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Oct 12 2012

Sometimes, ADHD is real

A lot of people seem to have the idea that attention deficit hyperactivity disorder is something less than a real condition. Many have claimed that the diagnosis of ADHD pathologizes what’s actually normal childhood behavior, or that it’s presented as a problem in order to sell a solution in the form of unnecessary medication with unknown long-term effects. Others say that ADHD is real but overdiagnosed, and medication is used where changes to the child’s environment would be more appropriate. Most recently, the New York Times reported on a doctor who prescribed ADHD medication to children who are struggling in school, regardless of whether they actually have ADHD. He believes that the school system is poorly suited to children, but that people are unwilling to make changes on a systemic level, and so they resort to medicating their children.

The problem is that many of these folk theories about the reality, causes and proper treatment of ADHD are mostly nonsense, perpetuated by people who think they’ve uncovered some grand conspiracy but have very little understanding of what they’re talking about.

Our 9-year-old son has ADHD, and he takes medication for it. His mother has ADHD, his father has ADHD, and his younger brother sometimes appears to have symptoms of ADHD – although this can be largely indistinguishable from the typical range of toddler behavior. And anyone who believes that ADHD is a hoax or can be addressed solely by environmental changes should really try spending some time with our son when he’s unmedicated.

While it’s certainly possible that children have been inappropriately diagnosed with ADHD in some circumstances, this does nothing to show that ADHD does not exist in other children. This also isn’t a matter of making an exclusive choice between either medication, or alternative means of support. There’s no reason why we can’t use everything at our disposal to treat this. And while the side effects of medication always need to be taken into account, it’s also crucial to consider the effects of withholding treatment that works.

We waited for as long as possible before looking into medication for our son. We explored every other option that was available to us. He had a specialized plan at school and extra tutoring, and he still does. We worked closely with him every day to help him understand his work, and we gave him extra practice in every subject. And it wasn’t enough.

This was not just an instance of a child chafing against the unreasonable constraints of standardized education. His environment was not the problem, and shaping his environment around him would have meant letting him flounder. This was a second-grader who would often spend three hours trying to complete a single sheet of simple addition, with the help of two adults. This was a child who had to be reminded a dozen times before he would even remember how to complete a basic task like setting the table – let alone actually getting it done. This was a kid who could not stop himself from talking, yelling, and running wildly around the house. His insomnia would keep him up all night, doing nothing but talking to himself in bed, until he was so tired that he fell asleep almost every day in school. His teachers would make him sit through 40 minutes of reading class, 15 minutes of recess, and 50 more minutes of science class just trying to get him to write a single sentence.

His eyes would glaze over halfway through trying his best to add 5 and 4, when he lost track of what he was doing and had to start over for the third time. He would stumble through trying to read short sentences, and couldn’t tell us what they actually meant even after we read them back to him. He continually failed to be influenced by incentives or even understand their purpose. He forgot to bring home his work, and he didn’t turn it in when it was finished. He would burst into tears every day when trying to do his homework. He told us he was “the worst kid ever” and that he wanted to kill himself. This was a child who was going to be held back a grade, again. And he knew that he had a serious problem. He did not like how he was, and he did not want to be like this. He just wanted to be good, and he couldn’t, no matter how hard he tried.

His instructors and evaluators refused to believe that he could have ADHD, because they thought it was “overdiagnosed”. They laughed at my partner when she suggested it, even when she told them that his father had been successfully treated for ADHD. Instead, they claimed he was mentally handicapped, and that was why he was consistently performing more slowly than the other children. We knew that couldn’t be the case, because in those brief moments when we could get him to focus, he could understand his work. Something was just getting in the way. Only after intelligence tests found him to be above average did his teachers admit that ADHD was a possibility.

We had already figured this out, and we still didn’t want to have to medicate him. We were worried about the long-term effects, too. We didn’t want him to have to rely on medication instead of developing coping strategies. But we were wrong. Eventually, we had to recognize that this constant pain was not encouraging him to develop coping strategies. It was only making him miserable. This wasn’t helping him to grow – it was destroying him. Those who criticize parents for supposedly “taking the easy way out” when they have their children treated for ADHD have made the mistake of thinking that struggle must always be virtuous. They want to believe there must be some great payoff in proportion to all the trouble. But sometimes there’s not. In reality, his ongoing struggles weren’t good for any of us. We had to accept that when it came to the well-being of our son, it wasn’t our principles that mattered – it was the results.

Has his medication been a cure-all? Of course not, and this was by no means an excuse to stop helping him. He still gets all the support he needs from his family and from his school. The difference is that now, it’s actually working. Instead of running just to stay in place and still falling behind, this makes progress possible. He remembers to bring his work home and turn it in. He can finish his homework on his own without requiring constant attention, and he gets it right. He doesn’t fall asleep in school, and when he stays up late, he actually chooses to read books. He can focus and tell us what the sentences mean. He listens to us, he can control himself, and he can behave himself. And he smiles so much more! He’s happy now, he’s less anxious, and his attitude toward school has improved remarkably considering how difficult it had been for him. He’s passing instead of failing, because he finally has the basic abilities that are required to learn and succeed.

