Fasting and ADHD: Navigating Challenges During the Fast Days

The usual halachot (laws) related to fasts are familiar to many of us. Yet, special situations require specific halachic consideration. Just as it is clear that a sick person should consult the halachot relevant to them during a fast, similarly, people with ADHD may need customized halachic guidance. Here's a collection of intriguing questions related to ADHD and fasting.

Ritalin and Fasting with Water

I am diagnosed with ADHD and take medication daily to help with attention and focus, swallowing it with a bit of water. Can I take the medication with water during fasts (except Yom Kippur), or should I refrain from doing so?

The prophet Zechariah (Zechariah 8:19) states, "Thus said the Lord of Hosts: The fast of the fourth month, the fast of the fifth, the fast of the seventh, and the fast of the tenth shall become times of joy and gladness, happy festivals for the House of Judah." The fast of the fourth month is the 17th of Tammuz, the fifth is Tisha B'Av, the seventh is the Fast of Gedaliah, and the tenth is the 10th of Tevet. The reason all of Israel observes these four fasts is to commemorate the calamities that occurred during these times and to remind us of our wrongdoings and those of our ancestors, leading us to repent and improve our actions.

While eating and drinking are prohibited, only items considered food are forbidden. Things not fit for consumption, or those less than the amount considered a portion (approximately 30 cc), are permitted during fasts. Therefore, a pill, which isn't considered "food," can be swallowed on fasts, especially since it isn't consumed in the typical manner of eating. Consequently, taking medication, such as Ritalin, is allowed on fasts.

If unable to swallow the pill without water, it resembles what the poskim (Jewish legal scholars) permit for someone with a headache during a fast: taking an aspirin or similar medication with a little water since the intention isn't to enjoy the water but solely to help the pill go down. Hence, taking Ritalin with a small amount of water is permissible during fasts, especially if the disorder significantly affects daily functioning.

Summary: If you need to take medication for attention and focus, it is permitted during the four fasts, and if you have difficulty swallowing a pill, you may take it with a small amount of ordinary water. On Tisha B'Av, it is permitted only with slightly bitter water, such as strong tea essence without sugar.

Ritalin and Fasting with Food

My fifteen-year-old son started taking medication for attention and focus, but he finds it hard to swallow the pill with water, so he takes it with a piece of bread or similar. Is he allowed to swallow the pill with a little food on a fast, or must he refrain from taking the medication?

Swallowing a pill with water is allowed, as detailed in the previous answer, but not with food. The reasoning is that drinking water to swallow a pill isn't considered drinking for enjoyment, similar to when one has a bone stuck in their throat and uses water to clear it without reciting the blessing "shehakol." With food, however, it's considered eating since the body derives nourishment from the food.

This applies if the medication's purpose is mainly for focusing during study and prayer. However, if the disorder severely impacts daily functioning, like leading to arguments if the medication isn't taken or inability to maintain a proper daily schedule, it should be treated like the case of a sick person not in danger, and it would be permitted to swallow the pill even with a bit of food.

Summary: A teen who needs medication for attention and focus and usually takes the pill with a piece of bread or similar isn't permitted to do so on a fast but may take it with a little water. If the disorder causes significant daily functional impairment, it is permitted to take the pill even with a small amount of food (less than the size of an olive). On Tisha B'Av, one should consult a knowledgeable authority.

Candies for Kids During Fasts

My ten-year-old loves candy and finds it hard to resist. Since he isn't obligated to fast, can I give him candy during the fast? If he buys or takes candy himself, must I stop him?

If a child has reached the age of understanding to mourn for the destruction of Jerusalem, around age nine, ideally, one should prevent them from having candy during a fast to educate them about participating in the fast with the community, so giving candy during the fast is not appropriate.

But if the child takes treats or snacks on their own or buys candy with their money, there's no need to stop this action. It isn't considered as if the parents gave it, as the child does it willingly. There's no educational obligation since, by the letter of the law, a minor isn't required to fast at all. Ideally, parents shouldn’t give them candy, but if the child takes it themself, there's no need to prevent it.

Summary: A child from age nine should not be given candy during fasts. If they take it themselves or buy it with their own money, there is no need to prevent them from eating it. (For further elaboration and halachic sources, see the book "Kashuv Rab," section on halachot - holiday laws).

Rabbi Moshe Shmuel Dayan is the author of the book "Kashuv Rab."