Streams

We All Have Issues

Tuesday, February 23, 2010

New York Times and New York Times Magazine contributing writer Judith Warner, argues that the assumption that kids are over-diagnosed and over-medicalized for mental health disorders is potentially very destructive. She discusses her new book We've Got Issues: Children and Parents in the Age of Medication.

Event tonight: Judith Warner in conversation with New York Times columnist Lisa Belkin at the Parents League of New York; 6:30pm, free and open to the public.

Comments [48]

b. from nj

I was five years old when I was medicated for major depression in the early 80's, and again medicated at puberty until adulthood for whichever diagnosis fit the medications that were "helping" me at the time. I thought I was so "sick" my entire life. I am so grateful for the many miracles (including caring therapists NOT psychiatrists) allowing me to see that I never had a "biochemical imbalance", that my family has many problems and secrets, that certain physical allergies and illnesses affect mood and brain function, and that, as many different drugs as my brain and body have been subjected to, I have escaped the insanity of an industry which imprisons people body, mind, and spirit.

Feb. 23 2010 09:38 PM
Kristin from Huntington, NY 11743

As a board certified Child and Adolescent psychiatrist, there is so much that I want to comment on-- I think another show is in order, Brian! :)

We, child psychiatrists, are so often vilified in media and elsewhere, but I can tell you from experience, that when there is a child with significant mental health needs, we then become desperately needed and sought after. Like in any profession, there are great, good, and bad psychiatrists.

It is important to question prescribing patterns, overdiagnosis, questionable relationships between MDs and pharmaceutical companies, the lack of treatment options for children, for sure.

But ask any parent of a child in the throws of severe OCD, or Eating Disorder, or depression (or....) - all of which can and often do present in childhood or adolescence- and there is no doubt that these ailments are real.

Having worked with children with serious medical illness (diabetes, asthma, cancer, Crohn's disease, etc) -- the pharmacological treatments for these ailments often carry risk of side effects, some quite impairing. Why is it that psychiatric medications are so intensely and differently scrutinized? Have you ever seen a child on chronic steroid treatment for say, inflammatory bowel disease? Or chemotherapy for cancer? Or ramped up from the Albuterol for their asthma?.

There are grave morbidities associated with depression, anxiety, OCD, eating disorders-- including possible fatality.

I am all for being cautious, and asking these important questions about prescribing patterns, access to treatment, interests of pharmaceutical companies.

Medication can be a safe, effective and HIGHLY beneficial treatment component. Ask any kid with severe OCD who has benefitted from SSRI treatment and reclaimed their life.

And we must remember that there can be significant risks to NOT treating, too.

Feb. 23 2010 08:49 PM
maureen from rockland county

two comments.my 7ry old was pulling out her hair,i thought it was ringworm so off to the Dr.first and only thing the tired,uninvolved,female Dr-mother of young children herself-suggested was put her on medication,nothing else will work.we had just moved to NY from rural Australia,my child and our family was severely stressed.She took none of our family situation into account.My own common sense said don't do it,it's an over-reaction.I sought out a better Dr and found a pediatrition who was wonderful.He talked to my child like she was a human being,very gentle and understanding,gave us a range of options from do nothing to relaxation/yoga/therapy.I chose to do nothing but be there for my daughter emotionally .She's now eighteen and doing fine,I'm so glad I didn't medicate/label her OCD and so glad I found a good DR.
Second comment.My son-in-law's son from his first marriage has Tourette's,he has trouble at school,below reading for his age,can't behave in school,poor peer relations,the list goes on.My SIL is a veteran who has PTSD,his first marriage broke up when his wife had an affair while he was in Iraq.It's a recipe for disaster.The complexity of the situation is unbelievable.The child gets medication to help his condition.I can't tease out what is social/cultural/environmental from what is physical/genetic.I feel so sad for this kid,his mother is struggling financially,lives with an abusive boyfriend,is pregnant to him.Who knows what is causing his difficult behaviors.

