S/He’s Crazy

I am as guilty as many for using that expression be it both passive and aggressive. But in reality I have used it professionally. The term is often a bland name to dismiss someone’s behavior or ignore them when we don’t agree or understand their view. I could say that about Ginni Thomas, wife of Supreme Court Justice Clarence Thomas, but I think I actually mean it. There is something wrong there when you read her texts and missives to others regarding the election of 2020 and her hysterics over Trump’s loss. Her reaction is as nuts as Trump’s and the irony is that Trump and aides referred to Ginni as nuts during his time in the White House dealing with her. And with that I have called Trump mentally unstable and still do to this day. At some level in the diagnostic tool of mental health, The DSM, has I am sure one if not many potential mental health disorders for which he qualifies. That also said it used to claim being Homosexual was a mental illness, so there you go. Today they have added Grief as a mental illness in which to diagnose and in turn receive insurance payments for that treatment which I am sure will include a wild series of costly drugs to add to the pharmacy cabinet; no matter what the ailment it seems most disorders do seem to rely on meds to treat them. Go figure.

Today I read an interesting article in the Washington Post, challenging the notion that the pandemic has contributed to a rising tide of mental illness in children, the idea that was prior to the pandemic it is in fact the same but it was not good before so there you go. To that I concur. In my experience working with kids in schools the reality is that it is the same as it ever was, bad, real bad. But the spectrum of which that falls is rather large. There are serious learning disabilities that I don’t consider mental illness and in turn are often again treated with meds and the child is the sole source of the problem. This includes ADHD and Autism. They are very very different illnesses and with a diagnosis of Autism that too crosses a broad spectrum that simply means an entire adjustment of expectations by the family and those with whom they work for or with. Teachers who know a child is on the spectrum can simply not use the same measures of discipline and expectations and in turn avoid the endless circle of what comprises cause and effect of discipline in a classroom. Well that is if one exists I have not been in many classrooms that have said expectations and in turn repercussions for children who fail to meet them. This has been largely due to the racial component and with that a child is often simply classified as a “behavioral problem” versus one who has perhaps a serious learning disorder or mental health issue. And families of color are already resistant to the labels of SPED so they are not willing or if are able to find those who can diagnose and treat appropriately. This is an issue the article discusses in length and when you look at the comment section you see affirmations of how race and racism contributes to the stress.

My last sub gig which I have written about where I truly thought about suicide as I wondered if this was all there is had a redo. Yes the school sent me back in there as the rotating cast of subs have equally hated the gig and this was the straw for me telling the office to NEVER put me in this woman’s class again. The problems are all on the Teacher, she is retiring, a coddler and again teaches health where there is no accountability for her curriculum in the testing measurements; that she is also a Coach, that enables her to have a faux concern for students masked as acceptance but is in fact ignorance. I will never forget her coming into the class and ignoring my presence which again says a strong message to anyone in her orbit. Did I take it personally? No and yes because I was there and the reality is that I was angry as a person and professional. Do I know this woman? No and let’s keep it that way or it will get personal. And with that the behavior in this class did not disappoint. By the end of class a boy had touched girl, how or where or why I did not see or care until it became so loud that I could hear her anger and retorts through my airpods. Yes folks, I wear them as I cannot listen to the endless vulgar discussions that transpire. The kids cannot manage handling a broom to clean up the food they spilled, they have no sense of behavior or manners and respect to bother caring. I had more signs in that room than a hospital has, from DO NOT SIT HERE, DO NOT CLOSE WINDOWS, THE ANSWER IS “NO”, Ms… M.. is not here do not ask me where she is when she is coming back. DO THIS AND DON’T DO THAT. Dozens of repetitive signs throughout the room and yet they still asked. Reading is a problem on some level and following directions another. With 5 minutes left I called Security over this one as it was not an issue I could ignore, the girl ran from the room and the kids followed as class was over. Another student had just arrived, demanded I change attendance to tardy and this began the day. If you think there are mental health issues here, yes. But it is much more complex from lack of nutrition, sleep, parental/family engagement, poverty, poor housing and yes all the other factors that contribute to children’s decline which can be Racism, Abuse, Neglect and yes Physical and Mental health problems undiagnosed.

We have had such long term problems in the schools that to blame the pandemic is absurd, it simply pulled back the curtain on a stage that was full of problems. I have finally given up caring. I had to for my mental health, as when I actually contemplated ending my life as a result of endless observations over 30 years of the failures of our communities to deal with these tragedies it takes a toll. So the real issue is what are YOU going to do about it? Oh yeah, get on social media and rage and rant with the rest of the squad. Cancel them, call them out, fail to actually deal with or communicate to another is too fucking hard so shout, scream and rage and remember – the kids are watching, listening and learning.

