The “real” me: with medication or without?

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I’ve been doing research for my latest book and was interested to find studies are showing that students who take medication for AD/HD are conflicted about their identity. These students seem to be absorbing larger social impressions/myths that imply that some kinds of medicine are less valid than others.

While starting medication from a young age can allow a student to suddenly focus in class, students are also being impacted from a young age by the social myth that goes something like this, “Normal means being who you are without taking medication [unless you need medicine for life and death], so when you take medication for AD/HD you aren’t behaving like your normal self; you only are your normal self if you aren’t taking medication.”

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Obviously there are a few problems with the myth that says we aren’t our normal self when we take medicine, or that medicine impacts our identity and makes us someone else; that the behavior we exhibit when taking medication is not our ‘real self.’

In order to make it clearer why I think this is problematic, let me compare this version of what it means to be ‘normal’ or authentic, with what it would mean to be Type One diabetic and to not take insulin. We understand that people who need insulin and do not take it are more likely to have serious health impairments and that they will potentially die. So as a society we do not label someone who takes insulin as more or less their true self – we say they need to take insulin to maintain their health. As a society we suspend judgement about the person’s ‘authentic’ identity and tend to think that someone who is diabetic is their regular self while taking their insulin.

Yet, when someone takes medicine because of a health issue that affects their mental state, we seem – as a society – to be quicker to make judgements about the person: about how normal they are, about who they ‘really’ are; as if a person can be separated out and  should have to choose between being authentic, or being healthy. We don’t seem to be as quick to accept that a person can be their authentic self while taking their medication to remain healthy, or to function to their potential when the medicine impacts mental states. This seems most true for AD/HD medication but applies to a lesser extent to medications given for unrelated mental health issues (depression, anxiety, etc.)

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We’re giving young people in our society a very troubling message, and studies are showing that young people are absorbing this message. As a society we’re saying that there are medicines we see as being legitimate, and medicines which we see as enabling poor study habits, unruly behavior, and medicines which enable people who should be able to just ‘pull themselves together’ to get by without the effort other people put into life.

As parents, caregivers, and educators, we need to promote the idea that a medication that assists a child in being healthy, productive, and happy is not a crutch. Nor is the child less him or herself when taking their medicine. Just as our behavior will change if we don’t sleep for several days in a row, or our behavior changes if we consume a lot of sugar at once, our behavior can change under many circumstances. We remain ourselves, even when our behavior changes. Medicine may impact our behavior however, the medicine does not make us less real or genuine. We remain our true selves when we use medicine to assist our quality of life. We are not less genuine, less normal, or less our ‘real selves’ when we are using medication.

Of course, some people will always choose to not use medication and I certainly believe that individuals have the right to make choices. An insulin dependent diabetic who chooses to stop using insulin will have dramatic consequences. Young people who choose to stop using medication as they become adults entering college will also find they face some dramatic consequences; when any person stops using a medication that their body is accustomed to, both their health and their study habits will be significantly impacted. One’s body will react to any sudden change in chemical balance.

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Whatever medication a young person is accustomed to, if they are planning to stop using the medication on even a trial basis in college, I would suggest they begin this trial stoppage before college begins. At least allow one’s body the summer in between leaving high school and beginning college as an opportunity to begin the adjustment – I would also recommend staying in contact with a health care provider during this transition as any sudden change in body chemistry can threaten a person’s health.

Parents need to understand that they cannot force a student in college to remain on medication. Again, I would suggest families allow their students the summer months to practice what it is like to function without medication, so that students have some idea of what to be prepared for in college. I also recommend that anyone stopping their medication because they feel their identity/personality is impacted by the medication, work with a counselor. Identity is complex and fluid. We all tend to reach a point in our lives when we question who we are and what makes us our genuine selves. Students who have been medicated from a young age are increasingly finding this an internal debate that needs to be worked through and families can assist a young adult by making sure he or she has the necessary counseling support to assist talking through their concerns.

To recap: medicine is a valuable advancement that allows individuals to live a quality of life that is not possible without medication. Not everyone, however, will always choose to use medication, particularly if they are concerned that the medicine they take impacts their identity – their sense of self and personality. In cases where a person is questioning their identity due to the impact medication has on them (or on their behavior) then families can be supportive of counseling which helps a person work through the issues they are encountering. As a society, we can support the idea that a doctor and patient are best able to judge the medication a person legitimately needs and as individuals/groups we can spend less time and energy second guessing medical judgements about medication. The average person is not qualified to determine if someone really needs to take medication – leave that judgment to people who are qualified; when you hear someone else second guessing a person’s need for medication, then remind them that the doctor’s opinion is more valid than their personal bias.

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Whatever our personal bias about medicating children, particularly children living with AD/HD – we need to stop voicing these opinions in front of children. We, as part of our larger social groups, are having a negative impact on how these children view themselves. We, as individuals, can be the source of improving the social climate these children grow up in.

 

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