New York Times Magazine article questioning adhd commonplaces (including meds)

[Anonymous]

Anonymous wrote:TLDR; ADHD meds keep teachers happier but don’t actually result in better learning outcomes for kids at school.

And behavioral improvements taper off after 3 years too.

[Anonymous]

Anonymous wrote:

Anonymous wrote:NP. Moving what I wrote on duplicate locked thread over here.

****

My son is not ADHD but he dislikes most of his school. Fortunately he's accepted his parents' insistence that he get good grades. We talk a lot about how boring school is for him, even though much of his high school curriculum is the same as what his parents liked. This article hits really hard.

On DCUM, sometimes when people want to criticize what I write or what I mention about my kids, they give me an armchair diagnosis of some neurodivergence. To the point where I wonder if they are right, although I think it's more the result of the limited context of an anonymous Internet forum. I sometimes fall into what one quoted doctor called a category of people on "the left" who blame "post-industrial society" for the rise of ADHD.

Below are some sections of the article that caught my eye.

"Without the pills, they said, they just didn’t feel interested in the assignments they were supposed to be doing. They didn’t feel motivated. It all seemed pointless."

"Last year, the Centers for Disease Control and Prevention reported that 11.4 percent of American children had been diagnosed with A.D.H.D., a record high. That figure includes 15.5 percent of American adolescents, 21 percent of 14-year-old boys and 23 percent of 17-year-old boys. Seven million American children have received an A.D.H.D. diagnosis, up from six million in 2016 and two million in the mid-1990s."

"Sibley said it was important to remember that many of the symptoms of A.D.H.D. are actually pretty commonplace; at any given moment, she explained, the average American adult has two or three of them — halfway to an official diagnosis."

The fact that 1/4 of boys get dx with ADHD is just astonishing!

Sadly, for many of us, that statistic simply validates something we've observed in the world in the last few years. If you'd asked me to estimate the percent of boys diagnosed with ADHD in the US this year, I would have guessed 20-25%. And the interesting thing is that it crosses socioeconomic and cultural boundaries, which didn't used to be the case. There used to be a big race/class element to ADHD diagnosis, where it was really a diagnosis only accessible to wealthier and white families because they were more likely to seek out (and be able to afford) specialists to address behavioral or academic problems, and the pediatricians who served those families were more likely to suggest the issue could be neurological.

That's changed significantly in recent years, and now you see a ton of ADHD diagnoses in Title 1 schools, especially for boys, and crossing pretty much all racial categories. It's now the diagnosis of choice for any boy who has any issues. The number of boys age 6-12 I know who are diagnosed and on meds is astonishing to me. Definitely at least 1 in 4, possibly more (I think the diagnosis is likely more common in urban populations, there are more ADHD kids where we live in DC than in the rural/small town environments where the rest of our families live, though that's catching up too).

ADHD went from a niche phenomenon that seemed to explain difficulties a small percent of kids were having to this bizarre blanket diagnosis. It's jaw dropping and it's wild to me that some people still won't acknowledge that clearly something else is going on here.

[Anonymous]

I liked that they addressed the issue of teens and 20-somethings taking ADHD meds selectively, due to side affects, and extremely unaddressed aspect of ADHD medication that is widespread. I also know lots of families who do this for younger ages -- only take the meds on school days, or take a break from it in the summer and holidays.

It greatly undercuts the idea that people need ADHD meds "to function" and clearly indicates environmental causes to symptoms. It also raises the very real side effects to ADHD meds and how problematic they can be over the long run, probably the most-discussed one being appetite suppression and how hard this can be on teens especially.

[Anonymous]

Wait, what the heck is going on in this thread? I wrote a long and I think fair and nuanced post about our decision to try a school change over meds for our 7 yr old and it's gone. It wasn't even an anti-med post!

God I hate how ADHD is discussed on this freaking website sometimes. When you have to get posts deleted rather than engage in respectful conversation about what is actually a pretty nuanced topic, you've lost the plot.

[Anonymous]

Anonymous wrote:Wait, what the heck is going on in this thread? I wrote a long and I think fair and nuanced post about our decision to try a school change over meds for our 7 yr old and it's gone. It wasn't even an anti-med post!

God I hate how ADHD is discussed on this freaking website sometimes. When you have to get posts deleted rather than engage in respectful conversation about what is actually a pretty nuanced topic, you've lost the plot.

I see your post. Twice.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Wait, what the heck is going on in this thread? I wrote a long and I think fair and nuanced post about our decision to try a school change over meds for our 7 yr old and it's gone. It wasn't even an anti-med post!

God I hate how ADHD is discussed on this freaking website sometimes. When you have to get posts deleted rather than engage in respectful conversation about what is actually a pretty nuanced topic, you've lost the plot.

I see your post. Twice.

Actually I weirdly saw it missing for a minute too … but it’s there now.

[Anonymous]

Anonymous wrote:Really interesting read, OP. Thank you for the gift link.

We are right in the thick of this in my household right now, with a child recently diagnosed with ADHD at age 7 and debating the benefits of medication versus parent coaching (which I'm currently doing) and environmental changes. I am not opposed to medication in general (pro-vaccine, have been on SSRIs before, not anti Pharma) but something about putting my 7 year old on ADHD meds has really given me pause.

We wound up going another route for now. Not ruling medication out but opting for a school change to see if things improve. We are fortunate because DC has no academic issues associated with ADHD (on the contrary, the hyper focus element has resulted in a strong reader who loves doing math problems for fun). So we hope changing the school environment to a school with more outdoor time, a more joyous vibe, and fewer behavioral problems overall, might eliminate the need for meds. If it doesn't, we'll probably medicate.