The inertia of the status quo often gives it a certain privilege in people’s minds. They set higher standards of justification for switching to an alternative than they would for simply staying on the present course. But when we put our options on an equal footing and considered them fairly, we could not justify depriving him of the treatment that would actually help. This isn’t just a matter of how it’s affecting him now. When ADHD isn’t properly treated, it can lead to higher rates of substance abuse, anxiety, depression, dropping out, car accidents, unwanted pregnancies, STDs, unemployment, and everything else you might expect to result from being chronically unable to think clearly. And we’re not willing to stand by and watch him fail over and over while we try to find alternative treatments, when we already have one that works.

This was not our first choice, and if other means were sufficient to control his symptoms, we wouldn’t have chosen to medicate him. But as of right now, this is not possible. Do we enjoy paying for expensive medication? No, but there is absolutely no way I can regard it as some kind of scam. The value to our entire family has been incalculable. ADHD had made our above-average child seem like someone who was mentally challenged. This is what finally worked to undo that, and I could never expect other parents to forgo a treatment that’s had such a transformative effect.

Regardless of what anyone else may think, this is a personal decision to be made by the family based on their situation and their needs, and I don’t find it at all appropriate to issue blanket condemnations of medication for ADHD when this may be exactly what someone’s child needs. Everyone wants what’s best for kids, and certainly nobody wants what’s worse for them. But when people are unclear on how to achieve this, their ignorance can lead them to conclusions that fail to respect the reality of what these children are dealing with. We would know – we’ve been there.

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  1. 1
    mildlymagnificent

    Speaking as one who tutors children with various learning difficulties, may I say that people who believe it’s over-diagnosed need their heads read.

    The biggest problem, of course, is diagnosing ADD children who exhibit no hyperactivity at all – just vagueness, inability to concentrate. Watching the difference from one week with a child who could complete nothing in an hour and a half to the next week where every 10 minute task was neatly completed, in the time allocated. Bliss for everyone, especially the child. She wasn’t lazy, she wasn’t stupid, her brain just needed encouragement to work properly.

    As far as ‘learning to cope’ goes for the hyperactive. If they’re not medicated, they never have the chance to practice the skills of paying attention, getting things done – not just schoolwork – making and keeping friends and all the rest of it. Parents who want their child to learn these things need to remember that practice makes perfect. When you withdraw the support, the drugs, that help the child do things properly and promptly, you’re depriving them of the chance to acquire some automaticity in behaving and performing at their peak. You’re certainly putting at risk any friendships the child may have made when their behaviour was under control.

    (You may detect some irritation acquired from dealing with parents who insist that their children are “better off” for having weekends and holidays drug-free. You wouldn’t withhold asthma or diabetes medication on that basis. The only reason for such withholding periods is on good medical advice – backed up by good results from trying it. By good results I mean not losing friends, being able to play games that have actual rules and so on.)

    1. 1.1
      Tamsin

      The biggest problem, of course, is diagnosing ADD children who exhibit no hyperactivity at all – just vagueness, inability to concentrate.

      THIS. This was me. Everyone knew I was absent-minded, vague, disorganised, indecisive, and had a very short attention span (when I wasn’t hyperfocusing) but the idea that I might have ADD didn’t occur to anyone until I was about 13, because I wasn’t hyperactive. I grew up thinking I was a freak, and I’m still dealing with some of that emotional baggage now, in my early twenties.

    2. 1.2
      FirstTimer

      Disclaimer: first-time poster to FTB.

      Speaking as one who tutors children with various learning difficulties, may I say that people who believe it’s over-diagnosed need their heads read.

      I’m hoping, since these are the Freethought Blogs, that there’s a critical mass here of people who value fact-based studies over anecdotes. For the consideration of those people, I submit this study, which I remembered reading about earlier this year. A quote from one of the many mainstream news articles still available online discussing this study:

      It was found that children born in December, so the youngest in their school year, were 40 per cent more likely to be diagnosed and almost 50 per cent more likely to be treated for ADHD than children born in January, the start of the school year.

      Is it possible that the correlation can be explained by some weird seasonal effect? Maybe. Is it likely? No. Is this by any means a suggestion either by the authors of the study or myself that ADHD is not a real condition requiring treatment with drugs or otherwise? Absolutely not.

      It is however probable that at least in BC there is a likely problem with over-diagnosis, hyperbole regarding the need for head examinations notwithstanding.

      1. mimi

        Well, if you see it that way. The mirror to this argument is of course, that the older kids with AD/HD are getting underdiagnosed and may be skating by enough not to attract attention but not excelling either.

