Sunday, December 07, 2008

// // 25 comments

I'm Feeling Much Better Now...

by Reb Akiva at Mystical Paths

Dixie Yid posted an article compiling a series of articles and info from Rabbi Horrowitz on ADD/ADHD and medication. Here's some interesting info they missed...

Risperdal is an adult anti-psychotic medication for adult schizophrenia that started being given to children diagnosed with ADD, ADHD with "overbearing" behavior or having overbearing behavior alone. Overbearing behavior being horrible "syndromes" such as Oppositional Defiant Disorder or Conduct Disorder.

Oppositional Defiant Disorder is defined as "child is aggressive and tends to _bother_ others, or argues with adults, refuses to listen, is angry or resentful".

Conduct Disorder is defined as someone who "tends to break the rules, such as stays out at night after parent says come in, skips school, lies to get something or avoid work, or more seriously has stolen, bullied, or done anything else 'bad'."

"Over 5% of children have ODD, and over 6-10% of boys and 2-9% of girls have CD."

The primary drug of choice for these horrible conditions affecting 15% of children is ... Risperdal.

Recently the NY Times reported that US Congressional Investigators found that Johnson & Johnson, the drug company who developed Risperdal and marketed it for children "paid the doctor $1.4 million dollars" and "funded a research center for $1 million". The scientific research on Risperdal was NOT, it turns out, written by independent doctors, but rather "was drafted by the company and given to the doctor to sign — as if he were the author".

You'll surely recognize the behaviors above as normal for children in troubled and difficult circumstances as well as some normal childhood and adolescent behaviors (not ones we want children to have, but ones that do occur within normal situations as well). Today, thanks to the wonders of the drug companies, we can merely give our children these "very serious psychotropic brain altering medications" and the behaviors will magically go away.

No need to actually address the problems, nor to teach our children to improve their midos (attributes). Just pop a pill and make it all better.

I am certain having written this some irate parent is going to comment about how their absolutely uncontrollable child turned around their life with this medication. Thankfully, for your child there was this medication, and for a few others who truly have brain function issues that put them outside the bounds of normal societal operation. But 15% ??? That's 1 in 7 children who, per the drug company, NEED this medication.

In the average US yeshiva, 15% of the student body is psychotropicly medicated. There is no doubt we have defined many normal childhood behaviors as abnormal and avoid solving many real situational problems by just giving feeding our children a few happy pills.

Harsh, yes. True, also yes. We don't need to work on discipline anymore, just drug 'em. We don't need to pay attention to their problems anymore, just medicate 'em.

I'd like to focus on the last line of Rabbi Horowitz's article... "And along with all the challenges come opportunities. ADD/ADHD kids and adults are generally charming, outgoing, intelligent and ready for action. Their drive for excitement and stimulation, if channeled correctly, can produce high degrees of success later in life – in the communal arena, in business, and in other areas that require quick thinking, quick action and creativity. ADD/ADHD adults are often the ones that can run full steam ahead and still have enough energy to walk (or rather sprint) a few miles at the end of the day."

Indeed. Lets eliminate the outgoing, intelligent, DRIVEN people. The ones who invent, create businesses, open yeshivot, build shuls, do outreach, who spearhead the path. Then we can happily all be mediocre together.

BTW, I thought one of the whole points of Torah was to work on our midos, to overcome and improve the negative aspects of our natures and transform that ENERGY to a drive towards HASHEM. No need anymore, pop a pill and make the negative go away. So there's no drive towards Hashem, it's the least price we can pay for a quiet classroom. Thank you Johnson & Johnson, no need for this Tanya or Likutei Mohoran anymore.

25 comments:

DixieYid (جنوب يهودي) said...

Reb Akiva,

Unfortunately, it sounds like you are applying the bad scientific methods that you are stating were used with Risperdal to AD/HD and the various medications for that condition as well.

Furthermore, you seem to be laboring under an assumption that AD/HD medications are primarily for the purpose of making classroom or home management easier for teachers and parents, rather than for the good of the child.

It also seems as if you are confusing inability to focus, uncontrollable impulsivity and an inability to concentrate with problems with midos.

