ADHD: Does it really exist?

[Prof_Moriarty]

So...let's say you're at the supermarket, walking down the aisle. Up ahead you see a child, maybe 7 or 8 years old, proceeding to take things off the shelves and throw them around. Or stand in the middle of the aisle and SCREAM REALLY LOUD. Or do something else that's totally unacceptable.

Do you think: "Wow. That kid must have a really bad case of ADHD"?

I'm one of those people that strongly believe that ADHD is a fake diagnosis parents and doctors give kids that aren't properly disciplined. It's an oppurtunity for parents to allow riatlin and prozac to control their childrens' behavior when they don't know how or can't be arsed to do so themselves. It earns doctors, psychologists, and pharmaceutical companies millions upon millions of dollars just for saying 4 letters.

You know what else? For the most part, it doesn't really exist outside the US. As far as being a diagnosis, that is. ADHD-typical behavior elsewhere is usually seen as symptomatical to some other mental disorder such as dyslexia, or just poor self-control.

Yes, kids will be kids, and one shouldn't expect to be able to control such acting up 100% of the time... but what of the parent that, upon seeing their kid throw a temper tantrum while watching a movie at the theater, thinks: "The medication must be wearing off"? What of the 21 year old that drinks every night, steals, lies, and blames their inability to properly act on some "disorder" they were told to have 5 years ago?

This will probably step on some toes, especially since I'm really new here... but I thought it'd lead to an interesting debate. Sorry in advance if anyone's offended by my views.

So...discuss.

[Disfunction]

ADHD is more than JUST hyperactivity.

There are two forms of ADHD (as far as the medical labels are concerned). One is ADHD and the other is ADHD without hyperactivity (as it was explained to me by a psychologist who specialized in this). I have been diagnosed as ADHD without hyperactivity. I lack the ability to focus on a variety of subjects. If you research the history surrounding ADHD, it has existed far longer than the name. The trouble is that everyone knows about it now, and as people know about it, they seek to write off their own behaviours and even those of their children as being ADHD.

I understand your perspective, and I'd easily conceded that it is misdiagnosed far too often, but I won't go as far to say that it is a societal construct that exists to justify children who have poor behavioural controls.

[Metatron]

I don't have ADHD, so I can't share any experiences there, but I can say that, disregarding the impossible chance that ALL doctors are creating this disorder, that parents would not only sue, there would be a HUGE uproar amongst several groups. It's just not reasonable to say that something that is not only written as a disorder, but so widely known as a common problem. I don't think it's logical.

[Prof_Moriarty]

Hm. Good for both you and your parents. Xng. I mean, I really am sorry it took them so long to do the right thing, but I definitely understand their opinion, and their need to be sure that they're doing the right thing. I really do think medicating anyone should be a last resort, or at least anything but the first choice.

I'm honestly glad it works well for you, though. And for the record, I definitely don't look down upon you or anyone that needs medication to function. That'd be hypocritical... I mean, me - caffeine = dull and sloooow.

[Prof_Moriarty]

Originally Posted by Disfunction

ADHD is more than JUST hyperactivity.

Good point. After reading Xng's post, I realized was focusing more on that particular symptom and the lack of self-control, and not the difficultly in concentration.

Let me slightly alter my stance (and agree with most of you here): ADHD definitely doesn't exist in record amounts.

From the NIMH website:

It is estimated that between 3 and 5 percent of children have ADHD, or approximately 2 million children in the United States. This means that in a classroom of 25 to 30 children, it is likely that at least one will have ADHD.

To me, this just doesn't seem right. I'd wager (in my unschooled, relatively uninformed opinion) that the proper statistic should be half of that. One kid per classroom? Heck, I bet half the class has parents who think their kids have ADHD...and the likelihood that they're right is fairly low.

But...yeah. I'll agree that ADHD, as an actual mental inability to concentrate on a constant basis, exists.

[She_Is_My_Sin]

Originally Posted by Prof_Moriarty

You know what else? For the most part, it doesn't really exist outside the US.

There are a few people at my school who have been diagnosed with it & I don't live in the US.

[Sanctus Dei]

My sister has ADHD... it's about as real as it gets. She has problems concentrating on one thing for too long and was offically labeled as mentally 6-8 years behind herself mentally. At 18 she was thinking as a 10-11 yr old and could barely function as a High School Student, she had to drop out and go for her GED.