  2. 2
    Rowan vet-tech

    I, my mother, 3 of her siblings and her father all had/have severe ADHD. We’ve had, as a family, numerous tests done including fMRIs that show our brains shutting down as we concentrate instead of lighting up.

    I’m currently not medicated, though I desperately hope to get back on the meds that I finally found that worked. Frequently during the day I end up freezing in place to do a “brain reboot” and figure out just what the hell it is I was supposed to be doing. On bad days it is literally painful to think and utterly impossible to put together a coherent thought.

    I sometimes liken it to this: I want to say a sentence. First, I have to generate the thought. But first I must find the thought in pea-soup level fog. And the thought is made out of smoke so I have to somehow keep the smoke molecules in a set order and separate from the water molecules, and then this smoke has to travel a few thousand feet in the fog until it finally reaches a wall of molasses 10 feet thick and 1 degree above freezing solid. Now I must pass this smoke-thought through that wall for it make its way to the mouth.

    Every person I’ve encountered who actually has ADHD understands this story entirely. Brain fog sucks.

    It’s fortunate for me that my coworkers understand to not give me long verbal directions if I have stated at any point that day “I can’t English today, I have the dumb.”

    The hyperfocusing can be a nice trade off, but it’s not something I can sustain for long periods of time. Even typing this is hard right now because it was one of *those* days at work today and I keep deleting rambling sentences.

    Give your kidlet a thumbs up from me and tell him that, from one ADHD to another, I totally know he can make it. :D

  3. 3
    crowepps

    Thank you for this — we’re having exactly this argument.

    ADHD also runs in my family, we’re now dealing with its difficulties in my grandsons, and I am sure sick and tired of supposedly expert professionals who whine and complain t the parents and shame and denigrate the child for ‘not trying hard enough’ and being ‘impossible to teach’ who then turn around and say that attempting to actually TREAT THE NEUROLOGICAL PROBLEM in question is ‘an attempt to excuse poor parenting’ and ‘letting the child get away with defiance’.

    Sometimes individual cognitive differences that just naturally occur come up and need to be dealt with, just like poor eyesight or hearing, and the education system’s relentless focus on figuring out whose FAULT it is that something went wrong and shaming/blaming the parents and child to deflect any possible criticism of the system serves no useful purpose whatsoever and creates enormous problems, particularly for the child they teach to label him or herself substandard and defective. My daughter is in her 30′s and has pretty much learned to cope with her ADHD and her dyslexia, but her scars from being in the ‘special ed’ ghetto are still excrutiatingly painful.

  4. 4
    Torie

    This is so true.
    Since many mental or neurological disorders don’t always produce visible symptoms, some people wrongly believe they aren’t legitimate problems.

  5. 5
    Nire Bryce

    Zinnia, I think you should look at: http://www.youtube.com/watch?v=LyDliT0GZpE

    Its somewhat depressing, but its about ADD and how its name is mostly a misnomer, but still very, very there.

  6. 6
    Tamsin

    Thank you for this post, Zinnia.

  7. 7
    Natasha

    Bravo! I was recently diagnosed with ADHD very late in life. I know how much the meds I take help and yes I have to balance the dose for best results with minimum side effects but it is so worth it. I just wish the ADHD had made it so hard to follow through on getting myself evaluated, ironic no?

    I am so glad your son is doing so much better now. You and Heather are good parents.

  8. 8
    PanPan

    Thank you so much for this video ZJ. I’m 25 years old and have been coping with ADD/ADHD since I was 8. I actually didnt have much problems in my childhood, although I do recognize a lot of what you describe. I only really started having serious problems with it in my adult life. I had to drop out twice because of my bad grades and I suffered from severe depression and anxiety attacks because of it.
    Thankfully I’m doing much much better now thanks to the amazing support from my family and friends. I take medication for ADD/ADHD and for depression; I have a coach/tutor who helps me with studying and planning; and my parents act as a safety net. I need all three of these things to keep me on track, and I couldn’t have set up this system if people hadn’t taken my issues seriously. At my previous college I was simply dismissed as lazy, and didn’t get the help I needed, and it’s a mentality like that which is sadly still embraced by lots of people.

  9. 9
    Alexis

    Hi Zinnia,

    Thank you for another wonderful article. Before I did my training in Adult & Child Psychiatry I think I too was somewhat skeptical about the true prevalence of ADHD; but I now believe, as you suggested, that it’s much more common than we think and may in fact be under-diagnosed. Much of this may be due to stigma associated with “mental illness”. This is unfortunate for the kids because stimulants are very well studied, relatively safe, and have big effect sizes. So they make a huge difference in school and social performance and on self-esteem. And as you point out not treating it can have serious potentially long-term negative impacts on a person’s life. One of the things I think that surprised me the most during my training was how many of the kids actually want to be treated and can tell you exactly how the medications help them.