All in the Name

An outstanding article yesterday in the New York Times discussed the marketing of “Attention Deficit Disorder”and how by finding the right name for the right acronym is all part of the making of drugs but also of disease.

The article link is here and it is quite comprehensive with regards to how the sudden growth of varying prescription drugs and the diagnosis that fits has gone beyond those childhood years to adulthood. And includes of course the required celebrity imprinter, Ty Pennington, to endorse the drugs that somehow made him a better man. Shades of Paula Deen and her revelation of diabetes, after years of eating the crap she made and tales she spun, and her endorsement of a miracle drug.

The line of celebrities at the gate touting the miracles that resulted whence the ingested the cure for a myriad of ills has always been with us. But the marketing and insidious manipulation of those associated with ADD has been remarkable in its duplicity and aggressively.

And as always there is the kindly Doctor/Physician at the center of the controversy, a savior or a con, depending on how you see it. The dollars that exchange hands the sheer magnitude that shows when marketing a drug there is no page unturned, no avenue left unexplored.

Just like the little 6 year old who was expelled for “sexual harassment” there is undoubtedly a much more sinister cause and reason that this little boy with all his energy can be contained with a medication. Nothing ensure compliance and control more than a mass medicated society.

Here are some highlights of the article:

But even some of the field’s longtime advocates say the zeal to find and treat every A.D.H.D. child has led to too many people with scant symptoms receiving the diagnosis and medication. The disorder is now the second most frequent long-term diagnosis made in children, narrowly trailing asthma, according to a New York Times analysis of C.D.C. data.

The Food and Drug Administration has cited every major A.D.H.D. drug — stimulants like Adderall, Concerta, Focalin and Vyvanse, and nonstimulants like Intuniv and Strattera — for false and misleading advertising since 2000, some multiple times.

Sources of information that would seem neutral also delivered messages from the pharmaceutical industry. Doctors paid by drug companies have published research and delivered presentations that encourage physicians to make diagnoses more often that discredit growing concerns about over diagnosis.

It is amazing the depth and level that even supposed support groups and other benignly named acronyms will go to to ensure compliance and cooperation with the idea that your child will be better and more successful on a drug regime

The primary A.D.H.D. patient advocacy group, Children and Adults with Attention-Deficit/Hyperactivity Disorder, or Chadd, was founded in 1987 to gain greater respect for the condition and its treatment with Ritalin, the primary drug available at the time. Start-up funding was provided by Ciba-Geigy Pharmaceuticals, Ritalin’s primary manufacturer. Further drug company support helped create public service announcements and pamphlets, some of which tried to dispel concerns about Ritalin; one Chadd “fact sheet” conflicted with 60 years of science in claiming, “Psychostimulant drugs are not addictive.”

The program from the 2000 annual convention of the patient advocacy group Chadd thanked its 11 primary sponsors, all drug companies.

A 1995 documentary on PBS detailed how Chadd did not disclose its relationship with drug companies to either the Drug Enforcement Administration, which it was then lobbying to ease government regulation of stimulants, or the Department of Education, with which it collaborated on an A.D.H.D. educational video.

When I was investigating the malpractice I received from Harborview I found an innocuous named group, the “Traumatic Brain Injury Foundation”. I attended their support group meetings and found the same 6 people each with differing kinds of brain injury and utter uselessness and incompetence  from the organization with regards to support, information and other resources one would find beneficial in recovering from what is ostensibly a traumatic and life damaging illness.  The hilarious part was that the Social Workers who work in Harborview and are supposed to actually help clients do this refer TBI patients to this group.  Its like adding more idiocy on top of idiocy. A conversation with an idiot by one.

In Colorado, however, I found a highly organized and independent group divided and organized by brain injury ‘type’ and immense resources from where to find medical help to transportation. Theirs is group that clearly should be emulated and admired for who and what they do to provide community support to those in need and transition.   So you would be surprised given that state and its history of late.

I cannot say the same for the marginalized group I encountered here at home. And I found out why. They are nothing but more than a front for an Attorney who founded the non profit group and through his relationship with Harborview receives a list of all admitted individuals diagnosed with brain injury and how perfect has he is a Personal Injury Attorney. No conflict of interest or corruption there by giving names and contact information, as well as medical history to an Attorney who sues for a living. He is coincidentally a medical malpractice lawyer but I am sure that he would not have any problem defending those clients who found themselves a victim of malpractice by the same hospital that provides him with the bulk of his bread and butter right?

