Prescription for Thought

This belated post is especially for Debora, who asked for my impressions about ADD/ADHD medications for children.  (Disclaimer: I am not a doctor, nor do I play one on television.)

Medicating kids or adults for ADHD is a sticky topic.  Everyone has opinions!  Like many topics of heated discussion, usually everyone has several good points to make, and there are always a few people who take things to absurd extremes.  So let’s look at these points individually.  (I’ve boldfaced the points, so if you’ve already reached a state of analysis on that point, you can skip to the next one.)

Does ADD/ADHD even exist?  Is it just some scam made up by drug companies to make money?

Some years ago I received an email from someone who had decided the latter. I replied back with the following, which I have updated to reflect new information:

I find it interesting (alarming? saddening?) that you say you “don’t believe in ADHD.” Doubtless there have been/are some children who mis-diagnosed with and treated for ADHD and this is a real shame.  Equally tragic are those children (and adults) who missed diagnoses and struggle through life.

Objective evidence for ADD includes PET brain scans that show marked differences in the frontal lobe operations of people with and without ADHD. There is also evidence for a mostly genetic basis.

It is not a result of laziness, rebelliousness, bad parenting, or diet.  About 60% of the people with ADHD do not grow out of it.  (Those who do seem to “grow out of it” may be demonstrating that children don’t all mature at the same rate.) Although the some of the symptoms of ADHD can at times be present in anyone, it is both the 1) degree and 2) consistency over time to which these symptoms manifest themselves that allows for the diagnosis.

The prescription medication I am taking is a time-release combination of dopamine and norepinephrine, which are neural transmitters (chemicals involved in the transmission of electrical impulses from one nerve/brain cell to another.)  With the medication I don’t jiggle all the time, bite my nails less, interrupt less often, don’t daydream or mentally wander off-subject in class or during meetings, and can focus on studying for 90 minutes at a time, instead of 5 or 10 minutes.  Early on (without knowing about the diagnosis or medication) my daughter remarked to me, “Mom, you actually SAT through a whole movie!”

And yes, the medication is an amphetamine, and it is curious to note that with the medication, I can get to sleep more easily and have less hand tremors! I also drink a lot less coffee, which implies unconscious attempts at self-medication with stimulants.   This is in direct contrast to what would happen for an ordinary person taking an amphetamine.  It affects me differently because I am wired slightly differently. (More objective evidence: a different physical makeup of the body results in a different physical reaction.)

To be prescribed medication, I visited not only a psychologist, but also a psychiatrist, had to undergo interview testing (which paperwork hubby also had to fill out, in lieu of a parent) and my wretched school history was also gone over.  I did not undertake this diagnosis lightly, but after having struggled with school for 35 years (!) and consistently getting poor evaluations despite being smart and working hard.

If ADD is real, and I have it, why wasn’t I diagnosed with it earlier?  Because it wasn’t added to the Diagnostic Statistics Manual (DSM) until the early 1980’s, after I had (through much struggle) managed to graduate high school!  An earlier diagnosis was charmingly called “Minimal Brain Damage” and had different criteria (it was thought to be caused by physical trauma from birth or accident). The hyperactivity part was a separate diagnosis. It is not that ADHD didn’t exist earlier, but that the specific name and diagnostic criteria didn’t exist.  This is one of the reasons why there were “suddenly” more children (and adults) being diagnosed with ADHD.

But what if someone says they “don’t believe in ADHD.” Think on this: some people have asthma and take medication to treat the symptoms.  Most people don’t “grow out of” the asthma, nor is it imaginary.  It has a direct impact on how well a person can function at times. What if someone said to you, “I don’t believe in asthma”?  What if they said, “You just wheeze because you are out of shape.  That’s just an excuse.  You just need to TRY HARDER.  If you practiced or exercised more you could do just as well as everyone else.” What would you tell them?

Oh noes, labels!

People hesitate to get testing because they are worried that diagnoses will mean that there are “labels” assigned to their children.  But think about this:  what kind of “labels” are already assigned to your child?  Are they helping him, or preventing him from being helped?  Will the label actually give him less of an education because it refers him to different but unequal education?

What does the label mean to you?  A person is not the label given to them.  Furthermore, if you fear your child being labeled, what does this say about your own attitudes?  Do you fear that the identification of a particular kind is a stigma?  If your child is that particular kind of person, does that make them less of a person or a not-good or not-okay person?

