Recently, the New York Times published "Risky Rise of the Good-Grade Pill," examining the proliferation of prescription stimulant abuse among high school students. With familiar names like Ritalin, Adderall, and Vyvanse, students are popping and snorting these controlled substances — primarily meant for treating attention deficit hyperactivity disorder — to meet the challenges of academic rigor.
My younger brother, Alan*, and I have ADHD. Before he was diagnosed, my parents struggled to understand Alan’s misbehavior, impulses, fidgeting, and his low grades despite his undeniable intelligence. Put in countless time-out corners, teachers considered him "uncontrollable." Alan hated “the problem child” cloud. He mistook report cards as evidence that he was stupid and his distractions for character flaws. After diagnosis, he saw a parade of doctors and counselors, suffering through ADHD diet after diet. Between Ritalin and Adderall, he mixed self-criticism in with the medications' adverse effects.
Though I had some of Alan's issues, I was better able to cope. I rebuffed “the all over feeling,” if only to avoid sadness like my brother’s. I refused to take medication, doggedly denying that Alan and I shared similarities beyond the sameness of our faces. I couldn’t accept that I had his problem.
In grade school, teachers wrote "too talkative" and "makes careless mistakes" on my report cards. My behavior columns filled with sad-face stickers. As I got older, tests and homework were arduous, but I managed. In high school, I frantically scribbled down thoughts when I wanted to answer teachers' questions. I knew that otherwise I'd stop mid-answer — forgetful, lost, and embarrassed.
It was at university where I first saw students with multiple Ritalin prescriptions and the furtive lean of an Adderall buy in the library. I was happy in my intensive, multidisciplinary major, but by junior year, the limitations of my coping mechanisms had become evident. Though my blood turned to coffee and I slept little, my lack of focus was a time wasting liability. A year before I was to deliver my senior thesis, I realized I needed more than myself.
I made an appointment with my doctor. I hoped to discuss my options, but instead he quickly scribbled a prescription for Concerta, and told me I could call him if I needed something weaker or stronger. I protested, but he said he trusted that I wasn't scamming him, and gave me an uninspiring reassurance. Figuring that this was it, I filled the prescription and took it as directed.
"Tunnel vision" didn’t do the effect justice. I was amazed at the hours I could work, that the sky could turn light to dark without my realizing. As my heart pounded away, I ate less and slept less. I started thinking I had found a final answer.
But as time passed, something broke. I was constantly anxious and had little interest in things I loved. At Christmas, my parents noticed I was less myself. After four months, I felt chunks of my personality disappear. I flushed the Concerta. I couldn’t be someone I didn’t recognize. Despite the difficulties, my senior year’s last three months yielded straight A’s.
Around the same time, Alan also stopped taking his medication. After years of discontent, he no longer wanted to deal with side effects. Finally out from under my parents’ roof, he had decided to go at it alone.
Though we handle the disorder differently, Alan and I agree on a central point. Regardless of blame for ADHD prescription abuse, its proliferation has delegitimized the realities of those who suffer from the disorder. Alan and I characterize ourselves as "hyper” — invested and involved in an atypical number of endeavors — rather than tell others we have ADHD. Too often we've met with a conspiratorial laugh or the nudge-wink response, "Yeah, sure, me too."
When I headed to law school, I found it as monstrously rigorous as foretold. I spent hours reading, rereading, and re-rereading just to finish a case that I would then forget in class, despite pages of notes. I knew more students whose studying involved Ritalin and Adderall abuse than students whose did not. I found the frantic way they took the pills, and the snorting noises in the bathroom before finals, both hilarious and disconcerting.
Once, in the library, I accidentally dropped an Advil and watched quizzically as a classmate leaned to follow its path along the floor. "Oh my God, is that Ritalin? I'll buy it off you! Any price." When she later hinted at her near 4.0 GPA, simultaneously it was easy to feel jealous and difficult to be impressed. With others who bought pills, or admitted faking ADHD symptoms to a doctor with an easy prescription hand, I couldn’t help but question academia’s strange measure of success.
Once, a professor said she thought me "brilliant, but unfortunate” that my intellect didn't match my grades. I couldn't decide whether to laugh at the irony, or scream out of aggravation. The comment stuck. After setbacks and two-months of postgraduate study, I uncharacteristically burst into tears when I passed the bar exam on the first attempt. I didn’t expect to; I never thought it was something I could do by myself.
Knowing others who have ADHD, I understand the choice to take medication instead of shouldering the limitations and challenges of coping mechanisms. I neither consider someone with a legitimate prescription weak, nor do I consider myself particularly strong. The choice is personal, with both alternatives fraught with their difficulties.
Though no longer a student, I follow as educational institutions become more competitive, with standardized tests firmly rooting as touchstones of aptitude. I understand the importance of performance, but am increasingly skeptical about traditional measurements of capability and success. Though I don't know what the future will bring, I don't foresee one where students call off the search for the next academic advantage. ADHD has become as much a societal disorder as it is a psychiatric one. What is worse, the former persists as a condition without a treatment plan.
*Name has been changed