How we decided to do a ADHD medication-free school break

I’ve known I needed to write this post for the last 4 weeks, heck for the last 4 MONTHS. I’ve known that if I share why we did what we did and how we did it, and if I could adequately express the mixed-up jumble of emotions that I felt as a parent that it would help others. Perhaps it will help you decide what to do for the school year. Or here over the couple of long school breaks we have coming up. Or maybe you’ll just bookmark this for next summer so you can consider your own child’s situation with the benefit of my hindsight. Perhaps you’ll disagree with everything I type and skip on by – that’s cool, too.

The decision to medicate a child is never an easy one. You’re making choices for a body that you don’t reside in, but for which you are responsible. For some people, this is a clear and easy decision to make, but for most of us, it isn’t. I was going to say that in some circumstances the choice is obvious, like taking chemo for cancer…but for some people in certain situations with their unique belief structures even that choice may be murky.

How we decided to start medication in the first place

When we started learning about ADHD and how it affected my oldest, Max, we worried about the impacts of trying medication. So we tried weekly therapy sessions for more than 6 months first to see if that would help him with all the things he was struggling with: focus, impulsivity, 40-minute meltdowns over practicing 10 spelling words, etc. I worried that medication would turn him into a zombie or would change him into a different kid than the one I loved so desperately. But I also worried about how the challenges he was facing in school and at home were shaping his view of himself – like the kid who couldn’t deal, who was always getting in trouble or being spoken to, the kid who was behind, the kid who was so wild that no one wanted to play with him.

So we decided to try medication three years ago when he was halfway through 2nd grade. Within 2 days I saw a remarkable change in him. His writing skills improved. He started to read on his own and catch up to his peers. Conversations became 2-way instead of a constant one-sided monologue from him into the air around him. He was suddenly aware of his own body and where it was in space, relative to others and things. He had that split-second delay between thought and impulse to evaluate “is this a good idea? Or bad idea?” and then adjust his actions accordingly. In short, medication cleared up the fog Max had been wandering in and allowed his body to relax enough for his mind to shine through.

When Henry was diagnosed with ADHD and Tourette’s, we didn’t wait at all before starting medication. He was in such an extreme place with his symptoms we didn’t have a choice – for him to function in society he needed to be medicated. And we saw the same positive impacts with Henry as we had with Max. Henry was able to respond as you would expect any five-year-old would behave in situations, instead of flying into a two-hour meltdown over a torn piece of paper. He was able to sit and play with his toys and started imagining and telling us the most amazingly complex stories. Again, medication unlocked the best parts of my son, clearing away the static in his head and the debris in his path so he could interact with the world around him and show us what an awesome little person he is.

Why we stopped medication over the summer

As with most things, there is a downside to the medicine. It severely suppresses both of their appetites, so we’ve been keeping a close eye on both their weights and overall growth. We have to make sure breakfast and dinner are calorie-dense for them and monitor their water intake when it’s hot in the summer. Both are prone to dehydration because the hunger and thirst signals just aren’t there. It can affect Henry’s sleep sometimes. If we get the timing of his meds off, he will be wide awake until 1 am, simply unable to fall asleep no matter what we do for him.

While the sleep thing impacts ME the most, both boys will occasionally ask on the weekend if they can have “a hungry day” and skip their meds. They know they should be hungry and they miss it. I can see their point, and if our schedule allows for a more boisterous day, we allow it when we can.

The thing of it is, I know that while I get to be the boss of them now, when they’re little, in the not so distant future, they’re going to be in high school and then in college where I will most definitely not be the boss of them. I have to teach them how to make their own decisions about their bodies, which includes which medications to take or not. For them to make those decisions, they need to consciously feel the difference in their bodies and minds between a day when they take their medications and one where they don’t.

So, at the start of the summer, with the boys having just turned 10 and 7, they asked if they could stop their medication until school started again. We sat down as a family and discussed the choice together.

Alex, my husband, told the boys, “Your meds help you focus in school, but they also make it easier for you to have good behavior and good relationships with your friends and our family. Mom’s and my expectations for your behavior won’t change. You have to be willing to work harder to behave. If you’re willing to do that, then we can try this out as an experiment, and we’ll see how it goes.”

Both boys assured us they were willing to work harder and agreed if we started having issues at home or at the camp they were attending they would go back on their medication. We’ve always said that choices can’t be made that only work for the chooser. It has to work for everyone in the family/situation who is impacted by the decision being made.

I contacted the camp director and told him we were going to try this experiment and that our expectations for behavior remained the same. I asked him to let me know immediately if his counselors started having issues with either of the boys. I told him I’d check in a couple of times over the next few weeks just to make sure everything was going smoothly.

How did the summer go?

