Stop the Stigma

Take Your Pills: Netflix and Stigma

Netflix Take Your Pills

Sigh.  This again?  I’ve written before about documentaries that stigmatize psychiatric medications (A Prescription For Murder and Stigma and the Pathologization of Normal).  Now Netflix has released Take Your Pills, which looks at the use of stimulant medications for mental performance enhancement.

I started watching this documentary and gave up in disgust.  But after I read a critique by another blogger, I decided it was important to speak up about it. To do that, I thought it was important to give it another go and watch the whole thing.  While a somewhat more balanced perspective was conveyed when I watched the film in its entirety, I was still left with a lot of concerns.

Presenting stimulants as cognitive enhancers

The documentary describes psychostimulants as a tool for cognitive enhancement, enabling people to get an academic or career edge, get higher grades, perform in a way they perceive as ideal (particularly in the tech and finance sectors), do more detail-oriented work, and control weight.  Medications like Adderall are described as enabling people to “get to perfect” or be “jolted back to life”. 

One psychologist says that these medications prime people to expect that a pill will give them what they want.  A researcher who was interviewed jumped on the bandwagon, saying he’d tried Ritalin once and it felt like “such an enhancement of my day; it was a good experience”, something it strikes me as irresponsible to say when being interviewed as an expert on the topic.

A university student said that her parents told her she should get a lockbox for her stimulant medication.  “It’s RX gold” she said, adding “I don’t think I know anyone who’s prescribed it who doesn’t sell a little on the side”, and “everybody takes Adderall.”  One male interviewed said that as a millennial who went to a great college and worked in finance, “it’s impossible to avoid stimulants.”

Taking stimulants to be more productive was documented as early as the “pep pills” of the 1930’s.  Pharmaceutical companies were accused of creating ADHD to market stimulant medications as a way to improve children’s behaviour and grades.  The documentary explains that more children are diagnosed with ADHD in the United States than in any other country in the world, and the majority of them are medicated.  The implication was that ADHD is a mostly artificial condition created by drug companies’ marketing campaigns.  This is certainly not the first time I’ve seen this logical fallacy; misleading advertising does not invalidate the medical condition just because they falsely suggest that everyone suffers from it.

Side effects and lack of contextualization

Serious side effects such as addiction are mentioned, but the film does a poor job of contextualizing this as an individual risk vs benefit decision.  A political theorist interviewed suggested that stimulants blunt the human experience and creativity (I’ll just say that a Ph.D. in one field does not qualify someone to speak as a subject expert on an unrelated field).  One student believed her stimulant medication made her more boring and angrier.  These examples provide a very limited context by which to judge the appropriateness of these medications.

“Expert” opinions

A psychotherapist featured in the film said that “just like opiate painkillers are heroin in a pill, ADHD medicine is a very small dose of meth in a pill.”  A psychologist suggested that as a society we make a false distinction between licit amphetamines and illicit methamphetamine, and pointed out the chemical similarity of prescription amphetamines and illicit methamphetamine (which has an added methyl group consisting of 1 carbon and 3 hydrogen atoms).

This was an astonishing display of ignorance from someone whose doctorate in psychology doesn’t confer expertise in medicinal chemistry.  You know what also differs by a single methyl group?  The ethanol that you find at a liquor store and the poisonous methanol that’s in the antifreeze that can kill desperate alcoholics looking for a fix, including a former patient of mine.  

Never mind a full 4-atom methyl group, think of what happens when you throw a few subatomic neutrons on an atom and create a radioactive isotope.  One need only look so far as Wikipedia, which points out that, “unlike amphetamine,  methamphetamine is directly neurotoxic to dopamine neurons in both lab animals and humans”; this statement is backed by 3 references from scientific journals.

Everyone does not have “a little ADHD”

I cheered a little inside my head when one student who was interviewed expressed concerns about people saying things like “everyone has a little ADHD”, as this delegitimizes the actual illness.  Another student with ADHD had chosen to go off of Adderall, although his mother believed he likely wouldn’t have made it through high school without it.  It appeared from the documentary that those with a genuine medical need were actually the most reluctant to take medications.

In a study of college students without ADHD, using Adderall didn’t lead to objective improvements in cognitive performance, but participants did report a subjective sense of performance improvement.  A journalist interviewed in the film said that “what you have here is a dynamic of not only people using what is, you know, a dangerous drug… but you also find a bit of an arms race building up where if enough people see that their competition is doing it, they feel like they kind of have to do it too.”  The societal pressure to always be competitive and outperform others is well worth exploring, but to me that got lost in the focus on stimulant medications.

I don’t abuse my stimulant

My own bias viewing this documentary is that I take Dexedrine (dextroamphetamine).  I first started taking it for significant psychomotor retardation (slowing of movement and thoughts) that I experienced as a symptom of depression.  When that resolved, I cut down on my Dexedrine dose, and my mood worsened.  I’ve tried a few more times since then to cut back the dose, and it’s become clear that it’s definitely having a beneficial effect on my mood.  My doctor is very comfortable keeping me at a dose of 10mg in the morning and 5mg at noon because it is obviously having a therapeutic benefit.  

