Medicalization’s Role in ADHD Prescriptions for Children

The Medicalization Debate

The healthcare field has been one of the fasted growing industries across the globe in recent decades as researchers and medical professionals continue to search for new and improved forms of care. Advancements in new technology, drugs, and our understanding of various health-related conditions are constantly being made and shaping our perception of the world we live in. As Robert Crawford points out in his publication Health as a Meaningful Social Practice, medical policies, forms of treatment, and the way in which we understand different medical conditions influences how we perceive ourselves within the social sphere of society (Crawford, 2006). This relationship between healthcare and social practices becomes especially important when discussing the concept of medicalization. Medicalization refers to the process in which non-medical problems become redefined within the scope of medicine and are treated as such, according to Peter Conrad from Brandeis University (Conrad, 1992). Medicalization has become a point of focus recently as improper identification of an issue as being medical-related could have harmful effects on both patients and society as a whole. Researcher Erik Parens points out that medicalization itself is not necessarily a bad thing, but rather it becomes an issue when the medicine oversteps its limitations (Parens, 2013).

Emilia Kaczmarek describes four major risks that may arise in the case of over-medicalization. First, over-medicalization may have a negative impact on patient health as it promotes excessive treatment that could lead to undesirable side effects. Next, over-medicalization has an effect on the economy as it can promote the misplacement of both public and private funds. Third, over-medicalization can have important psychological implications by stigmatizing certain individuals or their “condition” as being sick and restrict personal freedom through pressures to alter one’s behavior to the standards of society. Finally, over-medicalization overlooks the different social, political, and interpersonal relationships that may play a role in the problem a person is facing (Kaczmarek, 2018). Excessive medicalization can be seen in a number of different examples, such as ADHD, women and childbirth, menopause, erectile dysfunction, sleep disorders, and much more. In each of these cases, the condition is viewed through a biological lens that causes other contributing factors to be overlooked and an emphasis to be placed on medications and other medical treatments. This reading will be focusing on the influence medicalization has had on ADHD specifically and the impact this has had on the most vulnerable patient population: children.


A Snapshot of ADHD in the U.S.

The Center for Disease Control and Prevention describes ADHD as a neurodevelopmental disorder that is commonly diagnosed during childhood and persists through adulthood (Center for Disease Control and Prevention [CDC], 2022). The condition is typically associated with an inability to pay attention, difficulty controlling impulsive behaviors, and being excessively active. In the U.S., it is estimated that around 6 million children are currently diagnosed with ADHD with over 265,000 of these diagnoses occurring in children between the ages of three and five (CDC, 2022). Of this patient population, 62% were consistently taking ADHD medication while 47% were receiving behavioral treatment for a combined 77% of children with ADHD taking some form of treatment. Behavioral treatment for ADHD does not have an impact on the core symptoms experienced by these patients, but rather it involves teaching children various coping strategies in order to control their symptoms. Behavioral therapy is comprised of two main components in order to help children manage the various symptoms of ADHD. The first is what is known as “parent training” that focuses on teaching children how to control their impulsive behavior. This portion of therapy involves both the children and their parents and provides parents with different strategies in dealing with their child’s behavior. The second form of behavioral therapy deals with what is known as “executive functions.” These executive functions are a set of skills that enable a child with ADHD to better manage their time, stay organized, and plan different tasks (Miller, 2022).

Although, nearly half of all diagnosed children are involved in ADHD behavioral therapy, treatment in the form of medication is much more common and also more relevant to the topic of medicalization. ADHD medication primarily involves stimulants such as methylphenidate or amphetamine. These stimulants, which include well-known brand-name drugs like Adderall and Concerta, are the most commonly used ADHD medications and are often varied by dosage depending on the patient’s needs. In general, long-term use of stimulants can have adverse health effects, primarily on the cardiovascular system, as it can lead to chronic high blood pressure, increased heart rate, and heart failure (Losch, 2023). As a result, concern has grown regarding prescribing ADHD medication to children, especially since some may begin taking these drugs as young as three years old.

Only a small fraction of children with ADHD have outwardly hyperactive symptoms.

ADDitude Magazine

The Medicalization of ADHD and the Risks it Poses to Children

With nearly 1 in 11 children in the U.S. currently having an ADHD diagnosis and this rate of instance steadily increasing since 1997, it calls into question the reason for this growing prevalence (Lanham, 2023; CDC, 2022). Are more people in the U.S. being affected by ADHD, is improved testing allowing for more accurate detection of ADHD, or is our understanding and perceptions of ADHD changing and causing a greater number of people to fall under what society categorizes as ADHD? This is where the topic of medicalization becomes relevant. The over-medicalization of ADHD has the potential to increase the rate of diagnosis in children and, as a result, increase the number of children receiving medicated treatment. It is possible that more people are not actually suffering from ADHD, but rather societal pressures, expectations, and norms are shaping how we view the condition. The structure of the U.S. education system requires students to sit at their desk for prolonged periods of time and often does not involve a lot of physical movement. When a kid fails to adhere to expectations that they remain attentive and non-disruptive for these prolonged periods of time, the first assumption may be that they are suffering from ADHD since an inability to focus and control impulsive behavior is associated with this condition. In today’s world, there is a much greater public awareness of ADHD that has caused it to become de-stigmatized, which could explain the growing numbers of cases. The inability of children to focus in a classroom setting may have previously been thought to be related more to the energetic nature of children, but increased public awareness has created an over-emphasis on the correlation between ADHD and hyperactivity in children, leading to far more diagnoses.

The reason that the changing perception of ADHD in society, leading to more supposed cases, is important again comes down to the emphasis on using of ADHD medication to treat the disorder. The nature of stimulants, like ADHD medications, can create a number of different side effects in those taking them. ADHD medications have been known to cause sleep problems, decreased appetite, delayed growth, frequent headaches and stomachaches, irritability as the drug wears off, tics, and changes in mood (Boorady, 2022). This has caused great concern in prescribing children these medications as they are undergoing significant neurological, hormonal, and physical development and the long-term impact these effects can have on this development are mostly unknown as most studies often involve non-human subjects due to the many ethical concerns of experimenting on humans (Volkow, 2008). The fact that the experience and severity of ADHD often varies among individuals can lead to an increase in the number of patients being diagnosed with and receiving treatment for ADHD as well. According to a study published in the National Library of Medicine, there is not a single pathophysiological entity that causes ADHD, but rather multiple risk factors work together to promote the condition we know as ADHD (Curatolo, 2010). This creates the potential for a number of different neurological conditions and features to be classified as having ADHD implications when they may not necessarily cause ADHD themselves and, therefore, more children may qualify for an ADHD diagnosis. This prevents the development of a biologically based test for diagnosing children and instead diagnosis relies on the clinician’s perception of the child’s behavior and parent description.

Image from HubPages


The over-medicalization of various disorders and conditions has major implications on patient health and overall quality of life. Viewing these disorders with an emphasis on their biological and medical applications opposed to a more comprehensive understanding of the different factors that may contribute to them may negatively affect the patients living with these problems. This becomes more relevant for disorders that are typically diagnosed in children as there could be many long-term effects that have the potential to adversely affect the patient later in life. ADHD is one of these conditions that generates a great deal of concern, especially since the main form of treatment for ADHD in children is prescription drugs. The over-medicalization of ADHD has the potential to increase incidence of diagnoses, and result in a greater number of children taking these prescriptions. ADHD, like many other overly medicalized conditions, lacks a strong biological basis where biological markers can be used to make a diagnosis. Instead, clinicians rely on observed behavior of the patient and descriptions from parents to make the decision of whether or not the child should be treated with a strong chemical compound. Understanding the role that medicalization has on our perception of conditions like ADHD and how this can influence our decisions is key in being able to prevent excessive treatment in vulnerable patients that may not necessarily require treatment.

Works Cited

Behavioral treatments for kids with ADHD. Child Mind Institute. (2023, January 25). Retrieved March 28, 2023, from

Carpiano, R. M. (2001). Passive medicalization: The case of Viagra and erectile dysfunction. Sociological Spectrum, 21(3), 441–450.

Centers for Disease Control and Prevention. (2022, August 9). ADHD throughout the years. Centers for Disease Control and Prevention. Retrieved March 28, 2023, from

Centers for Disease Control and Prevention. (2022, August 9). Data and statistics about ADHD. Centers for Disease Control and Prevention. Retrieved March 28, 2023, from

Centers for Disease Control and Prevention. (2022, August 9). What is ADHD? Centers for Disease Control and Prevention. Retrieved March 28, 2023, from,)%2C%20or%20be%20overly%20active.

Conrad, P. (1992). Medicalization and Social Control. Annual Review of Sociology, 18(1), 209–232.

Crawford, R. (2006). Health as a meaningful social practice. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, 10(4), 401–420.

Curatolo, P., D’Agati, E., & Moavero, R. (2010). The neurobiological basis of ADHD. Italian Journal of Pediatrics, 36(1), 79.

General prevalence of ADHD. CHADD. (2022, October 20). Retrieved March 28, 2023, from,%E2%80%9317%20(1%20in%2010)

Is there an increase in ADHD? CHADD. (2019, July 11). Retrieved March 28, 2023, from,and%20getting%20treatment%20for%20children.

Kaczmarek, E. (2018). How to distinguish medicalization from over-medicalization? Medicine, Health Care and Philosophy, 22(1), 119–128.

Mayo Foundation for Medical Education and Research. (2023, January 25). Adult attention-deficit/hyperactivity disorder (ADHD). Mayo Clinic. Retrieved March 28, 2023, from,Treatment,they%20don’t%20cure%20it.

PARENS, E. R. I. K. (2011). On good and bad forms of medicalization. Bioethics, 27(1), 28–35.

