Great stuff. I think part of the issue is that these disorders are over-diagnosed, in kids at least. Some people do have very real problems -- having been around people with truly severe ADHD, anxiety, and depression, medication really can help in the right cases. But as you state, just having trouble in school or feeling melancholy for a time doesn't warrant a diagnosis, and certainly doesn't warrant medication. We're treating the symptoms, not the cause.
Mental health is a tough subject. It is likely that we over prescribe drugs for mental health, but it's also true there are mental health issues that require drugs. I have friends with bipolar disorder who absolutely need drugs to stay stable, but they were originally mis-diagnosed with depression. Mental health diagnosis is imprecise compared to other forms of medicine.
Making the problem worse is the shortage of mental health professionals. Many people might benefit more from therapy than drugs, but good luck finding a good therapist! Drugs, unfortunately, scale better than people. AI might help a lot here, and the results from AI therapy are promising.
But I do worry about people self-diagnosing and self-treating their own mental health. Suicide rates are too high and while drugs can be bad, they are vastly better than that. We need some better, more scalable way to help people in this area!
Agree fully, and note I would not include bipolar in the discussion of 'popular' psych meds prescribed to large swaths of the population. Those are necessary, uncontroversial and help improve lives.
I always thought the chemical interpretation of mental illness is at least part BS, if not more. Not that there aren't neurotransmitters and various chemicals involved, but it's not like they take a serum sample from your brain during the latest trip to the psych ward, and say, "oh, lookie here, your serotonin is low, better take some Prozac."
Speaking of ADHD meds, I got a lot of good pharmaceutical grade speed that way in high school and college. It was fun until the Adderall turned my tongue blue... and as you point out, it wasn't from my own prescription! That was back in the 90s, so I can't imagine the situation has improved.
There are much cheaper ways to address anxiety, depression and the like. Journaling, cold showers, proper sleep and exercise, maybe some herbal supplements. Talking to a friend, family member, mentor or spiritual elder about your problems instead of paying some therapist (who doesn't know you from sue) exorbitant fees, so they can give you some pat answer that doesn't flow from being part of your life except in this strange way. But then, Big Pharma and its lackeys won't make much money off of these kind of timeless treatments for melancholy.
Sure, if you are full blown schizophrenic, maybe you need to take some lithium or something, but for many people this is not the case.
BTW I highly recommend the book "We've Had 100 Years of Psychotherapy and the World is Getting Worse" by James Hillman and Michael Ventura. It was what convinced me to drop out of college where I was going to get a psychology degree... I just re-read it. It still stands up.
Great comment, and yes of course this is why I said 'popular' psych meds in the title. With very acute/extreme conditions such as bipolar disorder the meds are a godsend and obviously necessary.
I liked Roadruck's comment too. Very true. I think of boredom as a gift. Boredom can lead to good culture. Gen X is rightly celebrated for our music, and so much of it came from not having anything to do, from being bored, and finding something to do. So boredom can lead to creativity, when you aren't overly stimulated -you turn inwards and one of the things that can lead to is good art in all its forms to share with others.
There is probably something about feral free time within this discussion as well. As you wrote, "It’s clear they are simply not getting enough physical play as we continue to pretend it’s natural to sit latent for hours on end. No one evolved for that, normal boyhood is ADHD. We need to fix schools if millions require being drugged to survive them."
The fact that so many of the newer built schools look like prisons architecturally doesn't help anyone's state of mind either. If we want our kids to flourish the environment itself should be harmonious not brutalist. The built environment has a profound effect on our psychology.
Getting into nature, into the green, away from the screen would help, as would just being more physical, doing things, to balance the mental aspect of education. (And I say this as someone who hated gym class! -I was a scrawny skater punk :)
Adhd wasn't invented when I was at school or I'd have been diagnosed and probably medicated. I dodged that bullet by kicking and screaming my way through the education they tried and failed to impose on me. Setting a chain of events in motion that ended with hospitalisation and a bipolar diagnosis. Noped my way the fuck out of a lifetime sentence of lithium (harder than it sounds) and never looked back, except in pity at the ones who bought the narrative and were chemically lobotomised along the way.
The system doesn't like our kind. We're way too homosapien for them. They need us neutered and stupid. Otherwise it all falls apart. Guess what - it's all falling apart anyway and guess who won't survive the chaos when it comes? 😈
I call it cosmetic psychopharmacology. I once found a doctor in NYC to give me an adderall prescription, not because I had an ADHD diagnosis (I did not) but because I was looking for an edge in studying for the LSAT. (Never ended up going to law school in any event.)
Yeah if you are an adult and can make the decision as I said that's all well and good. But kids typically don't have a say, or really understand what they're getting into.
I think the trick is having all decision makers educated and not do a "set it and forget it" or a blanket answer to try to solve everything. I definitely had a say when I was 15 and pushed to make it happen.
Great stuff. I think part of the issue is that these disorders are over-diagnosed, in kids at least. Some people do have very real problems -- having been around people with truly severe ADHD, anxiety, and depression, medication really can help in the right cases. But as you state, just having trouble in school or feeling melancholy for a time doesn't warrant a diagnosis, and certainly doesn't warrant medication. We're treating the symptoms, not the cause.
