Giving Ritalin a go

Me and drugs are a bit like oil and water: we don’t mix well. Or rather, the idea of us doesn’t feel very natural in my mind.

I did acid once in the mid-nineties, and nearly burnt myself on an imaginary stake in the heart of a bonfire, in front of a field of a couple of hundred people. Luckily, my best friend stopped me, carried me home, and calmed me when I was convinced that the Queen Mother was riding past my bedroom window on her horse, side-saddle.

Yes, I’ve dabbled. I’m about as cool as Louise Mensch though. The guilt and the general feeling of doom always gets the better of me. Having experienced the effects of my brothers’ heroin addiction when I was growing up, I find it hard to take a relaxed approach to drugs. Yes, they look fun, but I have always been more of a spectator than a participant.

Recreational are usually a no then, but pharmaceutical? In the last year I’ve probably downed the sum total of a blister pack of Nurofen and a couple of Temazepan I stole from my father’s medicine cabinet for a flight.

So when I went for an appointment with my daughter yesterday, and we decided, with the advice of the clinician, that she would start on a course of Ritalin it felt strangely unfamiliar.

I pretend to be an expert in areas I know nothing about, yet when it comes to things I should actually know lots about I am a complete ignoramus.

Take ADHD for example. I should know everything there is to know about the condition, because my daughter has it. I know very little though.

Ask me on a good day and I’ll be able to tell you that it has something to do with the deficiency of dopamine in the brain.

Ask me at another time and all the information I’ve ever learnt will have evaporated – I’ll give you some very vague description of the disorder. I might give you the non-abbreviated name and gesticulate wildly with my hands, to emphasise the  impulsivity and hyperactivity bits. Then I’d probably look you in the eye as if to say “You must know. Everybody knows about ADHD. Except me.”

Whatever ADHD stands for, or means, or how it is diagnosed, is pretty irrelevant to me now. I live with it. Or rather, I live with my daughter, and she has it.

Like so many other popular disorders (and I say popular because they often appear in soap opera storylines to give meat to the characters and don’t require extra budget or special actors) the condition is often used as hyperbole by people who have a tendency to over-exaggerate.

Those who might say “I wriggle a lot. I think I must have ADHD” might also be the same people who proclaim – after eating a chocolate bar: “OMG. I have got bulimia, but without the throwing up bit.” These terms, conditions, disorders, diagnoses or problems are sometimes real, and they are sometimes not.

With ADHD, who is to say? Unlike a diagnosis of cancer, there is no failsafe test. The rating score-sheets we’ve had to fill out over the years are not wholly objective. They cannot always be measured accurately.

But having been with my daughter since her birth nearly twelve years ago, it’s clear she can’t control a lot of her behaviour. She is hyperactive, impulsive, fidgety, unruly, often rude and at times uncontrollable. Those are obviously the hard-to-handle traits, and unfortunately they often overshadow the brilliant things about her. She is engaging, generous, bright, optimistic and entertaining.

Having received such exemplary care under the NHS at one of the country’s leading child and mental health centres for the last five years, I have slipped comfortably into the back seat: not out of sheer laziness, but because I trust the team that have dealt with my daughter implicitly. We have all been lucky. We know that.

The only thing that my husband and I have resisted has been the suggestion of drugs to help manage our daughter’s behaviour.

“We think Ritalin would be very effective in helping your daughter’s concentration.”

We batted that advice out of the room. We continued to support our daughter in all the other ways that we had been advised. The team continued to support us, and they did not pressure us unnecessarily to turn to the tablets.

We said no when the question of drugs came up last year. Actually, no thank you, because we are polite.

We said no thank you very much I think we’re OK thank you when our daughter was having issues with the transition from primary to secondary school.

We even said no after a period of really volcanic physical and emotional behaviour, where ‘fuck’ and ‘bitch’ and ‘fucking bitch’ and words that are too rude for the likes of this blog were shouted loud enough for the whole of Lambeth to hear; where heavy items were thrown out of frustration, and friendships and work at school were suffering. Why did we still resist drugs?  Because we didn’t really like the idea of them. If we were honest, we probably didn’t want to look like we were failing our daughter, or taking the easy option in the eyes of others.

But who were these others? My father, who has always said “You’re not going to go overboard like they do in the States and give her drugs, are you?”

Or the voices of people, usually not people I know, who didn’t agree with drugs being given to children in order to control their behaviour. Usually people who didn’t question anectodal evidence.

“Child turns into catatonic, compliant zombie after taking Ritalin. Bores everyone to death.”

And then, our daughter after all our gentle protestations, said yes. Yes please, I’d like to try the Ritalin. I’d like to be able to control my behaviour in class, and not answer back, and I don’t always want to be the one who is blamed for everything that goes wrong. I’d like to be able to make friends and keep them. I don’t want to always be seen as the annoying, over-excitable girl in school. And I don’t enjoy being rude.

And we, in turn, had to listen. Obviously the ultimate decision had to made by us, the parents, but when our daughter spoke up we had to question why we’d been so against the idea of Ritalin.

So we decided, after a consultation with the someone on the Neuropsychiatry team, that our daughter would start on a course of medication. Doses will be extremely low at first, and increased slowly over the coming weeks.

There will be side effects. We’d be mugs if we believed that drugs don’t carry such things, but hopefully they will be minimal and short-lived. She will be monitored, and if she doesn’t feel the benefits, she can stop at anytime.

I won’t be making excuses for our decision to try the drugs anymore, even if I’m only talking to myself. Ritalin is something that I might still be slightly wary of, but I am not my daughter, and for her they just might help.