Public Bickering And The Silent Suffering: A Response To John MacArthur

By now, much digital ink has been spilled on social media and in the blogosphere concerning inflammatory, if not unsurprising comments made by Pastor John MacArthur on the socially dynamic issue of mental health and illness. Speaking at a church conference in California on April 20, MacArthur went on record as saying that common mental health diagnoses such as OCD, ADHD, and PTSD do not actually exist, but are instead “noble lies” created by the fields of psychology and psychiatry to “medicate people.”1 MacArthur went on to assert that “Big Pharma” is to blame for much of the mental health crisis, and that its production and delivery of psychotropic medications is one of the most deadly circumstances ever unleashed on our children.

Beyond these comments, MacArthur continued to opine that diagnoses such as ADHD—or more appropriately, the cluster of symptoms surrounding the diagnosis—can all be attributed to poor (sinful) choices on the part of the child and bad parenting. MacArthur then warned that parents who choose to medicate their children in response to an ADHD diagnosis are setting them up to become “drug addicts and criminals.”

Here is where full disclosure in research hits for the purposes of this essay:

My wife and I are the parents of four kids. Three of the four are domestic adoptees. Each of the three were drug exposed in-utero. And two of the three have ADHD diagnoses; one with anxiety and the other with “inattentive type with impulsivity.” Common comorbidities in ADHD kids, such as learning disabilities and short-term memory issues, are present in both. I share their stories only after much reflection. The facts belong to them. But, given the gross misunderstandings which exist within the church, I cannot advocate for them and others as effectively by maintaining silence.

So, not only are my wife and I biblical counselors by vocation with a natural interest in these and related topics, but we are invested in these concerns at the highest of levels personally. I have to own my biases. That said, my desire is to engage these issues with biblical faithfulness and a fair-minded relationship to secular data and research. My own kids and the people to whom we minister depend on it. Contrary to what another biblical counseling pastor has asserted, our efforts are not about fascination with secular sophistication; it is all about family.

A Concern for Truth

When my wife and I listened to MacArthur’s comments, we both knew right away that the man was speaking out of turn, and in a way that could be a legitimate threat, spiritually and physically, to any who would hear him and be motivated to follow his counsel. Frankly, I found MacArthur’s comments to be rooted in a fear of what he does not well understand—by choice. MacArthur does not lack the ability to relate properly to these issues—he lacks the will.

To bring more clarity, it is important to understand that MacArthur does not deny that people experience troubling thoughts, emotions, and behaviors—those clusters of symptoms to which the secular mental health world has attached names like OCD, PTSD, and ADHD. What he denies is that they have any biological origin. He and others appear to take up this position because, to date, none of these diagnoses have been assigned an agreed upon pathology. The etiologies (origins) of these disorders are not fully and finally understood and identified. This is an unfortunate position to take; among other things, the lack of an established pathology is not equivalent to the conclusion, “ADHD does not exist.” In order to take up MacArthur’s position, one must willfully deny the mountain of well-researched evidence pointing to biological origins and interactions. The fact is, medical science could be just around the corner from discovering an identifiable pathology for any of these diagnoses; living as if that is not true does not help anyone.

Considering ADHD specifically, there is valuable and intriguing research evidence pointing to a lack of “white matter” in the brains of young boys who have been diagnosed with ADHD. White matter is that stuff which makes up or contains the neurological tissue wherein information is properly transmitted in the brain. The lack of white matter, it is reasonably hypothesized, is a physical condition of the brain wherein ADHD may well be the result, among other negative health outcomes.

The good news is that there is a growing body of research suggesting strongly that young ADHD boys who receive appropriate stimulant medication (specifically with a drug called methylphenidate) will see an increase in white matter over time.2 This is all, by the researchers’ own admissions, correlative. They cannot and do not claim causation. But the correlations are significant. To dismiss them out of hand and prohibit sufferers the opportunity to potentially benefit from the findings with appropriate caution while simultaneously receiving biblical counseling is foolish. This runs afoul, in my estimation, of a Reformed understanding of common grace.

