Quieting the Noise

I mentioned in my last post that one of the things helping Eli lately has been a new medication.

I hesitated to write even those few sentences last week because medication—especially medication for kids with ADHD and autism—is one of those subjects people tend to have opinions about.

I know because I used to have some pretty strong ones myself.

When Eli was first diagnosed with dyslexia and ADHD at five years old, I was wholly opposed to putting him on ADHD medication. Full stop.

But you gotta understand the lens I was looking through.

I’m an ’80s baby, which means I grew up in the ’90s — the era when ADHD medication pretty much meant one word → Ritalin.

Later, Adderall joined the conversation, but if you grew up when I did, you probably remember the whole Ritalin kid thing.

ADHD was becoming something everybody suddenly seemed to know about, stimulant prescriptions were climbing, and there was plenty of debate about whether we were diagnosing too many kids, medicating too many kids, or medicating kids because they couldn’t sit still in a classroom for seven hours.

That was the conversation happening around us. And in my own house, the two brothers I’m sandwiched between in age started ADHD medication in elementary school.

Now, I was a kid myself back then, so this is very much preteen/early-teenage Susan’s memory of it—not a scientific evaluation of their treatment plans.

But what I feel like I remember most is my parents not loving how different they seemed when they took it.

They just… weren’t quite themselves.

I’m not even sure if these are actual memories or if I overheard grown-ups talking, but I feel like they were just a little flatter, a little quieter. Nothing significant. Just… different.

Whether that was the medication, the dose, the particular medication available at the time, or simply my kid-brain interpretation of what was happening doesn’t really matter to this story.

What matters is that’s what I remember.

Like, for example – and I’m sure I will get some part of this wrong. I always misremember which brother it was, what grade he was in, and probably at least one other important detail — so we’re gonna speak in generics here.

My mom still tells a story about one of my brothers having a teacher who essentially “diagnosed” him with ADHD during a parent meeting and described him as being like a wild animal — or something very similar.

I’m sure the teacher thought she was being helpful with her colorful description of my brother.

She was not.

That meeting became a pretty pivotal moment in my mom’s parenting journey, in my brother’s education, and in the way mom advocated for her kids after that.

I know this because at some point later, I landed in that same teacher’s classroom.

My mother promptly marched herself right up to Mr. Principal’s office and asked to have me moved.

Mr. Principal told her they did not switch students simply because a parent had previously had a disagreement with a teacher.

My mother, apparently, did not find that policy particularly compelling.

I had a different teacher the very next day.

So when I say ADHD medication came with some baggage in my house, I don’t just mean the medication itself.

There was a whole history wrapped around it that I watched from the periphery growing up — teachers, labels, how kids were talked about, how parents were spoken to, and how quickly a child could become “the problem” in the room.

That was part of the lens I brought with me when Eli was diagnosed too.

And those were the memories I carried with me into that doctor’s office with my own five-year-old.
I wasn’t afraid that ADHD medication wouldn’t work.

I was afraid it would work by turning down all the parts of Eli that made him Eli.

His humor.
His curiosity.
His intensity.
The way his brain notices things the rest of us completely miss.
His light.

I didn’t want to quiet him just because his brain was loud.

So when the psychologist who diagnosed him suggested we also have his vision checked, I was more than happy to start there.

Turns out, he needed glasses.

Like, the kid was practically blind—which was an odd thing to learn considering he had passed the school’s eye exam just a few weeks earlier. 🤔

Anywho—great. Bonus! He was super—duper cute in glasses!

Glasses. Dyslexia tutoring. Extra support at school.

These were interventions I could get behind.

We started seeing some progress, and I thought maybe—just maybe—we could manage the ADHD without medication after all. Nope.

It didn’t take long before we found ourselves back at the doctor’s office, where Dr. Pediatrician put it to me in a way I couldn’t really argue with.

Clearly, you know your son needs glasses to see. Would you send him to school without his glasses?

Well, no, sir.

Then why, Dr. Pediatrician asked, would you send him without a support that might help his brain filter out some of the noise?

Damn it. Fine.

So we started with a very low dose of ADHD medication.

And slowly, things started clicking.

Not because Eli suddenly became a different kid.
Actually, kind of the opposite.

He could focus long enough to learn. He could access some of the skills everyone had been trying so hard to teach him. The glasses helped him see the page. The tutoring helped him understand the words.

And the medication helped turn down some of the competing radio stations playing in his brain at the same time.

That worked really well.
Until it didn’t anymore.

Because, as we’ve learned approximately eleven billion times while raising Eli, development is not a straight line.

Kids change.
Brains change.
Hormones enter the chat.
Expectations get harder.
Middle school happens.

And over time, some of the things that were making life difficult for Eli weren’t just about whether he could pay attention in class.

There was impulsivity.
Difficulty slowing himself down.
Big reactions.
Getting stuck on things.
Social anxiety.
The constant state of being just a little too “on.”