Children with AD/HD are unable to learn basic skills they need for life since they can't focus on learning to read or write long enough to learn those skills. In almost every subject in school, whether limudei kodesh or limudi chol, reading and writing are a necessary part of those subjects. If children lag behind in these, or in any other step in the cumulative process of learning, they begin to fail in school, feel like failures, and therefore act out in other areas in school, to mask their inability to function in school.

Low self esteem, a lack of friends, frustration, misbehavior, depression and going off the derech are much more serious "side-effects" than properly dosed AD/HD medication.

As Rabbi HOrowitz pointed out in his articles, as adults, these children who will one day be CEOs, communal leaders and entrepreneurs will be able to make choices about their occupations that will be well suited to their AD/HD nature. At that time, they may very well not need the medication since they will be able to channel their nature through their own life choices.

However, all children have to sit still in classes learning basic subjects that require a tremendous amount of time sitting still in a classroom setting. A 6 or 8 year old is not able to make the kind of lifestyle choices that would enable him or her to channel those AD/HD characteristics in an adaptive way. At that stage in life, the symptoms of AD/HD are almost exclusively unadaptive and have serious consequences for the child.

*Properly dosed*, and in consultation with a doctor who specializes in this issue (psychiatrists/neurologists/some pediatritians) AD/HD medications have few and minor side effects. The common side effects (like lack of appetite) are often far more minor than the sometimes catastrophic side effects of not treating this condition.

Confusing the symptoms of AD/HD as a moral problem with the child that need to be solved through midos improvement ignores the real and non-volitional aspect of the condition. Unfortunately, such an approach creates even more problems than it solves since it makes the child feel even more guilty than they already feel about their inability to succeed in school. This just exacerbates the low self-esteem and acting out that can result from failures in school.

More minor cases of AD/HD can be handled with behavioral techniques. And when this is the case, it should be treated that way. However, there are a children (and adults) whose AD/HD cannot be adequately treated by non-medical means. In such cases, it is more cruelty than kindness to deny them the treatment they need and thus subject them to all of the dangerous side effects of non-treatment.

-Dixie Yid

Myfanwy said...

The sad truth of the matter is that psychotropics are way over prescribed for both children and the elderly and are not used strategically. On the other hand, it's good that these medications exist, if used as an adjunct to primary treatment strategies as opposed to being used as a solution.

kobi said...

in america on talk-radio there's a program advertised called 'the total transformation'. it is cds/dvds that teach parents how to properly discipline/teach their children to behave properly. people rave about how simply knowing the right language to use and how to follow thru creates remarkable changes.

this is certainly far preferable to any drugs. save the drugs for the politicians.

DixieYid (جنوب يهودي) said...

myfanwy,

Absolutely, medication is great as part of a multi-front effort to help children succeed.

Kobi,

If only it were true that magic words could sove the deep and important issues that children suffering from AD/HD are suffering from.

Just as get-rich-quick schemes are usually too good to be true, overnight "solutions" to major issues are just as illusory. You ought to keep in mind that those advertisements are paid by the seller of the product, and are therefore unreliable as a source of information about what works or doesn't work.

-Dixie Yid

Myfanwy said...

Please stop equating magic with with stupid superstition. Magic and superstition are not the same thing. Real magic exists and it's neither superstitious nor for the lightminded.

Anonymous said...

Modern day psychiatry has no knowledge how to HEAL what afflicts the mind - so this is the way they can control the symptoms and alleviate some pain. I'm still waiting for some Kabbalist to start working on the remedies on how to heal - CURE what ails the mind/psyche - from a neuroscientifical/holistic approach. So far - NOTHING. Why is that?

If you know please post the answer.

DixieYid (جنوب يهودي) said...

Anon,

It is true that there is no way, at the current time, to cure the causes of AD/HD at their root, but for those people that need them, they are the only option for success at the present time. However, just because a real cure isn't invented yet, it does not mean that we should not treat the symptoms. Just it would be cruel to tell a nearsighted child that he couldn't have glasses just because "there may one day be a cure for nearsightedness" (assuming it was before Lazik), it would be just as unfair to withold Aderall/Concerta/Ritalin/whatever from a child who needs AD/HD medication in order to succeed in school/socially.

-Dixie Yid

Anonymous said...

I think what lies at the root of all of these disorders are the blueprints set out pre-natally and post till the age of 3 and children being bombarded with toxins, vaccines, bottled formulaes and removed from Nature, indoctrinated with plastics, vinyls, electronics and electro-magnetic fields in conjunction with egocentric-based caretaking by parents who are essentially adult-children themselves.