Side effects of ADHD medication. Child Mind Institute. (2023, January 25). Retrieved March 28, 2023, from

Staff, P. R. C. (2022, June 7). The long-term consequences of stimulant use. Pinelands Recovery Center of Medford. Retrieved March 28, 2023, from

Volkow, N. D., & Swanson, J. M. (2008). Does childhood treatment of ADHD with stimulant medication affect substance abuse in adulthood? American Journal of Psychiatry, 165(5), 553–555.

The Stigmatization of Mental Illness in College Campuses

For college students struggling with mental health, the weight of stigma and shame can feel heavier than the textbooks in their backpacks. Mental health conditions are among the most prevalent health issues affecting college students today. According to the American College Health Association, 63% of college students experienced overwhelming anxiety in the past year, while 40% reported symptoms of depression (Greenfield, B., & Gracey, E. 2010). However, despite the prevalence of these conditions, mental health stigma remains a major issue on college campuses. The stigmatization of mental illness can cause students to feel ashamed and embarrassed about their conditions, leading them to avoid seeking help and exacerbating feelings of isolation and social exclusion (Eisenberg, et al 2012).

Understanding the intersections of mental health and other types of marginalization is critical for effectively addressing mental health stigma on college campuses. This necessitates a consideration of how other kinds of oppression, such as ableism, racism, sexism, and homophobia, compound mental health stigma, and how these intersecting identities influence students’ experiences with mental health stigma.

In addition, decreasing mental health stigma involves a multi-pronged approach that targets the root causes of stigma, including as ignorance, fear, and misinformation, as well as the institutional and structural barriers that impede students from gaining access to the necessary services and assistance. By examining structural and institutional barriers to accessing care, promoting inclusive and affirming attitudes toward mental health, and addressing the intersectionality of mental health stigma and other forms of marginalization, we can create a higher education system that is more equitable and supportive for all students.

Factors Contributing to Mental Health Stigma in College Campuses

The stigmatization of mental illness in college campuses is deeply rooted in personal and social meanings of mental illness.

“The social organization of illness, including its meanings and symptoms, determines the cultural response to illness and the quality of care that patients receive”

Kleinman Arthur, Illness Narratives, 2017.

The preceding statement by Kleinman reaffirms that the way in which society views mental illness can affect the treatment and assistance provided to those with mental health disorders (Kleinman 2017). The stigmatization of mental illness prevents individuals from seeking care and discussing their experiences for fear of being judged by others. As detailed in Kleinman’s Ilness Narratives, broader societal attitudes and ideas about mental health shape the social meanings of mental illness. Contributing to the stigma around mental illness are media representations of mental disease, misconceptions of people with mental health disorders, and a general lack of knowledge and awareness. In Care Work: Dreaming Disability Justice, Lakshmi Piepzna-Samarasinha examines how cultural and societal notions about disability intersect with mental health stigma (Lakshmi Piepzna-Samarasinha, 2018). She adds that people with disabilities may be perceived as “unwanted” or “broken,” resulting in stigma and prejudice. In addition, mental health issues may be stigmatized due to cultural views about “normalcy” and able-bodiedness, which can result in feelings of shame and humiliation (Lakshmi Piepzna-Samarasinha, 2018).

Furthermore, the interconnectedness of disability and mental health further complicates the problem of mental health stigma on college campuses. According to Piepzna-Samarasinha’s Crip Emotional Intelligence, individuals with impairments are frequently subjected to stigma and discrimination, which may increase their risk of developing mental health issues (Piepzna-Samarasinha, L. 2018). In addition, the lack of accessibility and inclusivity on many college campuses can create further barriers for students with disabilities seeking mental health support.

“The disability community knows firsthand what it’s like to be told that our pain doesn’t matter, that our bodies are wrong, and that we don’t belong”

Piepzna-Samarasinha, Crip Emotional Intelligence

Specific examples of mental health stigma on college campuses illustrate these personal and social connotations of mental illness, as well as the intertwining of disability and mental health (Piepzna-Samarasinha, L 2018). For instance, individuals with mental health disorders are frequently described using negative language and stereotypes, reinforcing detrimental attitudes and beliefs. In addition, kids with mental health disorders may be excluded from social gatherings or treated harshly in the classroom, leading to feelings of isolation and perpetuating the stigma associated with mental illness. On college campuses, the stigma surrounding mental health is pervasive and well-documented (Lu, et al. 2019). Students with mental health disorders may encounter discrimination and negative attitudes from their peers, professors, and even healthcare professionals. Additionally, these students may have difficulty gaining access to necessary mental health resources on campus due to restricted availability, lengthy wait periods, or substandard care. The stigma associated with mental health may also discourage students from seeking assistance or admitting their condition, resulting in feelings of isolation and social exclusion (Piepzna-Samarasinha, L. 2018).

Impacts of Mental Health Stigma on Students and Campus Culture

The impact of mental health stigma on students and campus culture is profound and cannot be overstated. Daniel Eisenberg, of Mental Health on College Campuses: A Review, discovered that stigma and discrimination against students with mental health disorders are pervasive on college campuses, with many students avoiding assistance out of fear of receiving negative labelsand social rejection (Eisenberg et al., 2012). The American College Health Association (2019) reported that 63% of college students experienced overwhelming anxiety in the past year, while 40% reported symptoms of depression. However, only 20% of students with mental health conditions sought help from a mental health professional (Eisenberg et al., 2012). This can lead to detrimental consequences for students, including lower academic performance, decreased quality of life, and higher rates of substance abuse and suicide (American College Health Association, 2019).

The stigma associated with mental health also has a significant effect
on campus culture. Corrigan and Watson, of The Paradox of Self-stigma and Mental Illness, discovered that stigma can create a hostile and unsupportive atmosphere for students with mental health disorders, resulting in social isolation and limited access to resources and support. This can perpetuate the stigma and prejudice cycle,establishing a culture of neglect and apathy toward mental health. (Corrigan, 2004). Furthermore, the lack of money and resources for mental health services, as well as the dearth of skilled mental health practitioners on college campuses, exacerbates the impact of stigma and leaves many students without the care they require. (Eisenberg et al., 2012).

The impact of mental health stigma on students with mental health conditions is also profound. Linton, of The Ableism of Disability Studies, argues that mental health stigma can lead to a form of “internalized ableism,” where students with mental health conditions begin to internalize the negative attitudes and stereotypes associated with their condition and view themselves as inferior or inadequate (Linton, 2018). This can lead to self-doubt, low self-esteem, and a reluctance to seek help or disclose their condition to others (Linton, 2018). Furthermore, students with intersecting marginalized identities, such as those who identify as LGBTQ+ or have disabilities, are at an even higher risk for mental health stigma and its effects, exacerbating the impact of stigma on their mental health and overall well-being (Kaufman et al., 2018).

A comprehensive and evidence-based strategy is required to mitigate the effects of mental health stigma on students and campus culture. Vogel of Mental Health Stigma on Campus: A Review of Literature and Implications for Practice, argue that interventions that focus on developing mental health literacy, encouraging inclusive and affirming attitudes toward mental health, and strengthening access to resources and support can aid in reducing stigma and improving mental health outcomes for students (Vogel et al., 2007). In addition, policies that prioritize the recruitment and retention of diverse mental health professionals, as well as the provision of proper financing and resources for mental health services, can assist in addressing the shortage of resources and promoting a more equitable and inclusive campus culture. (American College Health Association, 2019).

The impact of mental health stigma on campus culture is also significant (Vogel et al 2007). Stigma can create a hostile and unsupportive environment for students with mental health conditions, leading to social isolation and a lack of access to resources and support (Corrigan & Watson, 2002). This can further perpetuate the cycle of stigma and discrimination, creating a culture of neglect and apathy towards mental health (Corrigan, 2004). Furthermore, the lack of resources and financial support for mental health services, as well as a shortage of skilled mental health practitioners on college campuses, exacerbates the impact of stigma and leaves many students without the care they require. (Eisenberg et al., 2012).

Potential Solutions to Address Mental Health Stigma in College Campuses

Mental health stigma is a pressing issue on college campuses, as it can prevent students from seeking help and exacerbate feelings of isolation and social exclusion (Greenfield, B., & Gracey, E. 2010). According to a survey conducted by the National Alliance on Mental Illness (NAMI), 64% of college students with mental health conditions report that stigma has made it difficult for them to succeed academically, and 50% report that stigma has prevented them from seeking help (Nelson, 2011). Additionally, a study by Eisenberg and colleagues (2013) found that only 11% of college students with mental health conditions receive treatment, with stigma being the most common barrier to seeking help (Eisenberg et al., 2012).

Several potential solutions have been proposed in the literature, including destigmatizing language and practices, increasing awareness and education, and involving students with mental health conditions in decision-making. According to Greenfield and Gracefield, of Disability Awareness: A Course for College Students. Journal of Postsecondary Education and Disability, disability awareness courses are one technique to enhance awareness and education (Greenfield, B., & Gracey, E. 2010). These courses allow learners to comprehend the experiences of people with disabilities, specifically those with mental health disorders. In addition, Lu and Feeley of Reducing Mental Health Stigma on College Campuses: Targeting External and Internal Sources of Stigma, argue that external causes of stigma, such as negative media portrayals, can be countered by media campaigns that challenge stigmatizing mental health representations (Lu & Feeley, 2018). Moreover, internal origins of stigma, such as self-stigma and shame, can be addressed through therapy procedures that emphasize the development of self-esteem and self-acceptance (Lu & Feeley, 2018).

However, these prospective solutions are not devoid of obstacles and constraints. Greenfield and Gracey, for instance, remark that disability awareness classes are not yet extensively implemented on college campuses, and there is a need for additional research to evaluate their efficacy (Greenfield, B., & Gracey, E. 2010). In addition, Lu and Feeley (2018) admit that media campaigns can be costly and difficult to continue, and that they may not necessarily alter deeply rooted cultural attitudes around mental health (Reczek et al (2016). Similarly, therapeutic interventions may not be available to all kids, especially those from marginalized backgrounds who may experience significant challenges to care access (Lu & Feeley, 2018).

