Teens often Assert their Independence by Refusing to take Prescribed Medication

A friend’s 18-year-old son recently decided he didn’t want to take his ADHD medication anymore.

“I don’t think I need it anymore, because I’m doing so well,” he told his parents.

Three weeks later, his parents found out he was in danger of failing a class he needed to get into the college he selected.

“Don’t worry,” he assured his parents. “The college doesn’t care about your grades during your last semester in high school.”

But, of course, his parents were worried.

“He’s going off to college in September and how is going to be able to do well if he is not able to concentrate and do his work,” his father asked. “It is really evident that he needs his medication, even if he doesn’t see the necessity of it any longer.”

Over the years, I worked with many adolescents and their families. Some of the teens took medication for the symptoms of ADHD; others were prescribed medications for other medical conditions, such as diabetes or seizure disorders. But there was a pattern that I began to recognize.

As teenagers reached their middle and late adolescent years, there was an increasing need to be self-sufficient, independent, and autonomous. They wanted to be grown up and to be their own person. For many of them this meant that they no longer wanted to be dependent on a drug or a medication. They needed to prove to themselves and others that they were an adult and that they were capable of handling their problems and symptoms without the aid of a medication. For some, it was like taking a medication meant weaknesses or a crippling dependency. It frequently reminded me of the toddler who proclaims “Me do it!” whenever an adult tries to assist them.

One adolescent I saw for counseling during his junior and senior years in high school, credited his success in high school to the medication he took to deal with his short attention span. In his second semester in college, he came back to see me during a spring break.

“I did really well my first semester in college,” he said. “But things really went downhill this term.”

When we talked about why this might have happened, he admitted he wasn’t taking his medication. “I thought I could do it on my own,” he said. “But I’ve been taking Ritalin for years and I’m tired of it. I just want to be normal.”

He did, however, agree to start taking his medication again, and as I anticipated, his grades went up.

Taking drugs, for many teens, becomes one more battleground in the adolescent power struggle and the need to assert greater personal autonomy. In other words, rebelling against the taking of medication – even when it is important for maintaining good health – is a way teenagers can feel more in control of their own lives.

For example, Diana resents every pill she puts in her mouth to manage her seizure disorder.

“I don’t want someone else telling me what I need to do,” Diana has said, “especially a grown-up.”

At 16, Diana was still living at home and going to high school. She had frequently had seizures in school, which resulted in her being taken by ambulance to an ER. She knew the medication prevented seizures, but still she resented taking the medication. As a compromise with her parents, she said that she would not stop taking her medication until she was 17.

“Then, I’ll stop taking it for a while and see if I can get along without it,” Diana said. “But if the seizures return, then I’ll go back on the medication.”

It is probably very clear to you that your adolescent might not be able to function adequately when not taking their medication. However, it is likely that your child has other issues – such as the need for independence, autonomy, and personal power – that may overshadow their judgment and commonsense.

Although your teenager may resent you telling them they need to continue taking their medication, a doctor, who is not their parent, is more likely to be listened to as an authority. If the doctor’s authority doesn’t work, you may have to stand by while your teen tests out their ability to function without their medication. Although this might be difficult for you, you may be able to be supportive and help them make a healthy decision once they have figured out that they can’t control a medical condition without medication. If you have been engaging in a conflict with your teen over the use of their medication, they just might hide their condition from you so that they don’t have to admit they were wrong or made a poor choice.