Subscribe To This Blog

Knowing if the medication works

Jan 4, 2018

I just read an article from ADDitude's Research Digest:


It relates the results of a small study of teens. They were given different amounts of medication, including placebo and asked to rate their effectiveness everyday. Even though their efficacy was clearly influenced by the medication, they reported not feeling a difference. The conclusion was that teens have difficulty telling if the medication works. 

The first question that came to my mind was, "compared to whom?" I would argue that teens, kids, and adults all vary widely in their ability to be able to tell if the meds are working. As a coach, my impression is that self awareness is one key to treatment. Some of us are born with more of it than others. But it is important to cultivate self awareness in regards to any treatment plan. I'm just not sure it it is an age related thing. 

I've know eight-year olds who can clearly articulate that the medication helps. I know that I could feel its effects very clearly at age 10 or 11 when I first started. In fact my doctor trusted me enough to allow me to decide how much I needed for a given activity at a very young age. School, baseball, and homework were 20 mg Ritalin tasks. Playing with friends or going to a birthday party might be 10 or 15 mg Ritalin activities. I knew what I needed. 

On the flip side, I also have adult clients who have no idea that the meds are working. I had one client who started over the weekend and we talked on Monday. He said that he couldn't tell if it was working. I asked him what his weekend was like. He told me that he finally did that project around the house that he'd been trying to get to, and that he actually put all of his tools away afterwards for the first time in his life. Coincidence? I think not. That's the medication doing its job.

Of course, the modern delivery systems of things like Concerta and Vyvanse are designed to be gentler on the system. I alway say that the best case scenario is that you are more focused and productive but don't "feel" any different. That's a good thing. So, if you or your teen are having trouble telling if the meds are working, take a look at what you are able to accomplish and how challenging it was to get it done. Is there a difference with the meds?

Another piece to consider is the dosage. Some people need more than others. Many times doctors aren't aggressive enough with the dosing to get their patients to the level where the meds will work. I particularly see this issue in teens because, often, doctors forget to reevaluate the dosing of stimulants that a kids has been taking for many years. A 150 lb. high school freshman full of hormones is not going to be effectively medicated on the same dose he/she took as a 50 lb. 3rd grader. There was actually another article in the Research Digest about undermedication. 


Lastly, teens are by their very nature, difficult. I very much believe in the conclusion of the first article. "The best way to sell medication is with honest." I would also add that honesty depends on education. Teach your teen about ADHD and what the medication does. They are much more likely to choose to take it in that scenario. 



Standard Disclaimer:  In an effort to foil my own perfectionist tendencies, I do not edit my posts much… if at all. Please and typos, mistakes, grammatical errors, or awkward phrasing. I focus on getting my content down. An imperfect post completed is better than a perfect post that goes unposted.



Share With Friends:
Direct Link


Great learning opportunity

Feb 9, 2018

Check out this flyer:
Great learning opportunity

Share With Friends:
Direct Link


New ADHD medication trial

Feb 2, 2018

Check out the attached flyer. Kids 6-12. Great opportunity.
New ADHD medication trial

Share With Friends:
Direct Link


Workout Tip #7: Use the weekends!

Jan 12, 2018

If you’re going to take my advice and not skip two days in a row. That means working out on weekends. But, beyond the idea that you’ll need to workout on the weekend once. You should workout on weekends. Why? Most of us have pretty busy lives. There just isn’t a ton of time during the work week. I’m lucky. I work from home and can be pretty creative with my workout scheduling. And it can still be tough. For most folks weekdays are... getting the kids ready in the morning, getting ourselves ready, commuting, working, working more, trying to get home in horrible Greater Boston traffic or on trains that break down, making dinner, eating dinner, squeezing in family time, getting the kids to bed and/or helping with homework, etc.


Not exactly a lot of free time. More power to you if you have the energy and discipline to get your exercise on after all that. More likely you are squeezing it in at “lunch” or going super early in the morning. I’m certainly not saying that it’s impossible to fit in workouts during the week. Either way, we have to do that. But it usually leaves us with limited options. My wife gets up and rides the spin bike most mornings. That’s the only time during the week she can do it. But it was not an easy habit to cultivate… and she’s neurotypical.


Of course our weekends are busy too. But, if you plan ahead and think about when you’ll have an hour or so, you can probably find time on Saturday and Sunday to get in a decent work out. In fact, it may actually be easier because you may find you can relax and enjoy the activity more. And, you may have more options than just the one class at the gym that’s offered at 6am. Bottom line: if you go Saturday and Sunday, that means you only need to get to the gym Tuesday and Thursday to make it a 4x week. If you manage a third weekday workout, then you’re a rock star 5x-a-weeker.



