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May 4, 2020
Change is brutal. For the vast majority of children and adults with attention deficit hyperactivity disorder (ADHD), this is true. So, while the whole world shifts under our feet, most of us are not eager to introduce more change. We see evidence of this ADDitude’s latest survey of 1,816 readers, two-thirds of whom say they are not adjusting the variables of ADHD treatment for themselves or their child while in quarantine.
For a small minority (6.5%), maintaining the status quo is not a choice; they have been unable to see their medical professional during the pandemic and, therefore, unable to make changes to their stimulant medication prescription. But more than 43% of survey respondents have seen a doctor in person or via telehealth over the last eight weeks, and nearly a third of all respondents have made some change to their ADHD treatment during this time.
Two-thirds of ADDitude readers use ADHD medication for themselves or their child, so a treatment change means consulting with a physician and adjusting the prescription and/or dosage accordingly. This is a delicate and detailed process. However, fully 46% of you are now integrating regular exercise into your ADHD treatment plan — a significant increase over the 37% who typically exercise to mitigate symptoms. For these people, treatment change may mean new daily walks, online yoga classes, or family bike rides. Similarly, twice as many children are using mindful meditation to manage their ADHD now — up from 13% typically to 26% in our most recent survey. The population of ADDitude readers using diet, supplements, and vitamins to address ADHD symptoms — roughly one-third — has remained largely unchanged over the last two months.
ADHD Treatment Options by Popularity Now
[Read This: The 2017 ADDitude ADHD Treatment Report]
When it comes to ADHD medication, why introduce more flux during this unstable time? The reasons vary considerably.
Changing ADHD Treatment for Financial Reasons
Nearly 18% of ADDitude readers say that financial pressure sparked by the pandemic has influence their treatment decisions. At least 12% of you have lost your job or source of income since mid-March, and with that lost paycheck comes lost health insurance for many.
“I can’t pay for my medication,” wrote one mother with ADHD raising a daughter with ADHD and a son with autism. “I’m no longer insured, and don’t qualify for Medicaid.”
Even those with insurance are reporting financial insecurity. Some are canceling therapy appointments and other ADHD treatments not fully covered by their insurers. Others are rationing their medication, taking lower doses or skipping weekends in order to make the pills last longer.
“I took one less dose per day to delay filling the prescription by a week,” wrote one adult with ADHD. “But my symptoms returned and I was achieving little.”
Others have reported feeling pressure to adjust their medication to save money, and many more are just worried about what the future holds for them medically, financially, and professionally.
“The possibility of layoffs/furloughs at my company have had me planning for a financial emergency,” wrote one adult with ADHD and anxiety. “Unfortunately, my medication and appointments are already very expensive even with insurance, so the possibility of having to pay for them without an income or insurance has caused me worry.”
[Doing Battle with Your Insurance Company]
Changing ADHD Treatment for Children
By and large, the parents who are adjusting their kids’ treatment now are either reducing or eliminating dosages due to diminished school demands, or they are trying out a new medication hoping for reduced side effects or greater efficacy.
Parents in the former group said they are making the most of flexible homeschooling schedules to shift their child’s toughest subjects to the time of day when they are best able to concentrate, introduce regular exercise breaks, and allow for more sleep — all modifications that have allowed their children to reduce medication usage.
“We have reduced her daily dose of medication by eliminating the second dose of Adderall,” wrote one mother of a child with ADHD and learning disabilities. “We have chosen to adjust her schoolwork schedule to include the subjects where she struggles more to focus (math and ELA) for in the morning. She then does her history reading before lunch. After lunch she does 30 minutes of physical activity then does her hands-on projects like science, art, music, etc.. She is actually doing better on her schoolwork with the 1:1 of homeschooling, fewer external distractions during ‘school time,’ and less medication. She also reports none of the ‘brain yo-yo’ sensation as the meds peaked and dropped in levels.”
“We are not medicating currently,” wrote the parent of a child with ADHD. “If he were at school and having to focus for 6 hours per day, we would medicate. He seems to be able to focus and attend during the 30-minute blocks of time he is required to attend class and/or instruction.”
Other parents have reported that stress and anxiety have diminished in lockstep with social interactions and classroom time, making medication less necessary.
“He isn’t taking his medication, which is for anxiety caused largely by being in the school setting,” wrote one parent.
Other caregivers are viewing the quarantine through a different lens — seeing it as an opportunity to experiment with medication changes that might have been difficult or even impossible with busy academic and athletic schedules.