[leticia]

there's also drud-iduced ADHD, which someone i knwo has, co drugs aren't always the answer. i guess xng's parents were right.

the way i see it is that, although some people have it, it is used a lot of the time as an excuse for something else. they say a kid has ADHD and then they can just ignore it, similarly with tyretts, which has some of the same symptoms as ADHD. some people diagnosed with it need help, but not for that.

in that sense i do agree with prof. 'this kid isn't badly disiplined, it's parents aren't lazy, it just has ADHD.' that happens too much.

[Ben Lahnger]

I'll jump into this with three thoughts.

1) I have ADD (without hyperactivity) and am thankful for Adderal when I can afford the doctors visit and prescription. I was diagnosed in my early 40's and could finally put a name on the unidentifiable fog, the invisible cage that hindered my progress all my life. I had seen counselors in my 20's and 30's and tried to explain the inexplicable trouble I had always had making any headway in life. I never ran into anyone who could comprehend the dichotomy between my obvious creative intelligence and my inability to concentrate on and complete tasks and my issues with memory retention. My teachers had explained it years before when they said to my parents, "He's so bright and he get's A's on all the tests. We just can't figure out why he doesn't apply himself to his daily schoolwork better." I graduated from high school in 1976 with mostly C's on my report cards (A's on tests and finals minus incomplete or no attemped homework equals C's).

I am currently unemployed and without health care insureance, so I am doing without Adderal. Experience has tought me that self-medicatiing with lots of caffiene somewhat counters the chemical imbalance and makes it easier for me to focus, but I must balance that with how irritable I become to live with if I have too much coffee. So it is hard and it makes the tedium of job searching even harder to stick to.

My ADD manifests as an inability to focus on things for any length of time. However, I am capable of a state of hyperfocus where I concentrate on nothing but a certain thing for long periods of time. It's kind of like having mental tunnel vision. I can be very good at long term projects that require patience and determination to complete. I just ignore everything else ... and I do mean everything. On the other hand, I am terrible in a fast paced enviroment where I am expected to multitask. That just frustrates the hell out of me.

2) I agree that the disorder is somewhat over-diagnosed, and there are some parents who are guilty of wanting to drug Johhny so they don't have to parent when he gets rambunctious. But I don't think it's as widely over-diagnosed as you believe. Looking at a comparison between the US and the rest of the world is a faulty indicator, as the rest of the world does not necessarily share the same reporting mechanism, diagnostice acumen or medical knowledge base to produce comparitive results. I also happen to believe that there are reasons why ADD and ADHD might occur much more often in the US than in other parts of the world, but I'll get to that in a minute.

Geisha, you have observed people you believe to have an Attention Disorder. Were all of those people dignosed? I ask because I know many people who have it have not been diagnosed ... I have witnessed some of them.

An example: a woman came into my store wanting a cell phone, but the process of getting her into one took a lot longer than it should because every other minute she was jumping on the phone. She would call a subordinate and drill through a list of commands in like 30 or 60 seconds. Then she'd get off the phone and ask me, "Now where were we?" And a minute later she's calling another subordinate and another machine-gun list of orders. I imagine her office is this bee-hive of people swarming around, each person hurtling along in a different direction due to her latest round of chaotic instructions. But she might not be diagnosed, as she is highly functional, at the cost of other people's sanity. Of course, she wasn't so functional with me, and I finally told her I needed her undivided attention or someone else would have to help her. It pissed her off at first, but we finally got the deal done.

Also, I have several books on ADD/ADHD and there is some link between creativity and this disorder. So some adults who have it might never get diagnosed because eccentric behavior is expected from artistic and creative people.

3) This is just a theory, but I think the human brain is evolving in a way that creates more Attention Disorder occurances, especially in the United States. In other words, the chemical imbalance is a result of changes in our physical, cultural and social enviroment. Let me make the case here:

When I was a kid, we would watch the same channel on TV for hours. In 1965, Sunday night was a no brainer - CBS all night: Lassie, My Favorite Martian, The Ed Sullivan Show, Perry Mason, Candid Camera and What's My Line. But on Thursday's it was a little more complicated. We watched NBC: Daniel Boone, Laredo, Mona McCluskey and the Dean Martin Show. We didn't want to watch Mona McCluskey, but we didn't have a remote control, so we sat through it. That's what people did back then.

