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Ritalin Nation: Rapid-Fire Culture And The Transformation Of Human Consciousness

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I want to address the Editorial Review from the New Yorker which dismisses this book as a non-scientific, nostalgic plea for a "simpler time." That review claims great scientific progress in understanding ADHD through brain imaging, and cites placebo controlled studies showing the efficacy of Ritalin and other stimulants.

I am not a nostalgic person longing for the simplicity of the early '50's. I am a licensed certified clinical social worker, authorized to perform DSM-IV diagnosis and to do psychotherapy. I have an advanced law degree in Law, Psychiatry and Criminology. I have over five years' experience working with disturbed children in various capacities. And over the past two years I have read twenty-five books, pro and con, on ADHD, stimulants, biopsychiatry and psychiatric medication. What I want to say is this:

The New Yorker exaggerates the state of scientific knowledge about the alleged biological and genetic basis of ADHD. Virtually all ADHD brain imaging studies are seriously flawed - the studied ADHD children have been on stimulant medication. IF any abnormalities were found, they would most likely be caused by the medication, not by the disorder.

So far, the few "differences" found between ADHD and "normal" brains are only averages between the ADHD and "normal" groups studied. There is a very large overlap between the two groups; brain imaging cannot, therefore, distinguish a "normal" individual's scan from one with "ADHD."

Moreover, even if a consistent difference were found in ADHD brains, biopsychiatry couldn't tell if it's caused by exposure to psychiatric drugs, by environment, or by heredity. Stimulants are known to produce brain changes in laboratory animals; experience, too, is known to alter brain structure ("brain plasticity'); despite the human genome hype, no replicable causal relationship has been established between genes and mental illness.

The New Yorker reviewer must know of the 1998 National Institute of Health's Consensus Conference on ADHD. Conference participants were largely those who accept biopsychiatry and its view of ADHD. Nonetheless, the conference summary concluded that there was no known biological cause of ADHD, adding that the same was also true of most serious psychiatric disorders.

Think about that. Biopsychiatry justifies medicating millions of ADHD children on the grounds that ADHD is a physically-based conditon. Yet they have to admit they don't really know of any brain defect causing ADHD. Then they seek to minimize what should be an immensely embarrassing admission by saying, "But don't worry - we don't know the physical basis of schizophrenia and the other serious mental illnesses either."

That is why this review is entitled "Consider the Source." Biopsychiatry's claims are misleading. For decades they have represented scientific "progress" in studying the brain as having reached the stage of actual knowledge clearly supporting their biological treatments. This is demonstrably not so.

My second point: the "science" behind placebo controlled studies showing Ritalin's efficacy, simply ain't necessarily so. The NIH Consensus Conference summary acknowledges: "There are no data establishing the long term safety and efficacy" of Ritalin and other stimulants for ADHD. This is a huge admission, considering how long Ritalin has been around. The Summary also acknowledges that Ritalin produces little or no improvement in social adjustment or in educational achievement (it makes some kids more passive in class, but actually impairs higher level cognitive functions. Long term achievement tests fail to show improvement on Ritalin).

Finally, regarding the quality of placebo controlled studies in this area, check out Breggin.com, in which Peter Breggin, M.D. presents A Critical Analysis of the NIMH Multimodal Treatment Study for Attention Deficit/Hyperactivity Disorder (The MTA Study). Despite biopsychiatry's attempts to marginalize Dr. Breggin, he remains a prodigious and courageous intellect in this field, who has been qualified as an expert witness in numerous malpractice and product liability cases involving psychiatric drugs accross the country. In fact, he was the sole invited presenter on stimulant medications' adverse effects at the NIH Consensus Conference on ADHD.

Dr. Breggin convincingly establishes that the MTA study, one of the largest and most widely cited on Ritalin's efficacy, has numerous fatal flaws, and in fact could as well be interpreted as proving Ritalin's LACK of efficacy.

