I can't really think of a better introduction to Dr. Hubsher than that he gave me my life back.  He is my psychiatrist and the founder of the center where I go for treatment.  I posed this controversial question to him after hearing too many people (teachers, parents, op-ed writers, etc.) claim that all kids and teens with ADD, anxiety, depression, bipolar, or other mental disorders are simply slaves to a pharmaceutical nation.  This was Dr. Hubsher's response:

Are kids and teens overdiagnosed and overmedicated?

This is a really good and important question. It certainly seems that a lot more kids and teens are being diagnosed with mental or psychiatric conditions than ever before. And we certainly hear about more kids and teens being medicated for these conditions than ever before. But the real question is, ‘Why?’

First of all, I think parents are more aware of these conditions than ever before. For example, everyone’s heard of ‘ADD’! And nowadays, lots of people have heard of bipolar disorder in kids and teens. The result is that more parents are recognizing that behaviors they see in their children may indicate a problem exists. Therefore, more kids and teens are being seen by mental health professionals than ever before.

One of the areas in which it seems more and more kids and teens are being diagnosed is ADHD (That’s the latest name for what used to be called “ADD”, even if the child is not hyperactive; I know, it doesn’t makes any sense!). The problem here is that many people incorrectly believe that if someone cannot pay attention or are easily distracted, ‘they are ADD’. Unfortunately, too many professionals make the same mistake. The reality is that anything that interferes with concentration can cause someone to appear ‘ADD’. For instance, if someone is depressed and can’t stop thinking about the upsetting things going on in their life, that person will not be able to pay attention very well to whatever is going on in class. The same holds true for someone with OCD, excessive anxiety or anything that pre-occupies their mind. Yet, unfortunately many of these people get diagnosed ‘ADHD’.

Another diagnosis that is appearing more and more frequently is childhood bipolar disorder. It used to be that only adults or older teenagers could develop bipolar disorder. But over the last few years researchers have determined that younger teenagers and even children can develop bipolar disorder. Unfortunately with this diagnosis, there is a lot of disagreement among professionals in the field as to what bipolar disorder in children and teens looks like. One group believes that it looks the same as in adults, with high ‘highs’ and low ‘lows’. However, there is another group that believes that any child or teenager who is unusually moody or irritable is ‘bipolar’. Now the thing is that with that last definition, lots of people can be diagnosed with bipolar disorder! My view is that everyone has mood swings, but that sometimes these mood swings can become excessive, disruptive and can cause problems. Whether we ‘label’ that ‘bipolar disorder’ or something else doesn’t really matter. What does matter is that help is available and can dramatically stabilize these mood swings so that the child or adolescent can function again and feel ‘level’.

At my Center, we are very careful to make the correct diagnosis if we are going to make a diagnosis at all! The reason for this is that if a child or teenager we see does not receive an accurate diagnosis, then the treatment we give will be all wrong and won’t help! Now, that brings us to the question about whether kids and teens are being ‘overmedicated’.

Treatment for most kids and teens we see generally involves some form of therapy or counseling. It might be to help the child or teenager deal with uncomfortable or upsetting feelings, or to better deal with family or social issues. However, we have come a long way in the treatment of mental or

psychiatric conditions. We have learned that when someone’s feelings, for instance, feel out of control, like with depression or anxiety, the chemical balance in the brain has been knocked off.  We now have medications that can return that chemical balance, and when that happens, the person feels better again. In many cases, the combination of therapy and medication is more effective than either one alone. The development of medications for these conditions has been a major advance in helping people with these conditions. People with debilitating depression, anxiety, OCD and other conditions who previously could not get better and could not function, now can live normal, happy lives. That is truly wonderful! But medications are not ‘magic pills’! They do not solve problems. They do not repair relationships. It is up to each individual to do that!

So, are we overmedicating kids and teens? Well, it depends on the circumstance or situation. If medications are being prescribed as a ‘solution to life’s problems’, I would say that this is absolutely an inappropriate and unreasonable overuse of medication. There are certainly situations in which this is happening. For example, the teenager who is prescribed Ritalin or Adderall in order to get higher scores on SAT’s is clearly being inappropriately medicated. The child who is given anti-depressant medication instead of therapy or counseling to deal with social or family problems is certainly being inappropriately medicated.

Medications like anti-depressants or ‘mood stabilizers’ save kids’ and teens’ lives every day. They allow them to function and feel good again, allow them to no longer feel tortured by feelings of extreme sadness, hopelessness and negativity or by emotionally exhausting mood swings. However, these medications must be respected. In the wrong hands or prescribed to the wrong kids, they can be dangerous! That is why it is so important that psychiatric medications be prescribed by a psychiatrist, and medications for children and teenagers be prescribed by a child & adolescent psychiatrist. Treating psychiatric conditions is not like treating the common cold. It requires an expertise by the doctor prescribing. At my Center, I ‘specialize’ in helping children and adolescents with these problems. That is what you should be looking for where you live, a ‘specialist’ treating these conditions to help you. I shouldn’t be treating bronchitis, and doctors who do not specialize in treating these conditions shouldn’t be doing so, either. It is way too important!

We are fortunate that we live in an age where help is available for kids and teens like never before! It is important that we make sure that kids and teens are not overdiagnosed and not overmedicated. But to tell you the truth, I worry even more about the kids and teens who are suffering because they have not been diagnosed or can be successfully treated with the aid of medication, but are not because they do not seek help. If you are here on Caitlin’s website, you know help is available. Tell people. Tell your parents, tell your friends. Don’t stay silent! Go get help. It can change your life! It can give you back your life!

Merritt Hubsher, MD is the medical director of ADHD, Mood & Behavior Center. He is a Board Certified Child, Adolescent and Adult psychiatrist, and specializes in the treatment of Attention Deficit Hyperactivity Disorder (ADD, ADHD) as well as all child and adolescent emotional, behavioral, social and academic disorders. He possesses an expertise in treatment of childhood mood disorders, such as Childhood Depression, Childhood Bipolar Disorder and Anxiety and OCD Disorders, behavior disorders such as Oppositional Defiant Disorder, as well as Pervasive Developmental Disorders, such as Asperger's Disorder and Autism, and Eating Disorders.  Check out the ADHD Mood & Behavior Center of New Jersey's website at www.adhdmoodbehaviorcenter.com