I was surprised. I thought the boys would struggle a lot more, but while they were in camp, we had very few issues. My only guess is the level of constant activity at camp was high enough to wear off a good chunk of the excess energy. At home, I definitely had to work a bit harder at parenting them. They loved being hungry though and put on some much-needed weight (and grew some serious inches, too!), so the tradeoff was worth it for me to have to do a bit more parenting (ahem, yelling).

But then they had 5 weeks “off” between their day camps and school starting. What a hot mess. I simply can’t provide for them the same level of activity they were getting daily at camp. Unless you’re a nanny, fueled with tons of caffeine, where it’s your job to tired them out, as a parent you can’t do it day in and day out. And it’s not that they were being “bad” – there were no meltdowns, nothing major happened. But every moment of every day was noticeably harder for all of us.

After a while, I felt worn out. I was tired of yelling at Max and Henry to put on their shoes in the morning or stop playing electronics in the afternoon or, for the love of god, to brush their teeth before bed after asking them nicely 45 times. And my poor babies. You could tell they were trying so hard to do what they knew they were supposed to be doing. Their bodies had hijacked their brains, though, and daily they were off like squirrels distracted by a puff of fuzz on the floor or their own reflection in the mirror. Workbook pages would take an hour to complete. I would have to sit in the bathroom and repeat the steps to brushing teeth over and over again to keep them on track. I had to stay right next to them and repeat, “PJs, pick out a book, climb into bed” a million times every night. It was exhausting.

Alex and I started having conversations about putting them back on their meds early before school started. He reiterated his point, “The deal was that them being off their meds had to work for everyone in the family. If you don’t feel like it’s working for you, then they need to start their medicine again.” But I wasn’t that cut and dry in my head. The decision to start the meds years ago was obvious to us and, knowing my kids, taking them while in school would be non-negotiable. But what about these in-between weeks where it was just hard? Was I being selfish? Was I a bad mom for wanting my kids to take their medication because it would be easier on ME?

Did we change our minds mid-summer?

In the end, we stuck it out. The boys didn’t start retaking their meds until the week before school started. We made sure to have a transition week to give their bodies time to readjust to the effects (especially my youngest. We definitely saw 1:30am that first night back on them.) The immediate difference in my boys was stunning. Workbook pages? 10 minutes flat, no fuss, no tears, no procrastination. The constant noise, movement, brotherly battles and yelling on my part? Gone. Replaced by mornings where I could get some work done, while they spent hours building cities out of legos or a whole day devoted to designing creatures and developing a story around them, complete with mythology around which god ruled which beings and all the relationships between them. I mean, it was worthy of the Greeks or Romans!

I felt so relieved that first morning! And then I immediately felt horribly guilty for being so glad they were back on medication because it was suddenly easier on me. I had visible proof that medication made life easier for them, but it also made my life easier, measurably so. Which made me feel guilty and question it all over again, even as I sat there listening in wonder to their conversations and watching them happily, peacefully playing. This is why this article has taken me forever to sit down and write. I needed time and space to process these conflicting emotions before I could share the experience with anyone else.

What did we learn and what will we do for the next break?

Ultimately, this experiment confirmed to me that their medication doesn’t change who they are. For my babies, it UNLOCKS their best selves from the chains and chaos ADHD wraps around their minds. It tempers the impulses of their bodies long enough so that their limbs can relax and settle, allowing an unfurling, a blossoming of their minds. It gives them internal balance between body and mind and that is a beautiful gift, regardless of how one achieves it.

And yes, having them on their meds works better for our whole family. And I’m okay with that being a factor we consider in this decision. We have to be a strong team, but Alex and I can’t teach them what they need to know or model the right behaviors in situations if we’re exhausted from managing the family dynamic that includes two frenetic boys with raging ADHD. So for now, the good of the family unit will continue to weigh heavily in our decision-making.

As for what we’ll do here over the holiday breaks, spring break, and next summer? In the short term, for the holidays, we will keep them on their medications. Max has proven over a couple one-day breaks on the weekend that not taking his medicine is the wrong choice for him right now. Henry handles the day-to-day stuff a bit easier at the moment. However, his sleep gets so messed up that for short week-long breaks it’s not worth the reintroduction phase he goes through. And I also have to consider how much excitement (and frustration) there is already around the holidays. I know staying on their medication will allow them the best chance of handling everything that comes at them with a shrug and a grin, instead of a meltdown. That’s 100% worth it to me.

I don’t know what we’ll do next summer. To be honest, these kiddos of mine will be completely different people in six more months. I have no idea what the best choice will be then. But I know we’ll sit down and talk about it as a family. We will make a decision for each individual child and give it a trial-run again. We will reevaluate how it’s going, for all of us, tweak the plan if needs-be, and then tackle the rest of the summer, together and guilt-free.