Standard Disclaimer:  In an effort to foil my own perfectionist tendencies, I do not edit my posts much… if at all. Please and typos, mistakes, grammatical errors, or awkward phrasing. I focus on getting my content down. An imperfect post completed is better than a perfect post that goes unposted.



Share With Friends:
Direct Link


Over stimulation at the holidays

Dec 21, 2017

When I turned 10 (I think) it was the last time that my parents invited everyone in my class to a birthday party at my house. It ended up being 30 or so kids running around and going crazy. Apparently it was too much for me to handle and I went outside and hid in my dad’s car. And I don’t mean hiding in the sense that no one knew where I was. I mean that I was hiding from the chaos.


As my Dad loves to tell this story, I have had a chance to reflect on its meaning many times over the years. I used to think of it as an anomaly. I never thought of myself as an introvert and am very much a social person. I spent my first career in commercial kitchens, which are, at best, controlled chaos. And, I thrived in that environment. So why the freak out at the birthday party all those years ago?


Well, I’ve realized recently that as much as I am a people person, I can also be over stimulated by my environment. Don’t love going food shopping in the middle of the day on Saturday at Wegmans. I never liked taking our son to the children’s museum on a Saturday unless it was members only hours. Generally speaking, I don’t love crowds.


I guess my point is that I’m a guy who handles busy situations pretty well and can thrive in them, but only if I have a way to make order out of the chaos. That was the case in the kitchens I working in. But, I can’t create structure in a supermarket on the Saturday before Christmas. So that I do find over stimulating.


There are many ADHDers who are even more susceptible to being overwhelmed by stimulation than I am. For those folks especially, it is really important to know their limits and be able to get the space that they need to feel comfortable. It’s also really important for spouses and other family members to understand those needs and be accomodating.


If you need to, give yourself a time out. (Like I did in the car at my birthday party.) Go into another room and sit by yourself and listen to a podcast, read a book, or meditate for a few minutes. Try not to plan too much back to back that could be overwhelming. Maybe sit out a select activity to give yourself room to breath. And, of course, exercise is always a good idea. Bring your running shoes to your folks’ house for the weekend and plan to get a few miles in before dinner.


And, while I’m speaking of planning… If you know yourself and plan ahead, you can probably predict when the points are that you may find overstimulating. Definitely plan ahead rather than waiting until you have an emergency. And, plan as a family. Let your spouse know what you are going to need to ‘survive’ the holiday so it’s not a surprise when you need to step a way for a bit.


Lastly, as a parent of an ADHD child, try to be aware of the potential over stimulation hazards that you child will face. Plan ahead, talk about it as a family, and teach self monitoring and self management skills. All of this should make your holiday season much more manageable and enjoyable.


I'll probably take a few weeks off from posting around the holidays. So, Happy Everything. And, look for my next post in the new year. Or consider using the new subscribe feature so you get an email whenever I post a new entry.


Standard Disclaimer:  In an effort to foil my own perfectionist tendencies, I do not edit my posts much… if at all. Please excuse and typos, mistakes, grammatical errors, or awkward phrasing. I focus on getting my content down. An imperfect post completed is better than a perfect post that goes unposted.



Share With Friends:
Direct Link


Workout Tip # 6: Don’t miss more than one day in a row

Dec 15, 2017

This one is short and to the point. If you are trying to develop a routine it is super important to be consistent. So yes, any working out is better than none. However, a workout routine that is more consistent is more likely to become a lasting habit. It has been my experience that once you miss two days in a row for any reason, it makes it really easy to not go on that third day… next thing you know you haven’t worked out for a week and your developing habit is disappearing before your eyes.


That’s why I recommend getting exercise at least 4 days a week. And, don’t assume that this has to be during the week. I think it can be easier to handle the demand of the work week if you make the commitment to exercise on the weekends and then you only have to go 2-3 times during the week.


It’s my feeling that going regularly is far more important that what you do or for how long. I think you are better off going 5x a week for 20 minutes than going than going twice a week for an hour each. It’s a better way to build good habits and probably better for your body and ADHD management. You can alway work up to longer workouts. Start with consistency.




Standard Disclaimer:  In an effort to foil my own perfectionist tendencies, I do not edit my posts much… if at all. Please excuse and typos, mistakes, grammatical errors, or awkward phrasing. I focus on getting my content down. An imperfect post completed is better than a perfect post that goes unposted.



Share With Friends:
Direct Link


page 12345678910 nextprevious