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A common interpretation: children with behavioral or emotional problems are being overmedicated by psychiatrists too busy to provide therapy, at the request of parents too busy to provide a healthy home environment. A corollary of this interpretation is to blame schools too busy to provide recess or activities for fidgety boys.

And usually the blame extends to the pharmaceutical companies that market medications in pursuit of profits. First, most of the prescriptions for stimulant drugs and antidepressants are not from psychiatrists. And drug companies, while frequently maligned, have reduced, not increased, their marketing budgets in the US.

If psychiatrists, parents, schools, or drug companies are not the culprit, who is? The answer is potentially more complicated and more worrisome.

We’ve Got Issues: Children and Parents in the Age of Medication

Is it possible that the increased use of medication is not the problem but a symptom? What if more children were struggling with severe psychiatric problems and actually the problem was not over-treatment but increased need? And, there actually are large increases in the incidence of Type I diabetes and food allergies. Skepticism regarding increased rates of emotional and behavioral difficulties as opposed to increases in other medical disorders can be attributed in part to the absence of biomarkers or laboratory tests for psychiatric diagnosis comparable to glucose tolerance tests for diabetes or anaphylactic reactions for allergies.

Absent these kinds of consistent, objective measures for mental disorders, we cannot distinguish between a true increase in the number of children affected or simply changing values or trends in diagnosis. Clearly context matters. What one parent might consider hyperactivity, another parent might consider healthy exuberance. What physicians once called attention deficit hyperactivity disorder ADHD , often now elicits a diagnosis of childhood bipolar disorder, leading to a fold increase in prevalence from to No question, in a field without biomarkers, there is a risk of over-diagnosis.

No question, subjective diagnosis could invite unnecessary treatment and over-medication.


  1. We've Got Issues: Children and Parents in the Age of Medication!
  2. We've Got Issues: Children and Parents in the Age of Medication by Judith Warner;
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But what if the increased use of medication reflected more children with severe developmental problems and more families in crisis? What if the bigger problem is not over-medication but under-treatment?

An Overview of Substance Use

Hearing that 7. Only five percent of American children take psychotropic drugs, she writes, yet that many suffer from extreme mental illness, while another 15 percent endure at least minimal illness. Not only has Warner never met a parent who lunged for the medicine cabinet to dope up their kids, but some fought the medication route as long as they could, to the detriment of their child. Warner cites research that girls, minority children and those with less-educated parents are undertreated for ADHD.

Careful reporter that she is, the author acknowledges that some experts might dispute parts of her thesis.

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Other signs of childhood trauma—teen pregnancy, school violence, crime, substance abuse and suicide—have declined, and Warner reports special professional skepticism about exploding rates of bipolar diagnoses in children. There was a problem adding your email address.

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