Several brain scientists recently wrote in the journal Nature (published online December 7) that it is time that science and society explore and, ultimately, sanction the use of pills to enhance brain function in people with no psychiatric disorder at all.  After all, they reason, pills already exist that can improve attention span, memory and alertness in normal individuals.  Many students already use illegally obtained Adderall to boost their academic performance, and many adults use Provigil to stay awake and energetic at work.  So why not sanction the use of these drugs and, perhaps, many others to help anyone who might want to perform better and feel better?

Using pharmaceuticals to change one’s mood, energy level or comfort socializing, one could argue, isn’t any different than men (who are not impotent) using Viagra to improve their sexual performance or any of us drinking six cups of caffeinated coffee a day to stay more awake and feel a little happier or less irritable.

There’s potential trouble, however, with any plan to open the floodgates and allow pharmaceutical manufacturers to develop and market substances that alter brain chemistry in healthy people.  One of the problems is that it could easily raise the bar in terms of what it takes to be competitive in school or at work—just as letting athletes freely use performance enhancing drugs in sports would make it a near-necessity for every athlete to use them.

Another problem is that once we green light chemically synthesized compounds for people without any disorder who simply want to be happier, more productive or more energetic, our laws against illicit substances like opiates (including pain killers like Percocet and Oxycontin) start to look suspect.  It could be argued that there may be millions of Americans with low potential for addiction who might enjoy the euphoric effects of Oxycontin, be able to work long into the night while using it and be able to stop using it periodically to prevent themselves from becoming fully dependent on it.

Perhaps the biggest problem is that using pills to alter how we function intellectually, emotionally or otherwise can easily create a tide that sweeps us further and further from the reality of our life circumstances.  Even if your work makes you unhappy, why consider following your heart to another career when you can change your brain chemistry so you feel alert and energized just by popping a pill?  Why make fundamental changes in your marriage to improve it when you can dose yourself with a substance that will make you feel calm and connected at home, without changing a thing?  Why learn to lead a balanced existence, with the time you need to reflect or to recharge, when all the valleys in your day can feel like peaks?  Sounds a lot like taking a drink or smoking a joint to dodge reality, doesn’t it?

It is probably inevitable that growing numbers of Americans will turn to pharmaceuticals already in existence to boost their brainpower.  But it may be a desirable brake on a potential runaway train that doctors currently have society’s blessing to prescribe medications only to those suffering with recognized psychiatric disorders.   Defining life itself, including work life, as a kind of disorder worth treating, or as a baseline to be raised chemically (higher and higher), feels like floating free of our ties to our real-life emotions and passions and possibilities.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement. Check out Dr. Ablow’s website at livingthetruth.com or e-mail him at info@keithablow.com.

A new report published in the online edition of Occupational and Environmental Medicine puts more data behind what we psychiatrists and psychologists have long known from listening to our patients:  Attention Deficit Hyperactivity Disorder (ADHD) is costing American businesses untold millions in lost productivity.

Studies reveal about 4.5 percent of working Americans suffer with ADHD.  One of the new findings is that each loses, on average, more than 22 days of productivity annually.  That translates into billions of dollars in losses.

I think the toll could be much higher.  Undiagnosed and untreated ADHD not only saps productivity in and of itself; it fuels other substantial causes of suffering and lost possibilities, including substance abuse and dependence, workplace accidents and inability to master new skills and reach increased levels of education and performance.

Many patients of mine only learn after visiting with me that their use and abuse of alcohol and illicit drugs (including cocaine) has been partly driven by searching for relief from the constant psychological discomfort of underlying ADHD.  Treating the ADHD makes it possible for them to become sober.

As an expert witness in cases involving the workplace, I know that ADHD is the music playing in the background of life-altering (and economically devastating) injuries.

Other patients I have treated tell me that they gave up hope for advanced training or for advanced degrees because they cannot focus long enough to master new skills or new knowledge. 

The modern workplace may itself be accelerating the costs.  Voicemail, e-mail, text messaging, video conferencing and telecommuting translate to a free flow of ideas, rapid transfer of information, and flexible lifestyles.  But they also call for quick changes of focus and self-direction.  For those with ADHD, the information super- highway can look a lot more like a maze. 

American employers would be well-served to offer education about ADHD, and confidential screening and treatment for it.  Even more could be saved — in human and economic terms — if that screening took place earlier rather than later, as part of our public education system. 
It any expanded screening and treatment program, it will be critical that ADHD is not oversimplified.  While stimulant medications can be tremendously helpful, patients of mine with ADHD have had complicated life stories, often marked by emotional turmoil early in life.

An essential part of helping my patients feel better includes listening to their stories and convincing them to stop running away from their feelings (by not focusing on them – or anything else).

The best reason for the education system and/or the workplace to undertake new initiatives to diagnose and treat ADHD is that the condition is indeed, treatable. 

Once patients identify ADHD as a major factor in their lives and get help for it, the changes I’ve seen in their lives are astounding and inspiring.

When “Fidgety Philip” grows up, the problems of attention deficit disorder can multiply into loss of nearly a month’s work per year.

Long seen as a problem for children, attention deficit hyperactivity disorder was first described in 1845 by Dr. Heinrich Hoffman, who wrote “The Story of Fidgety Philip.”

More recently, it has been recognized as continuing into adulthood for some people, and new research seeks to estimate the effect of ADHD on workers.

This lack of ability to concentrate costs the average adult sufferer 22.1 days of “role performance,” per year, including 8.7 extra days absent, according to researchers led by Dr. Ron de Graaf of the Netherlands Institute of Mental Health and Addiction. (Continue)

Children should be screened for heart problems with an electrocardiogram before getting drugs like Ritalin to treat hyperactivity and attention-deficit disorder, the American Heart Association recommended Monday.

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