After world war II, American citizens held deep-seated anxieties regarding modernity and the proper development of the nation. Teens, who ‘have always been viewed as a problem that needed to be managed and solved’ (Passanante, 8), posed the greatest threat to proper development. Which is why these larger deep-seated concerns manifested themselves in American societies preoccupation with adolescent behavior. Post world war II, teens were a cause of anxiety because of the rising levels of juvenile delinquency and teenage rebellion. Teens during this period were viewed as rebels who dressed in black leather and were vulnerable to external corruption. The only way to deal with rebels was to punish them. The cultural depiction of teens changed with the work of Erik H. Erikson on identity crisis. According to Erikson, identity crisis is ‘a period of ‘role confusion’ usually occurring in adolescence, when a person feels conflicting internal and external pressures as s/he searches for a clearer sense of self and the role s/he will play in society’ (Passanante, 13). It is this definition that began to change the perceptions attached to the teenager as a figure of society. This concept of identity crisis was discussed in Erikson’s book, Identity: Youth and Crisis, which was released in 1968. During this period, there was a larger cultural shift towards a culture of rehabilitation. The larger cultural shift and the perspective of teens as/is crisis, led to the development of rehabilitative edutainment post 1968. Rehabilitative edutainment was imagined to be a ‘realistic, socially relevant, and entertaining variety of popular culture that would be healthy and informative for impressionable teen consumers’ (Passanante, 4). The narratives featured in rehabilitative edutainment tended to be narratives of disability. Which only supported the conflation of adolescence and disability. This conflation made adolescence seem as if it was something to be overcome.
The combination of rehabilitative edutainment, the discourse of teens as/in crisis, and the normalization of the culture of rehabilitation led to a cultural shift in which teens were no longer viewed as rebels. Instead teens were viewed as patients. Teens still posed a threat to the proper development of the nation, but the corruption of teens no longer stemmed from external sources but internal medical diagnoses. The shift from rebel to patient ‘validated teen angst as deriving from a very real mind-body process that was simultaneously normal and pathological’ (Passanante, 13). The shift from rebel to patient only further cemented the connection between adolescence and disability, ‘both have been understood as abnormal (and undesirable) bodily states’ (Passanante, 14). The pathologization of adolescence rose during the 90s, with the release of new studies in the neuroscience field stating that ‘normal adolescence was a neurological impairment’ (Passanante, 133). The Decade of the Brain only served to promote more pharmaceutical interventions for adolescent behavior and normalize the connection between adolescence and disability. It was during the Decade of the Brain that the FDA enacted the Modernization Act of 1997. This act loosened FDA regulations and allowed for the use of direct to consumer pharmaceutical advertising. As a result of the Modernization Act of 1997, drug sales tripled to US $400 billion worldwide and almost US$200 billion in the US. Drug sales specifically for adolescent ADHD have increased about 8 percent each year, and diagnoses have increased about 42 percent in the last eight years. (Engel). The increases in drug sales and diagnoses can be explained using the pharmaceuticalization-medicalization complex. According to this complex, ‘doctors’ prescribing of pharmaceuticals may increase because of widening diagnostic criteria of conditions for which new drugs are emerging or for which existing drugs may be repackaged for a new market’ (Passanante, 292). The Decade of the Brain helped to establish adolescence as pathological and in need of pharmaceutical treatment. The concurrent loosening of FDA regulations provided teens with the pharmaceutical resources they need to overcome their neurological impairment.
The pharmaceuticalization/medicalization of adolescence only serves to ‘grant the institution of medicine undue authority of over teen bodies, minds, and lives, thereby limiting the individual autonomy and functioning as a form of social control’ (Bird, 152). In protest to pharmaceuticalization/medicalization, organizations such as the Citizens Commission on Human Rights (CCHR) have aired their own ads to subvert the dominant knowledge structures regarding teens as patients. One of their ads begins with the following words on a black screen: ‘5 million kids are labeled ‘ADHD’ the vast majority are boys’. After a few seconds a montage of boys skating begins to play on the screen. Throughout the montage the following words appear, ‘ boys are reckless, wild, impulsive, wired, untamed energy, constant motion’. There is another black screen with the phrase ‘the ADHD checklist’. The montage continues with the following phrases appearing on the bottom of the screen, ‘is often on the go, acts as if driven by a motor, runs or climbs excessively, difficulty playing quietly’. The montage ends and another black screen appears and the following phrases flash onto the screen, ‘Energy is not a disease, motion is not a disease, behavior is not a disease, childhood is not a disease, neither is adhd’. After one last shot of a kid on a skateboard, the ad ends (CCHRINT ADHD ads on national TV). Even though the message featured a little boy, the ad is still able to disrupt the depiction of the teen as a patient and question the pharmaceuticalization/medicalization of ‘normal’ behavior.
Another commercial, made by youtube user ‘themaple89’, is an imitation of direct to consumer ads. In the ad two teens are sitting in the car, one in the backseat and the other driving the car. The teen in the backseat is playing a person diagnosed with ADHD; the person driving the car is playing their parent. The commercial starts off with the ADHD person rambling and acting very energetic. The mom, who is clearly annoyed at this point, gives them their pills. While she does this, she says, ‘For days like these, Ritalin really helps me get through it’. The child in the back quiets down as the mom continues to drive. During this point, a minute long voice-over lists all the possible side effects of the pills (Ritalin Commercial). This commercial highlights the fact that the pharmaceuticalization/medicalization of teens was never about solving real teenage problems, but calming the anxieties of adults. Teens have never had autonomy over their bodies, and pharmaceuticalization/medicalization only further limits their autonomy.
Bird, Chloe E, et al. Handbook of Medical Sociology. Nashville: Vanderbilt University
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‘CCHRINT ADHD ads on national TV.’ Youtube. Youtube, 28 March 2012. Web. 8
Passanante, Julie Elman. Chronic Youth: Disability, Sexuality, and US Media Cultures of
Rehabilitation. New York: New York University Press, 2014. Print.
‘Ritalin Commercial.’ Youtube. Youtube, 4 April 2013. Web. 8 April 2015.
Engel, Meredith. “ADHD Medication Revenue Is Up: Report.” NY Daily News. Daily
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