Feb. 23 2010 06:52 PM
hjs from 11211

the truth
you're very consistent: god, spanking, anti-science. you could have lived 200 years ago

Feb. 23 2010 04:13 PM
Marielle from Brooklyn

[34] Oh, then I can only hope you have no children.

Feb. 23 2010 01:43 PM
DA trufe from

YEH SPANKING WORKS BEST FOR NUKLEHEDS

Feb. 23 2010 01:42 PM
a. g. from hudson county nj

super-sized aspertame phosphoric-acid car paint remover-diet coke anyone? we just had a binary,to medicate or not to medicate flat earth society discussion. no mention of refined carb,agri-surplus,gen-eng. school lunch crap that we feed our kids. btw,i do feel for parents who have kids with behavioral prob.and are looking for expediency for the sake of sanity[their own as well as their childs]. however,there is huge toxic overload on kids as is. industry in this country is constantly putting out new chemicals. all of which,tragically,are innocent till proven guilty. psychoactive[like many other drugs] have side effects. liver toxicity is one of them. donwe really want to augment the chemical burden on a child more than he/she already has to deal with,and the possible future physical problems?

Feb. 23 2010 01:26 PM
Frank from NJ from New Jersey

My son was diagnosed with ADHD as a 5th grader. We refused to use pharmaceuticals but have had marked success with the following (All under the guidance of our physician, which is an obvious and important step for everyone to take when dealing with ADHD naturally):

1. Natural supplements to promote dopamine production and spur natural remediation of some of the deficiencies which are associated with ADHD. (Such as a supplement called Lumina, also, DHA, EPA, OPC, B Vitamins).
2. Use of "Interactive Metronome" - a neuro-motor therapy provided by accredited health care providers.
3. Dietary changes reducing sugar intake (not eliminating it)
4. Eye exercises to eliminate "CONVERGENCE DEFICIENCY" a muscle weakness in the eye which creates symptoms which are incredibly similar to ADHD. No-one seems to know about the similarities between this condition and ADHD. We stumbled upon it almost accidentally. Doctors are not sure if ADHD causes convergence deficiency, vice versa, or if their confluence is not directly linked at all. At any rate, my son did have convergence deficiency and weekly visits to an eye doctor who specializes in it's treatment, along with home exercises have begun to eliminate the condition. We are still working at it.

All of the above have helped my son to maintain A's and B's in school, have reduced his impulsive behavior at home and in school, and generally have improved his "maturity".

Feb. 23 2010 12:52 PM
peter from vancouver

concerned parents, be consoled that school is not important. i was a terrible student but i turned it around in university and got a good degree and career. everything important i've learned in my free time, not in primary and secondary school. children who are interested in the world will learn about it, but not necessarily in a classroom.

Feb. 23 2010 12:49 PM
RCT from NYC

Amy [37]: I so agree.

My son has the ability to focus on tasks for very long periods of time (no bar to an ADHD diagnosis, I soon learned), but needs to work on a one-on-one, interactive basis to learn. He was "distracted" -- i.e., could not process information, and lost interest -- in a standard classroom.

The societal influences were the norms imposed upon him in a standard classroom. Some kids can't adapt. I told his principal (District 3 public school) in the first grade that he'd never work well in groups -- he'd "flunked" Gymboree -- but the verdict was, if he can't work well in groups, i.e. is "distractable," off to the pharmacist he goes. The fact that he'd spent a week trapping a fly in a Venus fly trap, then drawing a multicolored picture of the fly (at five years old, and all his own idea -- I still have the picture) didn't "fly" with either the schools or the therapists.

My husband and I joke that if we'd raised our son in the 19th century, and been members of the British peerage, our very bright child would have had tutors at home, then tutors at Oxbridge, and have done splendidly.

Bah, humbug -- lose the drugs!

Feb. 23 2010 12:31 PM
RCT from NYC

As for the migraine point: it may have sounded like a low shot, but I've read Judith's blogs on migraine drugs, and she seems very involved with and dependent upon such treatments. My point was that her own experience may have made her more willing to defer to the doctors whom she interviewed in writing her book.

