The New York Times ran yet another piece in the op ed section this week that takes a swing at ADHD medications, suggesting that adolescents who take them might be increasing their risk for anxiety disorders.
In the piece, Richard A. Friedman, a psychiatrist at Weill Cornell who is not a specialist in treating children and adolescents, wrote about the fact that teenagers are highly emotionally reactive, and their ability to regulate their emotions is not yet fully developed. They’re better at getting anxious than they are at calming down. Researchers think that’s one of the reasons they’re especially vulnerable to anxiety disorders. So far, so good.
But then Dr. Friedman floated the hypothesis, in the form of two rhetorical questions, that stimulant medications, since they can increase symptoms of anxiety in some kids, might be triggering anxiety disorders. He writes:
Might our promiscuous use of stimulants impair the ability of adolescents to suppress learned fear—something that is a normal part of development—and make them more fearful adults? And could stimulants unwittingly increase the risk of PTSD in adolescents exposed to trauma? In truth, we haven’t a clue.
Rhetorical questions may seem harmless, but as a parent, I know that this kind of speculation—when “in truth, we haven’t a clue”—stimulates worry without giving us real information.
We know that a lot of kids who have ADHD also have anxiety, and good clinicians are very careful when prescribing stimulant meds for a kid who is also anxious. But there is no evidence at all—and ADHD meds are the most thoroughly researched type of medication in use for kids, including follow-up studies—that kids taking Ritalin or Adderall are more at risk for anxiety disorders than kids who don’t take them. And what about the risk of developing anxiety as a result of struggling with untreated ADHD?
I don’t like to see parents subjected to what seems to me to be fear mongering. The Times has in the last year or so run a number of pieces that suggest, again and again, and without evidence, that kids who take stimulants are more at risk for substance abuse in later life than other kids. In fact there is substantial evidence from long-term studies that this is not the case.
Of course I’m not in favor of “promiscuous” use of stimulant medications for every kid who is struggling with attention or behavior problems. That really does kids a disservice. But adding these unfounded worries about medication that is very valuable to many kids does both kids and parents a disservice.
Brooke Garber Neidich is the chair of the Child Mind Institute Board of Directors.