Now I am hardly Kalinda on the Good Wife investigating fraud and lies to ensure the firms good deeds go unpunished, I am simply someone who started asking questions and looking at the financing and funding behind a group that takes a non profit tax deduction and yet seems to do actually nothing for the betterment of the community it was intending or designed to serve.

And I would wonder why a Teacher who is not a Doctor or a Doctor would suddenly prescribe a drug for a disorder that has NO TESTING of any kind to a mother who simply could use some help herself – be it financial or emotional – shows a callous if not disengaged person.   And the first question I would ask them, “where did you get this information and who gave it to you.”  As my mother used to remind me, take it from the source. 

I find talking and more importantly listening is the key.  One wonders if someone had actually visited the Lanza home and spent time with the mother of Adam and really understood what was going on in the home to actually help her and in turn Adam would Sandy Hook have happened?

Very few diagnosticians actually do just that. In the turn em and burn em society we have less than 15 minutes per visit and the speed and necessity to generate profit encourages the most for the least when it comes to most industries. It is universal across the fields of industry, from medicine to law, to banking, we see the quick buck is the king to the joker that is you.

Our societal mores are the problem, the kissing bandit, no, he’s six and “gots lots of energy”

Maybe we need to bottle that and take it and maybe use that energy to actually not just listen but hear what is truly going on and then prescribe what they really need.

Mother’s Little Helper

In the 70s that meant Valium. In the 90s that meant Xanax, today it means Adderal – for their children. Rather than medicate mom the industry of Medicine has chosen to medicate the children. It builds stamina and addiction 12 ways. Get them young and they are hooked for life. And they say street drugs and pushers are the problem. Really when you are a major corporation you can deal all the crap you want and its all legal.

Then add the costs of medical care when it comes to substance addiction and what that means as withdrawal can be difficult if not costly, in more ways than one.  It’s not like the show Intervention on A&E in the best of circumstances.

I work part time as a Substitute Teacher. I used to teach full time but the politics of Educaton rivals the dysfunction junction for the dysfunction part quite nicely. I used to say it was the insane running the insane asylum. I know many good Teachers and Administrators but I know few and far between and you can blame Unions but its far more a complex equation than any basic math Teacher could provide. There are mulitple variables with co-efficients that change with each passing fad or fancy. I would love to teach again but not in this heated environment its not worth the stress.

And today this article about the current plan by of course Doctors who are revered have decided to also throw their hat in Education reform by hopping up the kids on drugs to enhance performance. Gee if that is what it takes then next up Teachers as Dealers and they can ensure little Johnny’s performance on standardized tests. And in turn securing their job as well; its a win win. Parents if you think that is why your kid’s teacher is suggesting he/she take drugs, this might be why. Or you clearly have a problem on your hand. Remember this an Intrinsic culture when claiming success – came from nothing, up by bootstraps; extrinsic when failing – blame Government, regulations, Unions or anyone else.

What I see is simple math. Kids are broken. They have no infrastructure. Which is good as well our overall infrastructure, from roads to schools are broken too! As we have an aging population whose kids are grown and out of the house the idea of voting for levies and tax increases are counter-intuitive and of course falls into the “not my problem” as well I don’t have any kids so why would I pay for yours. Meanwhile that same kid is breaking into your car as they have nothing better to do and need the cash. Long range thinking do they have a drug for that? This is not diagnosis this is labeling. Put a label on it and you do have a drug for that.

This to me is another attempt to discriminate and overtreat and misdiagnose people who don’t fit into a comfortable box and oddly, ironically or coincidentally that falls largely into the poor and/or minority class. Even the article mentions that this is just a bandaid to substitute for the real need of tutoring, counseling and structure. And the disturbing fact is that these drugs are all paid for by Medicare in full when better more effective manners are being eradicated from budgets. And soon if they have their way in Congress Medicare will be equally eradicated. This is going to work out well.

I see this new obession with drugs just another way Big Pharma is winning the war on drugs – by prescribing them. It beats the whole down the alley bit really. David Simon could do a new version of the Wire only in Hospitals or Doctor’s offices. Dr. Stringer Bell calling,

Attention Disorder or Not, Pills to Help in School

By ALAN SCHWARZ
Published: October 9, 2012

CANTON, Ga. — When Dr. Michael Anderson hears about his low-income patients struggling in elementary school, he usually gives them a taste of some powerful medicine: Adderall.

