This reading group guide for ADHD Nation includes an introduction, discussion questions, and ideas for enhancing your book club. The suggested questions are intended to help your reading group find new and interesting angles and topics for your discussion. We hope that these ideas will enrich your conversation and increase your enjoyment of the book.Introduction
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In ADHD Nation
, former Pulitzer Prize–nominated New York Times
reporter Alan Schwarz offers an authoritative account of the explosion of ADHD diagnoses and the overmedication of children and adults, with consequences few understand. Based on more than 1,000 interviews with doctors, parents, children, pharmaceutical executives, teachers, and researchers, ADHD Nation
sounds an alarm and makes the case for society to wake up and address this national health crisis.Topics and Questions for Discussion
1. The opening of ADHD Nation
reads, “Attention deficit hyperactivity disorder is real. Don’t let anyone tell you otherwise.” Why do you think so many people don’t consider ADHD a true disorder? What impact does this skepticism have on afflicted patients’ ability to seek help?
2. In the introduction, Schwarz describes ADHD Nation
as a “we
book.” He writes, “It’s the story of how we, as a society, have allowed what could be a legitimate medical condition to become diluted beyond recognition, and beneficial medication to become a serious drug problem.” Why do you think he frames the book this way? What is the significance of “we” instead of “they?” How important it is to consider society as a whole instead of just the pharmaceutical industry?
3. How does knowing ADHD’s history affect your understanding of ADHD? Does its evolution give you confidence or discomfort?
4. Dr. C. Keith Conners could be considered the father of ADHD because he discovered and helped popularize the benefits of Ritalin for treating hyperactivity. He says he now has serious regrets about how ADHD has been handled. Why do think he feels this way? How would you feel if you were in his shoes?
5. The symptom questionnaire Conners developed to help doctors consider ADHD diagnoses measured “not necessarily a child’s behavior, but outsiders’ impression of it
for it.” What is the danger with such a subjective scale? Could Conners have predicted how others’ used it?
6. Teachers and schools have been greatly involved in diagnosing children with ADHD. Why did some pressure parents to put their children on Ritalin? How has the teacher’s role in ADHD diagnoses changed over time? Do you think involving teachers in children’s medical care is ever suitable?
7. What was the point of renaming minimal brain dysfunction (MBD) attention deficit disorder (ADD)? What did it accomplish? What did it fail to accomplish? Can you think of any other disorders that have been rebranded in a similar fashion?
8. Stephen Colbert once called the ADHD explosion “Meducation” and joked it was shocking that there are children in American who haven’t been diagnosed. Similarly, the Onion
sardonically profiled a four-year-old girl stricken with “Youthful Tendency Disorder.” What is the impact of this kind of satire when used to talk about a medical disorder? How large a role did US media play in the advancement of ADHD and Ritalin? How do media influence consumer perception of new drugs today?
9. What was your reaction when, on page 68, a panel of the field’s top experts failed to simply describe a typical child with ADHD? Do you think doctors today can provide this description? How would you describe the typical child with ADHD?
10. Does modern culture have a quick-fix, just-take-the-pill ethos? What other factors contribute?
11. The CDC reports that the rate of ADHD diagnoses among boys nationwide is 20 percent, but can be up to 30 percent or higher in southern states such as Mississippi, South Carolina, Louisiana, and Arkansas. Why do you think the rate is so much higher there? Why do you think the rate is generally higher for boys than it is for girls?
12. Schwarz frames the book around the narratives of two casualties of the ADHD epidemic: a seven-year-old girl who was mistakenly diagnosed and medicated, and a fourteen-year-old boy under tremendous academic pressure who faked having ADHD to get an Adderall prescription. What is your reaction to those stories? Do individual case studies help our understanding of larger trends?
13. ADHD drugs were among the first that drug companies directly marketed to consumers. What was the effect of this strategy? How did their aggressive and misleading advertising shape the ADHD epidemic? Does this type of advertising work for other disorders or drugs?
14. Recently, pharmaceutical companies have taken to marketing their drugs to adults—from working professionals to the elderly—who think they might have ADHD. Discuss the implications.Enhance your Book Club
1. Most people know at least one person diagnosed with ADHD or taking ADHD medication. Share your personal stories and conceptions of ADHD as a disorder. Discuss similarities and differences.
2. Have the ways in which society views ADHD changed? How do you think our perceptions will continue to change in the future?
3. Near the end of the book, Schwarz reports there is a new disorder being formulated by several ADHD figures: sluggish cognitive tempo (SCT). Discuss how recognition of that concept might impact American culture and medicine.