Customer Reviews

We've Got Issues: Children and Parents in the Age of Medication

5 star:		(10)
4 star:		(3)
3 star:		(4)
2 star:		(1)
1 star:		(3)

 

 

Judith Warner initially planned to write a book on how American children were falsely diagnosed and over-medicated by thoughtlessly competitive parents seeking a quick fix for their perfectly healthy (albeit quirky) children, for reasons ranging from enhancing their competitive edge (e.g. to raise their "B" grades to "A" grades) to "calming them down" to make parenting easier. She admits she once strongly believed, as many do, that hordes of children were medicated for "flavor of the week" disorders by lazy parents and unscrupulous doctors, and at the recommendation of teachers who needed their young charges to sit still for hours on end at school. What she discovered, however, after seeking such people...is that she couldn't find them. What she discovered instead were parents of sometimes desperately ill children who finally turned to medication (sometimes after years of "denial" about their child's illness) in desperation, more often than not as a last resort, and with great guilt, after trying every other nutritional or behavioral therapy they could identify. To all those adults who ask "where were all these children before when we were growing up?," Ms. Warner notes that they were always there. It's not that there are so many more now -- it's just that now we know what to look for. A kid with what we now know as Asperger's was once just labeled "weird." Similarly, we all knew kids with ADHD in school -- they were the wild, undisciplined kids who couldn't behave (not "wouldn't," but actually couldn't), or couldn't perform, or were labeled "stupid" or "lazy" and for whom the "treatment" ranged from failure to spanking. Ask any adult who lived through ADHD as a kid -- they remember, and they will tell you it exists. In serious cases of mental illness, children were labeled as anything from "retarded" to any other number of other maladies, and parents were urged to send them away to hospitals or institutions, perhaps forever. We're not talking about "quirky" or "different" kids here, or rough-housing little boys who are simply expelling energy -- we're talking about children that are often suffering terribly from the disorders that plague them. Ms. Warner also dispels the myth that practically "all" children are on medication. In fact, a very small percentage of children are medicated, probably fewer than actually need treatment. Most compellingly, she notes that, while it is encouraged, and even admired, for an adult to admit to and seek treatment for a mental illness, for some reason people don't want to extend that same privilege to children. That there is the idea that we should, without reservation, celebrate these "quirks" and "differences" and allow children to "outgrow" them, or alternatively that such children are simply budding geniuses and that treating them would stifle their creativity. What people seem to ignore while they are romanticizing these "differences" is that the children in question are often suffering terribly. Ask any parent of a child with ADHD so severe that they cannot function on any level at school or in social situations, for whom medication has allowed them to at least function on a fairly normal level, how "wonderful" it was for their children before this help became available. Thank you, Thank you Judith Warner, for speaking up for these parents who are simply trying their best in the face of this prejudice.

First, a BIG GIANT THANK YOU to Judith Warner! As a parent of a child "with issues" this book is documenting not just our journey, but the very similar journeys of many other parents. It is a great relief to read that our experiences were not unique. It deeply sad that we were out there on our own, while others were experiencing these things as well. If you as a parent are just starting this long and difficult journey this book is a must read! Also a great book to put into the hands of those within your circle of friends and family who stand in judgment of you!!!!

I've been a child clinical psychologist for 28 years and have seen pretty much all the changes in our cultural and medical views of childhood mental disorders as outlined in this book. Finally, someone sees the need to steer clear of all the hysteria and rhetoric and do something which child health professionals have been doing forever--actually getting to know these children and--gasp!--TALKING to their parents instead of condemning them. I'll say flatly that this book is nothing short of heroic. It demands to be read by anyone who is interested in a clearheaded, well-researched, and beautifully written work, stripped of all the ill-informed, judgmental and paranoid nonsense which abounds.

We've Got Issues is Judith Warner's attempt to justify the world's increasing use of medications for mental illness, particularly in children. This book would have been better as a New York Times column (as it once was) than as a full book. I use the term "full" liberally. A promising start quickly turned to a poorly-researched diatribe filled with anecdotes and pop culture references, but relatively few solid studies or statistics.

Warner's effort surely does not suffer from too few footnotes. Unfortunately, they are largely without relevance. Warner relies heavily upon second-hand media souces (Newsweek, UPI) and online magazines (Salon.com? And what the hell is "Spiked Online" anyway?) for her references. It appears that much of Warner's research was conducted via Google searches in which she simply finds statistics ("seek and ye shall find" as she notes in the book) that fit the particular questions that she posed. Even the more scholarly sources are from what are generally second-tier medical journals. There was not much New England Journal or JAMA in this book.

