Thoughts on ADHD, Diagnosis & Controversy

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What is ADHD?

ADHD is an extremely common disorder that is characterized by difficulty paying attention, distractibility and hyperactivity. And some say it’s even more common than previously thought.

For one, it’s now believed to be common in adults – not just children – and that a diagnosis of ADHD doesn’t always have all the symptoms commonly associated with it.

That means you don’t have to be hyperactive to have ADHD, though what you have would then be characterized by ADD, or Attention Deficit Disorder, not Attention Deficit Hyperactive Disorder.

Types of ADHD

It turns out there are several types of ADHD each with its own criteria. There’s the typical hyperactive form and then the inattentive form, characterized by poor attention. And then there’s the combined form, which has both. That puts the total at three, but some have argued for the existence of six different types.

There are good and bad aspects to this wider approach. On the one hand, it means that effected adults will greater understand what’s going on in their life and potentially get access to treatment. On the other, it’s part of a trend that increasingly makes normal human experiences into mental disorders.

After all, it’s only human to occasionally feel restless, unable to focus, or distractible. And despite claims of some ADHD proponents, there’s still no real test for ADHD like there is for Diabetes. There are diagnostic lists, but ultimately no black and white physical signs of the condition.

That said, there is a recent test, the quantitative electroenchephalogram, that famous author Dr. Hallowell reports is 90% accurate in diagnosing ADHD.  Additionally, ADHD is perhaps the single most heritable of all the psychological conditions – if your parent has it, then you have a 60%-90% of having it.

Combined that with the consistent discovery of brain differences in people with ADHD and the evidence for its existence is almost 100% definitive.

ADHD Treatment

Treatment for ADHD is no simple matter. Although the medications seem to be safe, they are potent stimulants, all of which have been used as street drugs. Adderall, for instance, is also popular as “speed.” While medications work most of the time, especially when combined with supportive therapy, it’s not clear what that means.

Stimulant medications are, after all, also used by college studies to cram for tests. Some say that they would help anyone focus and be less impulsive. Proponents respond that stimulants seem to have a paradoxical calming effect on people with ADHD. Instead of making them hyperactive and energetic, stimulants might calm them down and help them be focused.

Ultimately, however, stimulant treatment can be a life saver.  As Dr. Wender, a famous psychiatrist, puts it, some people who have ADHD and take stimulants can, “for the first time in their lives“(!) enjoy studying, having long conversations and so on.  Instead of getting C’s and D’s in college, they work hard and get B’s and A’s.  Instead of endlessly chasing new ideas, they settle down and function better than they ever had.

The difference is remarkable, consistent, and lasts typically for as long as the medication is taken.  These are effects that are far beyond the simple high that someone who abuses a stimulant medication might get.

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Pharmaceutical analyst who loves blogging about health and medical issues. Has written more than 150 articles and a book on attention deficit disorder. Correctly predicted delayed approval of Bydureon, approval of Provenge by FDA, and the non-approval of Acthar on June 11.

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2 COMMENTS

  1. “While medications work most of the time, especially when combined with supportive therapy, it’s not clear what that means.”

    What the heck is THAT statement supposed to mean?! This article is rife with subliminal attacks, like this, not only on the efficacy of medicating for ADHD, but also the need for medicating at all.

    PLUS, this article, in a slithery sort of way, implies that ADHD hasn’t yet been proven to actually exist, to wit: “…there’s still no real test for ADHD like there is for Diabetes. There are diagnostic lists, but ultimately no black and white physical signs of the condition. Yet there is research being done into this, and the signs seem to be…”

    There’s no “real test” for depression like there is for Diabetes either, and research is being done on depression also, so does that mean depression doesn’t exist?? Off-hand attacks on ADHD like this article can’t be disguised by simply providing an un-biased sounding title.

  2. northerner – you’re absolutely right. The more I research ADHD, the more issues with this post I see. Will update it and get it up to par.

    Thanks for pointing that out.

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