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                It was seven pm and the air was fresh with the excitement of early summer. School was out for the year and it was his tenth birthday. The party had been earlier that day and now everyone was home. Mike was sitting on the front porch in his usual position. Elbows on his knees, hands crossed in front of him, signature frown on his face. Harley sat next to him, with his elbows on his knees and his hands crossed in front of him. With a dazed smile that didn’t match the tone of his voice he whined,”Daddyyy, I have to take my meds.” Mike glanced at his watch and ignored his request. Harley’s voice grew to a high-pitched screech. “Daddyyyyy….” He pulled at Mike’s arm as he yelled, “I HAVE TO TAKE MY MEDS!!!” and like clockwork, the evening ritual of pill-popping and drool-induced sleep began before the sun even set.

                My younger brother Harley is just one out of the 2.7 million American youth between the age of 4 and 17 who is medicated for Attention Deficit Hyperactivity Disorder (ADHD). Over the course of his young life he has been prescribed more medications than most thirty year old adults. Various types of Ritalin, Adderall, and Concerta have graced the medicine cabinet in my family’s home along with sleeping pills, allergy medicine, mood stabilizers, and antidepressants. Whenever one wouldn’t work the doctor would move on to another, never once thinking to re-evaluate his diagnosis. Through trial and error, the doctor would find a cocktail of pills that suppressed Harley’s outbursts, confusion, and meltdowns and when they stopped working she upped the dose or added the newest miracle pill to the mix.

                “Hey buddy,” I said, groggy as I opened my eyes. He was standing in the corner of the room, back to me. In the dark I could just make out his shadow and nothing more. “What’s up?” He didn’t respond. Instead, Harley pulled down his pants and proceeded to pee on my bedroom floor, in a dead sleep. The next day he didn’t remember his surprise bathroom break and Mike installed a lock on his bedroom door.

                He came home from school one afternoon and kicked the door open. Throwing his coat on the floor, he scowled at me before he ran upstairs. I chalked it up to just another one of his moods until our brother told me that they had been weighed in gym class that day. My stomach sank as I imagined his embarrassment when it was his turn. He didn’t wear baggy tee-shirts and jogging pants every day because they were cool and he knew it wasn’t normal for kids his age to be on strict diets. He knew he was different and he was beginning to understand why.

                It’s impossible to measure the benefits of something when all the good comes at a high price.  For a stable mood Harley gained weight and sacrificed a genuine smile and the light in his eyes. In order to focus he gave up sleep. To capture the sleep that evaded him, my brother gave up evening bike rides and ice cream, baseball and game nights.

                Does Harley value stability, focus, and sleep? I don’t know because I never asked him and nobody else did either. He was six when he took his first pill and my mother was exhausted. Fed up with his incessant crying and the daily outbursts, she did what she had to do to make her life easier. A short-term solution for a lifelong problem, behavioral therapy has never been utilized though one would think it would be the first option for families with challenging children. Not only would behavioral therapy change patterns of thinking in the long-term, it can correct bad habits before they become too ingrained. Impressionable children learn coping skills and families can learn together how to manage ADHD with charts and incentives for the child to behave. At six, drugs should not be the first option but a last resort.

                There’s little emotion in his voice when he speaks. It’s weird to hear him talk because his voice is changing; it cracks sometimes and I try not to say anything about it because I don’t want to embarrass him. He’s fourteen, a freshman in high school but he’s still Harley to me, wearing those jogging pants and a baggy tee-shirt that falls to his knees.

 Reference

“Increasing Prevalence of Parent-Reported Attention –Deficit / Hyperactivity Disorder Among Children ---United States, 2003 and 2007” (12 Nov 2010). Morbidity and Mortality Weekly Report. Retrieved from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5944a3.htm?s_cid=mm5944a3_w