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More Book beastThe Overmedicated Myth
Hannah Seligson is a journalist. Her book, A Little Bit Married: How to Know When It’s Time to Walk Down the Aisle or Out the Door, which spotlights and uncovers a major trend in dating today, the long-term unmarried relationship, was published by Da Capo Press on Jan. 15.
Are doctors and parents trying to “perfect” children through various cocktails of medications? That’s what Judith Warner assumed, until she began researching her new book—and found that we are not, after all, a Ritalin nation.
Aren’t all kids on some kind of medication? Isn’t everyone diagnosed with something these days? Isn’t ADD as common as the sniffles?
Not really, says Judith Warner, author of the new book We’ve Got Issues: Children and Parents in the Age of Medication. Warner is best known for outing the culture of overparenting in her first book, Perfect Madness: Motherhood in the Age of Anxiety, and her Domestic Disturbances column on The New York Times Web site, and now she’s decided to quiet the cacophony of misconceptions about children, medication, overdiagnosing, and overmedicating in one confident hush.
How does Warner do it? She starts by challenging her own beliefs.
The overmedicated and overdiagnosed child, Warner argues, is a media embellishment. And it’s become an obsession and storyline that eclipses the realities.
When she began writing her book, almost five years ago, she came to it thinking the narratives the media had spun about children and medication were true: Parents were trying to “perfect” their children through various cocktails of medications; doctors were going prescription-happy; and kids who occasionally got sad were being labeled “depressed.”
“Those assumptions, however, weren’t borne out by clinicians, parents, children, or statistics,” says Warner, who did lots of research to support her thesis.
Here’s what the numbers teach us:
About 5 percent of kids take psychiatric medication and, depending on how one reads the data, anywhere between 5 and 20 percent of kids today have mental-health issues. We are not a Ritalin nation. According to The National Institute of Mental Health, attention deficit disorder occurs in about 3 to 5 percent of school-age children.
We’ve Got Issues: Children and Parents in the Age of Medication. By Judith Warner. 336 pages. Riverhead. $26.
The overmedicated and overdiagnosed child, Warner argues, is a media embellishment. And it’s become an obsession and storyline that eclipses the realities.
We’ve Got Issues spotlights a bigger problem: the lack of medical care for many children with mental issues. With an overwhelmed mental-health industry—there are only 7,000 child psychiatrists in the U.S., mostly concentrated in urban areas—those who need help often don’t get it. Mental-health issues have been portrayed as a bourgeois malady because that is the only segment of our population that can afford to have them. The full battery of tests to get a diagnosis costs about $2,000, which insurance companies often do not reimburse. Warner takes a stab at offering some policy solutions, including a clarion call for insurance companies to reimburse families for diagnostic tests and to increase the number of child psychiatrists.
She quotes John March, a Duke University psychiatrist, as saying, “Child psychiatry will really be the heart of psychiatry in the future. Epidemiology now shows that if you’re mentally ill as an adult, you first were mentally ill as a child or an adolescent.”
We’ve Got Issues is a reality check that separates the perceived outrages from the genuine ones, and for this alone Warner provides a real service.
Warner is saying “bring it on” to all the dicey, controversial, and murky areas that obscure the subject of children and medication, and she’s not afraid to acknowledge the issues on which there isn’t consensus, including whether there really are more children with mental issues today than there were 30 years ago. “I don’t know if there really are more, or we are just recognizing them more,” says Warner.
Still, she devotes a chapter to exploring the topic. One of the more intriguing explanations is “assortative mating,” a theory that researchers say could be one explanation for the mysterious surge of autism in our time. The theory is that today kids are getting a “higher genetic load” because people are now marrying mates who are similar to them. “Even one generation back you didn’t have a physicist marrying a physicist,” says Warner. Dr. Demitri Papolos, an associate professor of psychiatry at the Albert Einstein College of Medicine, says that in the past “spousal selection took into consideration knowledge of the partner’s family... now few couples have much of a clue as to the medical and psychiatric history of families they are marrying into.”
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Hannah Seligson is a journalist. Her book, A Little Bit Married: How to Know When It’s Time to Walk Down the Aisle or Out the Door, which spotlights and uncovers a major trend in dating today, the long-term unmarried relationship, was published by Da Capo Press on Jan. 15.
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Hannah Seligson is a journalist. Her book, A Little Bit Married: How to Know When It’s Time to Walk Down the Aisle or Out the Door, which spotlights and uncovers a major trend in dating today, the long-term unmarried relationship, was published by Da Capo Press on Jan. 15.
Frenchmanaz
Thank you Hannah. As a parent of an 8 year boy who was diagnosed by a few but questioned by other professionals, we have gone through the torment of placing our son on a, fortunately, very low does of Ritalin.
We are in the process of investigating further to see if the issue isn't related more to simple boredom and lack of stimulation in class. With class sizes bursting at the seams these days, some kids are simply not interested in sitting for hours on end while a teacher sits all the way over there teaching from a blackboard. I do not blame teachers for this because there is a dis-incentive to do hands on activities because handling so many children with more practical lessons can lead to chaos.