Feb. 23 2010 12:21 PM
Amy from Manhattan

OK, Ms. Warner just lost me. If these disorders were caused by societal factors, "all children would have them?" Nothing societal is that simple--can you name *anything* w/a social cause that's true of *every* member of a group in that society? Society is too complex to make such a blanket statement, & it casts doubt on everything else Warner says. [This may be pointless by now, since my comment didn't go through, but I'll try submitting it again.]

Feb. 23 2010 12:20 PM
CES from Brooklyn

I know these disorders exist but Judith Warner is unfair to teachers...following her own philosophy about the "gulf of experience" has she been teaching kids all day lately? My friend has been teaching art to elementary school kids for over 10 years in the Bronx and has witnessed a striking increase in extreme behavior. I have younger friends in college and am shocked to hear from them that among their peers it is abnormal not to be on a medication .

There is something wrong with this picture. We should be looking into the effects of nutrition and other factors more seriously.

Ms. Warner can take Enzymatic Therapy Butterbur extract, Gingko Phytosome (gingko with a phospholipid), Nature's Way Mygrafew and Natural Calm drink - a powdered magnesium (most migraine sufferers - in fact most Americans - are severely deficient in magnesium) daily if she wants to eliminate migraines and migraine medicines from her life.

Calm magnesium has been effective for children's ADHD as well. I would also suggest they take high levels of good quality fish oil.

Oh, and to the doctor who called, no I don't take the blasphemy of doctors getting drug company kickbacks "with a grain of salt".

Feb. 23 2010 12:19 PM
RCT from NYC

I guess the last comment wasn't my final one!

Our son had many friends and classmates who were treated with Ritalin -- which is speed, by the way. He tells me that many of these kids, now young adults, have continuing problems with judgment and impulse control. Judith would say -- "It's the ADHD!" My son insists that it's the long-term effects of Ritalin; it's as though part of the kids' brains did not mature. He says, "They're messed up, Mom."

We found an excellent therapist who has helped my son regain his self-esteem, and given him strategies -- that work --for adapting to school.

The biggest problem that these kids face is their feelings of helplessness and failure. Moreover, they know that the failures are not their fault, and so get really, really angry. Drugs don't address the underlying problem, which is social, not medical, but merely mask that problem by controlling behavior. We need to question the system, not the kid, and teach kids how to take control -- i.e., to think actively and creatively to adapt to what can't be changed.

We told our son, "Your difficulties in school are not your fault, but you have to learn to deal with school anyway; it's the only road to the life that you want to lead." In other words, we were realists, but tried to empower him.

Nor did we consider a diagnosis ADHD a "stigma". Rather, we considered that diagnosis a threat to our son's health and development -- because of the drug therapy that we knew would be pushed on him -- and responded accordingly.

No regrets. I feel as though we saved our kid from the maws of 20 tigers. My husband agrees 100%; we had this discussion on the way to work, after reading the NYT review of Judith's books and hearing that she'd be on Brian's show.

Feb. 23 2010 12:14 PM
the truth!! from BKNY

Sorry Marielle, not a joke, what has changed since our parents parented? without drugs...some of these kids are so zoned out the dont know up from down, some go on to have serious side effects from all the drugs, creating more severe and in some cases extreme emotional problems..just because you are emotionally attached to the story does not mean I am going to change my opinion.

Also, what is your experience with lower income families that you speak for them here?

Feb. 23 2010 12:14 PM
adsf from

Taher/27 --

1. Ritalin is not banned in Switzerland -- where did you hear that?

2. Is saying that the Brian Lehrer Show is "not the Gary Null" show (nor is it Democracy Now, BAI, etc. etc.) supposed to be an insult? I would assume that WNYC would be the first to admit means to be liberal mainstream, as irritating as that fact can be to the listener who wishes that it was more __________.

