Medicated

This story is not about tango, per se. But life (my life in particular) is a tango in that we navigate through it, making decisions that affect everything that comes after, figuring out how and when to lead and to follow, experiencing the journey and all the difficulties and joy that come with it. Tango has pretty much been my life for the last three decades, colouring every relationship I have, especially those with my children. Thanks, Shane, for being you, and for the go-ahead to tell this story.

“I would never medicate my kid.”

I didn’t say the words out loud, but that’s what I thought when a colleague told me she had put her son, who had been diagnosed with ADHD, on Ritalin. I knew little about the disorder and even less about the drugs used to treat it except that both were controversial and had bad reputations. Was ADHD even real? Wasn’t medicating your hyperactive kids just lazy parenting? Didn’t it turn them into glassy-eyed zombies?

This was more than 20 years ago. My own son was just under 3 years old, about five years younger than hers. I was a single parent and Shane was the joy of my life. Becoming a mother had taught me that all the clichés were true: It changes your life and it changes you. You discover a love more profound than any you had ever known, one that makes you both incredibly powerful and terribly vulnerable: You could do anything to protect your child and you would fall to irreparable pieces should anything befall them. While I knew full well that other parents probably felt the same way, I also knew that no other child was quite as beautiful or wonderful as mine. From the moment he was born, my heart swelled every day when I watched Shane sleep (never for very long and often in bed with me), listened to him talk (pretty much non-stop) and re-discovered the world with him.

Shane discovered the world with enthusiasm and without caution. As a toddler, when he fell down, he got right back up again, undeterred by hard surfaces, pointy corners or their resulting bumps and bruises. I had to watch him constantly; if I looked away for literally two seconds, he would be on the other side of the street or at the bottom of a concrete staircase, leaving me feeling like the worst mother in the world. His dive-in-head-first approach to life meant he learned things fast, mastering the art of tying shoes or riding a bike in a single day, bloody nose and all. As he got older, his excitement at learning new skills was often matched by the speed with which he lost interest in them, from soccer, hockey and diving to dance, karate and piano. Drumming is the one exception. He started at age 7 and has stuck with it to this day.

As Shane grew from toddler to school-aged child, I found myself buying books with titles like Your Spirited Child and Raising Your Strong-Willed Child. He was gorgeous, smart, funny, and affectionate, but also stubborn, moody, and prone to tantrum-throwing. When he was 2, I remember us walking home from running errands and him just lying down on his back and screaming in the middle of the sidewalk. I must have been particularly well-rested that day, because I took it in stride, shrugging my shoulders lightheartedly at those who glared disapprovingly and grinning back at those who smiled sympathetically. At home I wasn’t always so even-tempered: There were days I would ride out his tantrums by locking myself in the bathroom, where I would curl up on the floor, cover my ears and cry, and others when I would scream right back at him, sometimes so loud I was sure the neighbours must have heard. (If they did they never let on.)

I didn’t know then that not all kids had tantrums during which they would cut holes in their bed sheets or beat the inside of their bedroom door with a Nerf bat for a full hour. I never could talk Shane out of a tantrum, but I discovered that sometimes I could hug him out of one, especially if I caught it in the early stages. It didn’t always work and sometimes I was too angry myself to even try it, but when I did and when it did, it was the best solution for both of us. The tactic defused a few near-explosive battles even in his teenage years. My attempts at punishment, meanwhile, often backfired entirely.

One of my biggest challenges throughout Shane’s school years was getting him out the door on time. One morning when he was 3, I was furious at both Shane and myself because, not for the first time, I could not for the life of me get him dressed. This was not new: If it wasn’t the absence of his favourite green pants it was the presence of an itchy tag in his T-shirt or seam in his socks; if it was neither of those things it was something else: discontent with breakfast, with me or with the day to come. “That’s it!” I finally said in frustration, “If you’re not ready in five minutes I’m taking you to daycare in your pyjamas!” And I followed through on my threat: Off we went, with me convinced that this time, Shane was learning his lesson, as I marched him all the way there, five blocks along a busy street, in his PJs. On arrival, he gleefully announced to all who were present, “I get to be at daycare all day in my pyjamas!”