That said - to medicate symptoms might alleviate the pain and acting out in the short term but long term there is the danger of causing the brain/neurotransmitters/receivers more harm than good. And with that at the forefront of our consciousness, it would do us well to begin looking for alternatives that treat and heal the system simultaneously.

jos boersema said...

The psychiatry field (in Holland)is (also) corrupt: the pharmaceuticals pay for parties and free lunches for the "independent university" researchers and anyone they can find who may be in the loop for the prescription of drugs like Risperdal, Zyprexa. Elly Lilly is a big name in this, they sell their pills for big money. If you go look on a psychiatry "ward" here, you`ll find it looks great, friendly people, and so on. But, the psychiatrists seem prefer one thing: drug the patients. For some patients that is great and they readily say so. For the other half (about 50%), drugs means nothing or destroys the quality of life and turns people into zombies.

Curiously, the situation in the sixties was completely the opposite ! Patients would talk all day about their lives, which turned out to not work either. Now it is from that extreme into the drugs extreme: if you are unluky you will not have 1 conversation about your live even in a decade. This attitude by psychiatrists/companies has fueld the current corruption problem. It gives people who are likely guilty for damaging children/people the perfect excuse: no, the child was not abused, no, "it is ADHD for unknown reasons, and now with drugs he/she is a nice quit zombie ... " ("... like ourselves" I guess). Society does not want to change, and therefore enjoys putting the blame on the victim, whether that is deserved or not is irrelevant. We still live in the middle ages in some ways.

I honestly wonder how many people have commited suicide because of these pills. It is said they have a low suicide rate, but that sounds like they simply file all suicide under other causes. There must be thousands of suicided from these drugs because of what they do to the quality of life.

Patients should be shameless in sharing their negative experiences with this, otherwise how many more victims will there be from this corruption of sciense. (Don`t get me wrong: these pills can have a function, and for some people they do work. But they are given to too many indiscriminately, and as replacement to other forms of help.

(I speak from direct and long experience. Psychiaters are corrupt, they got to be demoted because they have a too physical/materialistic-chemist way of looking at people, except of course at their need for a high paycheck and kickback I guess ...)

All this stuff is known I think, but things don`t change fast enough. Be very careful with psychiaters, and never forget to consult with psychologists too and seek non-chemical treatments (first). !!!

Anonymous said...

Anyone considering medicating a child needs to watch this -

http://www.pbs.org/wgbh/pages/frontline/shows/medicating/

DixieYid (جنوب يهودي) said...

Anon 10:45:

Thank you for the link. Those 3 videos are very informative. Nicholas, the three year old in the first video seemed to clearly have AD/HD, though there would be no reason for him to start medication at that age, since he will not really fall behind in anything at that age. When he starts learning to read and write age 5 or 6, they would probably want to revisit the issue as part of a multi-faceted plan to make sure he would succeed in school and socially. It did seem that his parents were in denial about the issue, but it was the first time they'd heard about it so it was understandable. Any suggestion that he needed medication at that age though seemed unwarranted. What exactly the problem from the perspective of the child's welfare if he can't sit still at age three???

Nichole was a really great story about the comparison between the failures, and all of the problems that accompany that, of a child without the medication she needs and her success when her AD/HD obstacle is removed, with the help of the medication.

The third part pointed out a big problem that exists when any company trying to sell something can ethically pay the unbiased doctors who are supposed to have a duty to their patients wellbeing.

In law for example, under the New York Code of PRofessional Responsibility DR 5-107, a lawyer is prohibited from receiving a benefit from anyone related to his representation of clients, except with the client's informed consent. Of course doctors should be held to the same standard. It is silly to suggest that despite being paid to advocate a drug, that a doctor can remain unbiased about prescribing it. In this, I think doctors should have the same ethical rules that lawyers have.

It would seem that parents should ask their prescribing phicisian if he or she is receiving any financial benefit from any of the drug companies that are being considered for their child's treatment. Furthermore, as another commenter suggested, it would be wise to speak to a Psychologist as well (not an anti-medication idealouge either, but one who will look at a child's best individual treatment plan).

-Dixie Yid

Neshama said...