Further, research from a variety of sources bears significant data suggesting that children who receive proper medical care for ADHD experience better outcomes as they age in comparison to their peers who receive no medical care. The categories of concern include overall mortality and risk for drug abuse. MacArthur specifically warned parents that to medicate their children for ADHD would raise the risk of them becoming drug addicts. Unfortunately for MacArthur, the evidence is the exact opposite. Children who are properly treated for legitimate ADHD diagnoses (read: no, to over diagnosing and improperly medicating) experience lower levels of impulsivity, and as a result, see a significant percentage decrease in drug abuse.3

The circumstances I just summarized in brief remind me that MacArthur described ADHD kids as being “unable to sit still or pay attention.” This is a gross mischaracterization or simplification of what ADHD kids and their families actually experience on a daily basis. It is disappointing to know that some in the biblical counseling movement share this negligent understanding and take up ministry to these children and families as if these were the two main symptoms. In fact, the actual panoply of symptoms is quite diverse. If a biblical counselor intends to bring hope to those suffering from the effects of diagnoses such as ADHD, OCD, or PTSD, they owe it to their counselees and their families to be properly familiar with the actual experience and relevant data, and not settle for mere pop-level, colloquial definitions. Anything less is an inexcusable disservice to those we serve and a blight on the credibility of the biblical counselor’s work.

Trust Christ and All His Benefits 

After MacArthur’s initial statements lit the internet on fire, he appeared on a podcast with social media personality, Allie Beth Stuckey. In the interview, MacArthur attempted to defend and clarify his previous statements. At the conclusion of the interview, MacArthur made what I considered to be the most disastrous of pastoral comments: “Trust Christ, not chemicals.”4

Of all the comments MacArthur offered in this saga, this was the most insensitive and nonsensical. Nonsensical, because no one in the Christian community with whom I am familiar is advocating otherwise; quite the opposite. Insensitive, because the inference is that those who choose medication after prayer and deliberation have chosen to be disloyal to Christ. Such an assertion is highly offensive and unwarranted. To weaponize the complicated and nuanced decisions that families and struggling individuals are making under difficult circumstances is spiritually manipulative. Is it possible that someone out there somewhere is doing just that? Sure. But one ought not shame the majority because of the poor choices of a few—particularly when lives hang in the balance.

Instead of subscribing to MacArthur’s view of mental health care—which rejects out of hand the impressive body of observational evidence available to us in the secular realm as the direct result of God’s common grace to all mankind, and without appealing to the problematic use of cobelligerent research (a common problem within particular corners of biblical counseling)—I suggest, along with many other biblical counselors, that we make meaningful use of common grace truth, while holding fast to our biblical worldview.

The irony is that the God who gave us his special revelation in Scripture is the same God who provides that common grace truth found outside of Scripture. The artificial bifurcation of these two bodies of truth, where the common is labeled as wicked and of no use to the Christian, is an unfortunate circumstance driven by a variety of unnecessary factors. I suspect that fear, suspicion, rationalism, and biblicism are among them, but those are not topics for this post.

In the end, I will commend MacArthur and others for their strong commitment to and desire for a church wholly submitted to God and his Word. I would commend them for their great desire to see people everywhere anchored in the hope of Jesus Christ for all of life’s dominating circumstances. I and those who stand with me hold the same desires; we even share many of the same biblical strategies in our helping ministries. The rub comes where we hold some divergent ethical conclusions that we each consider to be valid and important.

The church needs us to work hard at reconciling those differences, because as we bicker in public, real people suffer in silence.

As we lean into the future of mental health care and biblical counseling, we must pursue what it means to enjoy Christ and all of his benefits, and to hold out to sinners and sufferers alike the full breadth and scope of all the help and hope that is contained therein.


  1. “Is Mental Health a Myth? Guest: Dr. John MacArthur,” Relatable with Allie Beth Stuckey, Episode 1008, April 20, 2024.
  2. Helen Dwork, “Methylphenidate May Affect Brain Development of Children with ADHD,” Additude, April 1, 2024, footnote 1.
  3. Nicole Kear, Melanie Wolkoff Wachsman, “ADHD Medication Use Lowers the Risk of Death, Hospitalization: Study,” Additude, April 5, 2024.
  4. Allie Beth Stuckie, “Is Mental Health a Myth? Guest: Dr. John MacArthur,” Relatable, May 24, 2024, podcast.

©Joshua Waulk. All Rights Reserved.