  10. 10
    mildlymagnificent

    One of the things I think that surprised me the most during my training was how many of the kids actually want to be treated and can tell you exactly how the medications help them.

    Oh yes! Some kids with insight into their problems (not all have it) can apologise profusely for their errors in behaviour and performance when they’re not medicated. Seeing as it really does run in families, it’s not surprising that parents of these children are often the least reliable in getting prescriptions made up or in giving it to the children at the right times if they do have it (somewhere) in the cupboard.

    And it’s easy to tell if parents gave it five rather than 30 minutes before the child arrives for a session. The first half hour is wasted while out-of-control kiddo insults all the others, and rearranges the furniture when your back is turned. Once the chemical magic happens, peace reigns as a well-mannered child sits where he’s told and does what’s expected.

  11. 11
    ischemgeek

    I have ADHD, and was diagnosed as an adult. I wanted to thank you for writing this.

    The only reason I made it through primary and secondary school is because I am very smart. I was sent to a psychologist who tested me as a kid, but because ADHD was thought of as a boys’ problem at the time, she didn’t think to test me for it. Despite having ADHD, I scored well into the “gifted” range when she tested me – I was one of those kids that hit all my intellectual milestones at least two or three years before expected (my physical milestones were as behind as my intellectual milestones were ahead, so I really was your stereotypical geek growing up). I slept through most of my classes because I was up all night from insomnia. I did most of my homework assignments in the morning before classes – I’m talking stuff that was supposed to take three weeks of work, I did in two hours. In third grade, I was in in-school suspension more days than I was in class, and in for recess about five times as much as I was allowed outside. Fourth grade onward, I learned how to fidget in a way that wasn’t disruptive to class (usually by jiggling my leg, a habit I retain to this day) and how to hide my exhaustion and/or distraction (a common technique for me was to hide a book inside my school book, or to doodle on the last page of my notebook and flip back to my ‘work’ whenever the teacher looked my way. My handwriting was so horrible that I failed tests purely because the teacher couldn’t read what I’d written, and when called on in class, there were times where even I coudln’t read what I’d written. Even now, I’m the only one I know that can make out my writing unless I’ve made a dedicated effort to be legible, and my “trying to be legible” writing is about as messy as most peoples’ “just scribbling it off” writing. Doing boring work, like handwriting sheets, would literally bore or frustrate me to tears, depending on my mood. My parents finally declared to the teacher that they weren’t going to make me do them anymore because they made me so miserable – and when they told me they weren’t going to make me do them anymore, I jumped for joy and thanked them both for about an hour straight because it used to be a six hour battle after school every day to get three sheets of handwriting done, which would usually be failed by my teacher anyway because handwriting is not something that kids with ADHD do well at. So then the teacher would assign even more handwriting and around it would go.

    I made it through undergrad because I figured out how to make my distractibility work for me and so took way too many courses – around 30 credit hours a semester (about twice as many courses as recommended at my uni). For an idea of just how booksmart I am, I managed to maintain a high enough GPA to graduate magna cum laude despite taking that many extra courses, volunteering, being a member of a sports team, and being a member of two clubs. It’s not arrogance when I say I’m very booksmart. Things came to a head when I was writing my graduate thesis, and I spent four months getting thirty pages written and frustrated myself to tears at least five days a week trying and failing to make substantial progress. I finally went to the doctor’s and got myself evaluated because my sister (who’d been diagnosed three years before) had been bothering me to for months.

    When I got a diagnosis, I cried. Because it was so good to have someone tell me here is why you can’t stay organized to save your life, here is why you can spend all day at the computer and get nothing finished, here is why you will sometimes get so absorbed in something you’ll forget to eat or drink or sleep for days until you nearly pass out from hunger, exhaustion and/or thirst, here is why you have to send yourself lists and lists and lists of things to do and still usually forget stuff, here is why you need your partner to give you a checklist as you go out the door or you WILL forget something really important that you need at work like your ID or your keys or your computer, here is why everything that most people seem to do without thinking requires effort for you and why everything that most people spend a bit of effort on is nearly insurmountable for you. You are not lazy or incompetent or stupid. There is a reason for these difficulties you have.

    ADHD affects pretty much everything in my day. In the morning, it’s hard to get out of bed because I’m usually up until two or three in the morning, if not later, unless I’m running a really bad sleep debt, in which case I pass out at around nine PM and sleep until I’m late for work. After I get out of bed, it’s hard to remember to take my medication. After I take my meds, I have to be careful not to surf the net, lest I get absorbed in it and forget my breakfast. While I eat breakfast, I have to be careful not to get too absorbed in anything, or else I’ll be late getting out the door. On the bus, I get bored silly and annoy other passengers with fidgeting, but if I bring something to occupy myself, I miss the stop more often than not. I get to work, and I irritate my coworkers by flitting around from thing to thing without apparent focus – so much so that my boss gives me more projects than most people just so that I can shotgun my energy and if I get distracted from X, I can work on Y. Or I’ll get absorbed in something and the next thing I know, oh crap, it’s ten PM, I’ve been here for fourteen hours, my partner is frantic because I should’ve been home five hours ago and I didn’t call, and oh, by the way, the last bus left twenty minutes ago so I have an hour long walk home ahead of me. In Canada, so in the cold six months of the year. On the bus home, I have the same problem as the morning. Making supper? I burn food one day in two if I don’t set timers (which my roommates shut off because they find the beep annoying).

