I never thought I’d see this day.  I’m actually contemplating whether or not it might be best, after all, to put Flipper on ADHD medication, such as Ritalin.

I am, in general, highly opposed to medicating our kids for the terrible sin of acting like kids.  Ritalin (and similar drugs) are highly over-prescribed, not because the kids have anything ‘wrong’ with them, but because the school system is ‘wrong’ for these kids.  They’re still bright, creative kids who just have an abundance of energy.

I also strongly believe that many cases of over-hyper kids are caused by specific, remediable problems, such as the school system and pressures, or food allergies, or nutritional deficiencies.

But, I do also believe that there is a legitimate brain disorder that some people have, and that medication is probably the right treatment for some people.  Just not as many (or for the same reasons) as is generally common these days.

Just as I do believe that anti-depressant drugs, while generally a Not Good Thing, are a necessary life-saver in certain situations.  When someone is at the end of their rope and not even willing to try to climb up, the right drug to “artificially” spur them to WANT to recover, to get to the place where they can begin to manage their recovery themselves, that’s a Good Thing.  It’s like a crutch, a cane, not in the negative sense, but in the sense of a helpful tool for someone to lean on while learning to walk again.

When nothing else works, perhaps Ritalin is the right thing to do.  The problem is… how to know that for sure.

Flipper has always been hyper.  But since he has always been homeschooled, many of the typical symptoms of ADHD have been either non-existent or irrelevant.  He’s never been expected to sit quietly at a desk for hours and hours doing boring worksheet.  We’ve been able to tailor his education to his learning styles.  It hasn’t always been easy, but we manage.  He shows no signs of learning disabilities whatsoever, he’s bright and creative and learns well.  He has a sharp, keen memory and is willing to do his work.  He wasn’t always, but we’ve found a routine and method that works for him, he’s happy to go along with it.

For most kids labeled ADHD, “schoolwork” is their #1 problem.  Parents might not have a problem with their kids’ high energy levels, they just want them to be able to attend to their schoolwork.  “Schoolwork” is not our problem.

Things clarified for me quite a bit more a couple years ago when I learned about Sensory Processing Disorder, or Sensory Integration Dysfunction.  Flipper is most definitely a “sensory seeker”, always needing more sensory input than what normal life gives him.  He is always moving, fidgeting, fiddling.  He literally is unable to stay still for more than a few seconds, he just does not have control of his own body.  He puts his shirts, his blankets, his pencils and his fingers in his mouth all the time.   He stomps and crashes and bangs into things.

He breaks things.  Unintentionally, most of the time, just from not paying attention.  Other times, it’s intentional.  He doesn’t think about what he’s doing.  He is utterly impulsive.  If he gets the idea to break something, he just does it, without thinking about consequences.  He is at heart, kind and caring.  But because he does not think and consider his actions, he can be thoughtless, reckless, even cruel.  Not out of meanness, but out of simple selfish unthinking.

And he utterly lacks motivation.  He claims that he wants to do well at things, but shows absolutely no evidence of this in his actions.  He is content to flail about randomly through life.

He really does seem like he’s not completely ‘here’… like he is not connected to reality, like he is trapped behind something.

He had been doing better lately.  I blogged about his “Change of Attitude”, where his tantrums had drastically abated.  This is still fairly true.  But his overall behaviour has deteriorated back to the way it was.  He’s less angry, but he’s just as unmotivated, careless, and thoughtless.

Tonight, his gymnastics coach talked to me about it.  He noticed a quite drastic change for the worse about two weeks ago, just about when I started noticing it too.  He has talent, but he just doesn’t try.  He throws himself around in goofy flailing fits.  And he’s disrupting the rest of the class.

The coach isn’t upset with Flipper.  We’ve talked before about his issues, and he knows about young boys.  He tries to make eye contact, he tries to keep him engaged, he was really just wondering if there was anything more he should be doing that I could tell him about, to help my son stay focussed in class.

This isn’t like school class.  This is his gymnastics training.  This is, by his own account, his favourite activity outside of video games.  He has won medals and is preparing for the Provincials.  This is no mere hobby.  He talks about someday coaching.

And yet, in class, he just doesn’t care to even try to do his best.

It’s this utter lack of motivation that scares me the most.  I can live with fidgeting.  It drives me crazy, but if that were the worst of it, I could live with it.  But his inner drive is non-existent.  Even if we resort to ‘bribes’ and ultimatums, it won’t work.   He just doesn’t seem to care.

After the chat with the coach tonight, I started to wonder if we’ve hit that point where the drugs are worth considering.

Nothing here has changed since he was doing ‘better’ a few weeks ago.

We have tried diet, looking for allergies and sensitivities.  We have tried vitamins, fatty acids, minerals, herbs and homeopathy.  We have tried SPD treatments like weighted blankets.  We have improved his sleep.  I don’t know what else we can do.

Reading up on Ritalin and how it’s believed to work, I learned about dopamine.  ADHD kids seem to have an imbalance with their dopamine, either not making enough or not ‘reading’ what they have.  So it would make sense that they are constantly seeking stimulation, since they are not getting the ‘feeling’ from dopamine that normal life usually gives.

Also… and this was MOST interesting to me… dopamine is believed to be essential to motivation.  Humans learn patterns of behaviour based on anticipation of reward.  You do something, you have a good result.  The reward can be something concrete like a tasty treat or something more esoteric, like the ‘feeling of a job well done’.  While life is not ruled entirely by behaviourism, of course, it does play a large role in forming our sense of self-motivation.

Studies have shown that low dopamine is associated with a low ‘recall’ of reward.  Motivation is lacking because the sense of anticipation of the reward does not exist.  They still enjoy an activity, but are unmotivated to DO it.

Wow, does that sound familiar.

So I don’t know.  We’ve tried all the ‘alternatives’.  We’re not interested in medicating him for ’school’.  We’re not looking to turn him into a zombie, I’m happy with him being high-energy.  I’m concerned about the destructive side of his energy, and with his lack of motivation and lack of connection with himself.  The utter impulsivity and lack of any degree of self-control.  Even when he wants to control himself, he fails.

He’s almost 11 years old, we have waited to see if he would ‘mature’ out of his behaviours, we didn’t leap on a diagnosis when he was barely school-aged.  And some problems have improved.  But the more disturbing ones, if anything, have gotten worse.

We’re going to revamp his sleep again, I think we’ve drifted off a bit from where we had it a few weeks ago, I think that’s not helping.  And I think we’ll try upping his B6, magnesium, and zinc… who knows.  But if this doesn’t help… I don’t know.  All the potential problems scare me to death.  But maybe it’s the right thing to do.

I don’t know.

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