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  • Joshua Waulk
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    Joshua Waulk is the founder and executive director at Baylight Counseling, Inc. in Clearwater, Fl. He is married to Christy, and has four children, three of whom are adopted. Josh earned his MA in Biblical Counseling at Southeastern Baptist Theological Seminary, and is completing his final project toward the Doctor of Ministry, also in biblical counseling at SEBTS. His project focuses on attachment issues in Christian adoptive parenting.

    More by Joshua Waulk ›

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  1. Having been a sheep for well over half a century I have run into this same line of thinking many times from my shepherds. Never being the object of their counseling, yet seeing the results, I have witnessed the carnage. One Pastor in particular, who was trained in the Jay Adams nouthetic counseling method announced once that he did not believe in mental illness. There is only sinfulness or “brain damage”. He also proudly bragged that he had never taken “mood altering drugs” but had read the psalms as his medicine. This statement was made in a bible study to a woman who was being treated for schizophrenia. I appreciate you advocating for those who experience these challenging illnesses.

  2. Well said! MacArthur statements put him on the same level in many respects to ‘name it and claim it’ preachers who tell their congregants to stop taking medicine because they are healed.

  3. What gives with John MacArthur? Where is his pastoral heart for the hurting? And instead of casting stones at Big Pharma for pushing RXs for mental illness and related issues, why doesn’t he tear into BP for foisting COVID-19 and its “safe and effective” vaccines on the populace, resulting in a never- ending, worldwide medical holocaust?

    And is MacArthur so steeped in 1Timothy doctrine that he views women are mere receptacles for men a la Driscoll and nothing more? CT reported in early 2023 that several women at Grace Community Church “had been doubted, dismissed, and implicitly or explicitly threatened with discipline while seeking refuge from their abusive marriages” by GCC elders and MacArthur (see and

    May the Lord work in this man to give him a compassionate, less critical heart of flesh. I continue to reject out of hand any of his books suggested by friends and our church; I don’t wish to benefit his bank account. And perhaps he should read a book previously reviewed at the HB:

  4. I admit I have no real insight into how such issues are addressed in a traditional therapeutic context, but I do think it is incumbent upon those seeking to help others to take seriously all of the possible contributing factors including dietary choices (sugar content, caffeine content, artificial flavoring and coloring, etc), exposure to the relentless barrage of media that our current age offers, and parenting approaches.

    One of our five adoptive children came into our care at 10 years old with a list of diagnoses and accompanying medications for them. He had been on them for years prior to joining our family. After a few years, by God’s grace, we were able to eliminate all of his medications with the oversight of the clinic that had been administering the medication. This is obviously a sample size of 1, but it does speak to the potential effectiveness of consistent and intentional care when a child diagnosed with ADHD, ODD, anger issues, and Asperger’s is now graduating high school with above average grades and is, by all accounts of those who knew him before, a completely different person.

    This is surely a divisive topic though I wish it weren’t but I am hopeful that more consideration will be given to the detrimental effects to things which most in our age take for granted, such as the prevalence of caffeine and media intake, regardless of age. I am praying for and actively seeking to encourage other Christians to think more seriously about what it means to not be conformed to this present age. I believe it would help address quite a few of the issues in mental health and also give the church a more effective witness to a dark and dying world. There seems to be an underestimation of how pervasive the effects of the curse are even in those who have been redeemed and indwelt by the Spirit of Christ. From my admittedly limited observation, humble and regular introspection regarding the day to day choices we make and how our walk with the Lord is helped or hindered by those choices seems to be a rarity amongst those for whom Christ died.

    Recognizing how a position such as mine can be misunderstood, I readily acknowledge that each individual is unique and some approaches will prove more beneficial than others, but I do think that what I briefly alluded to above should be an integral consideration for every thoughtful Christian irrespective of any diagnosis they might be dealing with.

    If anyone is reading this and would be interested in discussing my likely poor attempt to articulate my concerns in a more conversational setting than a comments section, please do let me know.

    • Christopher – No self-deprecation please! Yours was NOT a “poor attempt” at all! I too should’ve taken the time to mention how so many food additives, etc. indeed precipitate, let alone exacerbate, mental/mood aberrations and the like. I shudder when I see the long lists of multi-syllabic caca that goes into so many prepared foods, as well as supposedly-healthful supplements and the like. We have perverted purity of foods under the guise of progress and science… Blessings!