For these reasons, I apply an acid test to writings about mental health: if, like the New Yorker reviewer, an author uncriticaly cites the scientific "advances" behind current biopsychiatric treatments, or if such an author claims placebo controlled studies establish the effectiveness of psychiatric drugs, I know there's something wrong. The brain science and genetics to support their claims just aren't there; the placebo controlled studies are notoriously manipulable and are routinely used to show things that just can't be supported.

Richard DeGrandpre may not have everything right. Biopsychiatry may be right about some things. But you can't show it by the kind of argumentation presented by the New Yorker reviewer. Unfortunately, that and worse (TV ads are horribly misleading in the same way)are what the public usually gets. The N. Y. Times, the Washington Post, Time, Newsweek, etc., routinely just parrot writers like the New Yorker reviewer.

Aside from DeGrandpre's masterful deconstruction of the "ADHD" phenomenon, this book offers a unique perspective on the impact of speeding up our activities and lives. This is vastly superior to Gleick's recent book "Speed," for example. Looking at ADHD as some sort of brain disorder is a uniquely North American view, and it has to be tied to larger social trends in North America. This book argues brilliantly that kids benefit least from this view, and that the longer-term impact of providing them with pharmacological stimulation are bound to be devastating. If you enjoy keeping your head firmly in the sand, don't read this book.

I've never been one to write a review, so I'll make this short and to the point. Speaking as someone who was "diagnosed" with ADD in the 80s, I can say that DeGrandre's work has provided me with hard evidence and strong logic to rethink the reality that was thrust upon me. After deconstructing the ADD myth, DeGrandpre offers salient advice and solutions for rebuilding what has been torn apart by our fast paced society. If you or anyone you know has had to deal with ADD, I suggest this book as a real eye-opener.

There are no easy solutions to the multiple societal problems Richard Grandpre illuminates so clearly in his new book, but we would do well to pay attention to what he has to say. In a brilliantly constructed examination of our "hurried society" and the "culture of neglect" that surrounds the lives of children today, Grandpre carefully explains the effects of speed, technology and rapid cultural change on our brains and behavior. He argues that drug intervention for what is a social and psychological problem is mis-guided, ineffective and dangerous. He exposes the diagnosis of ADHD as a medical or inherited problem as having no basis in fact and backs up his claim with thorough research analysis. This book will be controversial and disturbing to many readers seeking help for their children, but it is a must read nevertheless.

Dr. DeGrandpre makes a most compelling case for the cultural determinants behind attention deficit disorder, bravely taking on the entrenched orthodoxy of biological psychiatry, the pharmaceutical industry, the parents-as-victims movement, and the media which would defend them all. He defends the victims of our speed-up culture, the children, and brilliantly shows the moral and psychological weaknesses of the drug "cure" Ritalin offers. As a psychologist with considerable experience in this field, I found the book an easy read, but readers without such a background or at least a strong interest in the topic might get a little bogged down in his footnoted recap of the research. Parents should invest the effort, however, especially before succumbing to the temptation to drug their children.

As a physician and neuroscientist the whole ADD phenomenon has always baffled me. How can so many well-off, white American students "suffer' from a disorder that seems to be unheard of in other cultures? How did my peers survive school without stimulants? Some answers to these and other pressing questions on the subject are suggested in this excellent book. It should be required reading for all educators. I fear, perhaps, that my medical colleagues have to much invested in the ADD diagnosis and need to be challenged by the community at large.

Exposes Ritalin approaches to what has come to to be called ADHD as so much witchdoctoring -- that is, coming a diagnosis of a condition from the success or failure of a modality to treat it. This kind of medical approach should have gone out with the dark ages, and wouldn't be tolerated by the medical profession in dealing with cancer, heart disease, AIDS, or any other disease condition. School psychologists and psychiatrists should be ashamed of themselves!

I read Dr. Degrandpre's first book before I attended his talk at a local book store. He came across as genuinely kind and sincere, but at the same time I found it frustrating to listen to him tell the audience that AD/HD is not a brain disorder, that it is inappropriate to treat AD/HD with stimulant medication, and that AD/HD is the unfortunate result of the environment that we live in.