Sometimes there are other things that will occur in addition to ADHD, such as sleep issues, handwriting problems (dysgraphia), [central] auditory processing disorder (APD or CAPD), nonverbal learning disorder (NLD or NVLD), Asperger’s or tics. These are technically known as “comorbid” conditions, a term which I find awkward.  Sometimes things like APD are misdiagnosed as ADHD, simply because there are overlapping categories of effects, and people are more familiar with ADHD.  But don’t panic.  I certainly don’t mean to scare you; it is not an overwhelming percentage, by a long shot.  Just be aware that other issues may surface over the years, and don’t let schools act like everything is due to ADHD, and/or that a student is limited to one diagnosis.

The good news is that being really bright can also be “comorbid” with ADHD!  (-:  Indeed, these “twice-exceptional” students can be hard to diagnose, because the smarts and the disabilities tend to cancel each other out.  Plus, people can get so over-focused on remediating the behavioral problems that they forget there’s a smart and really bored kid … smart + bored + bouncey + inquisitive = ____ Well, it depends partly on the teacher; the result could be a stellar student, or one who is just known for “being a problem” instead of “having specific problems”.  ::sigh::

Is there too much over-diagnosis?  Is there too much over-medication?

Deciding whether or not to take medications is a big issue.  Doubtless there have been/are some children who mis-diagnosed with and treated for ADHD, and this is a real shame, if not possibly dangerous.  Equally tragic are those children and adults who missed diagnoses, and struggle through life, feeling like they are lazy, stupid, etc.  (Readers, feel free to “raise your hand” and comment!)

Although Ritalin and similar meds are amphetamines, they do not have the same affect upon the ADHD brain that they do upon the NT (neurotypical, i.e. “normal”) brain.  If a person does not respond well to medication, it might be the formulation (type of medication; they’re not all the same), the dosage, the diagnosis (other things can share some of the symptoms ADHD), or the person just might be someone who doesn’t respond well to the meds.

Some people are concerned that, “we don’t know enough about these medications and how they affect kids”.  (Some of those are people who feel that nothing but 100% surety is enough, which is unreasonable because hardly anything in life is that sure.)  In truth, stimulant meds have been in use for about fifty years, so most of the effects are pretty well known, even the long-term ones.  Plus, research keeps plugging along and we discover new things.

One of those things is that although there will be a few people with Tourette’s or tic disorders may have an earlier onset of tics when treated with stimulant meds, that does not mean that stimulant meds will cause tics or Tourette’s, nor even necessarily aggravate them. Personally, I’ve always had some tics, and they have become more pronounced over the years (as have other issues, such as nearsightedness, tinnitus, arthritis).  I went off the ADHD meds for nearly two years, and realized that there wasn’t really much difference in the tics, but that I really did better with the meds, so I went back on them.  That may seem like a long time, especially since the meds wear off so quick.  But tics will wax and wane and the types of tics tend to change and repeat over time, so a longer time period helps determine if the results are just those normal ups and downs or a real trend (this is what the stats people refer to as “regression toward the mean”). It’s also notable that although stress does not cause tics, stress can aggravate tics. Entering puberty can also trigger Tourette’s or tic disorders; merely being diagnosed with ADHD and getting the stimulant meds, and then developing tics does not mean the meds caused the tics.  Of course, my personal story doesn’t mean squat (“testimonials are not data”), but I could pull up the research paper titles if anyone really wants to know.

“Take this pill – it’ll make everything better” – NOT.

There is also the simple fact that medication does not completely resolve the problems associated with ADHD.

The first few weeks on the meds, it is amazing!  You can get things done, sit still, pay attention, whee! People around you notice.  They like it when you are on the meds.  You get concerned; you want them to like the “real” you, not the medicated you.  Well, big news:  YOU ARE STILL YOU. The medication does not change your core personality. You are perhaps a bit less frantic you, and perhaps a bit more attentive.  As for myself, I am still the same nutz person I have always been.  (Classic disclaimer:  “Your results may differ.”)

And after a while … you notice that although the meds help, you still have some problems.  Part of those problems may be issues of organization, study habits, work habit is, et cetera; actually, those can now be dealt with more effectively with the meds, as you learn or re-train yourself.

I tried a week off the meds.  I felt like, “Oh, I really don’t need them; they don’t help that much.”  And then I got comments like a class feedback form saying, “Instructor should consider switching to decaf coffee” — and I HAD been drinking decaffeinated coffee — yikes!  Um…  Well, now I understand why some people go off their “crazy-meds”; they feel like they are just fine!  And then things start sliding downhill…

The meds of course don’t “cure” the problems, nor do they remove them — they make it easier to be more focused and get less distracted, and can help settle down some of the impulsivity and boing!boing!boing! (That said, I’m still a leg-jiggler, and just tell my students, “fidget quietly!”)

