Beyond Ritalin [Paperback]

Although "Nature's Ritalin for the Marathon Mind" was my first book (chosen since it dealt with the use of physical exercise in helping focus the sufferer) the book "Beyond Ritalin" by Garber, Garber, and Spizman was my second. What I found especially impressive was that the authors did not espouse any given method of treatment. They were not "all for' or "completely against" medication as a method of approach, and they were up-front with what medication could and could not do for the sufferer of ADHD.

More than anything the authors made it obvious that ADHD is a DIAGNOSIS and NOT AN EXCUSE. It is not an excuse for the sufferer to "drop out" of the world or give up because it's "hopeless" and certainly not an excuse for parents to give up on parenting the child with ADHD just because he/she is "on medication" or "impossible."

The discussion of the various types of medications available was very honest, describing potential side effects, variation in individual response, and effective limitations. Most importantly, as they point out in some of their section headings: "Medication does not teach socially acceptable behavior (p. 130)," "Medication does not help ADHD youth or adults feel happier (p. 130)," "Medication does not teach reflective thinking (p. 144)," "Medication does not teach you how to control where to focus attention (p. 145)," "Medication does not make the individual organized (p. 161)," "Medication doesn't improve self-esteem or self-confidence (p. 206)," etc. In short, both the sufferers and their families have a lot of work to do, and it's hard work. However, not to do that work is to spend the rest of ones life spinning ones wheels.

Among the suggestions for treatment of the disorder are those that the authors have found effective in their clinical practice. Their observations about complications arising from learning disorders and skills deficits were very cogent. Certainly the individual suffering already from ADHD is beat before they start until learning problems are addressed and missed skills are remedied possibly with the aid of special tutors.

Suggestions for behavioral training (with respect to remembering things, completing projects, organizing the environment and ones day) were all very helpful as were the social skills training for individuals who have difficulty making friends and "fitting in." The problems with task commitment and test taking were especially informative. The authors' point out that many individuals can do the work but may find testing situations frustrating and overwhelming. I especially found the hints about limiting and defining the task, sometimes even visually (by covering part of a page with a piece of paper) were helpful, as were those offered for developing organizational skills. As they write with respect to the latter, "Most people find getting organized difficult. The difference is that whereas most people can get away with being disorganized, those with ADHD cannot. Since ADHD people are easily distracted, disorganization can 'do them in (p.173).'"

The authors also point out that living with ADHD can be very stressful and irritating. Their chapter "Taming the Tiger Within" points out that medication can be somewhat lumpy in its effects throughout the day. It also may make the person look and act calmer, but may leave them actually feeling just as they always do. They can listen better, accomplish more, get better grades, but still not feel calm or relaxed. The authors suggest some progressive relaxation training, or imagery: "Relaxation exercises remain one of the best ways to manage symptoms of ADHD and to permit the individual to acquire feelings of control (p. 186)."

The last chapter pertains to ADHD among adults. Here the authors note that ADHD is not a disorder that the sufferer just "grows out of with time" but continues to effect the individual into adulthood. Most significant are the findings that in adulthood the outcomes of the disorder do not seem to be distinguishable between those individuals treated with medication as children and those who were not. It seems that multidimensional treatment modalities have a greater chance of improving outcomes and that it's never too late to get help.