I have my doubts about Rabbi Horowitz. Yes I know he is lauded by many in and out of the field; but I have a nagging concern that some very good minds have been convinced via 'belonging to the mainstream' and 'subscribing to 'control' methods via drugs', and being 'educated by the American system* of doctoring' and I feel that their priorities are not in the right place.

So much in the Frum world is concerned with externals, "how will it look" "what will "they" say? I'm sorry, but it's just too easy to prescribe pills for all the ills that effect people today. And these ills are symptoms of a lifestyle gone awry.

And I'll say something else that most people will not agree with and will not even understand. Reverend Wright was not so off base when spoke about how 'whities and blackies' have different methods of learning. He was in his own distorted way hi-lighting a uniqueness of the human being, in that the WHOLE person needs to be taught and not everyone learns the same way.

I don't believe you can cram a well-crafted curriculum down the throat of every child, making them into good little robots, i.e. there is more than one way to teach. The 'method' has become more important that the child.

It's all symptomatic of how the American lifestyle has affected the Jewish way of living.

DixieYid (جنوب يهودي) said...

Neshama,

It is unfortunate that you mistake R. Horowitz, one of the loudest voices against superficial "what will the Shwartzes say?" Yiddishkeit, as a proponent of that method. His whole Project YES program is all about individualized learning and education for those who learn differently. It would be better to learn about someone first before shooting off motzi shem rah about him.

As to your points regarding the fact that it is the ideal to educate individuals in different ways, according to how they learn best, I and Rav Horowitz (obviously) would agree with that.

Regarding whether children suffering from AD/HD are prodcts of "a lifestyle gone awry;" Besides being a horribly offensive way to talk about children who cannot function properly in school, it is false. No one's "lifestyle" causes a child to be unable to focus on a lesson or learn to read because of the inability to pay attention or sit for more than a few seconds. It's that child's nature.

After consultation with educational, psychological and/or medical professionals and trying different methods looking for effectiveness, medication is sometimes necessary for some children to succeed in school and life. The "side-effects" of continued failure in school without the medication for that child are very serious as I mentioned above (discouragement, depression, lack of self-esteem, acting out to mask the inability to function in school, going off the derech, etc.).

It is quite ironic to advocate the good of the child and individualized teaching while advocating a blanket, one-size-fits-all opposition to AD/HD medication for those children that need it. I pray that if Hashem should should place a child *in need* of such medication in your care, that you will open your mind to a wider array of solutions for that child's benefit.

-Dixie Yid

Leah W said...

Good Morning

I have not had a chance to read all the blogs as i have to prepare for the day, but i would like to add some first hand knowlege. i am a 23 year year old, married, college attendee who was diagnosed with ADHD 1.5 years ago. i could not understand why my post graduate grades where sinking like a stone, and yet i KNEW that i knew the information. i would sit in a classroom of 68 students and get increasingly frusterated. i would squirm, and twitch, and write notes because I COULD NOT CONTROL IT!!

people have often asked me how i got through high school, & i tell them in all honesty, because Hashem gave me two wonderful gifts - i can memorize on the spot (aka as the teacher is talking) and i was drama head in high school so i was able to fudge my way through.

in college someone suggested looking into the ADD/ADHD part, and i discovered that i was classic ADHD material. it was like reading my personality on a spread sheet.

it took almost a year before my dr. and i found the right combination of meds, and B"H i am still in school, doing well.

i would like to point out a few things if they were not obvious. 1) i was an adult when i started to develope the classic symptoms and had to be on meds - but i had shown symptoms all my life
2) i had NO WAY of controlling said symptoms without medication
3) i desperatly needed those medications to continue in school

just one last important point. when i was first diagnosed i refused to refer to ADHD as a disability (even though it is classified under the Americans with Disabilities Act as such). i erroniously thought that it was something that you deal with and move on. but, in the 1.5 years that i've been dealing with it i have come to realixe it effects every part of your life. if my husband tells me to pay the bills, i forget. if i am given homework for school, i forget... lay people don't realize it but details surround your every motion and that is what a lot of ADD/ADHD people are bad at.

so while perhaps it is over diagnosed, and not everyone should be medicated, don't let that sway you from the very dire need of some people. it can and will make a difference in their life.