    And so on, and so forth.

    So, yeah. Thanks for acknowledging my disorder and admitting that it exists. Thanks for acknowledging the pain and frustration it causes kids with it. It’s a lot more than most people will do. :)

  12. 12
    mimi

    AD/HD is real. It is controlled by the same genes that control Tourette’s, OCD, seizures disorder and Autism. That makes it partially within the Autism spectrum, and some AD/HD have autistic traits. AD/HD and autism are undermedicated and underdiagnosed. Most adults do not realise they have ASD or ADHD.

    What I say to parents on the fence is “Would you try to treat diabetes without medicine? Why would you do different for AD/HD?”

    BTW, Do NOT go through your school for diagnosis of disability. They MISSED my son’s textbook Aspergers behaviors and it took 3 years until a psychiatrist diagnosed him. He is on medicine and we are thrilled with the change in him.

  13. 13
    todd bstevens

    This post worries me somewhat. For a specific reason

    I am *not* saying, first, that ADHD is not real.

    The debate brings me back to my troubles with clinical depression. It was very real, trouble, but I had a difficult time getting relief for a long time, as I went through periods of ‘adjusting the meds’ where they take six months to become affective, and can stop being effective suddenly.

    I know these are supported by peer reviewed studies. I was *in* the abilify study

    I know for a fact I have certain dopamine and seratonin deficiencies. I was in a study, which gave me CAT MCAT and PET scans for depression charactaristics, yup, have them.

    Maybe Ritalin is a solution. It may not be a good solution, and many people make money on the sales.

    I know I spent a ton of money on drugs which had side effects, and no clear result. Did make me feel like I was doing something. It really would have been better, for me, to focus on cognitive behavioral therapy. I stopped taking the antis, and focused on that, and have been doing fine, no major depressive epsodes. This is something I was told was rather impossible with my brain chemistry.

    I do not doubt your problem. From personal exprience, I wish you would be searching, informed, but sceptical about medication. I was myself, a college educted adult, in my opinion convinced to overmedicate myself. I could not Imagine the presure if my child was having difficulties.

    ADHD is real. Statement of fact. It is also overmedicated. Same, BTW, with dpression. It took careful thought for me to decide which category I fell into. I expect you give this matter careful thought, and hope you take no offence at my heartfelt advice on this contentious subject.

    Best, TBS

    1. 13.1
      Rowan vet-tech

      “ADHD is real. Statement of fact. It is also overmedicated. Same, BTW, with dpression.”

      My brother would likely wish to challenge you on this assertion, as he has been struggling with severe depression his whole life and is still trying to find a medication to help. He desperately wants a medication to help.

      So I am with my ADHD. It is horrible, and I can barely function. There are days after work where I’m scared to drive home because my brain just isn’t working anymore after so much concentrating. I’m lucky I find my job so fascinating, otherwise I’d probably be out of work from my ADHD.

      Telling me to be skeptical of my medication, a medication that I found that the only side effect was a blessing (turned me into a neat freak at work, all to the better in a hospital setting), a medication that did not alter my personality in any way but let me understand what people told me and gave me the focus to get things done, is aggravating. I cannot wait to get back on this medication as it made me feel like I wasn’t lazy, or stupid. It helped correct the severe memory problems I have that are a result from the ADHD and let me tell you that knowing what I did yesterday was a joy.

      1. todd bstevens

        Any criticisim of use of these medications in specific seems to become a criticisim of their anecdotal value for individual people.

        I specifically agreed that both ADHD and depression are real things, and mitigated by expert applications of drugs.

        Hey, I was so looped on anti-depressants that at one time I couldnt find my house. Wrong dosage, does this invalidate anti depressants overall. NO why should it?

        Does your sucess on a drug make it something everyone should do? NO why should it?

        My argument is also from anecdotal evidence. I was given more antis than I needed, this was on best advice by professionals.

        I think there are people medicated that do not need to be. You likely are not one of them. Given the profits on these medicines you may know one. I was one.

  14. 14
    mildlymagnificent

    ADHD is real. Statement of fact. It is also overmedicated.

    I’d tend to disagree with that. If the issue seems to be “over” medication, then the real problem is either wrong diagnosis or inadequate medical supervision.