During the daycare years, I was called in a few times to discuss Shane’s impulsive behaviour. In Kindergarten, his teacher asked more than once that we replace his box of markers because he had somehow managed to lose them all, yet again. Still a chatterbox, Shane had great verbal skills and was as able to read, write, count, draw, run and jump as well as any of the other kids. But as the months and years went on many of his teachers would describe him as lazy, distracted and forgetful.

And he hated school. He never wanted to go and so our mornings didn’t get any easier. Thankfully, he was charming and likeable and therefore had friends, but academically, he struggled, especially once the homework years started. (In Grade Two!) Now, not only were many of our mornings positively horrible, but our evenings were increasingly stained with tears and frustration over uncompleted school work.

By the time Shane started school, I had met the man who would become my life partner for the next two decades and, gradually, Shane’s dad. When Shane was almost 5, he got a little sister, too, named Mia. All this meant that he had more love and support than ever, but also that he had a new authority figure to clash with and a lot of changes to adjust to one after another: new parent, new sister, new school.

When Shane had just turned 8, we took our second trip to Peru to visit my partner’s family. The four of us had a wonderful time, visiting such extraordinary places as the Colca canyon and the Pacific Ocean and bonding with the kids’ abuela and tíos. We stayed with them in the big house they all shared, and a few days before we left, one tío, a family doctor, pulled us aside and suggested we might want to fill out a couple of questionnaires in regard to Shane. I immediately felt defensive, but he was diplomatic and I wanted a more peaceful family dynamic, so when we got back home to Montreal we pulled out the forms, read the questions and started checking boxes. Two questionnaires later, virtually all our answers pointed in one clear direction: ADHD, or attention deficit hyperactivity disorder.

Spirited, strong-willed, impulsive, volatile, moody. These were adjectives I sometimes used to describe Shane, but I had never seriously considered that he might have the Dreaded Disorder.

Any health issue means navigating the nightmarish labyrinth that is Quebec’s healthcare system. After much research, I had narrowed our choices to two: the Montreal Children’s Hospital or the Douglas Mental Health Institute. I settled on the latter, because I had heard that at the Children’s they just put your kid on meds, and no way was I going to medicate my kid!

Months went by and we finally got called for our first appointment. We were assigned a team of one psychiatrist and one therapist, who asked us lots of questions and sent us away with more forms to fill out and boxes to check. There were some for us, some for our family doctor and some for Shane’s teacher. When we took the forms to his Grade Three teacher, he took them grudgingly. “Shane doesn’t have ADHD,” the teacher told us dismissively. After all, he was clearly an expert on dealing with distractible kids: Once, when Shane had been unable to complete an in-class assignment, the teacher gave him extra work to do, in the classroom while the rest of the class watched a dinosaur movie. Another time, the teacher gave 8-year-old Shane lines to copy 100 times at home as punishment for not being able to get through his work in class. The boxes that the teacher checked, like ours and like our doctor’s, told a different story.

During the session when our duo of professionals gave us their unwavering ADHD diagnosis, I mentioned that the reason we had chosen them was that I had heard that the other hospital was too dead-set on the medication option. Our therapist smiled knowingly (and a little condescendingly) at me and said that if we weren’t willing to consider medication, they couldn’t help us.

Over the next few visits, they proceeded to talk us into giving meds a try. They told us that kids with ADHD who aren’t medicated have a much higher risk of “self-medicating” in adolescence. They also told us that most of the scary anecdotal stories we had heard weren’t true: “zombie-children” was a myth, as were tall tales about kids becoming more hyperactive than ever before if they went off their meds. We were also told that the drugs would somehow help Shane learn to deal with his lack of focus, preparing him for a day in the distant future when he might want to try life drug-free.

Weeks went by and a decision had to be made if we wanted treatment to continue, so we all, little Shane included, agreed, not without hesitation, to give the meds a try.