Warner takes great pains to portray herself as a moderate in the debate. This leads to so many contradictions that the main points become irrelevant by the end of the book. She begins the book with the premise that we are indeed over-medicated. But, she is so touched by the stories she heard that she changed her mind. She attacks liberals as too flighty and hostile of psychiatry; and conservatives as too close-minded and traditional. The "perfect" middle.

She insists that our fascination with medication is not simply a result of our over-stressed, ultra-competitive society. We have issues, after all. Then, she spends the last three chapters bemoaning society as over-stressed and ultra-competitive. Somewhere along the way, the same author of Perfect Madness forgot which book she was writing.

Our fascination with pharmaceuticals is more than just massive drug company marketing. We have issues, after all. Yet, she devotes an nearly a full chapter to the need of pharmaceutical reform. Psychiatrists get a bum rap from psychologists, social workers, and others for their perceived over-reliance on drugs over therapy. But, she then talks about the need for mental health parity particularly through cognitive behavioral therapy. "Psychiatry has changed" she writes at one point. That's it. She never elaborates on how or why it has changed. But, hey, how could one distrust a profession that waited until 1980 to officially remove homosexuality as a diagnosable illness?

The contradictions continue for most of the book. For example, on one hand only the wealthy can take advantage of new and expensive therapies and coping mechanisms especially for childhood illnesses like ADHD and autism. Then, she cites another crack source that says the privileged may be less likely to go to therapy because of the stigma. Which is it? Warner so desperate to prove a multitude of points throughout the book that she forgets which points she was trying to prove in the first place. Perhaps during Warner's "awakening" from a pharma-doubter to a true believer, she forgot to remove the parts of the book that conformed to her original thesis.

I was about to give this book an average 3 out of 5 stars. Perhaps I was too critical. Perhaps it was unfair of me to expect an academic exploration. That is not the point of this book. But, by the time Warner got to the last few chapters on society pressures, and wants for more government action with no data, I could barely squeak 2 stars out of this book. Warner does a decent, journalistic job of preaching to the converted. It is a light read for those who want to learn more about the subjects of childhood mental illness but do not want to spend a month at the medical library. I cannot recommend this for anyone who craves anything beyond some personal interest stories and "common sense" sililoquies.

After I finished "We've Got Issues," I bought four copies to give to friends. We need a way to move discussions about childrens' mental health forward, and this book -- because it is so well written -- helps us do that.

I agree with another reviewer that the material in the book is not revolutionary. Warner writes:

"Most of those who need mental health services don't get any care at all. Too much power and influence has been given to drug makers, rendering the science the public relies upon for information highly unreliable. Too much stigma remains. We tend to believe that, today, we have moved beyond the age-old prejudices against people with mental illness. But, in fact, that prejudice is alive and well in our time and has a new and socially acceptable face: it expresses itself in the eye-rolling laments about "pushy parents" and "drugged-up kids."

In 2005, Peter Kramer made the exact same points in his book "Against Depression."

But Warner, who writes principally for intelligent moms (she's the author of a great book about motherhood, and is also a former NY Times columnist), takes the message closer to home. The first part of the book -- where she tells about how the book came to be written -- is especially persuasive.

Parents would be wise to pick up a copy of Judith Warner's book, read through the research she presents, and begin to face their fears about mental health issues in their own families and schools. It would do a world of good.

First, I would endorse the positive observations in the first two reviews. The book's account of the journey from one point of view to another makes it highly accessible. Warner recognizes that the same behavior in different degrees and people can reflect Disorder, Trait, or Gift. Variant attention can be Attention Deficit Disorder, Attention Direction Diversity, or A Different Drummer; thinking outside the box can be a gift, unless one is in an ensemble helplessly running counter to the beat agreed on.
Warner's book is nicely complemented by Gary Greenberg's "Manufacturing Depression."

I am not a parent who has the unique challenge of raising a child with mental illness. My best friend, who has a small child that has been through a gauntlet of testing, specialists, and behaviorists, recommended this book to me after she read it when she and her husband were at the point of considering medicating their daughter--when nothing else had worked.

I am so grateful to Judith Warner for writing a prosaic, thoughtful, honest (she goes into great detail right out of the gate about her faulty premise when she first planned to write this book), compassionate book. Before I read this book, I had vague, uninformed, holier-than-thou notions about children "with issues" and their parents, and Warner not only changed my mind, but she has made me a vocal advocate for better children's mental health care, and for the parents who, by and large, struggle exhaustively to find treatment for their children.

Warner lays out the case for the reality of children's mental illness, without avoiding the sordid history of psychiatry and the pharmaceutical industry. It is a complex topic, and she manages to advocate on behalf of children without ignoring the very real reasons that many people have for doubt and distrust of mental health care.

