Judith Warner Calls Concerns About Overmedicated Kids "Narrative"

Yesterday, the New York Times embarrassed itself by running an article on John McCain in which he was accused of having an affair with and doling out favors for a female lobbyist. I happened to read the piece when it went live evening before last and found it very thin--so thin that, as someone who's done a fair amount of investigative reporting, I know that article would've never had my byline on it. If you are going to wipe out a politician, then you'd better make sure your Glock is loaded with live rounds instead of blanks.

Another piece that wouldn't have my byline on it since its argument is mildly intriguing but runs counter to the facts as I know them was penned today by my new best friend Judith Warner in her blog on the Times' website. Last week, I hammered Warner for making the argument that as a culture we were too warm to the notion that we are overmedicating ourselves and that things are just fine.

This week, she's back with a piece entitled "The Med Scare." And I am back to give her the ass-kicking she deserves. She's playing the old game of everything-is-social-conditioning like a dumb Lit grad student trying to play New Historicist. Let's just dive right in:

"I asked Mintz [Steven, a Columbia University historian] this week what he believes are the underlying anxieties — conscious or not — that animate the stories of peril we tell about children in our time.

"'Tremendous fears about downward mobility,' he quickly answered. 'We believe we’re living in a new world where the avenues of success are harder to get into and there’s no guarantee that things will work out. There’s tremendous worry that our kids won’t be able to recreate our class status. This creates an adversarial relationship between our kids and other kids.' And, he added, 'displaced guilt.'

"I couldn’t agree more. And I believe it’s these fears, this worry, this adversarial attitude and this bad conscience that keep the narrative of the overdiagnosed and overmedicated child alive.

"Let me make clear again why I keep referring to the overdiagnosis and overmedication of children today as a 'narrative' – the sort of phenomenon that deserves to find its place among what Mintz calls 'public panics' – and not as an established fact. It’s because I believe that, over the past decade or so, scattered reports of increased diagnoses of mental health ills and of increasing use of psychotropic medications by the young have been woven into a scary storyline that distorts the reality of what’s happening to kids in our country.

OK, so how does an increase of 4,000 percent in the diagnosis of alleged child bipolar disorder over the past decade or so and concerns about the same get written off as mere narrative, when in fact the diagnosis does not exist in the DSM and is hotly debated by child psychiatrists? How would the fact that these children are mostly boys and are being slammed with anti-psychotics--a narrative shift without historical precedent--go down with any intelligent adult as not being a big deal?

More Warner:

"Only half of the 3 to 5 percent of children believed to have ADHD receive any kind of treatment (generally medication)."

I am beginning to wonder if Warner reads journal articles very often or just cites the ones her sources hand her, because how else could she be unaware of recent studies which establish that ADHD treatments don't make much difference in at least 50 percent of cases of ADHD, that most ADHD kids turn out just fine by the time they are 18 (medicated or not, and I refer to the previous link) or hit the fifth grade? And, BTW, ADHD meds seem to slow brain development too (referring to the link immediately prior). None of that strikes me as panicky narrative. Kind of beats the they-aren't-getting-treatment argument to death. Or renders it a moot point.

But, then, let's be clear: most of the ADHD kids are boys and Warner must find it really easy to stop digging around for information the minute a historian--who last time I checked has no credentials in the medical world--tells her something that suits her own preloaded panicky narrative of we aren't treating the kids enough. I just don't think Warner gives a crap about little boys unless they are well-behaved and docile.

"Why, then, the exaggerated belief that we’re raising a nation of pacified, high-performance zombies? I think it’s because we have real worries about the state of children – and childhood itself – in our time. We know that our current lifestyle of 24/7 work, constant competition, chronic stress and compensatory consumerism is toxic. But we also know – or feel – that there’s not much we can do about it. We feel guilty about the world we’ve created for our kids, one of lots of work and not much free play. But we’re also wedded to that world, invested in it, utterly complicit with its values and demands.

"And so we shift the focus of our fears away from big forces we feel we can’t do anything about (globalization, an increasingly merciless marketplace, a growing gap between the wealthiest Americans and everyone else, the general indignities of life in the beleaguered middle class). Instead, we focus on decisions we can control (whether or not we will “drug” our kids). Our minds shift away from the myriad ways we collude in making life toxic for our children, and we obsess instead on condemning other people for allegedly poisoning their children’s bodies."

Her assertion that this is all somehow misplaced guilt over toxic lives led by adults is an interesting one, but she sure takes it places I wouldn't. She apparently forgets about the Rebecca Riley case, the boy on Risperdal wildly jerking his head about on Frontline recently, the fact that in Washington State there is an 8-month-old child on Zyprexa. The fact that in Florida half of the anti-psychtoic use in the state's Medicaid program is for ADHD diagnoses--last time I checked ADHD was not a psychotic disorder. The fact that in upstate New York, one county is doping the hell out of its foster kids. The fact that some child psychiatrists argue that the alleged bipolar child diagnosis is in fact a personality disorder. The fact that Massachusetts is engaging in a brave, new social experiment. And so on. These are hardly isolated narratives.

Oh, but there's more:

"We jump at every story that shows other people’s kids (and it’s always other people’s kids whose maladies are “fashionable;” one’s own children’s problems are always “real” and unique) succumbing to any one of the “epidemic” mental ills said to be sweeping the nation’s youth. And we snap up the idea that other parents are drugging their kids to perform like racehorses; how could they not be, when our own kids are struggling so much to get by? In this age of personal trainers for tots and pre-K tutors, isn’t everyone always fighting to do whatever they can do to give their kids an advantage? Take away test jitters with Zoloft, super-prime their minds for cram sessions with Adderall, chemically lobotomize them into the kind of docile behavior that wins a spot in the very, very best private preschools?

"The belief that overmedicated children are the canaries in the coal mine for our sick society ought to place the onus of blame upon society. Instead, I fear, to borrow a phrase from family therapists, it’s the kids who have emerged as the “designated patients” in our self-serving displacement systems.

"It’s easy to panic about the state of The Child. It’s a whole lot harder to take action on behalf of real children."

I don't know about that Judy. I have. And what is this special universe Warner lives in where rich parents dope their kids so they get into the best private preschool? Maybe, Warner should take a look at what's up in public schools where most of America's school children exist.

I suppose Warner is entitled to a narrative of childhood behavior and its cures all her own but her blog posts are sure beginning to read like a weird form of self-therapy and self-justification. What really bugs me is that if you just rest upon the testimony of academics without testing the evidence yourself, then you will never stand on your own two feet. That's often the outcome when a writer is sent to do a reporter's job.

I know for fact that some prominent psychiatrists are beginning to say that anti-depressants sure ain't all they are cracked up to be in adults and the evidence base for their use in children is very thin. You would've never heard such talk in news articles until very recently. And I'll tell you more about what I know when I can.

I think it's high time that the Times started introducing some counter voice and opinions on the pages of its paper and on its website. They do it for politics. Why not here where medicine has clear socio-political overtones? Or is Judith The Medicator solely in possession of the truth?

What do you all think? BTW, if any of you are so inclined, go leave comments on Warner's blog. Be polite, please.