Research tells us that usually works best is a combination of meds and counseling or teaching of coping strategies. (We’re not shocked when other research also tells us that the same is true for depression — antidepressives make it easier to be interested in and make use of counseling.) The meds make it easier for the person to assess and understand what sort of things are going on, to implement strategies, and to evaluate progress. It can be helpful to brain-storm ideas and solutions with other ADHD people, assuming the conversation doesn’t get too off track. Alas, some of those ADHD chat boards are pretty useless, as they are such pity-parties, gah!

Things like ADHD, Asperger’s, NVLD, APD, Tourette’s and so on all have some similarities of frontal lobe processing that is referred to as Executive Function.  EF includes planning, prioritising, initiating, being aware of what one is doing, assessing what one is doing, correcting actions (troubleshooting), and inhibiting wrong actions or distractions. Doing all these things at once requires juggling a lot of thoughts in short-term and active processing memory; they use up a lot of cerebral RAM. Unfortunately, getting those aforementioned coping mechanisms implemented and whatnot requires … Executive Function!  Oh, the irony.

Some people react badly to medication.  If one does not work, do consider trying another.   Side effects can be seriously not-fun business; I had numerous side effects to two different medications.  I had never before had side effects from meds, but then I realized that all I had ever had were ordinary analgesics and antibiotics.  I have since had side effects from still other kinds of medications (including mundane things like blood pressure medication).

It has also been found that some drug-abusers are undiagnosed ADHD and were self-medicating with stimulants.  Moreover, the happy reverse it true; persons prescribed with the correct meds end up with fewer problems with drug addiction.

Well, it is a loaded issue.  Ask sixteen people, and you will get sixteen different opinions. But I’ll warn you, ask someone with ADHD and you probably won’t get a short answer!

18 Comments

  1. Lunch Admin. said,

    4 September 2008 at 14:24

    “but no one ever should take these until they know how they will be affected.”

    That’s the Catch-22 about the whole thing isn’t it? One MUST take the drugs in order to determine if they work …

    Vastarien202’s doctor should be hung by the thumbs.

  2. Vastarien202 said,

    3 September 2008 at 4:37

    Hey all. I have been lurking for a while, and enjoying myself immensely.
    I agree that no one has a true “One-size-fits-all” answer to the drug question, but I am personally against them. Vhemently so. I was put on Welbutrin for insomnia and depression several years ago, and it was the most horrible experience of my life. I consider it nothing less than mind-rape, and will say this until I pass from this world. I felt like a 90 year-old man; weak and dazed, unable to defend myself. In my head it was worse, my nightmares were true glimpses into Hell, and hyper-real, I could not wake up due to the sedatives, but upon waking, I could feel no emotions at all. I never wanted to die so badly as when I was taking meds, but I had not the will to do it. When the chance came to stop taking them, I did, and have never been happier with myself. Sorry about the long post, but I refuse all psych meds for a reason. If they work for you, great, I am happy for you, but no one ever should take these until they know how they will be affected.
    When I spoke to my doctor about the horrors I was going through, he actually said that it was “normal, and you’ll get used to it.”
    I’m glad I flushed them all, and never looked back.

  3. Lunch Admin. said,

    13 August 2008 at 22:55

    Where is it written that team activities are overused and that physical education puts too much emphasis on competition? Team sports can be fun! Competition can be exciting! That is, if you’re allowed to play.

  4. Ettina said,

    8 August 2008 at 18:53

    Ange, I have a lot of sympathy for you. Pretty much any attempt to help a kid who is struggling in school depends on the cooperation of the school system, and it sounds like you don’t have that.
    Could you maybe get him into another school setting, or even homeschool him? That’s what worked for me.

  5. Ettina said,

    8 August 2008 at 18:50

    “No offense to Ettina, but man oh man – I was subjected to many MANY years of the ‘change the environment’ thing to make me better. Mostly what that meant was a loss of privileges. For example, since I couldn’t handle a pair of scissors I was kept out of art class. Gym activities didn’t come naturally to me, so I often sat on the sidelines for the required physical exercise expected of everybody else. On the rare occasion when I might participate in gym, I was only allowed to scoot balloons along the floor with a badminton racket. Humiliating!”

