A cross post from Furious Seasons.
Bruce Levine, a clinical psychologist and writer, has an interesting article on Alternet today discussing his view that good old-fashioned teenage defiance has been medicalized and resulted in teens being doped-up in order to shut them up.
"Disruptive young people who are medicated with Ritalin, Adderall and other amphetamines routinely report that these drugs make them "care less" about their boredom, resentments and other negative emotions, thus making them more compliant and manageable. And so-called atypical antipsychotics such as Risperdal and Zyprexa -- powerful tranquilizing drugs -- are increasingly prescribed to disruptive young Americans, even though in most cases they are not displaying any psychotic symptoms.
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He's certainly right about how these drugs are used and their effects. It all gives new meaning to "teenage wasteland." Levine most directly links this dynamic with oppositional defiant disorder, an alleged mental illness that, among other symptoms, involves arguing with adults and refusing to follow adults' rules.
The problem with Levine's assertion is that it's not backed by any data. Is ODD diagnosed in teens more now than say 10 years ago? I suspect that it is, but I don't know. Certainly, much of the drugging of teens is tied to dramatic increases in the prevalence of bipolar disorder and ADHD in kids and teens, but I'm less clear about what percentage of teens is now taking meds due to a diagnosis of ODD. I'm sure it's much more than in 1995, for example, but absent a thorough academic study there's little data to point to on ODD.
And, are these diagnoses of ADHD and bipolar disorder the result of teen rebellion against stultifying environments--making them proxies for ODD in a way--or are they representative of genuinely disordered behavior? I suspect that Levine's views are close to the truth. By today's standards Jesus Christ would be diagnosed with some kind of mental illness and medicated into the ground. So would half the saints and ancient prophets. And, the punk rockers and goths? Goes without saying.
Levine has some fun with mental health professionals and how their own experiences and expectations shape how they interpret human behavior:
"When compliant M.D.s and Ph.D.s begin seeing noncompliant patients, many of these doctors become anxious, sometimes even ashamed of their own excessive compliance, and this anxiety and shame can be fuel for diseasing normal human reactions."
Yes, that sounds nice and objective and scientific. For some time, I've been criticizing doctors--especially psych researchers--who have set themselves up as behavioral and mood norms for Western culture. The funny thing is that many things doctors do in their training and careers strikes me as being so divorced from common human experience that one wonders who the screwballs truly are.
I mean if you are a teen stuck in a boring school, then not being defiant might be the greater sign of a problem.
Perhaps my views on this are shaded by my experiences as a one-time pharma rep, patient and reporter, but I've certainly seen oodles of behavior by docs that strikes me as containing the same kind of excesses which docs pick apart as signs of an illness in patients. If it's grandiosity and wildly expansive egos you want to see in our culture, then check out the self-love of surgeons and almost any researcher who's just published a study. I can assure you that they often view themselves as gods and goddesses and that skeptical questions about their work (as a reporter, I'm supposed to be asking those) are met with heavy doses of defiance. And so on.
Levine also lays some of the blame on Big Pharma:
"It would certainly be a dream of Big Pharma and those who favor an authoritarian society if every would-be Tom Paine -- or Crazy Horse, Tecumseh, Emma Goldman or Malcolm X -- were diagnosed as a youngster with mental illness and quieted with a lifelong regimen of chill pills. The question is: Has this dream become reality?"
Right now, it's not possible to say just how much this is a reality in American culture. I think many of us sense that something is going on out there--talk to anyone who works in a school system--but we are at a loss for hard data. For me, I'm not sure how much to blame the pharma companies. They are simply one set of actors in a dynamic that involves families, teens, doctors, therapists, schools, teachers, coaches, governments and so on.
What do you think?