A Pill to be Nice

This past week, a mother in my pediatric practice (details, as always, have been changed to protect my patients privacy) asked if I would increase the dose of her 13 year old daughter’s ADHD medication “so she would be nice all of the time.” She was perfectly serious, saying, “I know she’s capable of it, she can be so sweet.” When I told her that in my experience most 13 year old girls were not “always nice” to their parents, and that I might be worried about a child if she were, she became furious with me. She accused me of giving her daughter permission to be oppositional.

Later that day I opened the most recent issue of the Journal of Developmental and Behavioral Pediatrics. I found the following two page ad placed prominently on the inside cover.

“His ADHD symptoms can be disruptive, but there’s a great kid in there.
Now there’s a new way to help him out”Below this writing is a photograph of a big green monster, with the head removed to reveal a sweet, smiling boy inside.


I am not pleased with this ad. Research in developmental psychology and neuroscience clearly shows that recognizing the meaning of a child’s behavior leads to healthy emotional development. In this case, my patient is working on becoming her own person and so, to leave the comfort and security of her mother’s embrace, she must sometimes actively run in the opposite direction. While certainly her mother does not need to condone her behavior, understanding and respecting her feelings will go a long way in helping her negotiate this difficult developmental stage.

But with the powerful pharmaceutical industry running ads indicating that any unpleasant behavior can be eliminated by a pill, it’s no wonder I have a hard time getting my message across.