The bottom line is that there is a pervasive, accepted notion in our culture that children would be fine, normal, if we would do any number of things differently. If we moms would quit our jobs and focus on the kids, if we fed them organic fruits and vegetables, got rid of our televisions, and moved to the countryside, we could avoid the specters of ADHD, depression, bipolar disorder, and the myriad of other, *very real* mental illnesses that affect children in our communities.

Rather than sitting atop our high horses, criticizing parents and children who are truly suffering, it's time we rejected the flat, antiquated meme about "bad children and worse parents," and started talking compassionately to those folks, and talking--as a society--about what we could and should be doing to give our children and their parents a hand.

I am truly, truly humbled by this book, and by the lack of compassion I didn't even realize I had been showing toward people who are grasping in the dark for solutions. They don't need us throwing hand grenades at them while they do it.

For many years, I've read with gratitude Ms. Warner's smart, heartfelt essays on her blog with the New York Times.

During this time, she was writing against the tide of "ADHD is a Gift" mania that held sway until the economy tanked. Yes, in reasonable doses, pointing out that ADHD is not "all bad" was a very useful idea, a necessary balance. Trouble was, the Gift Propaganda typically came in overdoses, serving only to confuse the public, the media, and many vulnerable parents of children with ADHD.

Being on the front lines of ADHD advocacy, as a volunteer in Silicon Valley and online, I knew that solid information about ADHD and its coping/treatment strategies were vitally important to the lives of real people -- and the futures of real children. It could, in fact, make all the difference.

Nervously sensing that the Go Go Economy of yesteryear was a false one, and that when it tanked, people with ADHD would be the ones most at risk (of losing jobs and medical insurance, falling into bankruptcy and losing their homes), I felt a sense of urgency on this subject. And that is why I was always grateful to find Ms. Warner's column, often an isolated spot of compassionate clear thinking in a sea of misleading anti-science fearmongering.

It's also why I am grateful now, to have this book as a resource for parents who want the best for their children with ADHD and yet whose heads are spinning at receiving so many critical and conflicting messages from their friends and family members about "pathologizing childhood." Readers of "We've Got Issues" will find a thinking parent's voice of clarity. Ms. Warner calmly acknowledges all the complexity faced by families trying to make sense of the most medically advanced and yet confusing landscape any generation has ever faced when dealing with their children's physical and psychological health. And she helps them to squarely and honestly face these issues.

For her five years of research, Ms. Warner interviewed parents, psychologists, psychiatrists, researchers and therapists. She found cases in which children were over-diagnosed and others where they were under-diagnosed. She talked with parents about the consequences of giving or not giving their children medication. And she explains how a nexus of contemporary life and scientific advances have created new paradigms for viewing children's health.

The irony is that Ms. Warner set out to write a very different book than "We've Got issues", one that looked more skeptically upon the "over-diagnosing of children" that increasingly has seemed epidemic in our culture. As she delved into the research, however, work on writing the book stalled, inexplicably for a time, until Ms. Warner discovered, "the problem really had to do with my book idea. Which, I started to realize when the ink on the contract was barely dry, maybe wasn't all that good."

What made her change tack? An excellent journalist's willingness to face an issue without preconceived bias. A willingness to research with toughminded intellect but also a compassionate heart a complex issue that calls for care and caution, not more hype. (Kudos to her, because the hype-filled books are easier sells and guaranteed to get an author on talk shows.)

I can't say enough good things about "We've Got Issues" and the admirable integrity of journalist Judith Warner. This is a book that will help people to think through sometimes frightening ideas with sense and compassion.

I was so excited when I first read about this book; finally, someone who understands the countless lives and families helped, even saved, by psychiatry! As an adult with mental illnesses that first struck when I was a young teenager, it was incredibly validating to read about how the author came to understand the struggles and heartbreak of those who are directly affected and have firsthand experience with both mental illness and mental healthcare. I give the author major props for her openness about her previous misconceptions and how she changed her mind, and for taking an unpopular position in a debate that is frequently dominated by ignorance, prejudice and downright cruelty. That said, some of the scientific theories and experiments she describes sound problematic at best to this college undergrad, which made me wonder how a seasoned journalist could take them seriously. Nevertheless, I think her conclusions are generally spot-on(her observations about the abysmal state of mental healthcare, particularly for children, are unfortunately accurate in my experience) and the book is an easy and engaging read.

This gives parents an opportunity to benefit from Judith Warner's indepth research on the pros and cons of medication for children with ADD/ADHD.