Leah W said...

i was rereading my comment from a few minutes ago, btw, it's 7:45 AM, and i realized something that may not be apparent to some lay people. i would like to point it out to you.

the first part of my comment is well articulated and without spelling errors (i think). the second half is a little disjointed, has typos, and may not make that much sense.

the reason for this is it is 7:45 AM, i have been up for an hour reading and writing on this site, and i have not taken my meds. i am unbelieveably twitchy right now and i can not sit still. just a thought for all those 'don't medicate people' thinkers out there. some of us desperatly need it.

Rachel Tzipporah said...

Personally, I agree that most kids are overmedicated. SOME really need it, but I think that number is much, much smaller than those recieving medication.

Im lucky I didnt grow up now. Doctors wanted me on antidepressants and would have had me on ADHD medicine if it had been developed then as it is now. My mom (vehemently against these things) helped.

I flourished once I hit middle school and had different classrooms and teachers to break up my day. Now I am k'h a successful writer - although I still struggle with corporate mentality that asks me to sit for 8 hours straight like a robot.

The rest of the issues got sorted out over time, and with some insightful counselors, I learned how to not only work around my "different" work style, but use it to my advantage.

Most kids need this kind of counseling, NOT drugs.

DixieYid (جنوب يهودي) said...

Leah W,

Thank you for sharing what you have. Reb Akiva and others chalk it up to choices kids make, who therefore have to work on their midos. Other people think it's just made up. For them, because B"H they don't have that kind of non-volitional inability to focus so they just project their own perception of reality onto everyone else and assume that people "could really control it if they wanted to." Let them learn a little Likutei Moharan and Tanya and work on themselves. If only it were that simple.

I appreciate your story and hope that it opens people's minds to the realities of AD/HD for those people who do suffer from it.

Rachel Tzipporah,

I appreciate what you're saying as well.

It may be that medication is often overperscribed to people who don't need it for classroom management reasons, or whatever, but as you pointed out, for those people who would really benefit from it, it is a lifesaver. And it should not be withheld from them on some kind of idealogical basis, just because it is wrongly given to some kids who don't need it.

B"H you didn't need it and were able to compensate in other ways, Chasdei Hashem. Kol tuv.

-Dixie Yid

Akiva said...

Dixie Yid - You mischaracterize what I said. Certainly these behaviors are real. The question is twofold - at what level are they "aberrant" and have we created a situation where more and more formerly somewhat normal behavior is characterized as problematic.

Example - a person is somewhat forgetful. Annoying and life impacting, definitely. Take a pill, or keep a to-do list or other compensating measures?

A somewhat impulsive person may occasional take risks - like a kid climbing a tree and jumping off, he could break his arm G-d forbid. And as an adult, his tendency towards impulsiveness could lead him to jump into relationships without thoroughly thinking it through - it could also lead him to quit his job and try starting a company.

He can curb that impulsiveness with a pill - and society will lose that company start up attempt. But he'll have a more calm normal mediocre life like everyone else.

Neshama said...

First of all, I think we can all agree that we ALL WANT THE SAME THING. WE WANT OUR CHILDREN TO GROW HEALTHY AND ABLE TO MEET LIFE HEAD-ON EQUIPPED TO FACE THE REALITIES OF THE WORLD WE LIVE IN THESE DAYS. Some just question the application of certain pathways.

That said,

One can have doubts about a person without it being classified as “shooting off motzi shem rah about him.” Why so angry? I didn’t say anything negative about Rabbi Horowitz. I have heard him speak, and have read some of his articles. This means I have some knowledge about his efforts. He has taken on a crusade that many more parents should and perhaps are involved.

So sorry if I led you to believe this, but I do not think this:  "...children suffering from AD/HD are prodcts of "a lifestyle gone awry;" Besides being a horribly offensive way to talk about children who cannot function properly in school..."  Such a strong attack!

Not the children, rather the method of diagnosing and treating suffering children is what I was implying. The method(s) of putting them in categories with terms that fall under particular methods of medicating them is what bothers me. 

On the contrary, to the point of, "No one's "lifestyle" causes a child to be unable to focus...", could be argued that lack of adequate bonding, early stimuli during crucial growth stages, diets lacking empty nutritional value, a bump on the head from a fall down the steps, could contribute to learning disabilities and could cover the gamut of "inability to focus".

Ah, yes, "some children...."  This is the yardstick that needs to be applied. It is all too easy to clump children showing certain outward signs of difficulties into squares and triangles of medication categories is what bothers me. 