Despite these challenges, college campuses have begun implementing effective programs and initiatives to combat mental health stigma. For instance, Lakshmi Piepzna-Samarasinha’s Care Work, explores the role of “crip emotional intelligence” and “sick and crazy healer” in creating supportive and inclusive spaces for people with disabilities, including those with mental health conditions (Lakshmi Piepzna-Samarasinha. 2018). Similarly, the National Alliance on Mental Illness (NAMI) has created initiatives like as Ending the Silence and NAMI on Campus to improve awareness, decrease stigma, and give resources and support for students with mental health disorders (Eisenberg, et al 2009).

Going Beyond the Classroom

As a current undergraduate student pursuing pre-health and global affairs at the University of Notre Dame, I am acutely aware of the critical importance of mental health in the college setting. College represents a pivotal time for young adults as they navigate new experiences, opportunities, and challenges that can profoundly shape their personal and professional trajectory. However, mental health conditions such as anxiety, depression, and stress can significantly impact a student’s academic, personal, and social life, making it difficult for students such as myself, to thrive in this dynamic and demanding environment.

The stigma surrounding mental health further exacerbates these challenges, creating significant barriers for students to access care and support, hindering their ability to manage and overcome their conditions effectively. Moreover, given that college graduates are often future leaders and contributors to the building of a more equitable and just society, decreasing mental health stigma on college campuses can have far-reaching effects on society as a whole. By increasing awareness, reducing stigma, and improving access to mental health services and assistance, we can foster a campus environment that is healthier, more resilient, and more conducive to the growth and development of all students.


  1. Crawford, R. (2006). Health as a meaningful social practice. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, 10(4), 401-420.
  2. Corrigan, P. W., & Watson, A. C. (2002). The paradox of self-stigma and mental illness. Clinical Psychology: Science and Practice, 9(1), 35-53.
  3. Corrigan, P. W. (2004). How stigma interferes with mental health care. American Psychologist, 59(7), 614-625.
  4. Eisenberg, D., Golberstein, E., & Hunt, J. B. (2012). Mental health and academic success in college. The BE Journal of Economic Analysis & Policy, 12(1), 1-37.
  5. Linton, S. (1998). The ableism of disability studies. Disability & Society, 13(5), 665-666.
  6. Piepzna-Samarasinha, L. (2018). Crip emotional intelligence. In Care work: Dreaming disability justice (pp. 23-30). Arsenal Pulp Press.
  7. Vogel, D. L., Wade, N. G., & Hackler, A. H. (2007). Perceived public stigma and the willingness to seek counseling: The mediating roles of self-stigma and attitudes toward counseling. Journal of Counseling Psychology, 54(1), 40-50.
  8. Vogel, D. L., Bitman, R. L., Hammer, J. H., & Wade, N. G. (2013). Is stigma internalized? The longitudinal impact of public stigma on self-stigma. Journal of Counseling Psychology, 60(2), 311-316.
  9. Vogel, D. L., Wester, S. R., & Larson, L. M. (2007). Avoidance of counseling: Psychological factors that inhibit seeking help. Journal of Counseling & Development, 85(3), 410-422.
  10. Vogel, D. L., Wester, S. R., Wei, M., & Boysen, G. A. (2005). The role of outcome expectations and attitudes on decisions to seek professional help. Journal of Counseling Psychology, 52(4), 459-470.
  11. “Mental Health on College Campuses: A Review” by Eisenberg, Golberstein, and Hunt
  12. “Mental Health Stigma on Campus: A Review of Literature and Implications for Practice” by Vogel et al.
  13. “The Stigma and Shame of Illness” from Care Work by Lakshmi Piepzna-Samarasinha

Chronic Fatigue Syndrome and Its Ever Present Issues


Contested illnesses inflict untold burdens on their sufferers. These burdens are not simply manifested in the physiological or psychological implications that are typical of disease. These illnesses vastly impact the social and interpersonal lives of their sufferers. From six years of firsthand experiences, watching my brother battle with his own contested illness, I know how these struggles can lead to distrust, confusion, and even animosity between loved ones. Often these issues arise from misunderstandings and incomplete knowledge of the condition, a facet that is at the heart of the “contested” nature of these diseases. These personal experiences my family and I have had, have caused us to make a point of understanding and explaining the true nature of these afflictions from both objective and empathetic perspectives. 

John’s Story

When my brother was going into his junior year of college, he decided to end his college baseball career and transfer back to our hometown college. Around this time he was having a series of strange symptoms come and go. Mainly, he was suffering from migraines and blurred vision. At the time he chalked this up to the stress of his new transition and a bad eyeglass prescription. Throughout the next five years, he struggled with receiving a lasting diagnosis as well as a constant increase in symptom presence and intensity. Eventually, after spending five weeks at the Mayo Clinic, John was able to finally receive the diagnosis that he was expecting, Chronic Fatigue Syndrome. As we discussed in class, this diagnosis came with mixed emotions. While being diagnosed with a contested illness may come with uncertainties and fear, this was the first time that he felt that he knew what was happening to him and he felt a sense of belonging and relief. 

Having a brother experience this was hard, not just for him but for all of our family. We saw someone transition from a college athlete to being functionally disabled at times. Throughout the diagnosis process, there were times when our family and loved ones questioned his status and even his symptoms. This caused social and interpersonal strain throughout our extended family. To this day, he still faces others questioning his illness and doctors disagreeing with his diagnosis. Furthermore, this illness has burdened my mother financially as she now supports her son financially and often fills the role of unpaid caregiver.

Issues in CFS Care

Seeing this process from a closer and more personal vantage point has allowed me to see some of the issues that exist within the treatment of Chronic Fatigue Syndrome; paired with the readings from class and further outside research, I feel that I have gained a more rounded perspective on this topic. One issue that I quickly noted was the fragmentation of medical care. With specialists occupying 66% of United States doctors [1], holistic care for systemic issues becomes unattainable. In search of a diagnosis, John went to ophthalmologists, neurologists, immunologists, orthodontists, endocrinologists, and many more specialists. Each offered their own theory that fell into their category of expertise. It wasn’t until he underwent long-term testing under the supervision of multiple practitioners at the Mayo Clinic that he was officially diagnosed. According to the CDC, an estimated 836,000 to 2.5 million Americans suffer from Chronic Fatigue Syndrome [4]. With estimates this large, the current model of fragmentation of care is not sustainable. Under models of incremental care, such as that of Dr. Loder from, “The Heroism of Incremental Care” [5], patients would not need to be passed around between dozens of specialists. Rather, primary care providers could work with patients to note minute changes in their symptomology and address diagnoses and further visits from a more holistic view. 

Between 836,000 and 2.5 million Americans have been estimated to have ME/CFS


A second issue that is ever present with Chronic Fatigue Syndrome is the inconsistency of therapy. Some sources, such as the CDC, focus more on short-term symptom palliation while others attempt to reduce the intensity of all symptoms on a long-term scale [8]. One example of the latter is what is known as graded exercise therapy (GET). David Scales quickly mentions this as a point of contention in Chronic Fatigue communities [6]. This program aims to slowly build up strength and condition the patients through incremental exercise regimens. However, this type of therapy can worsen the post-exertional malaise symptom of these patients and potentially be deleterious to their intended goals. Furthermore, this therapy is founded on a flawed study with improper design and poor data [7]. Even with this knowledge, GET is still widely applied. However, it seems that the tides are turning on this practice and the Mayo Clinic reversed its stance on GET, removing it from their regimen in 2021 [2]. 

Source: LaraPhysiotherapy

One final issue that was at the heart of much of my brother’s pain was the disbelief tied into this condition. As a contested illness, it inherently comes with doubts and debates as to the symptomatology, etiology, prognosis, etc. but the one aspect that needs to be believed is the patient’s pain and suffering. Too often he (and many like him) was told that his symptoms were in his head, or that he needed to work harder to get through it. Just as Boodman points out with fibromyalgia patients, the disbelief from medical professionals is nothing short of “medical gaslighting” and does nothing further perpetuate their patients’ pains [3].


While my unique perspective has allowed me to view this condition and others like it with a particular air of empathy, I also understand that it has made me biased toward the situation. I try to view evidence from a more objective lens and view patient experiences from a more empathetic lens, though this does not breed the best level of research. However, I believe that my circumstances have given me the drive to look further into this condition and examine what areas need to be fixed. These experiences have been foundational to my desire to pursue medicine, and I hope that I carry this zeal toward all aspects of my professional career.


[1] “Active Physicians with a U.S. Doctor of Medicine (U.S. MD) Degree by Specialty, 2019.” AAMC, Dec. 2019,

[2] Bateman, Lucinda, and et. al. “Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Essentials of Diagnosis and Management.” Mayo Clinic Proceedings, U.S. National Library of Medicine, 25 Aug. 2021,

[3] Boodman, Eric. “In a Sea of Skeptics, This Physician Was One of Fibromyalgia Patients’ Few True Allies. or Was He?” STAT, 27 Oct. 2021,

[4] “Epidemiology.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 21 Apr. 2021,,diagnosis%20from%20a%20healthcare%20provider.

[5] Gawande, Atul. “The Heroism of Incremental Care.” The New Yorker, The New Yorker, 16 Jan. 2017,

[6] Scales, David. “What I’ve Learned Reporting about Lyme Disease, a Contested Illness.” Columbia Journalism Review, Columbia Journalism Review, 18 Dec. 2018,

[7] Simon, Stephanie. “Bad Science Misled Millions with Chronic Fatigue Syndrome. Here’s How We Fought Back.” STAT, 29 Dec. 2016,

[8] “Treatment of ME/CFS.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 28 Jan. 2021,,a%20sense%20of%20well%2Dbeing. 