Then we got remote controls, and we could change channels for that half hour of program. So we clicked once at 8:30 and back again at 9:00. But we still watched every commercial straight through, because there were only 3 networks.

Then with the advent of cable, and MTV in particular, things changed dramatically. MTV was the first channel that perfected and profited from programing that lasted less than 30 minutes. And the abundance of channels suddenly available meant that there was a better option than sitting through the latest 30 second commercial.

Now many of our movies are spliced together with jump-cut, camera-always-moving action to keep our attention. Commercials are going further and further to keep you from tuning out. Networks are shifting the start and end times of TV programs in a bid to keep your attention for a few minutes longer. Movies are sped up to run in a shorter timeframe when they air on TV. We live in an information-overload, can't-get-it-quick-enough, I'm-5-minutes-late-for -my-appointment-road-rage time. And I believe it is accelerating.

One of my favorite movies of all time is "12 Angry Men" from 1957. It is the story of 12 men on a jury and almost the whole movie takes place in one small room where these men are deliberating the verdict of a murder case. There is no fast editing. There is no change of scenery. There are no special effects. It's just a slow, deliberate drama about the very important converstaion these 12 men have. And I cannot get my girlfriend's daughters to watch it because "It's too slow and boring."

In my opinion, most of the citizens of the United States have an attention deficit.

[Disfunction]

I would like to take that theory relating to "especially the United States" and draw it out to any TV oriented culture. In most of the entertainment industry they will have a basic plot outlined for any television show, and then any number of subplots for supporting characters. You watch any television show and it will go from one angle, to another, to another, to another. Family oriented television shows hop from character to character to maintain interest in the matter at hand. Too much of the same lags interest, and lagged interest means risking anyone changing the channel. If they change the channel then they are losing viewers, and money from advertising.

So they climax at the break, and viewers have to stay, attention gets diverted many times since few commercials are entertaining anyway. I think it's a learned behaviour of preferencial interest.

Canada, though we often like to deny it among ourselves, is like a miniscule replication of the United States that tends toward more liberal ideas. We have the same TV culture as the United States (with an added Canadian media twist; there are laws that require a certain level of content on Canadian networks to be Canadian-made; personally, I think this is awesome, because it means that once my singing career develops and I debut as an animator, as well as a comedian/writer... I'll be able to exploit these laws on all fronts).

I don't really remember where I was going with this... I guess what I will say is that since the subject of ADHD has been more fervently addressed in the United States and Canada than in most other countries, there is a general tendency to be more conscious of people's behaviours in general, and therefore a greater awareness of the warning signs of the condition. A lot of people argue that ADHD doesn't exist, and that always makes me a little upset, because it does... The problem is that many doctors prescribe the medication without approaching someone with a more expert opinion on the subject.

Rant rant rant

[Sanctus Dei]

Originally Posted by GeishaGirl

That sounds like a problem far beyond ADHD. It sounds, and I'm not trying to offend here, but it sounds like mild mental retardation. I'M NOT TRYING TO BE MEAN! PLEASE DON'T HATE ME!

My friends sister has mental retardation. She's 26 and she thinks at the level of a 10 year old. She did get a GED. It sounds a bit similar.

No she's not quite that bad... she's actually really fox-like sneaky, but she has problems concentrating on things that are not directly related to her interests. Not to mention her attention span is next to null.

[Ben Lahnger]

Originally Posted by Disfunction

A lot of people argue that ADHD doesn't exist, and that always makes me a little upset, because it does... The problem is that many doctors prescribe the medication without approaching someone with a more expert opinion on the subject.

Dis, I appreciate the comments. Yes, it's definitley not just the United States, and as you say Canada is sort of a microcosm of America in some ways. I just think the reporting and diagnosing are higher here for a reason. But the cable-and-satelite-television, high-speed-internet, hundred-radio-station-and-downloadable-mp3, email-and-instant-messaging, advertising-everywhere culture that we live in is influencing society around the world.

