Editor’s Note: Tazin Karim (@PharmaCulture) is a medical anthropologist who studies pharmaceutical culture in the US and contexts of prescription stimulant use. She is also active in the Digital Humanities and Social Sciences. In this post for our Virtual Identity edition, Taz examines the ways in which people use Twitter to construct virtual identities centered on the brand name stimulant Adderall.
In today’s digital world, choosing the right Twitter username is an important decision. It’s the first thing people notice and immediately signals to a potential follower who you are and why they should be interested in what you have to say. Although many stick to their given names, others use the opportunity to highlight their best qualities and brand themselves as an expert academic, baseball fanatic, or mother of the year. So when I found out there were over a hundred people on Twitter with the word “Adderall” in their username, it definitely got my attention. Of all the things to advertise, why would someone want to brand themselves around a mental health drug?
Adderall is a prescription stimulant designed to treat the symptoms of Attention Deficit and Hyperactivity Disorder (ADHD) – a condition affecting 12% of children and 5% of adults in the U.S. It is also used non-medically by a number of people from middle aged mothers to professional football players looking to manage their high-stress lives. My research in particular looks at the popularity of Adderall use among college students and how it is influencing cultural conceptions of mental health and academic performance.
Like other prescription drugs, the consumption of Adderall has become an important part of identity construction for many Americans. For a person with ADHD, it acts to reify the sick role by offering a tangible solution to an illness that is difficult to biomedically conceptualize. Lay conceptions of ADHD extend beyond biomedicine and are intimately tied to academic culture (“my grades are poor because I have ADHD” or “his grades are poor, he must have ADHD”). As a result, Adderall consumption can also construct and facilitate non-medical identities like being a good student, son/daughter, athlete, or friend. As the prevalence of these pharmaceutical practices increases, Adderall use is becoming not only de-stigmatized in American culture, but a normalized, and even glamorized way to achieve these idealized identities – both off and online.
Discovering Adderall-centric identities on Twitter was the result of my own struggle to create the perfect username. Although my dissertation work looks at prescription stimulant use in higher education, I didn’t want to pigeonhole myself as an “Adderall” researcher. I also didn’t want people to think I was somehow promoting the drug or associated with the pharmaceutical company who manufactures it. But when I discovered so many people who featured the term “Adderall” in their own usernames, I wondered if I was missing something. Weren’t they concerned about people passing judgment on their mental illness or use of prescription stimulants? After all, there is a big difference between occasionally tweeting about ADHD/Adderall and making it the core of your digital identity. In this piece, I want to offer two examples to address this question and highlight the unexpected ways in which Americans are branding themselves as Adderall users online.
Anna Smith* aka: @AnnaAdderall* is a college student who tweets about typical college girl things like fitness, Netflix, and keeping up with schoolwork. Although Anna rarely mentions the term “Adderall” in her actual status updates, I was interested to see if there was some connection between her advertised prescription drug use and what she was tweeting. For example, Anna often talks about dieting and her struggles with food. From time to time, she might tweet about feeling guilty for giving into a craving for a sugary snack or missing out on a day at the gym. These are usually followed by a series of tweets commending herself for getting back to the gym or on her diet so she can reach her next fitness goal.
While there is nothing suspicious about the tweets themselves, I couldn’t help but think about how prescription stimulants are often abused by college students for weight-loss because it increases energy and suppresses appetite. I don’t know for sure if Anna actually uses Adderall for this purpose or just to manage her ADHD, but I found that my analysis of her tweets was filtered through the fact that she had incorporated Adderall into the core of her virtual identity. Although my perception of the username @AnnaAdderall may not affect her real life, there are others viewing her profile that might. For example, Anna’s twitter account is linked to her professional website in the fitness industry. On the site she has before and after pictures of her weight loss in college – which may or may not have been aided by Adderall. But the fact that she is willing to not only reveal, but advertise her prescription stimulant use to her employers and future clients suggests that Anna doesn’t view it as something questionable.
While @AnnaAdderall is Anna’s primary twitter account, there are hundreds of people who have built entire virtual identities dedicated to the “Adderall lifestyle”. Almost all of these accounts are pseudonymous and not publicly associated with a real person or organization. This pseudonymity allows them to tweet freely about their opinions and experiences with ADHD and Adderall use without fear of social or legal repercussions. As these accounts gain more notoriety on Twitter, a few of their creators have gone public in an attempt to leverage this new found celebrity.
