Labels and the lamebrains who love them

One of the first columns I ever wrote was about our parental struggle to get Colter medication for what was diagnosed as ADHD. Here's an abbreviated version:

He was almost 6 at the time and the psychologist we'd been working with for several years was confident that was the proper diagnosis, so she referred us to the psychiatrist in her office. The psychiatrist was worried that Colter might be predisposed to a bipolar disorder, given my family history (both my mother and sister have been treated and hospitalized for manic depression).

The challenge was that Colter was too young to be properly diagnosed or treated for bipolar, and the psychiatrist encouraged us to wait it out. At the time, Colter was extremely aggressive at home and unable to focus at school.

So we pushed for ADHD medication and it made an immediate and dramatic difference in his ability to settle down, follow directions, and be the kid he wanted to be.

Colter started taking the ADHD medication about a year and a half ago. Since then, he's been tested by his school for its gifted program and clearly fit the criteria (he's been thriving academically). He's formed better friendships and feels entirely confident about his ability to control himself. I've since discovered some interesting literature on the relationship between ADHD and giftedness (many of the characteristics overlap) and for the most part, we've been comfortable with how he's progressed.

Until Sunday, when I read something that still has me shivering. The story in my local paper (the St. Petersburg Times) was about a 12-year-old boy who was being treated for ADHD but was actually bipolar. The stimulant he was taking for his ADHD actually exacerbated his bipolar disorder, and he hanged himself in his bedroom with a belt.

I'm now agonizing over whether we should have Colter re-evaluated, which wouldn't be too difficult since he continues to see a psychiatrist for med checks. If it ain't broke, why fix it? Because there may be invisible cracks destroying the foundation he'll depend on for years to come.

Colter knows he takes medication to help him make better choices; he also knows it's still his responsibility, not the medicine's, to make those choices. And when we experimented with taking a break from the drugs on weekends, he asked to resume. He doesn't know he's been diagnosed with anything, and I don't see the value in him knowing right now. But I want to know as much as possible. I need to know.

And yet, how many labels can a sweet, smart, and energetic 7-year-old possibly carry?

Comments

[G]

I don't have any personal experience with bipolar or with ADHD, but in my work I have studied both conditions and some of the medications that treat them. While I can't speak to the specific case you mentioned, I think that if you maintain a close relationship with your son as he gets into his adolescent years and continue re-evaluating his situation, you are likely to be able to see signs of depression or a "troubled" mind before he would try to take his own life. Obviously there are cases where people "don't see it coming," but it sounds to me like you have a solid relationship and would be likely to be able to detect problems before they reached such a serious level. Another suggestion to help ease your mind is simply to familiarize yourself with symptoms of depression, especially in children. They are not limited to crying and sadness, but indeed there are many other sometimes surprising symptoms including rapid weight loss or weight gain, insomnia or even sleeping more than usual, and many others.

It sounds like you are doing the right things--doing right by your son!!

[Kelly]

Julie, that's such a powerful question you're asking. It seems to me that you're working hard as a family to help Colter feel good about who he is and how he shows up in and experiences the world. It's such a tricky thing being out there interacting and adding labels to the burden of being a child can only damage. i think that whenever we're medicating we need to be constantly re-evaluating because we just don't really know what the long-term effects will be for some of these meds and every brain is different. I would want to keep looking at it. Thanks for sharing this, we're having a lot of ADHD type issues with Tyler as well and haven't quite decided what to do about it. This gives me more food for thought. You know, cuz it's all about me.