Many of the ‘ADD generation’ say no to meds; Newly minted grown-ups are carrying out a massive natural experiment by choosing to do without the drugs that profoundly affected their experience of childhood. By Melissa Healy, Las Angeles Times December 18, 2006
This article focuses primarily on a number of young adults who, diagnosed with and treated with medication for Attention Deficit Disorder in childhood, have chosen to discontinue those stimulants.
Commentary
This article exemplifies one of the most problematic aspects of the lay press reporting on healthcare issues by promoting a point of view that could influence readers.
There is no indication that any aspect of the story is inaccurate or intentionally misleading. On the other hand, each of the individuals who decided to stop taking their ADD medications is reported to have done well. Further, support for the discontinuation of medication is presented uncritically while doubt is cast upon theories and studies favoring the ongoing use of these medications.
And, consider the tone of these excerpts:
But as the 23-year-old navigates his way into adulthood, he’s managed to pay the roadside distractions a little less attention. And he’s learned a thing or two about getting himself from one destination to the next without taking major detours.
Looking back, he acknowledges that Ritalin did help him academically. But he also felt that it blunted his natural sociability, made it “hard to feel passionate about anything.” And the same intensity of focus that helped him in class, he believes, impaired his instincts on the soccer field — a troublesome side effect for a rising soccer star. He quit Ritalin as a freshman in high school. Off the drug, he says: “I felt more like a happier person. I just felt more like myself,” voicing an observation heard again and again among young adults who abandoned their ADD medication.
They [young adults who have taken stimulants for ADD] want, overwhelmingly, to feel normal, Fischer says — to be like other kids who can make it through a school day without being chided for daydreaming or sent to the nurse for a midday pill. Many, she says, are keen to try life without the medications to prove something: “to feel that your success, your accomplishments, your failures are truly your own and not the product of medication.”
In a nod to his ADD, Barclay says he accomplishes many of his grown-up tasks in pinball fashion, bouncing haphazardly from paying a bill to tending the home he owns to walking his dog. “I get things accomplished. It’s probably not as efficiently or as quickly as other people, but it happens in my own way,” he says.
The penultimate portion of the article is devoted to Dr. Lawrence Diller, the author of “The Last Normal Child,” in which he “raises concerns about the effect on society and children when parents, schools and the medical establishment reach too easily for such medication [for ADD].”
Diller calls it “unduly pessimistic” to believe that two-thirds of kids with ADD will continue to suffer symptoms negative enough to require medication as adults. By a young adult’s mid-20s or so, he believes that many who were diagnosed with ADD as children have developed strategies, as Devin Barclay has, to work around their weaknesses. And they are better equipped to answer the question — to medicate or not? — with a clear sense of their adult selves. Diller feels that those diagnosed with ADD — as well as their parents and counselors — should revisit “the bargain” that many made with Ritalin and other such drugs as children as they meander through their early adult years. In return for the often-reported side effects of the medication — sleep difficulties, appetite suppression, a “not quite me” feeling — children and their parents expected ADD medication to help them succeed in school at a time when sitting still and compliance with rules was highly valued. But in the adult world, young people with ADD have far wider choices, and they should make them with an awareness of their strengths and their weaknesses, Diller says — not what others expect of them. Using medication “to take octagonal kids and fit them into square holes” may be acceptable in grade school, he says. But “they will be patients for the rest of their lives,” he adds, if they pursue fields that require enormous attention to detail or intense concentration on matters that do not fire their interest.
The issues raised, whether ADHD medications should be taken indefinitely and, if not, how the decision to continue or discontinue the medication is determined, is both legitimate and important. A reporter’s responsibilities in presenting the story are less clear. In this case, a newspaper story that features reports of interesting individuals who seem to have made the right decision going off a medication, breezy summaries of research and ideas about the disease, and a clear air of approbation for independence-minded young adults who defy their parents and doctors by discontinuing their medications is, it would seem, more likely to influence those facing this decision than pages of grey print reporting findings of scientific studies.
Footnotes
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