yellaryan Studies show that at least 50% of children with ADHD do grow out of it. In fact studies show that Brain Development is Delayed by 2 to 5 years in children with ADHD The ADHD brain develops the same as kids without ADHD but is just delayed and catches up as adults. Certain traits associated with ADHD, such as hyperfocus, can be advantageous, and famous people throughout history including Bill Gates, Walt Disney, and five U.S. presidents have used these traits to change society for the better Its always best to look at your glass as half full not half empty. Reality is that all people are not the same and ADHD can be a big blessing in disguise!! Wishful thinking is a good thing!

Posted by leslie 1 on Apr 15, 2014 at 6:00pm

Leslie 1:

The various different studies that seek to determine the percentage of children who will eventually “grow out” of ADHD are quite variable and sometimes conflicting.  It sounds like you are “citing” only one particular study which concluded the number who do grow out of it was “at least 50%.” 

If you could supply a reference to the one (or perhaps more?) study which concludes that the number IS greater than 50% that will be a good place to start—discussing how to best look at a research study in particular (methodology, data obtained, & conclusions reached) which also includes, among other things, considering what other possible conclusions one could reach other than what the researchers themselves claim to have concluded.

After that one must move on to considering what other research studies have concluded (especially when/if the results are not the same). 

We humans tend to have a tendency to filter data through our own filters of pre-conceived ideas, pre-existing beliefs, and skepticism.  The concept of confirmatory bias is always at play.  Whenever our pre-existing notions or beliefs are supported by some data point we tend to be able to readily & easily accept that data point as being TRUE or VALID (even if it is not) whereas data points which conflict with our own preconceived ideas or beliefs are awarded less VALIDITY or TRUTH. 

The notion of confirmatory bias is that we humans tend to put much more weight on anything which supports our own ideas/beliefs while we can totally ignore, discount, or minimize anything which does not support them (especially anything which would directly contradict our ideas/beliefs).

The fact that you so readily assert that the “correct” percentage of people who outgrow ADHD is >50% tells me that either you are not aware of other studies that are out there, or if you are, you are simply choosing to ignore them because they would challenge your pre-existing beliefs (or possibly even contradict them).

Posted by BC on Apr 15, 2014 at 6:57pm

You are correct if you look at the internet you can find any study to support your ideas INCLUDING YOURS. But actual life experience is what really matters. From my experience most kids grow out of ADHD and I have great hopes for my son and all his abilities.

Posted by leslie 1 on Apr 15, 2014 at 7:57pm

I’m actually starting to come to a belief that maybe the answer is somewhere in the middle.  I have some adult friends with ADHD, am watching my son mature with ADHD, and have read a bunch of different articles by different experts on the subject.

I think the real issue with ADHD is when it becomes a problem… when it hinders lives and makes coping and succeeding difficult or impossible.  (We can all be a little “ADHD” sometimes… but when it becomes something that can be diagnosed, it’s because it’s interfering with our lives.)

School age is hard for those with ADHD.  They have to do work they aren’t particularly interested in, and do it this way, with that thing, in this amount of time, etc.  They don’t get to pick and choose what they want to do or even how they do it.  That’s why so many kids struggle.

But when they reach adulthood, there’s a lot more choice!  They can pursue things that interest them, and aren’t necessarily forced to do things that don’t.  There’s a lot more choice, and a lot less sitting around.  I’m guessing that has an awful lot to do with the ADHD symptoms appearing less severe.

Of course maturity comes into play, and an awful lot of kids seem to outgrow the hyper side of ADHD.  But I think adulthood brings a lot of freedom that eases ADHD symptoms.  I don’t think they’re gone, or actually “outgrown”, but because their lives have changed, the symptoms are no longer the issue they once were.

Posted by Rai0414 on Apr 15, 2014 at 8:11pm

Also on the topic of “true self”.  I don’t believe my son is his true self when his ADHD symptoms are at their peak.

My husband has OCD.  (He just developed it about 5 years ago, and we’ve been married almost 20, so I know how he was before compared to now.)  He is not his true self when off his medication and the anxiety is raging.  And with OCD, it’s a chemical issue in the brain, same as ADHD.

We’ve been lucky so far… my son responded very well to the first medication we tried.  I’m not sure the effects are night and day, but he has virtually no side effects.  It’s really just another support for him.  He still needs accommodations, support from parents and teachers, patience and understanding, etc. etc., but the medication seems to make doing what he needs to do easier.  It seems to make his life a little bit easier.