“We had been trying to alter meds, but it was hard to do when school was in session,” wrote one parent. “Now that my boys are home in isolation, we are successfully doing the med changes.”
Similarly, some families are trying the Feingold Diet for the first time because they are eating homemade meals every night and able to control what foods come into the house. Others are scheduling times for daily bike rides or walks that never would happen in the pandemonium of their pre-quarantine lives.
Still other parents are allowing their teens to try managing school and home responsibilities without medication during this relatively low-pressure time. For some, this could highlight the need for continued treatment; for others, it could point the way to long-term treatment adjustment.
“My son is trying to do school work without his meds to see how well he can concentrate without them,” wrote one parent of a teenager with ADHD.
Changing ADHD Treatment for Adults
While caregivers are largely scaling back ADHD medication for their homeschooling children, adults with ADHD are doing the opposite during this pandemic. Faced with new and tricky challenges related to working for home — while often simultaneously overseeing and facilitating learning for their children with ADHD — many ADDitude survey respondents said they are adding a second daily dose, increasing dosage, or even starting ADHD medication for the first time.
“I have started taking Concerta,” wrote one adult with ADHD and anxiety. “I wasn’t taking any stimulant medications for a year and a half before the pandemic.”
“More time with the kids means I am needing two doses daily of long-acting meds instead of one long and one short,” wrote one father with ADHD. “I also don’t think effects are lasting as long due to increased stress.”
“I have had to take additional doses of my Adderall to make it through my work days, as I’ve been procrastinating more and therefore needing to have longer days getting things done,” wrote one young adult with ADHD in California.
Medication is not the only treatment getting more time and attention. The vast majority of survey respondents said they are exercising more regularly, practicing mindful meditation daily, and eating healthier now. Some miss their gym routine and work-out classes, for sure, but many said they are working on developing healthy habits.
“I have increased the level and intensity of my exercise, and persistently commit to at least 10 mins (or more) of mindfulness meditation daily,” wrote one respondent.
Other adults reported that sleep is impacting their ADHD medication routine. Whether their sleep is interrupted due to anxiety or more plentiful due to WFH schedules, they are off their normal routine and not taking medication at the same time every day. This is largely causing treatment hiccups and new stresses.
“Disturbed sleep patterns make it harder for me to wake up once I’m asleep, leaving me to sleep in several days in the week, missing my meds,” wrote one middle aged adult with ADHD.
“I have been inconsistent with taking my meds as I am out of my normal morning wake up time and routine,” wrote another.
Still other adults with ADHD said they planned to cut back on medication due to contamination worry regarding visits to the doctor and the pharmacy.
“I haven’t changed anything yet, but I’ve been considering whether it’s worth the possible risk to have to go pick up my next prescription refill from the doctor’s office then take it to the pharmacy,” wrote one mother with ADHD. “Where do you find the balance when taking care of your mental/emotional health means walking into one of the highest risk facilities possible in order to do so?”
“I’m afraid to visit my physician to pick up my prescription due to fear of surely coming in contact with the virus, so I’ve been weaning myself off my medication,” wrote one young professional in California. “Since it’s a controlled substance, I have to visit my doctor’s office in person every month to pick up the prescription and drop it off at the pharmacy as well. Not only do I not want to do this, but I’m living with and share a car with someone who’s immune compromised. It’s pretty upsetting overall.”
Pandemic Emotions April 27 – May 3, 2020
Indeed, the mood among ADDitude readers has swung back in the direction of worry and exhaustion after a brief uptick in calm acceptance last week. Almost 60% of you said you’re feeling overwhelmed or exhausted now, compared to 54% last week. Likewise, 57% report feeling anxiety over the pandemic, up from 48% one week prior. Frustration over enduring stay-at-home orders was cited less frequently than was the fear that states are opening up too soon and risking a second wave of virus contagion.
Other phrases used to describe the emotions experienced in week 7 of quarantine included “numb,” “irritated about everything,” “guilty for not using time for productively,” “short tempered,” “hopeless,” “grieving,” “bored,” “unmotivated,” and “overworked.”
“I can go from feeling optimistic and calmly accepting what the current situation is, to the very next day feeling extremely depressed and not wanting to talk to anyone,” wrote one reader.
We understand totally — at least for today.
[The Benefits of ADHD in a Crisis: Hyperfocus, Creativity, Resilience & More]
Updated on May 4, 2020