The pills boost focus and impulse control in children with attention deficit hyperactivity disorder. Although A.D.H.D is the diagnosis Dr. Anderson makes, he calls the disorder “made up” and “an excuse” to prescribe the pills to treat what he considers the children’s true ill — poor academic performance in inadequate schools.

“I don’t have a whole lot of choice,” said Dr. Anderson, a pediatrician for many poor families in Cherokee County, north of Atlanta. “We’ve decided as a society that it’s too expensive to modify the kid’s environment. So we have to modify the kid.”

Dr. Anderson is one of the more outspoken proponents of an idea that is gaining interest among some physicians. They are prescribing stimulants to struggling students in schools starved of extra money — not to treat A.D.H.D., necessarily, but to boost their academic performance.

It is not yet clear whether Dr. Anderson is representative of a widening trend. But some experts note that as wealthy students abuse stimulants to raise already-good grades in colleges and high schools, the medications are being used on low-income elementary school children with faltering grades and parents eager to see them succeed.

“We as a society have been unwilling to invest in very effective nonpharmaceutical interventions for these children and their families,” said Dr. Ramesh Raghavan, a child mental-health services researcher at Washington University in St. Louis and an expert in prescription drug use among low-income children. “We are effectively forcing local community psychiatrists to use the only tool at their disposal, which is psychotropic medications.”

Dr. Nancy Rappaport, a child psychiatrist in Cambridge, Mass., who works primarily with lower-income children and their schools, added: “We are seeing this more and more. We are using a chemical straitjacket instead of doing things that are just as important to also do, sometimes more.”

Dr. Anderson’s instinct, he said, is that of a “social justice thinker” who is “evening the scales a little bit.” He said that the children he sees with academic problems are essentially “mismatched with their environment” — square pegs chafing the round holes of public education. Because their families can rarely afford behavior-based therapies like tutoring and family counseling, he said, medication becomes the most reliable and pragmatic way to redirect the student toward success.

“People who are getting A’s and B’s, I won’t give it to them,” he said. For some parents the pills provide great relief. Jacqueline Williams said she can’t thank Dr. Anderson enough for diagnosing A.D.H.D. in her children — Eric, 15; Chekiara, 14; and Shamya, 11 — and prescribing Concerta, a long-acting stimulant, for them all. She said each was having trouble listening to instructions and concentrating on schoolwork.

“My kids don’t want to take it, but I told them, ‘These are your grades when you’re taking it, this is when you don’t,’ and they understood,” Ms. Williams said, noting that Medicaid covers almost every penny of her doctor and prescription costs.

Some experts see little harm in a responsible physician using A.D.H.D. medications to help a struggling student. Others — even among the many like Dr. Rappaport who praise the use of stimulants as treatment for classic A.D.H.D. — fear that doctors are exposing children to unwarranted physical and psychological risks. Reported side effects of the drugs have included growth suppression, increased blood pressure and, in rare cases, psychotic episodes.

The disorder, which is characterized by severe inattention and impulsivity, is an increasingly common psychiatric diagnosis among American youth: about 9.5 percent of Americans ages 4 to 17 were judged to have it in 2007, or about 5.4 million children, according to the Centers for Disease Control and Prevention.

The reported prevalence of the disorder has risen steadily for more than a decade, with some doctors gratified by its widening recognition but others fearful that the diagnosis, and the drugs to treat it, are handed out too loosely and at the exclusion of nonpharmaceutical therapies.

The Drug Enforcement Administration classifies these medications as Schedule II Controlled Substances because they are particularly addictive. Long-term effects of extended use are not well understood, said many medical experts. Some of them worry that children can become dependent on the medication well into adulthood, long after any A.D.H.D. symptoms can dissipate.

According to guidelines published last year by the American Academy of Pediatrics, physicians should use one of several behavior rating scales, some of which feature dozens of categories, to make sure that a child not only fits criteria for A.D.H.D., but also has no related condition like dyslexia or oppositional defiant disorder, in which intense anger is directed toward authority figures. However, a 2010 study in the Journal of Attention Disorders suggested that at least 20 percent of doctors said they did not follow this protocol when making their A.D.H.D. diagnoses, with many of them following personal instinct.

