Letters to the Editor
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Echoes of the past...
The deeper I got into David Amsden's essay the more I thought I was reading something I'd written thirty years ago. Oh to be in my twenties again, thinking I had all the answers and sharing them with everyone vis-a-vis broad sweeping generalizations and idealized notions of what life is all about.
As well intentioned as I'm sure Amsden's thoughts were, they suffer from the myopic hubris of youth, which his articulate writing doesn't do a very good job of masking. As another letter writer observed, this was an essay that felt like it should have been on Amsden's blog rather than on Salon.
Is it too late to append Salon's biggest misses of the past ten years?
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Brilliant!
On the basis of what expertise does Amsden declare such diverse conditions as adult ADD and generalized anxiety disorder "quasi-societal"? Oh, right. He sold prescription meds in High School to kids who needed to stay up late to study. That's the sum total of Amsden's expertise.
He could have troubled himself to do at least a little actual research into the validity of these conditions AS conditions, to lend his essay some faint air of credibility, but it was probably more fun to talk out of his ass.
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Life Stress vs. Stress Response
I have no argument with Amsden's overall point in this piece, but his chortled aside about "generalized anxiety disorder" as his "favorite example" of dubious, quasi-societal disorders betrays a striking degree of sloppiness in his research.
Generalized Anxiety Disorder has nothing to do with depression, and little to do with stress. It has to do with having an overactive (biochemical) response to life events, which seems to somehow trip a circuit in the brain, so that one carries on responding, at the biological level, in fight or flight mode long after the initial, anxiety-provoking event. GAD is not dissimilar to having a hyperactive immune system. In both cases, the body responds to an increasingly generalized number of 'threats.'
It's bloody hard to reset the circuitry, let me tell you, as someone whose been plagued by this for years. But it can be done without resorting to meds.
A more apt illustration of what Amsden is trying to say would be, for instance, "Malicious Mother Syndrome," which pops up in custody cases these days.
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Drugs and ADD
Back in the real olden days, the 1940s, yours truly had constant problems concentrating and was a real pain-in-the-ass to my mother and other family members. My school grades from kindergarten through my first year of college were poor. Except for the two years I spent attending a private boarding prep-school in Beirut, Lebanon. While there, I was forced to sit at a desk 2-3 hours a night and, at least, pretend to be studying. While my ability to concentrate remained a problem, I did learn how to study. My performance on the College Entrance Boards was, at best, mediocre. I was accepted at a very small college in New Mexico. While there, I barely passed my classes and, with the help of my advisor, was able to transfer to Oregon State.
Shortly after my arrival in Corvallis I met a fellow student whose father was a pharmacist and who himself was a pharmacy student. He suggested that taking amphetamines would make it easier for me to memorize all those thousands of things that a student in the biological sciences was expected to know. Back in 1954 all students entering Oregon State took a standardized A.C.E. test which purportedly measured one�s probability of success in college. My test results put me into the fourth percentile. After taking my first set of exams a totally surprised advisor told me that he did not understand how I could done so well. He had expected me to fail. To make along story short my grades improved so much that I was often was on the honor roll and upon graduation was accepted at the University of California, Berkeley. Prior to my arrival to Berkeley I had traveled to the Middle East and, while there, had purchased hundreds of Dexedrine tables for use in graduate school. Had it not been for these drugs I am sure I would not have made it through my first year of graduate school. During this period of time I discovered espresso coffee and, through most of the subsequent years I used caffeine and related alkaloids to sharpen my mind. I recently took one of those on-line tests to determine if I am an ADD individual and, low and behold, I test positive.
I am now 70 years of age and unable to ingest large amounts of any stimulant due to a medical condition. Did my arrhythmia come from my years of taking stimulants? Who knows? Is my increasing inability to concentrate due to A.D.D., aging or something else? Who knows? What I do know is that I am more alert and my mind is sharper when I drink a double espresso
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Scientific illiteracy: The disorder
There seems to be a growing population of people who self-diagnose, unthinkingly connecting their feelings with "chemical imbalances" in the absence of actual lab tests or even formal diagnoses. The, "I feel bad, therefore it must be a chemical problem in my brain" mentality represents the worst kind of armchair medicine.
However, in parallel with this trend, there are an increasing number of armchair social scientists (e.g., the author of this article) who attempt to fit societal trends to an appealing, media-friendly model in the absence of critical thought. The rising wave of psychotropic drug use reflects many factors that neatly dovetail with one another, including: the virtually unchecked practices of pharmaceutical sales and advertising, the development of safer, more efficacious, and more potent psychotropic drugs with fewer bothersome side effects, and various abuses of the legitimate push for better screening for mental illness. These are issues that require complex analysis, and they can't be neatly reduced to another tired story about The Way We Live Today.
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Who is moralizing?
Skepticism about ADD has been discussed many times, and in a more disciplined way that it is treated in this article. There are compelling reasons for this skepticism, none of which are presented here. It has become a standard middlebrow talking point to reflexively decry the use of psychotropic drugs, and here it is merely reiterated in a glib manner.
The idea stated in the tagline, "Is it time to retire our moralistic distinction between "recreational" and "medical" drugs? " is the most interesting part of the article. Unfortunately, this idea is briefly discussed. If one is asserts something that goes against conventional wisdom it is a good idea to support it with a modicum of evidence. I don't disagree with the assertion that most people who use illegal drugs never become addicted -- because I don't know. I wouldn't begin to form an opinion on that without looking for some sort of statistical evidence. Am I to base this just on the number of people I know who talk freely about there drug habits? Amsden does not offer even anecdotal evidence. I suppose if he is writing about people that try any illegal drug once or a few times and never again, it would be a more reasonable statement that I could accept unsupported. But what he is stating is that people "smoke pot and do coke much the way they 'drink responsibly' ". Pot and coke are comparable? Not in my experience. I've met lots of people who are or have been addicted to coke, but few if any that smoked pot to the point it was creating serious adverse affects on their lives. I also know few people who use coke as a sort of lifelong innocuous habit like drinking.
People seem to be quite comfortable condemning the use of drugs to treat disorders about which they have no knowledge or first-hand experience. The irony is that some of these same people apply a double standard to those drugs while using recreational drugs at will. Maybe THEY are the ones that need to retire their moralizing distinctions.