Thanks to the support of my husband, I live in an ideal environment and I still struggle with symptoms of AD/HD. Over the past fifteen years, I have met many others like myself, more than 3,000. We exchanged information about what worked, and what didn't. What I learned is that there are many approaches to living with AD/HD symptoms and that when stimulant medication works well, nothing works better.

I also learned that medication alone is not enough for some of us. I experienced additional relief from my symptoms after I added a basic vitamin regimen of a multi, B-complex, C, E, a calcium/magnesium/D/K/mineral formulation, and fish oil. Medication, afterall, does not treat vitamin deficiencies. A good, first read on the benefits of nutritional supplements for the brain is Your Miracle Brain by Jean Carper.

It has also helped to follow the advice of others: get enough sleep; eat regular, healthy meals; exercise; treat yourself and others with courtesy and respect; work hard; find time to play; make time for family and friends; and surround yourself with work, people, and interests that "make your heart glad".

All helpful, but the reality is that untreated AD/HD and, to a lesser degree, treated AD/HD - (there is no cure, only a reduction in symptoms) - interfers with the ability to consistently do all of the above.

Living with the symptoms of AD/HD means falling off the horse again and again, and getting right back on if you're smart. I think AD/HD is best described as an "inconsistent performance disorder". Do all people experience this? Yes. Do all people experience this to the same degree that people diagnosed with AD/HD do? No. That's how we define AD/HD as a "difference", a "condition", or a "disorder".

My favorite quote of late is by John Wooden: "Do not let what you cannot do interfer with what you can do.".

I periodically read both pro- and anti-biopsychiatry books. The problem with the books that argue strongly against taking stimulant medication is that they fail to discuss or even acknowledge that there are many people who have improved their quality of life by privately taking stimulant medication over long periods of time. To date, I have not found a better treatment. I think it wrong to discourage people diagnosed with AD/HD from trying the short-acting stimulant medications. If the first stimulant doesn't work well, often the second or third stimulant tried will. It's then just a matter of adjusting the dosage.

If you choose, like I do, to read books with differing viewpoints, I encourage you to read at least one pro-biopsychiatry book. Daniel Amen's book, Healing ADD, provides a fascinating look into what Dr. Amen has learned from the 10,000+ SPECT brain scans of his patients. And it offers guidance on which medications and nutritional supplements to try first for each of the six sub-types of AD/HD that he describes in the book and treats in his medical practice.

For parents, I recommend any book by Mel Levine, M.D. I also recommend the parenting techniques described in Howard Glasser's book, Transforming the Difficult Child, The Nurtured Heart, eventhough it, sadly, like Degrandpre's book, is opposed to treatment with stimulant medication.

And for those adults who continue to struggle with symptoms that sometimes accompany the core symptoms of AD/HD, particularly anxiety and/or anger, many have benefitted from the cognitive-behavioral methods taught by Recovery, Inc. groups throughout the U.S. and elsewhere since the 1930's. Meetings are non-religious, weekly, and are supported by free-will offerings. The group uses the book, Mental Health Through Will Training by Abraham A. Low, M.D. It's very dated, but the principles are as true today as they were then. It's a classic work.

Ritalin Nation was on target about the abuse of medication in children today. It should be required reading to combat the pro medication society. Teachers, especially those working with LD or BD children should take a good look.

I cannot make a long story short - you need to read this book to understand why the medical community perpetuates the belief that there was such an entity like ADHD without providing convincing scientific evidence. It gave me great relief that I have not been the only one refusing to do what we have been trained to do in current in pediatric residency programs - to label children with non-favored behaviour as ill. The disorder is within our communities - unfortunately not only in the US - other societies are catching up. Fortunately, there is a new review of the (lacking) scientific evidence in the December 2005 issue of the Journal of Child Neurology, which will hopefully spurn a wider discussion. But beyond questioning the existence of ADHD, the book helped me to value the gift of time - and sharing it especially with children.