The View From Kalamazoo

(Later than I had intended, but I’m starting week 4 of ‘hell week: the month’ and things were just too stressful to take a few minutes to write anything. I may have to take up smoking just so I can take smoking breaks. Why do I work here, again?)

Part of the difficulty of having a child with ADHD is the stigma – the common media-touted belief that all ADHD is can be explained by blaming bad parents who are too lazy to raise their children, and so demand medication. Her symptoms are my fault, getting a diagnosis and treatment is my fault – there is no end to the accusations (and with electronic media like this blog, as well as other genres, it can be a near-daily bombardment).

It’s been all over the media for 15 years, whether mainstream and prime time, pbs, you name it. Alternative medicine sites blame western medicine, overly structured school environments (because basic classroom control is new, right? anyone reading attend elementary school pre-1980?), vaccinations, sugar, food dye, wheat, caffeine, processed foods, and who-the-hell-else-knows. I’m sure someone has blamed it on the conservatives, and others on the liberals. I really wonder about the dramatically high rates of cephalo-anal conjuncture in the U.S., at this point.

I don’t get defensive. I don’t feel guilt. I do, however, get really damn angry that a lot of kids are suffering in frustration because a whole lot of adults can’t seem to make it to the realization that this isn’t about them, and isn’t about their politics. But the thing is, it’s hardly only the U.S. – in fact, we’re closer to getting it right than anyone else (and that’s sad considering the mount of flotsam fouling the waters here). Treatment in Europe trails U.S. : For unruly pupils, the wrong answers? (which ran nearly a year ago, but I’ve been lax in posting about it) shows just how far ahead we really are. The UK is second in awareness and treatment, but that’s not a close second (not only are the numbers and support institutions/groups lagging, but they stop treatment once the child reaches adulthood).and other European countries are barely within range of the starting block. The symptoms of ADHD are blamed on single parenting, mixed-race families, poor discipline, and just plain bad kids (“People here just don’t want to recognize it. They think ADHD is just an American version of being a naughty boy.”) – where is the care in medical care? Where is the education in the educational systems?

“Most primary care clinics are very psychoanalytic and don’t see this as a problem of the child that has to do with biology,” said Dr. Véronique Gaillac of the Ste-Anne psychiatric hospital in Paris. “Some of these children go through years of psychoanalysis, which to me is not at all effective. Many doctors are passionately, angrily against the idea of ADHD. They think it is an American invention.” … Schools and teachers, who know little about ADHD, are often vehemently opposed to medication and offer “nothing” in the way of therapy or behavior modification, Gaillac said.

An American invention. So was the telephone – do they have those in France? (sorry, snarky. I’ll get back on topic)

A good friend of mine, faculty at a very large state university, has had numerous conversations about this. His son was diagnosed, and through that diagnosis (it often runs in families, folks) realized his own struggles pointed directly to the disorder. In Europe the reaction to a kid with what we know as symptoms of ADHD was punishment – a good cuffing – and a child growing up believing that he is bad, stupid. This was my friend’s experience in Germany. He still struggles as an adult, but he had developed coping mechanisms long before he had any inkling of the root cause – he was one of the lucky ones, in this regard. Children with more severe symptoms, or who are less inquisitive and intellectually driven than my very bright friend, do not fare as well.

Studies have shown that the fallout of undertreatment is dire and longstanding. Among teenagers with untreated ADD, 40 percent need special education, 40 percent of girls with the condition end up pregnant, 20 to 25 percent end up arrested and 20 percent have serious problems with drugs, according to Dr. Russell Barkley, a professor of psychiatry at the University of South Carolina Medical School.

“I don’t want to oversell this disorder, but its not benign — not just about a little too much energy, or too much chocolate or caffeine,” Barkley said. “Treated early in childhood, these kids do well. But there are irreparable consequences from not taking it seriously.”

On websites and in media sources I often encounter ranting about how 85-90% of the diagnoses and stimulant medication treatment worldwide is in the U.S. Accusatory tone and wild knee-jerking as the statistic is misapplied not withstanding, the response I have is “No kidding – the leader in research, education, and treatment development and implementation has a lot of diagnoses and people being treated? Funny thing, that.” Actually the response I initially have is much shorter and a lot crasser, so you can insert whatever vulgar, sarcastic response you care for and it’s probably close to the mark.

The author of the article notes that “If treatment rates varied this much for appendectomies or Caesarean sections, it would be a considered a medical scandal. But mental health diagnosis depends not just on science, but also on doctors’ paradigms of psychiatry and on society’s attitudes toward children.”

Exactly.

My attitude revolves around doing the best I can for my child, no matter how hard that is financially and emotionally – I’ll fight for her education, for her emotional well-being, for her future. I’m just lucky to live in a country where, shortcomings aside, I have the best chance of it.