The drugging of America is taking a new turn. The following article is interesting but very scary:

Commentary
Nature , | doi:10.1038/456702a;
Published online 7 December 2008
Towards responsible use of cognitive-enhancing drugs by the healthy. Society must respond to the growing demand for cognitive enhancement. That response must start by rejecting the idea that 'enhancement' is a dirty word, argue Henry Greely and colleagues. Today, on university campuses around the world, students are striking deals to buy and sell prescription drugs such as Adderall and Ritalin — not to get high, but to get higher grades, to provide an edge over their fellow students or to increase in some measurable way their capacity for learning. These transactions are crimes in the United States, punishable by prison [balance of this article can be found at http://www.nature.com/nature/journal/vaop/ncurrent/full/456702a.html

My opinion is the OPPOSITE TO “one-size-fits-all opposition to AD/HD medication for those children that need it.” It is not opposition to RESPONSIBLY DIAGNOSES.

I forgive the pain and your intention in the following directed toward me: I pray that if Hashem should should place a child *in need* of such medication in your care, that you will open your mind to a wider array of solutions for that child's benefit.”

In your response to another commenter of, “And it should not be withheld from them on some kind of idealogical basis, just because it is wrongly given to some kids who don't need it.”

So you do concede that it may be WRONGLY given to SOME KIDS that don’t need it! This was my entire point.

And might I add, Reb Akiva does a great deal to apply Likutei Moharan and Tanya in his outreach to suffering neshomas that eventually find ‘themselves’ and ‘their place in society’ where they can function with the G.od given ingredients that go into creating their personalities, which in effect collided with a myriad of inadeqacies existing in our fragmented society and with some holding distorted priorities pushing ‘their perspective’ on others.

My last thought on this situation is an analogy:

Someone makes a soup or stew in a big pot, then the contents are scooped out to serving bowls until we reach the bottom of the pot; and there we find bits and pieces and what one would call the dregs of the stew -- There is a chassidishe story or song about these rich, thick dregs that become the choicest bits and pieces from all the ingredients that are actually favored by many with eclectic taste buds. Who doesn't like to "scrape the bottom of the pot"?

Well, my analysis is that in these end days before the arrival of Moshiach, there are certain neshomas that could be compared to "the choicest bits and pieces, scraping the bottom of the pot" of thousands of generations of neshomas that are returning for their last tikkunim.

I believe that the many neshomas we are witnessing these days who are struggling with one thing or another are in need of our reaching out to touch their emotions and pains and difficulties as a forced expression of achdus that the Great and Awesome Hashem is forcing us to be involved with.

I hope I have explained myself in a way that you can understand my point and received it with the affection I feel.

Kol Tuv

DixieYid (جنوب يهودي) said...

Akiva,

In those practical examples that you gave, I would agree with you. I think it is clear from my comments that medication is not the answer for *all* children who have any slight difficulty with anything in life. If that didn't come across as abundantly clear, I appalogize.

I can't disagree with you because the examples you have given are from cases where (based on the limited facts) medication wouldn't be warranted.

However, what you did not address in your post or public comment is whether you would withhold medication from those children who are heavily affected by their AD/HD in school and socially, and whose parents have tried therapy/behavioral methods/tutors/etc, etc. etc. first? In those cases, would you admit that medical treatment such a child could be lifesaving?

Neshamah,

With regard to your comment about R' Horowitz, you said that you thought his priorities weren't in the right place and that he was part of the section of the frum world more concerned about externals, etc. Such an allegation which is so deeply at odds with everything he is trying to do sounds like a false allegation, though I'm sure this was due to a lack of knowledge rather than any intentional effort to impute his intentions.

And yes, my words criticizing your comment about children with AD/HD being products of a lifestyle gone awry were intended to be strong. Although you sounded like you were talking about the conditions themselves that children may be suffering from, I now understand your clarification that you were referring to misdiagnosis as a product of a lifestyle gone awry. My criticism of those harsh sounding words was not directed your actual intention as defined by your subsequent clarification.

You originally never mentioned that you acknowledge that medication is needed for those children who need it (after propper evaluation of the child, a risk-benefit analysis, etc.), and that your concern is *only* about misdiagnosis and irresponsibility in the dissemination of meds for the wrong reasons. You have clarified that this is what you believe, which is a good thing.