    I’ll readily grant that there are some parents who are pretty poor at managing children. I have special concerns about inadequate sleep for children of all ages as well as too much (that means any for under 10s) equipment in children’s bedrooms. No TV, or computer, or phones – none. (As a bonus, this practice controls bullying directed to or by your child.)

    But for most students with attention, concentration and associated behavioural difficulties, the medication issue boils down to dose and timing. Those who seem over-medicated often have parents with similar problems of disorganisation who thereby get the timings skew-whiff or forget entirely or double up because they forgot they gave an earlier dose.

    I’m not fond of family physicians initiating the medication – specialists are preferable. I’m especially not fond of any medical practitioner issuing a prescription without detailed instructions for observation and oversight during the settling in period. Once everything seems to be under control, the family doctor can probably manage on the basis of the specialist report with 6 or 12 month reviews.

  15. 15
    Giliell, professional cynic -Ilk-

    It’s a lot like with antibiotics:
    The fact that some doctors hand them out like candy and that this is harming all of us does not mean they’re not life-saving medication.
    The problem I have with the whole complex surrounding Ad(H)D and the misdiagnosis thereoff is that at least here you don’t need a special qualification to diagnose and treat it.
    That means that pediatricians who got their license 30 years ago and have all their knowledge about this from the media and the nice leaflets they are sent are still allowed to make that diagnosis, or often fail to make it in the case of “dreamy girls”.
    As much as I believe that parents of ADHD kids can’t hear about the kid who lacked discipline and got given Ritalin instead anymore, it doesn’t mean that kid isn’t real.
    My sister used to work in neuropediatry and they would get exactly those cases, usually after the drugs failed to make a noticable difference. And they found that without drugs but with a structure in their lives, those kids did very well.
    And of course they had the other kids, whose docs refused to diagnose them with ADHD and who left the hospital with medication and a smile on their faces*
    So, I think the bottom line is: We need better and standardized diagnosis
    No more people exercising their own philosophical ideas on ADHA on the backs of children.

    *Being genuinly unhappy seems to be a very consistent trait of ADHD kids. The plain disruptive spoiled brat isn’t unhappy, instead they tend to brag about how they did not do their homework.

    1. 15.1
      todd bstevens

      Agree one thousand percent with the point of inconsistent and incorrect diagnosis by non specialists.

      Same BTW for depression, I got my first Zoloft script from a GP.

  16. 16
    otrame

    The pediatric neurologist who officially diagnosed my oldest son with ADD said that he hated the phrase, because the problem is not an attention deficit. Show such a kid something that interests them and they will latch on and World War III could start without ruining the kid’s attention. The “deficit” happens because such kids are entirely intolerant of boredom, even a little bit of boredom, and do not know how to force themselves to stay focused when they are bored. That was about 30 years ago, and it was his description that made me realize that I had had ADD all my life. In recent years my doc put me on meds that have made a huge difference for me just as the meds available at the time made a huge difference for both my kids.

    ADHD is an entirely different kettle of fish, of course, and I don’t know much about it.

    All that being said, I think the school system, originally developed to teach illiterate farmer’s kids to know enough to work in a factory, has been so bypassed by changes in technology and culture that they actively harm the average kid and can destroy kids with ADD and ADHD. I think that many kids simply don’t tolerate the school system as it is, and not all those kids have ADD or ADHD. I have no bloody idea of a practical way to fix it.

    I just tried to help my kids deal with it as best they could. As adults, they have learned skills needed to deal with boredom when it threatens to make them lose focus and one is able to get meds (he lives in the UK).

    Anyway, good for you for standing up for your kid. Hang in there. I had a 2.4 grade point average in high school and graduated Summa Cum Laude for my BA. Being an adult makes a big difference.

  17. 17
    mildlymagnificent

    Being genuinly unhappy seems to be a very consistent trait of ADHD kids. The plain disruptive spoiled brat isn’t unhappy, …

    The big issue for such children with behavioural issues is that it’s very hard for them to make friends – and even harder to keep them when their unpredictable, annoying and often insulting behaviour gets in the way. They can’t remember, let alone follow, rules for the games that kids make up among themselves. It can be a lonely life.

    And the homework thing? They either don’t do it, don’t do it on time, don’t do it as instructed or make a complete hash of it. Not feeling in control of what they do, they’re constantly nervous and ashamed for fear of being criticised – again – when they do hand stuff in.

    1. 17.1
      Rowan vet-tech

      Homework was the sole reason why I didn’t get straight As in school. The only subject I had true difficulty with was history… because the way it’s taught is painfully boring. I’m horrible at memorizing names and dates, especially when they seem to have little relevance to anything. But everything else I excelled at, knowledge-wise. Homework has never helped me learn anything. My mind is one where I either get it or I don’t, and practice doesn’t improve this. For example, Calculus… I was HORRIBLE at limits, but the best in my class at differentiating. Trigonometry I pretty much failed and never “got”, but algebra and geometry were a walk in the park.