Anyway, I've been reading TONS of literature on ADHD and medication over the last few months, including literally every study mentioned in this article. So it was validating to read the nuance here and made me feel like we reached the right conclusion. The article is not anti-meds. It's just much more nuanced about what ADHD is and how meds can help (and how sometimes they don't). It's very needed as a counterbalance to what I have heard other places: that I'm stupid for having any reticence in medicating my kid, that environmental shifts can't possibly help with ADHD because "either you have it or you don't", that medicating early is beneficial because the meds will help to "rewire your kid's brain" (a very popular argument these days), and so on. The level of pressure I've felt to medicate is probably one of the reasons I've pushed back so hard, so I just really appreciate a balanced, deeply reported take on this that doesn't vilify medication but also doesn't gloss over the ways in which it can be complicated.

Sounds like my DS18 when he was growing up. We did go with meds in MS because the executive functioning demands became too much- he started having problems handing in homework, losing things, starting tasks, etc. The meds didn't help because he really didn't want to do the homework. He went off the meds in HS- his grades shot up to As his Freshman year of HS because (his words) "colleges will see these grades." He went from high As to mid and lower As without meds and made a decent SAT score without meds or accomodations. Going to a T40 in biochemistry this Fall.
Word of caution- try to keep the hyperfocus off the phone and video games-- this is where it diverts to in MS. ADHDers have a special problem with electronics and my DS is no exception.
Like us, you're lucky your kid is exceptionally smart. It's very protective against some of the worse ADHD outcomes.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Wait, what the heck is going on in this thread? I wrote a long and I think fair and nuanced post about our decision to try a school change over meds for our 7 yr old and it's gone. It wasn't even an anti-med post!

God I hate how ADHD is discussed on this freaking website sometimes. When you have to get posts deleted rather than engage in respectful conversation about what is actually a pretty nuanced topic, you've lost the plot.

I see your post. Twice.

It was gone at some point. I didn't repost it.

[Anonymous]

Anonymous wrote:to me it's so boring to make meds the centerpiece of this reporting and relitigate them. much more interesting to delve into what adhd actually is and the idea that if we chunked it out in more granular ways, like autism, we might find better and more bespoke treatment options. right now it's like us putting 25% of boys in a bucket of 'this is your problem now here is your medicine' when clearly it's not one homogenous issue.

Did you actually read the article?

[Anonymous]

Anonymous wrote:Really interesting read, OP. Thank you for the gift link.

We are right in the thick of this in my household right now, with a child recently diagnosed with ADHD at age 7 and debating the benefits of medication versus parent coaching (which I'm currently doing) and environmental changes. I am not opposed to medication in general (pro-vaccine, have been on SSRIs before, not anti Pharma) but something about putting my 7 year old on ADHD meds has really given me pause.

We wound up going another route for now. Not ruling medication out but opting for a school change to see if things improve. We are fortunate because DC has no academic issues associated with ADHD (on the contrary, the hyper focus element has resulted in a strong reader who loves doing math problems for fun). So we hope changing the school environment to a school with more outdoor time, a more joyous vibe, and fewer behavioral problems overall, might eliminate the need for meds. If it doesn't, we'll probably medicate.

Anyway, I've been reading TONS of literature on ADHD and medication over the last few months, including literally every study mentioned in this article. So it was validating to read the nuance here and made me feel like we reached the right conclusion. The article is not anti-meds. It's just much more nuanced about what ADHD is and how meds can help (and how sometimes they don't). It's very needed as a counterbalance to what I have heard other places: that I'm stupid for having any reticence in medicating my kid, that environmental shifts can't possibly help with ADHD because "either you have it or you don't", that medicating early is beneficial because the meds will help to "rewire your kid's brain" (a very popular argument these days), and so on. The level of pressure I've felt to medicate is probably one of the reasons I've pushed back so hard, so I just really appreciate a balanced, deeply reported take on this that doesn't vilify medication but also doesn't gloss over the ways in which it can be complicated.

Good for you. I love your approach. Hope the new school works for your son

[Anonymous]

One part of the article that strongly resonated with me is where they talk about the fact that symptoms can come and go. Testing a kid at a certain age can point to ADHD while at a different time, many of the symptoms would not be there. ADHD is actually a continuum rather than as previously thought of - that you either have it or don’t. I have never been diagnosed with ADHD. I grew up in a different country where it is still barely on the radar. But sometimes I feel like I might have ADHD but other times I don’t think that. This article gives me clarity on my shifting perspectives

[Anonymous]

The fact that the medication does not help academic outcomes is mind blowing to me. Why take it especially with all the side effects?

[Anonymous]

Anonymous wrote:The fact that the medication does not help academic outcomes is mind blowing to me. Why take it especially with all the side effects?

Well I think this is news. That’s the reason for the long article and new thread on DCUM about it.

But I agree. I’ve been in the fence myself about one of my kids and this has made it a clear no for us.

[Anonymous]

Anonymous wrote:The fact that the medication does not help academic outcomes is mind blowing to me. Why take it especially with all the side effects?

The side effects aren't bad for all kids and the effect behavioral issues can have on a kids life is barely discussed in the article.

[Anonymous]

Anonymous wrote:The fact that the medication does not help academic outcomes is mind blowing to me. Why take it especially with all the side effects?

I think it is mind blowing to most of us. We did not medicate our son but we agonized about it because we thought by not medicating him we were limiting his options later due to poor grades. Perhaps his outcomes would have been the same either way.