Drugs for ADHD: Coursera ADHD Class Weeks 9 & 10

Drugs are one of the most common, if not the most common, treatment for ADHD. They can help individuals be more productive, calm, and in control of themselves, at least while the drugs are active. ADHD drugs are similar to prescription eye glasses. They help an individual function while they are in use, but they do not cure the underlying condition.

The Coursera class on ADHD takes the standard medical line that if used as prescribed and not abused, ADHD drugs, in most cases, cause no significant or long-term ill effects. Dr. Rostain cites statistics that stimulants are not over-prescribed for ADHD and that untreated ADHD leads to much worse outcomes than medical treatment of ADHD. Most studies on drugs for ADHD last just months, not years. Given that many individuals with ADHD take drugs for 5 years or more, and start at a young age, it is troubling that there aren’t better long-range studies on their effects.

Dr. Rostain covers many myths about stimulant drugs for ADHD. One stood out to me. The myth is that these drugs do not improve academic achievement. He states that stimulant treatment of ADHD improves work productivity, classroom conduct and rule-following, peer interactions, grades, and leads to reduced punishment, fewer days absent, and makes repeating grades less likely. So yes, on stimulants a child with ADHD will appear to be a better student and will certainly be easier for the teacher to have in class. Dr. Rostain didn’t mention that some studies have shown that psychostimulants have not been shown to achieve long-term positive changes in peer relationships, social or academic skills, or school achievement. He also did not mention that there is evidence that stimulant treatment of ADHD in juveniles can damage their developing brains. Long-term use of ADHD can also create a loss of motivation. Students, especially college students, may feel that their success is due to the drugs and a shift of agency may create a dependence on the drugs and low self-esteem.

There are three basic types of drugs used to treat ADHD: stimulants, non-stimulants, and antidepressants. Each affects the signaling of neurons in the brain in a slightly different manner and the lectures on them were too detailed to easily summarize. The comprehensive “What we know” brochure on Managing Medication for Children and Adolescents with ADHD from the National Resource Center on AD|HD is a good place to start. The last couple pages have suggested readings and then a handy reference chart for the drugs which includes the generic names, the brand names, the duration of action for each drug, the form the drugs come in, the dosage ranges, and the common side effects.

Even though there is a great deal of evidence that drugs can help treat ADHD symptoms in the short-term, they still carry risks. Risks that your pediatrician or health services provider may not mention. The best approach if you are considering ADHD drugs for your child is to learn all you can about the various drug options and then carefully, with the help of your child, monitor both the short-term and the long-term effects of any drug you give your child. Pay attention to both the physical side effects, such as stomach aches and sleep problems, and the more subtle psychological effects that may include decreased drive and motivation. Ask yourself, are you trading their initiative and innate personality for a child that is easier to live with and more compliant?

The Grown-Up Gifted Child

Recently I have been re-reading one of my favorite books on living with and raising gifted children, the award-winning, A Parent’s Guide to Gifted Children. Early in the book there is a table that lists, “Problems Associated with the Characteristic Strengths in Gifted Children.” As I was reading this list again I realized, I know these people. The funny thing is, they aren’t kids anymore.

When gifted kids grow up they don’t usually age-out of their gifted passions, strengths, intensities, and quirks. They may learn to act in a more socially acceptable manner and they, hopefully, gain a measure of perspective and self-discipline that they lacked as children. However, the essence of who they are and how they are different stays intact. One of the big arguments in favor of programs exclusively for gifted students is that they aren’t just bright. Their brains are wired differently and while, yes, they can complete typical school work at an accelerated pace, that isn’t what defines them. They are more passionate, sensitive, and intense. Merely completing the lesson plan isn’t enough. They want to go beyond the lesson plan, or alternatively, question its basic worth. They are more driven by deeper meanings and philosophical questions than other students their age. This can make them an under-achieving, dejected, argumentative, moody pain in the wrong classroom environment or the engaged, high-performing, thoughtful student in the right classroom environment.

The same is true once they grow up. Just look at the a few of the strengths and associated issues they can create as detailed in the book.

Strength Possible Problem
Acquires and retains information quickly Impatient with slowness of others; dislikes routine and drill; may resist mastering foundation skills; may make concepts unduly complex
Ability to conceptualize, abstract, synthesize; enjoys problem-solving and intellectual activity Rejects or omits details; resists practice or drill; questions teaching procedures
Enjoys organizing things and people into structure and order, seeks to systematize Constructs complicated rules or systems; may be seen as bossy, rude, or domineering
Thinks critically; has high expectations; is self-critical and evaluates others Critical or intolerant toward others; may become discouraged or depresses; perfectionistic
Creative and innovative; likes new ways of doing things May disrupt plans or reject what is already known; seen by others as different and out-of-step
Intense concentration; long attention span in areas of interest; goal-directed behavior; persistent Resists interruption; neglects duties or people during periods of focused interest; seen as stubborn
Sensitivity, empathy for others; desire to be accepted by others Sensitivity to criticism or peer rejection; expects others to have similar values; need for success and recognition; may feel different and alienated
High energy, alertness, eagerness, periods of intense efforts Frustrated with inactivity; eagerness may disrupt others’ schedules; needs continual stimulation; may be seen as hyperactive
Diverse interests and abilities; versatile May appear scattered and disorganized; becomes frustrated over lack of time; others may expect continual competence

In the work environment these possible problems can limit opportunities, cause issues with HR, and possibly lead to terminations. Perhaps this is why many gifted individuals become entrepreneurs. As their own boss they can find the best way to work with their strengths.

In relationships, when the innate characteristics of gifted boyfriends, girlfriends, and spouses go unrecognized, unrealistic expectations from both parties can poison the partnership.

Gifted individuals need to understand themselves and how they may differ from others at home and in the workplace. Self-knowledge of natural strengths and how they can become liabilities is essential to long-term happiness and fulfillment. This information guides the grown-up gifted child in working through misunderstandings and frustrations with their significant others, at home. At work, it enables them to increase their productivity, improve relationships, and perhaps even realize when their current work place is just a bad fit and it is time to move on.

Developing self-awareness in gifted students is one of the primary goals of quality programs for the gifted. It is also one that is virtually impossible to reach when gifted “programs” consist primarily of accelerated, in-classroom, differentiation. The farther away from the mean a student is, the more likely it is that her strengths will cause her issues at some point in her life. Gifted educators need to mentor their students on how to live in and thrive in the regular world as a highly, profoundly, or exceptionally gifted individuals.