Youth Caregivers in the United States

Caregiving in the United States has had some improvement in the resources and financial aid allocated to help informal caregivers, but America has still not identified and supported the alarmingly increasing number of youth caregivers.

Image from Unsplash

Care giving in America

According to John Hopkins University, a caregiver is a person who provides direct care for someone who has a short or long-term limitation due to an injury, illness, or some other condition (McQuay) As we learned in class, informal or unpaid caregivers have become a hidden foundation for the long-term care of family members and can impact the carer’s health due to the added stress and responsibility. In the United States, some policies and programs are in place to help caregivers, but all these resources fail to address or aid a hidden group of caregivers, children under the age of eighteen. Children are oftentimes associated as the ones who receive care and support from an adult figure in their life, but according to a 2020 study conducted by AARP on family caregiving in the United States, there are approximately 5.4 million youth caregivers whose roles are reversed as they care and assist their family members  (AARP Family Caregiving, 2020). These youth caregivers are placed in a unique situation as they learn to juggle school and any house and care responsibilities they must bear. Those same stressors and negative health effects we discussed in class that affect adult caregivers are also impacting children carers, having a long-lasting impact on their development and ability to learn.

There are approximately 5.4 million youth caregivers whose roles are reversed as they care and assist their family members

AARP Family Caregiving 2020
Image from iStock

First Experience with a Youth Caregiver

(No names are mentioned in order to respect her privacy and is being included with her permission)

The idea of a child taking over an adult’s responsibilities is not uncommon in the area where I grew up, but I saw just how much the role of a caregiver plays in a student’s life through one of my close friends in high school. There isn’t a specific instance that could fully encompass the emotional toll being a caregiver had on her, but to give you an idea of the physical strain she went through, I will explain what a day in her life looked like. She is the ninth of thirteen children, but because of her interest in medicine along with her determination to stay in school, the responsibility of caring for her mother, younger siblings, nieces, and nephews fell to her. Her morning began around five in the morning as she prepared lunch for her older brothers who went to work before she woke up her younger siblings. Breakfast was prepared for her mother along with her morning medication and helped dress the children who would be staying at home as they were still too young for school. By seven in the morning, she would be heading out to drop off her siblings at their perspective school before rushing to the high school. She would spend the first half of the day in her AP classes before heading out to her job as a server after lunch. Her siblings would ride the bus in the afternoon, and she would finish her shift in time to prepare dinner and help ready her mother for bed before helping her siblings with homework. Once everyone was settled and fed, she would sit down to work on her homework before repeating this stressful schedule the next day. There were some days when she would miss school to take her mother or siblings to an appointment. While most high school students had the opportunity to attend games or hang out with friends, she was spending her weekends cleaning the house and helping care for her siblings and mother. She worked hard throughout high school to be able to attend university, and when she left to study, all the caretaking responsibilities fell on her two younger sisters at the age of 13 and 14. This situation is not an isolated occurrence and is common to see these responsibilities fall to the daughters of families beginning at ages as young as eleven years old.

Image from pexels by Kamaji Ogino

Health Impact on Youth Carers

According to research conducted by Kavanaugh et al, the responsibilities that young carers take on expose them to multiple negative health and education outcomes. Studies have shown that child caregivers are more likely to be anxious and depressed than children who are not caregivers. This, coupled with the fact that a disproportionate amount of youth caregivers in the United States come from lower-income families, means that these kids are also less likely to be able to seek help from the healthcare system  (Kavanaugh, 2016). Learning and development are also impacted by their role as caregivers leading students to have problems focusing during class or causing them to miss school due to their caretaking responsibilities. One study, conducted by the Bill and Melinda Gates Foundation found that 22% of young adults that drop out of school cited caring for a family member as the main reason for their decision  (Gunnerson, 2021). Social development is also affected as youth caregivers are more likely to experience isolation as they are not able to participate in social activities with their peers due to their workload. They could also isolate or become aggressive toward any authoritative figure who could remove them from their home. “Caregiving is not on people’s radar,” said Siskowski, one of the scientists studying the health effects on youth carers. “What they do is behind closed doors, so it’s out of sight, out of mind.” The need for youth carers to keep their situation a secret can increase their anxiety levels and disrupt their sleep What they do is behind closed doors, so it’s out of sight, out of mind (Diaz et al, 2007). This need for secrecy also means that the 5.4 million reported by AARP is probably an underestimate  (Lewis, 2021).

“What they do is behind closed doors, so it’s out of sight, out of mind.”

Connie Siskowski, scientist studying health effects on youth caregivers

Resources for Youth Caregivers

Despite the large number of children impacted by this situation, the current American policies and programs exclude any caregivers under the age of 18 from receiving any aid or access to resources. There are non-profit organizations such as the American Association of Caregiving Youth which was founded in Florida dedicated to supporting children who have the responsibility of being a caregiver and help to provide them with resources to aid the family and work with the school system to help the student succeed in their classes, but there is no centralized system dedicated to identifying and supporting this hidden group of caregivers leaving the responsibility to fall on the individual school systems and more specifically, the teachers and counselors  (Armstrong-Carter et al., 2021). The first step in helping youth caregivers is working to recognize them and their increasing numbers in legislation, helping them by providing them with information and emotional support, and working with schools to accommodate students with these added responsibilities.

Works Cited

AARP Family Caregiving. “Caregiving in the U.S.” (2020) Web. Mar 27, 2023.

Armstrong-Carter, Emma, et al. “The United States should Recognize and Support Caregiving Youth.” Social Policy Report 34.2 (2021): 1-24. Web.

Diaz, Naelys, et al. “Latino Young Caregivers in the United States: Who Are They and What Are the Academic Implications of This Role?” Child & Youth Care Forum, vol. 36, no. 4, 2007, pp. 131–40,

Gunnerson, Tate. “A growing phenomenon, youth caregivers need recognition, support.” Nov 3, 2021. Web. Mar 27, 2023. 03/a-growing-phenomenon-youth-caregivers-need-recognition-support.

Kavanaugh, Melinda S. “Unacknowledged Caregivers: A Scoping Review of Research on Caregiving Youth in the United States | SpringerLink.” Springer Link (2015): 29-49. Web. Mar 27, 2023.

Lewis, Feylyn. “Youth Caregivers: Before, During, and After the Pandemic.” Oct 20, 2021. Web. Mar 27, 2023, youth-caregivers-and-pandemic.

McQuay, Jessica. “What Is A Caregiver? | Johns Hopkins Bayview Medical Center.” Web. Mar 27, 2023,

Considerations in treating HIV/AIDS today with a potential HIV vaccine on the horizon

In watching the film How to Survive a Plague and reading Steven Epstein’s piece on AIDS activism and clinical trial reform, it is clear that the fight to provide care and treatment for those suffering from AIDS has been extremely difficult. Both of these also demonstrate the strong linkage between activism for HIV/AIDS research and treatment is strongly linked to identity, as the 1980s AIDS movement became led by affected individuals that often identified with the gay community. Because AIDS became associated with things like sex and drugs, AIDS became heavily stigmatized and the connection between identity and illness became problematic.   The AIDS movement revealed many systemic issues in the way research is conducted and how those with stigmatized conditions are treated by the medical community and society as a whole (Epstein).  The HIV/AIDS epidemic has been a public health issue for several decades, and though great strides have been made in developing drugs to treat AIDS, there is no cure and an effective vaccine has yet to be developed.   Why has vaccine and drug development for HIV/AIDS been such a long and challenging process? Once available, how will stigmatization and bias toward HIV/AIDS impact vaccination efforts? 

Overview on HIV and AIDS

Since first identified in the US during the 1980s, human immunodeficiency virus (HIV) has remained a public health concern and affects millions of people across the globe.  HIV is a virus that causes flu-like symptoms in the acute stages.  However, if left untreated HIV weakens a person’s immune system such that the infected person develops AIDS (acquired immunodeficiency syndrome).  Once a person progresses to AIDS, they typically only live for a few years, and are at serious risk for contracting opportunistic pathogens that cause fatal infections in a person with AIDS (“Symptoms of HIV and AIDS: What to Look For?”).  HIV is transmitted through contact with bodily fluids and men who have sex with other men, particularly black men, are most affected by HIV, but anyone can contract HIV if exposed (Levine).  

Challenges to Treatment

HIV’s association with and increased incidence in the gay and bisexual communities complicates treatment.  Homophobia has historically played a large role in creating HIV stigma and continues to play a role today. During the AIDS movement of the 1980s many, including government and church officials, judged those with HIV and AIDS, believing that sexual behaviors that contributed to spread the virus were immoral (How to Survive a Plague).  Homophobia prevents many from getting tested for HIV, has caused resistance to pre-exposure prophylaxis, a newer preventative medication for HIV and AIDS, and inhibits safe sex education efforts.  Gay and bisexual men often experience discrimination that causes higher rates of suicide, depression, and drug abuse.  Some lose support from their families after coming out to them which can make them economically disadvantaged, inhibiting their access to healthcare (Halkitis).  Though more people are becoming accepting of the gay and bisexual communities remnants of historic discrimination and homophobia are still evident today and affect these communities’ healthcare especially as a group that remains vulnerable for contracting HIV. 

The difficulty in treating HIV is also due to the biology of this disease.  Unlike other infectious diseases like COVID19 and influenza which are RNA viruses, HIV is a DNA based retrovirus that is less easily targeted by mRNA vaccines.  Specifically, HIV latency phase can prevent HIV from being easily detected.  An HIV positive individual can live for over a decade with latent HIV infection where the virus exists in the body at very low levels (Cure – Science of HIV).  They are still able to transmit HIV with a detectable viral load, but proper medication with antiretroviral therapies (ARTs) can allow a person to have an undetectable viral load that prevents the person from experiencing symptoms or being able to transmit the disease.  However, as a retrovirus, HIV integrates into the infected person’s DNA, so ARTs can prevent replication of HIV, but cannot eradicate HIV DNA from the host.  Thus, those at risk for contracting HIV must be regularly tested and positive individuals must monitor viral loads to understand their risk for developing AIDS and whether they can transmit the virus to others.  With respect to vaccine development, typical antibody neutralization of HIV is challenged by the virus’ ability to evolve and mutate rapidly to evade antibody mediated neutralization.  