And sleep—which, as I mentioned in the last post, was its own beast.

So recently, we finally sat down with a child psychiatrist to look at the whole picture instead of treating every piece separately.

We talked about ADHD.
We talked about autism.
We talked about anxiety.
We talked about sleep.

We talked about the difference between a kid who won’t do something and a nervous system that sometimes seems incapable of slowing down enough to do it.

And after all of that, Dr. Psychiatrist recommended adding a very low dose of…

a blood-pressure medication.

Excuse me, what?

Guanfacine.

Yes, guanfacine really was developed and used as a medication for high blood pressure (if you want to learn more, all my sources are linked at the end of this post or on my Helpful Links page🤓).

But that’s not the whole story.

We’re gonna tap into our science nerd selves for just a little minute—k?

Guanfacine acts on alpha-2A adrenergic receptors, including receptors in areas of the brain involved in things like attention, impulse control, and regulation.

Or, in much less science-nerdy terms: It can help some brains find the brakes.

Which suddenly made a whole lot more sense for our kid.

Extended-release guanfacine is FDA-approved to treat ADHD and can be used either on its own or alongside stimulant medication.

And researchers have studied it specifically in autistic children who also struggle with hyperactivity, impulsivity, and distractibility.

In one randomized study, autistic children receiving extended-release guanfacine had a 43.6% reduction in hyperactivity scores compared with a 13.2% reduction in the placebo group. Half of the children receiving guanfacine were rated much or very much improved, compared with 9.4% of those receiving placebo.

Researchers have also found improvement in some oppositional and repetitive behaviors, although the evidence that guanfacine directly treats anxiety is much less clear. In that same research program, guanfacine was not significantly better than placebo for anxiety.

And that distinction matters because Dr. Psychiatrist wasn’t giving Eli a “blood-pressure pill for social anxiety.” She was looking at a nervous system where several things overlapped.

ADHD doesn’t just mean “can’t pay attention.”
It can mean difficulty regulating attention, impulses, activity level, and reactions.

Autism can come with its own challenges around regulation, transitions, sensory input, repetitive thinking, and becoming overwhelmed.

Anxiety can pile on top of all of it.

And sometimes it’s really hard to tell where one thing ends and another begins.

Sometimes what looks like defiance is overwhelm.
Sometimes what looks like overreaction is a nervous system that went from zero to sixty before the thinking part of the brain ever got a vote.
Sometimes a kid is trying incredibly hard—and his brain is still just… LOUD.

Guanfacine can help turn the volume down for some kids.

Not off.

Not erase the noise completely.

And definitely not erase him.

Just lower the background noise enough that he has a little more room to operate.

And for Eli?

The difference has been significant.

He’s sleeping!
Sometimes through the night—which never happened before!

He’s more comfortable socially.
He’s interacting more.
He’s able to stay in situations that would have overwhelmed him before.

Like the birthday party I wrote about last week.
I walked into that party fully expecting the usual.
Instead, he talked to people.
He played outside.
He hung out.
And he never once asked to leave.

Was that all because of one medication? Of course not.

That’s years of therapy, maturity, accommodations, teaching, support, trial and error—and a whole lot of hard work on Eli’s part.

But do I think finally getting the sleep his body needed and having a nervous system that isn’t running quite so hot has helped him access all of those skills?

One hundred-eleventeen-thousand percent!

And that’s the part I wish I’d understood when he was five.

The boy I was so afraid medication would somehow take away from me all those years ago is still very much here.

Still funny.
Still opinionated.
Still obsessed with whatever subject currently has his attention.
Still saying things that make me wonder where in the world they came from.
Still Eli.

If anything, lately we’re seeing more of him.

And watching that happen has forced me to reconsider the fear I carried into that doctor’s office all those years ago.

I thought medication might diminish his light.

What I didn’t understand yet was how exhausting it must be to shine when your brain is fighting through so much noise just to get there.

Medication isn’t the answer for every kid.

It isn’t magic.

And this certainly isn’t me telling anyone else what they should do with their child.

Good grief. I’m still trying to figure out my own.

It doesn’t replace therapy (still ongoing), accommodations (still in place), teaching (still learning), patience (still practicing), structure (still required), or all the other things we’ve spent years building around Eli.

And finding the right medication—or the right whatever support your kid needs—isn’t always simple.

Guanfacine can cause side effects including sleepiness, fatigue, dizziness, low blood pressure, and a slower heart rate, which is exactly why these are conversations to have with the medical professionals who actually know your kid.
But I wish the version of me sitting in that doctor’s office eight years ago could see him now.

Because I wasn’t wrong to want to protect Eli’s light.

I just misunderstood what I was protecting it from.

The medication wasn’t there to make him quieter for the rest of us.
It was there to make things a little quieter for him.
And there is a very big difference.