  18. 18
    kemist, Dark Lord of the Sith

    I just don’t understand this “teh drugs is evuuulll” reaction to prescription medication.

    It goes beyond real side effects and/or inconvenience. It often takes moral overtones, with those choosing to take pills having to somehow justify why they take them. As if suffering and struggling longer against illness when there is a simple, non-invasive, faster solution was somehow nobler as opposed to merely stubborn and sometimes frankly stupid.

    The attitude isn’t limited to mental, or hard to detect illness. It’s widely spread to so-called “organic” illness too, such as HBP or type II diabetes.

    For instance, I have hypothyroidism, and have to take synthroid every morning. Still, for some people, it’s wrong to take a synthetic hormone – why don’t I try iodine ? Well, because iodine won’t work, because my thyroid is failing, duh. And what’s the freaking problem with taking a small 15$/month pill (which costs less than most so-called “natural” supplements or vitamins, by the way) every day if it keeps my thyroid from growing to football size ? Or with the nadolol (generic, cheaper than birth control pills) I take to prevent migraines ? I’d rather pop a pill every night that I tolerate rather well than be cowering in a dark quiet room at least once a week.

    1. 18.1
      mildlymagnificent

      Even worse. I recall someone asking about ‘teh ebul drugs’ on a health forum because she was intending to get pregnant and worried about ‘drugs’ affecting her baby.

      I just barely refrained from pointing out that “cretin” is an insult only because it refers to people with distinctive facial features and serious intellectual impairment …. caused entirely by their mother’s hypothyroidism. All of us on the forum did, eventually, persuade her that hypothyroidism was worth treating to remain as healthy as possible. But, really!

    2. 18.2
      Giliell, professional cynic -Ilk-

      OMG, finally finding out that I have Hashimoto’s disease and my thyroid is failing and taking just plain simply Thyroxin has increased my quality of life so much.
      It was a shock coming to terms with “I need to take medication for the rest of my life”, but then I decided to say “Yay, I live in the 21st century industrialized western world with health insurance, there’s an easy solution to my problem.”
      Has this been without side-effects? No, of course not. I would need to have a strict timetable for taking medication and then having breakfast which is plain not possible, but it’s much better than without.
      And at the moment my daugther has scarlet fever.
      That’s a fucking murderous disease, only that I took her to the doc, got her some antibiotics and now it’s a major inconvenience because she can’t go to childcare until Wednesday.
      I know people who refuse to give their kids antibiotics and let the child suffer for 6 weeks to get over it “naturally”.
      That’s child abuse. Refusing to give your kid appropriate medication when you have access to them is child abuse. I don’t see the difference between causing your kid pain by hitting them and causing them pain by not treating them.

  19. 19
    David Warman

    How nice to find this article, and how _really_ nice to have so many personal testaments as opposed to comments on somebody else who has ADHD. To know I am not alone, or uniquely weird.

    I meant to be brief. Impossible. In short, 2e_ADHD, diagnosed at 64, need to change habits, figuring out best medication is HARD. Need a good support group.

    Or the long version (because I enjoyed reading yours, probably boring for those non-affected, but life-asserting for us):

    I always knew I was different, we could never figure out why I was a C student other than I got that without studying (and hence did not learn study habits I needed once I got to University:(, but until my work environment underwent a major change and I coincidentally turned 64 I had no basis for understanding.

    The work change was getting a job with strangers via LinkedIn. Up till then, I had been passed from one company to another, on a long timescale (only 3-5 job changes in a 47 year career), from/to people who already knew me and wanted my services (anything to do with computers, from logic design to software, comes naturally). Which meant they were doing my compensation for me, protecting me from “normal” expectations (my longest term work partner told me this in so many words after my diagnosis, as in “I knew from when we met you’re strange and so my role was to protect you so you could do what you do”). Which in turn meant my own compensations were somewhat distorted from what I need in the real world.

    Then all that went away and I have to fit in with normals. And suddenly no-one knows what to do with me, and have difficulty following my “word spaghetti” (as my boss put it). Don’t like me finishing their sentences, or leaping ahead, or jumping around the topic, or being late for meetings. Got so intense I began to feel something had broken in me so went on a 1 year search for the cause.

    Official diagnosis: “twice-exceptional adult with ADHD”. Comments from both first and second opinion on parts of the Weschler testing “wow! I’ve never seen anyone do that before” (from professionals who have administered these tests thousands of times). 3 sigma average score. But a characteristic of the ADHD part of it that I demonstrated was very uneven performance, unseparated logical levels in presentation, difficulty staying on topic, anxiety off the chart. Plus my own normal life habits turned out to also be characteristic – insomnia, forgetting to eat or go to the toilet, missing appointments, apparent sudden disinterest in what my friends are saying, and hyperfocus. Man, what hyperfocus.

