I'm not talking about the kind of medication vacation you take with a group of college girlfriends to Joshua Tree where you share CBD Gummies and make shroom sandwiches together. This actually sounds like a fun trip (no pun intended) and something I might need to do soon to escape the stresses of parenthood...
This type of "Medication Vacation" has so far been...interesting. At times, it's been wonderful to see his passion, creativity, and energy come out. At other times, it's been a bit of a dumpster fire since it's meant that our son is going through the summer as a pre-teenaged, unmedicated ADHD dude. And let me tell you, this particular dude knows how to keep these long summer days jam-packed with crazy antics that keep us wide awake and utterly exhausted from the non-stop parenting.
Now, before you go all judgy on me (I can practically hear the tsk tsk from some folks), let me explain.
Last month, when I called the pediatrician to order the next months prescription of ADHD meds, I was told that it was time for his bi-annual checkup to ensure that all is well with his mental and physical health. I've always appreciated these check-ins because I absolutely believe that any long term medications (and especially stimulants) should be closely monitored by a qualified physician.
You see, when you have a child who requires ADHD medication, it is a requirement that their pediatrician see them at least once every six months. In fact, now that I think about it, I also have to be seen every six months in order to continue on my own ADHD medication.
This is actually a good guideline, albeit annoying for me sometimes as I try to plan for and squeeze in yet another doctors appointment using my already taxed executive functioning skills. All I want to do is make a quick phone call and pick up the prescription at CVS the next day, but I respect the rule because I know it's meant to ensure that doctors are actually monitoring the effects of the medications they prescribe.
So, anyhow, it's the last week of school and we've finally crawled towards the finish line where the carefree summer days await! Normally, we can't wait for this, but this particular June also brought with it a cancer diagnosis for my Ty so it felt more like the start of a Bummer Summer to me.
I just needed to keep the rest of my life on cruise control so I could focus on getting Ty through a scary surgery and prepare to go to battle with the looming mental health crisis my family would soon face once my kids found out about their daddy.
My life was a building storm of anxiety, anger, and all the other bad things, but on steroids (or maybe on fire?) and coming at me from every angle!
So, that is why when I took my awesome ADHD kid for his checkup and our pediatrician confidently and calmly suggested that we try a summer medication vacation, I panicked.
The Appointment
Our family pediatrician has cared for our children since birth, so we absolutely trust her and know that she makes well informed decisions based on best practice. After engaging with my son for quite some time about his current interests and answering his many curious questions, she sat us both down and gushed about what a wonderful young man he has become. She raved about his many admirable qualities and proposed that it might be time for a long medication vacation.
Me (in my head): "Whoa whoa whoa, doc. Let's put a hard stop to that silly idea before it takes off, mmmmK?"
Me (out loud to the doctor): "Well that's an interesting idea. What makes you think he should do that?"
I was smiling and nodding my head as she beamed about what an incredible kid I have and how she cannot believe how well he doing in life and in school. Inside, I was slowly consumed with worries of my own, because I knew very well that my kids' entire world was already about to crumble with the weight of the news of their dad's health we were about to tell them later that week.
I know my son. I know that his emotional regulation skills are still very much under development and pretty limited at the moment. His ADHD medication definitely helps with this - granting him the mental space to process emotional hardships.
Under normal summer circumstances, I would have been totally open to a no-medication experiment. We've actually tried them before with some success, but these current circumstances were absolutely insane. I just didn't think we could handle anymore "hard" in our life at the moment.
There are some very valid reasons for ADHD Medication Vacations:
Assess progress: An updated read on a child's behavioral and cognitive functioning is important for gauging how a child is developing, monitoring improvements, and assessing the continued benefits of medication.
Build confidence: Make it clear to an individual that it is possible to work on and improve executive functioning and emotional regulation strategies without reliance on medication.
Boost growth: ADHD Medications can cause a loss of appetite and can be associated with lower than average BMI.
Monitor mental health: Pausing medication can help to obtain clarity on co-occurring mental health diagnoses, such as depression, anxiety, or disruptive behavioral disorders.
Do I agree with all of these reasons? Absolutely. Well, at least in theory.
I want more than anything for my child to thrive both with and without medication in their system. Each day, my goal is to teach him how to be successful in life while gradually reducing his level of support (pharmacological or otherwise).