    Just to clarify – trying to change the environment to better suit a child *does not* mean unfair procedures such as this. Exclusion is not a good solution, both because of the psychological impact on the excluded student, and because of missed opportunities to learn.
    For a kid who can’t handle scissors, I might use accomodations such as doing more open-ended crafts where you could choose whether or not to cut things (which wouldn’t single out the disabled kid). In phys ed, I’d have much less emphasis on competition, and more on building skills and learning activities to keep fit (I think team activities in general are overused, because if you want the kids to be in good physical fitness, they should learn things they can easily do outside of school as well). Most importantly, I’d check in with the disabled kid about how they feel about the accomodations and whether it’s working well.

  6. Lunch Admin. said,

    7 August 2008 at 19:50

    Ange,

    Try not to overly-internalize what other people say about your son or predict what they might be thinking; you can be only so much obliged to the type of constant feedback an ADHD child brings upon the family unit.

    When you’ve hit critical mass, take a moment to remind yourself of the neuro-typical people out there who do “choose to be bad” – the Enron-fixers and Iraq WMD liars and so on.

    They deserve such a label – not your son.

  7. ange said,

    7 August 2008 at 13:17

    I skimmed this (my mid kept jumping) so I will have to come back and reread several times…I really struggle with medication for my oldest. I want to be smart about it, I want to give him a jumping off point so that he has a chance to be successful… last year he was on a higher dose of stimulant and an antipsychotic, “no behavior problems” in school but awful rebound and threshold issues when he got home. I went to school and saw a withdrawn depressed little boy, but yes he was being “good.” He is now on a low dose stimulant. We feel like we have our child back, but in the school environment he is a “different kid.” Immature, back to avoiding work, very inattentive. He has various learning disabilities, neurological differences, yada yada yada… we are trying to figure it out, but it is so draining. I suppose we are “lucky” that medication assists him in some ways, but I get so frustrated that people then think “well then loook how ‘good’ he is being, he doesn’t have such and such issues…” when they have no idea what we have done and what HE has to do to present like that. We try the modification/accomodation route first, but people can’t get past the behaviors and perceptions to help him… adding inflexible and inconsistent to the inattention and impulsive somehow makes people call him “manipulative” “defiant” “choosing to be bad.” Last year I was told how sweet and well-mannered he was. Which was true, but he was compulsively picking himself until he bled, very depressed, and hyper-focused. Add to the fact MY anxiety issues, my paranoia about the adverse affects of medication on his health, my inability to react well to the rebound issues…OY!!!! I hope we find a “happy medium.” (Sorry for the mini rant, but it helped me get it out since I can’t seem to post about about it on my own blog)

  8. 6 August 2008 at 23:38

    I remember an occasion being forced to wear lab goggles with 3X5 cards taped on the sides in order to keep me from staring sideways. Blinders or not, I was still unable to be in command of my gaze and my mind continued to wander hither and thither besides.

    Gah, that reminds me of one mini-institution’s solution to the fact that I kept (because of being overdrugged on neuroleptics) falling asleep in “class”. (If you could call that school anyway.) They sat me in a big easy chair, put me facing away from the other students so that they wouldn’t see me (because they kept complaining that I “got” to fall asleep, as if halfway passing out into one’s own drool is really a fun activity), put a Walkman onto my lap, headphones on my ears, and blasted audiotapes into my ears at high volume to try to keep me awake. (Since my “sleeping” wasn’t natural sleep, it didn’t really work, I just had a weird uneasy experience of alternately passing out and waking up to passages of “The Diary of Anne Frank” and so forth.)

    I think you might appreciate this page which shows a genuine IEP goal from that time period. They miswrote, but it was consequently the most accurate goal in the entire IEP.

  9. Lunch Admin. said,

    6 August 2008 at 19:08

    No offense to Ettina, but man oh man – I was subjected to many MANY years of the ‘change the environment’ thing to make me better. Mostly what that meant was a loss of privileges. For example, since I couldn’t handle a pair of scissors I was kept out of art class. Gym activities didn’t come naturally to me, so I often sat on the sidelines for the required physical exercise expected of everybody else. On the rare occasion when I might participate in gym, I was only allowed to scoot balloons along the floor with a badminton racket. Humiliating!

    Occasionally a new L.D. PhD candidate would blow through town and outfit kids like me with bulky hearing devices to help us attend to verbal commands, as if our inattentiveness were a simple volume problem. For Pete’s sake – we weren’t deaf! I remember an occasion being forced to wear lab goggles with 3X5 cards taped on the sides in order to keep me from staring sideways. Blinders or not, I was still unable to be in command of my gaze and my mind continued to wander hither and thither besides.