As is the case with any drug taken long-term, there were several readjustments to be made over the next months. Shane was started on Ritalin, which had to be taken three times a day, once in the morning, once at lunch and once after school to help with homework. The lunchtime dose had to be administered by the school office, so sometimes he forgot to go and occasionally we forgot the morning or after-school pill, too. The dosage was increased at least once, and eventually our therapy team suggested we try Concerta, a time-release version of the same drug (methylphenidate) that only needed to be taken once a day. We were warned about two common side effects with Concerta: sleeplessness and loss of appetite.

While we did notice some improvement in Shane’s concentration levels and school marks, and there was no sign of the dreaded “zombie” effect, Shane—already not a great sleeper—definitely started having more trouble getting to sleep at night and his appetite shrank significantly. We were being followed by our family doctor as well, and although Shane did get thinner, there didn’t seem to be any worrisome health effects, so he stayed on the meds.

We were advised not to take “medication vacations” on weekends or holidays, so he was on the meds full time, but now and then we would forget one morning and oh, man. Shane would absolutely bounce off the walls. I hate to admit it, but I had trouble being in the same room with him on those days. He became hyperactive to a level he had never come close to previously. And his appetite! It would come back with a vengeance and he would gorge on all the food he could get his hands on until he felt sick. It was disturbing.

In the end, the meds seemed to help Shane get through the school day and the school year, so we kept him on Concerta all through elementary school and into Grade Seven, known in Quebec as Secondary One. All the while I felt guilty and unsure, feeling that I was essentially drugging my child in order for him to fit an inflexible, one-size-fits-all education system. But he did need to fit the system, didn’t he?

We sent him to a private school we couldn’t really afford for his first year of high school. He had close friends going to the same school, it was conveniently located in a beautiful building with nice facilities, and there were lots of extra help services available—for a fee, of course. It was also a French school, which added a level of difficulty, even though he heard French at home and had been in immersion throughout elementary school. Shane received extra time to write exams, had regular visits with a resource teacher and private after-school tutoring sessions several times a week. The drugs and the extra help made things a little easier academically, but none of it made him like school any better.

Then Shane got depressed. We did not have an official diagnosis of clinical depression, but by about halfway through that school year when he was 12, he spent every minute at home shut away in his room with no interest in seeing friends, eating dinner with the family, or really doing anything at all, besides playing video games. This might sound like typical pre-teen behaviour to some, but it was not typical Shane behaviour. Shane had been many things: impetuous, moody, argumentative and distracted, but he was also charming, friendly, sociable and energetic. Never depressed. I had never been so worried about him as I was that year.

I continually questioned whether we were doing the right thing by keeping him on meds, but we didn’t know if they were causing the depression or if it was just the stress of the new school and his changing hormones. I also wondered if we had chosen the right school. We were struggling financially, had to pay for every help service we took advantage of and wondered whether an English school might make things easier for him. Then one day I got called into school because his teachers were complaining about him. He was what I tended to call “buzzy,” hyperactive and unable to sit still or concentrate, the way he got when he forgot his pill, which he had that morning. I explained that he had simply not taken his medication that morning, and the resource teacher, barely listening to me, told me flat out that I should put him on stronger meds. I was taken aback. I don’t think educators are supposed to offer diagnoses or recommend drug treatment plans.

Shane had started expressing a desire to try an English-language public school and that day sealed the deal for me.

That summer he also told us he wanted to go off the meds. I agreed immediately, hoping it would improve his mood (and sleep and appetite) without ruining his chances of getting through high school.

We spoke to our family doctor (by this time the department and our file at the Douglas had long been shut), who suggested we get on another months-long waiting list for a social worker before stopping the meds. We agreed, and got on the list, but the wait was so long that a couple of months into the new school year we went ahead and stopped the drugs on our own.

The difference in mood and behaviour was night and day. He instantly became happier, more sociable and energetic, but he was also constantly “buzzy,” unable to sit still or focus for more than five minutes. And he started to eat again, all day, every day, it seemed. As if his body were trying to make up for four years of deprivation. He gained 30 pounds in three months, going from skinny to chubby in one winter.