As of now, there is no cure for HIV/AIDS.  Antiretroviral therapy (ART) is the most effective strategy to date for HIV management.  Since the start of the HIV/AIDS epidemic, nearly 24 different pharmacological agents have been approved for treating HIV and work by preventing viral replication.  In addition to ART, pre-exposure prophylaxis (PrEP) was approved in 2012 and is highly effective at preventing HIV infection.  Current work is aimed at developing a vaccine for HIV especially as mRNA vaccines have shown great promise for the COVID19 pandemic.  Moderna and the National Institute of Allergy and Infectious Diseases are currently testing mRNA based HIV vaccines in phase 1 trials.  Though initial data from these trials, an additional 5-10 years of trials must be conducted before these vaccines can become widely available (Vesper).   

Enacting an Effective Vaccination Campaign

Beyond overcoming biological challenges in developing an effective vaccine, combating systemic issues and likely opposition to HIV vaccination will be a major concern in disseminating the vaccine to the population.  First, HIV stigma, homophobia, and embarrassment  may prevent people from wanting to get vaccinated.  Many might think vaccination is not necessary for them because it is only common in the gay and bisexual communities, and if they do not identify with those communities they might be reluctant to get vaccinated.  Advocates for improved HIV/AIDS treatment development efforts suggest investing in community engagement and behavioral science to increase reception to vaccination.  With more people receptive to receiving vaccination the social risk a person takes in getting vaccinated decreases.  The COVID19 vaccination effort was wildly successful because public health officials and epidemiologists were able to generate excitement around getting vaccinated and brought millions of vaccines to people in a coordinated effort.  To obtain similar success with HIV vaccination, significant work would need to be done in educating the public about the benefits of vaccination and reducing stigma and perceived social risk surrounding vaccination.  In addition, ensuring that the public has access to vaccination is critical to ensuring success of an HIV vaccination campaign.  This could be accomplished by creating a public vaccination program for an HIV vaccine or by expanding insurance plans to cover an HIV vaccine.  A lack of a federal vaccination program would present challenges in ensuring vaccines reach uninsured people, especially as many at risk for HIV may not have strong health insurance.  A final consideration in bringing vaccination to the public is overcoming vaccine hesitancy.  A significant number of Americans have become wary of vaccines such that the WHO has identified hesitancy to vaccinate as a top ten global health threat.  Even if researchers and vaccine developers can overcome scientific barriers in developing an HIV vaccine, combating systemic issues and societal reluctance to vaccinate will be an equally challenging factor in the vaccine’s success (Bose).  

6 Surprising Things You May Not Know About HIV/AIDS Today | Johnson &  Johnson

Levine, Hallie. “6 Surprising Things You May Not Know About HIV/AIDS Today.” Content Lab U.S., 15 Mar. 2023,


Currently 1.2 million people in the United States have HIV and over 18,000 people died of HIV in 2020 alone (“HIV And AIDS Trends and U.S. Statistics Overview”).  The battle for effective therapies for HIV/AIDS has been ongoing for decades, and without better therapies, people will continue to suffer from this disease especially as climate change will increase opportunistic pathogens that contribute to deaths in the coming years.  As vaccination is one of the most effective ways to prevent death for most diseases, an HIV vaccine would significantly improve the status of HIV positive individuals (Ten Threats to Global Health in 2019).  

However, just developing the vaccine is not enough, and strategizing ways to vaccinate the public will be critical in the vaccine’s success.  With the existence of vaccine hesitancy among Americans, public health officials must properly educate Americans on HIV and the efficacy of the future vaccine.  Additional work must be done to de-stigmatize HIV/AIDS to increase reception to an HIV vaccine and increase the number of vaccinated individuals.  Education is incredibly powerful in helping Americans understand the severity and complexity of this epidemic.  In anticipation of a vaccine, advocates must continue the momentum begun in the 1980s in support of HIV/AIDS treatment and care.  


Arts, Eric J., and Daria J. Hazuda. “HIV-1 Antiretroviral Drug Therapy.” Cold Spring Harbor Perspectives in Medicine, vol. 2, no. 4, Cold Spring Harbor Laboratory Press, Apr. 2012, p. a007161.

Bose, Devi Leena. “Preparing Society for a HIV Vaccine.” Nature India, Nature Portfolio, May 2022,

Casadevall, Arturo. “Climate Change Brings the Specter of New Infectious Diseases.” Journal of Clinical Investigation, vol. 130, no. 2, American Society for Clinical Investigation, Feb. 2020, pp. 553–55.

Cure – Science of HIV.,detected%20by%20the%20immune%20system.

Epstein, Steven. “The Construction of Lay Expertise: AIDS Activism and the Forging of Credibility in the Reform of Clinical Trials.” Science, Technology, & Human Values, vol. 20, no. 4, 1993.

Halkitis, Perry N. “Discrimination and Homophobia Fuel the HIV Epidemic in Gay and Bisexual Men.”,

“HIV And AIDS Trends and U.S. Statistics Overview.”,

How to Survive a Plague. Directed by David France, Public Square Films, 2009.

Levine, Hallie. “6 Surprising Things You May Not Know About HIV/AIDS Today.” Content Lab U.S., 15 Mar. 2023,

“Symptoms of HIV and AIDS: What to Look For?”,

Ten Threats to Global Health in 2019.

Vesper, Inga. “Cautious Optimism for Trials of mRNA-based HIV Vaccine.” SciDev.Net, 30 Mar. 2022,

Stigma and Power Hierarchies in College Medical Care


For many college students, they are away from home for an extended period for the first time in their lives. Used to having their medical problems taken care of by their parents, this complicates seeking care for sicknesses at school. Many schools offer some form of a clinic on-campus, but these are commonly reported to be insufficient to take proper care of what students need. For many female students, especially those seeking reproductive care, it is difficult to seek care for an issue commonly characterized as taboo. As reported in class, women are more likely to see medical care, especially regarding to reproductive issues. At Notre Dame, issues like these become even more complicated as certain medical procedures are restricted due to the dominant Catholic views of the school. Seeking medical care alone as a young woman exposes patients to stigma and shame, allows women to feel ignored in their own experiences with their bodies, and reveals the impact that illness can have on overall lifestyle.

A typical college lecture hall filled with students. Sourced from Unsplash.

Personal Encounter with UHS

Note: I have changed the name of my friend who agreed to let me use this story for class to preserve her privacy.

My friend, Janie, experienced chronic urinary tract infections (UTIs) while at school at Notre Dame from an unknown cause. When she visited University Health Services (UHS) and her gynecologist at home, she experienced extreme judgement and stigma. The first thing her gynecologist asked her was whether she had a boyfriend (not her number of sexual partners, but whether she had a boyfriend) and when she said yes, they noted that in her chart as a piece of medical information. At her follow up appointments, her gynecologist asked about her boyfriend specifically, inquiring whether he was from home or school, how long they had been together, and other personal pieces of information.

Her gynecologist and UHS were ultimately unable to identify the root causes of what they diagnosed as chronic UTIs. Janie suffered four UTIs in four months as doctors from her hometown and Notre Dame refused to acknowledge that a bigger issue might be at play. They accused her of sleeping around and STDs contributing to her pain while refusing to give her antibiotics that would alleviate her pain or evaluate her for a more serious, long-lasting condition.

They made me feel as though my pain was not worthy of serious consideration, that I must be making it up for attention.

Janie on her experiences with medical professionals at University Health Services in Notre Dame

The condition became drawn out over four months, and it greatly impacted Janie’s quality of life. She was in extreme pain and often had to leave class during lecture due to pain. It eventually got to the point that she was unable to walk back from a class building to her dorm (a 15 minute walk). When she called UHS desperately requesting an appointment and reporting symptoms of kidney stones, the nurse told her that there was nothing she could do to get her an appointment in the next week and remarked, “if you were my daughter and in this much pain, I would send you to the ER.” With no car and nobody to take her to the ER, Janie took 3 Advils and tried to take a nap. She woke up to find herself in some relief (after months of agony) and her gynecologist from home later confirmed that she must have passed the kidney stones unaided by medicine.

Stock photo of a patient holding unmarked pills. Sourced from Pexels.

Reading Janie’s story alongside the texts from the course reveals three themes from this module. She experiences stigma and judgement about her character from her medical condition, encounters the power dynamics which dictate access to medicine for a college-aged girl by herself, and is confronted with the reality of illness and how it affects life outside of the medical realm.

Stigma in the Medical Sphere

Janie experienced stigma and shame from medical professionals because she was a college-aged woman seeking healthcare by herself for a UTI. There is a medical link between UTIs and sex, as anything that allows bacteria to enter the urinary tract can increase the risk of UTIs. Janie faced extreme judgement for her condition because medical professionals who were supposed to be caring for her often assumed that it was her fault that she was experiencing pain, and she deserved it because of her promiscuity. As discussed in Chapter 10 of Kleinman’s Illness Narratives, stigma often has religious ties, and “the afflicted person is viewed as sinful or evil…or [can be associated with] a moral connotation of weakness and dishonor” (Kleinman, 2020). It’s very likely that Notre Dame’s status as a Catholic University influenced the training that UHS employees get and affects the way that they interact with patients for conditions that may be related to premarital sex. When Janie experienced the medical professionals’ reaction to her health condition, she felt silenced and judged, just as patients in Kleinman’s book reported feeling.

