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Column originally published Jan 13, 2009

University Student With ADHD Needs Medication

Question: I have a serious dilemma. Our daughter is a second year university student. She failed two of her first year university courses. This year, things are a whole lot worse. She missed deadlines for her assignments; she didn’t study before her mid-term exams and she failed miserably. We know that she is drinking a little, and she smokes pot once in a while when she hangs out with her high school friends. When we asked her why she is doing so poorly in university, she said that she couldn’t pay attention in class. I recall her elementary school teachers had told us that she was distracted very easily and had a hard time focusing in class, but she was smart and always did well in school, although we had to supervise her with her homework and make sure that she study before exams. Last month, the student counselor in her university arranged for her to see a psychiatrist, and she was diagnosed to have ADHD. This doctor prescribed a long-acting pill for her. I have to admit that our daughter has done much better since that time: she hasn’t missed an assignment and actually did well in tests. However, I am still very skeptical about the whole thing, especially the medicine that she takes. I have searched the Internet about ADHD, and the pill that she was given. What I read worries me. I know she needs help, but I am not sure medicine is the right thing.

Answer:

You are right to question about the use of medicine in your daughter’s situation. Her medical condition is not something that is obvious. She looks perfectly healthy, and probably acts completely normal, except for the fact that she is not doing well in univer- sity. It is very different if she has a physical illness.

However, Attention Deficit Hyperactivity Disorder (ADHD) is a real medical condition of the brain. First of all, it is a genetic condition. Scientists have already identified a number of genes that are associated with ADHD. Moreover, ADHD is not a single medical condition: different people are affected differently, and it depends on the person’s life experience, the home and work environment, as well as the severity of the condition.

The fact that your daughter did well in grade school and is able to attend university already tells me that she is a bright person. Both you and her teachers have done all the right things in her early years to help her to succeed, until now. Obviously she does not have the more severe form of ADHD. Those children would have been identified much earlier: they disrupt the classroom or have great deal of difficulty learning.

Over the years, I have seen many young men and women like your daughter. They have done well throughout elementary, junior and senior high schools. Some of them actually graduated high school with honour. However, they encounter major difficulty in college or university. There are many reasons why this would happen. Some of them move into university residence or have to move to another city to attend university. They lost the support and supervision of their parents. The newfound freedom is often difficult for them to handle. They may have problem scheduling when they should get up in the morning to attend classes, and when to go to bed. More importantly, they often leave assignments and projects till the last minute, and end up missing deadlines. They not only have difficulty paying attention in class and when they study, they have a hard time organizing when to do assignments and when to study, and this often leads to their downfall.

What caused your daughter’s problem is the chemicals in her brain. Our brain has billions of cells which are called neurons. They communicate with each other using chemicals, and there are many of them. The ones that are affected in those with ADHD are dopamine and noradrenaline. She has difficulty focusing, especially on academic things, and it is not easy for her to organize her activities with the high demand of university education.

The most effective treatment for ADHD is medication. I know many people are skeptical about medicine, especially after some of the highly publicized side effects of certain medications. If you search the internet, the kind of information that you can find often will scare you. I should tell you that there is a lot of misinformation about ADHD. The medications are very safe when used carefully and prescribed by experienced physicians. If your daughter can see her doctor regularly, her medicine can be adjusted so that it gives her the best benefit with little or no side effect.

Many colleges and universities have special allowance for students with ADHD and other learning difficulties. If your daughter is living at the university residence, she can apply for a single room in a quiet residence so that she can study in her room if she wants, and avoid the rowdiness in many university residences. The student services of her university may also arrange for her to have extra time for tests and examinations, and doing these in smaller classrooms instead of in large halls to reduce noise and distraction.

Many young people experiment with drugs and alcohol at this stage. Drugs like marijuana can calm the brain in those with ADHD, but can lead to addiction of other drugs. Research has clearly shown that those with untreated or inadequately treated ADHD are much more likely to experiment and get addicted with drugs and alcohol. On the other hand, medications are not addictive when used as prescribed. The newer long-acting formulations available in the last few years are better and safer than before.

I have seen many young men and women in the last twenty years that are like your daughter. I am glad to tell you that most of them have done well, able to finish college and university. I can count, among them, teachers, nurses, doctors, engineers, as well as carpenters, electricians, chefs, and many others. Having ADHD does not mean the person will not succeed. Some may not need medicine, but many do. Some of the adults who have finished education and are working still require medicine. Medicine helps their brain to focus on what they have to do. If a person needs to wear glasses to help their eyes to focus, he should not stop wearing them after he finishes school. The same reasoning applies to the use of medicine in ADHD.

I hope this information will help you to understand your daughter’s situation so that you can be more receptive about her condition and give her the support that she needs.