We’ve Got Issues
Published by: Riverhead Hardcover
Release Date: February 23, 2010
Buy the Book: Amazon, Barnes & Noble, IndieBound
We've Got Issues has been selected to receive the National Alliance on Mental Illness's 2010 Outstanding Media Award for Science & Health Reporting.
In her more than twenty years as a journalist, Judith Warner — a former contributing columnist for the New York Times and special correspondent forNewsweek in Paris — has written about women’s issues, American society and culture, adulthood and child care, fatherhood, family leave, the politics of everyday life, and much more. Now the author of the New York Times bestselling Perfect Madness: Motherhood in the Age of Anxiety offers a provocative and compelling report from inside many American homes where families are grappling with how to help children suffering from a host of disorders, including autism, obsessive-compulsive disorder, bipolar disorder, Asperger’s disorder, attention-deficit/hyperactivity disorder (ADHD), dyspraxia, dyslexia, and more.
Written with a reporter’s eye, Warner’s new book, WE’VE GOT ISSUES: Children and Parents in the Age of Medication (Riverhead Books; February 23, 2010) explores how pervasive these disorders are today and shows how complex and painful a journey it can be for parents trying to make the right decisions, particularly in the face of the ongoing discussion in this country as to whether we are misdiagnosing our children with special needs and overprescribing medications to modify their behavior.
How many kids really have behavioral, emotional, and learning issues? What is the nature of those issues, and are they really epidemic? Why do they appear to be so greatly on the rise? Are they real? Are parents willing to “drug” their kids? And perhaps most significantly, how do the children themselves feel about it? What are their lives like? Warner answers these and many more questions in a book that reframes our most commonly held beliefs about children and parents struggling with mental health issues.
Warner’s starting point was a common preconception—that children are being overpathologized and overmedicated by anxious, neurotic parents and test result–driven schools that were demanding unrealistic levels of performance from kids. She found, however, once she began seriously researching her book, that this storyline didn’t hold: epidemiological studies didn’t indicate a widespread pattern of gross overdiagnosis or overmedication. Interviews and surveys didn’t indicate an avidity on the part of parents to “drug” their kids to enhance their performance and behavior. And the children receiving diagnoses and medication weren’t just “normal,” high-spirited kids who simply didn’t meet society’s unrealistic demands. They were, by and large, children who suffered, often enormously, and experienced serious limitations to how fully and well they could live their lives.
Drawing on extensive research and interviews with parents, child psychiatrists and psychologists, pediatricians, and other experts, Warner lays out the current scientific understandings of the disorders that affect millions of children each year. She shows what life is really like for parents and children struggling with these very real illnesses. And she shifts the focus of our attention beyond the hyped-up headlines and all the hand-wringing, finger-pointing, moralizing, and catastrophizing that too often dominate our discussions of children’s “issues,” and instead starts to articulate a new way to think more realistically, compassionately, and productively about and to help a very vulnerable population of kids and their parents.
"In this impassioned book, the author argues that childhood mental illness is real, widespread and painful to families caught in its grip....Frantic parents try everything from biofeedback to acupuncture in hopes of curing children who are mentally ill, self-destructive or violent. Warner argues that many of these children would thrive with meds and cognitive therapy. In these cases, the crime isn't overmedication—far from it: 'Most children with mental health issues get no care at all.' "
"Warner, New York Times columnist and author of the best-selling Perfect Madness: Motherhood in the Age of Anxiety , set out to write a follow-up volume exposing what she believed were capricious diagnoses and medication of children's mental and learning disorders. Instead, she fell down the rabbit hole to an alternative reality. Although she found the stereotype of pushy parents who shop for prescriptions or educational accommodations to fit their overscheduled children, Warner's heartbreaking conversations with pediatricians and the parents of children with mental issues such as attention deficit/hyperactivity disorder, autism, serious depression, or bipolar disorders led her to see beyond her prejudices…. Parents, social workers, and educators will find Warner's compelling study troubling but enlightening. Highly recommended."
—Library Journal (starred review)
"Parents of mentally ill children will find this tonic reassuring, while all parents will find it a valuable reminder that it’s not poor parenting to seek medical help for your children."
— Kirkus Reviews
"Readers love Judith Warner because she is open, honest, attuned, and curious. In We’ve Got Issues, Warner considers children and psychotherapeutic medicine: whether drug companies hold too much sway, whether doctors overprescribe, but also whether troubled boys and girls might sometimes need more help than they get today. The result is a caring and informed book that will earn the trust and loyalty of a wide audience."
—Peter D. Kramer, author of Listening to Prozac
“This is an important book, a landmark book, a triumph of honesty over bigotry and of patient learning over the rush to judgment. I see every day in my office the awful, preventable damage done by zealots and reductionistic ‘thinking.’ Judith Warner rejects the panicky sound bites that have plagued the discussion of children’s mental health for the complexity of truth. She brings to all who read her book the resoundingly good and hopeful news of how much we have learned over the past few decades, how transforming the best help can be, and how all children can turn into responsible, joyful adults. We owe her a huge debt.”
