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Students with learning difficulties such as ADHD and depression can struggle to keep up with their peers in school. They will often have trouble paying attention, fail to understand instructions, and give up more easily on school tasks. Many suggest medication for ADHD, depression and other learning difficulties may be the answer to help students overcome these issues that hold them back in school.
Seeing a child struggle in school is difficult and so when a student needs extra support, parents and teachers will meet to discuss ways they can help the student to succeed better. While behavioral interventions and differentiation are always discussed, many parents and teachers want to help students see results more quickly. This can lead to discussions about whether medication might “unlock” the student’s potential and allow them to develop without the hindrance of their learning difficulty.
Does Medication Help Students with Learning Difficulties?
Medication can seem like a quick route to success when dealing with a struggling student. Medications are fast acting and are specifically targeted to help students in their area of weakness, whether that be ADHD, depression, or other conditions that can make learning in school more difficult.
While it can be difficult to see a student suffering from depression, simply medicating the problem away often does not result in any lasting changes for the sufferer. While there may be some short term changes that may be encouraging, medication often only works temporarily and does not actually teach students how to actually manage their emotions and learn how to utilize how their brain works to be successful in life.
Approaches such as Cognitive Behavioral Therapy (CBT) have shown significant improvements in sufferers with depression due to actually helping students get to the root of their issues and learn mental strategies to stop negative thought spirals that stay with them throughout life without any negative side effects.
Many suggest that medication only works in tandem with strategies such as CBT, one reducing the barrier to success and the other teaching the strategies to move past them. Many teachers and parents report students previously struggling with ADHD were significantly more able to focus on their work and remain on task when taking medication. New research has put this assertion into question, however, and suggests that medication may not only be unhelpful, but actually cause long term harm.
Especially in the late 90s and early 2000s in the United States, medication was being hailed as a groundbreaking way to help students manage their symptoms so that they can reach their true potential. Data from 2001 indicates that over 4% of all US students were taking Methylphenidate, more commonly called Ritalin. (Elflein) Ritalin is one of the most common drugs used to help students with ADHD focus better in class.
Since then, however, the number of students on medication has sharply declined as more research comes out questioning the efficacy of this quick fix. In 2021, the percentage of US students taking Ritalin had dropped from the 2001 high of 4.2% to just .5%. (Elflein)
This article will cover the new research that has put depression and ADHD medication’s efficacy into question. While medication may help students in the short term, it should only be used as a last resort for extreme cases as there are far more effective solutions that help students improve themselves to be more capable and have a higher quality of life in the long run.
Research on Medication for Depression
Depression is one of the most common mental conditions that students struggle with. While it can be difficult to differentiate the difference between teenagers’ natural tendency towards negativity and true depression, data from the Pew Research Center shows that 20% of teenage girls and 7% of teenage boys will experience major depression before reaching the age of 18.
Students suffering from depression and anxiety can have a very difficult time focusing in class and getting work done. In severe cases, this can even lead students to consider of even commit suicide. Because of these sobering statistics, it is imperative to understand whether medication can be a route to help students improve their quality of life and overcome their depression.
Research was conducted using data collected from the United States’ Medical Expenditures Panel Survey in order to determine whether depression medication led to long term improvements in the quality of life of patients. (Almohammed et al.) In order to quantify their results, the researchers used a measurement called health-related quality of life (HRQoL).
HRQoL is used by researchers to objectively measure a person or group’s mental and physical wellbeing over time. The data revealed that despite some small improvements in mental wellbeing in patients who had taken medication, this was no different than improvements seen in patients who had not taken medication.
These results show that while there may be a measurable improvement in mental health, it is important to not confuse correlation with causation. Since these same benefits were seen in patients who had not taken medication as well, the medication could not have been the reason for the increase in mental wellbeing.
Whether a person takes medication or not did not have any measurable effect on their wellbeing. Because of this, it puts into question whether the side effects, costs, and time investment of getting on medication are really worth it for an individual suffering from depression. It seems more likely that as people age and mature, they are better able to manage their minds and know themselves better as people. They also are no longer held back by general school standards and have moved on to careers that are more likely to suit their individual interests and skill sets.
Research on Medication for ADHD
Students in Canada also saw a period of very high medication for students with ADHD in the late 90s and early 2000s due to legislative changes that made stimulant medication, such as Ritalin, easier to access due to an increase in insurance coverage. Because of this, researchers based in Quebec wanted to see the effects this uptick in medication had for children.
The researchers used survey data along with questionnaires to assess children who had been on stimulant medications for various time periods in order to see the medium and long term efficacy of the medications they were taking. The study was a “natural” study that did not occur under laboratory conditions, this type of “natural” experiment has benefits of seeing how the increase in medication worked in a real world setting, rather than some ideal perfect scenario.
The results showed that not only did those receiving medication for ADHD not show improvements, the researchers found a plethora of negative effects. According to head researchers Janet Currie, “We find little evidence of positive effects on academic outcomes or schooling attainment. In fact, we find deterioration in important academic outcomes including grade repetition and math scores.” (Currie et al.)
So rather than helping students to manage their symptoms and perform better, the researchers found that being on ADHD medication had a marked negative effect on grades and even the rate of students being held back a whole year. The researchers gave several suggestions for why this may be the case.
- Medication can lead to social stigma.
According to the researchers, being on medication often comes with social stigma. Students who are on medication are often also in special education programs that, while generally effective, may isolate students and lower their self esteem.