    It is difficult to put into words how these absurd environmental interventions hastened my already deep feelings of despair and uselessness. When I bother to remember this time in my life I often wonder if these newly minted L.D. specialists were aware of the futility in their actions. Did they care about the outcome at all? Did they care how the doodads, gizmos and exclusionary tactics made me feel? Probably not.

    On another note, I have no problem comparing stimulant meds for ADHD’ers with insulin for folks with DM type I.

    For one thing, the comparison is an excellent rejoinder to those who make it their business to dismiss and devalue the reality of ADHD. Also, the insulin/stimulant comparison makes sense taking into account the research showing a connection between ADHD symptoms and dopamine, an essential neurotransmitter.

    You see, as with injections of insulin replacing what the pancreas cannot produce, stimulant meds are dopamine “reuptake inhibitors,” meaning that they affect the pattern of the brain’s dopamine release and re-absorption. Stimulant medications seem to allow the dopamine produced naturally in the brain to activate the brain’s receptors for a longer period of time before being reabsorbed. This mechanism of action is not fully understood, but most therapeutic agents now in development for ADHD are addressing the symptoms of inattention by tinkering with dopamine neurotransmitter systems.

    Imagine the progress researchers could be making in this direction if not for the collective doubts about the authenticity of the ADHD diagnosis as well as the ongoing refusal to accept the efficacy of stimulant therapy.

    It’s so very sad.

  10. qw88nb88 said,

    6 August 2008 at 15:56

    Ettina,
    Thank you for that clarification.
    andrea

  11. Ettina said,

    6 August 2008 at 15:52

    The technique I’d use to help someone with ADHD is firstly to change the environment as much as possible to accomodate them, and only if that doesn’t help enough I’d suggest meds.

    Every medication has side effects (some worse than others) and if you can effectively deal with a problem without medication, that’s usually better. If there are still significant problems, or the environmental modifications needed are very extreme, or (unfortunately) it’s really difficult to get proper accomodations in place, then it’s worth some risk of side effects.

    One thing I really hate, however, is people equating stimulants for ADHD to insulin for diabetes. Insulin is a hormone people have naturally, that diabetic people don’t have enough of or are unresponsive to. Stimulants are not.
    And you’re wrong that stimulants affect ADHDers differently. With everyone, there are two effects stimulants can have. In low doses, they improve concentration, in high doses they impair it. This is because of the curve between concentration and arousal – concentration is best at medium levels of arousal. Different people tend to be at different levels of arousal, depending on stress, anxiety, sensory needs, etc. ADHDers appear to be chronically underaroused, and therefore stimulants, which raise arousal, are helpful. Other people can have ADHD features unrelated to arousal, which are usually unaffected by stimulants, or ADHD features due to overarousal, which are worsened by stimulants (for example, some studies have shown that children with PTSD often meet DSM-IV criteria for ADHD, but due to chronic anxiety and hyperarousal).

  12. excavator said,

    6 August 2008 at 15:30

    Andrea, thank you so much for this post.

    I appreciate the responses it has been receiving too. I would love to read Lunch Administrator’s story of how he/she “took control of my disorders”.

    Thank you again

  13. speakingaut said,

    6 August 2008 at 14:49

    I love this post.

    What drives me crazy is the people who go “Oh, I’m so ADD” when they get distracted by something. I mean, honestly.

    The other thing that drives me crazy is the number of adults (usually young adults) who get diagnosed for the sole purpose of “scoring” amphetamines.

    (There’s a pattern here, I just know it.)

  14. Lunch Admin. said,

    6 August 2008 at 13:29

    Hi Andrea. I was 29 before I decided to see somebody who took my complaints seriously. Up until then, I had been dismissed with the usual tired arguments in the book. My entire young life was compromised and my anger boils over when I consider that effective treatment was only arms-length away. But why would I ‘need’ it, my teachers and remedial specialists asked.

    Why couldn’t I just try harder and quit whining already?

    The specialists reported to my parents that he best they could predict was that maybe I would grow up and be able to find meaningful work doing “something with my hands.” Ha! Without the ability to focus, my hands were as useless as my brain! Why they didn’t make the connection between fine motor skills and attention-span, I’ll never know. Needless to say, my parents bought this cop-out argument and as a result, they never expected much from me.

    Now that I am finally on stimulant medications, I am able to remember names, brush my hair, take out the garbage, taste my food, tie my shoes correctly, recognize danger, engage in multifaceted conversation and a list of other activities dependent on one’s ability to focus.

