According to a report in the New York Times, almost one in five U.S. high school boys has been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), and over half of those takes medication (usually Ritalin or Adderall).
The American Psychological Association is planning to revise the definition of ADHD. To curtail over-diagnosis, you might think. You’d be wrong. It’s to allow even more people to be diagnosed and medicated.
There is no clear-cut diagnostic test for ADHD. It’s just a subjective judgment, based on talking with kids, parents, and teachers. And, the Times notes, even that process is often skipped due to time constraints and parental pressure.
It is indeed easy to sneer at all the medicated people in America – as though it’s not living authentically, like zombies, or something. Or to cynically cast the pharmaceutical industry as drug pushers trying to hook us on their products, for profits’ sake, contributing to ever-rising health costs.
Yet, the fact is, we get a lot of value for that spending. If living authentically and unmedicated means pain and suffering, and early death, you can keep it, thank you very much. Modern medicine gives us lives not only longer but of better quality. That’s worth paying plenty for. I’ve mentioned that someone close to me takes a medication that literally changed a crappy life to a happy life.
This is why Ritalin too is so popular. It improves self-control and focus, and school performance; it’s been called the “good grade” pill, the academic analog of steroids in sports. And as I’ve emphasized, America has a real problem with under-education. If Ritalin helps with that, good.
But what does bother me are the D’s in ADHD – “deficit” and “disorder.” It’s part of what I call the medicalization of normality. There isn’t one rigid behavior pattern that should be expected for everybody. Humans are complex and diverse and traits range along a spectrum, the classical bell-shaped curve. Some, for example are highly sexed (JFK, Clinton); others are the opposite (Nixon); most fall in between; but only at the extremes might it make sense to talk of “disorder” rather than merely normal variation.
The same applies to ADHD. This “disorder” should, in most cases, be more simply diagnosed as being a kid.
Now, as in everything, drugs like Ritalin have their trade-offs, with potentially undesirable side-effects. I generally believe people should be free to choose for themselves, but kids of course may be unable to. So caution is in order. But if families, weighing the risks, decide that such chemicals will improve the quality of a child’s life, I say go for it – with no need to stigmatize him as having a “disorder.”
Meantime pharmacology is advancing, and “better living through chemistry” will become increasingly available. Ritalin is just a foretaste; we can expect a more general “happy pill.”
This seemingly evokes Brave New World’s “soma” pill making everyone serene zombies. But this dystopian notion reflects what is again an irrational prejudice. There is no qualitative distinction between feelings induced chemically versus “naturally.” The neurons’ activity is the same, and any idea that one “should” feel different than one actually feels is incoherent. Anyhow, there is no virtue in authenticity to the extent it entails suffering that can be ameliorated. As I’ve argued, the only source of meaning, whatsoever, in the Universe, is the feelings of beings capable of feeling. How such feelings are affected is ultimately the only ethical touchstone.
Ethics does also encompass justice. And if you feel bad because you’ve done wrong, you should. But that’s a special case; more generally happiness is not deserved or undeserved. While some scolds do view it as something to be striven for, through a life well-lived, etc., the reality is that genetic make-up plays a big role. This makes happiness or unhappiness something befalling people, a matter of luck more than personal responsibility.
We actually already have widespread use of mood altering drugs: alcohol, tobacco, caffeine, sugar; and, for Depression sufferers, SSRIs like Prozac and Zoloft. But why shouldn’t everyone be free to utilize such a medication intended simply to make one feel better? Especially if it can be engineered to avoid the nasty side effects of drugs like alcohol or tobacco. (Even if addictive, that by itself would not be a problem absent other ill-effects, if the pill is widely affordable.)
I recently came across a 2009 Free Inquiry article, The Case for Happy-People Pills, by Mark Alan Walker. He argues that such a pill would be profoundly egalitarian. Differences in the genetic propensity for a happy disposition constitute an inequality more salient than wealth differences. After all, wealth is only an instrumentality toward happiness, and one can be happy without it. A happy pill would enable us to distribute more fairly the bottom line desideratum of well-being, by giving it to those not lucky enough to win the genetic lottery for a happiness predisposition. And this, unlike with wealth redistribution, could be achieved without taking anything away from anybody.