Feb. 23 2010 12:14 PM
Marielle from Brooklyn

[30] I hope that was a joke.

[26] Your story demonstrates the excellent point that each child needs to be considered individually and decisions made based on what is right for each one - unfortunately, we live in a one-size-fits-all world, and woe unto you if you don't fit the mold. Very glad to hear that you found solutions that worked well for both your boys.

Feb. 23 2010 12:06 PM
the truth!! from BKNY

I am from the old school, it is disturbing when I read "my daughter's psycholgist says..." truly disturbing.

Feb. 23 2010 12:03 PM
the truth!! from BKNY

We replaced spanking with medication! Most just need a taste-o-the belt!

Feb. 23 2010 12:01 PM
susan from tribeca

I have two boys (now 27 and 16) who were lucky enough to go to a school which was public, but progressive. There were tables and no desks and kids could walk around the room. My older son would have likely been diagnosed if he had been asked to sit still for 7 hours a day. Education in this country gets worse and worse, yet medication usage goes up and up. The system requires that kids be medicated in order to learn in our system. The system needs to change, kids need to play outside more, and eat healthy foods. I didn't hear a single comment about improvement of life style instead of meds.

Feb. 23 2010 12:00 PM
superf88@gmail.com from NJ

another point -- as so called special ed kids are increasingly being mainstreamed -- for budgetary reasons -- public school teachers are gaining expertise in diagnosis and treatment that had previously been administered by specialized private schools.

Feb. 23 2010 11:59 AM
Taher from Croton on Hudson

[17] a. g. from hudson county nj
this radio show is not about the Gary Null view of the world. The establishment reigns supreme here. I am on the same page with you.

Feb. 23 2010 11:58 AM
Karin Spraggs from Harlem

I have two boys- both with ADHD, one who is medicated and one that isn't. It is the severity of the ADHD for my younger son, that we chose to put him on medication. We resisted it for a while and now regret not having put him on medication earlier. The change has been monumental- his reading skills have flourished and his focus in school has been amazing which in turn has helped him get along better with his peers. We need to take in to account each child and how it affects his/her daily life. Kudos to Judith, thank you for your work in this subject!

Feb. 23 2010 11:58 AM
jennifer from ny

My child went to a highly competitive pressure-laden public school on the Upper East Side where there was truly a cookie-cutter culture, not indicative of most public schools. The pressure I experienced to medicate my child (including threats of special education, which for him, was not appropriate) due to a blizzard of factors was insurmountable. His behavior issues, my stand out at the school as a single mother, and more importantly, a single mother without money, and my financial inability to follow my gut and look into something very radical (a life change, a job change to accommodate his needs). I did it. I medicated him. In short, it was awful. He was a zombie, nothing more. Medications are freely not only prescribed, but championed by doctors when there is not sufficient data on the drugs. I see doctors in this scenario as prostitutes. They are paid to lie down for the pharm companies. They cannot resist the money and the perks. Early on, parents are heartbroken and desperate and ripe for abuse by these “professionals.”

Our experience has many nightmarish anecdotes, including a vulture of a doctor who kept calling me, months after my son had discontinued private therapy with him because our health benefit ran out, urging me to let him put my son on an adult drug, cut down for size to “try it” on a child. Years later, after navigating the Special Ed system and advocacy, I still see and hear things that amaze me, but by now I have my wits about me.
I know some kids need medication to function at school; it did not help my son. It DID NOT SOLVE HIS BEHAVIORAL PROBLEMS, it merely kept the school off his back. Great solution. I have great guilt over this. I am thankful that there were a few shining lights for him in the school, people who, while restricted by the system, took time to love him and see beyond the aggression and listen to him.

Feb. 23 2010 11:57 AM
Marielle from Brooklyn

This is an incredibly moving segment - what could me more agonizing to parents than trying to figure out how to help their children? And it comes as very little surprise that lower-income families have more difficulty getting appropriate diagnoses and assistance. Truly heart-rending.

