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For me, it was an easy choice, but hard work

My mother (Mary N. Wessling, who’s a medical researcher) pointed me to this article in MedPage Today: Are Physicians Too Quick to Medicate ADHD?

The article posits whether family physicians are prescribing ADHD drugs at a too high rate to kids they see, without referring them to a qualified mental health professional. Clearly, this is the case. And clearly, the medical establishment has abdicated responsibility for it.

When my daughter was a preschooler, I was told by a doctor that it was common knowledge amongst doctors that you can diagnose ADHD by giving stimulants to kids. “If the stimulants work to help them focus, then it’s ADHD.” I believe that this is still a common belief amongst physicians, even though it’s been proven without a doubt not to be the case. Look at the recent New Yorker article about how college kids are taking black market ADHD drugs so that they can focus better when studying for tests. These are not college kids with diagnosed ADHD: these are kids who have always done just fine in school and have never been diagnosed as hyperactive. And surprise, the drugs help them focus, too.

A while back I started to research various theories of behavioral problems. I would have had no problem getting an ADHD diagnosis for my daughter (many doctors fill parent requests for ADHD drugs without much investigation if the parents say the child needs them, especially if a school recommends them). But I didn’t want to drug her. I wanted to figure out what was going on. She was a hyper-smart, funny, loving, creative person who in certain situations (like school) completely lost it.

What I found in my research[1] is that there are two worlds out there: there’s the world of the psychiatrist we saw who didn’t question that she needed drugs; she just wanted to figure out which one. Then there was the other world: practitioners of all sorts of therapies from Western to Eastern, concerned parents, and some Western-trained psychologists were all asking the obvious question: Why do we have ADHD now and not before? What has changed?

The answer is one that any amateur sociologist could have given: Our lifestyle and culture have changed. Our expectations of children have changed. Where we live, what we do, and how long we do it for has changed.

This is how my mother puts it: “We give disease names to behaviors that previously have just been considered difficult. That is not to say that things were better–these children were often the recipients of damaging physical and psychological abuse called ‘discipline’. We now have many more resources  and information available.”

This is how the phenomenon is described by James T. Webb[2], a leading expert on gifted children (who are, he admits, often “quirky” and unusual): “I think our society has become increasingly less tolerant of quirkiness. Our schools, too. … In psychiatry and psychology, the number of diagnoses has proliferated increasingly. … For example, the unruly child is now seen as a diagnosable disorder, Oppositional Disorder . The town drunk now is an alcoholic and that’s a disease. There’s been a redefining. I think it’s been overboard.”

So this change has led to drugging children for what was once considered part of the normal continuum of human behavior. What’s shocking is not the research that revealed the success of therapies including diet change, having unstructured play time, and more time outside. What’s shocking is that our MDs just seem to have missed that boat. They are going happily along in their search for more and better drugs, and totally ignoring all the evidence that says that drugs are not the answer for many or possibly most of these kids.[3]

From the MedPage article: “Teachers and parents are looking for a quick fix,” added Mark D. Smaller, PhD, a psychoanalyst in private practice in Chicago who was not involved in the paper. “They’re reluctant to look at what’s behind that behavior, at what’s going on at home.”

The article cites child abuse as one possible cause of ADHD. Yes, that may be the case, but that rules out all the rest of us: the loving, imperfect parents who are just trying to raise their kids with the knowledge we have. And I don’t think that those parents would react badly if after explaining their child’s schedule to their pediatrician, the pediatrician suggested, “Perhaps you need to cancel tae kwon do one day a week and go for a long walk in the woods.”

Some of the alternative prescriptions for behavioral modification cost money: homeopathy, for example, is usually very expensive and not covered by insurance. Some of them take a lot of time: occupational therapy, for example. Some take a lot of change in the home: parenting changes, diet changes. But most of them are as cheap as a big bottle of fish pills from Costco. An hour walking in the woods with your child, finding out what he’s thinking about, giving him loving advice from the person he knows best.

But things that are hard are sometimes better. Yes, drugs are easy and cheap. But what does your child learn from drugs? That she can’t control her own behavior. That she can’t look at her environment and realize that it’s not good for her. These are not lessons I want my children to learn. I want her to know that she can make herself strong and healthy, that she can depend on herself and trust herself.

Last week one of the teachers in her homeschool program took me aside and said a few words about the changes she’s seen in my daughter.[4] One thing she said really hit me. “With a lot of kids who start behaving well in the classroom, you can see that they’re holding themselves back. They’re stopping themselves from doing things they’ve been told not to do. But your daughter has fundamentally changed. She’s enjoying her time in the classroom and she is doing what comes naturally to her now.”

Or she could be on drugs. I think we made the right choice. [5]

1. My article: Alternative treatments for behavioral problems

2.  My article about James T. Webb and the evolution of knowledge about the particular social/emotional problems of gifted children.

3.  I am well aware that there are children who desperately need medical treatments for real, difficult problems

4.  Some details of the changes we made in our daughter’s lifestyle, including diet and environment

5. My news article on this topic on the Gifted Children Examiner.

Posted in Culture, Health, Parenting, Psychology.

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