After my oldest daughter was diagnosed with ADHD her freshman year of high school, I began to worry—and for good reason. She was fourteen and I’d witnessed what happened when someone self-medicated through high school and beyond. My adopted brother, who was four years older than me, had ADHD growing up. I watched my parents worry about him from the time he started grade school. They'd get calls from his teachers complaining that he’d disrupted class or had a hard time focusing that day. His report cards reflected his struggles, and when Mom and Dad would talk to him about that, he’d have outbursts—sometimes unable to control his emotions.
When my brother was eleven and in sixth grade, his behavior became so concerning for my parents, they took him to a psychologist to have him evaluated—I discovered the report years later. The psychologist recommended that my brother continue with extra educational support, positive behavior modification and counseling, and if those didn’t work, medication to manage his inability to focus. To the best of my knowledge, my parents never medicated him, so by the age of fourteen, he started self-medicating with alcohol and marijuana. His high school years were challenging for our entire family as my brother’s grades plummeted. He began hanging out with older neighborhood boys who were known to party and eventually dropped out of school—I didn’t want that for my daughter.
Although my daughter had a milder case of ADHD than my brother, watching him struggle all through school left me concerned about her future and I found myself projecting my fears onto my daughter—I didn’t want her to have the same kinds of problems. My first child was my "practice child," but I needed to get this right. I was thankful my brother and I were adopted from different families and didn’t share the same genes, but I could remember struggling in school, and I knew there were family members on my husband’s side of the family that had ADHD as well.
After the diagnosis, my daughter was prescribed a stimulant, which brought up new worries. My only drugs were daily vitamins, so I questioned if it was really necessary to medicate her. She was reluctant too. She didn’t like the stigma of her diagnosis or the way the medication made her feel. So in the beginning, she only took it before a test or when she needed to study for long periods of time.
I knew there had been a lot of research done on ADHD since my brother’s diagnosis in the early 70s, but I was determined to do everything I could to make sure my daughter didn’t follow in his footsteps. I was worried about the risks of putting my daughter on a prescribed medication, but after talking to professionals and reading more about ADHD and self-medicating, all the experts agreed that people with ADHD who took their medications were less likely than their untreated counterparts to abuse drugs or alcohol.
My daughter was forgetful, had a limited attention span, and was easily distracted in grade school and middle school. As she reached high school, she was more impulsive and not always able to see the consequences of her actions—often needing to learn things for herself. If I told her, “Don’t touch the hot stove, “ she would touch it anyway—she needed to see for herself how hot it was. I wanted to give my daughter the independence she craved during high school, but I was worried for her safety. I wanted to make sure she was well equipped to leave the nest when she graduated high school, but I didn’t want her to burn herself so badly that she’d be left scarred for life.
There was a lot of trial and error through those years, as I tried to figure out how best to parent her and learned from my mistakes. She consumed more of my time and energy than my younger children because I kept a closer eye on her comings and goings during her middle school and high school years. I stayed connected to her friends' parents and I would call to confirm sleepovers and parties. My daughter would say, “Why do you need to call? You’re the only parent who does this.” We used the phone tracker apps, and I told her it was my responsibility to keep her safe. If I had a dollar for every eye roll I got from her when I made one of those calls, I’d be a rich woman today. But I didn’t care. I wasn’t there to be her best friend.
When I discovered she had experimented with alcohol in high school, I came unhinged. I worried it was a sign that she was going down the same path as my brother, but I held my composure the best I could. I began lecturing her about why it was wrong and how she was killing her brain cells—her eyes quickly glazed over. After a few attempts, I realized I wasn’t getting through, so I changed my approach. I stopped talking at her and began asking questions. Why do you want to drink? How much are you drinking? When you drink too much, do you feel safe? Looking back on last night, would you do things differently next time? This opened up a dialogue between us and I realized she was thinking about my questions. My approach didn’t mean I condoned her drinking, but I wanted her to think about why she was making the choices she made and to think through the consequences. Her parental safety net would be removed soon and I wanted to set her up for success in college. Those high school years continued to have their challenges, and she had to touch that hot stove a few times before she figured out how to manage her life.
My daughter turned a corner at the beginning of her junior year in high school. College was fast approaching and she knew her grades counted. She finally came to me and said, “I want to try taking my medication daily. I want to do well in school this year.” After she started taking her medication regularly, her grades reflected her ability to focus. Her self-esteem rose and so did my confidence in her. By the time she left for college, I felt comfortable that she’d learned from her mistakes and I was ready to remove her safety net. I wasn’t naive enough to think she wasn’t going to touch that hot stove a few more times while in college, but I hoped that by helping my daughter think for herself instead of thinking for her, we both gained confidence that her college years would be successful ones.
By Laurie James
UCLA Semel Institute for Neuroscience and Human Behavior
Center for Disease Control