Feb. 23 2010 11:56 AM
Jesse

It's fair enough to try to emphasize that there ARE kids who benefit from these drugs. But here's something I wonder: how much do we know about how these kids' development itself is affected by the drugs? Is there data on kids with psychiatric disorders who then grow out of them? Do the drugs help them grow out of them? Hinder them? These seem like important questions to me.

Feb. 23 2010 11:55 AM
J O'Connell from New Jersey

Great Topic. Many people do not accept Mental Illness as Truth.

A person who may need a medication to balance their BRAIN chemistry...is no different that a diabetic needing Insullin to balance their Glucose Chemistry.

Your caller just now with the 9 year old said just about everything we have been through.I heard the frustration in her voice. We try and try to get HELP for our suffering kids!

Insurance Companies AND Public schools be-little Mental illness.

Feb. 23 2010 11:55 AM
eastvilliage from eastvillage

Is this the same Judith Warner that advocated for the invasion of Iraq back in 2001-2002?

Feb. 23 2010 11:54 AM
Katherine T. from Ramsey, NJ

Medication has allowed my severely autistic son to attend school, feel happy and refrain from serious self-injury and aggressive behaviors. My experience has been that competent psychiatrists don't rush to medicate. If trying medication, they start with low doses and carefully monitor.

Feb. 23 2010 11:54 AM
RCT from NYC

One last comment -- the learning issue is obviously a major one for us -- but the fact that Judith was so quick to dismiss our family's story indicates the strength of her conversion to the drug culture. I noted that "one" psychiatrist --not all of them -- had discussed adaptation as a possible issue.

We weren't the exceptional case in which the diagnosis was wrong; we were a typical case in which the parents were pressured into treating a child who was not conforming to classroom norms.

Feb. 23 2010 11:53 AM
Jesse from Glen Cove

Where is the conversation of:...."Tell Your Doctor ABOUT..."

Pharmaceuticals are telling us WHAT to ask our Drs. for and CREATING drug markets.

Let's get real people! Nothing is new...My parents dealt with "ADHD" by discipline and love - NOT medication. AND surprise, surprise I made it!

Until we deal with the fact that people in general want a way to medicate their lives away - we have a fundamental problem.

Feb. 23 2010 11:53 AM
a. g. from hudson county nj

i was addicted to psych drugs for yrs. homeopathy,organic juicing, supplements and that curse word on npr and ny times gary null,changed it all around. but what the heck....

Feb. 23 2010 11:52 AM
Nicole from NYC

The caller just online indicated a piece of the problem - it is not natural to sit still for 7 or more hours per day. Kids are also eating many foods that exacerbating certain "bad" behaviors, and there are many other environmental factors adding to these problems. That we are moving to medication (potentially for life), is at best a band-aid solution to what is a much deeper issue in our society.

Feb. 23 2010 11:52 AM
Glenn from Manhattan

We teach karate to kids with learning disorders and our method has shown to help kids overcome these difficulties, who are on medication or are trying alternatives to medication. Parents have seen positive changes in their kids while training with us. The brain can change if thinking, balance and exercise are used together as therapy. fitnessforfocus.com

Feb. 23 2010 11:51 AM
Dave from Brooklyn

I am concerned about the compression of the "normal" spectrum. When i grew up the variations of normal kids was significant. Everything i see and read now suggests that the spectrum of behavior is getting narrower and narrower and will eventually result in a very specific type of person being classified as normal

Feb. 23 2010 11:51 AM
RCT from NYC

The doctors included a noted author of kids books on learning disabilities. The psychiatrist with whom I had the discussion re adaptation was a Columbia University trained "psychiatrist/pharmacologist". The point is that the diagnoses are WRONG, and the success story was our successful effort to buck the system.

Feb. 23 2010 11:49 AM
Judy from NYC

My daughter's neuro-psychologist recommended ritalin for our daughter. She has other medical issues outside of ADHD, but the neuro-psyche said we shouldn't punish her for being well behaved. It seems that misbehaviour reaps the benefit of Ritalin, but the quiet kids who don't act out but have attention issues often get missed.