My hope that you would open your mind more if you were ever in a position as a parent of such a child was predicated on your implication by omission that you were *always* opposed to medication. Since you've clarified that such an understanding of your first comment was mistaken, I appologize for wrongly assuming that you weren't already open-minded in such a way.

On the other side of the coin, my comments have been focusing on those children who do have *serious problems* keeping up with their grade level in school. The obvious implication of this is that it is very wrong to medicate those children who do not have such issues, and have parents or teachers who want to medicate them just to make their own lives easier.

Like any serious medication, it should only be taken for a legitimate need for the patient him/herself, and not to make other people's lives easier.

However, the main problem I had with your comment, as well as Reb Akiva's post, is with making the kind of blanket condemnations of the recognition of AD/HD as a condition and with the use of medication as a treatment for this condition that y'all have made. When you do not clarify that you are only criticizing *mis*diagnosis, and medication for *those children* who don't need it for their own success, you contribute to the fear of recognizing and treating those legitimate cases of AD/HD. It can also cause those kids' parents to be fearful of necessary treatment options that would make all of the difference for those kids to succeed. If you do not clarify that for the small number of kids who need it, these drugs can be *lifesaving*, you are perhaps unintentionally contributing to a dangerous one-size-fits-all blanket opposition to AD/HD medication that some people (not yourselves) actually do subscribe to.

I would encourage you & others to be more careful with your words and to at least make a caveat or two when your point is not actually as sweeping and broad as it first appeared.

-Dixie Yid

Anonymous said...

I think you all need to read this and internalize the information making it Knowledge, Wisdom and Understanding. If you think you can feed children toxins and put chemicals in their bodies and bloodstreams without causing havoc - you're WRONG. Capital W. And to continue feeding them horrific diets and then drugging them on TOP OF THAT? It's criminal - no matter how many excuses you come up with.

Now read!

http://www.naturalnews.com/001868.html

Akiva said...

Dixie Yid - My dear friend, please re-read what I wrote and I think you'll find that I specifically DID address what you are writing. I don't make a blanket statement, I do however strongly insinuate that the medications are seriously overprescribed.

Here's where I say that: "I am certain having written this some irate parent is going to comment about how their absolutely uncontrollable child turned around their life with this medication. Thankfully, for your child there was this medication, and for a few others who truly have brain function issues that put them outside the bounds of normal societal operation. But 15% ??? That's 1 in 7 children who, per the drug company, NEED this medication.

In the average US yeshiva, 15% of the student body is psychotropicly medicated. There is no doubt we have defined many normal childhood behaviors as abnormal and avoid solving many real situational problems by just giving feeding our children a few happy pills."

Neshama said...

Dixie, I don't doubt that you mean well, and that your intentions are coming from an earnest place; I only take exception to your misguided accusation about what you read into what I said about the Rabbi. Please correct that publicly.

I only expressed some doubt (reservations); which is a personal analytical assessment. This was based solely by SOME of what I heard him say. Let me make it clear that I do not denigrate his wonderful work.

Much gratitude also goes toward the other non-professional people in the helping field who are counseling many of our distraught youth in a one-to-one manner; really getting to know them in order to help them.

The rest of my comments were about OTHER professionals that many many people feel like me that they diagnose too quickly the use of drugs.

Tell me, what did our ancestors do with children who could have been deemed troublesome? These medications were not available back then. I propose they worked with them on a one-to-one basis; as well as finding a way to keep them in the family environment.

I further accuse the medical establishment of being greatly influenced by doctors who have spurious financial links with pharmaceutical companies.

I propose the drugging of America has its roots in the written results of medical experiments performed in Germany during WWII. Many of the doctors landed in America. I don't recall the name of the book now, but many years ago this was all documented in a chilling book.

Please let's put this topic to rest for now. Maybe, Dixie, you could open your own blog for an ongoing dialogue.

Kol Tuv

DixieYid (جنوب يهودي) said...

Reb Akiva,

I see from the quote that you pointed out that you did address the legitimate need for medication in some circumstances. So I appologize for saying that you didn't acknowledge that. Although it seems to me that you are minimizing the legitimate cases of of children who do suffer from this, you indeed did not make a blanket statement, as if it applied in all cases.

