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Monthly NewsNote
December 2005
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Medicate On Holidays And Weekends
I believe it is important to use medication on a daily basis including vacations
and school holidays. This helps the child behave in a consistent way with less
impulsivity, less hyperactivity and better peer relationships. But in addition
to being good for the child, it is good for the family. Let me use two cases to
illustrate my point.
Rob is a delightful 9 year old boy, who left to his own behavior is impulsive,
very hyper and totally distractible. Listening is a problem, sitting still doesn't
happen, and he doesn't get along well with his sibling.
These problems, of course existed at school and during homework time. However,
the use of stimulant medication has removed the problems, though he does have
minor distractibility at times.
I asked Mom if Rob had medication on weekends, and she said "I don't want
to give him medication he doesn't need". I asked how it was on weekends,
and she said "difficult - no actually awful". She described the boy's
impulsive behavior, talked of how he disrupted the family, and mentioned that
kids didn't want to play with him on weekends.
The point here is that the whole family was being changed by the ADD. There
was anger, frustration and some guilt. The ADD was a family problem.
A similar situation exists with Mike, age 13. He is very easily frustrated
and has a temper in addition to his distractibility. With his impulsivity he
is often disruptive and in some kind of trouble. In school he did well with
medication. At home there was terrible tension involving not only the patient
but all members of the family. When I asked Mom why she didn't give him the
medication on weekends she said "I thought it was only for school".
However, she then went on to discuss her guilt about putting her child on medication
and her anxiety about what the medication might do to him.
We talked about her concerns and she seemed calmer. I urged that she use the
medication every day as it made things at home so much better for the boy and
the family. Perhaps she will.
Parents often feel guilty about giving medication on weekends because they
feel it is "not so bad" or their job as parents to make things better.
In fact, the child is unhappy and the family under stress. Therefore, it is
perfectly appropriate to give the child medication to make the family life better!
If you are a parent reading this, please review the treatment of the ADD considering
the needs of the whole family. If you are the therapist, perhaps you can help
parents deal with guilt and anxiety and understand how a content family is good
for all members. And to achieve this the ADD patient should be on medication.
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