  5. Many years ago I listened to GTY, as I had little background in the Christian faith and found McArthur to be an effective teacher. As a psychiatrist who has sought to understand and treat my patients from multi dimensional perspective (biological – psychological – social/relational – spiritual) I tired of his periodic attacks on my profession and stopped listening to him. Eventually as I came to a solidly Reformed understanding of Scripture, I had zero use for him.

    Perhaps it has become far more acceptable for Christians to discuss psychiatric issues than it used to be, but McArthur has been making the same IGNORANT comments for decades! Honestly I never got any ‘traction’ in my own critiques of him, so I stopped commenting.

    Pharma has become a horribly corrupting influence in medicine (see COVID – both by active attacks on those of us advocating HCQ, IVM, etc and when we opposed the jabs). Many years ago I did some educational / promotional talks but stopped in 2000 when the companies were mandating they become more of an “infomercial.” There is no doubt there is a problem, and I do think meds are thrown at children too quickly. But as noted, ADHD is real.

    So is PTSD, and the complex interaction between physiology, cognition, memory, and emotion become disordered. Add in physical damage (TBI – traumatic brain injury) from having “my HUMVEE blown up under me” (as a former patient used to say) and one is dealing with a complex situation requiring highly individualized treatment.

    And THAT is where I indict our medical system: no longer do MDs learn to truly evaluate a patient & develop an evolving treatment plan. Instead they go through a “symptom checklist,” order the “recommended” tests, and then follow a cookbook protocol. For some areas of medicine, such an approach works. For dealing with psychiatric issues, this is inadequate. I tell my patients we are doing a research study with N=1 subject. Such an approach takes time, commitment, and a breadth of perspective (various ‘theoretical models’ if you will) that are no longer taught. Also observe that psychiatry has been corrupted by social forces. A man believing he is actually a woman USED TO BE understood as delusional. Now he is BRAVE!

    May God have mercy on us all!

  6. Seems like underlying MacArthur’s comments is a faulty anthropology. Man has a bipartite nature, body and spirit, and the interrelation between those two parts is something of a mystery. To say that sins, dysfunctions, or mental illnesses can’t arise biologically is to treat people as something other than a body-soul unity. Perhaps it reflects that famous but quite wrong maxim, “You don’t have a soul. You are a soul who has a body.” Anyone who has ever lashed out in anger, only to realize he is “hangry” (not as an excuse, but as an explanation for otherwise unexplainable behavior), knows that the body affects the soul.

  7. I appreciate the perspective. Reasonating with me is your comment that we might just be around the corner from identifying a pathology. I couldn’t agree more. I go to Grace, and this is something that has always felt a little off, but I am seeing it more and more as an issue that informs the way our church handles its counseling so it has real consequences. We were told the pastor has taken time away from the pulpit to study the issue more thoroughly, and we can only hope the the holy spirit leads him to a correct understanding.

  8. I wrote off John MacArthur a while ago for dismissing a woman in his church during the Lord’s Supper for her refusal to return to her abusive husband as required by his elders. When I read his comments on PTSD I feared for the members of the military, firefighters, EMS and police in his congregation who have been diagnosed with PTSD. Do not tell them that this affliction is not real.

    • I work as a correctional chaplain and can attest that PTSD is not only real, it has figured into the deaths of multiple of my peers. In over 15 years of work in corrections, I have performed more suicide funerals for co-workers than I could have ever imagined. In fact, the last data shows that the suicide rate among corrections professionals stands at 105 per 100,000, more than double that of the next nearest profession, and 7 times higher than the national average.

      A bit over 7 years ago, I attended two separate week-long training seminars concerning PTSD, what it is, and how to deal with it. Having been taught the Jay Adams nouthetic counseling system in seminary, I found it wasn’t quite enough when confronted with those whose memories of trauma came unbidden to the fore of their minds. Most of the people I work with want to change, they want not to remember, they want not to be depressed, they want not to become violent, they want not to be on medication, and their anguish as they share their stories is heartbreaking. To dismiss their condition as John MacArthur does is ignorant at best and horribly unloving at worst.

  9. If only Paul had been a little holier, I bet God would have pulled that thorn in his flesh right out!

    I really appreciate this author’s appeal to common grace. Common grace is for believers too. It is no sin to enjoy the blessing of medicine. Of course sin is the real source of the problem! That’s what it means to be born under Adam’s curse! Creation is corrupted. But it’s an “over-realized eschatology” that assumes we can escape every consequence of that corruption this side of Christ’s return. Till then, we wait eagerly for the redemption of our bodies. That includes mental illness.

