As you know, DearReader, I enjoy talking about science with the Boss, aka the US taxpayer, aka my friends, neighbors and acquaintances. In fact I not only enjoy it but I think of it as responsibility both to them, the people who fund the NIH, and to my fellow scientists.
You are also likely aware that I have school-aged children and therefore this circle of interactions with the taxpayer includes chatting with the parents of children that my own kids interact with.
One of the conversations that arises fairly frequently has to do with medications prescribed for Attention Deficit Disorder / Attention Deficit Hyperactivity Disorder (ADD, ADHD). This is, of course, a big can of worms to be opening on the blogosphere and let me make it clear I’m not planning on discussing ADHD science per se.
In brief outline of the issues let us reflect on the following.
-as with most of the mental/behavioral disorders there exists a distribution or spectrum of traits, symptoms or behaviors. Depending on how you want to view them. At some point of extremity, we (meaning the clinical psychiatry/psychology communities) define or diagnose conditions as pathological and in need of intervention
-diagnosis is imperfect, we do not have alternate biomarker validation in most cases and there will always be those on the threshold
-specific traits or behaviors can be either trivial or maladaptive depending on circumstances.
-therapeutic intervention, even in the clearly pathological cases, is less than 100% successful.
-interventions which involve repeated or chronic administration of drugs which affect brain and other body systems have risks.
These end up being complicated situations for parents to navigate. Parents are subject to the usual stigmas about mental health, and are reluctant to consider that their child might actually benefit from therapeutic drugs. They are worried about the lasting consequences. They have, perhaps, run across the criticisms (some valid, many not) of ADHD diagnosis and medication that are available on the internet.
And their doctors are failing them.