The point of explaining my story is that all of these self important prognosticators who accuse parents of over medicating have turned what was already a negative mark against children even further. Parents who make the heart wrenching decision to put their children on this kind of medication are made to feel like drug pushers and the children incompetent.
It's quite disgusting how parents with " perfect " kids judge.
One only need to look at scientology to understand how such harsh opposition to medication, in any form, but mostly for our children can lead to horrific consequences. John Travolta lost his beautiful son as a result of following this very detrimental doctrine.
While I understand that there are parents out there who are so weak that would rather medicate their kids in the hopes that these kids will behave like obedient drones, but for the rest of us, it's a heart wrenching decision only amplified by self important, selfish " experts " who invent statistics that make, those parents who must make these decisions, feel even more guilt, all with the aim of selling more books.
Please continue your push on this matter. It may never change the opinions of the pathetic " perfect parents and children " from looking down on people like myself and my child, but I see only positivity coming from marginalizing these " experts " into obscurity.
mdreader
If all our children were the same, we'd have the same answer to the same problem. Your child's ADD (if he really has it) is likely not the same as my child's. And our responses and solutions are different--as they should be. We chose not to medicate and I'm seeing improvements as he is getting older. His best friend, however, is not, and could probably benefit from some medication. As long as your child continues to grow, thrive and enjoy life, keep doing what you're doing. After all, if we were all the same, what a boring world this would be.
greatcrestedgrebe
This is so true! I am so sick of everyone saying that people are misdiagnosed all the time and that only rich people have these disorders because they make them up. It's so blatantly not true. As a sufferer from OCD, I can safely say my life would be a lot harder with medication. Obviously its not the favorite option but when you need help, you need help.
Brucie61
What a great article. Thanks for calling attention to Warner's book. Lots of great revelations there and how medication can improve lives and that mental illness has its roots in childhood. Screening for mental illness should be as routine as screening for scoliosis in children. It could help so many families
californiagirl
I do not agree read my post ....I think most children outgrow their childhood eccentricities and it is important to let children be children and not screen them as you say but let them be children and grow...and not drug them, the ill effects on them are horrendous.
rjcrawford33
A lot depends on the way this issue is framed and I think this review creates a caricature of an extremely complex issue. Seligman mistakes quantitative for the qualitative, positing that we are not "over medicated" because percentages of usage are low. This is a ridiculous simplification. Moreover, the focus on creating perfect children is misplaced: serious mental illness should be the focus, not yuppie ambitions.
I have always understood that the concern over meds is that they are often the first and perhaps only recourse that doctors consider - supported by a combination of academic research skewed to genetic explanations, drug company ads, the insurance industries, and government policy. As normal procedure, in this view, doctors prescribe drugs to alleviate "behavioral problems" of troubled (i.e. troublesome) children. As such, the issue is one of mindset, with a bureaucratic superstructure backing it up.
This means that the old route of depth psychology - essentially seeking to find meaning in symptoms that reflect life issues - is largely neglected. It is easier to experiment with the right cocktail of drugs than to ask what is going on and why a life isn't working. The admittedly more difficult and long-term introspective route is now taken by fewer and fewer. It is about the direction the entire field of medical psychiatry has taken, culminating in doling out pills.
I have seen this in the lives of many friends. For example, one old and dear friend has a daughter whose anxiety was so severe that she wanted to commit suicide - at the age of 11. The crisis occurred after her mother had had a difficult pregnancy that kept her bedridden for the entire term. The treatment that they eventually settled on was a mix of tranquilizers and amphetamines - without asking themselves why she might feel so bad. "It's just a chemical imbalance," she says. Now, after many years of such therapy with crises of med changes at regular intervals, the child is still a psychological wreck, however well her "bad behavior" is hidden as a sullen recluse behind closed doors. All you have to do is look into the child's eyes to see the pain and confusion. This story is repeated in the lives of many of my old friends, including adults with depression.
OK, my kids do not exhibit these problems, thank god. I do not know what I would do if they did and perhaps the relief of drugs calming them down (as long as they remain effective) would tempt me to sedate them. But I would also ask myself the hard questions of why they are so anguished, i.e. what responsibility did I as a parent have. The pain that my friend has experienced regarding her child is unspeakable, but I fear she is avoiding a confrontation with the real issues.
californiagirl
This is so typical of the problems with parents raising children these days. Looking for a pill to ease their conscience and medicate the problems away.
Children need back yards and wood and activity and not computer time and not be treated like adults.
keep your children running and playing and exercising outdoors for long periods, be firm and loving with them and keep them off medicatiosn which will ruin their lives and make them dependent on drugs for life.
Most children outgrow their fears, their qualms, their ticks and strange behaviors as they grow older, give them the space and confidence to grow up as children, weird at first and they they learn to fly....
plswatson
It sounds like you don't have any children, from the way you refer to the "problems with parents raising children these days," so, you'll have to forgive me if I a) don't care about your uninformed opinion and b) strongly disapprove of your unsupportive attitude. Raising children is difficult and it's unfair of you to generalize and assume that the "problems" parents face are their own faults for not giving their children "activity," and not letting them "grow up as children." If anyone needs to grow up here, it's you.
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