This is what has happened so far:
#1: Watching my child like a hawk 24/7 because I'm genuinely worried he will accidentally hurt himself or hurt someone else due to his unbridled physical energy mixed with impulsiveness - a deadly combination.
Last week, we were at a weeklong family reunion sharing a cabin with several others and it was nearly impossible for my son to get through the week unscathed. On day two, he made the very impulsive decision to get on an e-bike without a helmet and convinced two cousins to ride on the back seats (also without helmets. The roads were uneven and he was going a bit too fast, causing the bike to lose control and send them all flying!
They walked back into the cabin with badly skinned knees and a story to tell. Though I believe childhood should include bumps and bruises and even a few small scars, the fact that he wasn't thinking clearly and was in too much of a hurry to even put on helmets made this a scary experience for the entire family.
Luckily nobody was severely hurt, and my son explained with a lot of regret that "I just wasn't even thinking, I don't even know what I was thinking."
#2: My child getting dozens upon dozens of negative messages each day from every person around him as we try to "correct" his behavior.
We observed that our son's behavior was wildly inappropriate at times and seemingly in need of constant feedback. However, for a kid with severe ADHD, sharing a living space with over a dozen family members meant he was getting reprimanded and yelled at almost constantly!
It's hard to explain to others (and, at times, to remember ourselves) how neurodiverse kids require different parenting than neurotypical kids.
It's also hard to expect others to have the patience to deal with the severe behaviors and reactions when we often lack this patience ourselves.
As we constantly try to remind each other, our child's behavior isn't caused by bad parenting or a lack of discipline (although we will be the first to admit that we are still very much a work in progress). It's caused by a difference in brain chemistry, structure, and functionality that causes challenges with impulse control, emotional regulation, executive functioning, and the processing of reward and consequences. It is caused by ADHD.
Whatever it's called, every time my son gets in trouble, it hurts my mama heart hard. And I often blame myself for his behavior.
However, despite the challenges we have faced during this grand experiment, there have also been some real, genuine positive experiences:
#3: Getting to see what a fun, authentically funny, emotionally intelligent boy we have.
It has been heartwarming and wonderful to see our son's brain with a fresh perspective. Without medication, he's been full of energy and full of hilarious conversations that have our entire family rolling on the ground laughing! Last week he was spontaneously inspired to cook up a complicated recipe from the Nick DiGiovanni cookbook, and even though the kitchen was a disaster afterwards, we watched in wonder at this talented kid create delicious food with such passion. With or without medication, our son is a charismatic, hilarious guy, so it's been a joy getting to know this side of him.
#4: Many learning opportunities to have important discussions about self-control and self-discipline.
This part has been my favorite consequence so far. It is hard to watch our kids make mistakes and suffer because of them, but it's also is crucial to raising resilient kids who can handle life's challenges.
After the e-bike incident, he got to experience the very real consequence of cousins getting hurt due to his own bad decision-making. He felt genuine regret and I doubt he will make that decision again. And later, when he was reprimanded for being too crazy in the living room filled with others, we got to talk with him about taking notice of his environment so he can be respectful to others around him.
He may disagree with the rules, but he still must learn to respect them.
In many of our conversations, our son has attempted to use his ADHD diagnosis as a sort of get-out-of-jail-free card. He would lean on his diagnosis like a crutch - something he could point to that absolved him of all blame.
"It wasn't me! It was that guy!" (pointing at the shadowy figure of ADHD)
These proclamations have led to many constructive conversations about always needing to own and take personal responsibility for his choices, and how having ADHD means that you might have to work twice as hard as other kids to stay in control and make good choices. In other words, ADHD isn't an excuse, but more like having a risk-taking friend prone to making bad decisions who you also have to look out for.
The Verdict is Still Out...
I previously described our initial decision to put our child on ADHD medication, and still believe that this was unquestionably the right call.
We are about halfway through summer so far and I can't say whether our ADHD Medication Vacation has been a success yet.
I've had days where I raise my white flag in defeat and raise my fist in anger because it feels like this decision has single handedly ruined our sweet summer days. In these moments, I find myself counting the days until we can stop this experience and start him on meds again.
But I've also had days where I am in complete awe of the amazing kid my son is becoming, with a huge heart and an unmatched zest for life. In these magical moments, I know in my heart that things are going to be okay...
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