—Edward Hallowell, M.D., coauthor of Superparenting for ADD and author ofThe Childhood Roots of Adult Happiness
"This is a groundbreaking, thoughtfully argued book. My experience with families in the consulting room supports Judith Warner’s nuanced argument exactly. The myth perpetrated by a breathless news media is false: In reality, parents don't want to medicate their children. And every one of us has family members and friends (or ourselves!) who could have led richer, less anguished lives had they been given appropriate medication during childhood for chronic learning or emotional problems."
—Wendy Mogel, author of The Blessing of A Skinned Knee
1. What were some of the assumptions you started with when you began writing this book?
I assumed that children were being grossly overdiagnosed and overmedicated. I assumed that society’s neuroses were being turned into pathologies in children; that what was being diagnosed as disorders in them was everything that was wrong in the competitive, high performance, driven, anxiety-filled world of childhood and family life in America today. The basic assumption was that those disorders, which no one seemed to have had when I was a kid – weren’t real, or were at least being diagnosed far more frequently than they ought to have been. How I knew this, I don’t know. Mixed in with the thought that the diagnoses were bogus was the idea that the medications used to treat children didn’t work; that they were a palliative for parents; and that parents were searching for an easy way out of their kids’ problems rather than looking at themselves, their families or society in general. And all of that rested on a basic disbelief in the direction that modern psychiatry was taking and a basic disrespect for parents who seemed to me to be willing to sacrifice their kids to their own ambitions and laziness. It was easy to have all these views. They were, and still are—although perhaps to a slightly lesser degree—the basic lens through which a lot of children’s mental health issues continue to be viewed. (For example, there’s still a lot of disbelief out there that things like ADHD or bipolar disorder are real. A lot of people still believe these problems are being grossly exaggerated and over-treated and think this is happening because parents want to “perfect” their kids).
2. What happened as you started working on the book, trying to report the various pieces of it?
As I started working on the book, I very quickly ran into problems. When I tried to back up the idea that what these kids had wrong with them wasn’t real, it became impossible to prove. I contacted experts – prominent psychologists and psychiatrists I’d seen quoted in the media indicating that kids were being overdiagnosed or overmedicated, people whose beliefs, I thought, paralleled my assumptions – and they didn’t actually believe that the mental disorders I was asking about weren’t real. And those who did believe that disorders like ADHD were socially constructed forms of disease tended to be people who were out on the fringe. The websites where I was finding articles agreeing with my point of view often were linking back to Scientology sites or other hard-core antipsychiatry groups and staking out ideological positions. I increasingly began to wonder about some of the things I thought were obvious and true. And when I talked to parents of children with mental health issues about my assumptions I encountered real hostility. One friend in particular just looked at me when I told her that I thought kids with nothing wrong with them were being overdiagnosed and that medication didn’t work. She forcefully asked, “How do you know that?” I would later learn that her son, who was ultimately diagnosed with Asperger’s Disorder, had seriously contemplated suicide at age six, had violent outbursts and paranoid episodes by age eight, and had begun holding the family hostage to his destructive rages by his early teens, and that my friend had gone through an ordeal of her own in trying to get him the best possible treatment. Something wasn’t right. I just couldn’t find answers to prove that I knew what I thought I knew.
The notion of these kids being symptoms of something wrong in society, “canaries in the coal mine,” as it’s often said, worked as an intellectual construct, but it broke down whenever I talked to a parent of a child with mental health issues. Once I listened to parents’ stories, the intellectual construct fell apart.
3. Millions of parents struggle each year with how to help their children suffering from disorders like autism, Asperger’s, attention-deficit/hyperactivity disorder (ADHD), bipolar disorder, obsessive-compulsive disorder, and the like. What sort of challenges do these parents face as they try to make the right decisions about their children’s health?
These parents not only have to struggle with understanding their children’s disorders and finding the right treatments, but they also have to contend with enormous self-doubt and, often, skepticism and even condemnation from people around them who believe they’re exaggerating their children’s problems and pathologizing them. It is very difficult for them to find their way, particularly since it’s so hard to find doctors who can really take the time to explain treatment options to them and so hard to find institutions they can trust for good information.
The issue of medicating children was eye-catchingly in the news last week. First, Carolyn Riley, the Massachusetts mother of a 4-year-old who had been diagnosed with attention-deficit/hyperactivity disorder and bipolar disorder, was convicted of second-degree murder for overdosing her daughter with psychiatric drugs. The following day, doctors proposed revisions to the psychiatric “bible,” the DSM-IV, in an effort to reduce the number of children diagnosed as bipolar and treated with powerful, and dangerous, anti-psychotic medications.