Power Hierarchies Affecting Care

When Janie called and requested an appointment after reporting severe symptoms, UHS repeatedly told her that they were unable to fit her in. One nurse even told her that she would tell her own daughter to “just go to the ER.” And when Janie reported to the UHS nurse on the phone that she was experiencing extreme pain (7-8 out of 10), the nurse seemed skeptical, asking “really? There’s no way.” When she told the professionals that she thought she may have a kidney stone, reporting typical symptoms like proteinuria and radiating pain from her back down her hip, she was shut down and told that it was probably just another UTI. Similarly, Nelson writes that the communities served by the Black Panthers’ free clinics often described experiences where when “the resident…comes in to check up on [you, he]…talks to you as though you weren’t there” (Nelson, 2013). Because the medical professionals at the top of the power hierarchy did not view those communities as worthy of knowledge, the medical information was weaponized as it was withheld. Janie was also not treated as capable of understanding her own body, denied explanations of why doctors would not treat her for kidney stones and why her symptoms did not qualify. Just as the gay community protesting for AIDS treatments found themselves having to prove themselves credible in order to engage in healthcare discussions over their own care, Janie did not seem intelligent or credible enough as a young woman to be granted agency in her own care (Epstein 2020).

Stock photo showing a doctor explaining something to a patient. Sourced from Pexels.

Impact of Illness on Lifestyle

When Janie was chronically ill for four months, her illness affected more than just her physical health. It impacted her academics, mental health, and relationships with her friends and partner. In Chapter One of Illness Narratives, Kleinman acknowledges the far-reaching impacts of “illness,” defining it as “how the sick person and the members of the…social network perceive, live with, and respond to symptoms and disability” (Kleinman, 2020). Because she was in such severe pain and was denied medication, she had to leave class during lecture for long periods of time and fell behind on schoolwork. She was also unable to exercise, affecting her mental health. Kleinman details the effect of chronic illness on Alice Alcott, who experiences emotional reactions to her medical condition that affect the rest of her life. He explains that the work of the healer is also to deal with emotional consequences that may come from conditions and treatments (Kleinman, 2020). When Janie’s doctor refused to address her feelings of pain or her concern that it may be a more serious cause, she neglected this duty.


Epstein, S. (1995). The construction of lay expertise: AIDS activism and the forging of credibility in the reform of clinical trials. Science, Technology, & Human Values, 20(4), 408–437.

Kleinman, A. (2020). The meaning of symptoms and disorders. In The illness narratives: Suffering, healing, and the human condition (pp. 3–30). essay, Basic Books.

Kleinman, A. (2020). The personal and social meanings of illness. In The illness narratives: Suffering, healing, and the human condition (pp. 31–56). essay, Basic Books.

Kleinman, A. (2020). The Stigma and Shame of Illness. In The illness narratives: Suffering, healing, and the human condition (pp. 169–180). essay, Basic Books.

Nelson, A. (2013). The People’s Free Medical Clinic. In Body and soul: The black panther party and the fight against medical discrimination (pp. 75–114). essay, University of Minnesota Press.

Society’s Meaning of Sickness and its Toll on the Sick

The Cost of Illness

Illness comes with overwhelming amounts of pain, symptoms, trauma, and costs. These emotions consist of negative feelings such as guilt, frustration, apathy, hopelessness, anxiety, loneliness, denial, grief, and disempowerment. Healthcare and treatment costs are at an all time high, leaving behind concerning levels of debt and a lack of affordability for those who need help most. Symptoms and effects of illnesses are not always properly understood; therefore, it is not always known how to treat them. The list of the struggles for the sick person goes on and on. All of these factors shape individuals’ experiences and therefore shape their livelihoods. However, there are other factors that end up placing an additional burden on the sick. Each sick individual’s immediate communities as well as their social environments work hand in hand to affect their personal interpretation of their illnesses through defining them with stigmas, utilizing the ideology of health, and pushing for the creation of controlling health practices. 

First, I will elaborate on how our healthcare system and the society we live in create and place powerful stigmas on the sick, utilize the ideology of health to form systems of beliefs, and misuse their power to control society. Then, I will detail the numerous mental and emotional effects these factors leave on the sick. I will conclude by discussing possible solutions to these issues, specifically focusing on how physicians can better their care of those who are ill.

The Social Meaning of Sickness

Every sick individual has their own unique personal human experience of their symptoms and their suffering. However, both their immediate community as well as their social one adds an additional burden and an additional dimension of suffering they are forced to deal with through stigmas, ideologies, and methods of control.

“Acting like a sponge, illness soaks up personal and social significance from the world of the sick person.”

Kleinman Arthur, Illness Narratives, 2017.

The Power of Stigmas

Stigma is defined by Goffman as discredited attributes that are clearly visible and identifiable, marking patients with disgrace and shame, spoiling their identity, and creating an internalized feeling of being inferior and less than (Goffman 2022). They become defined as straying away from the “normal” status quo as their health is altered in some way, leading to them becoming “disqualified from full social acceptance” (Goffman 2022). My younger cousin is incredibly intelligent, most likely the smartest person I know at the young age of 14. He excels in school, rapidly spits out definitions of complex vocabulary terms, easily explains difficult concepts, and is incredibly quirky with his random comments and daily quotes. His personality and knowledge astounds me everyday. However, he is looked at differently because of his disability. He was diagnosed with autism at a very early age. This has led to him getting degraded and picked on by peers, labeled and placed in a box by educational professionals, and defined by healthcare workers. They all base their understanding of who he is on his differences. “The stigmatized person is defined as an alien other…whose persona…the group regards as opposite to ones it values. In this sense the stigma helps to define the social identity of the group” (Goffman 2022). My cousin is a prime example of an individual who is labeled as “other” by people in society and people in positions of power. 

Ideologies and Their Effects

Ideology is philosophical. It is symbolic and it is practical. It is a system of beliefs shared by a certain group in an effort to shape action, succeeding by covering up patterns of dominance, power, and inequality (Crawford 2006). Ideology becomes acceptable to us. Crawford argues that health itself is an ideology that is powerful and effective as a form of social control as it succeeds in pushing us to participate in certain behaviors and consume certain goods (Crawford 2006). It works to replace the concern for a mutual obligation with a sense of tackling sickness with an individual responsibility for health. In the film “How to Survive a Plague” on the AIDS epidemic, those suffering with AIDS were held to the personal responsibility of fighting for themselves, doing their own research, finding their own drugs and treatment, and using their own voices to protest and stand up against lawmakers and pharmaceutical companies (France 2012). It was clear that those in power were not prioritizing the issue, owning up to their responsibilities of protecting the health of citizens, or assisting those who were suffering incredibly.

AIDS activists protesting for proper treatment, medication, and other rights for victims

Establishment of Control Using Health

In addition to stigmas placed on people and the ideology of health affecting quality of care, the sick person battles differing forms of social and moral control. Medicine and health have become a form of authority that is not often questioned. There is a control over technology and jurisdiction over what is considered to be a good life. There is this idea that there is a rational and objective way to maintain healthy lifestyles and deal with certain illnesses in a way that is deemed “right.” When there is any attempt to step away and do anything in a different way, they are looked down upon and defined as resisting the correct way to heal. This takes an additional step towards labeling people. We become defined as being sick, dysfunctional, or needing medical intervention, leading to healthism where there is no upper limit of health, wellness, and fitness. There is always more you can do to remain healthy or heal. Sick people are pressured to answer two main questions of “why me” and “what can be done.” Without the answer to these questions, they may feel that they have failed, not dealt with their illness in the “correct” way, and deserve to be ill or that it is in some way their fault.

All in all, health practices act as a way to control, hack, and exploit the sick without having to force or coerce them as the effectiveness of social control removes the need for central or government power. A prime example of this is the overwhelming presence of wellness programs from gyms in work offices to the promotion of cycling classes and pilates. These work to create a more productive workforce, reduce liability through providing resources for healthy lifestyles, and attract more employees with the appearance of benefits (Winant 2018). Winant highlights Ehrenreich’s observance of the “fixation on controlling the body encouraged by cynical and self-interested professionals in the name of wellness” and how self care has become “a coercive and exploitative obligation [with] endless medical tests, drugs, wellness practices, and exercise fads that threaten to become the point of life” (Winant 2018).

Moving Forward: Recommendations for Clinicians

So how do we move forward from here? What steps can we take to better treat and care for the sick in a way that respects their dignity and right to fair care and treatment? We must ask ourselves how we can provide the utmost compassion and most effective care and treatment. It starts with those in power and those who interact most closely with the sick. This means physicians must take the first step. In this way, we can work to tackle the many issues that exist and thrive in our societies, hospitals, schools, and even homes.

Kleiman has offered some incredible advice for how we can take steps to achieve this through affirmation, listening, and offering empathy and compassion. He stresses that clinicians should work to affirm both the patients and their family members’ experience with a certain illness as constituted by lay explanatory models (Kleinman 2017). He also highlights the need for empathetic witnessing, which is listening (with care and intention) to what he calls the sick person’s persona myth or the story that they tell in an attempt to make sense of their illness (Kleinman 2017. We must also listen to their and their families fears and the trials and tribulations they face while mirroring these stories back to the patients in order to assist these patients in constructing these narratives (Kleinman 2017. I love these pieces of advice because in my opinion, one of the most important aspects of caring for an individual and bettering their health is forming proper relationships with them, relationships with total and complete care, fair equal dynamics, and dignity for the sick. Compassion and the feeling of being heard and understood is so important as those that are sick often face the experience of not having their voices heard, being constantly invalidated for their pain and emotions, and having their personal experiences be overlooked.