After living with the condition all my life, it is more than a little upsetting to me when people question it's existence. Yes, there are parents that innappropriately address hyperactivity with drugs (the ritalin controvoversy has been around for a while) but I really don't think there are as many doctors acting irresponsibly as people in the general public think. Those conclusions are drawn from a little bit of personal experience with some bad parents and a little bit of knowledge about some new headlines and statistics.

I have been diagnosed twice. The first psychiatrist ran me through some rigorous testing before reaching a diagnostic conclusion. And when I switched doctors, the second psychiatris looked over the first ones paperwork, then tested me thouroughly himself. Through support groups and online resources I have become friends with a number of adults who also have ADD or ADHD, and all of their stories are the same. The current standard among Psychiatrists is exacting dilligence in carefully screening each potential case. As I said, I think the abuse of the system and diagnosis, while a significant problem in the past, is no longer as big a problem as people think. There just are a lot of people out there with ADD.

Oh, and Dis, good luck persuing that career if you really want to do it. I think the sense of humor you've displayed here would serve you well in that pursuit. :-)

[emeraldlonewoulf]

I think Ben hit the nail on the head with the evolving brain theory. I mean, look at how technology has progressed at such an exponentially increasing rate. We went from the first airplane to the moonlanding in about sixty years. Look at communications and transport. Its' scary. I think something is changing about how the human brain works, about how we pick up and process information, and how we put together these bits of information to make new ideas. I think that maybe for some people, it is easier to concentrate on harder to grasp ideas because that is what their brains were built for, so to think and respond "normally", they have to slow down so much that you lose your train of thought. For me, a classic example is the difference between handwritten and typed text. If I type, my sentences are clearer, more concise, and contain more complicated ideas. If I try to write the same thing by hand, I have forgotten and have to re-read what I have written a couple of times to finish the sentence. I have never been diagnosed with ADD or ADHD, but in early elementary school the teachers tried to get my mother to get me on medication. In adult life, after learning about some of the symptoms, i think I might have a very mild case. However, I am a generation "behind" my peers (older parents, going back two to three generations), and several of them were diagnosed as children. Strangely, this same group of people seem to be more intelligent, able to grasp new concepts easily and build on them quickly. Also, in this same group they are less likely to hold down a traditional job, more prone to self medicating, and are in one way or another creatively inclined. Their social skills seem somewhat underdeveloped, UNTIL they are speaking with someone else who is in this same demographic. When they get together, conversations shift quickly from one subject to another, and also contain more abstract ideas, with very little confusion. One of these people coupled in conversation with one from the "normal" demographic, to the "normal" seem to have stilted and unconnected conversation, and tension seems to develop due to this.
All of these things are subtle, at first, until you really think about it. But why wouldn't our brains change over time in response to the huge amount of information thrown at them every day? And then become more dependent on that to function "smoothly"?

[emeraldlonewoulf]

I suppose you are right about my posts. I use paragraphs, but forget to put an extra line between them.


That is partly what I am saying, although I hesitate to call one group of people more intelligent than another. I am saying that it is a different type of intelligence, one more suited to abstract and complicated ideas, and yes, it does help feed creativity. I think it means a person's thinking is faster, not necessarily an inability to focus.

[emeraldlonewoulf]

I don't really know, I haven't studied psychology or any related field, but it makes sense. I think that is part of the reason some children diagnosed with it have a hard time in reading class. They should have been exposed to letters and words earlier, because now they are at a developmental ability more suited to picking up on groups of words, and sentences, kind of like how some one would in speed reading, even thought they haven't learned the first stages yet. Learning becomes hard because they are presented with too little information, and in response, teachers give them even less and go over some concepts slower, in the wrong way.

They need to be presented with "flashes" of information, instead of long strings, because that is how their brains were designed to work. They are teaching the material in the wrong format, kind of like trying to run a microsoft program on a Linux operating system, it just won't work.

[Ben Lahnger]

Xng, there may be a link between ADD/ADHD and intelligence. I suspect it's not that people with ADD/ADHD are more intelligent, but that people with higher intelligence are more prone to ADD/ADHD.

And there is a definite link between ADD/ADHD and creativity. I think the ADD brain is less able to focus on minutiae, but more unrestrained in grasping the abstract.

emeraldlonewolf, I like your thinking. Thank you for spacing the paragraphs.

