Sunday, February 27, 2011

Week 9: We've Got Issues


We've Got Issues: Children and Parents in the Age of Medication, by Judith Warner

Judith Warner started out to write a rant about the overdiagnosis and overmedication of children in this degenerate age of pressure to perform. She was going to denounce perfectionistic parents who gave their normal, if boisterious, children drugs in order to get better grades out of them or give them an edge in a competitive world. The trouble was, she discovered that the story everyone knows isn't actually true. So We've Got Issues is her effort at documenting the actual state of modern child psychiatry--and I'd recommend it to anyone struggling with these difficult issues.

We hear a lot of things like "Kids didn't have ADHD or bipolar disorder when we were kids!"--but that's not really true. A lot of children were simply labeled stupid or bad or delinquent. Children with severe mental issues were not seen because they were often simply institutionalized--for years at a time--and given Haldol or other strong tranquilizers; if they stayed at home, they did not usually attend school. They were invisible, but they existed. Now they are much more visible, so it seems as though this is a new problem that must be caused by a sick society or bad parents, but that is not the case at all.

That isn't to say that things are wonderful now. Most children who suffer from mental disorders are not treated, or are not treated well. The psychiatric profession has undermined its own credibility by getting too friendly with drug companies. There has been a lot of progress, but boy is there a long way to go. Still, Warner's descriptions of new treatments offer a lot of hope, if we can just figure out a way to get the treatments to the people who need them.

Warner's chapters on parents' struggles to help their children interested me a lot. We talk about parents who go for the easy fix, who drug their children so they won't have to parent them, but in fact the vast majority of parents will go to superhuman efforts to help their children and will only accept medications as a last, hated, resort. It was really interesting to me to see that Warner's data confirmed my own experience that mothers are very reluctant to medicate but will eventually accept it, while fathers really hate it and will often simply refuse to engage at all.

There was also quite a bit about the tendency to blame parents for their child's problems. It's very easy to believe that the only reason a child would develop ADHD or serious mental illness is because of bad parenting. This reaction seems to me to very often be a sort of superstition, or a defense mechanism; if you can believe that these problems only happen to kids with bad parents, they'll never happen to you, because you are (or would be) a good parent, which will keep you safe and in control of the world. This all sounds very familiar to me, because my daughter has severe food allergies, and it's quite common for people to assume that I'm either overprotective and making it up, or overprotective about hygiene, which causes the allergies. It's much less vicious in my case, but it's the same superstition. And yet the more scientific progress we make, the more we find out that allergies and mental problems both seem to have genetic components that interact with the environment in unpredictable ways.

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