Many students on mediation for ADHD or depression may also not want their peers to know they are taking medication for similar reasons. They may worry that their friends will think less of them for taking medication. This can lead to anxiety as students will worry that their friends and peers might find out about their medication and add more anxiety than help.
- Medication can be used in place of more effective treatments.
Another possibility the researchers posited is that medication is often used as a quick fix and leads to other, more optimal interventions not being employed. Medication quiets and calms students, but does not help them learn. Students who are calm and “under control” will get less attention from the teacher and this can obviously lead to less learning.
- Dosage and adherence may not be optimal and therefore not effective.
Medications for the brain are extremely dose dependent, meaning that not being on an appropriate dosage can either not create effects if not high enough or be overwhelming and have many side effects if too high. In addition to this, effective dosages are very different between individuals. One person may require a high dose in order to get any positive effects at all, while others may only need a small dose.
This makes it very difficult for doctors to get patients on a proper dosage as it often involves quite a bit of trial and error before finally landing on a dose that appears to work. This trial and error period may involve students being on dosages that worsen their conditions rather than helping, perhaps leading to some of the negative effects seen in the study.
In addition to these negative effects found on academic performance, the researchers noted that being on a stimulant medication for ADHD actually led to an increase in reporting of a lower mental wellbeing and a higher likelihood that the student would develop depression, but surprisingly only for females.
While the reason for this is unclear, it is still important to note that medication should never be something that is simply tried out “just to see” if it will work as it can have very serious side effects. Depression is one of the known possible side effects of some ADHD medications.
Getting on medication for ADHD may take a child who simply has too much energy and has trouble focusing and give them depression. While the calming and sedative effects of ADHD medications may calm students down, it can also bring them too far down, sucking out their positivity and energy and replacing it with blank stares and a feeling of emptiness.
Conclusion
While medication does have its place in the most severe of cases, these results show that medication is not the best solution for the vast majority of students suffering from mental health conditions or learning difficulties. Medications often come with a host of negative side effects and appropriate dosage can be very difficult to pin down.
There are other approaches, such as Cognitive Behavioral Therapy (CBT) which help people to learn to manage their symptoms and understand their brains better without using chemicals to suppress troublesome symptoms. These non pharmacological approaches are also backed by solid research and don’t have the negative side effects that often accompany medication. (Lepping et al.)
When a person wants to strengthen their muscles, they have to use their muscles regularly in a mindful way in order to slowly see improvement in their muscle structure. Similarly, when trying to improve a person’s mental health and thought patterns, it is crucial to train thoughts using thoughts themselves rather than trying to find some chemical shortcut.
It is also important to not focus on the now and instead focus on what will lead to long term improvements. Patients in mental asylums in the mid 20th century were often given sedatives that made them easier to manage, but ended up leading to them being often ignored, stigmatized, and did not lead to better health outcomes.
Similarly, it is important to not confuse students being more “manageable” in the short term with an actual improvement in their mind’s ability to perform. Being on medication may reduce symptoms for a time, but medication does not teach, it only suppresses. This will result in students on medication to, at best, be reliant on a medication in order to function, and at worst, may simply trade a lack of focus for depression which may then in turn lead to more ineffective and side effect ridden medications.
Instead, teachers and parents should seek to help students develop mental strategies that the student can take with them the rest of their lives. Just as a person who exercises mindfully will get stronger muscles and lead to better overall health, a person who trains their mind using mental strategies will have a healthier mind.
Some people, especially those with physical conditions, may need to see a physical therapist or personal trainer to learn better techniques and approaches that work for their bodies, some sufferers of mental health issues may need their own trainer in the form of a therapist or psychologist to give them mental exercises to train their brain.
If a teacher sees a student struggling with attention in class or seems quite down and sad, their first thought should not be to suggest medication, but instead to suggest visiting the school counselor, psychologist or learning support teacher. Medication should only be used as a last resort for the most extreme cases when everything else has been tried.
Just like teaching to a test may seem to show good results as they will probably score higher on that test they’ve been taught, this approach does not teach students how to learn and do better on all future tests. While not using medication may lead to students being harder to work with, in the end, they will be better balanced and developed individuals who have strategies to manage the way their brain works and cope with the struggles they will inevitably face in life.
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References
Almohammed, Omar A., et al. “Antidepressants and Health-Related Quality of Life (Hrqol) for Patients with Depression: Analysis of the Medical Expenditure Panel Survey from the United States.” PLOS ONE, vol. 17, no. 4, 2022, https://doi.org/10.1371/journal.pone.0265928.
Currie, Janet, et al. “Do Stimulant Medications Improve Educational and Behavioral Outcomes for Children with ADHD?” Journal of Health Economics, vol. 37, 2014, pp. 58–69., https://doi.org/10.1016/j.jhealeco.2014.05.002.
Elflein, John. “Ritalin Use Annual Prevalence among U.S. Students 2021.” Statista, 11 Feb. 2022, https://www.statista.com/statistics/696531/us-annual-prevalence-of-ritalin-use-in-grades-8-10-12-since-2001/.
“Health-Related Quality of Life (Hrqol).” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 16 June 2021, https://www.cdc.gov/hrqol/index.htm.
Lepping, P., et al. “Clinical Relevance of Findings in Trials of CBT for Depression.” European Psychiatry, vol. 45, 2017, pp. 207–211., https://doi.org/10.1016/j.eurpsy.2017.07.003.