And his school work suffered. We tried tutors, we finally did get some visits from a social worker and I went to the school to ask if they had anything to offer, such as extra exam time. Turns out they did, but a now five-year-old report from a hospital department that no longer existed wasn’t going to cut it. We needed a new psychological evaluation for Shane to qualify for any of the school’s special help services. So while his teachers got accustomed to sending him out of the classroom for walks around the hallways till he calmed down and our evenings tearing our hair out over unfinished homework continued, we found a psychologist. That is not a service covered by medicare, which meant no waiting list, but it cost a couple thousand dollars.

Shane met with her for 12 weeks, after which time she produced a report that was tens of pages long, describing him and helping us understand him in great, fascinating detail, from his hypersensitivity, which explained his emotional ups and downs as well as his intolerance of itchy clothing, to his high level of self-awareness, to his crystal-clear diagnosis with ADHD.

His appetite, energy levels and weight eventually settled down and evened out, but sitting through classes, homework and exams remained a huge challenge. The rest of high school dragged by in a blur of in-school services, tutoring, vitamin supplements, summer courses, and two more school changes. High school was, without any exaggeration, hell for Shane and for the whole family.

He did get through it, graduating one year later than planned and having briefly gone back on Ritalin of his own volition in his final year.

What I didn’t know at the time was that he, like so many of his peers, was trading, crushing, snorting and otherwise abusing his prescription as well as experimenting with just about every other drug he could get his hands on. I knew he was smoking cigarettes and “a little weed.” I did not know he was also experimenting with coke, mushrooms and who knows how many prescription drugs, often spending his entire school day high.

Shane and I have always been close, and through all of this and until this day he has usually been extraordinarily open with me. But he didn’t tell me about the extent of his drug abuse until two years later when he had already quit the hard stuff, and I’m ashamed to say I really didn’t suspect it was going on.

I also didn’t know it when he started abusing hard drugs again a couple of years ago. Sure, I knew he liked to go out and was generally considered the life of the party, but I thought it was just late nights and the occasional hangover. I had no idea it was weekend benders filled with all-nighters, cocaine and pills to go along with the alcohol. It came to light when the family was reeling from my pretty devastating breakup with the man who raised Shane and fathered my daughter, the result of which is that Shane has almost no relationship with him today. That situation didn’t cause Shane’s renewed substance abuse, but I’m pretty sure it escalated it. To the point he almost lost his job, which might have been a blessing in disguise, because his boss (and mentor and good friend) reached out to me and pushed Shane to get help. As I mentioned earlier, when Shane is determined to do something, he does it, and as I write this, he is 14 months sober. He’s also on prescription antidepressants that treat ADHD as well, and carry a low risk of dependance or abuse.

Would he still have “self-medicated” so much had he stayed on ADHD meds through his teens? Or had we never put him on them at all?

Sometimes I wonder whether ADHD should even be considered a disorder. On the one hand, a name and a diagnosis offer a solid reason for the behaviours—and permission for people to be how they are, rather than being labelled lazy, hyper, distracted. On the other hand, calling it a disorder implies something is wrong, rather than, say, different. Or even a gift. After all, people with ADHD are often creative, fun, quick-thinking. Why does a brain that falls outside the “norm” have to be disordered, rather than simply other? And then we rush to medicate that brain just so we can ram it into an inflexible, unforgiving system that expects everyone to conform to a middle-ground behavioural norm. The thing is, it’s not only hard for societal systems to accommodate people who think and behave differently, it can also be hard for those people to work, study and function in a system that is full of constructs and expectations. And sometimes it’s difficult just to be in a hyperactive, impulsive, unfocused brain. Even if it seems like a Band-Aid, medication can bring relief.

A couple of times I have asked now-26-year-old Shane whether in retrospect he thought I had made the wrong choice in putting him on meds back in elementary school and he said yes. But he doesn’t hold it against me and I try not to hold it against myself. I also try not to hold it against myself that I failed on two counts to provide my son with a lifelong, trustworthy father. And I wonder if our unstructured family life, headed by tango teachers who worked nights and weekends and basically raised their kids in a dance club, contributed to Shane’s difficulties.

With all of those factors put together and more, I will never know whether I made the right decision or the wrong one when I medicated my child, but I can’t take it back now and I did what I thought was best at the time. One thing I do know is I would never again judge another parent’s choices quite so readily.

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