The parents of Y., a clever, vivacious and curious 10-year-old, made a courageous decision a few months ago, to stop giving him his daily dose of Ritalin. In doing so, they went against the opinion of their son's counselor, at his north Tel Aviv school, and the recommendation of the psychiatrist who examined him.
The parents are not in denial about the problem: Y. does find it difficult to concentrate in class, especially during math and Hebrew. He is a disturbance both to himself and to his classmates. But his parents disagreed with the choice of the solution that was selected, of prescribing medication. They notice a simple fact: when Y. is at home, he is usually relaxed, quiet and focused. He is interested chiefly in playing piano and in acting. They realized that their child is not sick. He simply has trouble adapting himself to some of the classroom lessons.
It is not easy today to go against the current when it comes to Ritalin. The drug, which is prescribed for people diagnosed with Attention Deficit Disorder (ADD), has become very popular in the past few years: Ritalin is being prescribed to 35,000 Israeli elementary and secondary school students annually, according to reports by the pharmaceutical division of the Ministry of Health. In the United States, about four million students, or nearly one child in every class, takes the drug.
One can assume that the rate of Ritalin use among Israeli children will increase and even surpass that in the U.S.: Two years ago the Health Ministry initiated a campaign to encourage the use of Ritalin in schools.
Israeli schools suffer from large class sizes and "discipline problems," and is desperate for a panacea. The media, for their part, have recently jumped on the marketing bandwagon and reported in a variety of articles that ADD is the next big thing. In universities, at work, in clubs, Ritalin helps people to pass tests, to appear relaxed and to function in the office, and even aids in the struggle to lose weight and look good. Even celebrities like Avri Gilad have been diagnosed with the disorder.
This, of course, is not the first time that drug companies have created a mass phenomenon based on the genuine need of a minority. Ritalin, like the antidepressant Prozac and related drugs can greatly improve the lives of children and adults with hyperactivity and significant difficulties with concentration. But the number of people suffering from these disorders from birth, in all contexts, is very small. They are insufficient to create a large and profitable market. Every big market - for Nike sneakers, for Coca-Cola, for Ritalin - requires a mass trend.
However, in order to create a mass market for a medication it is not enough for people to follow a fashion: a normalization of the necessity for taking it is needed. In the case of Ritalin, this normalization - the conformist functioning, the satisfied smile - is not just a marketing strategy, it is also the value that is being marketed. The system - the schools, workplaces, the market - all want children and adults who are attentive, smiling, happy. Ritalin is therefore not just a drug that treats the small number of people who suffer from a disorder. It is also, and chiefly, a drug that treats a system that suffers from disorders. Instead of reducing class sizes, offering solutions tailored for a range of children with a range of needs, taking the active children to the playing fields and letting them enjoy their creative energies, we give them medication. Being different, showing opposition and difficulties, which can encourage compensatory coping, creativity and a unique lifestyle, are sedated with a pill.
If adults wish to follow this path, it's their right. But parents who choose to give their children a drug against restlessness should consider the personal price - philosophical and psychological - at which this enforced quiet is purchased. In the past few months Y. has been studying math and Hebrew privately and participating in music and theater after-school groups. He is still restless in some of his classes but his parents think that as long as he is developing and enjoying school and retaining his independence in other areas, it is not so bad. Maybe he will not have an easy time in math class, but they prefer their solution to this particular problem.
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