Actor Tom Cruise has recently caused a brouhaha in the mental health world calling psychiatry a pseudo-science, saying there is no such thing as a chemical balance, that anti-depressants only mask the problem, and Ritalin and Adderall are street drugs. Did he earn his medical degree between making movies?
While it is true that some medications are over prescribed and misused, it is also true that some medications improve the quality of life and learning for some students. The American Psychiatric Association has responded with this statement:
Joint statement of the American Psychiatric Association (APA), NAMI (National Alliance for the Mentally Ill), and the National Mental Health Association (NMHA):
"While we respect the right of individuals to express their own points of view, they are not entitled to their own facts. Mental illnesses are real medical conditions that affect millions of Americans.
FACT: Over the past five years, the nation has more than doubled its investment in the study of the human brain and behavior, leading to a vastly expanded understanding of postpartum depression, bipolar disorder and attention-deficit/hyperactivity disorder. Much of this research has been conducted by the National Institutes of Health and the nation's leading academic institutions.
FACT: Safe and effective treatments are available and may include talk therapy, medication or a combination of the two. Rigorous, published, peer-reviewed research clearly demonstrates that treatment works.
FACT: Medications can be an important and even life-saving part of a comprehensive and individualized treatment plan. As in other areas of medicine, medications are a safe and effective way to improve the quality of life for millions of Americans who have mental health concerns.
FACT: Mental health is a critical ingredient of overall health. It is unfortunate that in the face of this remarkable scientific and clinical progress that a small number of individuals and groups persist in questioning its legitimacy.
FACT: Mental illnesses are highly treatable and seeking help is a sign of strength.
It is irresponsible for Mr. Cruise to use his movie publicity tour to promote his own ideological views and deter people with mental illness from getting the care they need."
CHADD has joined their group effort by supporting this news release.
Students who cannot attend on demand frustrate others -- friends, family, and teachers. Pay attention! In a classroom, the student who is not following along with the others is missing information and may be distracting other students as she or he attends to other things that may be more interesting than the task at hand.
New medicines promise to help these students focus. Medicines like dexedrine, adderall, cylert, tofranil, norpramine, and catapres are now available along with ritalin which has been prescribed for many years. As with most medications, all of these medications carry precautions and there will be a period of trial and error for finding the right dosage, or even the most tolerable medication.
Teachers have been known to tell parents to put their kid on medication--so the student can learn better or to make the teacher's job easier? Having been a teacher for many years, I understand how difficult teaching can be. But, teachers are not qualified to make this assertion. While a teacher might suspect that a student has an attentional deficit based on behaviors, a teacher may only recommend an assessment or evaluation. The assessment may be started at the school level, but should continue with a medical professional who is knowledgeable about ADHD.
The school personnel should work collaboratively with the medical professional and develop a comprehensive treatment plan including academic accommodations, educational progam modifications, a behavioral plan, and counseling. If medication is recommended as part of the treatment plan, most parents are understandably reluctant to medicate their children. After all, we preach "don't do drugs," then we insist that they take their meds. How can one resolve this issue?
In Learning Outside the Lines, David Cole writes:
Ritalin? No pat answer or suggestion even as to where I stand on the yesorno of it. It's not yes or no to drugs. It is more complicated. Like, it's okay to give a child who needs pain medication some pain medication because he is in pain. It is not okay to give him pain medication so you don't have to read him a bedtime story before he can go to sleep. I was given Ritalin as a kid so that I would sit down at my desk more often in school. This was also the use of a chemical restraint on a seven-year-old. Powerful psychotropic drugs were used to maintain order in an inaccessible and inappropriate academic environment. (53)
In I Would if I Could: A Teenager's Guide To ADHD, Dr. Gordon's ficticious Sam writes:
It's kind of funny that, when I took the first pill, I sort of sat there in class and waited for this overpowering spell to take hold of me. It never happened. As a matter of fact, I don't feel all that different. I have noticed the kinds of things Larry talked about. The first day I was listening to my math teacher drone on about binomial equations, and I actually found myself following what she was talking about and I didn't get distracted by the usual medley of sights and sound. It was odd but it made understanding binomial equations a heck of a lot easier. (31)
What's a parent to do? Are you using a chemical restraint to make the teacher's job easier, or are you helping your child to learn?
My experience tells me that if a student has ADHD and it is left untreated, the traditional school experience emotionally beats this child up leading him down the path to misbehaviors or depression, and sometimes self-medication. I used to tell some of my students that the medication would help them tolerate school better. After school, they will hopefully find a work environment to better match their performance style. Sad, but true.
David Cole writes: The first time I got high, it was as if someone cut off a straight-jacket I didn't even know I was wearing. I stopped trying to follow the rules. I got high and felt comfortable. Drugs gave me the ability to alter the world--to turn it into a place where the effort I put out was just right. Self-medication? Maybe, but also chemical self-acceptance. I lowered my own expectations. And it came with a lifestyle, and money, and rules of conduct. I became very good at bringing my standards down. School was irrelevant. (55)
Many of my students who take medication for ADHD have told me that the medication gives them time to think before they act.
Dr. Gordon's Sam writes: At this point, I'm feeling okay about the medicine but it's clear to me that what Dr. Calm said was true -- that it wouldn't make all of my problems disappear or take away my responsibility for my actions. The way I look at it, the pills help me settle down some and get enough control over myself so that I can make better decisions and keep from getting sidetracked. Fortunately, I don't have any side effects other than that I'm usually not very hungry at lunch. I make up for it big time at dinner. (32)
Both educators and parents need to weigh the pros and cons of medicating children and be willing to experiment under the guidance of a medical professional who will work with you and the child to make the best decision for him. You must also be willing to monitor the child's performance both with and without the medication including the child as much as possible in the process of learning how the medication affects his behavior. And, you must be involved in a total treatment plan including academic accommodations, positive behavioral supports, and counseling as recommended by the team of professionals involved in the assessment. Continuous collaboration between parents, educators, the medical professionals, and the student is necessary to ensure a positive outcome.