[Ben Lahnger]

By the way, I'd like to take this post to point out two books that have been extremely useful to me in dealing with this condition. They have helped me to pursue life as a survivor rather than as a victim. They have shown me that depression and self-medication are common reactions from people who have this disorder. They have also answered some questions I had far better than any therapist I have seen.

------------------
"Adult ADD"
by Thomas A. Whiteman, PhD and Michele Novotni, PhD
(Pinon Press - www.pinon.org)
A reader-friendly guide to identifying, understanding and treating Adult ADD

Tom has a mild form of ADD himself, so when the authors state the following, they know what they are talking about:

"Reader-Friendly Format - We've learned that people with ADD often start books but don't finish then. This book is primarily for the person who has ADD (or thinks he or she has it.) So, our first goal is to make it highly readable for those who are easily distracted.

------------------
"Living With ADD"
by M. Susan Roberts, PhD and Gerard J. Jansen, PhD
(New Harbinger Publications, Inc. - www.newharbinger.com)
A Workbook For Adults With Attention Deficit Disorder

This workbook helps the person with ADD identify their strengths and weaknesses. Through exercises it helps those dealing with ADD discover how to make best use of those strengths and manage the weaknesses to minimize the negative impact on their life. To quote the book:

"This interactive workbook enables readers who are struggling with the condition to identify the personal problems caused by it and develop skills for coping with them. Readers learn how to assess themselves and work through exercises structured to help them deal with self-esteem issues, change negative or distorted thinking patterns, manage stress, and develop a structured approach starting and finishing tasks. Final chapters offer specific suggestions for handling common problems at work and school, dealing with intimate relationships, and finding support."

------------------

Neither of these books promote self-diagnosis. They both recommend seeking out a well-trained professional for diagnosis. As the authors of "Adult ADD" state on the book's back cover, "ADD is the most over- and under-diagnosed mental issue today." Make sure you know who is qualified to diagnose and treat ADD/ADHD before you jump to any conclusions.

[Ben Lahnger]

Originally Posted by GeishaGirl

Ben, my best friend has been diagnosed and is "taking" pills. I don't know what kind, and I put taking in quotes because I'm not so sure she takes them all the time.

I have another friend who was diagnosed, but is not medicated. Her, I'm not so sure if it's ADHD, or she just doesn't give a rats ass. She can concentrate plenty on everything, never had bad grades, pretty much normal. Her only thing is that she's impulsive. If she wants it, she takes it, consequences be damned.

For instance, she recently became attracted to her boss at work, and started sleeping with him. This was completly impulsive and at no regard for her job, his job, his family (a wife and two little girls), or her friends job, because her friend knew about it. We were having a long discussion about what should be done and her friend stated that she has ADHD and that's what made her do it. I'm thinking no. It's hormones and no damn sense.

Geisha ADD and ADHD are complex conditions that do not manifest the same way in all people. Not all sufferers share the same symptoms. And sometimes the symptoms can actually indicate a different disorder or none at all. To quote "Adult ADD" (see my post above) - "We all have some degree of disorganization, inattentiveness, or impulsiveness. Don't be too quick to assume you have a disorder."

Robert Resnick, president of the American Psychological Association says "What concerns me is when a fifteen-minute interview in a doctor's office leads to an attention deficit diagnosis." In Resnick's office, clinicians spend about six hours screening a client for ADD.

Your friend who demonstrates the impulsiveness is probably not ADD/ADHD, unless there are other corroborating symptoms to look at. Poor impulse-control is pretty common in our society today, and could simply be attributable to a character defect or bad manners or another condition. As far as the diagnosis she recieved is concerned; if the condition so prominently affects her that she engages in risky behavior like that office affair on a regular basis, and the clinician did not suggest medication for treating the condition, then she should get a second opinion. But I'm with you; unless there are other symptoms, it's probably hormones ... and stupid behavior.

By the way, just so you know, the only books, clinicians and support resources I use all preach that you should not use ADD as a crutch or an excuse.

[655322]

My nephew was diagnosed with ADD. He has the withdrawn type. Not hyperactive. This is a tricky issue. So many factors.

