Pills Over Progress

I was eight. My third grade teacher, in a moment I forgot or perhaps repressed (but my parents remember), told me “you didn’t think you were succeeding, did you?” The doctors made the increasingly widespread diagnosis, Attention Deficit Disorder, and offered medication, warning that it could stunt growth, cause anxiety, and even occasionally trigger psychosis. My parents took me home. Instead of medication I got a “504 Plan”: small changes in my environment that made a surprising difference. My tests stopped being timed. I no longer had to copy things from the board. I was allowed to walk around the classroom if I didn’t disturb other children.

I suppose the punch line to this story might be that I’m succeeding academically now (“aren’t I?”). But that isn’t really the point. I was diagnosed in the most educated neighborhood in America, and my parents, despite both working full-time, were willing to spend hours a day walking me through math problems until I did them on my own. They also had money for doctors and the support of the school system. My success shouldn’t really be a surprise—although I imagine it would be to my third-grade teacher—because ADD is not about intelligence, but learning style.

The punch line, or maybe just punch in the gut, came from a New York Times article last week that described how parents and doctors of struggling low-income children gave them ADD medications to help them do better in school—not because the children actually had ADD, but because they couldn’t come up with other resources. One father, who gave all four of his children Adderall “merely to help with their grades,” called his daughter “a little blah.” “If they’re feeling positive, happy, socializing more, and it’s helping them,” he asked, “why wouldn’t you? Why not?”

One reason is that Adderall is not only addictive, but can also be dangerous. The irony of the father’s quote is that his son potently exemplifies the danger of taking Adderall for “cosmetic” reasons—he became schizophrenic and suicidal at age 10.

There are some less extreme reasons, too, that are nevertheless extremely troubling. Some prominent researchers argue Adderall does not work in the long term. L. Alan Strofe, a researcher who used to promote drugs for ADD but now writes about their risks, notes that in the short term, behavioral changes can be quite striking, but—as with many similar recreational drugs—the brain develops a tolerance. Recent studies suggest that the effects of Adderall on school performance, behavior, and peer relationships last about four to eight weeks. After that, children return to their original behavior and go through withdrawal if they are taken off the medication. “Bad” behavior due to withdrawal often convinces parents that the drugs work because the child had been doing better before.  As a result, the child stays on the medication but doesn’t really benefit, and the parents and school feel that they have taken action. “Drugs get everyone—politicians, scientists, teachers and parents—off the hook,” says Stroufe. “Everyone except the children, that is.”

I write about this topic for two reasons. The first is to emphasize to those who have the options that I did that treatment without medication can work. The second is to point out, as the Times article did, that part of the reason so many children are being put on addictive drugs is that school systems and parents do not or cannot manage better. Perhaps some parents don’t want to put in the effort, but others are working two or more jobs, are uninformed, or are just desperately trying everything to get their children out of a socioeconomic wormhole.

School systems, too, are strapped for resources. One school superintendent in California told the New York Times that as school funding declined, the number of children on ADD medication rose. It’s easy to imagine how the correlation could be causal: pills are a less expensive alternative to holistic and often much more effective long-term care. “I don’t have a whole lot of choice,” Dr. Michael Anderson told the Times. “We’ve decided as a society that it’s too expensive to modify the kid’s environment. So we have to modify the kid.” Like Anderson, I cannot believe that it is the children, rather than our school system and larger economic system, that need to be radically altered.

ADD doesn’t go away, although it can sometimes become less severe if the patient spends years practicing organizational skills and strengthening their mental capabilities. This is extremely taxing, but it also teaches larger lessons. From my ADD, I learned to ask for help, to try again, to fail some things, to not need to be the best. I learned the virtue of work and a little humility, as well. Most of all, I learned to be grateful for the one and only brain I will ever have and to recognize its beauty and worth even when others did not. But all this took a great deal of support that many students—with and without ADD—cannot find.

Sarah C. Stein Lubrano ’13 is a social studies concentrator in Kirkland House. Her column appears on alternate Wednesdays.