Neshamah,

As to what you said about Rabbi Horowitz, I didn't hear you clarify any possible misunderstanding on my part when I reiterated your assertion that "his priorities weren't in the right place and that he was part of the section of the frum world more concerned about externals, etc." If I am somehow mis-explaining what you said, please clarify. At any rate, this point has been beaten into the ground at this juncture. To the extent that you meant what I understood you to mean, I would just suggest reading more of his articles to get more background.

Interestingly, it is important to consider what people did before these medications were available, as you mention. We may also wonder how people used to function before all kinds of other medical advances were made. Before quaduple bypass heart surgery, people died younger of cardiac arrest. Before glasses, people just made due as best they could with bad eyesight. B"H, people with these conditions today can live much longer and more productive and happier lives because of these advances.

Similarly, before AD/HD medications existed, people had to just make due as best they could, or they wallowed in failure. Either way, I assume they didn't just roll up into a ball for the rest of their lives and cease contact with the world just because they had these challenges to deal with.

However, you don't have to go all the way back to "ancient times." Even when I was a kid, after Ritalin was invented, not everyone who needed it used it or that particular medication may have had side effects making it not worth it to use for certain people. Therefore, we have lots of relatively youthful examples of what people with unmedicated AD/HD did with themselves.

I can tell you that I know a number of people who went to yeshiva their whole lives and never learned to read Hebrew fluently or understand it. They're great people but they literally went through 14+ years of yeshiva without learning almost any skills or information! One can look at the fact that these people did in fact manage to grow up, and that they did good things with themselves and with a sweeping gesture, say "See, everything turned out fine without the medication!" However, if one looks beneath the surface, one could ask how much better or more accomplished or adapted they would have turned out had they been able to function properly on some basic level in school as children to actually learn what was being taught to them. If this was the case with them, then it was Ratzon Hashem for them and it was lechatchila for whatever reason, but just because people *used* to live with certain disabilities doesn't mean that we should consign our children to that same fate even after treatments are invented!

L'ma'aseh, what has come out of this discussion is that there is no major qualitative difference between what you and Reb Akiva and I are saying at this point. Y'all emphasize the dangers of overmedicating (which I agree with) and I am emphasizing the dangers of not medicating those children who need it (which it sounds like y'all would agree with as well).

As to the matter of me convincing you to put more emphasis on the needs of children suffering from AD/HD or you convincing me to focus more on the needs of non-AD/HD's children being over-diagnosed with AD/HD and mismedicated, we'll all just have to agree to disagree.

-Dixie Yid

An O.T. said...

The above discussion has been all about perceptions and internal manifestations.
I will try to simplify this. HOpe not too much.
What we know is generally this:
The brain works by the flow of information across neural paths, from one neuron to another.
Certain chemicals are needed to enable this to occur. Different chemicals have different effects on how the brain performs.
In ADD /ADHD, the brain is not producing enough of certain chemicals, or is excreting it too quickly. Either way, results in brain dysfunction.
The medications generally assist in the movement across from nerve to nerve.
These are not imagined, and to date we are not able to vountarily make our brains make more of the chemical needed.

Try to imagine yourself having not slept for 24 hours, and driving in the car, while listening to someone who is trying to teach you something technical. You just don't absorb it. IF you try to listen, you get irritated.
This is what it is like for many ADDers. There are similarities with narcolepsy - a sleep disorder.
Now if you have to stay up, and force yourself, you will be edgey and anxious easily. This too is like the ADD experience.
One major problem in ADD is that if there is not enough of the chemicals in the frontal lobes of the brain, the person's executive function goes to, well, all over the place. The ADDer literally cannot control their mind.
They cannot make themselves remember to remember.
Lists? maybe, but easily the list is lost, or a person habituates to it, and doesn't notice it anymore.
From what I have seen, the Jewish observant community is pretty ignorant about this and many other neurological problems.
A big problem is that when the brain cannot find the correct chemicals, it grabs the next best thing, which happens to eseentially induce anxiety and fight or flight response. Which is why you see all the huge acting out in schools. The kids are being forced to conform, their brains don't go along, and this can literally through them into a huge panic reaction.
Sitting still is literally painful.
And the lady above - Leah - stated what has been proven. ADDers on meds do in fact have much better fine motor skills then when off, and it is so robust as to be observeable.

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