For example, Kristen B.* is a college student in Arizona studying to be an optometrist. As @KristenB.*, she tweets as herself about her life, sports and other events directly related to her offline identity. In 2010, Kristen decided to create a second account to share her opinions, observations, and experiences with Adderall and ADHD management. Today, her account “@Adderall_XR” has nearly 60,000 followers – an audience over 20 times the size of her primary account. She explains on her website:
Creating this twitter account was one of the best decisions I’ve ever made and now it’s definitely felt rewarding ever since I went public. Most of my friends were shocked Adderall XR was me which was really funny. Now, I run into my followers all over the United States and it is one of the best feelings to know I have so many people that love my account as much as I do and follow it on a daily basis. I wouldn’t consider myself a celebrity or “twitter celebrity” at all, just a normal college girl with ADHD that somehow accommodated thousands of followers through sharing her thoughts.
Although Kristen may not have set out to become a “twitter celebrity”, the way her digital identity has evolved over the last three years fits Sneft’s (2008) definition of microcelebrity. She explains:
Twitter’s directed friendship model replaces ‘friends’ with ‘followers’ and prominently displays the number of followers on each person’s Twitter page, creating a quantifiable metric for social status. The ability to strategically appeal to broad audiences and retain the attention of others is publicly valued…Micro-celebrity practices like interacting directly with followers, appealing to multiple audiences, creating an affable brand and sharing personal information are rewarded, and consequently encouraged, in Twitter culture. The ability to attract and command attention becomes a status symbol.
For Kristen, tweeting as @Adderall_XR is a performance. She is portraying a satirized, relatable version of herself, the prototypical college student on Adderall dealing with ADHD, final exams, and the various side effects of the drug. Furthermore, she is leveraging the popularity of Adderall use in order to promote herself and opinions as Kristen B. – aka “The Adderall XR Girl”. For example, during finals week this spring, she created a series of advertisements on other social media sites like Facebook and Instagram promoting her virtual identity:
Like myself, you may be wondering how being branded as “The Adderall_XR Girl” will play out for Kristen once she leaves the auspices of college life and attempts to enter the professional world. After all, wouldn’t an employer be wary of someone creating a virtual persona based on prescription stimulant use? Kristen doesn’t seem to think so – and in fact encourages others to do the same. She writes on her website:
I’m actually still amazed I had the potential to create such a popular twitter account haha and definitely recommend every one try it. It’s been really fun and worth all the hard work of trying to constantly think of new things to tweet lol. I hope this opens some opportunities down the road for me, but if not, that’s completely okay because I love tweeting and will continue tweeting on @Adderall_XR for as long as I can.
The fact that Anna and Kristen are only two among hundreds of Adderall-centric accounts suggests that Twitter would be a fruitful site for ethnographic research on biomedicalized identities. Are there Twitter accounts dedicated to other prescription drugs? Are they also pseudonymous or are people willing to attach them to their real identities? What are their motivations for creating these accounts? Do they serve as illness narratives, microcelebrity practices, or is it something altogether different? As social media structures become an extension of our lived experience, it is only logical that medical anthropologists take stock on what is happening online – because it is just too interesting and important to ignore.
*Names in this blog post have been changed/ modified per request of the editors for Ethnography Matters. I have mixed feelings about this as Tweets are legally considered publications and therefore are openly accessible and searchable by the general public (including myself). Furthermore, micro-celebrities like @Adderall_XR have appeared in other digital publications and openly claim ownership over their tweets. However, I also understand the desire to protect people’s identities and avoid recontextualizing their tweets in a way they may not agree with. This specific issue is one I have written about in the past [see here] and continue to grapple with. I would be happy to hear your thoughts about this via email, twitter, or the comments section below.
Senft, T. (2008). Camgirls: Celebrity and Community in the Age of Social Networks. New York: Peter Lang.
Marwick, A. and D. Boyd. (2011). “I tweet honestly, I tweet passionately: Twitter users, context collapse, and the imagined audience”. New Media Society. 13(1), 144-133.