  1. Crawford, Robert. “Health as a Meaningful Social Practice.” Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, vol. 10, no. 4, 2006, pp. 401–420., 
  2. France, David, director. 2012. How to Survive a Plague. Sundance Selects. 109 min.
  3. GOFFMAN, ERVING. Stigma: Notes on the Management of Spoiled Identity. PENGUIN BOOKS, 2022.
  4. Kleinman, Arthur. “The Illness Narratives.” Academic Medicine, vol. 92, no. 10, 2017, p. 1406., 
  5. Winant, Gabriel. “A Radical Critique of Wellness Culture.” The New Republic, 23 May 2018, 

Wellness Culture: Looking to the Past for a Better Future

Would it shock you to learn that only 15% of a physician’s medical decisions are based on scientific evidence (Pfeffer & Sutton 2006)? It’s a somewhat shocking revelation, and one that has become a hot topic in medical communities in recent years. When even medical decisions are frequently based on obsolete knowledge and past experience, it shouldn’t be shocking that societal conceptions of wellness and health are commonly based on aesthetics and heavily influenced by commercial interests (Pfeffer & Sutton 2006, Winant 2023). Nonetheless, there are evidence-based measures of health that are worth pursuing (Johnston, et al 2009). Today, individuals are in need of a balanced and holistic approach to healthy living. By looking to the past for models of “self-care,” modern day wellness culture can find ways to evolve to better promote the health of individuals. 

Critiques of Modern Wellness Culture

Juice cleanses, meditation, gym memberships in excess of $1,000 annually—all are at the forefront of present day “wellness.” It is inaccessible, ineffective, and creates the illusion that the mind and body can be a “perfectly self-regulating machine” (Winant 2023). This illusion perpetuates feelings of personal inadequacy, detrimental to mental well-being and having the opposite intended effect of wellness culture (Blei 2017).

“Health has become both a goal and a social anxiety”

Health as a Meaningful Social Practice, Crawford 2006

The commercialization of health has permitted non evidence-based methods of pursuing wellness to proliferate. Moreover, it has allowed objectively unhealthy practices to persist in the name of profits. Highly processed foods have been found to share pharmacokinetic properties with addictive drugs (Schulte 2015). “Wellness” practices that have risen to popularity, such as “liquid chlorophyll” and the “internal shower” drink, have questionable health benefits (Rogers, et al 2022). Influencers seeking personal gains propel the masses in pursuit of their shining example towards products that do little more than drain their bank accounts. 

Perhaps a critique applicable to modern culture in general, but certainly relevant to modern pursuits of wellness, is the natural desire to seek out the path of least resistance. In fact, a psychological study conducted by the University College London found that taking the path of least resistance is hard-wired into our brains (UCL 2017). It is this attitude that may be foundational to the widespread existence of corporate “wellness” propositions that provide few true benefits. Seeking an easy or quick fix, particularly one that allows us to maintain other unhealthy habits, is a temptation that is difficult to avoid, and is one that is detrimental to modern pursuits of wellness. 

Positive Elements of Past Models of Wellness

ACT UP Demonstration at NIH
Photo taken from Creative Commons

“Act up! Fight back! End AIDS!” (France 2012). The signature slogan of the ACT UP organization encapsulates the passion of its members. Their relentless pursuit of progress enabled their success. In crisis situations, individuals are willing to make drastic sacrifices in order to recapture the status quo. Members of ACT UP quit their jobs in order to devote significant time to advocacy and self-education (France 2012). More recently, amid the COVID-19 pandemic, individuals made drastic alterations to their lifestyle and daily habits in order to “slow the spread.” These individual acts of self-sacrifice aided in the social pursuit of health and wellness. 

The “health consciousness” movement of the 1970s brought into focus new attitudes of self-help through diet and exercise (Crawford 2006). While this permitted the eventual rise of commercial interventions in mental and physical well-being, individual agency over wellness is an essential component of shaping a healthier society. Perhaps one of the most empowering views of personal health, the health consciousness movement viewed individual wellness “as a matter of common sense,” rejecting the now seemingly heavy dependence on corporate interventions (Crawford 2006). Importantly, however, this attitude must coincide with a true ability to achieve objective standards of wellness in order to avoid inculcating feelings of defeat and hopelessness. 

Looking Forward

While it is clear by looking at examples from the AIDS epidemic and COVID-19 pandemic that individuals can be passionate in pursuit of health and wellness, it is also conspicuous that this is not an omnipresent attitude. In pursuit of a more effective wellness culture, this passion must be ignited with the aim of extinguishing present deficiencies. Individuals must confront the realities of human nature, and take the initiative to educate themselves of objective standards of health and evidence-based means of achieving and maintaining them. Redefining and limiting what it means to be “well” on objective standards creates a finish line—a visible model for healthy living. This alone can help many to “live well,” and can reduce the anxieties associated with a culture that implores never-ending improvement and incites competition to be the most aesthetically “well.”

Photo taken from Creative Commons

On a societal level, effort must be put forth to make healthy living more accessible. Though large corporations have taken the initiative to install fitness centers and provide quality food to their employees, accessible means of healthy living are not so readily available to large swaths of the population. Many of the barriers are quite obvious. Low wages keep many working long hours to make a living, leaving little time for routine exercise. High prices of fresh meats, seafood, fruits, and vegetables are prohibitive to individuals and families on tight budgets. As a result, the United States has abnormally high rates of obesity and chronic disease (Tikkanen & Abrams 2020). Effective means of reducing these barriers are not so obvious. Perfection is a difficult thing to attain. Nevertheless, it is at least in some ways comforting to know what we do not know; for it provides hope that with effort we can progress towards a more positive wellness culture and a healthier tomorrow. 

Works Cited

Blei, D. (2017, January 4). The False Promises of Wellness Culture. JSTOR. Retrieved March 25, 2023, from 

Crawford, R. (2006). Health as a Meaningful Social Practice. Health: An Interdisciplinary Journal for the Social Study of Health, Illness, and Medicine, 10, 401–420. 

France, D. Director. (2012). How to Survive a Plague [Film]. Public Square Films and Ninety Thousand Words. 

Johnston, D., Propper, C., & Shields, M. (2009). Comparing Subjective and Objective Measures of Health: Evidence from Hypertension for the Income/Health Gradient. Journal of Health Economics, 28(3), 540–552. Retrieved 2023, from 

Pfeffer, J., & Sutton, R. (2006, January). Evidence-Based Management. Harvard Business Review, 63–74.

Rogers, K., LaMotte, S., & Marples, M. (2022, December 28). The Tiktok Wellness Trends We Should and Shouldn’t Take into 2023, According to Experts. CNN. Retrieved March 25, 2023, from 

Schulte, E. M., Avena, N. M., & Gearhardt, A. N. (2015). Which foods may be addictive? The roles of processing, fat content, and glycemic load. PloS one, 10(2), e0117959.

Tikkanen , R., & Abrams, M. (2020, January 30). U.S. Health Care from a Global Perspective, 2019: Higher Spending, Worse Outcomes? Improving Health Care Quality. Retrieved March 27, 2023, from 

University College London. (2017, February 21). Humans are hard-wired to follow the path of least resistance. UCL News. Retrieved March 27, 2023, from 

Winant, G. (2023, March 24). A Radical Critique of Wellness Culture. The New Republic. Retrieved March 24, 2023, from 

Caregiving In the Black Community

The responsibility of caring for her 104-year-old mother has fallen squarely on Kathleen Leonard’s shoulders. Due to her close proximity to her mother’s home and the fact that her siblings live out-of-state, Leonard helps her mother with basic caregiving tasks daily. These include therapy appointments lasting around 2 hours and routine evening showers at exactly 8 p.m. While Leonard is grateful that she still gets to spend time with her mother, the emotional stress and burnout of caregiving is taking a toll on her mental health. This emotional rollercoaster worsens when she visits her grandchildren in New York; the guilt of physically leaving her mother in Houston doesn’t allow her to fully relax and enjoy her time with other family members. “I love my mother, but it doesn’t minimize the stress,” she said.5 Leonard’s story reflects the struggles that many Black caregivers face– while roughly 19.3% of American adults act as caregivers, Black caregivers report higher rates of intense caregiving and suffer a bigger impact from Covid-19 than other racial groups.1 Cultural dynamics further complicate caregiving in Black communities, placing more responsibility on family members to take care of loved ones.

“I love my mother, but it doesn’t minimize the stress.”

Kathleen Leonard

Impact of Covid-19

Pre-pandemic, caregiving for adult family members was already more commonplace in Black families than in white families. In fact, 18% of Black women reported caregiving compared to only 12% of white women.4 Similar to the gender makeup of caregivers for all races, Black women take on the brunt of caregiving work.5 The pandemic both exacerbated stress for existing caregivers and forced more women to become caregivers, with an additional 11% of Black female KFF survey respondents reporting that they started or picked up additional caregiving duties for family members during the pandemic.4

Covid-19’s health risks and disruption of work habits played a big role in the pandemic’s negative impacts on Black caregivers. Black workers and other workers of color were much more likely to be on the frontlines of the pandemic, which added the stress of having to keep working while simultaneously caregiving during their few hours spent at home.1 When considering the fact that Black Americans are less likely to have received at least one vaccine dose than Latinx or white Americans, the fear of bringing home illness to a physically compromised loved one adds to existing caregiving stress.1 

The pandemic also caused upset in the dynamics of homes with adult caregivers– the massive disruption of routines made it difficult for many caregivers to help family members readjust to a new way of life. Such as in the case of Sabrina Scott, a 56-year-old Black woman who was the primary caregiver for her maternal grandmother through the pandemic, disrupted routines may have contributed to the health decline of her grandmother and other adults who depended on caregiving.1 The pandemic’s disproportionate health, financial, and work-related effects on the Black community directly impacted the mental and physical health of both Black caregivers and their loved ones they looked after.

Photo taken from Pexels

It Takes a Village

“Healthcare providers aren’t patient, don’t listen and tend to make assumptions about African Americans and Blacks.”