As a teacher, I come across ADD/ADHD children all the time. In a class of thirty children, there is always at least one who shows signs of it. The effect this one child can have on the class can be devastating. They are usually not interested , or are easily distracted in the classroom, and always distract other kids. For this reason, many intolerant teachers will freak out and start hating the child for disrupting their lessons. Therein begins the school life from hell for that kid.

I try to make my lessons as stimulating as possible, and 29 out of the 30 kids do concentrate and study. However, if one kid can't concentrate for 50 minutes, it is a waste for them because of the way the schooling system is at the moment. I can't change my teaching style to suit one kid when the other 29 are doing fine. No matter how much I'd like to. I believe if the kid has a real problem, the parents should consider enrolling the child in a school where the classes are smaller and the teacher can pay more attention to each child. Of course this depends on availability of that type of school in the area, and the financial cost of the school.

I'm sure there are some parents who freak out if their child shows signs of this too. If their child isn't "normal" they will be compelled to do something because ADD kids are "embarrassing". Often through plain ignorance, and because "everyone knows about ADD" they will do what they think is right and put their kids on drugs.

I also think the link between giving drugs to these kids and the TV culture is a "quick fix" syndrome.
I'm bored, I will watch TV.
I don't like this channel; I will use my "god stick" (remote control) and change it, OR turn the TV off and read a book (for christs' sake).
I don't like the way my kid is behaving, so I will give him/her this nifty magic candy that will make him/her a "nice and happy" in no time!

I think ADD/ADHD is too vague a diagnosis. This is why many people think that "ADD doesn't exist" or "It's a drug company conspiracy!" There are so many types, all lumped into one. I think a lot of kids simply lack some parental attention and that is the cause. PADD (Parental Attention Deficit Disorder) is often not diagnosed at all.

As far as being chemically imbalanced, try Omega - 3, I here it works wonders.

I'd be interested to here any opinions about the educating people with ADD/ADHD side of things.

[Ben Lahnger]

Originally Posted by 655322

As a teacher, I come across ADD/ADHD children all the time. In a class of thirty children, there is always at least one who shows signs of it. The effect this one child can have on the class can be devastating. They are usually not interested , or are easily distracted in the classroom, and always distract other kids. For this reason, many intolerant teachers will freak out and start hating the child for disrupting their lessons. Therein begins the school life from hell for that kid.

I try to make my lessons as stimulating as possible, and 29 out of the 30 kids do concentrate and study. However, if one kid can't concentrate for 50 minutes, it is a waste for them because of the way the schooling system is at the moment. I can't change my teaching style to suit one kid when the other 29 are doing fine. No matter how much I'd like to. I believe if the kid has a real problem, the parents should consider enrolling the child in a school where the classes are smaller and the teacher can pay more attention to each child. Of course this depends on availability of that type of school in the area, and the financial cost of the school.

655322, good to hear a teacher's take on this. As much as this is a challenge to the child, it is equally a challenge to those charged with trying to educate and inform him or her. When I went to school there was no awareness of this issue ... I was just an underachiever. I appreciate the efforts you make to make your lessons compelling, and I understand the judgement you must make as far as deciding when the rest of the class is being penalized by one student's behavior.

Originally Posted by 655322

I think ADD/ADHD is too vague a diagnosis. This is why many people think that "ADD doesn't exist" or "It's a drug company conspiracy!" There are so many types, all lumped into one. I think a lot of kids simply lack some parental attention and that is the cause. PADD (Parental Attention Deficit Disorder) is often not diagnosed at all..

Yes, I agree with this too. I believe that ADD and ADHD will eventually be broken down into more accurate sub-catagories that will better define symptoms and treatment for the different types of problems that are currently lumped under one umbrella, poorly-defined term. And "Hear, Hear!" to the call for more attention to PADD. That is one maddeningly clear condition in our society today that could so easily be cured.

*Cue the public service announcement! ... "PARENTING ... IT'S NOT JUST A CHOICE!"*

[Nemesis]

I do think it exsists, my brother doesnt have ADHD but because of his autism he is very hyperactive, and can be very different, now you tell me that its normal for a person to be like that all the time? It isnt, he has a chemical imbalance, he has to have ritalin which restores the balance...If it was made up then why drug him?!