Wednesday, March 16, 2011
Over-medicated Kids!
For those of us who are parents or teachers, we know that there are a lot of kids out there who are over-medicated. Yes, there are children who genuinely need to be treated for ADD or ADHD, because without medication they can not conduct a normal life, but I would guess that about half of the children that are on medication for these 'conditions' does not need to be. I just perused an article that was in my RSS Feed from NPR about diet and the connection to ADHD, and I really like where research is headed. I am a big proponent of how much diet and exercise can effect your life, and here is a strong correlation between the two! Read the article, Diet and ADHD, and comment!
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What I like about this study is that it makes a connection between food and behavior, which is often either 1) forgotten, or 2) ignored. The reality is that it takes A LOT of work in order to narrow down what foods trigger certain behaviors. Managed care simply is not built in a way that encourages trial and error, many visits, or frequent data collection under the supervision of a physician. Medicine is a business, and economics plays into it on all sides, including insurance, doctor contact time, and the pharmaceutical industry. If you are a parent of a child with ADHD symptoms, you have to be willing to try more than one course of treatment before giving up. If you want to try adjusting/restricting diet (which I highly recommend), you need the attitude that the answers might not come right away and that you will have to experiment to find what works. Medication is somewhat easier to work with, but sometimes trial and error is necessary with this as well. However, a lot of children respond to the first medication that is tried, and they may stay on it for a long time. This promise of a "quick fix" is alluring, because it is easier and cheaper. I don’t use that term to deride parents who choose to medicate, but we do have to be careful that we don’t always choose the path of least resistance. Breakthroughs don’t happen by always going downhill.
ReplyDeleteWhat I don't like about this study is the wild logical leap that the researcher makes that suggests that because these symptoms can be treated with diet, that it does not constitute a disorder. They use the term disease, which is not typically how American psychology or behavioral medicine describes it, but I digress. ADHD is real, and it affects everyday function. The course of treatment does not really determine whether a cluster of symptoms constitutes a disorder. If a child has ADHD, his function is impaired. Impairment suggests disorder. Systematically watch a child with behavioral disinhibition (Barkley's hallmark of ADHD) for just 20 minutes, and try to think about how productive you would be with that kind (and frequency) of distraction. Just because eliminating a preservative or a food dye makes the symptoms go away doesn't mean a disorder isn't present. Unfortunately, I think people will this summary’s rhetoric about how ADHD isn’t a true disease and will not pay attention to what the message should be: that food affects behavior.
The future direction here is to develop an easy-to-follow protocol for parents to follow. If the diet isn't too weird (like restricting specific nutrients or something), then a parent ought to be able to experiment with the diet without the supervision of a physician. That's the only way I can see this catching on, because if it is always going to take a pediatrician's explanation in order for a parent to understand what a child should and should not eat, our managed care system won't support it. I don’t see mental health care catching up to physical health care anytime soon in the US, so we are obligated to work with what we have.