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42 of 45 people found the following review helpful
on March 2, 2010
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 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.
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20 of 23 people found the following review helpful
on March 3, 2010
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!!!!
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17 of 21 people found the following review helpful
on March 19, 2010
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.
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6 of 7 people found the following review helpful
on March 23, 2012
Are kids today over-medicated and over-diagnosed by their hovering helicopter parents? Or, is all the medication and treatment necessary to help kids manage their very real mental disorders? Those are the questions Judith Warner addresses in We've Got Issues: Children and Parents in the Age of Medication. As Warner explains, she started writing this book based on the premise that today's kids are over-medicated and over-diagnosed, but as she continued her research, she decided that the media and it's anecdotal evidence were oversimplifying the picture.

As an engineer, I love that Warner actually researched the topic, and allowed the evidence to influence her thinking. I also appreciated that she has such an extensive reference list, over 50 pages for those who want to learn more. As a reader, I appreciated the well written style of the book. But, as a therapist, I thought the conclusions were too simply stated, and the conversational, anecdotal tone was relied on so much it interfered with a more rigorous analysis.

Surely, the truth lies somewhere in the middle. Some parents hover, expect too much from their kids, and pathologize normal behavior. Other parents, certainly the overwhelming majority of the families I've seen, are dealing with kids who are clearly struggling, kids who have evident difficulties, and their parents allow medication and diagnosis only with caution and reluctance. But the way to illustrate this truth is through facts and data, and too often Warner relies on examples and stories from the families she's interviewed. A compelling read, no doubt, but ironic in that Warner is criticizing the very type of research-by-anecdotal-evidence that she's using here.

Warner also criticizes the mental health treatment in our country, and I don't think anyone would argue with her. But she illustrates her thesis with a series of examples from many of the families she's met, who told of shoddy treatment and erroneous diagnosis. Warner complains because there's no clear path for parents to take, and they end up "wandering in the dark forest, without a compass, as they tried to figure out how to help their son." Again, although I agree with Warner's concerns, it's a sad truth that mental illness and its treatment is so complex that there's often more art than science involved. The best treatment may involve uncertain diagnoses, trial therapies, and a great deal of uncertainty. There may not be a clear path.

Still, I'm including this book on my blog list because, in spite of its shortcomings, it is a worthwhile and interesting read. With its extensive reference list there's plenty of material so you can take your own understanding to a much deeper level.
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7 of 9 people found the following review helpful
on March 24, 2010
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.
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9 of 12 people found the following review helpful
on November 22, 2010
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.
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4 of 5 people found the following review helpful
on January 16, 2013
Thank you for this book. I'm sorry Bookgirl, reading medical records all day long is not the same as seeing and working with a child too distracted to even hear his or her name called in a classroom. You have to experience, as a parent or educator, how destructive ADHD can be on early learning. I deal occasionally with parents who feel legitimate medication for an organic deficit is "drugging" their child. It's difficult to explain that the child's system in not in a normal mode and this medication gets them to that state so information can be understood and retained. Insulin for a diabetic child is not drugging them, it is getting their system to normal. My high-blood pressure medication gets my system to a normal level.

Armchair quarterbacks who criticize medication and have never seen the frustration that these children experience when the are unable to keep up and cope with the progress of the other children, are doing a terrible disservice to parents, and perpetuate an unfounded myth of drugging children. I can't tell you how many parents have come into my office a few weeks after their children start medication and in tears thank me for convincing them to look into that option. Those of us who work with these children know the dramatic turn-around that takes place in learning, and how this helps us to teach them strategies to cope with their ADHD so that eventually they can stop medication and self-monitor themselves.
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19 of 28 people found the following review helpful
on June 1, 2010
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 ( 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.
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7 of 10 people found the following review helpful
on March 5, 2010
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."
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5 of 8 people found the following review helpful
on April 25, 2010
This is a good, well-written, well-researched book for the most part. It is balanced, as far as it goes. Sometimes it is a little bit repetitious in my opinion, but not to the extent that it bores one to death. She just likes to provide all the evidence. I think it will be helpful to parents and to the general public--it avoids stigma, rash judgment, and polemics.

I have one major criticism of this book, however. I am not at all sure that the author is correct and that there are no "epidemics" of childhood mental illnesses and developmental disorders except those caused by societal pressures and better diagnoses. Ironically, she uses the words "toxic" and "environment" and "canaries in a coal mine" when discussing the social pressures and hazards of living in today's families and schools, but fails to realize that these terms could also be taken literally--in terms of the numbers of exogenous chemicals to which our children are exposed in the environment. Because of genetic diversity, some children (the "canaries") are going to be more vulnerable to these chemicals than others. The "blood-brain barrier" is not as absolute a protection, nor is the placental-fetal circulation as benign a filter as was once thought. Our newborns are born now with more chemicals than ever in their blood already. Medical treatment (yes, including added vaccines), household chemicals, plastics, etc. all add even more after birth. Pesticides, mercury in the atmosphere from coal powered plants, plastics, air pollution from paper mills and other industries add to the stew. There is NO scientific data says (or really, can possibly say) that all of this is safe, that there are no synergistic effects of all this on the most delicate and complex organic structure in all of nature: our brains. A deficit in nutrition, toxic carpets, lead paint on toys, a genetic vulnerability to mercury (like lupus-prone mice have), social stress (the author does discuss the effects of long term high cortisol levels), incidents like the PBB contamination in 1976 of the food supply (and consequently the bodies of the population) in Michigan--the list goes on and on. It is not possible by good parenting or just eating organic foods, or by avoiding articial colors and flavors,positive though these steps may be, to avoid all these factors. The damage caused may well require medication. It is toxicity, but in a more literal sense.

Yes, some children are the "canaries in the coal mine." Yes, genetics loads the gun and the environment pulls the trigger, as the author quoted...but please remember that, like other animals, we still breathe, drink, and eat. We even absorb chemicals through our skin. These exposures are just as real a part of the influence on the development of our children as parental nurture. Affection and appropriate attention cannot correct poisoning. Social policies that fail to take into account the effects of mercury on the brain when that mercury is breathed in by vulnerable children or eaten in the form of fish by pregnant mothers, are not looking at all the cost of coal-powered power plant.

Increased mortality and morbidity and also developmental defects of many kinds, are found in places like Love Canal where industries have been irresponsible. I strongly suspect that this is only the tip of the iceberg. No, we do not have enough information to prove it. But it isn't sufficient to blame parents (which this author does not do, to her credit), or pharmaceutical companies (even if sometimes, as she documents, their practices are unethical), or psychiatrists. Our schools are failing a large number of children because they really are facing novel situations--and not just lack of funds or the latest Department of Education rulings. Our children are affected more by these issues in every subsequent generation. We need to take responsibility for the health of our environment in a literal, not just a metaphorical way.

Other than this one glaring omission, this is an excellent book. I can understand the author's avoidance of these questions to some extent because many parts of the overall whole are controversial. But at least a disclaimer would have been helpful.

Kathleen Eickwort, PhD, Ecology, Cornell University
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