While raising three children through elementary school, high school, and college, I often struggled with the question whether I was doing all I could to make certain my children had the same chance to succeed as their classmates. I would feel as if I was not doing my job as parent, if my children had a condition that made school more difficult, and I did nothing to help them.
Untreated attention problems place children at greater risk of failure in school, which in turn lessens the chance that they will eventually have a sense of control over their destiny in a career they enjoy. Children who fail in school are more likely to reject authority, and more likely to engage in behaviors that cause problems down the line, including smoking cigarettes and experimentation with drugs and alcohol. Many adults treated for attention deficit disorder remark that ‘if I knew about this earlier, I would have gone to college.’ Unfortunately, that pathway is often out of reach, after a history of low test scores and failures– not to mention the impact of failure on the person’s self esteem. How do we know if our children have a condition that impacts their performance, that would benefit with treatment? For that matter, how do we know if we ourselves have such a disorder?! Given the difficult questions, most people take the path of doing nothing, and letting the chips fall as they may. In this post I will discuss the considerations that are made over a diagnosis of ADD, and describe the process for treating ADD, including the cost.
For as long as I can remember, news stories have decried the increased number of people, young and old, diagnosed with attention deficit disorder (ADD) or the syndrome’s hyperactive cousin, ADHD. Growing up in the 1960′s and 1970′s, I remember overhearing discussions about students sharing my classroom who ‘took medication’.
About 4 years ago I started a blog for my psychiatry practice, entitled ‘Psychiatric Times.’ The web address for that blog was fdlpsych/blog, and when I eventually bought the ‘patienttimes’ domain name, I lost most of my posts during the migration process. I recently stumbled across the old posts at archive.org, a site that contains ‘snapshots’ of the internet that have been archived over the past twenty years. Remember Netscape?
I plan to reassemble the old posts over the next few weeks. Of all those old posts, the only one that stood out in my mind — a post about a certain conceptualization of psychiatric medication— was not part of the archives. Bummer… until I searched the web using parts of the post with Google. To my surprise, I found that old post, copied on several web pages belonging to other people, with no mention that I was the person who wrote the post in the first place. If imitation is the ‘sincerest form of flattery’…. Then I’m flattered.
I copied the post from one of the sites to reclaim it as my own. In case you’ve seen it before— I can assure you that it started here, at my blog!
The Warm Coat Theory of Psychiatric Prescribing
I sometimes envy scientists and physicians from 100 years ago who took credit for all of the easy discoveries and attached their names to them. The Bernoulli Principle, for example, describes how the pressure of an inviscid material decreases as the rate of flow of the material increases, i.e. why the disgusting shower drapes in cheap motels are pulled toward people taking showers. I’m sure I noticed that effect when I was about six years old, and had it not been already figured out (and named for Bernoulli), I would have come up with my own theory eventually! But life is harder now, and the days of just thinking real, real, hard and coming up with a ‘discovery’ are long gone.