Listen to thisHow a nation's turn to pills is reshaping childhood mental health
An investigation by The Wall Street Journal into ADHD prescribing revealed a national phenomenon racing ahead faster than families, science, or ethics can keep pace (Ramachandran, McKay, & McGinty, 2025). Within that reporting, the story of Danielle Gansky stands out as a portrait of the hopes parents cling to and the risks they often never see coming.
Danielle was 7 years old when her school suggested a psychiatric evaluation due to concerns about distraction and sloppy work. What followed was a decades-long journey through 14 psychiatric medications that left her unsure who she might have become without them.
Danielle began with a stimulant intended to help her focus. Instead, it left her agitated and moody. Prozac was added. Then more medications. Each new pill promised balance but created a deeper sense of detachment. Danielle said she felt she was living in a body hijacked by medication. By her late 20s, she was fighting to taper off an antidepressant and still trying to understand the long-term consequences of medications she had been too young to question.
Her story mirrors a nationwide trajectory. Millions of American children are prescribed ADHD medications, and many progress to a cascade of antipsychotics, antidepressants, and sedatives. Medicaid data show that children who start on ADHD medication are far more likely to be on additional psychiatric drugs within four years. Most had never received behavioral therapy, even though guidelines from the American Academy of Pediatrics advise behavioral approaches first for young children (Wolraich et. al., 2019). When schools push for quick improvement and parents fear their child will be expelled or fall behind, medication becomes the default.
The Rise of Polypharmacy
The rise of multidrug treatment in children is not new. More than 30 years ago, my colleague and I examined prescribing patterns and warned that some children were being placed on multiple psychiatric medications without sufficient evidence of safety or benefit (Goldstein and Turner, 2001). Our early findings showed a steady climb in combinations prescribed to manage side effects rather than underlying disorders, a pattern now fully visible in today’s data (Ozbeck et. al., 2025). The concerns we documented then have only intensified.
Parents often arrive at appointments exhausted, pressured, and out of options. Clinicians who lack extensive pediatric mental-health training may respond to stimulant side effects by adding more medication. Insomnia, irritability, or anxiety may be mistaken for new disorders requiring additional drugs.
For preschool children, evidence that drug combinations are safe or necessary remains strikingly limited. Researchers warn that the long-term effects of multiple psychiatric medications on the developing brain remain largely unknown. Antipsychotics raise particular concerns, with adult data hinting at cognitive risks after prolonged use, though comparable studies in children are scarce (Olfson and Blanco, 2016).
This landscape would have deeply troubled my mentor and friend, Dr. Keith Conners. Connors's research transformed the ADHD diagnosis through the Conners Rating Scale. His work legitimized a misunderstood condition. Yet near the end of his life, he issued a profound warning. In a 2013 interview, Connors lamented that ADHD had become a national disaster of overdiagnosis and feared he had helped fuel a runaway culture of medication (Schwarz, 2013). Connors died in 2017, burdened by that regret (Belluck, 2017).
What Pills Cannot Teach
For decades, I have emphasized an essential truth: Pills do not teach skills. In my parent guide, Hyperactivity (Goldstein, 1993), I argued that medication might stabilize behavior long enough for learning to occur. Medication cannot teach emotional regulation, self-control, frustration tolerance, or social competence. Those capacities require teaching, modeling, and repetition. When medication becomes the only intervention, children lose the opportunity to develop the abilities that shape long-term independence.
Families across the country describe how the scarcity of behavioral therapy contributes to overprescribing. In some communities, wait lists for therapy stretch months or years. Parents choose medication not because it is the best answer but because it is the only available one.
Trauma compounds the problem. Many children who have faced instability or loss develop behaviors that resemble ADHD. Medication may suppress those behaviors temporarily, but it does not heal trauma. Without trauma-informed care, children accumulate medications rather than skills.
What the Future Must Look Like
Polypharmacy in children has spiraled because quick fixes have replaced comprehensive evaluations. This trend has only intensified by the proliferation of online telehealth companies devoted to diagnosing ADHD (Huskamp, et. al., 2024).
To reverse the tide, clinicians need time to understand a child’s history rather than rely on a brief visit and a prescription pad. Schools must not pressure families to medicate for classroom convenience. Parents need real access to behavioral therapy that is affordable and available. Researchers need to produce the long-term safety data that should have been prioritized decades ago.
Above all, children need adults willing to slow down and look past symptoms to the story underneath. Medication should remain an option. It is transformative when used carefully. But it must always be paired with the supports that teach the skills children require to navigate life.
Children deserve a future shaped not by pressure or haste but by insight, patience, and developmentally grounded care. If we commit to that path, fewer will grow up like Danielle, piecing themselves together after years overshadowed by medication intended to help but often doing something else entirely.
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References
Belluck, P. (2017, July 13). Keith Conners, psychologist who set standard for diagnosing A.D.H.D., dies at 84. The New York Times. https://www.nytimes.com/2017/07/13/health/keith-conners-dead.html
Diller, L., & Goldstein, S. (2006). Science, ethics and the psychosocial treatment of ADHD. In L. Diller (Ed.), The Last Normal Child (pp. 31–36). Praeger.
Goldstein, S. (1993). Hyperactivity. Wiley.
Goldstein, S. & Turner, D. (2001). The extent of drug therapy for ADHD among children in a large public school district. Journal of Attention Disorders, 4, 212-219.10.1177/108705470100400403
Huskamp, H. A., Uscher-Pines, L., Raja, P., Normand, S. T., Mehrotra, A., & Busch, A. B. (2024). Trends in use of telemedicine for stimulant initiations among children and adults. Psychiatric Services, 75, 630 to 637. https://doi.org/10.1176/appi.ps.20230421
Olfson, M., & Blanco, C. (2015). Treatment of young people with antipsychotic medications in the United States. JAMA Psychiatry. https://doi.org/10.1001/jamapsychiatry.2015.0500
Özbek, M. M., Atay, E., Sevinçok, D., & Özbay, H. C. (2025). Psychotropic polypharmacy and related factors in children and adolescents. Psychiatry Investigation, 22(3), e12444199. https//doi.org/10.30773/pi.2025.0137
Ramachandran, S., McKay, B., & McGinty, T. (2025, November 19). Millions of kids are on ADHD pills. For many, it is the start of a drug cascade. The Wall Street Journal. https://www.wsj.com/health/wellness/kids-adhd-drugs-medication-06dfa0b7
Schwarz, A. (2013, October 31). The Selling of Attention Deficit Disorder. The New York Times. https://www.nytimes.com/2013/12/15/health/the-selling-of-attention-deficit-disorder.html
Wolraich, M. L., Hagan, J. F., Allan, C., Chan, E., Davison, D., Earls, M., ... & Zurhellen, W. (2019). Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 144(4), e20192528. https://doi.org/10.1542/peds.2019-2528
From: Psychology Today - https://www.psychologytoday.com/us/blog/raising-resilient-children/202511/the-unintended-consequences-of-quick-fixes-in-kids