    As for working with my hands, I am college educated and perform meaningful work in HIV research at a major hospital.

    After I finally took control of my disorders (that’s another story), it took me a while to find the stimulant that worked best as well as the correct dose. Actually, thinking back, it took about 8 months of experimenting with the help of my Neuro doc.

    If only somebody had thought to try medication when I was much younger!

  15. qw88nb88 said,

    6 August 2008 at 13:01

    Thank you for the comments!

    Something I meant to mention (got distracted during the proofreading), is that just as the meds do not change one’s core personality, they also do not change one’s core responsibility.

    A person with ADHD is still responsible for their successes — not the presence of, or lack of meds.

    A person with ADHD is still responsible for their failures — not the lack of, or presence of meds.

    For many people, the meds make it much easier to achieve the successes, and to avoid the failures. But medication alone will not do that — a person must also make a conscious effort to implement coping strategies, to do their job work and school work and personal work, and to make plans to achieve goals.

    For more thoughts on the problems and benefits of “labels”
    , see this post, “Mystery Jam and Other Achievements”.

    They say you should label jars, not people. That can be a helpful attitude, insofar as people are more than the sum of their descriptors. But part of the reason we create labels is to describe things and to validate them, and without such labels others would frequently resort to other descriptors that are much less helpful. Labels are not bad unto themselves; it’s how we use them that matter.

    Losing the label doesn’t always mean losing the condition, just losing the severity of the problems associated with the condition. Losing the label doesn’t mean that one doesn’t have to try a bit harder, or manage things a little bit differently to succeed. It is something of a foolishness to expect that if someone has lost their label that everything is peachy-keen fine, smooth sailing from now on.

    Having lost the label means that one can also lose some of the support systems, and thus have lost some of the accommodations. Having lost the label means that one can also lose some of the acceptance and understanding that doing everything things requires a bit more effort, and that when stressed, doing everyday things requires even more effort.

    andrea

  16. Norah said,

    6 August 2008 at 12:50

    Someone I know with ADHD (not the only one, but the only one who has discussed this) took Ritalin for a few years, but in the end decided to find a way to live without it or other medication, because he did not like the way it made him feel despite enabling him to focus better.

  17. Sharon said,

    6 August 2008 at 11:30

    Another well written post Andrea. You have made several points clearly. I’d encourage anyone making the claims you address to read this post.

    One paediatrician suggested that Duncan may have ADHD as well as autism and suggested trying stimulants. At this stage, I don’t think he needs them, and he has not had a proper diagnosis of the condition. Perhaps if he went to school it would be more difficult for him to cope without medication, I don’t know. But I’d prefer to wait until he’s older and can express his own wishes and has more input into what feels better to him.

  18. Suzanne said,

    6 August 2008 at 11:01

    When I didn’t know how to study because the text on the page would blur, they gave me spectacles.

    When I had trouble sleeping and couldn’t get out of bed in the morning, and when I still couldn’t study they said I was lazy and difficult.

    When I became depressed and started to drink to block them out they said that there was ‘something wrong with me’ for not wanting to be with them.

    When I drank too much and too often, I was told that I should stop because I shouldn’t ‘need’ to drink, but that I should always accept alcohol when it was offerred by my family because they don’t like to drink alone.

    When I started on antidepressants, I got advice that I should stop taking them because I shouldn’t ‘need’ them and should be able to sort things out for myself.

    When I started on Cognitive Behaviour Therapy, I got advice that I should stop going because I shouldn’t ‘need’ it and should be able to sort things out for myself.

    I still wear glasses, and have problem with depression and go to CBT, and since then I found out that I am autistic (Aspergers), am dyslexic and have Irlen Sydrome, have APD and tinnitus, and adult onset acne.
    When I added meds for Adult ADD, I didn’t bother to tell them. Within a few days, I reduced my coffee consumption and stopped drinking alcohol.

    The point of this spiel is that I am taking a lot of medications and am happier than I have been all my life; however, no-one seems to have noticed (except my doctors!) that I am in control only because I have access to those medications.

    Medication does for my brain that which it cannot do for itself, so without them I would no longer be in control. But by society’s standards, I would be a better person because I did not become addicted to (prescribed medically necessary) medication, but would at the same time revert to being an object of scorn for being lazy, difficult and antisocial, and of pity for being unable to control the neurophysiological functioning of my brain.

    Yes, there is cause for concern at overmedicalisation and overmedication of normal human differences, but for me it was a life and death decision and if I am going to live my life, I want it to be a life worth living.


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