I don’t feel “high” from it and never have.  Dexedrine isn’t enough to fully compensate for the cognitive and physical slowing I experience with depression, and my overall cognitive performance and energy level remain lower even while on Dexedrine than they are when my depression was previously in remission.

So when Netflix portrays my medication as either a performance enhancer or a legal version of crystal meth, it does not sit well with me.  There is already so much stigma against mental illness and psychiatric medication, and this sort of messaging is not helpful.  There was a really valid point buried underneath the performance-enhancing pill-popping message, and it would be great to see a documentary that truly addresses the issue of societal hyper-competitiveness.  Unfortunately, Netflix missed the mark.

Mental illness: Stop the stigma - graphic of face and megaphone with the words "speak up"

You can find more on mental illness stigma on the Stop the Stigma page.

Book cover: A Brief History of Stigma by Ashley L. Peterson

A Brief History of Stigma is the upcoming new release from Mental Health @ Home Books. It looks at the nature of stigma, the contexts in which it occurs, and how to challenge it most effectively.

Visit the book page for tips on how to be an effective advocate.

book cover: Psych Meds Made Simple by Ashley L. Peterson

Want to know more about psych meds and how they work? Psych Meds Made Simple is everything you didn’t realize you wanted to know about medications.

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14 thoughts on “Take Your Pills: Netflix and Stigma”

  1. 👏🏼 Too much misinformation out there and people are confused. Sounds like these shows confuse even more. Too many “experts” who are not qualified to objectively give information. Politics mixed into the conversation kills any chance of truth. Excellent write-up. 👍🏼 I am off all medication after years of back-n-forth… like you i would notice how medicine made things better until they no longer made them better and i could cope mentally. So, perhaps it is how people handle their diagnose and treat their medical advice, follow-up appointments and post-mental health diagnosis that is more crucial than all these rampant opinions. ❤️✌🏼

  2. Yes, I thought this exact thing when I saw this documentary pop up on Netflix. Such a shame really. Thank you for consistently speaking up about these issues, it’s admirable!

  3. I like that you spoke up on this issue . It’s super controversial. Especially in terms of education, is it cheating or not cheating ? Adderol and Ritalin are ‘study drugs’ . During finals and midterm seasons in university, you would be shocked with the amount of people who are selling these prescription drugs and how easy it is to get it on school grounds . You’d also be surprised with how many people use it too. To be honest, especially when I was going through school without treatment for my depression… I relied a lot on trying to find someone with one of these prescriptions . I became quite dependent on it for studying … I couldn’t study without it . I will say it was more for the focus effect .. if you got distracted .. there would be no going back to studying. I got to a point where II asked myself … do I really need it or am I convincing myself that I need it so I am now starting to believe it . Just thought I’d share. I haven’t watched the documentary so I can’t have too much of an opinion on this .

    1. I guess back in the day when I was in university it either just wasn’t a thing or I wasn’t aware of it, but at the time I didn’t know of anyone using stimulants other than caffeine.

      1. Oh people use caffeine pills like crazy. It’s dangerous . They pop it like candy . Study drugs have become a big issue sadly and people are a lot more open about it . If you study on campus, it would be easy to find someone in the library with it . I just graduated last year . I took a healthy psychology class and a health science , both discussed the dangers and prominence of it . If you’re interested, type into google ‘are study drugs a form of cheating” lots will pop up.

  4. Well constructed review. My children both have adhd and take medication for it. In the UK it’s classed as a controlled substance and is kept in a safe in the pharmacy. My older son started taking it about age 11 and it calms his mind sufficiently to allow him to see things more clearly, for example before medication he could not do jigsaw puzzles, not even a 50 piece puzzle, he couldn’t discriminate the pieces, within months of being on medication he began doing larger and larger puzzles up to 500 pieces. It has improved both boys concentration and focus but offers no intellectual advantage.
    It’s a very misunderstood drug and adhd is a much misunderstood condition.

    1. I agree. In a way taking stimulants for ADHD is like taking antidepressants for depression – it doesn’t make you a super-performer, it just brings you closer to what you’re capable of.

  5. Andrew Solomon has an excellent chapter in his Noonday Demon book on drugs and addiction, where which drugs are legal and which are illegal is debated.

    It makes me pissed off on how people think it is quirky and cool to be caffeine or sugar dependant and have cute shirts about it but god forbid you take a fucking Xanax. Yes, very different drugs, but then shut up about your addiction being “cool”.

  6. I actually just published a post about my take on the documentary. I loved it! I think it highlights people who abuse the medication and this is necessary for people who take it for genuine medical needs, like ours. I’ll put a link to my post, but you can delete it if you don’t allow that sort of thing. I understand how you feel though. I cringe when I hear people rant about how psych meds turn people into mass murderers. Stigma is real, folks!

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