Where To Start

I have a tendency to rant about this subject quite a bit. As an acupuncturist I used to see people come in taking some pretty weird prescription combinations. The first question I always asked was "did you fill all of these at the same pharmacy?" Somebody needs to make sure that they don't end up with three different prescriptions for the same antidepressant (wellbutrin, buproprion and zyban) from three different doctors. Unless.

Salon.com Life | Life: The disorder: "Likely in part because the first heavily medicated generation of teens is now drifting into adulthood and still renewing their prescriptions, and partly because new diagnoses are steadily increasing. 'Adult ADD' -- full name: attention deficient and hyperactivity disorder -- appears to be at the cusp of making the transition of so many psychosocial disorders before it: from unheard of to skeptically acknowledged to culturally sanctioned.

Earlier this year it was the subject of a sober cover story in the New York Times Magazine, after which, curiously, television advertisements for Strattera, Eli Lilly's drug for adult ADD, suddenly seemed impossible to avoid. Robert S. Epstein, Medco's chief doctor, tells the Times that the current data indicates 'a clear recognition and new thinking that treatment for A.D.H.D. does not go away for many children after adolescence.' Another doctor, James McGough of UCLA, adds that still more adults should be on such drugs -- a sentiment echoed a few days later on the 'Today' show by Dr. Edward Hallowell, author of 'Delivered From Distraction: Getting the Most Out of Life With Attention Deficit Disorder.'

Is it me, or is there something peculiar going on here? Adults have taken what began as a controversial adolescent disorder and coolly co-opted it as their own, as if there were never any doubts about its legitimacy. In the '70s, when ADD drugs were first being tested, they were among the only psychotropic meds for which clinical trials involved children and teens first. The thinking was simple: The adolescent years are ones of hormonal pandemonium that make focusing on pre-calc next to impossible for many; pills like Ritalin eased the pain. In time such reasoning was applied to younger kids -- twitchy, foot-tapping 7- and 8-year-olds, too. As for adults? It was assumed that growing up meant, well, growing up, and that taking such pills would be viewed as a frowned-upon crutch. But today's revised attitude has it that the trouble one had with memorizing state capitals or grasping the quadratic formula may be similar to the trouble one has listening to that PowerPoint presentation. We are all -- or many of us are, potentially -- antsy kids spaced out in the back of the class."

Perhaps kids need more exercise to burn off all that energy? When I look back on the childhood that I spent with my nose in a book, I still got outside and learned how to ride a bike, rollerskate, and play other oudoor games. We played all the time and then we went to sleep at bedtime which was either 8 or 9 o'clock. And we went to sleep, the kind that regenerates you and enables you to face the next day.

"We live in a society where it's increasingly difficult to differentiate between adults and kids. Go to a mall, squint your eyes, and see if you can tell the difference between the alarming 18-year-olds who seem 35 and the much more alarming 35-year-olds trying to pass for 18."

So true and thats just the clothes. The conversations are the really frightening part.

"Since time immemorial grown-ups have made a point of telling children that adulthood isn't easy -- that it's a constant exercise in (cue affectedly furrowed brows) doing things you don't want to do. But such preaching suddenly sounds archaic, doesn't it, when the same adult superpowers are now patting themselves on the back for acknowledging that those PowerPoint presentations may, like Pink Floyd's "The Wall," be a whole lot more palatable on drugs?"

Snicker. "The Wall" was such a depressing movie, how about something with a little more color like Finding Nemo or action like The Matrix?

"I don't mean to sound overly flip. I'm simply finding it hard not to see this as a tragicomic step toward the classic concern about psychotropic drugs: the redefining of life as a disorder. Think, for a moment, about antidepressants. Over the past decade they shifted from being adult-only drugs to being acceptably prescribed (off-label) to children and teens. How come? On one hand it was recognized that children suffered from serious depression, and that certain pills were remarkably effective treatments. But at the same time the definition of treatable depression was watered down -- renamed as social anxiety disorder, panic disorder and, my personal favorite, generalized anxiety disorder -- to include a seemingly endless demographic of adults and children. So the same way we recognized that adult disorders can be applied to children, we are now, with ADD, noting that those of childhood can be applied to adults. It makes it hard not to imagine a future in which the smallest hardships (trouble studying, stress over a breakup, or perhaps a desire to prevent such nuisances) lead seamlessly to a fully medicated existence starting well before the onset of adulthood."

Could you see our generation going through the Depression? How about exploring the West? Setting out across the ocean when you think the world might be flat? We're a bunch of whiners. Life isn't going like it does in the movies, I'm depressed. I can't focus in school, I have ADHD. I'm overweight so I would rather take a pill that has the potential to make me crap uncontrollably in public than seriously diet and exercise to take it off and change my life in the process. That is too much work and too much responsibility for their own life. I have a headache, where's the ...?

"But must it be only one or the other? It seems especially stubborn -- dare I say immature -- that the medical community refuses to acknowledge just how much certain psychotropic drugs blur the line between the biochemical and societal. Even more peculiar is that while we usher in a state of being permanently medicated, selective dosing is still viewed as "recreational" and "risky." What's interesting about ADD drugs is that they are remarkably effective regardless of how your brain looks when scanned, achieving what for centuries we've turned to coffee to accomplish, with about the same potential for side effects. So here's a radical thought: Why not just put them in the same category? After all, what's worse, continuing to find ways to define the everyday in terms of disorders until we're all taking pills to curb the effects of other pills, or admitting that we've synthesized substances that can help, from time to time, in different doses for both adults and children, take the edge off in a way that doesn't throw you off track? To me it seems more honest this way, more grown-up, and less likely to rouse our collective inner voices into an anxious chorus constantly wondering what's "wrong" with us."

Nothing. We just spend too much time contemplating our navels. Otherwise know as omphaloskepsis and as a nation the US excels so well I'm surprised we haven't tried to make it an Olympic sport.

Life is hard. Right now it is sucking the big weenie and taking a pill to make me feel less like a failure because it hasn't all worked out like I planned or hoped will not change the fact that it didn't work out like I planned or hoped. Maybe I need to change my plan or ask for help. If I was in Darfur or Iraq no matter how many pills I took it would not change my situation so why should I expect it to make my life better in the US? We seem to spend a lot of time doing and very little time being. Some of you are so unhappy with who you are you are willing to take medications to make you just like everyone else never realizing you are just like everyone else. What a waste of your life. As I was told growing up, drugs don't solve problems they only hide them or make them worse.

Remember, you are unique.

Just like everyone else.

Update: The first story I found after this one had this to say on the subject.

"The findings, say researchers, point to possible instances of inappropriate prescribing to children.

While guidelines call for children to be treated with either mental health counseling or a combination of counseling and medication, the study found a trend of antidepressants replacing talk therapy.

snip

This study, the researchers conclude, "raises concerns about physicians' adherence to evidence-based medicine.""

Why am I not surprised?