I don’t know if he’ll need the medication when he’s an adult.  But right now he needs it.  He needs it to learn at school, but (more importantly) he needs it for his own peace of mind.  Things got really, really bad before we started medication.  He was very literally near a mental breakdown from the stress, anxiety, etc. of being required to do things he just wasn’t able to do.  He’s 11 now and had started walking out of class, refusing his teachers’ requests, distancing himself from friends, destroying things at home, etc.  I can’t imagine how life might have been if he’d hit that emotional turmoil in his teens… with a driver’s license… with access to drugs or alcohol… (Look up the stats on unmedicated ADHD teens compared to medicated… it’s not pretty.)

Right now my son needs the medication.  I don’t know what tomorrow will bring, but today he needs it.

Posted by Rai0414 on Apr 15, 2014 at 8:25pm

Just wanted to reiterate something Rai0414 brought up: “...an awful lot of kids seem to outgrow the hyper side of ADHD.  But I think adulthood brings a lot of freedom that eases ADHD symptoms.  I don’t think they’re gone, or actually “outgrown”, but because their lives have changed, the symptoms are no longer the issue they once were.”

This is a very important point I hope to drive home—that during adolescence/puberty an awful lot of brain changes will occur in all (not just ADHD).  Probably the biggest thing that directly led to both the general public and mental health providers to at one time erroneously believe that ADHD was purely a condition of childhood (and that therefore WOULD BE grown out of) is based on the very same observation you’ve made (his ADHD has turned to ADD). 

The PHYSICAL hyperactivity that is so noticeable in boys (yet often can be much less noticeable when it is present in girls) is/was THE hallmark trait of the condition.  Not surprisingly, when that PHYSICAL hyperactivity was almost universally observed to get appreciably better or even completely disappear with age—this is what led to the erroneous conclusion of it being only a disorder of childhood.

I don’t remember which books and/or articles of Ned Hallowell, MD’s contain the story of how he was among the first to realize this was a completely erroneous conclusion, but it’s an interesting story to read.  When he was doing his fellowship (it’s been a while since I read it, so some of my “facts”—details—may be a bit off) in child psychology he was assigned to work with a group of ADHD boys that were being studied (given Ritalin) and he noted that so many of those boys reminded him of himself at that same age, so he began to question if he had (note the use of past tense) ADHD as well.  He concluded that was definitely true, but the more he pondered the subject the more he realized it had never gone away, it (and the very different roles, responsibilities, and tasks of adulthood) had simply changed over time.  The frank motor hyperactivity of childhood was replaced by a less noticeable (and more socially acceptable) physical restlessness and/or mental hyperactivity. 

This was somewhere around 1990 when he began his quest to advocate this paradigm shift—that there IS a thing called adult ADHD—and to increase awareness of how differently it manifests in childhood versus adulthood. 

From all the reading and research I’ve done the past few years the general consensus is that we do not know for sure exactly what percentage of children with ADHD will go on to have adult ADHD (hell, nobody can agree on what the ACTUAL percentage of children who have ADHD is), but that the numbers seem to indicate that the majority (>50%) of people will have it as a lifelong condition. 

There’s a difference between WISHFUL thinking (that not ALL will have it as a lifelong condition so perhaps he will be in that minority group of people who outgrow it) and MAGICAL thinking (that the odds of him or anyone else growing out of it are higher than <50%).  Please don’t fall into the trap of repeating the mistakes of the past—believing that a decrease in observable motor hyperactivity means anything other than what usually happens as a person with ADHD matures.

I first became acquainted with my husband in 7th Grade.  At the time he was the epitome of the ADHD (hyperactive) male.  After graduation we went our separate ways but met up again later in college (1989).  The difference between him as an adolescent and as an adult was STRIKING.  One would have mistakenly believed that whatever it was that ailed him through junior high & high school had completely disappeared (maybe with a little additional help from being in the military).  I mistakenly believed that was true.  Oh how I wish I would have found out about Dr. Hallowell’s observations when he made them (a year later, in 1990) or when “Driven To Distraction” was published (1994).  It could have saved me from living in a magical fairy tale world of believing he’d outgrown that thing that caused him to be the most obnoxious & annoying classmate I’d ever known.

