Overselling A.D.H.D.

> so it all boils down to the pharma companies not creating enough drugs for ADHD?

Conflating "treatment options" with "drugs" is kind of the central thesis of Schwarz's critique...

> to me it feels like the author is just manufacturing conflict for the sake of selling a book.

If you've ever worked in or around a private practice doctor's office, you're aware of the pressure to proscribe.

Many, many doctors are high-quality professionals who make decisions solely in the best interest of the patient. Many other doctors are only interested in pushing as many people through the office as possible, spending less than a minute per customer and quickly writing a script for whatever the pharma rep is selling. A little bit for the perks, but mostly because it's a way to push as many people through the office as possible. The pharma rep provides fantastic marketing and "educational" material that does the doctor's job for him, allowing him to push more people through than if he had to sit down and discuss an array of treatment options with the patient.

Regardless of the author's motivations, his critique isn't without merit (and certainly isn't specific to ADHD).

By "wider range of treatment options" he doesn't mean more drugs, he means nonpharmaceutical methods as well.

> ... Great, so it all boils down to the pharma companies not creating enough drugs for ADHD?

"a wider range of treatment options than an endless litany of stimulants" is not the same as "more drugs". Now, that could include non-stimulant drugs if those would be effective treatments for the condition, but the obvious meaning seems to be that the excessive pushing of stimulant drugs as a treatment has swamped non-pharmacological treatment options for ADHD.

I actually do have ADHD, but I'm unmedicated for well over 15 years now. This is completely by choice; every time a new doctor sees my medical history they basically ask in a rather pushy manner, "Ya want some pills for this?"

I didn't grow out of ADHD, but I have had to learn a lot of coping mechanisms. I can't work with silence, I always have to have music on. If I don't, I start wandering around the internet and getting nothing done.

Pair programming is basically God's Gift to ADHD. All of my team knows that they are encouraged, and appreciated if I'm driving and they're like, "Whoa you are WAAAAAY off on some tangent here. Our card says to do X, let's do X."

To-Do lists and journaling are a way of life. Note taking during meetings is simply a must. If I don't, my short term memory gets really slippery and I start interrupting people with questions and thoughts lest I forget them in the next 20 seconds.

But the point is, while I have all sorts of weird hoops to jump through, they really aren't things that normal, non-ADHD people don't do. I just rely on and need them far more than non-ADHD people. Yet every doctor wants to give me a prescription for my ADHD. This is extremely ironic give a later point in this comment.

Meanwhile, while medication isn't an answer all the time, sometimes it is really the only option. Taking the medication is hell.

I know a group of people I grew up with who can't get through a workday without prescription stimulants. Then, they have to try to handle kids sporting events, social events, etc. on the weekends without it to try to keep their tolerances down. Still, those tolerances don't quite reset fully. Almost everyone in that group has to take regular PTO every 6 months and go off them for two weeks. They can't work. They can't clean the house. They can't care for their kids. It's pure misery. Sure, they may run off to a resort, but they're mostly just doing that so they can drink and sleep their way through withdrawals while their other half handles the kids.

In same group, there are a few that actively struggle to take their medication as prescribed as opposed to eating a 30 day supply in 10 days. We're talking getting the day's doses each morning from a significant other with the rest kept in a lock box that only said SO has the key.

Also, it's insanely embarrassing and stigmatized to get your medication filled when you're an adult. Pharmacies will be out of Ritalin when you show up to fill your prescription in the morning. "I don't know when we'll have more in, sorry." Then, a few days later you'll hear that same pharmacy filled your friend's daughter's prescription in 20 minutes a few hours after you left.

So on one hand, you have Big Pharma pushing the diagnosis and medication on children who are still neurologically developing. On the other hand, you have an informal cadre of pharmacists that think it's okay for kids to take this, but if an adult is taking it they're some meth'ed up tweaker. So kids who don't and probably shouldn't take these drugs are flooded with them. The adults that need it just to hold down a job and make rent can't get it.

The entire ADHD situation is just one massive, never ending mess. I'm so glad I'm on the lighter end of it and can side step the medication entirely.