On the Rocafort family’s kitchen shelf in Ball Ground, Ga., next to the peanut butter and chicken broth, sits a wire basket brimming with bottles of the children’s medications, prescribed by Dr. Anderson: Adderall for Alexis, 12; and Ethan, 9; Risperdal (an antipsychotic for mood stabilization) for Quintn and Perry, both 11; and Clonidine (a sleep aid to counteract the other medications) for all four, taken nightly.

Quintn began taking Adderall for A.D.H.D. about five years ago, when his disruptive school behavior led to calls home and in-school suspensions. He immediately settled down and became a more earnest, attentive student — a little bit more like Perry, who also took Adderall for his A.D.H.D.

When puberty’s chemical maelstrom began at about 10, though, Quintn got into fights at school because, he said, other children were insulting his mother. The problem was, they were not; Quintn was seeing people and hearing voices that were not there, a rare but recognized side effect of Adderall. After Quintn admitted to being suicidal, Dr. Anderson prescribed a week in a local psychiatric hospital, and a switch to Risperdal.

While telling this story, the Rocaforts called Quintn into the kitchen and asked him to describe why he had been given Adderall.

“To help me focus on my school work, my homework, listening to Mom and Dad, and not doing what I used to do to my teachers, to make them mad,” he said. He described the week in the hospital and the effects of Risperdal: “If I don’t take my medicine I’d be having attitudes. I’d be disrespecting my parents. I wouldn’t be like this.”

Despite Quintn’s experience with Adderall, the Rocaforts decided to use it with their 12-year-old daughter, Alexis, and 9-year-old son, Ethan. These children don’t have A.D.H.D., their parents said. The Adderall is merely to help their grades, and because Alexis was, in her father’s words, “a little blah.”

”We’ve seen both sides of the spectrum: we’ve seen positive, we’ve seen negative,” the father, Rocky Rocafort, said. Acknowledging that Alexis’s use of Adderall is “cosmetic,” he added, “If they’re feeling positive, happy, socializing more, and it’s helping them, why wouldn’t you? Why not?”

Dr. William Graf, a pediatrician and child neurologist who serves many poor families in New Haven, said that a family should be able to choose for itself whether Adderall can benefit its non-A.D.H.D. child, and that a physician can ethically prescribe a trial as long as side effects are closely monitored. He expressed concern, however, that the rising use of stimulants in this manner can threaten what he called “the authenticity of development.”

“These children are still in the developmental phase, and we still don’t know how these drugs biologically affect the developing brain,” he said. “There’s an obligation for parents, doctors and teachers to respect the authenticity issue, and I’m not sure that’s always happening.”

Dr. Anderson said that every child he treats with A.D.H.D. medication has met qualifications. But he also railed against those criteria, saying they were codified only to “make something completely subjective look objective.” He added that teacher reports almost invariably come back as citing the behaviors that would warrant a diagnosis, a decision he called more economic than medical.

“The school said if they had other ideas they would,” Dr. Anderson said. “But the other ideas cost money and resources compared to meds.”

Dr. Anderson cited William G. Hasty Elementary School here in Canton as one school he deals with often. Izell McGruder, the school’s principal, did not respond to several messages seeking comment.

Several educators contacted for this article considered the subject of A.D.H.D. so controversial — the diagnosis was misused at times, they said, but for many children it is a serious learning disability — that they declined to comment. The superintendent of one major school district in California, who spoke on the condition of anonymity, noted that diagnosis rates of A.D.H.D. have risen as sharply as school funding has declined.

“It’s scary to think that this is what we’ve come to; how not funding public education to meet the needs of all kids has led to this,” said the superintendent, referring to the use of stimulants in children without classic A.D.H.D. “I don’t know, but it could be happening right here. Maybe not as knowingly, but it could be a consequence of a doctor who sees a kid failing in overcrowded classes with 42 other kids and the frustrated parents asking what they can do. The doctor says, ‘Maybe it’s A.D.H.D., let’s give this a try.’ ”

When told that the Rocaforts insist that their two children on Adderall do not have A.D.H.D. and never did, Dr. Anderson said he was surprised. He consulted their charts and found the parent questionnaire. Every category, which assessed the severity of behaviors associated with A.D.H.D., received a five out of five except one, which was a four.

“This is my whole angst about the thing,” Dr. Anderson said. “We put a label on something that isn’t binary — you have it or you don’t. We won’t just say that there is a student who has problems in school, problems at home, and probably, according to the doctor with agreement of the parents, will try medical treatment.”
He added, “We might not know the long-term effects, but we do know the short-term costs of school failure, which are real. I am looking to the individual person and where they are right now. I am the doctor for the patient, not for society.”