  10. It would seem to me that the generalizations are the problem, i.e., there’s no such thing as this or that, or on the other hand all cases are legitimate ADHD, PTSD, OCD.
    I’ve benefited greatly from books (Jay Adam’s included) and biblical counseling regarding panic attacks, bi-polar disorder. I was for a time prescribed Zoloft. At the heart of my issues was a sin problem of selfishness and lust, anger and bitterness.
    Now, most kids may not indulge in the same behaviors as I, but many don’t get proper excersice, healthy diet, many were left in day-care or schools, and many do not have a biblical upbringing. Indeed for me it was also a poor theology of works, guilt and harboring shame that only exacerbated the problems.
    It’s the ease with which our society proscribes a pill as the solution. Each case must be taken individually no doubt.

    • Agree completely, Ken.

      These drugs are handed out like candy to people who are having minor difficulties in life. It is esp sad to see young people prescribed these drugs, many of which we don’t even quite know how they (the drugs) work.

      There’s a real difference between actual war PTSD and a teen girl who is ‘depressed’ because she didn’t get asked to prom. Or the boy who is depressed because he was refused when asked.

      Both MacArthur and many people on the other side of the issue need to be a little more discerning in their positions.

      Sometimes depression/ anxiety (outside of war and REAL abuse) is something one must walk through. I get that the non-Christian has no real means of doing so, and he taking his ‘soma’ is probably the best he feels he can do. Noe one wants pain, after all. Better to dampen its affect through drugs (of any sort, but medically prescribed ones remove personal responsibility and a patina of respectability).

      But for the Christian (who KNOWS this world is an evil and wicked place, and that we are to manfully journey to our real home, fighting evil in ourselves) it’s a dreadful thing to take the ‘soma’ rather than trust in Jesus. Esp as the ‘soma’ has many truly detrimental impacts on one’s life and spirit and relationships.

      It seems we Christians are quick to follow all ‘medical experts’ in this matter, rather than believing our Lord, who says we will have great tribulation here.

      We want a fix when in grief. I get it. But these pills only mask, they don’t remove, pain. This is why most people can’t get off of them. VERY tragic situation, for sure.

      PS: Mad in America is an interesting website to read up on these things, but from a non-Christian POV.

      • Of course there are cases where what you are saying is true. Some people with depression can manage without drugs to treat the symptoms. That includes (but is not limited to) Christians. Some drugs are prescribed too liberally. There are degrees of illness.

        But the above is introducing a strawman into the JMac discussion. He has taken a hard stance against medical treatment for mental illness in favor of Biblical counseling and “trusting in Christ.” It’s frustrating, because ceasing medication on JMac’s advice will actually kill people (Christian people, since that is primarily JMac’s audience). Symptoms of mental illness can be truly horrific, even in Godly men and women. You are not doing people any good by telling them their PTSD is a faith problem. You are actually leading them into further despair. We do not trust in Christ in order that we be free of present suffering. We trust in him for our salvation.

      • Sure, many teenagers make up matters as they struggle through an emotional period of their life. But it is not helpful to say that “well it’s not war so it’s not real suffering.” Everyday teenagers/adults who might even live perfect lives from our outdoor perspective can and do suffer from depression, anxiety, OCD, etc…
        They can be saved Christians who are trusting completely in Christ. Yes, we can rightfully say medicine is over prescribed. But let us not then say “well there people aren’t really in need of this medical attention/therapy/whatever it might be”

  11. Back in World War I there was shellshock and aviators succumbed to what was called “the Twitch”. MacArthur seems to be hung up on nomenclature and ignorant (willfully, given that it’s him) how far back soldiers have known that the war traumatizes body and soul.

    Timothy Patitsas has a book called The Ethics of Beauty that, among other things, discusses how people have known war traumatizes since as far back as The Iliad and that while the ways of naming the trauma and its symptoms have changed over centuries the spiritual and physical wounds have been identifiable for ages. Contemporary therapeutic methods do have weaknesses but that doesn’t mean they have no value at all. It’s possible to get medical or psychological help that you need and pray the Lord heals. I mean, even Rudolf Bultmann probably would’ve said as much.

