Photo by Caitlin Abrams
Dr. Tim Culbert
Dr. Tim Culbert examines a baboon puppet, one of several toys he keeps in his office to help his young patients.
American children are in the middle of a fearsome ADHD epidemic—today about one in five American boys has an ADHD diagnosis, according to the Centers for Disease Control.
Or maybe it’s not an epidemic at all. “It’s all driven by the insurance game,” says Dr. Tim Culbert, an Uptown resident and one of the country’s leading pediatricians specializing in integrative mental health care. “For insurance purposes, you get a checklist of symptoms, check enough boxes: Bingo! It’s ADHD.”
Culbert winces and shrinks when he describes the pressures on doctors to diagnose ADHD in kids. “A lot of characteristics we are supposed to medicate these kids for would be positives in another context: High-energy people who can shift focus easily—that can describe Albert Einstein just as easily as it can describe a kid who can’t sit through six hours of lectures in a classroom. Someone who makes frequent loose, tangential associations? You could call that person unfocused, or a good musician or marketer. Yet if you give a kid a label, you’re going to leave him thinking he’s a lousy thinker,” Culbert says, adding that people tend to give up more easily after the diagnosis has been made. “A lot of schools say: If you can’t sit in a classroom for six hours and listen to one set of inputs, lectures, that’s pathologic. Do I think that’s pathologic? Absolutely not. And that’s what the whole system [of children’s mental health care] comes down to now. Label, pathologize, medicate. It makes me want to vomit.”
What’s the alternative?
There are lots, and they are what Culbert has dedicated his life to—explaining the alternatives to doctors (through his textbook, Integrative Pediatrics) and to parents and kids through his series of books on self-care for kids, including Be the Boss of Your Stress and Be the Boss of Your Pain. In his medical practice, leading Pediatric Integrative Medicine at PrairieCare, Culbert teaches kids individually how to use other stress-management skills including biofeedback, acupressure, and aromatherapy. “If you teach a kid half a dozen ways of dealing with stress, one or two will appeal to them. There’s no right answer,” Culbert explains.
Well, scratch that, he corrects himself. There is one right answer: “More skills, less pills. Kids tell me all the time: ‘I don’t want to take more pills.’ And why won’t we let them? We tell them: ‘We’re going to do things for you and to you—but you can’t do anything yourself.’”
But kids—even anxious, spacey, or angry kids—are not powerless, Culbert insists. Biofeedback, meditation, aromatherapy, acupressure, visualization, exercise, sleep, conversation and connection, healthy eating, and general life-management skills can do more for a child in difficulty—and help shape the adult the child will become—than all the Adderall in the world.
How did a Minnesota pediatrician straight from the world of board certifications and hospital administration come to lead the charge for sleep and exercise? It all comes from growing up in Northeast Minneapolis, Culbert guesses. It was there that he ate at Kramarczuk’s and attended Totino-Grace Catholic school, and developed a Nordeast working-class view of life, with underdogs scrapping against the power-elites.
The more he spent time in pediatrics, the more he became convinced that there was no more under-underdog than a kid with a ring of adults around him focused on a developmental, behavioral, or emotional “problem.” The more time he spent with these “problem” kids, the more convinced he became that most of them could be cured with daily exercise, good food (lots of vegetables, fruits, and healthy fats, and fewer processed carbohydrates and sugar), removal from stressful situations such as abuse, adequate vitamin D, turning off all screens two hours before bed, getting plenty of sleep, and learning stress-management techniques.
“There have been plenty of people over the years who call me a crackpot,” Culbert says. “I think that’s why I have so many board certifications. As a medical doctor, I never thought I’d spend my career talking about sleep, food, exercise, and stress management, and then arguing about whether these were radical ideas.” Could it all be that simple? In 17th-century England, children were wrecked by scurvy—a disease caused by lack of vitamin C. In Victorian England, children were felled by rickets—a disease caused by a lack of vitamin D. Will we look back on our days as a time of ADHD, when children were staggered by disease caused by a lack of good food and good sleep? If so, it’s people like Dr. Tim Culbert that will lead us back from the cliffs.