Since putting my daughter on medication, she has been progressing academically. We're thrilled.

Feb. 23 2010 11:49 AM
RCT from NYC

Three schools, many doctors, same diagnosis -- ADHD -- the discussion with the psychiatrist concerned the widening definition of ADHD, and possibility that such diagnosis were subjective and that the kids merely had problems adapting to socially-imposed norms.

Feb. 23 2010 11:47 AM
Taher from Croton on Hudson

Ritalin is made by Novartis Pharmaceuticals of Switzerland.
The drug is banned in Switzerland.

Feb. 23 2010 11:46 AM
lynne from CT

When my sons were in preschool about 10 years ago, the 3 & 4 year old boys were expected to sit calmly in circle several times a day and generally were discouraged from a lot of physical activity. In several cases, parents were advised by the preschool teachers to have their boys checked for ADHD and possible Ritalin. One particular boy was checked by numerous doctors, who found nothing wrong, except for the fact that he was a 4-year old boy and needed to run around and be active. He is now a teenager doing fine.

I think is part of the "war on boys". Ritalin is diagnosed far, far more for boys than girls.

Feb. 23 2010 11:44 AM
RCT from NYC

We are highly educated, by the way, not "lower income" folks who are easily made hysterical (a stereotype, Judith).

Feb. 23 2010 11:41 AM
a. g. from hudson county nj

diagnosis? how in the world do you allow a so called diagnosis,emanating from observation,on the part of a dr.,a purely empirical often off the cuff shot in the dark,to dictate drugging kids. how many people have gotten five different diagnosis,from five different doctors. get my point judith?

Feb. 23 2010 11:40 AM
RCT from NYC

Our child was pathologized by schools that tolerated very little deviation from a so-called behavioral norm. He was a happy kid prior to starting school, but was miserable in a standard classroom (private or public schools, NYC).

One psychiatrist acknowledged to me that the issue was adaptation, not a disorder, but pointed out to me that adaptation was important for success. I told him that, by that standard, if I were a Saudi woman who wanted to drive a car, I should be medicated.

We fought tooth and nail to keep him from being medicated, and we won. He has struggled in school, but has learned to adapt and is now in college. He thanks us for not having medicated him.

Judith has drunk the Kool-Aid. She is too willing to listen to authority figures and takes medications herself -- for migraines -- our own experience taught us to be wary of drugs.

Feb. 23 2010 11:40 AM
janey

Slate has a take up about the role of the schools in this debate:

http://www.doublex.com/blog/xxfactor/public-school-issue-judith-warner-ignores

Feb. 23 2010 11:17 AM
Alice from Westchester

Please ask her to comment on what parents can do when their child has been misdiagnosed for a period of time and there have been dire consequences?

When do practioners take responsibility for the dire consequences?

What do we do about that?

Does she support malpractice changes?

Feb. 23 2010 10:43 AM
a. g. from hudson county nj

we've pathologized just about every behavior. the notion of conformity to the dictates of a medical model created by an avaricious pharmaceutical monolith, is disturbing to say the least. anyone trying to defend this misguided paradighm,is either naive or has a good chance of being a beneficiary of an abundant institutional money stream.

Feb. 23 2010 10:15 AM
Kathy Shea from New York

Could you please mention that Judith is speaking tonight at All Souls Church at 6:30 PM (Lex Ave @ 80th Street) for the Parents League? Her books will be available there as well. Thanks!

Feb. 23 2010 10:10 AM
Jeff from NJ

Hi Brian,

Please ask her to comment on Gary Greenberg's great new book Manufacturing Depression.

Thanks,

Jeff

Feb. 23 2010 08:50 AM

Leave a Comment

Email addresses are required but never displayed.

The Morning Brief

Enter your email address and we’ll send you our top 5 stories every day, plus breaking news and weather.