Anonymous respondent to American Society on Aging survey

According to the American Society on Aging, Black caregivers are less likely to have undergone formal training or enlist the help of paid caregivers/care facilities.2 This can be due to multiple reasons, such as the fact that there is a stigma against entrusting the care of loved ones to others outside of family, friends, and community members. Due to a historical bar of access and subsequent poor interactions with medical staff, many Black families are deterred from the traditional medical system of caregiving. When attempts to use the traditional system are made, 56% of surveyed Black caregivers report some or a great deal of difficulty coordinating with health care professionals such as doctors, nurses, and service workers.2 A respondent to the aforementioned survey included the sentiment “Healthcare providers aren’t patient, don’t listen and tend to make assumptions about African Americans and Blacks,” exemplifying the reason why loved ones who cannot advocate for themselves are not commonly left in the care of medical professionals.2

This cultural attitude towards refusing formal caregiving assistance was noticed by Sabrina Scott, who felt the added pressure to take care of her grandmother herself. Her family resisted a higher level of care for both her maternal and paternal grandmothers, essentially saying, “We don’t do that.”

We meaning Black people,” Scott further explained.1 Overall, informal sources of support such as friends, family, church congregations, and other community members are much more common for Black caregivers who enlist additional help.2 

“We don’t do that. ‘We’ meaning Black people.”

Sabrina Scott

Cultural practices play a large role in the dynamics of Black caregiving– both in positive and negative ways. The value placed on community and family can help provide additional support networks and often justifies the reason family members are willing to make sacrifices to care for their loved ones. While roughly half of the respondents to a National Alliance for Caregiving survey reported that they felt they had no choice in caregiving, the majority said they found an important sense of purpose or meaning in their role (more so than white and Asian respondents).3

From “It’s Time to Meet the Needs of African American and Black Caregivers”

However, cultural factors can also have negative impacts. Black caregivers work the most unpaid hours of any race, averaging 31.4 hours weekly, and 54% of Black caregivers provide high intensity care.1 This is likely due to the reluctance to enlist formal medical services to assist in caregiving, although the cultural mistrust of such services is justifiable. Cultural generational differences can also create tension in households, which adds to caregiver stress. While Millennials are more likely to be open about mental health issues, the deeply ingrained stigma about mental health in the Black community makes discussing mental health a point of contention for many Black seniors.5 The role that cultural dynamics play in Black caregiving is important to consider when trying to integrate healthcare and formal support workers into caregivers’ support networks. 


Moving forward, it is essential that an effort is made to regain and establish the Black community’s trust in medical professionals, particularly those that work in long term care or assisted living sectors. Healthcare workers must continually check in on the mental and physical health of Black caregivers, and all formal support workers must be educated on how they can begin to heal the divide of mistreatment and mistrust. Partnering with faith-based or community-based organizations to spread the word about assistance for caregivers would be a step in the right direction.2 While family and community holds an incredibly important position in many Black communities, caregiving is still labor.

Photo taken from Pexels

Works Cited

1. Courage, Katherine Harmon. “America Isn’t Taking Care of Caregivers.” Vox, 4 Aug. 2021,

2. Le, Ocean, and Angie Boddie. “It’s Time to Meet the Needs of African American and Black Caregivers.” Generations, American Society on Aging, 2020,

3. National Alliance for Caregiving. The “Typical” African American Caregiver. 2020,

4. “Women, Work, and Family During COVID-19: Findings from the KFF Women’s Health Survey.” KFF, 22 Mar. 2021,

5. Worthington, Ravelle. “Unique Caregiving Challenges the Black Community Is Navigating and What Can Help.” Care.Com Resources, 29 Apr. 2022,

The Toxic Culture of Health & Medicine: The Calvin Ridley Story

Calving Ridley is an All-Pro wide receiver in the NFL. However, his prosperous young career was disrupted this past season when he was banned from the NFL for gambling on his own team, the Atlanta Falcons, to win. He made a mistake and he owns up to it. However, just recently he shared his personal story which provides a lot more insight into what he was going through at the time. In diving deeper into his career and experiences, he highlights a handful of ways in which the culture of health and medicine within the NFL had failed him and led him down an extremely dark path. A team trainer contested and ignored Ridley’s broken foot. Then, Ridley reflects on his personal experience surrounding the passive medicalization of painkillers in the NFL. Finally, we see a more complete picture as Ridley expands upon the social impacts and stigmas around mental health as an athlete.

“Nah, bro, this is different. My shit broke.”

Calvin Ridley on pain in his foot to teammate Julio Jones5

Contesting Broken Bones

Ridley begins his story talking about his early career in the NFL. During his first two years, he played through bone spurs with the help of painkillers. He was performing at an extremely high level despite the pain. Then came the 2020 season, and after a Week 8 game against Carolina, Ridley’s pain level was at an all-time high. Feeling that there was something seriously wrong, he went to the team trainer and got an MRI. The trainer said it was just a bone bruise. Feeling that this was an injury and pain that he could manage, Ridley finished out the season posting career high numbers in receiving yards and touchdowns. However, his team was not performing as well and finished the season 4-12 resulting in a complete staff overhaul. When the new trainer came in, Ridley was sent to a specialist who within the first hour of the examination admitted to Ridley, “Your foot is definitely broken.”5

Broken bones are usually not a contested illness or condition, but in this case it was. While each scenario exemplifies key differences, Calvin Ridley’s injury reflects a lot of similarities to others who deal with contested illnesses. One example of such a condition includes Chronic Fatigue Syndrome. Patients experience incapacitating physical and mental fatigue, but due to the abstract nature and complexity of symptoms and indicators, this condition has historically been highly contested.6 Just like Ridley, these patients know there is something more serious going on even though doctors assure them that they are fine. This often leads to false diagnoses along with excessive, unnecessary, and often ineffective treatments. 

“I’m a football player. I know what we get paid for, you feel me?”

Calvin Ridley on taking Toreador shots every Sunday5

Passive Medicalization of Toradol in the NFL

In Ridley’s case, he was experiencing a ton of pain but persisted on playing through his “bone bruise.” In order to accomplish this goal, he took Toradol every Sunday to ensure that he could play with minimal pain and continue to perform at a high level. Now, Toradol is a drug, often injected, used for quick-acting pain relief. However, it is not supposed to be taken frequently due to high risk of side effects.3 Nevertheless, it was allowed and normalized because of the culture of the NFL and the expectations of its athletes. 

There are several parallels between the use of Toradol and the passive medicalization of Viagra. Similar to the societal expectations we place on athletes, the culture norms of masculinity contribute to the negative feelings that emanate from erectile dysfunction.1 Social factors such as insecurity stigmas around men’s health explain the high demand of Viagra. Men will often opt to take the pill for the quick fix rather than feeling the embarrassment of actually addressing the root causes of their ED. Thus, Viagra users eliminate the possibility of seeking counseling or any other solutions that would more effectively help and potentially solve their condition long term.

“My daughter don’t care. She’s two years old, and she’s running straight up to me, “Dadddyyyyyy!!!” She’s wanting to bake some cookies in the Fisher-Price oven, you know? But I’m coming home broken. I can’t even do anything but lie around in a dark room.”

Calvin Ridley on mental health issues off the field5

Social Impacts and Stigma around Mental Health as an Athlete

As Arthur Kleinman highlights, it is often not until detailed context of a lengthy case is revealed that we can come to fully understand and experience the social meaning and impact of illness.2 As Ridley continued with his struggles with injury, he explains that “after practice, once that painkiller wears off, you still have to come home and be a husband and a father.”5 The social structure of a patient’s life is an integral part of their inner experience and is an aspect of healthcare that is important and necessary but is often ignored. In Ridley’s case, he had a daughter, a wife, teammates, coaches, and even a whole city that were counting on him in one way or another, and the last thing he wanted to do was let anybody down. 

However, the pressure of these expectations compounded with his injury struggles is where the anxiety began. Ridley knew something was off but could not let anybody down, so he just stuck to pills, shots, and gritting it out. This really speaks to the stigma around men’s health, specifically the male athlete.4 There is often a feeling of expectation that men should deal with their problems on their own, and athletes especially are taught to just tough it out. Eventually, Ridley realized that his mental health issues were getting to be too much, and he decided to step away from football to seek help. Even then, there were people in the building that were supportive, Ridley recalls other people looking at him like, “You good, bro.”

Official Statement by the Atlanta Falcons after Calvin Ridley’s suspension4

Depression, Shame, and Recovery

Ridley recalls his time away from the game as major low in his life. He was extremely depressed, did not know what to do or where to go, and was just trying to get through each day. He hit rock bottom when the gambling scandal became public.

“Whenever people ask, ‘What were you thinking?’ The only answer I can give is, ‘I wasn’t.'” 

Calvin Ridley on responding to criticism relating to his gambling scandal5

Ridley eventually sought real help and contacted a therapist. He finally was able to learn more about what he was going through as well as how to cope with the emotions he was feeling. Throughout his story he recognizes and owns his mistakes but also reveals more of the background on what led him to that moment. It is not all his fault and much of what occurred can be attributed to a broken system that has much room to grow in how physical and mental health is handled. 


1Carpiano, Richard M. “Passive Medicalization: The Case of Viagra and Erectile Dysfunction.” Sociological Spectrum, vol. 21, no. 3, 2001, pp. 441–450., 

2Kleinman, Arthur. “The Illness Narratives: Suffering, Healing, and the Human Condition.” Academic Medicine, vol. 92, no. 10, 2017, p. 1406., 

3Murdock, Joshua. “Toradol (Ketorolac): Pros and Cons of This NSAID Pain Reliever – Goodrx.” GoodRx Health, 7 Oct. 2021, 

4“Official Website of the Atlanta Falcons Football Club.” Falcons Home, 

5Ridley, Calvin. “A Letter to the Game: By Calvin Ridley.” The Players’ Tribune, The Players’ Tribune, 8 Mar. 2023, 

6Walker, Jacob. “Researching Contested Illnesses: The Case of Chronic Fatigue Syndrome (CFS).” In-Training, 28 Feb. 2016,