I'm glad you found a better solution for you!
Mental health is a tough subject. It is likely that we over prescribe drugs for mental health, but it's also true there are mental health issues that require drugs. I have friends with bipolar disorder who absolutely need drugs to stay stable, but they were originally mis-diagnosed with depression. Mental health diagnosis is imprecise compared to other forms of medicine.
Making the problem worse is the shortage of mental health professionals. Many people might benefit more from therapy than drugs, but good luck finding a good therapist! Drugs, unfortunately, scale better than people. AI might help a lot here, and the results from AI therapy are promising.
But I do worry about people self-diagnosing and self-treating their own mental health. Suicide rates are too high and while drugs can be bad, they are vastly better than that. We need some better, more scalable way to help people in this area!
Agree fully, and note I would not include bipolar in the discussion of 'popular' psych meds prescribed to large swaths of the population. Those are necessary, uncontroversial and help improve lives.
I always thought the chemical interpretation of mental illness is at least part BS, if not more. Not that there aren't neurotransmitters and various chemicals involved, but it's not like they take a serum sample from your brain during the latest trip to the psych ward, and say, "oh, lookie here, your serotonin is low, better take some Prozac."
Speaking of ADHD meds, I got a lot of good pharmaceutical grade speed that way in high school and college. It was fun until the Adderall turned my tongue blue... and as you point out, it wasn't from my own prescription! That was back in the 90s, so I can't imagine the situation has improved.
There are much cheaper ways to address anxiety, depression and the like. Journaling, cold showers, proper sleep and exercise, maybe some herbal supplements. Talking to a friend, family member, mentor or spiritual elder about your problems instead of paying some therapist (who doesn't know you from sue) exorbitant fees, so they can give you some pat answer that doesn't flow from being part of your life except in this strange way. But then, Big Pharma and its lackeys won't make much money off of these kind of timeless treatments for melancholy.
Sure, if you are full blown schizophrenic, maybe you need to take some lithium or something, but for many people this is not the case.
BTW I highly recommend the book "We've Had 100 Years of Psychotherapy and the World is Getting Worse" by James Hillman and Michael Ventura. It was what convinced me to drop out of college where I was going to get a psychology degree... I just re-read it. It still stands up.
Great comment, and yes of course this is why I said 'popular' psych meds in the title. With very acute/extreme conditions such as bipolar disorder the meds are a godsend and obviously necessary.
Agreed. This topic gets me fired up. Thanks for a great post.
Good comment from a Twitter follower too, how these drugs are 'for the adults' not the kids: https://x.com/KrisRoadruck/status/1912488045472895447
I liked Roadruck's comment too. Very true. I think of boredom as a gift. Boredom can lead to good culture. Gen X is rightly celebrated for our music, and so much of it came from not having anything to do, from being bored, and finding something to do. So boredom can lead to creativity, when you aren't overly stimulated -you turn inwards and one of the things that can lead to is good art in all its forms to share with others.
There is probably something about feral free time within this discussion as well. As you wrote, "It’s clear they are simply not getting enough physical play as we continue to pretend it’s natural to sit latent for hours on end. No one evolved for that, normal boyhood is ADHD. We need to fix schools if millions require being drugged to survive them."
The fact that so many of the newer built schools look like prisons architecturally doesn't help anyone's state of mind either. If we want our kids to flourish the environment itself should be harmonious not brutalist. The built environment has a profound effect on our psychology.
Getting into nature, into the green, away from the screen would help, as would just being more physical, doing things, to balance the mental aspect of education. (And I say this as someone who hated gym class! -I was a scrawny skater punk :)
Adhd wasn't invented when I was at school or I'd have been diagnosed and probably medicated. I dodged that bullet by kicking and screaming my way through the education they tried and failed to impose on me. Setting a chain of events in motion that ended with hospitalisation and a bipolar diagnosis. Noped my way the fuck out of a lifetime sentence of lithium (harder than it sounds) and never looked back, except in pity at the ones who bought the narrative and were chemically lobotomised along the way.
The system doesn't like our kind. We're way too homosapien for them. They need us neutered and stupid. Otherwise it all falls apart. Guess what - it's all falling apart anyway and guess who won't survive the chaos when it comes? 😈
I call it cosmetic psychopharmacology. I once found a doctor in NYC to give me an adderall prescription, not because I had an ADHD diagnosis (I did not) but because I was looking for an edge in studying for the LSAT. (Never ended up going to law school in any event.)
My full dose ritatlin 20 years ago side effects were bad. It did help a lot.
My 5mg add extended release has been a gamechanger when I discussed with my Dr in my late 30s. The 3month check ins definitely help.
Yeah if you are an adult and can make the decision as I said that's all well and good. But kids typically don't have a say, or really understand what they're getting into.
I think the trick is having all decision makers educated and not do a "set it and forget it" or a blanket answer to try to solve everything. I definitely had a say when I was 15 and pushed to make it happen.