Q: I teach a 17 year old girl at my church who has been diagnosed with ADHD. She refuses to take her medication because she doesn't like how it makes her tired and lethargic. When in class, she is very upbeat, outgoing, full of energy, and always initiating discussion (which is greatly appreciated). She has asked me whether or not I think she should take the medication. I think no, but I don't know enough about it. I'd rather have the kid who participates in class and is happy, than the one who is tired and falling asleep to my lectures. I am no psychiatrist, but I believe this condition is often mis-diagnosed. Suggestions?
Alarmed in California

A: Indeed, you are correct in assuming that the symptoms associated with ADHD are frequently misdiagnosed. Many psychologists believe that much behavior that is within the normal range of child and teen behavior is labeled ADHD simply because it is troubling to parents and/or teachers and difficult to deal with. The first step is to inform yourself about this issue. A recent TV documentary that is fair to both sides is the Investigative Reports program entitled "Ritalin." It is available online from A&E. One good critical book on the topic is Talking Back to Ritalin by Peter Breggin, MD. You can find it at your county library. He is thorough and backs up his points with research evidence. If you cite actual research that points not only to potential misdiagnosis but also the possible negative side-effects of taking Ritalin, your suggestion will carry more weight. I would also suggest doing an Internet search using the terms "Ritalin critique" for additional points of view on this topic.

     However, it is advisable for anyone already taking medication to consult a medical doctor or psychiatrist for advice about weaning themselves from any medication of this kind. If this girl's physician is not amenable to weaning her from the drug, I can provide you with an alternative physician recommendation in your area.

     Lastly, it is important for her to remember that it is her body and she has the moral right to make choices about what substances she ingests. However, the legal issue is complicated by the fact that she is a minor. Though adults have the right to refuse medication, she, as a minor, may need to consult a lawyer about her legal rights in this matter, should there be a conflict between her choice and her parents' choice.