In the first 30 seconds of the Netflix documentary, Take Your Pills, we hear about the troubling physical effects of stimulant medication, followed quickly with credits featuring images of skulls and skeletons slowly sinking in an ever-growing avalanche of pills. This film is not a balanced look at stimulant medication, and at its core, this movie is about vilifying the use of stimulant medications. Admittedly, this movie raises several interesting questions in an unfocused manner (ironic for a film on ADHD medications), but its take-home message is, in the words of Mr. Mackie, “Drugs are bad! Mm-kay?”
In theory, the “drugs are bad” message sounds great. The problem is that when it comes to legitimate psychiatric diagnoses, this documentary may dissuade those who need medications to function in their daily lives. While I’m not a prescriber, a substantial portion of my clients take medications concurrently with the therapy we do. For some, medications are long-term, while for others it’s a temporary thing to keep their symptoms in check while we focus on the root of things. Many of my past clients, despite have very serious symptoms and impairment in their ability to function, were scared to get a psychiatric evaluation for medications because of the stigma against taking medications for mental health challenges, as well as a fear that they, “won’t be them anymore.” I see this film as deepening this stigma and fear. For a contrary (and hopeful) view, see How to ADHD creator Jessica McCabe’s heartfelt message thanking her mother for “drugging” her. Grab tissues before you watch it.
Back to Take Your Pills. As a premise, if the film wants to question if a psychiatric diagnosis is over-diagnosed? Great! That’s a wonderful question to be asking and researching! If they want to condemn the illegal use of controlled substances to gain an academic or athletic edge? Awesome! If they want to ask if there are better psychiatric solutions than the ones we currently have and examine psychedelics and non-FDA approved supplements? Okay! If they want to question the pharmaceutical and insurance industries’ influence on the US medical system? Lay it on me! This documentary does all this, but it doesn’t do a good job of balancing these questions against the experience of actually having ADHD.
Relatively little focus is placed on the debilitating symptoms of properly-diagnosed ADHD. Every mental health diagnosis requires that the symptoms cause significant distress and/or impairment in functioning. If significant impairment and/or distress isn’t present, it’s not a diagnosis. Not until nearly halfway through the movie do they address the difference in the experiences of those with ADHD and those without ADHD. One interviewee stated:
“For some reason, everyone’s like, ‘Everyone has a little ADD.’ No, that’s not true. We have distractions in our life, but not everyone has a brain that functions like somebody’s with ADHD… I think it’s pretty detrimental for people to constantly be saying things like that… because it illigitimizes [sic] the struggle and the actual power that ADHD might have over somebody’s life.”
This is a powerful position to consider as we think about who needs medication. Less than two minutes later, another interviewee questions the line between having ADHD and “having grown up in an [ADHD] society?” which is quickly followed by his mother (a former special education teacher) expressing sadness over his choice to take medication, feeding into the overall narrative of the movie.
It’s tangential, but from a purely factual perspective, there was one moment in the film that particularly bothered me. Though they don’t make it clear from where they cite this, there was a statistic claiming, “Around one-third of children with ADHD receive the diagnosis before age six.” This was set against a background of mildly dramatic music. Firstly, a good soundtrack does a stellar job of manipulating emotions. For hilarious evidence of this, watch the Community episode: Paradigms of Human Memory. Secondly, of course a substantial portion of those diagnosed with a childhood disorder are young children! This is not shocking! It’s literally part of the diagnostic criteria of ADHD that symptoms must manifest before a certain age.
Regardless of the age at diagnosis, the stigma of medical intervention that this documentary perpetuates is damaging. I reached out to McCabe, who said:
“I think Take Your Pills authentically touched on the discomfort that many ADHDers feel about taking their medication. Ironically, that discomfort often has nothing to do with the medication itself, but the stigma hammered into us that we “should” be able to get by without it. That medically treating a mental health condition should be a last resort, something that’s appropriate only after trying literally everything else, something to stop as soon as possible. A stigma that this documentary perpetuates.”
Jessica McCabe
Ultimately, we’re all searching for solutions that work for everyone who suffers. If there was one easy answer, we’d have found it by now. In the meantime, I hope that anyone who has concerns about their mental health or psychiatric medications will work with a qualified professional who knows your case to find what’s right for you. In the meantime, don’t let sensational documentaries scare you. McCabe adds, “When well-meaning people warn of the dangers of ADHD medication, they forget that not treating ADHD has side effects, too.”
Raffael Boccamazzo (AKA “Dr. B”) is a doctor of clinical psychology and clinical director of Take This. He also runs a private psychotherapy and psychological assessment practice in the Seattle area and works as a social skills coach, often using tabletop role playing games to teach social skills for older teens and young adults with high functioning autism spectrum diagnoses.
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