Friday, April 24, 2009

Majoring in Stress

by Judith Warner
The New York Times
April 23, 2009

The illustration accompanying Margaret Talbot’s disturbing article on “neuroenhancement” in The New Yorker this week shows a young woman in what looks like a college sweatshirt typing at her desk in the middle of the night. She should, the picture suggests, be dying for sleep. But thanks to the pills spread strategically to the left of her laptop, she is alert and typing, even faintly smiling.

I kept turning back to that image with a sense of recognition, while reading about college students stocking up on pilfered Adderall, a psychostimulant prescribed for attention deficit hyperactivity disorder; professors beefing up mentally with the anti-narcolepsy drug Provigil; and a whole mini-world of would-be high achievers turning to “cosmetic neurology” to achieve even more.

I knew exactly how that young woman felt.

One week in early February, 1995, I had to finish two books in three days. Don’t ask me why; I just did. I also had, the day after my deadline, to pack up my entire apartment for a move overseas. I had to do it alone, because my husband, Max, had already left to start working in a new job, and I had to avoid thinking about the move so that I could focus.

Sound impossible? I thought so, too. But then I got my hands on some Ritalin. The same way college kids do: from a friend with a prescription. The Ritalin made me feel as if I was inside a tunnel. There was utter brain silence – crystal-clear focus, a noise-canceling sound of whooshing in my ears. I was able, in this way, to work for 36 consecutive hours without sleep.

By the time I got up from my desk, my feet were so swollen I could barely get them into shoes. The next day, I had a blinding migraine. (I made my corrections lying down, a different pill bottle at hand, and with one eye closed.)

I haven’t taken Ritalin – or its descendants – since and never will, although, throughout the past year, trying to pull together the disparate threads of a seemingly unwritable book while blocking out the background noise of scheduling issues, grocery needs, in-law visits and the like, I have thought about doing so almost every day.

I resist because of the memory of those swollen feet and that headache. I resist because that memory indicates to me, very strongly and very simply, that there are limits to what we are supposed to do.

The refusal to acknowledge any limits, the assurance that self-fulfillment resides in breaking through all the bounds of intellect and energy and focus and motivation, was a large part of what I found so troubling in Talbot’s story about the college students and (mostly) young adults taking psychotropic medications for no reason other than “self-enhancement.” It was not just that these drug-takers appeared to be utterly ignorant of, or untroubled by, the serious health side effects, including addiction, that can come from stimulant abuse. It was also that they’d embraced, with a strong sense of pride and happy purpose, an utterly toxic way of being.

“Alex,” a recent Harvard graduate who faked A.D.H.D. symptoms to get stimulant prescriptions, had at one point in his undergraduate years taken 15 milligrams of Adderall “most evenings, usually after dinner, guaranteeing that he would maintain intense focus while losing ‘any ability to sleep for approximately eight to ten hours.’” He’d found that the drug allowed him to be all but superhuman: keep a full courseload, spend 40 hours a week on extracurriculars, do homework on weeknights and party hard on the weekends without losing time to any sort of recovery.

Throughout our nation’s colleges, particularly among white male students in the competitive schools of the Northeast, Talbot wrote, such behavior is now common. At one small college, a 2002 study found that more than 35 percent of undergraduates had abused prescription stimulants in the preceding year.

Students seem to find it relatively normal, acceptable, even advisable now, to attempt to turn themselves into maximum-performance machines.

It is surprising to me that stimulant drug abuse hasn’t sparked anything like the large-scale outcry that greeted the spread of psychostimulant use in children with A.D.H.D. over the past 15 or so years. Maybe that’s because drug use by college students and young adults is no new story. Maybe it’s because stimulant use generally, by now, is an old story.

Probably it’s because many people don’t really make a distinction between off-label abuse and therapeutic use of stimulants. Both tend to be viewed as a form of competitive self-enhancement. (Even Andrea Tone, a medical historian who really ought to know better, refers to Ritalin as a “lifestyle drug” in her new book, “The Age of Anxiety: A History of America’s Turbulent Affair with Tranquilizers.”) In the public mind, the “legal-drugging” of kids, as Arianna Huffington once put it, and the dangerous mind-doping of young adults, are merely points on the same continuum: symbols of the vicissitudes of life in our performance-driven times.
It is so easy, so intellectually satisfying, to class all stimulant-using kids and young adults together and turn them into so productive a metaphor. And it’s so wrong.

Making people into metaphors renders them unreal. And stimulant users, of whatever variety, are real people with real problems. Those with A.D.H.D. have serious struggles. As for the Alexes of the world – they strike me as lost souls who are engaging in some really dangerous behavior. It’s perilous not just because they’re abusing powerful drugs with no seeming awareness of the potential health consequences, but also because, in doing so, they’re embarking upon a way of living that is a sure recipe for chronic unhappiness, stress and failure. Or at least: a sense of failure that will strike them when they finally realize they’ve been so busy performing that they’ve forgotten to experience their lives.

Parents, teachers, colleges and high schools really need to show some leadership in reversing the lifestyle of impossibility that today’s overachievers embrace as a point of pride. If we don’t, I fear, we’re soon going to have a lot of really sick young adults on our hands.

Copyright 2009 The New York Times Company

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