Thursday, April 18, 2013

Ritalin For Everyone!

Quite frequently I see posts on Facebook by my friends such as these:

Implying  that kids who have ADHD are simply normal energy level kids, and that parents and educators are lazy and just don't want to make the effort to control their kids.
     I can't answer for the system in the US, only here in Canada. B has ADD as one of her diagnosis. I have more experience than most people ever will in the child psychiatric and health arena, and I am going to say now, and for the record: Unless you have a kid with a diagnosed mental health disorder, you have no idea how lengthy and involved and complicated it is to get them diagnosed, so you should probably stop acting like you do.
     Even getting B diagnosed with ADD took several visits to Children's Hospital,  and hours, I mean HOURS of filling out mental health questionnaires. Dozens of them, all with similar yet slightly semantically different questions. She had to be interviewed and tested by two psychiatrists, and not just once, but five or six times over her life by different psychiatrists, all of whom can UNdiagnose as well as diagnose. That was what happened with her diagnosis of Nonverbal Learning Disorder. She was diagnosed with it when she was five and UNdiagnosed with it when she was a couple of years older, in a diagnostic test at Sunny Hill that took, and I am not exaggerating here, a full week to undergo. Seriously, 8 hours a day for a week.
     So let's be very clear here: In Canada, you do not walk in to a clinic and say: "Hey, Jimmy won't eat his peas and keeps jumping off the couch," and the doctor says, "Well, that sounds like ADD. I won't recommend any other course of action, let's simply shove Ritalin in his face and have done with it." (If your GP DID do that, report him him/her to the College of Physicians, because that is wrong.) NONE of the doctors B has had has EVER suggested medication for her ADD. For her anxiety, yes, and for her seizures, yes, but not ADD. Neither did they force me to medicate, even with the seizure medications. We had appointments, options were discussed, I read up on the medicines and things were tried. And anyone thinking that all she needed was a sea grass enema, relaxation tape, and a more understanding parent is at best deluded and at worst,  insulting and assumptive. Getting your kid diagnosed is the longest and most complicated way of being a lazy parent that anyone could undertake.
     And these diagnosis are hugely important. A diagnosis makes getting services in school and in the community possible. I know people with adult children who do not have a diagnosis, and they get no services. Their kids do not have a condition that is recognised, so they get nothing despite being fully acknowledged as having developmental, mental health, or physical problems. These services are not extra special treats that our kids are spoiled with, these services are meant to make independence or family life a bit more realistic and possible for us and our kids. Make no mistake, these kids 30-40 years ago were too often stuck in mental hospitals and abused their whole lives. They deserve better.
     And sometimes better means medication. And sometimes it works well, and some times it doesn't. And sometimes you have to try again. A lot of medicine is just educated guess work, and psychiatry is a soft science, but it is informed by hard science, by neurology and neuroscience, and there are things about the brain that are measurable and treatable.
     A few months ago, a friend posted this video:

     First, this video was made by the Citizens Commission on Human Rights, which sounds legitimate, but is actually a bogus mental health organisation run by the Church of Scientology. I wrote about them in an earlier post. I am not taking any advice on mental health from a bogus institution that bilks millions and was an admitted scam by L. Ron Hubbard. Second, even if this were by a legitimate mental health group, the perceived message here is that, "Parents and educators are just putting down non-conformists! Fight the man!" but the message I take from it is, "You can't have a mental health disorder and be anything but a mental health disorder. A diagnosis will end your life."
     I think, with the proper diagnosis, the right therapy and even medication, you can have a mental health disorder, and live a life, and be a leader. Diagnosis, proper diagnosis, and treatment doesn't preclude that, it makes it possible.
      None of this is to say that there aren't huge problems in healthcare, that we don't have to watch and care for human rights, but that is done by supporting and helping those who are affected, not by second guessing and criticising them. Not by making assumptions you are not qualified to make.
     You know what they say about making assumptions? If you assume, you become an ass. To me.
     I think the most hurtful thing is that the parents I know who medicate their kids, it's a hard decision. You come to it  at the end of reading and trying every other thing you can find. You don't just wake up one morning and think, "Ah, you know what would make life easier? Psychiatric and medical intervention for my kid."  For parents, learning about and facing that their beloved child may have problems and needs help is painful, and difficult, and lonely. Watching your kid go through school without making friends, or handling the work, or hitting regular milestones is devastating, and these parents actually have to work harder to educate schools, family members, friends. You have to reinvent the wheel for people time and time again. It's exhausting. So maybe the next time you go to post these, maybe think that there might be a better way to support these kids, maybe there's a better way to work on change in healthcare. And maybe that starts with asking someone who is a patient how you can help.


  1. This one definitely varies, and not just by jurisdiction. Our son was accepted for ADHD assessment based on a stab-in-the-dark referral from his endocrinologist, and at the assessment (an hour and a half or so), we were offered a course of medication on a "trial" basis, with the implication that if the medication for ADHD worked or didn't work, they could reverse-diagnose it from there. I hear from my family in the States that it's far worse there; when it costs an arm and a leg to even see a specialist, you're in a very difficult position vis a vis "do I take the first recommendation from this "expert", or do I wait and push for even more super-expensive evaluation?" I think a little counter-propaganda for a country where they can run commercials for Ritalin on TV at dinnertime has its place. If it's not about you, it's not about you.

  2. Like I said, a lot of medicine is educated guesswork, but you still needed a referral from a specialist to another specialist. You didn't wake up one morning, decide he was too much bother, and have him medicated by the afternoon. I have no experience with the states, and can't comment on their system. The problem is painting a huge swath of people with mental health problems, and their parents, as lazy without even knowing the system you're talking about. I have huge critiques of the medical and social system, and tons of experience in it, but I still can't judge others for their choices without learning about them.