    So the 3 sigma with ADHD is not a bed of roses. Not at all.

    I am now in the process of experimenting (no better word for it) to find the right medication for me so I can focus on developing habits to fix my sleep (first – underlies brain function which affects everything else), eating (gotta fuel the system, neh?), then ordering the other minutiae. Because the one compensation I had some conscious appreciation of was that I survive most things by having in place functioning habits. But I need to get over the activation threshold to change / install the new habits I now need to survive.

    I can tell you most emphatically the ADHD brain is chemically different to the non-ADHD brain. For normals, Adderal is, basically, speed. Which is why the pharmacist keeps it in a safe till I collect it. For my brain, it is a depressant. Not good. Killed the hyperfocus I need to do my job. Without even replacing it with the ability to work on new habits, like eating and sleeping by the clock.

    Last: anybody know of a good senior adults support group in the Seattle area? Seems like 95% of everything ADHD I can find is for chid ADHD, very little on adult, even less on seniors who have lived as long as I have undiagnosed. Other than general comments that the disability presents differently on the different demographics.

    1. 19.1
      ischemgeek

      Yeah, I’m like that with pretty much all stimulants. Totally get where you’re coming from there. Non-ADHD peeps are totally baffled that before I was medicated, I’d drink a coffee before bed to help me get to sleep. I don’t drink coffee to perk up like most people do, I drink it to calm down and also because I like the taste.

      Oddly, the reverse isn’t true about depressants. If anything, depressants seem to be extra effective on me. I’ll be weaving after two glasses of beer, and whenever I’ve been put under anaesthesia, the doctors have found they need far less anaesthesia to put me under than normal, and it takes about three times as long for me to come out of it.

      Also: I get you on word spaghetti. A post-doc I work with and I both have ADHD and are often on the same brainwave, and I’ve been told by our normal counterparts that our conversations make zero sense to those outside it. XD

      1. Rowan vet-tech

        I do the same thing with coffee! Though I think it tastes terrible. :P Most sedatives and stimulants acts completely opposite for me, and I react paradoxically to many many drugs.

        Valium, for example, makes me HIGHLY aggressive (found this out thanks to a bronchoscopy when I was little). I tried Dexadrine *once* in highschool and it gave me the most horrible mood swings. I spent an hour extremely happy, an hour bawl-my-eyes-out sad…. and an hour enraged. I knew it was the drug at this point, and asked my teacher to let me skip class because my control was tenuous at best. Spent that hour kicking and cursing at the school’s BBQ pit.

        I’m extremely sensitive to opiates, it turns out, and had to have a nurse sit with me for half an hour after surgery to remind me to breathe. They tried hydromorphone after the morphine did that number on me, and that dropped my blood pressure to crazy low levels (something like 60/40, which being a tech made me rather alarmed… which in turn raised my blood pressure by the time the doctor I insisted come check that arrived).

  20. 20
    CaNNoN

    I wonder what percentage of people reject mental illness/oddities because of religious teaching on demon possession. I don’t mean “oddities” in a derogatory sense, I have dissociative identity disorder, and I don’t consider it an illness, and the best way I can think of it is as an oddity of mental happenings. And I say oddity because I consider the other personalities just as real and human as I am (the host)especially being that they have their own experiences, memories, information, and preferences apart from me (even nationality and gender, which I must say has made life very interesting, especially when I was yet unaware of the others directly).

    I remember one night talking with my mother, and she had expressed that she thinks that depression is caused by “demon possession” which upset some of the others and myself, because if she thinks that demon possession is the cause of depression, then it could only be assumed what she would think of us (we haven’t told her). Especially being that she’s a christian, and the NT depicts people like us as “demon possessed”. And by that I refer to the whole “We are legion for we are many” situation where Jesus cast out the other personalities into pigs and supposedly drown themselves.

    So were very curious and concerned about people who reject mental illness/oddities as to their reasoning’s why. Just figured this would be some food for thought for anyone interested in expanding on these issues.

  21. 21
    kenz Gomez

    Great Article! I think that much of ADHD is based on the environment in which a child is raised. Lack of consistency regarding discipline and bribery by parents to

    get their kids to act a certain way has caused confusion. I think our schools need to reform the teaching environment so boys and girls can succeed equally. There

    is a difference between bad behavior and boy behavior.

    1. 21.1
      marianaanerud

      What now?

      You think that ADHD is caused by inconsistent discipline …

      …then essentially say that boys should be given a pass for bad behavior because they are boys?!

      It is really, really uncool to harshly judge others based on NO EVIDENCE what-so-ever and then give out advice to people who know infinitely more about the topic than you do.

      Then you topped that willfully ignorant obnoxious arm-chair parenting – with “boys will be boys”?

      Wow.

      Don’t have kids do you? Certainly – not any with special needs – or you would know better.

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