I definitely would have known better than to assign him the task of doing “his half” of the Thank You notes after we got married.  We found that half, awaiting addresses & a stamp, shoved in a filing cabinet 7 years later, long after some passive aggressive in-law had anonymously mailed me a clipping from the newspaper where Dear Abby came down hard on the Selfish & Lazy Bride who had failed to do the right thing and send out any Thank You Notes…the irony of it all given that I’ve got ADHD too, but am responsible & compulsive enough to create systems which are fool-proof for horribly important tasks which MUST get done.  I knew right away that even though we had both made a check mark next to each Thank You Note written that something had happened to a large number of Thank You Notes that apparently did not get mailed because once the project was FINALLY “complete” I still had a large number of “LOVE” stamps left over.  I had purchased the exact amount of stamps necessary in advance to serve as the thing which would prevent anything from possibly falling through the cracks (and THEN being blamed on the person who is traditionally given the task of writing ALL the Thank You Notes).

Posted by BC on Apr 18, 2014 at 10:17pm

I understand that a lot of people that had ADHD when they were kids still have it as adults. But most of the adults have learned to handle life and really do not have it that hard. Most men would not be thrilled about sending out thank you cards. ADHD or not.
  From the past posts I have seen of yellsryans she seems to think the ADHD brain is uncontrollable. It is insulting to say a person with ADHD is not capable of controlling things such as temper or that they are not able to have a good marriage. I think a lot of adults want to use adhd as a excuse for bad character. I think she feels better blaming her problems on adhd . She needs to come to reality. ADHD is no excuse for not growing up.

Posted by leslie 1 on Apr 19, 2014 at 12:40am

I think ADHD behaviours are uncontrollable in the sense that you can’t just say “be organized!” to someone with ADHD and expect them to be able to do it.  Or “focus!” and have their undivided attention.  Or tell them not to get so emotional, and have them be able to stay calm.  They have a harder time than most people being able to do those things, so in that way they can’t help it.  *But* (and this is what I think we’re trying to teach our kids) there *are* ways to help to be able to do those things.  My son is able to bring home all his homework supplies because he has a planner and his teacher checks it before he leaves for the day.  I know when times will be harder for him to stay calm and so try to avoid those situations (e.g. make sure he doesn’t get starving, make sure he gets enough sleep, make sure he gets support and help before he gets too frustrated with things, etc.) and I’m hoping, that as he gets older and matures, that he’ll learn those same strategies and start implementing them himself.  If he needs to focus on things he finds boring, he’ll need to learn to break up the task and give himself rewards (“if I can get through this last chapter, I’ll go get myself a coffee”).

I’m attending AHDH parenting classes at our local clinic and last week we were talking about ignoring some behaviours (even negative feedback can reinforce behaviours at times).  One behaviour that I thought of was the temper tantrums.  They are actually why I really considered ADHD in the first place actually… my son was just *way* too old to be still freaking out like that!  No matter what I did, he still had a crazy, strong reaction.  My older son outgrew that sort of thing very early on because I was consistent about discipline and not giving in.  I did the same for my ADHD son, but it wasn’t working.  Looking back, I realise that I learned that yelling, punishing, in fact reacting in almost any way, not only didn’t work but escalated the tantrum.  So I’ve been ignoring them. And over the years (yes, years), I’ve noticed that though they still happen, they’re usually shorter and usually consist of him storming off to his room and slamming the door.  I brought this up in the group, worried I was doing something wrong and that this behaviour would continue forever, but the psychologist pointed something out… it’s the beginning of self-regulation because he’s not destroying things, he’s not taking it out on anyone, and he’s leaving the stressful/frustrating situation to come back calmer later.  I hadn’t thought of that.  I asked what I could do to make them stop completely, and she just said to keep doing what you’re doing and eventually he’ll get it.  He’s not getting any stimulation from me (because I’m ignoring the outburst) and he’s working on self-regulation… which is a skill most kids learn, but ADHD kids take a *lot* longer to get.

Those with ADHD *aren’t capable of always doing what everyone else can with ease, but as they mature and grow into adulthood, hopefully they’re learning to structure their lives with support systems so they *can* accomplish the same things we all do… possibly even better…

Posted by Rai0414 on Apr 19, 2014 at 1:02am

As an adult with adhd its funny because most people who interact with me would call me organized, controlled, rational - even calm.  They dont know about the years of inner struggle trying to curb my natural reactions.  And they dont feel the sense of panic and anxiety that i have every day because i work so hard to stay on top of everything.  I dont believe we outgrow adhd and i dont feel that my child will - I believe it changes on us and we change on it - and we move on.

Posted by momtodom on Apr 19, 2014 at 1:28am

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