A Tale Of Two Kiddies . . . How Early Treatment Makes A Difference (with apologies to Charles Dickens)

“It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of Light, it was the season of Darkness, it was the spring of hope, it was the winter of despair, we had everything before us, we had nothing before us . . .”

Aaaaaaaahhhhhhhhhhh . . . . . . You all out there remember being a kid?

This is the story of two of my patients.  One of them I have seen for most of his life.  One, for just over a year.

I started seeing Mike when he was six years old or so.  Brought in by his mother, he was having all the classic problems that a child with ADHD has.  He was inattentive and distracted.  He was disorganized and was losing things.  He couldn’t sit still and would get in trouble for talking and playing when he was supposed to be sitting still and doing his work.  He was described as “lazy” when, in reality, that “lazy” was the standard disengaged and distracted “ain’t too interested in doing something I can’t pay attention to” thing we here in mental health land can easily diagnose as Attention Deficit Hyperactivity Disorder.  Mike was started on stimulant medicine and did great.  Over the years, he would come to see me every two or three months.  Medicine would be tweaked to ensure adequate coverage of his symptoms.  The occasional typical adolescent issues would surface and recede, but, by and large, he did very well.  He applied to colleges and got in, and has gone on to successfully complete a rigorous academic program in the field of his choosing.  Throughout the years, he would continue to come in and see me . . . and I would continue to provide treatment for him.  And he has been successful.

Paul is relatively new to me as a patient.  He was the sort of “getting by ok” student that often runs under the radar.  His tendency toward inattention and difficulty with task completion was evident for years, but he always did “well enough”.  Well enough, anyway, to avoid seeking treatment.  But the standard comments of his being “a bit lazy” and “not living up to his potential” were always there and always haunting him, contributing to his sense of not-being-good-enough.  Still, he did do well-enough to get by, and he, too, went to college.  But that is where he hit the brick wall.  Even though he was intellectually capable of performing adequately in college, the pace of the work was too much.  Old insecurities from years of struggling to succeed surfaced as his performance lagged and his grades plummeted.  Eventually his mood symptoms reached the point of Major Depression.  He had to return home and seek a medical withdrawal and . . . finally . . . ended up seeking treatment.  Initial treatments for his mood disorder were not well tolerated.  It was only after an astute colleague suggested that we send him for a Quotient-ADHD test that we stumbled upon the root of the problem.  Paul, after all these years of struggle and failure, was diagnosed with Attention Deficit Hyperactivity Disorder.  With this information in hand, appropriate medication and therapy interventions were developed . . . and Paul has thrived.

He is now taking a full roster of classes at the local community college (and getting all “A’s”) and getting ready to apply to local 4-year colleges.  He can attend to the tasks necessary to make this successful and can utilize his strong work ethic to work independently and proactively in his classes.  And he has no symptoms of a mood disorder . . . without the need for antidepressant medicines.

These two cases bring so many thoughts and questions to mind . . .

How would Mike have faired if he had not started in treatment at an early age . . . and how would Paul have done if he had?

How would Paul be today if he had not serendipitously come to my practice for treatment.  What if he had not had the benefit of the Quotient-ADHD testing system that can look below the presenting mood symptoms for those core neuropsychiatric symptoms of ADHD.  Would he still be muddling through with unpleasant trials of antidepressants?

What if ? . . . . What if? . . .  What if?????

These two scenarios highlight the importance of early diagnosis and treatment for ADHD.  Both of these young men are fortunate to have had their conditions identified and treated.  So many others are not so fortunate.  So many others suffer needlessly.  Untreated ADHD increases the risk that a child or adult will experience clinically significant Major Depression, anxiety and substance abuse issues.  Untreated ADHD increases the chances that you and your child’s life will be one of unfulfilled dreams.

If you have any suspicion that you or your child (or some other family member) might have ADHD symptoms . . . get them tested . . . and get them treated.  Assuming that “it will all work out ok” without intervention is taking a needless chance with someone’s life and future happiness.

It is a far, far better thing that I do, than I have ever done; it is a far, far better rest that I go to, than I have ever known.

–Dan Hartman, MD

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