Tuesday, September 13, 2016

Is There an Epidemic of ADHD?

It has often been said that children are our future. But, how are we, today’s Americans, doing by our children? How well are we bringing them up? How well are we preparing them to go out in the world?

In many parts of the world parents have relied on custom and tradition and have believed themselves responsible for their children’s moral development. In today’s America we do not teach filial piety and self-discipline. Any parent, like the Tiger Mom, who values such principles is excoriated and reviled.

Instead, we prefer to drug children into submission. We do not teach good behavior but we diagnose much bad behavior as a neurological disorder and give too many children medication that will not teach them good habits but will subdue their bad habits. We say that they have ADHD and we give them amphetamines.

We ignore ethics, but we believe that science has all the answers.

So says reporter Alan Schwarz in a new book called ADHD Nation. Dr. Sally Satel reviewed the book yesterday in the Wall Street Journal.

She begins by pointing out the epidemics in the news today:

Two epidemics dominate the news today: the Zika virus and the rampant use of opiate drugs. To these, New York Times reporter Alan Schwarz adds another: the long-simmering plague of rambunctious American children who have been diagnosed with Attention Deficit Hyperactivity Disorder and prescribed the drugs that treat it.

The numbers are startling. Today six million children under the age of 18, or 15% of the nation’s youth, are diagnosed with ADHD; for boys alone, the rate is 20%. Reasonable estimates of the disorder’s prevalence in children, many experts agree, should be in the 5% range.

We have seen many stories about how medical professionals are getting people hooked on opioids. They are and have been doing the same by overprescribing amphetamines to children. 

Schwarz is not the first to notice the point, but the fact deserves some serious consideration. Medical professionals, in collusion with parents and school teachers, are hooking an obscene percentage of children on amphetamines. Since they have medical licenses, we do not consider them to be pushers, but the stories Schwarz recounts suggest that that is what is happening.

Sometimes, Satel explains, children do suffer from ADHD. The diagnosis is not a mirage. And yet, when a child is suffering from other ADHD other, non-pharmaceutical options should be available. As it happens these options are more difficult and more time-consuming. Better to write a prescription and be done with it.

She writes:

Even when the diagnosis is legitimate, medication is not necessarily required—family counseling and cognitive-behavioral therapy can sometimes be sufficient. But medication is the default option, and medication, in this case, means stimulants, as counterintuitive as that may seem: The aim of the drugs is to increase neurotransmitters such as dopamine that boost focus and increase concentration.

Who is to blame?

The blame lies with overzealous physicians; parents worried that their kids will not excel at school and in life; school systems looking to rein in troublemakers; and pharmaceutical companies pushing new stimulants on physicians and, in ads, on parents.

While we are casting blame, why not mention a culture that has been promoting the idea that mental illness is caused by a chemical imbalance and that the right cocktail of designer drugs can bring you health, wealth and happiness. 


Trigger Warning said...

"The blame lies with overzealous physicians..."

I disagree. The "blame" lies with incompetent educators, including "school" psychologists, too-busy parents, and a toxic social milieu that is unsafe, or perceived as such, for children.

Primary and secondary teachers today cannot deal with children outside +/- 1.5 standard deviations of the mean. "School" psychologists, the most poorly-trained of any clinical specialty, are consulted and children referred to specialist teachers (each placement recieves a Federal bounty) and physicians. Physicians, equally poorly-trained to deal with developmental matters, are pressured to "do something".

This is a national disgrace, and the consequences are going to be ugly.

Sam L. said...

Good points, TW!

Anonymous said...

I had a friend who was a company VIP and shared with me that he had had ADHD as a child.

"Really? Did you take drugs for it?"
"No. My father found a treatment for it."
"Wow. What did he do?"
"He smacked me on the back of the head and told me to knock it off."

TW - couldn't agree more, although I'd place more blame on the parents than the schools. If parents spent as much time researching and implementing alternative methods of dealing with this 'diagnosis' as they do on facebook and/or twitter, things would be different.

Ares Olympus said...

Strangely when I started reading TW's "Primary and secondary teachers today cannot deal with children outside..." my mind hooked on the "outside" as a literal.

So many kids don't play outside any more, with entertainment centers and computer games holding their mental attention, along with high salt, sugar and fat snacks.

And this blog in the past is critical when schools actually try to feed the children a healthy lunch that doesn't meet the children's need for taste excitement like all the snacks they consume on a daily basis.

But to ADHD specifically, and the H part, hyperactivity, means the kids have more energy than they can handle sitting still for 6 hours per day. So I've also read that restoring gym time, or playground time may be critical to help kids work off all that energy, and then perhaps they can focus better, without drugs, or at least the ordinary hyperactive kids, versus some who may actually have ADHD, but still will benefit by the same "Prescription exercise".

Interestingly it seems in the last months I've seen more kids and teens at the local parks, but they're not bird watching like me, but staring at their smart phones, apparently looking for invisible monsters on their camera phones. But at least they're outside I guess, one step at a time!

jwenting said...

There are both far too many diagnoses as well as people not being diagnosed who should be.
And the tragedy is that many of those not being diagnosed aren't so as a result of the overdiagnosis of others in large part.
Sensible doctors and parents refuse to let their children be tested because of the stigma associated with the condition and being seen as "trying to drug your children to keep them quiet".

It's the same with autism (the entire scala of that).

And it's hurting those people as adults, when the results can be destroyed careers and lives, and even less chance of diagnosis and treatment as many doctors (and people in general) won't recognise the symptoms in adults at all, being under the mistaken impression that it only affects children "who will just grow out of it".