Before 1980 no distressed children or teenagers were labelled with the ‘brain-disease’ attention-deficit with hyperactivity psychiatric disorder. Neither were young people medicated prior to 1980. In 1980 nearly one million US children were labelled with ADHD, such that ADHD could be found in every classroom. Five years later that number had doubled. Today, some 3.5 million American children are medicated for ADHD resulting in one in every twenty-three American four to seventeen year old children being medicated. This phenomenon has been replicated throughout the Western world. What is interesting both here in Ireland and elsewhere is that the diagnosis of ADHD arises primarily from teacher complaints as “only a minority of children with the disorder exhibit symptoms during a physician’s office visit” (The Harvard Review of Psychiatry, 16 (2008): 151-66). Ritalin or Concerta are the drugs given to children who are diagnosed.
There are two fundamental questions to be asked concerning the unprecedented rise of ‘mental illness’ among children and the prescription of stimulants to treat the particular syndrome. The two questions are:
- Is ADHD a ‘brain disease’?
- Do the medications help?
As regards question one, there is no doubt that children and teenagers can be both troubled and troubling and that they and their parents and teachers need help to identify the sources of their distress and how best to resolve it within the social settings – family, classroom, school – they exhibit their unhappy state. To say that these young people have a mental illness – an absolutely frightening prospect for both the children and their parents – requires a substantial empirical basis. The truth is that “attempts to define a biological basis for ADHD have been consistently unsuccessful” (Gerald Golden, paediatric neurologist, Seminars on Neurology, 11, 1991). Furthermore, neuro-imaging has demonstrated that the brains of children with ADHD are normal! In 1998 a panel of experts convened by the National Institute of Health concluded: “After years of clinical research and experience with ADHD, our knowledge about the cause or causes of ADHD remains largely speculative.” In the Textbook of Neuropsychiatry (1997), the authors confessed that they have failed to identify any chemical imbalance in ADHD children. It is important to note that physicians did not look for a cause or causes beyond the neuro-biological domain.
Given the above research facts it appears unbelievable that professionals continue to label children with ADHD. In my own clinical experience the causes of children’s distressing responses lie in the context within which they live. Parents and teachers do their best, but there are none of us who do not unconsciously carry unresolved emotional issues from childhood into our adult years which, inevitably, affect how we interact with our partners, children, peers, neighbours and work colleagues. Helping adults who have charge of children to come into consciousness of their unconscious defences is the way forward to resolving the inner turmoil of children and teenagers. Children’s ‘difficult’ behaviour is unconsciously designed by them to show how difficult life is for them, not to make life difficult for parents, teachers and peers. Their hope is that their inner turmoil will be identified by some mature adult – whoever, lay or professional.
The Department of Education needs to drop its requirement of a psychiatric label before they provide professional supports for children in distress and for their parents and teachers. Relationship, relationship, relationship needs to be the primary focus of intervention. Medication, as we will see, is totally counterproductive to the child’s wellbeing.
The research evidence on Ritalin certainly shows that the medication benefits the teacher, but not the child! All of the research reports (detailed in Anatomy of an Epidemic (2010) by Robert Whitaker) reveal that students who had previously been disruptive in classroom were stilled – a great relief for the besieged teacher. For example, the drug research shows that medication:
- Reduces a child’s ‘curiosity about the environment’
- Causes the child to ‘lose his sparkle’
- Results in the child becoming ‘passive, submissive and socially withdrawn’
- Causes some children to appear ‘zombie-like’
In terms of the child’s progress, no benefits have been found. Indeed, Whitaker reports Ritalin makes children “depressed, lonely, fills them with a sense of inadequacy and impairs rather than improves learning.” Let me quote Whitaker – “Ritalin and the other ADHD medications cause a long list of physical, emotional, and psychiatric adverse effects. The physical problems include drowsiness, appetite loss, lethargy, insomnia, headaches, abdominal pain, motor abnormalities, facial and vocal tics, jaw clenching, skin problems, liver disorders, weight loss, growth suppression, hypertension and sudden cardiac death. The psychiatric problems include obsessive-compulsive symptoms, mania, paranoia, psychotic episodes, and hallucinations.”
Such are the research findings for Ritalin plus other ADHD medications. Whilst it is true to say that in the short term a child’s hyperactivity is altered in a way that both teachers and parents find helpful, the reality for the child is that his life is diminished in many ways and, later on as an adult, have a reduced physiological capacity to experience joy.
Dr. Tony Humphreys, Clinical psychologist, author and National and International Speaker. His book, Self-Esteem, the Key to Your Child’s Future is relevant to today’s article.