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Areas › Focus, starting, and ADHD › Treatment and medication
Symptoms are worth reducing because of what they do downstream, and that is where the goal should be set. It changes what you review, too. Instead of asking whether the ratings moved, you ask whether this year had fewer near misses, whether the job lasted, whether home is less bruising than it was. Sometimes the score barely shifts and the year is transformed, and the reverse happens too.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
Take action! God will see your actions (Quran 9:105). What is looked at is the doing, the actual life, which is a fair place to set the aim of treatment.
التوبة
وَقُلِ ٱعۡمَلُواْ فَسَيَرَى ٱللَّهُ عَمَلَكُمۡ وَرَسُولُهُۥ وَٱلۡمُؤۡمِنُونَۖ وَسَتُرَدُّونَ إِلَىٰ عَٰلِمِ ٱلۡغَيۡبِ وَٱلشَّهَٰدَةِ فَيُنَبِّئُكُم بِمَا كُنتُمۡ تَعۡمَلُونَ
Say [Prophet], ‘Take action! God will see your actions- as will His Messenger and the believers- and then you will be returned to Him who knows what is seen and unseen, and He will tell you what you have been doing
Qur’an 9:105read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
A randomised, double blind, placebo controlled trial in 445 young adults aged eighteen to thirty assessed atomoxetine on ADHD symptoms and on how people were functioning, treating both as outcomes that mattered. That choice reflects the same view: symptoms are being counted because of what they cost. It is one drug in one age group, so it demonstrates the approach rather than settling what any given person should take.
Durell TM, Adler LA, Williams DW, Deldar A, McGough JJ, Glaser PE, Rubin RL, Pigott TA, Sarkis EH, Fox BK. (2013). Atomoxetine treatment of attention-deficit/hyperactivity disorder in young adults with assessment of functional outcomes: a randomized, double-blind, placebo-controlled clinical trial.. Journal of clinical psychopharmacology doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Symptom counts and daily life do not always move together, so the thing you actually care about is the thing worth measuring.
After a working lifetime in this field, Barkley names the change in how a family sees the child as the most important step of all. Not the medication, not the charts.
When a child with ADHD and a parent get stuck in daily rows, the rows themselves start doing damage. Getting the ADHD properly managed early takes some heat out of those exchanges before defiance settles in as a habit.
People who use several kinds of help tend to report more benefit than people relying on one. Medication, therapy, coaching, reading, sleep and movement all seem to add something rather than compete.