    I met a medical professional years ago who told me she found the most pervasive problem in medicine she’s seen in the last few decades is as simple as this, too many doctors are treating the CHART and not the actual patient.

  12. As an OCD sufferer who has endured horrible darkness and who takes medication to control it but wishes I didn’t have to, thank you for this piece. MacArthur seems to have a knack for making offensive statements and speaking outside his domain of expertise. I think at least some of this arises from him holding a faulty view of the sufficiency of scripture.

  13. People wouldn’t be listening to MacArthur’s positions on medication and mental health if it weren’t for the reality that overmedication is a real problem. Some of the commenters on this page, despite disagreeing with MacArthur, recognize that.

    I live in an Army town outside Fort Leonard Wood. If anyone tries to tell me that PTSD is not real, I will show them obituaries and court documents of people who suffered and in some cases died from it. I’ll also point to historical descriptions of the symptoms, though using different names, dating back not just to World War II and World War I, but to the Civil War. Recognizing that literary license is a problem in older literature and it’s therefore very hard to know how carefully ancient authors were describing behavior, we can probably find PTSD all the way back to soldiers in antiquity — and I think we can probably include some of biblical descriptions of King David in that category. Unlike secular ancient literature, the biblical descriptions of King David’s symptoms are inerrant and trustworthy.

    If PTSD and depression are real — and they are — we need to be careful about dismissing other mental health diagnoses. Yes, I know the DSM-5 categories were largely created by secularists and quite a few of them had not just a non-Christian worldview but were aggressively opposed to orthodox Christian faith. Yes, I know applying DSM-5 criteria isn’t totally objective in the same sense as reading an X-ray and diagnosing a broken bone. But that doesn’t mean the behaviors and clusters of behaviors for which they created diagnostic criteria aren’t real.

    The problem is that we live in a world in which people, including teachers at the elementary school level, have been taught to promote prescriptions and pills as the simple solution to what are often significant and serious behavior problems, but in other cases are simply “boys being boys.” Too many doctors are happy to comply without the VERY in-depth and detailed examination of the patient that should be done to rule out other issues.

    The end result, in too many cases, is an unnecessarily medicated child who becomes compliant and easier to control — but at what cost?

    That approach carries over to adulthood. Too many children who have been taught that the solution to problems is a pill ask for or demand medication to control behavior for which medication should be a last resort, not a first step.

    It’s easy to criticize MacArthur for taking a chainsaw to a complicated issue that should be carefully considered and usually requires the precision of a scalpel, not a saw.

    But that doesn’t mean he’s not responding to a legitimate concern of many parents that we are using medical categories and prescribing medication rather than addressing real issues that are far more difficult to deal with, and not uncommonly involve problematic parenting, problematic life choices, and sometimes flat-out sin.

    Again, people wouldn’t be listening to MacArthur if what he says wasn’t resonating with some of what they see of people promoting pills to deal with problems.

  14. I’m the parent of two adult daughters who were diagnosed in elementary school as ADD & ADHD respectively and were medicated. They attended a Christian Reformed school, and were diagnosed by Christian professionals that dealt with learning disabilities in partnership with the school.

    The diagnosis was no surprise to us; our girls had shown symptoms from toddlerhood. We were by no means perfect parents, but we disciplined them and insisted on appropriate behavior in all settings. When they eventually attended school, they greatly struggled to pay attention in a classroom setting which affected their ability to learn. We did not glibly nor without serious reflection & prayer allow them to take the medication.

    There were some raised eyebrows in the church & extended family over this. I was also told that there was “No such thing” as ADD/ADHD by an individual that became a “Christian Counselor” by attending a short series of weekend conferences. My hunch is that those who make such claims have never known or spent any extended time with such children.

    There were side-effects and meds needed to be switched accordingly and tweaked. One eventually couldn’t tolerate the side effects and was successfully homeschooled for a few years. For the other, it greatly improved her quality of life as well as education. I am thankful to God for providing that tool that was an answer to prayer. In hindsight, I believe we made the right decision. No regrets.

    Both girls were Honor students in high school (The one who continued on the meds finished in the top 10 of her class), and both continued as honor students in college. Neither are taking any meds for this condition now. They have no regrets for the way we handled this either.


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